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Meningococcal Disease: How to Be Sure Your Teens Are Fully Protected

September 18, 2018 2 comments

Guest Post By Lynn Bozof, President, the National Meningitis Association

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This post was written by an extraordinary woman who passed away only days ago. Lynn spent the last phase of her life fighting to ensure that mothers, fathers, siblings and family members would never suffer the devastation of losing a child to a disease called meningitis. Many parents are now aware of this disease, and that is in large part due to the tireless advocacy and educational efforts of Lynn, and the many families who support the work of the National Meningitis Association.  The entire vaccine community will miss you dearly Lynn.  Every Child By Two  promises to remain steadfast in our shared goal to save others from this terrible disease.


 

 

As a parent, it’s no surprise that the busy lives of teenagers can leave little wiggle room between school schedules, homework, and numerous extra-curricular activities. It’s hard to believe we’re already only a few weeks away from Thanksgiving break. Those off days from school are the perfect time to check in with your child’s healthcare provider to make sure they’ve received all recommended vaccines to prevent against deadly diseases – including meningococcal disease.

In 1998, I lost my son Evan Bozof to meningococcal disease – commonly referred to as bacterial meningitis. Evan was a vibrant, healthy teenage athlete, but within a month my husband and I watched this terrible disease attack every part of Evan’s body and ultimately take his life. No one had ever told me that there was a vaccine available that might have prevented it.

Ever since then, I’ve made it my mission to spread awareness of bacterial meningitis and encourage parents to get their children vaccinated. As we head into the colder months, here is everything you should know about this disease and the vaccines available to prevent it.

 

What is Meningococcal Disease?

 

Meningococcal disease is a rare but potentially deadly bacterial infection involving the inflammation of the membranes (meninges) surrounding the brain and spinal cord. The disease strikes quickly and can lead to devastating complications if your teen has not been fully vaccinated.

Of those who contract meningococcal disease, 10 to 15 percent die from it. Among those who survive, as many as 20 percent live with permanent disabilities, such as brain damage, hearing loss, loss of kidney function or limb amputations. Vaccinations offer the best protection against meningococcal disease.

Symptoms and Progression: What is Important to Know

 

Meningococcal disease is often misdiagnosed, as early symptoms resemble those of other illnesses such as the flu. They may include sudden high fever, headache, nausea, vomiting and exhaustion, and can progress into sensitivity to light, abnormal skin color or rash, with the most extreme symptoms being confusion, delirium or loss of consciousness.

Symptoms of meningitis advance incredibly quickly. Within 24 hours, patients can go from being entirely healthy to near death.

 

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What You Should Know About Vaccination Options

 

There are two vaccines available to prevent against the five major strains of bacteria (A, C, W, Y and B)that cause meningococcal disease. The MenACWY vaccine protects against four strains, while the MenB vaccine protects against the fifth.

The Centers for Disease Control and Prevention (CDC) recommends the MenACWY vaccine to all adolescents at age 11-12, with a booster at age 16.

The MenB vaccine was recommended for permissive (aka Category B) use among those age 16-23 – with preferred vaccination between 16 and 18 – by the CDC in 2015. Older adolescents and young adults can decide, in collaboration with their doctors, whether they’d like to receive the MenB vaccine. Nearly MenACWYevery insurance plan covers the MenACWY and MenB vaccines, and adolescents without insurance can get vaccinated at little to no cost.

The NMA believes that all adolescents should be vaccinated against meningitis B, as it is the strain most commonly linked to outbreaks on college campuses. Vaccination is always the best method of meningitis prevention.

For a full list of those recommended by the CDC for meningococcal vaccination, please visit the CDC website.

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Why Teens Are Most at Risk

 

Meningitis is a rare disease, but once it strikes it can prove deadly within a matter of hours. Teens and young adults are the group most at risk because they often live in close quarters – like a dormitory – and tend to share beverages more often than adults or young children.

In the winter of 2016, three cases of meningitis occurred at the University of Santa Clara. The year before, the University of Oregon experienced a six-month meningitis outbreak that infected seven students and left one dead.

Increasingly, colleges have begun mandating that students receive the second dose of the MenACWY vaccine – as well as the MenB vaccine – prior to matriculation. The NMA fully supports these efforts and believes that the best path to meningococcal prevention is complete vaccination.

 

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About one in ten people carry meningococcal bacteria in their nose or throat without showing any signs or symptoms of the disease. These people can unknowingly transmit the bacteria to others.

 

Putting It into Perspective

 

It’s normal for kids and teens to think they’re invincible and not see the importance of getting vaccinated. Caitlin Brison was a high school senior when her doctor asked at her routine checkup if she wanted to receive the second meningitis vaccine. Not wanting another needle, Caitlin said no. That decision ultimately came back to haunt her.

In college, Caitlin contracted a severe case of bacterial meningitis that ultimately led to months of dialysis, as well as memory loss and physical therapy to re-learn how to walk. Several years later, she received a kidney transplant. Caitlin says she can still remember that day in the doctor’s office like it was yesterday. “My first question was ‘Do I have to have it?’’’ she says. “He said no, so then I said no, and that was a big, big mistake.”

