Fake news is nothing new to vaccine advocates.
For years we’ve been countering vaccine misinformation from a large number of sites such as Mercola, Natural News, Age of Autism and dozens of others. They each have their own way of claiming that vaccine risks outweigh their benefits, despite the overwhelming scientific evidence from experts around the world that says otherwise.
Despite the fact that these sites fail to provide evidence to back up their false claims, the misinformation they routinely publish is widely circulated on social media and it’s likely that their efforts can contribute to the doubts that some Americans have about the safety and efficacy of today’s vaccines.
This is why day after day, and year after year, countless organizations like Every Child By Two, work hard to provide the public with evidence-based information about vaccines through informative websites like Vaccinate Your Family, and social media accounts like the Vaccinate Your Family Facebook page and @ShotofPrev Twitter account.
But this week, fake vaccine news has entered an entirely new realm and it is rather concerning.
Yesterday I woke to such headlines as, ‘Trump Orders CDC to Remove all Vaccination Related Information from Website’ and ‘President Trump Signed an Executive Order Banning Childhood Vaccinations for 90 Days’.
These, and other outrageous stories that are circulating on the internet, signal a new level of hysteria that is dangerous for us all.
While it is comforting to know that these articles were irresponsibly inaccurate, I’m still left questioning the motives and intent behind these headlines. What were the the authors’ and publishers’ hoping to achieve? Read more…
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…
Earlier today, Tom Frieden, M.D., M.P.H., director of the CDC, joined leading medical and public health experts at the National Foundation of Infectious Diseases (NFID) News Conference to discuss the upcoming 2016-2017 flu season and vaccination coverage results from last season.
While flu season doesn’t “officially” begin until October 1st, Dr. Frieden reminded the public that the flu is unpredictable and there is no way to know when the virus will be circulating in your community. This is why experts recommend getting yourself and your family members vaccinated now.
During his opening remarks, Dr. Frieden explained that the CDC has already tested 5,000 viruses and has begun to identify cases of flu across the U.S. While it appears that this year’s vaccine will be a good match to the strains that were circulating at the end of last year, he explained that there’s no way to predict what type of flu season we will have in 2016-2017. The best that we can do is to be get vaccinated.
Dr. Frieden conceded that flu vaccination is not perfect. While we all wish it were better, he urged everyone over 6 months of age to get vaccinated since a flu vaccine can reduce a person’s risk of flu by at least 50%. Flu vaccination also substantially reduces the risk of hospitalizations and other complications, while also reducing the risk of death. In a bad year, the flu kills up to 49,000 Americans, 100 of which are infants and children. Sadly, about 90% of the children who have lost their lives to flu were unvaccinated.
The most promising statement Dr. Frieden made in his opening remarks helped illustrate the enormous impact flu vaccination can have on our health and our communities.
“If we could increase influenza vaccination coverage by just 5%, we would prevent 800,000 illnesses and almost 10,000 hospitalizations.”
Childhood Flu Vaccination According to the Numbers
Over the years, we’ve been making progress in increasing flu vaccination rates, however there is still plenty of room for improvement.
For example, Patricia Whitley-Williams, M.D., NFID Vice President and Division Chief and Professor of Pediatrics at Rutgers Robert Wood Johnson Medical School, stated that ten years ago only about 10-20% of children ages 6-23 months of age were vaccinated against flu. In contrast, last year about 75% of kids in that same age group were vaccinated for flu, exceeding our national public health goal.
Unfortunately, the goal has yet to be met in other age groups. Dr. Whitley-Williams explained that as kids get older, flu vaccination rates tend to decline, with only 47% of children 13-17 years being vaccinated last year. This has had a direct impact on the 20,000 kids under the age of 5 who are hospitalized with flu related complications in this country every year. While roughly 46% of people over the age of 6 months old were vaccinated last season, there were still 30 million kids that didn’t get a flu vaccine.
