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What Your Dentist Should Be Telling You About Oral Cancer and HPV

April 6, 2018 1 comment

oral-cancer-monthI had my teeth cleaned yesterday, and while I was at the dentist I remembered that April is Oral Cancer Awareness Month. 

The dentist never mentioned it, but I knew just what she was doing when she put her gloves on and started rolling her fingers around the inside of my checks, under my tongue and on the outside of my neck and jaw.  She was doing what all oral health professionals should do – a thorough examination that could help with early detection of oropharyngeal cancers (also known as cancers of the throat and tongue) which are commonly caused by the human papillomavirus (HPV). 

As someone who has been diagnosed with two different cancers in the past, I no longer think “not me”.  Quite honestly, knowing how prevalent HPV is (it’s estimated that 80% of sexually active people will contract HPV at some point in their life) it’s probably more likely that I would be diagnosed with an HPV related cancer than many other types of cancer. Although most cases of HPV resolve without incident, the fact remains that approximately 14 million new cases of HPV occur in the U.S. each year, with at least 79 million people estimated to be currently infected and about 31,500 cases of HPV related cancers diagnosed in men and women each year in the U.S.. This includes cancers in the oropharynx, cervix, vagina, vulva, penis, and anus.  

While HPV can cause up to six different types of cancer, oral cancers are on the rise.  It’s estimated that HPV-associated oropharyngeal cancer affects about 16,400 people each year, and that by year 2020, it will become the most common HPV-related cancer in the US, surpassing cervical cancer.  

Here are a few other details to consider:

While I’m pleased that my dentist took the time to closely examine my neck, throat, mouth and tongue for any abnormalities, I’m disappointed that she didn’t take the opportunity to discuss the importance of HPV vaccination with me. 

Education of the public regarding the risk factors which lead to oral cancer, recognition of the early signs and symptoms, and the development of patient awareness, are primary responsibilities of the dental community.  

In 2017, the American Academy of Pediatric Dentistry (AAPD) issued a policy statement on HPV vaccination that encourages oral health care providers to educate patients and parents on the relationship of HPV to oral and oropharyngeal cancer and to counsel them regarding the HPV vaccination, in accordance with CDC recommendations. Currently, the CDC recommends two doses of HPV vaccination for girls and boys beginning at ages 11 or 12, but vaccination can be started at age 9 and can be administered through age 26 for females and age 21 for males.

Screen Shot 2018-04-06 at 10.36.56 AMWhile oral health professionals should be recommending HPV vaccination to all age-eligible patients, it would be prudent to also provide that information to patients who are parents. Although my dentist is not a pediatric dentist, my five children are also patients and we all get our regularly scheduled dental cleanings twice each year. 

At no point has anyone at this particular dental practice ever discussed oral cancer or HPV with me or any of my children, despite the fact that all five of my children are  considered “age-eligible”. (I know this because after my appointment yesterday, I asked my kids.)

Yesterday, my dentist failed to discuss HPV vaccination as a potential way to prevent oral and oropharyngeal cancers, which I consider to be a missed opportunity. However, during our collective twelve appointments each year for the past five years, it’s actually more like 60 enormous missed opportunities!

I get it.  Dentists may not be comfortable discussing vaccines. Or HPV.  But how comfortable can it be for them to have to tell their patients they may have oral cancer? How comfortable can it be for those patients who will end up having to suffer through an oral cancer that may have been preventable?

Fortunately, there are tests that can help detect HPV in women before they develop cervical cancer.  However, the same is not true for HPV-related head and neck cancers. These cancers typically develop in the throat at the base of the tongue, in the folds of the tonsils or the back of the throat, making them very difficult to detect. That is why regular dental exams can be vital. But prevention is always preferred to treatment, and HPV vaccination represents our best chance at prevention. 

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Since my dentist didn’t provide the information I feel all parents and patients deserve to know, I plan to bring them this action guide for Dental Health Providers, created by the National HPV Vaccination Roundtable when I return next week for my daughter’s visit. 