Cases like Caitlin’s serve as a reminder to parents and adolescents to think about the big picture when it comes to vaccination. A small prick in the arm is nothing in comparison to kidney failure, loss of arms or legs, or any of the other debilitating after- effects that survivors of meningitis often must manage for the rest of their lives. Listening to survivors talk about their long and painful paths to recovery illustrates not only the horror of meningitis, but the importance of vaccines as prevention.

If I had known that there was a vaccine available to prevent against bacterial meningitis, my son might still be alive today. The NMA continues to advocate for the broadest possible vaccine recommendations from the CDC so that other families don’t have to experience the truly devastating impact of meningococcal disease.

 

Where Can I Find More Information?

 

Following are additional resources that provide more information about meningococcal disease and prevention methods, including vaccination:

 

 

 

 

How Do We Know Vaccines are Safe?

August 15, 2018 8 comments

Vaccinate Your Family_MomGrandmaLittleGirlToo often, we hear misinformation about vaccines and their safety. Some people claim that they are not tested for safety before being licensed and recommended for use in people in the United States. Others say that vaccines are not held to the same safety standards as drugs, when in fact they are held to a higher standard. And some others wrongly proclaim that vaccines are not monitored for safety after they are licensed by the U.S. Food and Drug Administration (FDA) and recommended for the public by the Centers for Disease Control and Prevention (CDC), as they are unaware of the strong vaccine surveillance systems we have in place in the U.S.

The United States has the safest, most effective vaccine supply in its history.

Below, we offer an overview of how vaccines are tested and monitored for safety and effectiveness:

Clinical trials

Vaccines are one of the most thoroughly tested medical products available in the U.S. Before a vaccine can be considered for approval by the FDA, a vaccine manufacturer must show it is safe and effective through clinical trials. Developing a new vaccine begins with exploratory stage and pre-clinical stage before advancing to three stages of clinical trials. Together, this scientific process can take over a decade and cost millions of dollars. The FDA then examines these studies and determines whether a vaccine is safe, effective, and ready to be licensed for use. The FDA only licenses vaccines that have data that shows that the vaccines’ benefits outweigh the potential risks. If there is any question about the data, or any holes in the data, the FDA will request further studies before approving the vaccine.

Four monitoring systems 

After a vaccine is licensed for use in the U.S., there are four systems in place that work together to help scientists monitor the safety of vaccines and identify any rare side effects that may not have been found in clinical trials. Even large clinical trials may not be big enough to find very rare side effects. For example, some side effects may only happen in 1 in 100,000 or 1 in 500,000 people. Second, vaccine trials may not include certain populations like pregnant women or people with specific medical conditions who might have different types of side effects or who might have a higher risk of side effects than the volunteers who got the vaccine during clinical trials.

Vaccine Adverse Events Reporting System (VAERS)

VAERS is a passive reporting system. That means it relies on individuals to report vaccine reactions. Anyone can report a reaction or injury, including healthcare providers, patients and patients’ representatives, such as caregivers or attorneys. The system is co-managed by the FDA and the CDC. However, it is important to note that VAERS data alone can’t be used to answer the question, “Does a certain vaccine cause a certain side effect?” This is because adverse events reported to VAERS may or may not be caused by vaccines. There are reports in VAERS of common conditions that occur just by chance after vaccination. Further investigation may find no medical link between vaccination and these conditions. Instead, the purpose of VAERS is to see if unexpected or unusual patterns emerge, which may indicate a vaccine safety issue that needs to be researched further.

The Vaccine Safety Datalink (VSD)

Established in 1990, VSD is a collaboration between the CDC’s Immunization Safety Office and eight health care organizations across the country. It conducts studies based on questions or concerns raised from the medical literature and reports to VAERS. In addition, when new vaccines are recommended or if changes are made in how a vaccine is recommended, VSD will monitor the safety of these vaccines.

The Clinical Immunization Safety Assessment Project (CISA)

CISA, which was created in 2001, is a national network of vaccine safety experts from the CDC’s Immunization Safety Office, seven medical research centers and other partners. CISA addresses vaccine safety issues, conducts high quality clinical research and assesses complex clinical adverse events following vaccination. CISA also helps to connect clinicians with experts who can help consult on vaccine safety questions related to individual patients.

The Post-Licensure Rapid Immunization Safety Monitoring System (PRISM)

PRISM is a partnership between the FDA’s Center for Biologics Evaluation and Research and leading health insurance companies. It actively monitors and analyzes data from a representative subset of the general population. PRISM links data from health plans with data from state and city immunization information systems (IIS). PRISM has access to information for over 190 million people allowing it to identify and analyze rare health outcomes that would otherwise be difficult to assess.

These four post-licensure monitoring systems have been able to address several important issues related to vaccines and their safety, including:

The Department of Health and Human Services (HHS) and its agencies, health insurance companies, scientists, healthcare providers, and other public health and medical groups are all dedicated to ensuring people of all ages are protected against serious infectious diseases by a safe, effective supply of vaccines.

