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Some Things You Outgrow as an Adult. Vaccines Aren’t One of Them.

August 17, 2017 1 comment

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Did you know that vaccines are recommended for people of all ages?

Even if you were fully vaccinated as a child, the protection from some vaccines you received can wear off over time and you may need a booster. There also are specific vaccines that you may need as you get older based on your age, job, lifestyle, travel, or other health conditions.

Below are 5 reasons adults need vaccines:

 

1) Every year, thousands of adults in the U.S. suffer serious health problems, are hospitalized, or even die from preventable diseases.

Much of this could be avoided if more adults received their recommended vaccines. While most adults recognize the need for childhood vaccinations, many adults simply don’t realize that vaccines are recommended to protect against diseases like whooping cough, hepatitis A and B, pneumococcal disease, shingles and influenza.

The latest data from the Centers for Disease Control and Prevention (CDC) shows that vaccination rates for adults are extremely low (National Health Interview Survey, 2014).

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Higher vaccination rates could help avoid the many cases of vaccine preventable diseases that adults suffer with each year.  For example, in 2015 there were about 27,000 cases of invasive pneumococcal disease and 3,300 deaths among adults. In 2016, there were more than 15,000 cases of whooping cough reported to the CDC.  Additionally, there are about 1 million cases of shingles and millions of cases of influenza that occur each year in the U.S.

2) Certain health conditions can put adults at greater risk of complications if they do get sick. 

As we go through life we’re often diagnosed with certain health conditions that put us at increased risk for complications from diseases such as pneumonia and influenza.  This includes conditions such as heart disease, asthma, chronic obstructive pulmonary disease (COPD) and diabetes. Even if we feel we have those conditions under control, it is best to get vaccinated to prevent an illness that can complicate these conditions and cause severe illness, hospitalization or even death.

3)  Adults are more likely to contract certain diseases.

As we age, we also become more likely to suffer with diseases such as shingles or pneumococcal disease.  That is why adults 65 and older are recommended to receive one or more pneumococcal vaccines, and those 60 years and older should get a shingles vaccine.

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Raising Awareness of Viral Hepatitis on World Hepatitis Day

Viral hepatitis is a major health problem and one of the leading causes of death globally.  Approximately 1.34 million people die each year all around the world, and million others are infected, most of which do not even know.  Since hepatitis is not limited to one location or one group of people, everyone around the world needs to understand the disease burden and the steps they can take for prevention, testing and treatment.  

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The ABC’s of Hepatitis

Hepatitis” means “inflammation” of the liver and it can be caused by things such as bacterial and viral infections, toxins, certain drugs, some diseases, and heavy alcohol use. There are currently five hepatitis viruses that have been identified that specifically attack the liver and cause “viral hepatitis”. The most common types are A, B, and C, but there is also D and E.

All of the hepatitis viruses cause a new or “acute” infection, but only the hepatitis B and C viruses can result in a “chronic” infection that increases the risk of a person developing cirrhosis, liver failure or liver cancer.

Hepatitis A virus (HAV):

Hepatitis A virus can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months. It is highly contagious and usually transmitted when the virus is taken in by mouth from contact with objects, food, or drinks that are contaminated by the feces (or stool) of an infected person.

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The best way to prevent an infection is by getting vaccinated with the 2-dose series of hepatitis which is routinely recommended for all children, travelers to certain countries, and persons at risk for the disease. Fortunately, the vaccine has helped reduce the incidence of hepatitis A, but there are still outbreaks in the U.S. every year. In 2014, there were an estimated 2,500 cases of acute hepatitis A infections in the United States. So far in 2017, there have been 275 cases in San Diego alone, resulting in 194 hospitalizations and 8 deaths.

Hepatitis B virus (HBV):

Hepatitis B virus can be transmitted through the body fluids of an infected person. This can happen through intimate contact, contact with the blood or open sore of an infected person, sharing needles, syringes, razors or toothbrushes, or from a mother to her baby at birth. Unlike hepatitis A, it is not routinely spread through food or water. However, it is possible to spread to babies when they receive pre-chewed food from an infected person.  Surprisingly, hepatitis B virus can survive outside the body for as long as 7 days. During that time, the virus can still cause infection if it enters the body of a person who is not infected.

Many people with chronic hepatitis B virus infection do not know they are infected since they do not feel or look sick. It is believed that 90% of people living with hepatitis B are unaware of their infection status. Unfortunately, this means they are often unknowingly spreading it to others.

