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Updates from June 2017 Meeting of the Advisory Committee on Immunization Practices

July 13, 2017 2 comments

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Recently, the Advisory Committee on Immunization Practices (ACIP) met to discuss several important developments concerning vaccines. As you may be aware, this impartial group of experts advises the U.S. Centers for Disease Control and Prevention (CDC) on all matters related to vaccine recommendations. In the coming years, the ability of the CDC and public health departments to implement the recommendations of this group may be under threat from proposed provisions within the health care reform bills and congressional budget cuts.

The activities of the ACIP are supported by staff at the CDC, which receives annual appropriations from the federal government to fulfill its duties.  This federal immunization funding is at risk of being drastically cut if the Prevention and Public Health Fund (PPHF) is eliminated. (Click here to see a breakdown of the impact of the elimination of the PPHF funds by state.) If Congress follows the recommendation of the President, funding will be reduced by another 14% beginning in Fiscal Year (FY) 2018.

The result is that CDC may no longer be able to fully support its immunization functions including:

  • ACIP staffing;
  • Vaccine purchase and supply management;
  • Vaccine safety monitoring;
  • Education initiatives;
  • Disease surveillance;
  • Outbreak response; and
  • Funding support for state, territory, and city immunization programs.

An example of the critical activities conducted by the CDC includes support for the ACIP.  This committee of experts from diverse fields such as vaccinology, immunology, pediatrics, internal medicine, nursing, family medicine, virology, public health, infectious diseases, and\preventive medicine meets three times a year to review and discuss vaccine research and scientific data related to vaccine effectiveness and safety, clinical trial results, outbreaks of vaccine-preventable disease or changes in vaccine supply.

There are 15 voting members, 8 ex officio members who represent other federal agencies with responsibility for immunization programs in the United States, and 30 non-voting representatives of liaison organizations that bring related immunization expertise. All members volunteer their time and come from many leading professional and public organizations such as the American Academy of Pediatrics, the National Foundation for Infectious Diseases, and the American Geriatrics Society. This is the only meeting to gather such a comprehensive group of experts whose aim it is to protect individual and public health.

The current health care reform discussions that are happening in Congress may have a direct impact on this Committee. Please continue to reach out to your Representatives and Senators to let them know the importance of keeping PPHF and CDC fully funded. (You can find your Members of Congress at http://whoismyrepresentative.com/ and some suggestive language to share here.) 

The value of the ACIP can not be overstated. During their most recent committee meeting in June, members discussed several important issues recapped in the summary below.

Read more…

101 Empty Chairs

June 23, 2017 1 comment

By Serese Marotta, Chief Operating Officer, Families Fighting Flu

Sadly, the Centers for Disease Control and Prevention (CDC) have reported that the 2016/2017 flu season has now claimed the lives of more than 100 children. 101 to be exact.  This statistic is hauntingly familiar – three of the past five flu seasons also claimed the lives of more than 100 children.

101 Pediatric Flu Deaths

Sometimes we forget what these numbers really mean.

It means that 101 families had to bury their beloved children; 101 families have to listen to the deafening sound of silence left by their lost loved ones; and 101 families now have empty chairs at their dinner tables every night.

I paint this picture because I know how these families feel. They’re probably thinking the same thing I did after my son died from the flu – how did this happen and what could I have done to prevent it? 

Unfortunately, unless flu has personally touched your family like it has mine, chances are you’re not all that worried about flu.  You may even think it’s just a bad cold. Well, as the mother of a child who lost her five-year old son to flu, I’m here to tell you, “Not so“.

According to the CDC, flu kills more Americans every year – up to 56,000 people – than any other vaccine-preventable disease.  Since 2004, when the CDC started reporting pediatric flu deaths, 1,466 children – many of whom were otherwise healthy – have lost their lives to flu.

Flu is that infectious disease that seems to fly under the radar. While everyone is focused on the latest outbreak of measles, mumps, pertussis or meningitis, flu is that one disease that we know we will have an outbreak of each and every year.  As prevalent as flu is, it still manages to creep up like a quiet thief in the night, stealing our loved ones right out from under our noses.  And yet when it does, we wonder why we never saw it coming.  Flu has killed millions of people worldwide – and it will continue to do so for the foreseeable future.

So what can we do to protect ourselves and our loved ones from influenza each year?  Annual vaccination.

Studies show that flu vaccination can reduce the likelihood of death and hospitalization from flu in people of all ages.  Yet, less than half of Americans get their annual flu vaccine.   Read more…

How My Sister Helped Save My Daughter From Whooping Cough 

June 19, 2017 20 comments

TamaraSheffieldHeadShotBy Tamara Sheffield, MD, MPA, MPH, Medical Director, Community Health and Prevention, Intermountain Healthcare

In my role as a medical director at Intermountain Healthcare in Salt Lake City, Utah, I am responsible for Community Health and Prevention.  You could say that I’m a professional advocate for immunizations, since they prevent many illnesses, hospitalizations and even deaths.  In fact, maternal immunizations are one of today’s most promising new preventive health strategies.

By vaccinating pregnant women against certain diseases – like whooping cough (pertussis) and influenza – we are reducing the amount of illness, hospitalization, miscarriage and pre-term labor these women experience as a result of these diseases.

Additionally, maternal vaccines enable pregnant women to pass on protective antibodies to their unborn babies.  These antibodies provide newborns with early, short-term protection against pertussis or flu, during the time when they are too young to receive their own vaccines to prevent these diseases.