Supercharge Your Kid’s Cancer Fighting Power

July 18, 2018 2 comments

By: Jennifer Zavolinsky, Director, Outreach Initiatives, ECBT

Kids having fun with mumIt’s hard to believe how quickly the summer is rushing by. The July 4th holiday is in the rearview mirror and stores are already putting their summer clothes on clearance. So now is a good time to start thinking about what you need to do to prepare your kids to go back to school.

Are You the Parent of an 11- or 12-Year-Old? 6-reasons-listicle-05

Make sure your preteen gets the three vaccines that protect against whooping cough (Tdap), meningococcal disease (MenACWY) and HPV cancers (HPV).

We can reduce the risk of our children getting certain cancers later in life by helping them make healthy choices now, including eating a healthy diet, staying away from tobacco, wearing sunscreen and being physically active. We can also help prevent most HPV cancers with just two shots of the HPV vaccine.

HPV vaccination helps prevent six types of cancers caused by the human papillomavirus (HPV) in both men and women including cervical, vaginal, vulvar, anal, penis and throat cancers. Every year in the United States, HPV causes approximately 32,000 cancers in men and women, and HPV vaccination can prevent most of the cancers from ever developing.

HPV is a Common Virus that Infects Teens and AdultsHPV is a common virus

HPV is so common that most people will get the virus at some point in their lives. About 14 million people in the U.S., including teens, become infected with HPV each year. HPV is passed during intimate sexual contact. You can get HPV by having vaginal, anal or oral sex with a person who has the virus. And the virus can be passed even when an infected person has no signs or symptoms. Most HPV infections go away on their own without lasting health problems. However, there is no way to know which infections will turn into cancer. That is why it is important that all children get vaccinated against HPV.

Vaccines are for Prevention, Not Treatment

Since vaccines are for prevention, not treatment, they only work if given BEFORE coming in contact with a virus. That’s why you want to get your child vaccinated against HPV at 11 or 12 years old. In addition, scientific studies have shown that children have the best immune response to the vaccine at these ages. The HPV vaccine is given as a series of two shots, and the series should be completed by age 13.

HPV Vaccines Are Continuously Monitored for Safety

Like all vaccines recommended in the U.S., HPV vaccines are monitored on an ongoing basis to make sure they remain safe and effective. With approximately 100 million doses of HPV vaccine distributed so far in the U.S., data continues to show that HPV vaccines are safe, effective and give long-lasting protection.

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Make sure to ask your preteen’s health care provider about the HPV vaccine at his/her next appointment.

Commonly-Asked Questions

Are HPV vaccines safe?

Yes, numerous research studies have been conducted to make sure HPV vaccines are safe, both before and after the vaccines were licensed. Before the three HPV vaccines were licensed for use in the U.S. by the FDA, each went through years of testing in thousands of people through clinical trials. After being licensed, the CDC and FDA have continued to monitor the safety of the HPV vaccines through the three surveillance systems in the U.S. Over 100 million doses of HPV vaccines have been distributed in the U.S. so far and HPV vaccines continue to have a good safety record.

Like any vaccine or medicine, HPV vaccines can cause side effects, but the most common side effects are mild. They include pain, redness or swelling in the arm where the shot was given; dizziness; fainting; nausea; and headache. The benefits of HPV vaccination far outweigh any potential risk of side effects.

Does the HPV vaccine contain dangerous ingredients?

No, the HPV vaccine does NOT contain harmful ingredients. While HPV vaccines, like some other vaccines, do contain a small amount of aluminum in order to boost the body’s immune response to the vaccine, it’s important to realize that people are actually exposed to aluminum every day. Aluminum is commonly found in numerous food and beverages, water, infant formula and even breast milk. Aluminum-containing vaccines have been used for decades and have been given to more than 1 billion people without problems. The quantities of aluminum present in vaccines are low and are regulated by the FDA’s Center for Biologics Evaluation and Research (CBER). Learn more about the use of aluminum and other ingredients in vaccines.

If I vaccinate my preteen now, won’t the vaccine wear off by the time he/she goes to college?

No, if you vaccinate your child at age 11 or 12, he or she should continue to be protected against HPV through college. Studies continue to monitor how long the vaccine protects against HPV infections, and protection has been shown to last at least 10 years with no signs of the protection weakening.

If I give my preteen the HPV vaccine, won’t it be like giving them permission to start having sex?

No, there have actually been scientific studies that have looked at this issue, and they show that there is no correlation between receiving the HPV vaccine and increased rates of, or earlier engagement in, sexual activity.

My child is not sexually active. Why should I vaccinate him/her against HPV now?

Preteens should receive all recommended doses of the HPV vaccine series long before they begin any type of sexual activity. Even if your child delays sexual activity until marriage, or only has one partner in the future, he or she could still be exposed to HPV if his/her partner has been exposed to HPV. Studies have shown that the HPV vaccine is most e­ffective in preventing the virus, and therefore HPV cancers, when given at age 11 or 12.

