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Influenza Vaccination Coverage Among Health-Care Personnel — 2011–12 Influenza Season, United States
Influenza Vaccination Coverage Among Health-Care Personnel — 2011–12 Influenza Season, United States
Source: Morbidity and Mortality Weekly Report (CDC)
Influenza vaccination of health-care personnel (HCP) is recommended by the Advisory Committee on Immunization Practices (ACIP) (1). Vaccination of HCP can reduce morbidity and mortality from influenza and its potentially serious consequences among HCP, their family members, and their patients (1–3). To provide timely estimates of influenza vaccination coverage and related data among HCP for the 2011–12 influenza season, CDC conducted an Internet panel survey with 2,348 HCP during April 2–20, 2012. This report summarizes the results of that survey, which found that, overall, 66.9% of HCP reported having had an influenza vaccination for the 2011–12 season. By occupation, vaccination coverage was 85.6% among physicians, 77.9% among nurses, and 62.8% among all other HCP participating in the survey. Vaccination coverage was 76.9% among HCP working in hospitals, 67.7% among those in physician offices, and 52.4% among those in long-term care facilities (LTCFs). Among HCP working in hospitals that required influenza vaccination, coverage was 95.2%; among HCP in hospitals not requiring vaccination, coverage was 68.2%. Widespread implementation of comprehensive HCP influenza vaccination strategies is needed, particularly among those who are not physicians or nurses and who work in LTCFs, to increase HCP vaccination coverage and minimize the risk for medical-care–acquired influenza illnesses.
See also: Influenza Vaccination Coverage Among Pregnant Women — 2011–12 Influenza Season, United States
National and State Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2011
National and State Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2011
Source: Morbidity and Mortality Weekly Report (CDC)
Since 2005, the Advisory Committee on Immunization Practices (ACIP) has expanded the routine adolescent vaccination schedule with administration of the following vaccines at ages 11 or 12 years: meningococcal conjugate (MenACWY), 2 doses*; tetanus, diphtheria, acellular pertussis (Tdap), 1 dose; human papillomavirus (HPV), 3 doses; and influenza, 1 dose annually (1). To assess vaccination coverage among adolescents aged 13–17 years,† CDC analyzed data from the National Immunization Survey-Teen (NIS-Teen). This report summarizes the results of that assessment, which indicated that, from 2010 to 2011, vaccination coverage increased for ≥1 dose Tdap on or after age 10 years (from 68.7% to 78.2%), ≥1 dose MenACWY (from 62.7% to 70.5%), and, among females, for ≥1 dose of HPV (from 48.7% to 53.0%) and ≥3 doses of HPV§ (from 32.0 to 34.8%) (2). Vaccination coverage varied widely among states. Interventions that increase adolescent vaccination coverage include strong recommendations from health-care providers, urging consideration of every health visit as an opportunity for vaccination, reducing out-of-pocket costs, and using reminder/recall systems. Despite increasing adolescent vaccination coverage, the percentage point increase in ≥1 dose HPV coverage among adolescent females was less than half that of the increase in ≥1 dose of Tdap or MenACWY. The causes of lower coverage with HPV vaccine are multifactorial; addressing missed opportunities for vaccination, as well as continued evaluation of vaccination-promoting initiatives, is needed to protect adolescents against HPV-related cancers.
The Role of Herd Immunity in Parents’ Decision to Vaccinate Children: A Systematic Review
The Role of Herd Immunity in Parents’ Decision to Vaccinate Children: A Systematic Review
Source: Pediatrics
BACKGROUND AND OBJECTIVE: Herd immunity is an important benefit of childhood immunization, but it is unknown if the concept of benefit to others influences parents’ decisions to immunize their children. Our objective was to determine if the concept of “benefit to others” has been found in the literature to influence parents’ motivation for childhood immunization.
METHODS: We systematically searched Medline through October 2010 for articles on parental/guardian decision-making regarding child immunization. Studies were included if they presented original work, elicited responses from parents/guardians of children <18 years old, and addressed vaccinating children for the benefit of others.
