Archive

Archive for the ‘In the News’ Category

Updates from the Advisory Committee on Immunization Practices February Meeting

March 6, 2018 2 comments
Original Title: BLDG21_0023.jpg

Photo Credit: James Gathany, Centers for Disease Control and Prevention

The Advisory Committee on Immunization Practices (ACIP) held its first meeting of 2018 on February 21st and 22nd.  The Committee consists of a panel of immunization experts that advise the Centers for Disease Control and Prevention (CDC).  Part of their charter is to continually evaluate new data and update or change vaccine recommendations as warranted. 

The agenda for the February 2018 meeting included presentations pertaining to several different diseases and vaccines, to include hepatitis, influenza, anthrax, HPV, pneumococcal, meningococcal and Japanese encephalitis.

A overview of the meeting is provided below, with details on presentations in the order they occurred: 

Hepatitis B

The committee voted unanimously to approve a non-preferential recommendation for a new Hepatitis B vaccine (Dynavax’s HEPISLAV-B™) to their list of recommended vaccines for adults 18 years and older against infections caused by all known subtypes of Hepatitis B.

This vote came following the presentation of data showing that the new two-dose vaccine generates a more rapid and higher antibody response than the standard 3 dose vaccine.

Hepatitis B is a viral disease of the liver that can become chronic and lead to cirrhosis, liver cancer and death. The hepatitis B virus is 50 to 100 times more infectious than HIV, and transmission is on the rise. In 2015, new cases of acute hepatitis B increased by more than 20 percent nationally and 850,000-2.2 million persons are estimated to be living with infection in the U.S.

Since there is no here is no cure for hepatitis B, vaccination is our best chance at preventing the disease. While about 90% of people are infected during infancy, in adults, hepatitis B is most often spread through contact with infected blood and through unprotected sex with an infected person. Some individuals who are especially susceptible include those who are immunosuppressed or living with diabetes. The CDC recommends vaccination for those at high risk for infection due to their jobs, lifestyle, living situations and travel to certain areas.

The Working Group summary suggested that this new vaccine option is likely to improve vaccine series completion and result in earlier protection, which is especially beneficial in persons with anticipated low adherence such as injection drug users.  Additionally, the improved immunogenicity in populations with typically poor vaccine response such as the elderly, diabetics and those on dialysis, is promising.  The ACIP will continue to review post-marketing surveillance studies and additional data to ensure safety and cost-effectiveness considerations.

Hepatitis A

The committee voted unanimously to pass three recommendations pertaining to Hepatitis A.

  • Hepatitis A vaccines should be administered for post-exposure prophylaxis for all persons 12 months of age or older.
  • Hepatitis A vaccine or immune globulin (IG) may be administered to persons 40 years of age or older, depending on the providers’ risk assessment.
  • Hepatitis A vaccine should be administered to infants age 6-11 months of age traveling outside the US when protection against hepatitis A is recommended. This recommendation takes into consideration the fact that infants under 12 months who will be traveling internationally will typically also need an MMR vaccine.  Since Hepatitis A immune globulin and MMR vaccine should not be administered simultaneously, these children should receive a single dose of HepA vaccine. It’s important to note that infants should then complete the full, 2 doses of MMR and HepA vaccines at 12 months of age as recommended.

Influenza

The Committee heard five presentations specific to influenza.

The first two were reports of current season data; one detailing flu surveillance, the other providing early influenza vaccine effectiveness data.

According to the update, the majority of circulating flu strains are similar to those contained in the 2017-2018 vaccine.  The only virus clearly showing antigenic drift was the B/Victoria lineage viruses which represents less than 1% of circulating viruses.  So far this season, influenza A (H3N2) has been dominant, with influenza B activity starting to increase more recently. Activity has been the highest we’ve seen since 2009, and while final severity can’t be determined until the end of the season, hospitalization rates and mortality could be similar to or exceed those send during the severe 2014-2015 season.

Screen Shot 2018-02-21 at 10.47.03 AM

Based on data from 4,562 children and adults with acute respiratory illness enrolled during November 2, 2017–February 3, 2018, at five study sites, the overall estimated effectiveness of the 2017–18 seasonal influenza vaccine for preventing medically attended, laboratory-confirmed influenza virus infection was 36%. The percentage differs by age group and by virus.  A detailed report can be found here.