Can HPV vaccination cause infertility?

No, there is no evidence that HPV vaccination causes fertility or reproductive problems. In fact, getting HPV vaccine, which protects against cervical cancer, can help ensure a woman’s ability to get pregnant and have healthy babies. For example, a woman who develops cervical cancer later in life due to HPV infection may require serious treatments that could leave her unable to have children. It’s also possible that treatment for cervical pre-cancer could put a woman at risk for problems with her cervix, which could cause preterm delivery or other problems. HPV vaccination can help prevent these complications.

Learn more about HPV vaccination at vaccinateyourfamily.org

 

CA Medical Board Takes Action to Protect Children’s Health: Dr. Bob Sears Placed on Probation

By Amy Pisani,  Executive Director, ECBT (mother of two fully vaccinated teenage boys)

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Last week, the Medical Board of California ordered a 35-month probation for Dr. Bob Sears, an Orange County pediatrician who is best known for hawking an “alternative” vaccination schedule for young children, promoting the unproven theory that vaccines cause autism, and being a champion for parents who seek to claim exemptions from school vaccination requirements.

The revocation of Dr. Sears’ medical license was stayed by the Medical Board, which allows him to continue practicing medicine, as long as he follows certain requirements of his probation including taking Board-approved medical education and ethics classes, and allowing a Board-approved monitor to watch and report on his medical practices. Through this disciplinary order, the Medical Board is providing Sears with a clear warning against future misconduct.

The overall charges against Sears include gross negligence and repeated negligence in his care and treatment of a patient (a child called J.G), and failure to maintain adequate and accurate records. The formal accusation brought by the Executive Director of the Medical Board of California Kimberly Kirchmeyer provides specific examples of Sears’ departures from the medical standard of care, “which require that a physician who is evaluating a patient for possible reaction to vaccines obtain a detailed history of the vaccines previously received as well as the reaction that occurred. Based on that information the physician should provide an evidence-based recommendation for future immunizations.” The accusation continues “the respondent was grossly negligent and departed from the standard of care in that he did not obtain the basic information necessary for decision making prior to determining to exclude the possibility of future vaccines leaving both the patient, the patient’s mother, and his future contacts at risk for preventable and communicable diseases.”

Forbes’ contributor Tara Haelle, who has been following this case against Dr. Bob Sears since last year, noted that:

“the charges involve much more than writing a vaccine exemption letter. According to the accusation, Sears failed to test the same toddler for neurological problems after the child was hit on the head with a hammer and failed to investigate alleged vaccine reactions that, if they did occur, would have been life-threatening. He also prescribed garlic for the child’s ear infection despite there being no evidence of its effectiveness. Such departures from the medical standard of care prompt questions about what other ways Sears might be practicing negligently beyond this complaint.”

Ms. Haelle’s latest Forbes article offers insight into Dr. Sears’ extensive history of anti-vaccination practices and advocacy efforts:

“When physicians practice this type of substandard care, it places children’s lives at risk. Dr. Sears’ bias against vaccines flies in the face of overwhelming evidence of the safety and necessity of timely vaccinations,” Amy Pisani, MS, executive director of Every Child By Two told me.

“With notoriety comes great responsibility. Dr. Sears’ promotion of his ‘alternative vaccine schedule’ has helped perpetuate the myth that vaccines are not safe for children, which is shameful,” Pisani said. “This ruling should send a strong message to providers that the practice of medicine must be based on evidence, not anecdote, and signing vaccine waivers without medical necessity is not an acceptable practice.”

Dorit Rubinstein Reiss, Professor of Law at the University of California Hastings College of the Law, details the legal ramifications of Sears’ probation and offers insight into Sears’ past actions in a recent Skeptical Raptor post 

Like many moms, I was an avid follower of the advice of Dr. Bill Sears, the father or Dr. Bob Spears and the well-known pediatrician who offered advice to parents on child rearing and attachment parenting. Over the last decade, it has been very disturbing to see Dr. Bob using his father’s name and the Sears Parenting Library to sell his books, which contain inaccurate vaccination information and fuel parents’ fears about vaccines. Dr. Bob Sears’ “alternative” vaccination schedule, which encourages parents to either skip or delay recommended vaccines for their children, is dangerous and ignores the importance of following the Centers for Disease Control and Prevention’s (CDC’s) recommended schedule.

The CDC sets the U.S. immunization schedules for children, teens and adults based on recommendations from the Advisory Committee on Immunization Practices (ACIP). The ACIP, which is made up of medical and public health experts, carefully considers many factors, including the safety and effectiveness of vaccines, before recommending a vaccine for use. As a result, the CDC’s recommended childhood immunization schedule (from birth to 18 years old) is the ONLY vaccination schedule for children and teens that is rigorously tested for safety and effectiveness. No “alternative” or “non-standard” schedule has ever been tested. The CDC’s recommended schedule is also endorsed by the leading medical groups including the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP). The vaccines in the schedule are carefully timed to provide protection to children when they are most vulnerable to diseases, and when the vaccines will produce the strongest response from their immune system.