For instance, children must be six months of age before they can receive their first flu vaccination, and the DTaP vaccine, which helps prevent whooping cough in children, is administered as a series of five shots (with doses at 2, 4, 6, 15-18 months, and 4-6 years of age). Sadly, there are about 100 pediatric deaths due to influenza each year, and 90% of all deaths associated with whooping cough are among infants, mostly because the thick mucus that accompanies the infection has a severe impact on a baby’s ability to breath.

For an expectant woman, changes in the immune system, heart and lungs during pregnancy make them more prone to illness.  When a pregnant women gets ill, it raises her risk of complications, such as premature labor and delivery.  But research shows that mothers can help protect themselves and their babies by getting vaccinated during pregnancy.

The flu vaccine is recommended at any trimester of each pregnancy. An adult Tdap booster vaccine is recommended during each pregnancy as well – and studies show that the best time for optimal transfer of protective antibodies is at 27-to-36 weeks gestation. The ongoing research continues to indicate that these maternal immunizations are effective at reducing the number of flu and whooping cough-related illnesses, hospitalizations and deaths among infants.

The abundance of scientific evidence on this matter is one reason I am a strong advocate for maternal vaccinations.  However, I have a very personal reason to advocate for maternal vaccinations as well.

You see, I know an amazing 25-year-old young woman who nearly died from whooping cough when she was just three weeks old. 

Alicia Outside ICU at Phoenix Childrens' Hospital

Like many infants who suffer with whooping cough, this beautiful baby girl contracted it from a family member.  During the weeks before delivery, her mother developed a persistent cough that went undiagnosed, and she unknowingly passed whooping cough on to her baby.  Three weeks later, after a couple of incidents where the baby stopped breathing and turned blue, her parents rushed her to the hospital. Read more…

What Parents of Every Teen Should Know About Meningitis

The most important thing parents of teens need to know about meningococcal disease is that it can be very serious.  And by serious, we mean debilitating and often deadly.

Even with prompt medical treatment, about 1 in 10 people with meningococcal disease will die from it. Of those who survive, about 1 to 2 will have permanent disabilities such as brain damage, hearing loss, loss of kidney function or limb amputations.

The best thing parents can do to protect their children from meningococcal disease is to get them vaccinated against all of the preventable forms of the disease.

 What causes meningitis and meningococcal disease?

Meningitis refers to a swelling of the protective membranes that cover the brain and spinal cord.   While meningitis is commonly caused by a bacterial or viral infection, it can also be caused by injuries, cancer, certain drugs, and other types of infections.

Meningococcal disease is specific to any illness caused by the bacterium Neisseria meningitidis (also referred to as meningococcus or meningococcal meningitis).  These types of infections can cause meningitis, but can also cause bloodstream infections (known as bacteremia or septicemia).

It’s possible to have meningitis without having meningococcal disease, and it’s possibly to have a type of meningococcal disease that isn’t necessarily meningitis.  The specific cause of illness is important to identify because the treatment differs depending on the cause.

  • Bacterial forms of meningitis can be extremely dangerous and fast-moving and have the greatest potential for being fatal. The long-term effects of bacterial meningitis can include multiple amputations, hearing loss and kidney damage. Many, but not all, forms of bacterial meningitis can be prevented by vaccination.
  • Viral meningitis has similar symptoms to bacterial meningitis, but for the most part is neither as deadly nor as debilitating. There is no specific treatment available for viral meningitis, but most patients fully recover over time.
Meningococcal Disease Facts

Who is at risk?

Read more…

Why Should Vaccinated Individuals Worry About Measles Outbreaks?

The United States is well on our way to a record year for measles cases.  So far in 2017, we’re on track to see more cases this year than last year.

In the state of Minnesota alone, where a Somali-American community was encouraged to refuse MMR vaccine during visits from Andrew Wakefield and other vaccine critics, a drop in vaccination rates has resulted in a dangerous measles outbreak.  So far, the Minnesota Department of Health has identified 66 total cases spread among four counties, with many cases involving the hospitalization of children.

SOTI-MeaslesCasesIG As the number of measles cases in MN is expected to climb, health departments across the U.S. are beginning to identify other measles cases as well.

For instance, the Maryland Department of Health is investigating a potential outbreak after a patients was admitted to Children’s National Medical Center in the District.  The patient had previously sought medical treatment at Prince George’s Hospital Center in MD, exposing countless people in that area as well.  Meanwhile, a teenaged tourist staying in a NJ hotel contracted measles, and now the New Jersey State Health Department fear other people may have been exposed before the patient was treated at The Valley Hospital in Ridgewood, NJ.

With measles cases emerging across the U.S., and large-scale outbreaks of measles being reported by the World Health Organization in places like Romania and Italy, it’s important to ask if measles outbreaks should be a concern to those who are vaccinated.  

Aren’t vaccinated individuals protected during outbreaks?  And if so, why should we care if others remain unvaccinated?

When it comes to infectious diseases like measles, one person’s decision not to vaccinate can negatively impact the health of others.  There are plenty of unvaccinated individuals who rely on protection from the vaccinated, to include children under one year of age who are too young to be vaccinated for measles, individuals who have medical reasons that restrict them from being vaccinated, or people with compromised immune systems.  These individuals are all at great risk of contracting measles and suffering serious complications and the only protection they have comes from those who are vaccinated.

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In fact, in order to keep measles from spreading, about 92-95% of the population needs to be immune to the disease.  Unfortunately, in the case of measles, even small pockets of un-immunized individuals can threaten the herd immunity threshold.  This is exactly why we are seeing an outbreak in Minnesota.

What’s the big deal?  Is measles even that dangerous? Read more…