The most notable news out of the Committee last week was the vote to restore the live attenuated influenza virus (LAIV) vaccine as an option for the 2018-19 season. LAIV is commonly known as the nasal spray flu vaccine or by its brand name, FluMist This renewed ACIP recommendation offers FluMist as one of several vaccine options for non-pregnant people who are 2-49 years of age during the 2018-2019 season, but does not indicate any preference for FluMist over injectable flu vaccines.

While FluMist has not been recommended for the past two flu seasons due to reduced effectiveness against the H1N1 flu strain in children, the Committee heard three presentations specific to LAIV vaccine efficacy in children prior to taking a vote on future recommendations for LAIV.  The first reported on the efficacy of Fluarix Quadrivalent in children 6-35 month of age. Another presented the results of a randomized trial of a new H1N1 LAIV strain in U.S. children. The third was a review LAIV in children 2-17 years of age.  

The possible root cause of the poor effectiveness of LAIV against H1N1 was discussed and poor replication of the H1N1 selected strain was thought to be the likely problem. A new strain selection process is now in place in cooperation with the Food & Drug Administration (FDA) and it suggested that the antibody responses of the latest reformulated version of the quadrivalent vaccine, which includes the new 2017-18 post-pandemic 2009 H1N1 LAIV strain (A/Slovenia), will perform significantly better than what was previously observed when the vaccine included the 2015-16 post-pandemic LAIV strain (A/Bolivia).  Immunogenicity and viral shedding data in small trials supported this notion, but no efficacy data is available at this time.

The Committee was therefore forced to a vote using only the science available to date. There was a lively discussion among members who expressed various concerns. While flu vaccine effectiveness is a serious issue, some committee members expressed concern that they may be holding FluMist to a higher standard than other influenza vaccines, yet all have efficacy challenges from year to year.  Other members were concerned with how the vaccine may perform in an H1N1 dominated season. Until the vaccine is used, further effectiveness assessments are performed, and a prominent H1N1 year occurs, a certain level of uncertainty will remain.

While members voted overwhelmingly (12-2) to reinstate LAIV on the immunization schedule, a second vote to give other flu vaccines a preferential recommendation over LAIV failed (11-3).  So, while the ACIP will not indicate a preference for any one type of flu vaccine over another, the public will ultimately determine whether there will be high uptake of this particular vaccine next season. Read more…

Immunization Funding is an Investment in Public Health that Saves Lives and Dollars

February 26, 2018 Leave a comment

ba3f8b28-e868-42b5-b217-1d8da24ffbd8For the past two decades, every President has proposed a fiscal budget that has underfunded immunization programming. Fortunately, over the years, Congress has been steadfast in approving higher amounts. As we approach another crossroad in our fiscal planning, we must, once again, call upon Congress to properly fund critical prevention programs.  

In the following Op Ed published in The Hill, Every Child By Two Executive Director, Amy Pisani, makes the case that Congress should support the CDC’s Immunization Program to the fullest extent possible. In order to truly effect change, the program requires $1.03 billion. While it may seem like a hefty sum, the argument in favor of full funding is that an investment in public health will save lives as well as future expense. 

 

Undercutting the Immunization Program

Puts Both Lives and Dollars at Risk

 

By Amy Pisani, executive director of Every Child By Two, a nonprofit organization committed to reducing the burden of vaccine-preventable diseases in families and individuals.

 

Earlier this month, President Trump released his proposed Fiscal Year 2019 budget. It notes an impressive achievement: For every $1 the Centers for Medicare and Medicaid Services (CMS) spends on preventing fraud and abuse, the agency saves $5.

Whenever you can spend money to save money in government, it’s a no brainer for policymakers. Unfortunately, that rationale seems to have escaped the President on the issue of vaccination.

For every $1 we spend on childhood vaccines, we save $10.10, which is nearly double the savings of preventing fraud. The vaccines given to children born over the past two decades will result in a savings of $360 billion in direct and nearly $1.65 trillion in societal costs.