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According to the Oral Cancer Foundation, there are over 100,000 dentists in the U.S., each one seeing between 8 and 15 patients per day. If you include those patients who come to a practice and see someone other than the dentist, such as the hygienist, the number of patient visits is significantly higher. If they each did their part to educate their patients, imagine what a huge difference they could make in boosting HPV vaccination rates and reducing oral cancers.

Until we start seeing more dentist taking these types of actions,  please help spread the word about the association between HPV and oral cancers, during Oral Cancer Awareness Month and all throughout the year.

Below you will find additional resources regarding HPV vaccination and HPV-related head and neck cancers.  Here’s hoping that you never have to deal with an oral cancer diagnosis, like Jason Mendelsohn, Scott Vetter, Frank Summers and others.   


 

 


 

 


Other Resources:

Head and Neck Cancer Alliance

Oral Cancer Foundation

National HPV Vaccination Roundtable

Vaccinate Your Family Website: HPV Information

Research Article: Reduced Prevalence of Oral Human Papillomavirus (HPV) 4 Years after Bivalent HPV Vaccination in a Randomized Clinical Trial in Costa Rica

 

 

Updates from the Advisory Committee on Immunization Practices February Meeting

March 6, 2018 2 comments
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Photo Credit: James Gathany, Centers for Disease Control and Prevention

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

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

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

Hepatitis B

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

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

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

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

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

Hepatitis A

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

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

Influenza

The Committee heard five presentations specific to influenza.

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

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

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

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

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

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

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

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

Meningitis B and Your College Student: Preventing the Call

February 14, 2018 Leave a comment

Emily was a 19-year-old college student when she called home complaining of a headache. Thirty-six hours later, she passed away due to serogroup B meningococcal disease. Emily was able to donate six of her organs, together with bones and tissue, to save the lives of five others.

Emily’s mother, Alicia Stillman, who graduated from Arizona State University, returned to Arizona after founding The Emily Stillman Foundation to honor her late daughter’s life. She shared the story of how Emily contracted Meningitis B and her family decision to donate Emily’s organs. She also explained the work she is doing to help educate others about the availability of Meningitis B vaccines in the United States and to encourage organ donation. She spoke with Debbie McCune Davis, Director of The Arizona Partnership for Immunization (TAPI), who is leading the effort to increase awareness of the approved vaccine and who is working with Arizona Universities to promote the Off to College education campaign.

Together these two women share a message of hope, as they work to save lives and prevent serogroup B meningococcal disease by educating parents, students, educators and medical professionals across Arizona and the nation.

 

 

Alicia: I always felt I was living a blessed life. I enjoyed motherhood. I had three beautiful children, a wonderful husband, and a successful career. I believed I was doing everything right to raise healthy, independent children, as I sent each one off to college.

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Emily and the Stillman family after her high school graduation.

My middle daughter Emily had a fabulous first year away at a small liberal arts college in Kalamazoo, Michigan. In 2013, she was well into the second semester of her sophomore year when she called home one evening, complaining of a headache. Thinking it was from lack of sleep, I advised her to take some ibuprofen, and to touch base with me in the morning. Little did I know that was to be the last time I would ever hear my Emily’s voice.

The call the next morning wouldn’t come from my Emily, but rather from the Dean of the College. She told me my daughter had been admitted to the hospital during the night with Bacterial Meningitis, that she was very sick, and I needed to get there as soon as possible. I remember insisting that this was not possible because even at that time, I knew she had received “the meningitis shot”. In fact, I even remembered that before she left for college, she had received a meningitis booster. What I did not yet know at that time was that the vaccine she had received (MenACWY) only protected her against 4 of the 5 common serogroups of Meningococcal Disease. I had no idea that there was a strain she was not protected against because a vaccine for that strain was not even available in the United States at that time.

Less than 36 hours later I said goodbye to my baby. My beautiful girl that I had promised to always protect and take care of was gone. As I said goodbye to her on that cold February morning, I told her that I would be ok…and that I would figure this out.  I would make sure this could not happen to other people.