RESULTS: The search yielded 5876 titles; 91 articles were identified for full review. Twenty-nine studies met inclusion criteria. Seventeen studies identified benefit to others as 1 among several motivating factors for immunization by using interviews or focus groups. Nine studies included the concept of benefit to others in surveys but did not rank its relative importance. In 3 studies, the importance of benefit to others was ranked relative to other motivating factors. One to six percent of parents ranked benefit to others as their primary reason to vaccinate their children, and 37% of parents ranked benefit to others as their second most important factor in decision-making.
CONCLUSIONS: There appears to be some parental willingness to immunize children for the benefit of others, but its relative importance as a motivator is largely unknown. Further work is needed to explore this concept as a possible motivational tool for increasing childhood immunization uptake.
Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Pra ctices (ACIP) — United States, 2012–13 Influenza Season
Source: Morbidity and Mortality Weekly Report (CDC)
In 2010, the Advisory Committee on Immunization Practices (ACIP) first recommended annual influenza vaccination for all persons aged ≥6 months in the United States (1). Annual influenza vaccination of all persons aged ≥6 months continues to be recommended. This document 1) describes influenza vaccine virus strains included in the U.S. seasonal influenza vaccine for 2012–13; 2) provides guidance for the use of influenza vaccines during the 2012–13 season, including an updated vaccination schedule for children aged 6 months through 8 years and a description of available vaccine products and indications; 3) discusses febrile seizures associated with administration of influenza and 13-valent pneumococcal conjugate (PCV-13) vaccines; 4) provides vaccination recommendations for persons with a history of egg allergy; and 5) discusses the development of quadrivalent influenza vaccines for use in future influenza seasons. Information regarding issues related to influenza vaccination that are not addressed in this update is available in CDC’s Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010 and associated updates (1,2).
Vaccines for Children Program: Vulnerabilities in Vaccine Management
Vaccines for Children Program: Vulnerabilities in Vaccine Management
Source: U.S. Department of Health and Human Services, Office of Inspector General
WHY WE DID THIS STUDY
CDC’s Vaccines for Children (VFC) program provides free vaccines to eligible children through a network of 61 grantees and 44,000 enrolled providers. In 2010, approximately 82 million VFC vaccine doses were administered to an estimated 40 million children at a cost of $3.6 billion. VFC providers must meet certain requirements for vaccine management, such as storing vaccines within required temperature ranges and monitoring expiration dates, to ensure that these vaccines provide children with maximum protection against preventable diseases. These requirements are also intended to decrease VFC program fraud, waste, and abuse.HOW WE DID THIS STUDY
Using CDC data, we selected a sample of 45 VFC providers from the 5 grantees with the highest volume of vaccines ordered in 2010. We conducted site visits at these providers’ medical practice locations, interviewed their vaccine coordinators, and observed their vaccine management practices. We also independently measured these providers’ vaccine storage unit temperatures for a 2-week period. Finally, we interviewed the five grantees’ VFC program staff regarding their program oversight.WHAT WE FOUND
Although the majority of storage temperatures we independently measured during a 2 week period were within the required ranges, VFC vaccines stored by 76 percent of the 45 selected providers were exposed to inappropriate temperatures for at least 5 cumulative hours during that period. Exposure to inappropriate temperatures can reduce vaccine potency and efficacy, increasing the risk that children are not provided with maximum protection against preventable diseases. Thirteen providers stored expired vaccines together with nonexpired vaccines, increasing the risk of mistakenly administering the expired vaccine. Finally, the selected providers generally did not meet vaccine management requirements or maintain required documentation. Similarly, none of the five selected grantees met all VFC program oversight requirements, and grantee site visits were not effective in ensuring that providers met vaccine management requirements over time.WHAT WE RECOMMEND
We recommend that CDC continue to work with grantees and providers to ensure that:
(1) VFC vaccines are stored according to requirements,
(2) Expired vaccines are identified and separated from nonexpired vaccines,
(3) Grantees better manage providers’ vaccine inventories, and
(4) Grantees meet oversight requirements.CDC concurred with all four of our recommendations and noted that vaccination is one of the most successful public health tools in preventing and controlling disease.
