This guest post was provided by the National Meningitis Foundation (NMA) and first appeared on their Parents Who Protect blog.
As our obsession with basketball’s March Madness has progressed to the Final Four, our efforts to encourage “both shots” in the fight against meningococcal disease remain at center court.
While March is a time when basketball steals the headlines, it’s also a time when meningococcal disease steals our children. In fact, while meningococcal disease can strike at any time of year, the number of cases peaks in the winter and early spring. Unfortunately, for many National Meningitis Association (NMA) members, such as the member of Moms on Meningitis (M.O.M.) and Together Educating About Meningitis (T.E.A.M), March is a time when we remember those we lost to meningococcal disease.
- N.M.A. board member, Leslie Maier lost her son Chris on March 2nd
- M.O.M. Judy Miller lost her daughter Beth on March 12th
And there have been plenty of others who never got their “shot” at life.
The higher incidence of meningococcal disease in March can be seen in the headlines of the last few years.
In March 2014, a Drexel University student died after visiting Princeton University, which was nearing the end of an outbreak that impacted eight students. In 2015, the University of Oregon was battling an outbreak of meningococcal disease with two additional cases appearing in March. In 2016, students at both Penn State and Rutgers University were hospitalized with meningococcal disease in March. This year there were cases on three college campuses by mid-March: Wake Forest University, Old Dominion University, and Oregon State University. There has also been an outbreak, at an elementary school in Virginia.
To rise to the challenge of this other recurring “March Madness”, we must increase our efforts to raise awareness of meningococcal disease and its prevention.
There are two kinds of vaccines that students need to be protected from meningococcal disease, the MenACWY vaccine and the MenB vaccine.
- The Centers for Disease Control and Prevention (CDC) recommends meningococcal vaccination against serogroups A, C, W and Y for all children at 11-12 with a booster at age 16 (MenACWY).
- CDC recommends permissive use of meningococcal vaccination against serogroup B at ages 16-23, with a preferred age of 16 to 18 years (MenB). (Click here for more information.)
It’s important that students remain vigilant and be able to recognize the symptoms of meningococcal disease including headache, fever, stiff neck, and a purplish rash, so that you can promptly seek medical attention.
This March, let’s get on the ball and take “both shots” to prevent the other March Madness.
The National Meningitis Association is a nonprofit organization founded by parents whose children have died or live with permanent disabilities from meningococcal disease. Their mission is to educate people about meningococcal disease and its prevention. To stay informed about meningococcal disease and how to prevent it, follow The National Meningitis Association on Facebook and Twitter and be sure to subscribe to their Parents Who Protect blog.
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.
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 opposed to adult flu deaths, we tend to see news reports throughout the flu season, such as these:
- A 7-year-old and a 17-year-old who died in Florida back in January.
- Four children who died from flu in New York City in January.
- Five children from Ohio to include 6-year-old Eva Harris, 7-year-old Ava Coronado, 9-year-old Korbyn Mathias who was vaccinated, but also asthmatic, as well as a 6-year-old boy from Salem and a 7-year-old boy from Columbiana County.
- 17-year-old Kayla Linton, a healthy but unvaccinated high school athlete from Maryland, who died in January
- And just this week, another child from Milwaukee.
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.
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.
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!
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.
The 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.
Learn 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 firstname.lastname@example.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.)
Every 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!
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.
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.
Some 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 is 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…
Teens and young adults have a tendency to believe they’re completely invincible. But their lifestyle – which often involves high levels of stress, inadequate amounts of sleep and close living quarters – can put them at an increased risk of certain infections such as flu, mumps, meningitis and HPV. As students return to class after winter break, they’re reunited with classmates, roommates, and professors who may have been exposed to infectious diseases during their travels to other states or other countries.
While it’s impossible to prevent every cough and sniffle, parents can help protect their kids by ensuring they’re up-to-date on all their recommended vaccines.
So what are all the vaccines that are recommended for teens and young adults?
And wouldn’t they be required for school anyway?