Vaccinating Healthcare Workers
We are making progress among healthcare workers as well. The data indicates that 9 out of 10 healthcare workers were vaccinated last year, and there was also a slight increase in coverage among healthcare personnel working in long-term care settings such as nursing homes. Yet, flu vaccination rates among adults age 50 and above decreased by 3% last year.
Importance of Flu Vaccine for Aging Adults
Wilbur H. Chen, M.D., Associate Professor, University of Maryland School of Medicine concluded the news conference by address the concerns of a growing adult population. The number of people age 60 and older will soon outnumber children 5 and under, and the concern is that this older demographic is often the hardest hit by flu.
Approximately 70-90% of influenza deaths occur among people 65 and older, and 50-75% of flu related hospitalizations occur in this age bracket as well. While people are living longer, they can’t avoid the fact that our immunological peak appears to occur somewhere around age 45. As a person ages, their immune system begins to decline resulting in higher rates of infection, more severe infections, and a lesser immune response when vaccinated. At an age when flu vaccination is vitally important, only 63% of adults over 65 were vaccinated for flu last season. Flu vaccination is an effective way to reduce illness and hospitalizations among this age group, while also helping to prevent other health complications such as heart attack and stroke.
Since pneumococcal and flu often go together, Dr. Chen suggested that older adults consider getting a pneumococcal vaccine in addition to their annual flu vaccine, if they haven’t already done so. There are two different pneumococcal vaccines that are recommended to the public; the first is for everyone 65 and over, while the other is for those under age 65 with certain health conditions. While pneumococcal sends half a million people to the hospital each year, 4 out of 10 Americans over 65 still haven’t received a pneumococcal vaccine.
Importance of Flu Vaccination in Pregnancy
Experts continue to emphasize the benefits of flu vaccination among pregnant women. Expectant woman are six times more likely to die from flu when pregnant, and contracting the flu during pregnancy can result in dangerous complications, to include pre-term labor. Studies have shown that vaccinating pregnant woman can help protect the mother and her pregnancy while also transferring passive immunity on to their babies which can help protect them against flu for several months after they are born, while they are too young to be vaccinated themselves. While flu vaccination coverage for pregnant women remained similar to previous season at 49.9%, this statitic measn that nearly half of all pregnant women and their babies are not protected from flu.
No Nasal Spray Flu Vaccine This Year
One of the biggest changes in the flu vaccine recommendations for the 2016-2017 season involves the elimination of the use of the nasal spray flu vaccine this year. Read more…
At the National Foundation of Infectious Diseases (NFID) 2015 Annual Influenza/Pneumococcal News Conference held in Washington, DC last week, expert panelists spoke about the burden of influenza (flu) in the US and the importance of annual flu vaccination as the best way to protect yourself and your family.
Special thanks to Daniel B. Jernigan, MD, MPH, Director of the Influenza Division at the Centers for Disease Control and Prevention (CDC) for sharing his perspective on the importance of annual flu vaccination for all people 6 months of age and older.
How serious is the flu?
Flu is a contagious respiratory illness caused by influenza viruses that can cause mild to severe illness. Flu seasons can vary in severity depending on what viruses are circulating, but the flu is much more than a nuisance or common cold. Every flu season, millions of people get sick, hundreds of thousands are hospitalized…
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The CDC’s Advisory Committee on Immunization Practices (ACIP) voted to recommend MenB vaccine earlier today in order to protect young adults from the deadly “b” strain of meningitis. The full recommendation wording is as follows,
“A serogroup B meningococcal (MenB) vaccine series may be administered to adolescents and young adults 16 through 23 years of age to provide short term protection against most strains of serogroup B meningococcal disease. The preferred age for MenB vaccination is 16 through 18 years of age.”
Several hours of deliberation by the Committee followed by heartbreaking testimony from the National Meningitis Association, Meningitis Angels and several families devastated by the serogroup B strain of meningitis preceded the vote.