Annual economic impacts of seasonal influenza on US counties: Spatial heterogeneity and patterns
Annual economic impacts of seasonal influenza on US counties: Spatial heterogeneity and patterns
Source: International Journal of Health Geographics
This research computed annual economic costs of seasonal influenza for 3,143 US counties based on Census 2010, identified inherent spatial patterns, and investigated cost-benefits of vaccination strategies. The computing model modified existing methods for national level estimation, and further emphasized spatial variations between counties, in terms of population size, age structure, influenza activity, and income level. Upon such a model, four vaccination strategies that prioritize different types of counties were simulated and their net returns were examined. The results indicate that the annual economic costs of influenza varied from $13.9 thousand to $957.5 million among US counties, with a median of $2.47 million. Prioritizing vaccines to counties with high influenza attack rates produces the lowest influenza cases and highest net returns. This research fills the current knowledge gap by downscaling the estimation to the county level, and adds spatial variability into studies of influenza economics and interventions. Compared to the national estimates, the presented statistics and maps will offer detailed guidance for state and local health agencies to fight against influenza.
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A Shot in the Arm for Adult Vaccination
Vaccine-preventable diseases take a heavy toll on U.S. adults despite the widespread availability of vaccines. Office-based providers can do more to promote adult vaccinations but need clearer guidance and a better business case to offer them.
Effect of a Text Messaging Intervention on Influenza Vaccination in an Urban, Low-Income Pediatric and Adolescent Population
ContextInfluenza infection results in substantial costs, morbidity, and mortality. Vaccination against influenza is particularly important in children and adolescents who are a significant source of transmission to other high-risk populations, yet pediatric and adolescent vaccine coverage remains low. Traditional vaccine reminders have had a limited effect on low-income populations; however, text messaging is a novel, scalable approach to promote influenza vaccination.ObjectiveTo evaluate targeted text message reminders for low-income, urban parents to promote receipt of influenza vaccination among children and adolescents.Design, Setting, and ParticipantsRandomized controlled trial of 9213 children and adolescents aged 6 months to 18 years receiving care at 4 community-based clinics in the United States during the 2010-2011 influenza season. Of the 9213 children and adolescents, 7574 had not received influenza vaccine prior to the intervention start date and were included in the primary analysis.InterventionParents of children assigned to the intervention received up to 5 weekly immunization registry–linked text messages providing educational information and instructions regarding Saturday clinics. Both the intervention and usual care groups received the usual care, an automated telephone reminder, and access to informational flyers posted at the study sites.Main Outcome MeasuresReceipt of an influenza vaccine dose recorded in the immunization registry via an electronic health record by March 31, 2011. Receipt was secondarily assessed at an earlier fall review date prior to typical widespread influenza activity.ResultsStudy children and adolescents were primarily minority, 88% were publicly insured, and 58% were from Spanish-speaking families. As of March 31, 2011, a higher proportion of children and adolescents in the intervention group (43.6%; n = 1653) compared with the usual care group (39.9%; n = 1509) had received influenza vaccine (difference, 3.7% [95% CI, 1.5%-5.9%]; relative rate ratio [RRR], 1.09 [95% CI, 1.04-1.15]; P = .001). At the fall review date, 27.1% (n = 1026) of the intervention group compared with 22.8% (n = 864) of the usual care group had received influenza vaccine (difference, 4.3% [95% CI, 2.3%-6.3%]; RRR, 1.19 [95% CI, 1.10-1.28]; P < .001).ConclusionsAmong children and adolescents in a low-income, urban population, a text messaging intervention compared with usual care was associated with an increased rate of influenza vaccination. However, the overall influenza vaccination rate remained low.