Vaccine requirements vary by state and don’t necessarily include all the vaccines that the CDC recommends. Therefore, as winter break come to an end, parents should review their students’ immunization records and arrange for them to get any missing shots before they return to class.
Here are a few of the diseases that students should be protected against.
Influenza is a dangerous viral infection that causes hundreds of thousands of hospitalizations and thousands of deaths each year in the U.S., even among health people of all ages. For the best protection, the CDC recommends that everyone over the age of 6 months receive an annual influenza vaccine.
Unfortunately, while flu vaccination rates are typically the highest among children, rates tend to drop among teens and young adults. If your college student hasn’t already received their annual flu vaccine it’s not too late. Bring them to their healthcare provider or local pharmacy to get them protected before they return to campus. Although it can take up to two weeks to develop antibodies post-vaccination, flu season often extends well into Spring, so students will benefit from protection for many months to come.
Mumps may not be considered “common” in the U.S. thanks to a 99% decrease in mumps cases once mumps vaccination began in 1967, but there have been several mumps outbreaks on college campuses in the past year, and approximately 4,258 cases across 46 states and DC in 2016.
This shouldn’t come as much of a surprise when you consider that crowded environments, such a large classes and dormitory living can all contribute to the likelihood of outbreaks. Also, since mumps is spread primarily through saliva, coughing and sneezing, teen behaviors such as kissing or sharing plates, utensils, cups, lipstick or cigarettes, are all factors that can increase the likelihood of transmission. Read more…
This guest post was written by Carolyn who works as a Home Health Community Nurse and who originally shared her son’s story on the Nurses Who Vaccinate blog to help raise awareness of the symptoms and dangers of pertussis.
My son is a healthy 16-year-old, middle linebacker for his Varsity football team. He jet skis, is an avid boater, plays lacrosse, and enjoys working out, eating healthy and exercising. I never suspected he would suffer with a vaccine preventable disease.
His cough was mild at first. Not a nagging cough, not a wet cough, just a mild cough. I asked my son if he was feeling well and although he said he was fine, I gave him cough syrup and took his temperature. It was normal (hint #1) and we both went to sleep, although I did hear him cough occasionally through the night.
This marked the beginning of the longest 7 weeks of our lives.
The occasional cough continued for a week, but then I noticed it was worsening, and it was making him very short of breath. One day he called me from school and asked me to pick him up. I took him to urgent care, where they diagnosed him with bronchitis, gave him amoxicillin, put him on a five-day dose of prednisone and gave him an inhaler.
That night was the beginning of the nightmare. He coughed so violently that he became short of breath. He was gasping and choking and even began vomiting (hint #2). This continued through the next day and night. He was exhausted. I was exhausted. And even though I am a nurse, I felt helpless.
I took him to the local Emergency Department where the pediatric physician prescribed an albuterol nebulizer and a chest X-ray. The chest x-ray came back crystal clear (hint #3). When I questioned the doctor about the vomiting, they suspected it was due to a gag reflex, but they decided to give him saline for dehydration and take blood and urine samples.
All of his blood work came back fine except for his neutrophils and his monocytes which were only slightly elevated (hint #4). They treated him as a case of atypical pneumonia and put him on a five-day dose of Zithromax and advised us to continue the prednisone until finished.
During the next 10 days, as he completed the medications, my son continued to have these bouts of uncontrollable violent coughing, always resulting in vomiting, choking on phlegm and gasping. He was eating, but also losing weight, and he was in and out of school, often due to being up all night coughing.
One evening he vomited in the basin where I noticed black stringy flecks. I immediately thought it was blood, but he assured me it was something he had eaten. The next morning he vomited again, and this time it was phlegm with blackened red strings (hint #5). I put the vomit in a baggie, put him in the car and took him back to the emergency room.
His sample tested positive for blood and so they gave him several nebulizer treatments, upped his prednisone, repeated the chest x-ray (which again came back clear), prescribed the inhaler every four hours and released him. With the increased prednisone, the cough did slow down a bit, but he still was vomiting phlegm and gasping, so I made a follow-up appointment with his physician where they did a thorough exam and diagnosed him with pertussis.