Debbie: Stories like Alicia’s weren’t preventable in the U.S. when Emily Stillman contracted and lost her life to Meningitis B, but they are today. In October of 2014 and January of 2015, the FDA approved licensing for two different vaccinations for Meningitis B. Soon after that, the Advisory Committee on Immunization Practices (ACIP) of the Center for Disease Control and Prevention (CDC) acknowledged that college age students should talk with their doctors about Meningitis B.

In Arizona, our Board of Regents (the governing board of our state university system) took quick action to recommend all incoming freshmen get the vaccine.  There had been outbreaks in the PAC 12 schools and Arizona wanted to promote healthy campuses. We, at TAPI, worked with the Universities, their Medical Directors and all of our professional medical organizations including Osteopaths, Pharmacists, Nurses, and Pediatricians to put forth a unified message and raise awareness.

Our Off to College flyer launched an awareness campaign for parents and college age students to make certain each has the benefit of protection from all strains of meningitis.

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Alicia: I live my promise to my Emily every single day with my work at The Emily Stillman Foundation. Before the vaccine was approved in the U.S., I discovered the vaccine was available in Canada. We took busloads of families across the Detroit/Windsor border into Canada to get the MenB vaccine. We met with the FDA (Food and Drug Administration) and many members of Congress to urge the fast tracking of the licensing process. I testified at the CDC and encouraged ACIP to grant a firm recommendation to protect our adolescents and young adults. I set up vaccination clinics locally to provide the vaccine before medical practices were willing to hear about it. I speak nationally, working with colleges, medical practices, and parents to raise awareness to this hideous disease, its symptoms, and the vaccinations now available to prevent it.

I won’t stop until the MenB vaccine is on the required list, and is available to all people.  Only then will my promise to my Emily be fulfilled. 

Debbie: Today, we at TAPI are taking it a step further…we don’t want kids to wait until they’ve moved into their dorms to receive their vaccination. 

We are working with high schools, parents groups, physicians, athletic departments and more to promote Vaccinate Before You Graduate here in Arizona.  We want this to become part of the college prep routine—take your college entrance exams, turn in your transcripts, apply for scholarships, choose your school, order your cap and gown and vaccinate!

 

As mothers, and as experts – one from a heart-breaking loss, and one as a professional who works tirelessly to prevent disease – we urge you to enjoy these moments with your child.  However, as you are giving them that final send off, smoothing the bedding on their dorm bunk, stocking snacks and toiletries, telling them to study hard and have fun (but not too much fun), asking them to be safe, be sure to also give them the tools to stay healthy.

Make sure they have their boosters, that they are up to date on all vaccination and be sure your health professional has given your child protection from all strains of meningitis, including Meningitis B. If your child has already started that journey and is off to college, check with the student health services at their school for information about vaccine availability on campus.

Do it for your child, do it for yourself and do it for Emily.


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Alicia Stillman lives in West Bloomfield, Michigan with her husband of 29 years, Michael. In addition to her angel daughter Emily, she has two live children – Karly, 25, and Zachary, 21. Alicia holds an MBA in Management Accounting, and is the Accounting Director for a multi-state Law Firm. She is the Co-Founder and Director of The Emily Stillman Foundation, founded in 2014 in memory of her late daughter Emily. The Foundation has a trifold mission to raise awareness for and encourage organ and tissue donation, to educate about Meningococcal Disease as well as all vaccine preventable diseases, and to advocate globally for all health and wellness issues. Most recently, Alicia partnered with Patti Wukovits to co-found the Meningitis B Action Project.  Alicia can be reached through the Foundation at emilystillmanfoundation@gmail.com.