Measles — United States, 2011
Measles — United States, 2011
Source: Morbidity and Mortality Weekly Report (CDC)
In 2000, the United States achieved measles elimination (defined as interruption of year-round endemic measles transmission) (1). However, importations of measles into the United States continue to occur, posing risks for measles outbreaks and sustained measles transmission. During 2011, a total of 222 measles cases (incidence rate: 0.7 per 1 million population) and 17 measles outbreaks (defined as three or more cases linked in time or place) were reported to CDC, compared with a median of 60 (range: 37–140) cases and four (range: 2–10) outbreaks reported annually during 2001–2010. This report updates an earlier report on measles in the United States during the first 5 months of 2011 (2). Of the 222 cases, 112 (50%) were associated with 17 outbreaks, and 200 (90%) were associated with importations from other countries, including 52 (26%) cases in U.S. residents returning from abroad and 20 (10%) cases in foreign visitors. Other cases associated with importations included 67 (34%) linked epidemiologically to importations, 39 (20%) with virologic evidence suggesting recent importation, and 22 (11%) linked to cases with virologic evidence of recent importation. Most patients (86%) were unvaccinated or had unknown vaccination status. The increased numbers of outbreaks and measles importations into the United States underscore the ongoing risk for measles among unvaccinated persons and the importance of vaccination against measles (3).
Recommended Adult Immunization Schedule — United States, 2012
Recommended Adult Immunization Schedule — United States, 2012
Source: Morbidity and Mortality Weekly Report (CDC)
Each year, the Advisory Committee on Immunization Practices (ACIP) reviews the recommended adult immunization schedule to ensure that the schedule reflects current recommendations for licensed vaccines. In October 2011, ACIP approved the adult immunization schedule for 2012, which includes several changes from 2011. A footnote directing readers to links for the full ACIP vaccine recommendations and where to find additional information on specific vaccine recommendations for travelers is now included. In addition, a Table summarizing precautions and contraindications was added. This table is based on the corresponding table in the 12th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases and is included to provide ready access to key safety information for adult vaccine providers (1).
Changes to the footnote for tetanus, diphtheria, and acellular pertussis (Tdap) and tetanus, diphtheria (Td) vaccines were made to update recommendations. Tdap vaccine is recommended specifically for persons who are close contacts of infants younger than 12 months of age (e.g., parents, grandparents, and child-care providers) and who have not received Tdap previously. Before 2011, vaccination postpartum was preferred for women who had not had a previous adult Tdap dose. However, in 2011, ACIP recommended pregnant women preferentially receive Tdap vaccination during later pregnancy (>20 weeks gestation). Other adults who are close contacts of children younger than 12 months of age continue to be recommended to receive a one-time dose of Tdap vaccine.
Updates to the footnotes and figures also were made for human papillomavirus (HPV) and hepatitis B vaccines based on recommendations made at the October 2011 ACIP meeting. The HPV vaccine recommendation has been updated to include routine vaccination of males 11–12 years of age, with catch-up vaccination recommended for males 13–21 years of age. HPV vaccine also is recommended for previously unvaccinated males 22–26 years of age who are immunocompromised, or who test positive for human immunodeficiency virus (HIV) infection, or who have sex with men.
ACIP also voted in October 2011 to recommend hepatitis B vaccine for adults <60 years of age who have diabetes, as soon as possible after diabetes is diagnosed. In addition, hepatitis B vaccination is recommended at the discretion of the treating clinician for adults with diabetes who are 60 years or older based on a patient's likely need for assisted blood glucose monitoring, likelihood of acquiring hepatitis B, and likelihood of immune response to vaccination.