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For some people, hepatitis B is an acute, or short-term, illness but for others, it can become a long-term, chronic infection. The younger a person is when infected, the greater their risk of developing chronic disease.  For example, approximately 90% of infected infants become chronically infected, compared with 2%–6% of adults. This is why the birth dose of hepatitis B vaccine is so critical in preventing chronic infections that can lead to serious health issues, like cirrhosis or liver cancer.  (To understand why babies need the vaccine at birth, see a guest post written by Carolyn Aldigé, President and Founder of the, Prevent Cancer Foundation here.)

In the U.S. an estimated 850,000-2.2 million persons have chronic hepatitis B. However, rates of acute hepatitis B in the U.S. have declined by approximately 82% since 1991, when the routine vaccination of children was implemented. Yet, in 2015, it was estimated that 257 million people are still living with hepatitis B infection worldwide.

Hepatitis C virus (HCV):

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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.

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The 60/40 Factor and This Year’s Flu Season: It’s Not Over Yet

March 10, 2017 4 comments

It’s March, and while we may be anxious for the arrival of spring, what we’ve seen instead is a whole lot of people sick with flu.  Surveillance data shows that while the flu may have peaked in some areas of the country, flu activity remains elevated throughout most of the U.S.  Since flu season typically extends into April and May, now is the time to remain vigilant and get vaccinated if that is still something you haven’t managed to do.

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Flu surveillance reports indicate that the flu strains that make up this year’s vaccine are a good match to those circulating across the U.S.  The most dominant strain has been the influenza A (H3N2) strain, and the estimated effectiveness of the vaccine in preventing illness caused by that strain has been 43%. However, we’re also seeing cases of influenza B virus, and the vaccine’s estimated effectiveness against that strain is 73%. This amounts to an overall vaccine protection of about 48%.

While some may question, “Why get a flu shot if it doesn’t guarantee you won’t get the flu?”, the answer is simple. 48% protection is much better than none.

When a vaccinated individual is exposed to flu, they are about half as likely to have to go to the doctor, be hospitalized or even die from the flu as compared to their unvaccinated counterpart.

Sure, the flu vaccine isn’t perfect.  But that doesn’t mean it’s not worth getting.  

Consider the fact that most everyone wears a seat belt when driving in a car, and yet they’ve only been shown to reduce vehicular injury and death by about 50%.  So if you wouldn’t drive your car without wearing a seatbelt, why would you want to skip a flu shot?

Another reason people often use to explain why they haven’t gotten a flu vaccine is because they’ve never had the flu and they don’t consider it to be dangerous.

The 60/40 factor tells us otherwise.

40:  This is the number of children who’ve died from the flu so far this season.  

While no parent every imagines that their child will die from a preventable disease, we know that 40 children across the nation have died from flu so far this season. And sadly, the season is not over yet.  (Update: as of March 13th the number of pediatric deaths has risen to 48). Most years the average is closer to 100 pediatric flu deaths and as high as 49,000 flu-related deaths among adults.

Since pediatric flu deaths must be reported, as flu112315opposed to adult flu deaths, we tend to see news reports throughout the flu season, such as these: 

While we may never know the specifics of each case, what we do know is that the flu is completely unpredictable.  From season to season, we don’t always know exactly which strain will be most prevalent, which will be most dangerous, and who will suffer, be hospitalized or even die as a result of the flu.

The 60/40 factor in regards to pediatric flu deaths: In a previous season, 60% of pediatric deaths occurred among children who were in a high risk category, while 40% had no chronic health problems.

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Special Report on the State of the ImmUnion Sent to Congress

February 28, 2017 Leave a comment

How strong are the country’s defenses against vaccine-preventable diseases and how well are U.S. citizens protected?   What we can do to make our “ImmUnion” stronger and more resilient in the face of emerging health threats?

Every Child By Two (ECBT) has shared a special report on the State of Our Nation’s “ImmUnion” with members of congress to highlight the power of vaccines and suggest areas of action to fortify the health of our nation.  While the medical community has the ability to protect Americans of all ages from deadly infectious diseases, public health workers continue to battle disease outbreaks across the nation that threaten the health and wellbeing of our citizens.  Many Americans continue to lack access to life-saving vaccines that can protect themselves, their families and their communities from preventable diseases, while others fail to realize that vaccines are available to protect them from many different life-threatening diseases.