The benefits don’t end with children. The U.S. still spends nearly $26.5 billion annually treating adults over the age of 50 for just four diseases that could be prevented by vaccines: influenza, pertussis, pneumococcal disease and shingles.

The majority of these avoidable costs are borne by federal health insurance programs. Yet for the second year in a row, the President has proposed gutting the Centers for Disease Control and Prevention’s (CDC’s) Immunization Program.

This is not just a discussion of dollars saved. It’s also a matter of lives saved. Over the past 23 years the Vaccines for Children program has prevented 381 million illnesses, 855,000 early deaths and 25 million hospitalizations, but we have much more work to do.

(Click here to read the full article on The Hill)

SOTI_Instagram_Graphic_Draft1

 

For information pertaining to the preparedness of our nation, and for suggestions on what we can do as a nation to make our country stronger and more resilient in the face of emerging health threats, review Vaccinate Your Family’s second annual State of the ImmUnion report here.   

Congress Proposes Big Cuts to Prevention and Public Health Fund

February 6, 2018 1 comment
by Erica DeWald, Director of Advocacy, Every Child By Two

Congress is Proposing a $2.85B Cut to Prevention and Public Health Fund (PPHF) over 10 Years

Congress is once again developing a Continuing Resolution (CR) to keep the government from shutting down on Thursday, February 8. Every Child By Two (ECBT) is pleased to report that the proposed CR budget also includes critical funding for many public health programs including two years of funding for community health centers and the National Health Service Corps.

Unfortunately, it also includes a $2.85 billion cut over ten years to the nation’s Prevention and Public Health Fund (PPHF).

Here’s how it’s broken down (courtesy of Trust for America’s Health):

Fiscal Year Current Law Latest CR Net Cumulative Net
FY2018 $900M $900M 0 0
FY2019 $800M $900M +$100M +$100M
FY2020 $800M $1.0B +$200M +$300M
FY2021 $800M $1.0B +$200M +$500M
FY2022 $1.25B $1.1B -$150M +$350M
FY2023 $1.0B $1.1B +$100M +$450M
FY2024 $1.7B $1.1B -$600M -$150M
FY2025 $2.0B $1.1B -$900M -$1.05B
FY2026 $2.0B $1.1B -$900M -$1.95B
FY2027 $2.0B $1.1B -$900M -$2.85B
FY2028 $2.0B $0B -$2.0B -$4.85B

As we’ve shared in previous updates, the PPHF accounts for 53% of Centers for Disease Control and Prevention’s (CDC’s) Immunization Program budget. Any cut could mean serious reductions in our country’s and states’ abilities to:

  • Support the science that informs our national immunization policy.
  • Provide a safety net to uninsured, low-income adults by enabling vaccine purchases;
  • Monitor the safety of vaccines.
  • Educate healthcare providers.
  • Perform community outreach.
  • Conduct surveillance, laboratory testing and epidemiology in response to disease outbreaks.

With the U.S. continuously facing costly outbreaks of vaccine-preventable diseases such as influenza, measles and pertussis (also known as whooping cough), now is not the time to weaken the backbone of our nation’s public health infrastructure.

We are watching these budget developments closely.

While it’s somewhat reassuring that Congress is replacing the money they cut from the PPHF to reauthorize the Children’s Health Insurance Program (CHIP) in this CR, no cut is acceptable. On the positive side, this delay in finalizing the budget does give us time to shore up support among Congressional Members for the critical services funded by the PPHF.

We will continue to send you updates on immunization funding and will be sure to let you know if we need to begin reaching out to our Members of Congress.

Thank you as always for your support of immunizations!



SOTI_Instagram_Graphic_Draft1.jpg

 

Every Child By Two/Vaccinate Your Family has prepared our second annual State of the ImmUnion report to examine how strong our defenses truly are against vaccine-preventable diseases and what we can do as public health advocates and legislators to make our country stronger and more resilient in the face of emerging health threats.

We hope this report will offer you insights into areas of improvement to strengthen our protection against dangerous, and potentially deadly, vaccine-preventable diseases.