A notation was included for zoster vaccine to acknowledge that the vaccine was recently approved by the Food and Drug Administration (FDA) for administration to persons 50 years of age and older; however, ACIP continues to recommend that vaccination begin at age 60 years. The influenza vaccine footnote was revised to specify age indications for the different licensed formulations of trivalent inactivated influenza vaccine (TIV). The footnote for the measles, mumps, rubella (MMR) vaccine was simplified to focus only on routine use of this vaccine in adults; information on use of the vaccine for outbreak control was removed. Readers are referred to the ACIP MMR recommendations and to the ACIP recommendations for the immunization of health-care personnel regarding the use of MMR vaccine in outbreak settings. Additional information on the use of quadrivalent meningococcal conjugate vaccine (MCV4) and meningococcal polysaccharide vaccine (MPSV4) for specific age and risk groups was added. Minor clarifications also were made to the footnotes for HPV vaccine, varicella vaccine, and pneumococcal polysaccharide vaccine (PPSV).
Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males — Advisory Committee on Immunization Practices (ACIP), 2011
Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males — Advisory Committee on Immunization Practices (ACIP), 2011
Source: Morbidity and Mortality Weekly Report (CDC)
On October 25, 2011, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of quadrivalent human papillomavirus (HPV) vaccine (HPV4; Gardasil, Merck & Co. Inc.) in males aged 11 or 12 years. ACIP also recommended vaccination with HPV4 for males aged 13 through 21 years who have not been vaccinated previously or who have not completed the 3-dose series; males aged 22 through 26 years may be vaccinated. These recommendations replace the October 2009 ACIP guidance that HPV4 may be given to males aged 9 through 26 years (1). For these recommendations, ACIP considered information on vaccine efficacy (including data available since October 2009, on prevention of grade 2 or 3 anal intraepithelial neoplasia [AIN2/3], a precursor of anal cancer), vaccine safety, estimates of disease and cancer resulting from HPV, cost-effectiveness, and programmatic considerations. The evidence for HPV4 vaccination of males was evaluated using Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methods (2).
Global Routine Vaccination Coverage, 2010
Global Routine Vaccination Coverage, 2010
Source: Morbidity and Mortality Weekly Report (CDC)
The Expanded Program on Immunization was established by the World Health Organization (WHO) in 1974 to ensure universal access to routinely recommended childhood vaccines. Six vaccine-preventable diseases initially were targeted: tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis, and measles. In 1974, fewer than 5% of the world’s infants were fully immunized (1); by 2005, global coverage with the third dose of diphtheria-tetanus-pertussis (DTP) vaccine (DTP3) was 79%, but many children, especially those living in poorer countries, still were not being reached. That year, WHO and the United Nations Children’s Fund (UNICEF) developed the Global Immunization Vision and Strategy (GIVS), with the aim of decreasing vaccine-preventable disease–related morbidity and mortality by improving national immunization programs (2). One goal of GIVS was for all countries to achieve 90% national DTP3 coverage by 2010. This report summarizes the status of vaccination coverage globally and regionally in 2010 and progress toward meeting the GIVS goal. In 2010, 130 (67%) countries had achieved 90% DTP3 coverage, and an estimated 85% of infants worldwide had received at least 3 doses of DTP vaccine. However, 19.3 million children were not fully vaccinated and remained at risk for diphtheria, tetanus, and pertussis and other vaccine-preventable causes of morbidity and mortality; approximately 50% of these children live in India, Nigeria, and the Democratic Republic of Congo. Despite the overall improvement in vaccination coverage during the past 37 years, routine vaccination programs need to be strengthened globally, especially in countries with the greatest numbers of unvaccinated children.