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This comprehensive 2017 State of the ImmUnion Report highlights the successes of vaccines, the economic and societal savings incurred from vaccines, challenges facing the public health system, and key areas we must focus on to achieve optimal protection for all Americans.

ECBT is hopeful that this report will not only help congressional leaders learn more about the vaccination rates in their home states, but that it will also help public health advocates prioritizing the benefits of immunizations in the years ahead.

ECBT is committed to working with all stakeholders to ensure this message reaches every level of state and federal government – from the local public health department, to the President of the United States. But we need your help!

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You are an important part of the equation.  Join us in helping to make sure that immunizations remain a public health priority by taking these simple steps:

1.  Support critical public health funding.

Having an adequate public health budget ensures that the Centers for Disease Control and Prevention (CDC), the states and the territories are all prepared to:

  • respond to existing and emerging vaccine-preventable disease outbreaks,
  • conduct community outreach,
  • educate providers and the public
  • maintain immunization registries, and
  • provide vaccine services to the community.

soti-vpdcostfbThe report highlights the success of vaccines and discusses the economic and societal saving that occur as a result of a well-vaccinated population.

Unfortunately, federal vaccine appropriations have not met the levels requested in annual justification reports from the CDC, and state appropriations are nearly non-existent. This has resulted in a loss of personnel and the disbanding of several highly effective statewide coalitions which had supported immunization efforts for decades.

Additionally, if and when the Affordable Care Act is repealed, nearly $600 million in funds that currently support the CDC and state immunization activities may be eliminated. You can learn more about the critical funding issues  here, and if you want to ensure legislators reallocate these funds, take a moment to add your name to Every Child By Two’s Vaccine Funding Support Statement here

2.  Support the science behind vaccines and the CDC’s recommended immunization schedule.

The public must be continually reassured that the timing of vaccines is carefully considered prior to CDC recommendation, and that vaccine safety is heavily monitored with pre and post licensure procedures. There are many disproven myths about the safety of vaccines and we need immunization champions who are well-informed and ready to respond to concerns with evidence-based responses. This report includes specific resources that can be helpful in addressing vaccine safety and policy concerns and even provides links to state specific immunization rates.

3.  Join your local immunization coalition to see how you can work to advance the State of the ImmUnion in your local area.  

soti-measlescasesfbLearn more about the vaccination rates in your state, and the impact vaccine-preventable diseases are having there, by accessing the resources cited in the State of the ImmUnion report, such as the American Academy of Pediatrics’ interactive map and the CDC’s VaxView.  If you want to connect with other immunization advocates in  your state, simply send an email to us at info@ecbt.org and we can help connect you with your local immunization coalition.

4.  Communicate directly with your state and federal legislators to encourage them to support a strong State of the ImmUnion. 

Whether you call, email or Tweet your state and federal legislators, grab their attention by including any of the informative graphics from this special report.  Simply include a link to the PDF report of the 2017 State of the ImmUnion along with some of the images we’ve compiled in our  State of the ImmUnion social media toolkit and you’ll be helping to get the message out.  (And don’t forget to tag @ShotofPrev in your tweets so we can help amplify your message.)

vyf-ecbt-logo-rgb-copyEvery Child By Two’s Vaccinate Your Family campaign is an initiative aimed at raising awareness of the critical importance of vaccines across the lifespan.  We are encouraged by the actions of so many devoted immunization champions all across the nation, and we hope you will join our efforts to ensure a strong “State of the ImmUnion”.  Be sure to subscribe to our Shot of Prevention blog, like our Vaccinate Your Family Facebook page, and follow us on Twitter at @ShotofPrev to continue to receive updates on how you can join us as a voice for positive change!   

 

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Founded in 1991 by Former First Lady Rosalynn Carter and Former First Lady of Arkansas Betty Bumpers, Every Child By Two works to protect families and individuals from vaccine-preventable diseases by raising awareness of the critical need for timely immunizations for people of all ages, increasing the public’s understanding of the bene ts of vaccines, increasing con dence in the safety of vaccines, ensuring that all families have access to life-saving vaccines, and advocating for policies that support timely vaccination. Learn more at ecbt.org.

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Even With All Our Modern Medicine, I Watched My Sister Die From Flu

February 1, 2017 6 comments

By Michael Northrop, M.D.

 

lizaIn December, 2009 my sister Liza died of influenza.

She was previously healthy and only 49 years old.  She sought medical care early. She was cared for at a good hospital in a major city.  She had no other infections. And she was unvaccinated.