 

McCune_Davis_16 - Member Photo.jpgDebbie McCune Davis has served as Director for The Arizona Partnership for Immunization, better known as TAPI, since February 1996. She was an elected member of the Arizona Legislature, serving from 1979 until 1994 and again from January 2003 until her retirement in January 2017, serving in both the House of Representatives and the Arizona State Senate. In her local community Debbie serves on numerous committees and task forces, working to improve the health status of women and children in Arizona. She has established a reputation for being a knowledgeable advocate for maternal and child health and childcare issues. In 2012 she was recognized for her advocacy by the Children’s Action Alliance in Phoenix and Every Child By Two in Washington, DC. Debbie also served on the Board of Directors of the American Immunization Registry Association and she volunteers her time as a member of the planning committee of the National Conference on Immunization and Health Coalitions. She is married to Glenn Davis and has a blended family of 5 children and 3 grandchildren. More information about TAPI may be found at www.whyimmunize.org.

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

January 13, 2018 10 comments

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

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

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

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

Right now, flu is widespread everywhere.  

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

FluWeeklyReportActivity is severe right now.

 

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

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

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

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

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

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

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

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

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

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

Vaccination is our best defense.  

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

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

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

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

Read more…

Resolve To Protect Your Family From Cancer

January 9, 2018 1 comment

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By Shaundra L. Hall, Southwest Regional Director, National Cervical Cancer Coalition (NCCC)

January is Cervical Health Awareness Month and if you’ve resolved to make healthier choices in 2018, then ensuring your loved ones are vaccinated against the deadly strains of human papillomavirus (HPV) should be on the top of the “resolutions to keep” list.

Cancer prevention is a gift of health for your child’s, and grandchildren’s, future.  But it’s only a gift if given early in life.

My journey with HPV began at the age of 17.

My very first Pap smear exam had an abnormal result. Over the next several years, I would have some normal and some abnormal Paps, and it was eventually determined that my cervical dysplasia required medical treatment to remove abnormal cell tissue that might become cancerous. I went on to have multiple procedures over the years – a LEEP/cold knife cone, cryosurgery – you name it, I had it.  So many painful treatments chipping away precious tissue from my cervix.

ShaundraHall2Years later, after my husband and I were married and bought our first house together, we started thinking about starting a family. When pregnancy didn’t happen as quickly as we had hoped, I made a visit to my gynecologist’s office. Back in to the stirrups I go, and with one look heard “Ohhhh…

My heart sank.

Until we had started trying for a family, I’d had four years of completely normal Pap tests and I felt confident that I was healthy enough to get pregnant.  I couldn’t have been more wrong.

During the course of about 10 months, some cancer switch turned on and I went from 4 years of a healthy cervix to invasive cervical cancer.  About fourteen days after my doctor’s appointment, I was in the hospital having a hysterectomy to save my life from a HPV related cancer.  Not only were my husband and I in our 20s trying to deal with the fact we would never have our own biological kids, but now we had the big “C” staring us in the face.  To say it was devastating is an understatement.

I wish I could say that I left all of that sadness from nearly 20 years ago behind me, but the reminders of my battle with HPV related cancer is with me every day. When I see my scar or when my legs, ankles and feet swell due to lymphedema from my missing abdominal lymph nodes, it’s clear that I can’t escape what the cancer has done to me. I think about it when I encourage my husband to keep each and every dental exam to ensure that he is not at risk for HPV related oropharyngeal or head and neck cancer.  My husband has been an amazing partner sticking with me through all of the intimacy challenges related to the physical modifications to my body, and I only wish we had the opportunity to be protected from HPV when we were younger. Read more…

Most Popular Posts of 2017 Address Flu, Vaccine Safety, Disease Outbreaks and Maternal Vaccines

December 27, 2017 Leave a comment

As we look back at the success of the Shot of Prevention blog this past year, we’re especially grateful to our blog readers, contributors and subscribers.

Whether you’ve shared a post, shared your story, or shared your expertise, we recognize that our growth and success would not have been possible without your support. Thanks to you, our posts are helping people to make important immunization decisions for themselves and their families.

In these final days of 2017, we hope that you will revisit the top ten posts from the past year and share them with others in your social networks.  