National and State Vaccination Coverage Among Adolescents Aged 13 Through 17 Years — United States, 2010
National and State Vaccination Coverage Among Adolescents Aged 13 Through 17 Years — United States, 2010
Source: Morbidity and Mortality Weekly Report (CDC)
The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents routinely receive meningococcal conjugate (MenACWY, 2 doses); tetanus, diphtheria, acellular pertussis (Tdap, 1 dose); and human papillomavirus (HPV, 3 doses) vaccines (influenza vaccine is recommended annually for all persons aged 6 months and older) (1). CDC tracks vaccination coverage among adolescents aged 13 through 17 years through the National Immunization Survey–Teen (NIS-Teen). To provide updated vaccination coverage estimates, CDC analyzed 2010 NIS-Teen data and compared results with 2009 NIS-Teen estimates (2). This report summarizes the results of that analysis, which found that coverage increased for all three of the routinely administered adolescent vaccines: Tdap from 55.6% to 68.7%, MenACWY from 53.6% to 62.7%, (among females) ≥1 dose of HPV from 44.3% to 48.7%, and ≥3 doses of HPV from 26.7% to 32.0%. Vaccination coverage varied widely among states; three states (Massachusetts, Rhode Island, and Washington) had coverage of >65% for ≥1 dose of all three vaccines (Tdap, MenACWY, and HPV). Continued evaluation of vaccination-promoting initiatives, including state vaccination-financing policies, is needed to understand their impact on adolescent vaccination and to promote effective practices.
Documents in the News — Adverse Effects of Vaccines: Evidence and Causality
Adverse Effects of Vaccines: Evidence and Causality
Source: Institute of Medicine
Immunizations are a cornerstone of the nation’s efforts to protect people from a host of infectious diseases. Though generally very rare or minor, there are side effects, or “adverse effects,” associated with some vaccines. Importantly, some adverse events following a vaccine may be due to coincidence and are not caused by the vaccine. To make this distinction, researchers use evidence to determine if adverse events following vaccination are causally linked to a specific vaccine; if so, these events are referred to as adverse effects. The Health Resources and Services Administration asked the IOM to review a list of adverse events associated with eight vaccines—varicella zoster, influenza (except 2009 H1N1), hepatitis B, HPV, MMR, hepatitis A, meningococcal, and those that contain tetanus—and evaluate the scientific evidence about the event–vaccine relationship. The IOM committee appointed to this task was not asked to assess the benefits or effectiveness of vaccines but only the risk of specific adverse events.
Using epidemiologic and mechanistic evidence, the committee developed 158 causality conclusions and assigned each relationship between a vaccine and an adverse health problem to one of four categories of causation:
- Evidence convincingly supports a causal relationship
- Evidence favors acceptance of a causal relationship
- Evidence favors rejection of a causal relationship
- Evidence is inadequate to accept or reject a causal relationship
The committee finds that evidence convincingly supports a causal relationship between some vaccines and some adverse events—such as MMR, varicella zoster, influenza, hepatitis B, meningococcal, and tetanus-containing vaccines linked to anaphylaxis. Additionally, evidence favors rejection of five vaccine-adverse event relationships, including MMR vaccine and autism and inactivated influenza vaccine and asthma episodes. However, for the majority of cases (135 vaccine-adverse event pairs), the evidence was inadequate to accept or reject a causal relationship. Overall, the committee concludes that few health problems are caused by or clearly associated with vaccines.
Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2011
Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2011
Source: Morbidity and Mortality Weekly Report (CDC)
This document provides updated guidance for the use of influenza vaccines in the United States for the 2011–12 influenza season. In 2010, the Advisory Committee on Immunization Practices (ACIP) first recommended annual influenza vaccination for all persons aged ≥6 months in the United States (1,2). Vaccination of all persons aged ≥6 months continues to be recommended. Information is presented in this report regarding vaccine strains for the 2011–12 influenza season, the vaccination schedule for children aged 6 months through 8 years, and considerations regarding vaccination of persons with egg allergy. Availability of a new Food and Drug Administration (FDA)–approved intradermally administered influenza vaccine formulation for adults aged 18 through 64 years is reported. For issues related to influenza vaccination that are not addressed in this update, refer to the 2010 ACIP statement on prevention and control of influenza with vaccines and associated updates (1,2).