To say I was surprised is an understatement.  And yet, I’m a pediatric intensive care physician.

As a clinician, it’s easy for me to trace out the clinical course of Liza’s illness. The physiology of organ failure, mechanical ventilation and critical illness are familiar to me in the same way that your daily work is to you. It’s the human side that I still haven’t come to terms with. The part where you watch your sister die over the course of three long weeks while you stand helpless.  The part where you listen to a physician tell your family that they are out of options.  The part where you know that they are right and you realize that influenza is sometimes too much to handle, even with all our modern medicine.

That part is much harder to process.

Her symptoms started with fever, but progressed to vomiting after a few days. She went to the urgent care clinic twice over the course of a few days before ending up in the emergency department of the local hospital.  She had begun to experience difficulty breathing, and the emergency physician noted that the oxygen saturation in her blood was very low.  They put her on oxygen, and an x-ray revealed that both her lungs were filled with fluid. A condition that led to her being diagnosed with pneumonia.

You see, your lungs are supposed to have air in them. They should look like sponges. Pneumonia is just the term we physicians use to describe the situation when fluid, infection, and inflammation fill those little air spaces in the sponge.

Pneumonia can come from viruses or bacteria. If your pneumonia is caused by a bacteria, you can get antibiotics to kill the bacteria.  However, if your pneumonia is caused by a virus, like influenza, there is not much we can do but ride it out and wait for your own immune system to clear it.  The simple fact is that we just don’t have very good medications for viruses. Tamiflu can be prescribed and it might slow down the virus, but it doesn’t kill it or stop it.

So, they did the only thing they really could do, and started her on IV Tamiflu.  She was moved to the intensive care unit downtown, and within the next few hours she struggled to breathe and her oxygen saturations continued to fall. She had to be placed on a ventilator, and the hope was that her lungs would recover after a few days. After all, it was ‘just the flu’.

We never did get to speak with her again.  

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Did the Flu Take Down the Packers & the Steelers in the NFL Playoffs?

January 23, 2017 1 comment

In the final weeks of NFL play, as the Green Bay Packers competed against the Atlanta Falcons and the Pittsburgh Steelers took on the New England Patriots, rumors circulated that several NFL players may have had the flu.  

screen-shot-2017-01-23-at-1-34-51-pmSome sources say the players had fallen ill with a flu-like bug, though it’s unclear what that’s supposed to mean.  It seems likely that a doctor’s exam, along with a flu test, could confirm, with relative certainty, whether these players were in fact suffering from influenza.

Some sources reported that the players have had the “stomach flu, which is confusing since there is really no such thing as a “stomach flu“. With flu, some people may have vomiting and diarrhea, though this screen-shot-2017-01-23-at-1-41-49-pmis more common in children than adults.  It is much more likely that these symptoms alone suggest gastrointestinal issues that are often referred to as stomach bugs, which again, should not be confused with influenza.

Then there’s the reference to the “24-hour flu in a report from ESPN Staff Writer, Jeremy Fowler.  The article leads with a statement that up to 15 people in the Pittsburgh Steelers facility suffered a setback from a “24-hour flu bug”.  To clarify, the flu is never a 24 hour ordeal.  Rather, the flu can last as long as 5-10 days.

In an interview on NFL.com, we hear sportscaster Charley Casserly and former general manager of the NFL’s Washington Redskins saying,

“Some of the best games I had players play in was when they were ill.  They had the flu. Hey, I don’t know what it is, but the flu, the flu could be good.  It could be good for those players.  A lot of them play well.”

I’m guessing Casserly doesn’t know much about the flu.  He has probably never had it himself or he wouldn’t suggest that players could play well while suffering with it.

This varied media coverage of these high-profile athletes and their suspected illnesses is just another example of how the public continues to be misinformed about the flu.

The flu is a serious illness, that kills and hospitalizes thousands of people in the U.S. each year.  Yet the majority of people I talk to, day after day, are unfamiliar with flu symptoms and the dangers of flu.

Yesterday I had dinner with a good friend – a friend who was only in town because she had traveled four hours to bring her college-aged son back to campus after he had been home suffering with the flu for over a week. She explained that she had never had the flu, nor had either of her two college-aged children.  Therefore, she had never even considered the need for a flu vaccine.  She then went on to explain that she never knew how bad it could be, until she saw her son lying in bed for days. He was very ill and lost 10 pounds in one week.  As he describes it, “It was the most awful thing and I’ve never been that sick ever.Read more…