1)  3 Things I’ve Learned Since Losing My Son To Flu

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It’s been eight years since Serese Marotta of Families Fighting Flu lost her five-year-old son, Joseph, to the flu. She’s not the same person she was eight years ago. Today, she sees things through a different lens as a bereaved parent. Losing a child is devastating, but she feels a responsibility to pass on some of the lessons she’s learned through her personal tragedy, which she does in her article here.

 

2)  10 Things Parents Who Don’t Vaccinate Their Kids Should Know

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In some cases, children who have suffered with a preventable disease were unvaccinated.  This could be the result of parents who did not have access to certain vaccines, parents who willfully refused a particular vaccine, or it could because they were too young to be fully vaccinated. After Riley Hughes passed away in the arms of his parents when he was just 32 days old, his parents made it their mission to educate people about the dangers of whooping cough, and promote the need for vaccination. In a plea to parents who still choose not to vaccinate, Riley’s mom posted the following list of “things to know” here.

 

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

lizaLiza was healthy and only 49 years old when she contracted flu. 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 that her death was a surprise to her brother is an understatement.  And yet her brother, Dr. Michael Northrop is a pediatric intensive care physician. His story traces the clinical course of Liza’s illness, and expresses the grief he felt as he helplessly watched his sister  succumbs to an illness that even modern medicine can’t always save us from. To read his story, click here.

 

4) Take It From This Mom, The Flu Is No Joke

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After her four-year old daughter is rushed to the emergency room, she writes a warning to others.  “The words just the flu need to be eradicated from our lexicon. Because this? This is the flu. There’s no ‘just’ about this. It was terrifying. It was the most helpless I’ve ever felt as a mommy. And it was potentially deadly.  All because I was too busy to get our flu shots.” Read the full story here.

 

5) Flu Vaccine Benefits Go Beyond Effectiveness of One Strain

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Amid speculation about how effective the flu vaccine will be this year, Dr. LJ Tan addresses some of the public’s most prominent concerns. He starts with a basic explanation of flu and flu vaccines, discusses the factors that play into vaccine effectiveness, and addresses rumors about this year’s flu vaccines. To gain a better understanding, read more here.

 

6) How My Sister Helped Save My Daughter From Whooping Cough

As a Medical Director responsible for Community Health and Prevention at Intermountain Healthcare in Salt Lake City, Utah, Tamara Sheffield is a huge advocate for SOTI_Pertussis_FBimmunizations. She is especially appreciative of maternal immunizations, which she considers one of today’s most promising new preventive health strategies. But her reasons go beyond her professional understanding of how maternal flu and Tdap vaccines pass on protective antibodies to newborns. Her surprising story ends with a twist involving her own daughter who nearly died from whooping cough when she was just three weeks old. Read it here.

 

7) Multiple Vaccine Oversight Committees Ensure Our Public Safety

While 2017 brought a lot of uncertainty about health services in this country, Dr. Dorit Reiss, Professor of Law at the University of California Hastings College of Law, explains 178_NFID_Vaccine_Safety_infograms_2_FINALwhy the public should remain confident in vaccine safety. In this post she reviews the specific ways in which vaccine safety is regulated in the U.S., and the oversight committees that monitor vaccines pre and post licensure. Her scrutiny explains that it would be hard to hide a problem if one existed, and that when problems do occur, they are quickly discovered and addressed. To learn more about vaccine safety oversight, read the full post here.

 

8) Why Should Vaccinated Individuals Worry About Measles Outbreaks

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With various measles outbreaks reported across the U.S. and the world in 2017, it’s important to understand why vaccinated individuals should be concerned. Many people mistakenly think that vaccinated individuals are not at risk during outbreaks. However, when it comes to infectious diseases like measles, one person’s decision not to vaccinate can negatively impact the health of others and this post explains how.