Methodology for the formulation of the ACIP annual influenza statement has been described previously (1). The ACIP Influenza Work Group meets every 2–4 weeks throughout the year. Work Group membership includes several voting members of the ACIP, as well as representatives from ACIP Liaison Organizations. Meetings are held by teleconference and include discussion of influenza-related issues, such as vaccine effectiveness and safety, coverage in groups recommended for vaccination, feasibility, cost-effectiveness, and anticipated vaccine supply. Presentations are requested from invited experts, and published and unpublished data are discussed. CDC’s Influenza Division provides influenza surveillance and antiviral resistance data, and the Immunization Safety Office and Immunization Services Division provide information on vaccine safety and distribution and coverage, respectively.
FDA approves vaccines for the 2011-2012 influenza season
FDA approves vaccines for the 2011-2012 influenza season
Source: U.S. Food and Drug Administration
The U.S. Food and Drug Administration announced today that it has approved the 2011-2012 influenza vaccine formulation for all six manufacturers licensed to produce and distribute influenza vaccine for the United States.
Vaccination remains the cornerstone of preventing influenza, a contagious respiratory disease caused by influenza viruses. The vaccine formulation protects against the three virus strains that surveillance indicates will be most common during the upcoming season and includes the same virus strains used for the 2010-2011 influenza season.
On average, between 5 percent and 20 percent of the U.S. population develops influenza each year, leading to more than 200,000 hospitalizations from related complications, according to the U.S. Centers for Disease Control and Prevention (CDC). Influenza-related deaths vary yearly, ranging from a low of about 3,000 to a high of 49,000 people.
FDA approves Boostrix to prevent tetanus, diphtheria, and pertussis in older people
FDA approves Boostrix to prevent tetanus, diphtheria, and pertussis in older people
Source: U.S. Food and Drug Administrtion
The U.S. Food and Drug Administration today approved Boostrix vaccine to prevent tetanus, diphtheria, and pertussis (whooping cough) in people ages 65 and older.
Currently, there are vaccines approved for the prevention of tetanus and diphtheria that can be used in adults 65 and older. Boostrix, which is given as a single-dose booster shot, is the first vaccine approved to prevent all three diseases in older people.
Tetanus can cause paralysis and is caused by bacteria that live in soil, dust, and manure. The bacteria usually enter the body through a deep cut. Diphtheria is a serious bacterial infection that usually causes a bad sore throat, swollen glands, fever, and chills. If not properly diagnosed and treated, serious complications such as heart failure or paralysis can result. Pertussis is a disease that causes uncontrollable coughing; the infected person makes a noise when they breathe after coughing that sounds like “whoop.” The incidence of pertussis disease in the United States has been increasing since 2007, with large local outbreaks occurring in 2010 in California, Michigan, and Ohio.
County-Level Trends in Vaccination Coverage Among Children Aged 19–35 Months — United States, 1995–2008
County-Level Trends in Vaccination Coverage Among Children Aged 19–35 Months — United States, 1995–2008
Source: Morbidity and Mortality Weekly Report
During 1995–2008, 185,336 children aged 19–35 months sampled by NIS had adequate provider data and lived in one of the 257 counties where the combined sample size for at least one of the seven biennial periods during 1995–2008 was ≥35. Statistically significant increases in estimated vaccination coverage occurred in 27 of 233 counties (12%) with ≥4 doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP); for 38 of 233 counties (16%) with ≥3 doses of polio vaccine; eight of 233 counties (3%) with ≥1 dose of measles, mumps, and rubella (MMR); nine of 233 counties (4%) with ≥3 doses of Haemophilus influenzae type B (Hib) vaccine; 193 of 233 counties (83%) with ≥3 doses of hepatitis B vaccine; 228 of 232 counties (98%) with ≥1 dose of varicella vaccine; and 187 of 192 counties (97%) with ≥4 doses of 7-valent pneumococcal conjugate vaccine (PCV7). Six of 233 (2%) counties had significant decreases in vaccination coverage for Hib. During the 2007–2008 biennial period, the percentage of 193 counties with estimated vaccine coverage that achieved the Healthy People 2010 objective of 90% vaccination coverage was 8% for DTaP/DTP vaccines, 93% for polio vaccine, 86% for MMR vaccine, 71% Hib vaccine, 94% for hepatitis B vaccine, 50% for varicella vaccine, and <1% for PCV7. Among 104 counties, the estimated percentage of children aged 6–23 months who were administered ≥1 dose of the seasonal influenza vaccine during the 2007–2008 influenza vaccination season was 39.0% (range: 22.2%–68.8%). For most vaccines and vaccine series, higher levels of county-level vaccination coverage correlated with a higher number of pediatricians per capita, a higher number of people living in group quarters (e.g., college residence halls, residential treatment centers, skilled nursing facilities, group homes, military barracks, correctional facilities, workers' dormitories, and facilities for persons experiencing homelessness) per capita, higher per capita income, a higher number of Hispanics per capita, and having a service-dependent economy. Lower levels of county-level vaccination coverage correlated with higher number of persons in poverty per capita, a higher percentage of black children among children aged <5 years, higher levels of housing stress (i.e., ≥30% income for rent or mortgage and certain inadequate housing characteristics), a higher number of pediatric intensive care beds per capita, and designation as a nonmetropolitan county with an economy dependent on recreation activities.