Learn more about how the vaccine schedule is determined and why it is never okay to delay a child’s vaccines.

 

Advisory Committee on Immunization Practices June 2018 Meeting Update

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The Advisory Committee on Immunization Practices (ACIP) held their second of three annual meetings at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA last week.  ECBT staff took advantage of the opportunity to view the meeting via webcast, and strongly encourage members of the public to take advantage of this technology in order to gain a better understanding of the deliberations that take place to ensure the ongoing safety and effectiveness of the vaccines licensed for use in the U.S.

The CDC sets the recommended immunization schedules for people of all ages in the U.S. based on recommendations from the ACIP. The ACIP establishes, updates and continually evaluates all the vaccine recommendations that are made in the United States for infants, adolescents and adults. These guidelines are considered the gold standard among healthcare providers. The ACIP consists of 15 voting members, 8 ex officio members and 30 non-voting representatives who participate voluntarily. In addition to the three meetings per year, which are open to the public, ACIP members serve on various work groups that are active throughout the year. Work groups review the latest studies on specific vaccines (including safety and efficacy reports), in order to provide recommendations to the larger committee.

Last week the ACIP voted on recommendations for influenza (flu) and anthrax vaccinations, and discussed HPV, mumps, shingles (herpes zoster), Japanese encephalitis, and pneumococcal vaccines. Votes and highlights from the discussions are detailed below.

 

Influenza (Flu) Vaccination Discussion and Vote

It will come as no surprise to our readers that the flu virus hit a brutal blow to people of all ages during the very severe 2017-18 flu season in the U.S., striking at nearly the same time nationwide.

 

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Influenza A (H3N2) was the predominant circulating strain and this year the effectiveness of the vaccine against this strain was approximately 24% (similar to the previous flu season). Effectiveness against the influenza A (H1N1) strain was 65% and 49% against the influenza B (Yamagata) strain.

 

 

 

Now the good news – vaccination reduced flu-related visits to healthcare providers (outpatient) by 40% among all people ages 6 months and older. Among adults, the vaccine reduced outpatient visits and hospitalizations by 22%.

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The ACIP listened to vaccine safety reports provided by representatives from the Food and Drug Administration (FDA), vaccine manufacturers, and the vaccine safety surveillance systems in the U.S. – the Vaccine Adverse Event Reporting System (VAERS) and Vaccine Safety Datalink (VSD) which is a collaboration between CDC and nine healthcare organizations that began in 1990 and analyzes up to 10 million immunization records per year to ensure ongoing safety.  After an extensive review of the safety of this season’s flu vaccines, the ACIP confirmed that there were no vaccine safety signals of concern including anaphylaxis, narcolepsy and Guillian-Barre Syndrome, each of which received increased scrutiny due to a number of news and anecdotal reports in recent years.

The ACIP approved the following influenza recommendations for the 2018-19 season:

Everyone 6 months of age and older should be vaccinated with any licensed, age-appropriate influenza vaccine (IIV, recombinant influenza vaccine [RIV], or LAIV), as indicated. No preference is given for any one vaccine over another. In its February meeting, the ACIP once again recommended LAIV (the nasal spray vaccine known as FluMist) for healthy, non-pregnant people 2 through 49 years old during the 2018-19 season. This recommendation was made after ACIP reviewed effectiveness data presented by the manufacturers of FluMist.

Of Note: The Redbook Committee of the American Academy of Pediatrics, who typically endorses the recommendations of the ACIP, have stated a preference for the flu shot (IIV or RIV) over the nasal spray vaccine (LAIV), recommending that pediatricians only give the nasal spray as a last resort. This decision by the AAP is not without controversy as it may lead to confusion among parents and their providers. ECBT Board Member Dr. Paul Offit recently created a Medscape video explaining why he agrees with the ACIP’s decision to recommend the use of FluMist in children based on the effectiveness data.

 

Pneumococcal Vaccination Discussion

Two pneumococcal vaccines are currently recommended for all adults over the age of 65 – one dose of pneumococcal conjugate vaccine (PCV13) with a booster dose of pneumococcal polysaccharide vaccine (PPSV). ACIP is re-examining whether PCV13 should be routinely recommended for otherwise healthy older adults. Some experts believe the childhood recommendations for routine vaccination with PCV13 is sufficiently lowering the disease burden in adults by reducing the circulation of the disease in communities. In data presented to the ACIP, however, it seems there are persistent disparities in the rate of pneumococcal disease and vaccine uptake  pneumoacip062018

among minority populations and those in poverty, which puts into question whether it would be wise to eliminate the vaccine recommendation for adults.  The ACIP will continue to deliberate the data and have continued discussions into 2019.