The State of the ImmUnion: A Report on Vaccine-Preventable Diseases in the U.S.

February 1, 2018 Leave a comment

As we continue to reflect on the State of the Union this week, Every Child By Two’s Vaccinate Your Family program has prepared a special report that examines the State of the ImmUnion.

SOTI-AdultCoverFB_2018

At a time when legislators are examining ways to make our country stronger and more resilient, this report emphasizes the need to improve our defenses against emerging health threats by detailing ways in which we can protect our citizens from the dangers of vaccine-preventable diseases.

The statistics are staggering.  Vaccine preventable diseases are currently costing our economy billions of dollars, all while threatening the health of our citizens.  As an example, each year flu causes anywhere from 3,000-49,000 deaths in the U.S. and over $87 billion in direct and indirect costs to our economy.  And this is just the toll of one particular disease over the course of one year.  There are plenty of other vaccine preventable diseases that we can, and should, turn our attention to.  There are also many actions we can take as a nation to raise immunization rates and lower disease incidence, all while saving both lives and money.

So what is it that public health advocates and legislators can do?

In the second annual State of the ImmUnion report, Vaccinate Your Family details the challenges that lie ahead and offers specific ways in which legislators can support strong vaccine policies.

Immunization supporters across the country are encouraged to share this resource with legislators and call upon them to strengthen the State of the ImmUnion.

Simply send them an email or tag them in a tweet with a link to the report (http://vaccinateyourfamily.org/soti).

Here are some suggested messages you can use:

Preventable diseases cost the U.S. economy billions each year! Legislators (tag key state/federal legislators) can help reduce these costs by ensuring all citizens have access to life-saving and cost-saving #vaccines. Get the facts from Vaccinate Your Family in their 2018 #StateoftheImmUnion report. http://vaccinateyourfamily.org/soti #SOTI2018

SOTI-VPDCostTW

 

What should legislators be doing to make the #SOTU more resilient in the face of emerging health threats? Strengthen the #StateoftheImmUnion with suggestions found in Vaccinate Your Family’s #SOTI2018 report. http://vaccinateyourfamily.org/soti

SOTI-NeedImprovementTW.jpg

 

Disease outbreaks like seasonal flu cost money and lives. Find out how policymakers can help ensure a strong #StateoftheImmUnion in Vaccinate Your Family’s #SOTI2018 report. http://vaccinateyourfamily.org/soti

SOTI-AdultCoverFB_2018

 

Thank you for your continued support and stay tuned for updates on how Vaccinate Your Family’s State of the ImmUnion report can be used to advocate for strong immunization policies throughout the year. 

Young Hockey Player’s Death A Flu Warning

January 22, 2018 2 comments

By Amy Pisani, Executive Director of Every Child By Two/Vaccinate Your Family

Each of us has a tipping point; the moment when a news story becomes personal, more impactful and perhaps spurs action.

placid

Every Child By Two Executive Director, Amy Pisani, with her son Nicholas, a fellow hockey player from CT.

After hearing of the tragic death of 10-year-old Nico Mallozzi, an ice hockey player from a neighboring town who died Sunday from complications related to flu, I immediately reached out to our hockey league president to ask him to urge our teams to implement the same flu protocol that Nico’s team is now doing: Stay home if you have symptoms of influenza, don’t share water bottles and shake hands post game with gloves on. Thursday evening our league distributed Nico Mallozzi # 7 memorial stickers for every player’s helmet.

According to friends and family writing online, Nico was a sweet, happy, healthy child from New Canaan, CT. He had traveled to upstate New York to cheer on his team during a hockey tournament in which he did not participate because he was feeling sick.  Nico was hospitalized on his way home and died the same day, reportedly from influenza and its complications.

As the executive director of Every Child By Two, a national non-profit organization whose mission is to ensure that all families are protected from vaccine-preventable diseases, it saddens me to learn of yet another family suffering the devastating loss of a child. As a fellow hockey mom, this tragedy resonates deeply.  Anyone with a child on a team knows that hockey families are a tight group. From fall to early spring, we travel the region at all hours of the day and night in support of our children. We cherish our children’s teammates, who we watch grow up from wobbly “learn to skaters” to dedicated players who often commit five or six days a week to practice and playing games, building lifelong friendships.