Pertussis? Really? How did my healthy kid get whooping cough? I was diligent in getting him vaccinated. How did three different doctors miss this?
Last week, the Advisory Committee on Immunization Practices (ACIP) held it’s third and final meeting of 2016. The agenda included presentations pertaining to hepatitis B, pertussis, HPV, meningococcal, herpes zoster, pneumococcal and RSV vaccines, and surveillance updates on Zika and influenza viruses.
During the two-day meeting, the committee took nine votes on newly proposed vaccine recommendations that addressed vaccination timing, number of doses needed, and dosing intervals for hepatitis B, pertussis, HPV and meningococcal vaccines. They also approved the child, adolescent and adult immunization schedules.
This post provides a recap of each agenda item in the order they occurred.
Hepatitis B Vaccine
The recommended first dose of the three-series hepatitis B vaccine is often referred to as “birth dose” and is typically administered to infants in the hospital after birth. At this meeting, the Hepatitis B Work Group asked that the Committee consider removal of the permissive language that appears at the end of the recommendation which allows for a delay of the birth dose until after hospital discharge.
When hepatitis B vaccine is administered within 24 hours of birth it can help prevent transmission of the hepatitis B virus from an infected mother to her child. The intent of the birth dose is to provide an additional safety net to prevent transmission from HepB positive mothers that are not properly identified due to errors in maternal testing or reporting. In these instances, when the mother is not properly identified as HepB positive before birth, the HepB vaccine alone is 75% effective in preventing prenatal transmission, and 94% effective when used in conjunction with Hepatitis B immune globulin.
Since delaying hepatitis B vaccination can interfere with the prevention of Hepatitis B – especially in a child unknowingly born to a HepB positive mother – the HepB Work Group proposed that the reference to delaying vaccination be removed from the recommendation. It had originally been added in 2005, but the data suggests that administering the birth dose in the hospital leads to timely completion of the series. The current birth dose coverage was stated to be 72.4% of children, which remains below the Healthy People 2020 goal of 84%.
The Committee voted to remove the permissive language as well as include new language to clarify that the first dose of vaccine should be administered within 24 hours of birth, which is more explicit than “before hospital discharge”.
The anticipated changes to the previous recommendation are indicated below, however the exact wording may differ once published by the CDC:
“For all medically stable infants weighing 2,000 grams or more at birth and born to HBsAg-negative mothers, the first dose of vaccine should be administered
before hospital dischargewithin 24 hours of birth. Only single antigen HepB vaccine should be used for the birth dose. On a case-by-case basis and only in rare circumstances, the first dose may be delayed until after hospital discharge for an infant who weighs 2,000 grams or more and whose mother is HBsAG-negative”.
*It should be noted that for those infants with birth weight of less than 2,000 grams, the birth dose is not counted as part of the vaccine series.
There was some discussion concerning the removal of the option to delay vaccination and it was emphasized that having a clear recommendation from the ACIP is not a vaccine mandate. Rather, practitioners, public health professionals and parents rely on the ACIP recommendations as expert guidance and best practice. The Hepatitis B “birth dose” has been a successful strategy to help eliminate hepatitis B virus transmission in the U.S., and the ACIP’s revised recommendations only emphasize the importance of vaccinating within the 24 hours timeframe that will help prevent further transmission.
Other key updates to the hepatitis B vaccine recommendations included:
- Providing examples of chronic liver disease, including recommending HepB vaccine for persons with HCV infection.
- Post vaccination serologic testing for infants who’s mother’s HBsAg status remains unknown indefinitely.
- Testing HBsAg-positive pregnant women for HBV DNA.
For more information as to why babies need a Hepatitis B vaccine at birth, read these Shot of Prevention blog posts here.
The Committee reviewed the history of Tdap vaccination in pregnant women and reviewed studies that found that maternal Tdap vaccination to both safe and effective at preventing infant pertussis. Read more…