 

9) Five Things I’ve Learned About Vaccines Through 21 Years of Parenting

HowHerdImmunityWorksWe’ve all received plenty of unsolicited advice about how to care for our children. However, when making health decision for our families we should rely on evidence based research and credible information from reputable sources. In this post, I share five of the most important things I’ve learned about vaccines through my journey as a parent and immunization blogger. Spoiler alert: it begins with science and it ends with action.

 

10) Five Things Expectant Parents Need to Know About Vaccines in Pregnancy

SOTI-PregnancyCoverFBWhile well-meaning friends and family will provide a constant stream of advice on what to do and what to avoid while pregnant, all this information can be overwhelming. Expectant couples should rely on credible medical sources such as the CDC, the American College of Obstetricians and Gynecologists (ACOG), and the American College of Nurse Midwives. This blog post reviews the 5 things these trusted organizations say about the flu and Tdap vaccines routinely recommended during pregnancy. Learn more here.

 

We hope you have found our content to be engaging and informative.  We have exciting changes planned for Shot of Prevention in 2018 in hopes of engaging even more people in these important immunization conversations in the years to come.  

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Thanks again for your continued support and best wishes for a happy and healthy new year!

Flu Vaccine Benefits Go Beyond Effectiveness of One Strain

December 11, 2017 3 comments
LJ TanGuest post by Litjen (LJ) Tan, MS, PhD; co-chair and co-founder of the National Adult and Influenza Immunization Summit.

 

There seems to be a lot of speculation recently about how effective the influenza (flu) vaccine will be at preventing cases of influenza this season.

We have heard suggestions that the vaccine may only be 10% effective against flu this year, that there may be mismatches in the vaccine compared to the influenza strains that are circulating, and thus, that the vaccine is not worth getting.

To address these concerns I will start with a basic explanation of flu and flu vaccines, and then discuss the factors that play into vaccine effectiveness.

First, let me say that influenza is a serious respiratory infection that is responsible for about 30% of all the respiratory infections during the winter season. When I say serious, I mean that flu can keep you down for a week or more, and you will feel completely miserable. Additionally, each year thousands of people of all ages die from flu in the U.S.; it can be very dangerous. So, that office colleague who said that he was out with the flu yesterday very likely did not have influenza. Not fully understanding the dangers of flu is why some people fail to see the value of flu prevention.  

Flu is caused by multiple strains of influenza viruses that circulate during the winter season; specifically, we have influenza type A (with the H3N2 and H1N1 strains) and influenza type B (there are two type B strains that can circulate and currently 90% appear to be the Yamagata lineage, but since it is still so early in the season and sample sizes are small, this data point may not be statistically significant). Because these strains of flu viruses can switch every season in terms of dominance, and can also mutate, manufacturers need to develop a new influenza vaccine every year and people need to be re-vaccinated each year.

To be clear, the vaccine development process is the same every year, it is just that the starting, or “seed”, vaccine virus that we immunize against has to be identified before it can be used to develop our country’s annual vaccines.

When that seed virus is identified, it is then amplified (or passaged) to develop more seed virus. Then that seed virus is further amplified to create the large quantities of vaccine virus that we ultimately need to prepare an adequate supply of vaccines to protect our population. That amplification of the seed virus, and the making of large amounts of vaccine virus, can occur in eggs, which is the more traditional way, or it can also occur in cell cultures. So there needs to be four seed viruses developed and amplified to create influenza vaccines – an H3N2 seed, an H1N1 seed, and the two B seed viruses.

So why do we keep hearing people say that this year’s flu vaccine may only be 10% effective? Where did that suggestion come from?

When we say that a flu vaccine is 10% effective, what we usually mean is that it was effective in preventing 10% of cases of influenza in those who were vaccinated. This 10% number that you may have heard is actually a data point from Australia, and it’s not against all strains of flu, but specifically against the H3N2 strain that dominated the southern hemisphere this past flu season. If you look at the Australian data for all influenza, the vaccine effectiveness goes up to 33%. Agreed, that’s not great for Australians (although, it’s still better than no protection), but is looking at the Australian data truly reflective of what might happen in the US?

It’s unlikely, and here’s why. Read more…