 

Anthrax Vaccination Discussion and Vote

The anthrax vaccine is currently approved for use by the FDA for 18-65 year olds, and is usually given to select populations of adults (i.e. military). As the Department of Health and Human Services (HHS) and CDC review their plans for responding to an anthrax “mass event”, they have asked ACIP to offer guidance on how best to use the vaccine in the event of emergency. Specifically, they asked ACIP whether the anthrax vaccine would be equally effective and safe if they had to administer the vaccine in fewer or smaller doses to ensure there was enough vaccine for everyone affected.  Also under consideration was the utilization of different types of needles to be used in the event of a needle shortage. The current vaccine is given subcutaneously, not intramuscularly, like typical vaccines. Intramuscular needles are therefore more readily available.

After reviewing the data, the ACIP agreed unanimously that reduced dosing would still save lives, as would offering the vaccine intramuscularly instead of subcutaneously. There was no data, however, on whether reduced doses given intramuscularly would be equally effective. The Committee also offered their recommendations on the duration of antimicrobial treatment following vaccination. There is a new intramuscular anthrax vaccine on the horizon which may help federal agencies better plan for a possible emergency situation.

The ACIP made the following recommendations:

The intramuscular route of administration may be used if the subcutaneous route presents clinical, operational, or logistical challenges that may delay or prevent effective vaccination.

  • Should there be an inadequate supply of anthrax vaccine available for Post Exposure Prophylaxis (PEP), either 2 full doses or 3 half doses of AVA may be used to expand vaccine coverage.
  • In immunocompetent individuals 18-65 years of age, antimicrobials given in conjunction with vaccine may be discontinued at 42 days after the first vaccine dose or 2 weeks after the last vaccine dose, whichever comes later.

 

Japanese Encephalitis Vaccination Discussion

The cell culture-derived Japanese encephalitis vaccine (JE-VC) is both safe and effective, but given how few U.S. travelers contract the disease, ACIP is re-evaluating their recommendations. They are in the midst of re-evaluating the cost effectiveness of the vaccine and whether their recommendations should be more targeted. ACIP will continue deliberations at a future meeting.

 

Mumps Vaccination Discussion

Mumps outbreaks continue to crop up throughout the nation. From late 2016 through 2017, there were 56 outbreaks, which included 3,914 cases, and in 2018, there have already been 30 outbreaks, including 1,415 cases. The ACIP previously recommended the use of a 3rd dose of mumps virus-containing vaccine (MMR) for people identified at increased risk during a mumps outbreak. img_0681.pngDuring the June, 2018 ACIP meeting, the CDC provided guidance for public health officials to assist them on the use of a 3rd dose of MMR vaccine during an outbreak, including identifying groups of people at risk for acquiring mumps during an outbreak; assessing transmission in the settings to determine if groups are at increased risk; and how to implement a 3rd dose recommendation.

 

Shingles (Herpes Zoster) Vaccination Discussion

In October 2017, ACIP made recommendations for a new recombinant zoster vaccine (RZV) called Shingrix. The vaccine is recommended for the prevention of shingles and related complications for adults 50 years of age and older. It is also recommended for adults 50 and older who previously received zoster vaccine live (ZVL), and it is preferred over ZVL for the prevention of shingles and related complications.

GSK, the manufacturer of Shingrix, reported to the Committee that it is increasing the number of doses available due to high demand and shipping delays.  They are also continuing to study the safety and effectiveness of the vaccine.  The CDC also continues to monitor shingles vaccine coverage and vaccine supply. As it does with all vaccines, the CDC is using U.S. safety surveillance systems – VAERS and VSD – to monitor the shingles vaccine (RZV). VAERS is a passive system that is not designed to determine if a vaccine caused a health problem, but does help to detect unusual or unexpected patterns of adverse events that might indicate a possible safety problem with a vaccine. The CDC reported that were 680 reports to VAERS between October 20, 2017 and April 27, 2018, and the majority concerned females. There were no unusual patterns or unexpected adverse events. 48 (7%) of reports involved co-administration with 1 or more other vaccines, and the most commonly reported side effects from RZV were injection site pain and pyrexia (fever).

The CDC also reported to ACIP about VSD monitoring of the shingles vaccine.  The staff of the  VSD conducted vaccine safety studies based on questions and concerns raised from the medical literature and reports to VAERS. As of May 31, 2018, 37,303 total doses of RZV were administered at the participating VSD sites. The VSD monitoring for RZV includes high priority short-term outcomes (GBS, anaphylaxis, and acute myocardial infarction); lower priority short-term outcomes for descriptive analysis (gout, local and systematic reactions); and longer-term outcomes (potential immune-mediated diseases). Evidence of safety and effectiveness of shingles vaccine in immunocompromised is currently being reviewed.

The CDC has created a number of resources for RZV. For providers, the CDC developed a report published in MMWR on vaccine administrative errors, a Continuing Medical Education program (CME) called “You Call the Shots”, a Medscape video, web pages, webinars/conferences and fact sheets. For the public, the CDC created a vaccine information statement (VIS) on the RZV, web pages and a fact sheet.