Nico’s tragic death is a poignant reminder that children of any age, even those who are healthy and athletic, can be taken by flu in a heartbeat. 

Each year, the Centers for Disease Control and Prevention warns us that approximately 100 children will die from influenza every season. Sadly, as of last week, here in the U.S. there have already been 30 children who died from flu so far this season, and this number will continue to climb, as we are nowhere near the end of this outbreak. Unfortunately, these kinds of statistics don’t always resonate with the public and as a result, health advocates are challenged to find ways to spur families to take the time to vaccinate everyone 6 months and older against flu each and every year.

To make matters worse, there are mixed messages about the effectiveness of influenza vaccines and getting across the idea that some protection from the vaccine is better than none is often difficult. As with any infectious disease, community prevention is of paramount importance. Since no vaccine is 100 percent effective and not everyone is able to be vaccinated due to age or underlying medical conditions, we must provide a barrier around one another to keep diseases from taking the lives of children like Nico.

nicomemory

 

It’s not too late to get a flu shot for yourself and your family.

While the peak of flu activity varies from year to year, it often occurs between December and February, and can last as long as until May. Although 12,000 to 56,000 people die each season, influenza vaccination has been shown to reduce the risk of flu-associated death by 65 percent among healthy children and by 51 percent among children with underlying high-risk medical conditions. Other research indicates that adults benefit from repeated flu vaccination year after year. The study found flu vaccination was 74 percent effective in preventing intensive care unit admissions in older individuals and 70 percent effective in preventing deaths among older adults.

These statistics matter and they all say the same thing; protect your entire family from flu by getting vaccinated against this potentially deadly disease every year.

For more information on this year’s flu season, visit:

 


This editorial was originally published in the Hartford Courant.

 

Is This Season’s Flu More Severe Than Usual or Just Highly Active?

January 13, 2018 10 comments

At this point in the flu season people often wonder if all the media hype is part of an orchestrated effort to panic people about flu, or if it is really signaling serious concern.

There are lots of flu stories in the news these days.  From reports of  74 Californian’s who’ve died from flu – five times the number seen at this point last year – to 13 school districts in TX closing due to the high number of flu cases among students, we’re left to wonder….

Is this year’s flu season more severe than usual or just highly active at the moment?

A recent CDC media briefing has helped clarify the following concerns regarding the latest flu activity in the U.S.: 

Right now, flu is widespread everywhere.  

One of the most notable differences between this season and others is in relation to the geographic spread of flu. This is the first time over the course of 13 years of surveillance data that the entire nation is experiencing widespread flu at the exact same time, as can be noted by the color of CDC’s flu surveillance map below.

FluWeeklyReportActivity is severe right now.

 

One of the ways the CDC tracks influenza activity is to record the number of lab confirmed cases of flu and hospitalizations by week. What they’ve noted is a very rapid increase in the number of people seeing their healthcare providers for flu diagnosis, along with a rapid rise in the numbers of people being hospitalized with lab confirmed flu. For instance, this week’s surveillance data indicates that there’s been 22.7 hospitalizations per 100,000 people in the U.S., which is up considerably from the 13.7 number recorded last week.

So far this season, influenza A (H3N2), has been the most prevalent strain in circulation. Unfortunately, historically it is often the strain linked to more severe illness, especially among children and older individuals above the age of 65. Interestingly enough, the current flu surveillance observations seem to be in line with two more previous H3N2 dominant seasons; the 2014-2015 and 2012-2013 seasons.WHOPHL02_small

Additionally the hospitalizations so far this season seem to be in line with other H3N2 predominant seasons, with the highest rates among those over the age of 65, those between 50-64, and children under 5 years of age.

Flu can cause mild disease in some, but severe disease and death in others.

FFF_website_Callout_FluIsSerious_social

Sadly, there have been as many as 30 pediatric deaths so far this season. While children are at great risk, there are plenty of reports of otherwise healthy adults who have been hospitalized or died from flu this season.

Peak season may have started early, but there are many more weeks to go.