Vaccination Coverage Among Children in Kindergarten — United States, 2009–10 School Year
Vaccination Coverage Among Children in Kindergarten — United States, 2009–10 School Year
Source: Morbidity and Mortality Weekly Report (CDC)
Healthy People 2020 objectives include maintaining vaccination coverage among children in kindergarten (IID-10) (1). The target is ≥95% vaccination coverage for the following vaccines: poliovirus; diphtheria and tetanus toxoids and acellular pertussis (DTP/DTaP/DT); measles, mumps, and rubella (MMR); hepatitis B (HepB); and varicella (1). Data from school assessment surveys are used to monitor vaccination coverage and vaccination exemption levels among children enrolled in kindergarten. This report summarizes data from school assessment surveys submitted to CDC by 48 federal immunization program grantees (including 47 states and the District of Columbia) for the 2009–10 school year to describe vaccination coverage and exemption rates (2). For that period, 17 grantees reported coverage of ≥95% for four vaccines (poliovirus, DTP/DTaP/DT, MMR, and HepB) and four grantees reported coverage of ≥95% for 2 doses of varicella vaccine. Total exemption rates, including medical, religious, and philosophical exemptions, ranged from <1% to 6.2% across grantees, and 15 grantees reported exemption rates <1%. Survey methods for vaccination coverage and exemption rates varied among grantees, making comparisons difficult and limiting the use of school assessment surveys to report aggregate national rates. Further standardization of school assessment survey methods will generate comparable data between grantees to monitor and track progress in reaching national objectives, and allow development of best practice guidelines for grantees to more effectively use and report school coverage and exemption data. CDC will continue to monitor vaccination coverage and exemption levels and assist grantees in identification of local areas with low vaccination coverage or high exemption rates for further evaluation or intervention.
Vaccination strategies for epidemic cholera in Haiti with implications for the developing world
Vaccination strategies for epidemic cholera in Haiti with implications for the developing world
Source: Proceedings of the National Academy of Sciences
In October 2010, a virulent South Asian strain of El Tor cholera began to spread in Haiti. Interventions have included treatment of cases and improved sanitation. Use of cholera vaccines would likely have further reduced morbidity and mortality, but such vaccines are in short supply and little is known about effective vaccination strategies for epidemic cholera. We use a mathematical cholera transmission model to assess different vaccination strategies. With limited vaccine quantities, concentrating vaccine in high-risk areas is always most efficient. We show that targeting one million doses of vaccine to areas with high exposure to Vibrio cholerae, enough for two doses for 5% of the population, would reduce the number of cases by 11%. The same strategy with enough vaccine for 30% of the population with modest hygienic improvement could reduce cases by 55% and save 3,320 lives. For epidemic cholera, we recommend a large mobile stockpile of enough vaccine to cover 30% of a country’s population to be reactively targeted to populations at high risk of exposure.
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