Human Papillomavirus (HPV) Vaccination Discussion

In October 2018, the FDA is expected to complete a review of scientific studies to determine whether 9-valent HPV vaccine (GARDASIL®9) is safe and effective for use in adults ages 27 to 45. The vaccine will continue to serve as a prophylactic to prevent new infections, and is not expected to prevent progression of the disease among those who already have a HPV infection. The ACIP is also simultaneously reviewing the evidence that has been sent to the FDA and will determine whether to recommend the vaccine if and when the FDA approves the vaccine for use among mid-aged adults. Factoring into the ACIP decision will be the fact that the overall population-level benefit will be lower among mid-aged adults than among younger populations. This is due to the fact that this

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population may have already been exposed to HPV and thus already have an infection, or have immunity against some strains of the disease. In addition they tend to have fewer new sex partners and have several other factors that will make the vaccine less beneficial (but not without merit) for this older group than for those ages 11-12, who can be vaccinated prior to exposure.

The ACIP’s HPV work group is also continuing to review data in consideration of “harmonizing” the schedule for males and females so that both populations would be recommended up to the age of 26 instead of up to age 21 for males and up to age 26 for females and will report back to the full ACIP at a future meeting.

ECBT will keep you informed on this and other deliberations of this important committee.  

Learn more about each of these vaccines and the diseases they prevent on the Vaccinate Your Family website and Facebook page.

 

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What You Don’t Know About Hepatitis Can Hurt You

More than four million Americans are living with viral hepatitis, but most don’t know they’re infected.

HepABCs-cubeMany people can live with hepatitis for decades without feeling sick or exhibiting any symptoms.  But left untreated, there are three different types of viral hepatitis which can cause serious health problems, including liver damage, liver failure, liver cancer or even cirrhosis, a condition that causes permanent scarring of the liver.

In honor of Hepatitis Awareness Month, learn how the different types of viral hepatitis are spread, as well as how they can be prevented or treated. 

Hepatitis A

Hepatitis A can range in severity from a mild illness lasting a few weeks to a severe illness lasting several months.

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It is usually spread by contact with people who are infected or from contact with objects, food, water or drinks contaminated by the feces of an infected person, which can easily happen if someone doesn’t properly wash his or her hands after using the toilet. It’s important to know that not all people with hepatitis A have symptoms, but it’s more likely for adults to have symptoms than children. If symptoms develop, they usually appear two to six weeks after being infected and may include:

  • Fatigue
  • Nausea and vomiting
  • Loss of appetite
  • Fever
  • Dark urine
  • Gray-colored stools
  • Joint pain
  • Yellowing of the skin and eyes (jaundice)
  • Severe stomach pains and diarrhea (mainly in children)

The good news is that hepatitis A is easily prevented with a safe and effective vaccine. For the best protection, it is recommended that children receive two  doses of Hep A vaccine with the first dose being administered between 12 and 23 months of age, and a second dose administered 6 to 18 months after the first dose. Adults who have not been previously vaccinated, or who are at risk due to their work or travel. should also be vaccinated.  Since the introduction of the vaccine, cases of hepatitis A have plummeted across the country.  However, outbreaks still do occur. 

Currently, there are reported outbreaks in West Virginia, Kentucky and California in which hundreds of cases have been identified and several deaths have occurred. This is why all everyone should ensure they are protected against hepatitis A.

Hepatitis B

People who get infected with the hepatitis B virus, especially young children, can go on to develop a chronic or lifelong infection which can cause serious liver damage, liver failure, liver cancer or cirrhosis.

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Hepatitis B virus can be spread through contact with an infected person’s blood, semen, or other body fluids.  This may happen when someone has a cut or sore, when someone is bitten by another person (as in the case of children in daycare), through the sharing of a toothbrush or food has been chewed (like in the case of young children), from an infected mother to her baby during childbirth, through sexual contact, or by sharing needles, syringes, or other drug-injection equipment.

Not all people with hepatitis B have symptoms. However, if they occur, they usually appear about three months after infection and can range from mild to severe, including:

  • Dark urine
  • Fever
  • Joint, muscle and stomach pain
  • Loss of appetite
  • Nausea, diarrhea and vomiting
  • Fatigue
  • Yellowing of your skin and the whites of your eyes (jaundice)

The best way to prevent hepatitis B is by getting vaccinated. The vaccine is recommended for: 

  • All infants, starting with the first dose of hepatitis B vaccine within 24 hours of birth.  This shot acts as a safety net, reducing the risk of a child getting hepatitis B from moms or family members who may not know they are infected with the disease. Additional doses of the vaccine should be given between 1 and 2 months, and between 6 and 18 months of age.Newborns who become infected with hepatitis B virus have a 90% chance of developing chronic Hepatitis B, which can eventually lead to serious health problems, including liver damage, liver cancer, and even death. This is why the birth dose has been an extremely effective way of reducing the risk of chronic Hepatitis B infection. 
  • All children and adolescents younger than 19 years of age who have not been fully vaccinated against hepatitis B
  • Unvaccinated adults at risk for hepatitis, in addition to any adult who wants to be protected from hepatitis B.

Unfortunately, many people got infected before the hepatitis B vaccine was widely available. That’s why the CDC recommends that anyone born in areas where hepatitis B is common (such as Asia, the Pacific Islands or Africa), or whose parents were born in these regions, get tested for hepatitis B.