Speaking to the media on behalf of the CDC on Friday, Dr.  Jernigan explained,

“If we look at the timing of the season, even if we have hit the top of the curve or the peak of the seasonal activity, it still means we have a lot more flu to go.”

He went on to suggest that there will likely be at least 11 to 13 more weeks of elevated influenza activity this season, before activity begins to subside. Even though it can take about two weeks for protection from vaccination to set in, Dr. Jernigan explained that we still have a lot of flu season to get through and that vaccination efforts should continue as long as influenza viruses are circulating.

While we are seeing a lot of H3N2 circulating now, we are also seeing H1N1 show up in states that have already had H3N2 activity. And we know that B viruses also tend to show up later in the season. Each of these strains are covered in the vaccine, so flu vaccination now can still help to prevent, or lessen the severity of flu throughout the remainder of the season.

Vaccination is our best defense.  

While flu vaccination is far from perfect, it remains our best defense. Not only can it help prevent flu, but it can also help lessen the severity of symptoms if a vaccinated person does end up getting infected.  This can reduce the chances of an individual being hospitalized or dying from flu.

flu-benefit-burden-infographic-1024px

In fact, a recent study showed that influenza vaccination reduced the risk of flu-associated death by 65% among healthy children and by 51% among children with underlying high-risk medical conditions. Another study indicated that many older adults benefit from repeated flu vaccination. When getting vaccinated in both the current and previous seasons, the study found flu vaccination was 74% effective in preventing ICU admissions in older individuals and 70% effective in preventing deaths among older adults.

Manufacturers are reporting that they’ve shipped more than 151 million doses of flu vaccine this season, so there shouldn’t be a problem finding a flu vaccine in your area.  Simply refer to the flu vaccine finder for assistance.

We won’t know preliminary flu vaccine effectiveness until February.  

Read more…

Impact of Latest Congressional Actions on Immunization Programs

December 12, 2017 Leave a comment
By Erica DeWald, Director of Advocacy, Every Child By Two/Vaccinate Your Family

ba3f8b28-e868-42b5-b217-1d8da24ffbd8

As we near the end of 2017, we want to extend a big thanks to each of you! Without your support for immunizations, our voice would not be heard in Washington. Only through regular outreach to our lawmakers have we been able to demonstrate the impact federal policies would have on vaccination rates and thus our country’s health.

Unfortunately, our work for the year isn’t over yet. We are still closely monitoring the appropriations process as well as the reauthorization of the Children’s Health Program (CHIP), which provides health coverage for 8.9 million children who are uninsured.

Congress has twice extended the deadline for an FY18 spending bill. The next Continuing Resolution (CR) expires December 22. A new proposal from House Appropriations Chairman Frelinghuysen would extend funding for all non-defense spending through January 19 and reauthorize the CHIP funding for five-years. Unfortunately, the proposal also includes $6.35 billion in cuts to the Prevention and Public Health Fund (PPHF). As a reminder, PPHF accounts for 53% of the Immunization Program’s funding.

The Immunization Program’s non-PPHF funding also remains in jeopardy. The Senate has proposed level funding from FY17 for the Centers for Disease Control and Prevention’s Immunization Program (which received a 4 million dollar cut last year), while the House has proposed a 50 million dollar cut. That large of a cut would devastate immunization infrastructure. 

Both CHIP and the Immunization Program enjoy bipartisan support but Congress has had difficulty understanding how their funding choices affect our nation’s health. If fewer children are able to access health care through CHIP – either because Congress is delaying reauthorization or because they have instituted new demands that states match funds – then less children will end up receiving life-saving vaccines. Second, if Congress uses Prevention & Public Health Fund (PPHF) dollars to help pay for CHIP as proposed in the House bill, they are in fact cutting essential funds from the very public health clinics and immunization programs that accept CHIP and provide care to children.

Please consider calling your Representative and Senators to urge them to support ALL public health funding. Ask them to reauthorize CHIP without using the PPHF as a budgetary offset. You can find contact information for your legislators at whoismyrepresentative.com.

Every Child By Two/Vaccinate Your Family will continue to watch these legislative issues and do our best to keep you informed.   

Thank you again for your interest and support!