You can learn more about who may be at increased risk of hepatitis B here. Fortunately, treatments are available that can delay or reduce the risk of developing liver cancer.

Hepatitis C

FACT: People born from 1945 - 1965 are 5 times more likely to be infected with Hepatitis C. Learn more: //www.cdc.gov/KnowMoreHepatitis/

For some people, hepatitis C is a short-term illness, but for 70%–85% of people who become infected, it becomes a long-term, chronic infection which can cause serious liver damage and even liver cancer over time. Unfortunately, the majority of infected people are not aware of their infection because they are not clinically ill.

In the past, hepatitis C was spread through blood transfusions and organ transplants. However, widespread screening of the blood supply began in 1990 and the hepatitis C virus was virtually eliminated from the blood supply by 1992. Today, most people become infected with hepatitis C by sharing needles, syringes, or any other equipment to inject drugs. For reasons that are not entirely understood, people born from 1945 to 1965 are five times more likely to have hepatitis C than other age groups.

Unfortunately, there is currently no vaccine to prevent hepatitis C. However, once diagnosed, most people can be treated and cured in just 8 to 12 weeks, reducing liver cancer risk by 75%. This is why awareness and testing is so critical.


The CDC has developed an online Hepatitis Risk Assessment to help people find out if they should get tested or vaccinated for viral hepatitis.

ARE YOU AT RISK? Millions of Americans have VIRAL HEPATITIS. Most don't know it. Take this online assessment to see if you're at risk. //www.cdc.gov/hepatitis/riskassessment/

The assessment, which takes only five minutes, will provide personalized testing and vaccination recommendations for hepatitis A, hepatitis B, and/or hepatitis C.  Take it today and protect yourself from these viruses that can so easily go undetected.  

Five Important Reasons to Vaccinate Your Child

April 23, 2018 3 comments

Every parent wants to do what’s best for their children. However, when parents are bombarded by conflicting messages, it can be a struggle to try to determine what is best.  Every decision – from the type of car seat to purchase, to how to soothe a fussy child – elicits a variety of opinions.  But when it comes to protecting our children from dangerous and sometimes deadly diseases, parents should rely on evidence based information from trusted sources.  

In honor of National Infant Immunization Week 2018, we’ve outlined some of the top reasons experts give for immunizing for your child, along with trusted sources where parents can get more information:

 

1.) The diseases we can prevent through immunization are dangerous and sometimes deadly.  

The 14 different diseases that we can now prevent through vaccination had once injured or killed thousands of children in the U.S. each year. Today, we may hardly ever see these diseases, but the fact remains that these diseases still exist and can be extremely dangerous, especially to children.

Take polio as an example. Polio was once America’s most feared disease, causing death and paralysis across the country.  Thanks to vaccination, the U.S. has been polio-free since 1979.  But small pockets of polio still exist in Afghanistan and Pakistan, and the threat to your child may just be a plane ride away.  (Read Judith’s polio story.)

There are lots of other vaccine preventable diseases that we see more frequently here in the U.S., such as flu, measles and pertussis.  So far during the flu season, over 150 children have died from flu.  And in the past few years, we’ve seen a resurgence of measles.  Back in 2014, there was an outbreak involving 667 cases of measles in 27 states. Another large multi-state outbreak linked to an amusement park in California occured in 2015 involved 147 people. And more recently, an outbreak in MN resulted in the hospitalizations of a dozen children.

Learn more about the 14 different diseases we can prevent through vaccination with this interactive eBook which includes a description of each disease, its symptoms and an explanation of how the disease can be prevented through immunization. 

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2.) Vaccines are safe and effective. 

Vaccines today are the safest they’ve ever been. Of course, parents are bound to hear stories from people on the internet claiming that their children were injured by vaccines.  Since it is extremely difficult to validate these stories, parents should rely on evidence based information when making conclusions about the safety of vaccines.

It is important to acknowledge that vaccines do come with a risk of side effects. However, since vaccines are administered to almost every child in the U.S., they undergo an enormous amount of safety surveillance and scrutiny by scientists, doctors, and healthcare professionals.  The most common vaccine side effects are minor and include redness or swelling at the site of the shot, which is minimal compared to the pain, discomfort, and risk of injury and death from the diseases these vaccines prevent. Serious side effects following vaccination, such as severe allergic reaction, can happen, but are extremely rare.

Considering the dangers of the diseases we are trying to prevent, the benefits of vaccines far outweigh the minimal risk of side effects.

This video, as well as others available on our Vaccinate Your Family Facebook page, address some of the most common safety questions parents have about vaccines.  

 

3.) Childhood vaccines contribute to the community immunity that helps keep everyone free from disease.  

Some vaccines are not administered until a child is 2, 6 or 12 months of age.  Some vaccines even require multiple doses before a child receives optimal immunity.  Prior to being fully vaccinated, these infants remain vulnerable to diseases that can be particularly dangerous for infants.   Read more…