Members of the Committee felt that the data available currently regarding the short length of duration of protection with the vaccine, combined with the high cost burden of vaccinating the entire public for a disease that has a relatively low incidence rate, were some of the rationales for including the wording “may be vaccinated” in the recommendation. This wording designates the recommendation as a “Category B or permissive recommendation”
Many who testified feared that a Category B recommendation could cause confusion among providers and the public and would result in a lack of access if insurers failed to cover the costs of the vaccine. The Committee was assured by the CDC that a Category B recommendation will result in the vaccine being covered by the Vaccines For Children Program and the Affordable Care Act.
Meningitis survivor Andy Marso pleaded with the Committee to consider fully recommending the vaccine in order to avoid confusion among providers and inequitable access for the public. Andy contracted meningitis as a college student and racked up $2 million dollars in hospital bills within just the first year. “That would buy a lot of vaccines,” he stated.
“I need your help” he continued, “I want to make sure others don’t get meningitis because every time I hear of another person who contracts meningitis it strikes me in the chest.” “I wonder what if I had done more? What if I had talked to more people? Maybe my warnings could have reached that person. Maybe that person would have gotten vaccinated, or not shared that bacteria-ridden cup, or gotten to the hospital on time…I have a terrible responsibility now…and you can help free me by fully recommending the vaccine.”
As noted in a recent Shot of Prevention post, “the ACIP also recommends that adolescents receive the quadrivalent meningococcal conjugate vaccine (MCV4) at ages 11-12, with a booster dose at age 16, to protect against the A, C, W and Y strains of meningococcal bacteria. Statistics show that nearly 80% of teens have received at least one dose of this vaccine, which is fairly remarkable considering the fact that the vaccine is recommended, but is not mandated for school or college in most states. However, it’s important that parents realize that the MCV4 vaccine does not prevent serogroup B meningococcal disease, which currently accounts for 1/3 of all U.S. cases of meningococcal disease and has been spreading through college campuses in recent years.”
One thing is certain, moving forward there will be a herculean task of educating the public and providers about the new recommendation. Stay tuned for a more thorough post on the meeting in the coming days.
If you follow health news at all, you simply can’t ignore the fact that measles is showing up here, there and everywhere – from Minnesota , Utah and Vermont, to the New England Aquarium,
the Waldorf School in Charlottesville, VA, and even Dr. Bob Sears’ Facebook page.
The irony is that this blog is supported by Every Child By Two (ECBT) which was founded in 1991 as a result of a measles epidemic that killed nearly 150 people. The goals of ECBT have been to raise awareness of the critical need for timely immunizations and to foster a systematic way to immunize all of America’s children by age two.
In the past 20 years, we have come so far. In fact, in November 2002, measles was no longer considered an endemic disease in the Americas. However, the current measles cases are reason for concern. In the period from January 1st through May 20th, 2011, the U.S. has seen a record number of measles cases – 118 identified cases according to the Center for Disease Control and Prevention’s recent report – and with more recent cases that number will most certainly grow throughout the remainder of the year. So why, given the current situation, do we hear Dr. Bob telling the parent of an unvaccinated child that the measles outbreaks do not pose “much risk”?
Maybe it’s because 118 cases doesn’t sound like a lot to Dr. Bob and others. And oh, by the way, no one has died…yet…though 47 of them were hospitalized. However you look at it, the numbers indicate a concern. We haven’t seen this many cases of measles since 1996. Comparatively, in 2009, there were only a total of 71 cases of measles reported in the U.S. that year. So why are we in this situation now?
Well, perhaps the answer lies with overall global health. The CDC’s report has identified that 89% of the U.S. cases this year have stemmed from infections acquired outside the U.S. – in places such as Europe and Southeast Asia, where measles cases are much higher. For instance, France has reported more than 7,500 cases from Jan through March this year and cases have been reported in 38 countries across the region, including outbreaks in Spain, Serbia, Macedonia, and Turkey, among others. Maybe Americans should become more global minded when it comes to vaccine preventable diseases.
One way to do that would be to help fund vaccine initiatives in other countries. Another way would be to educate people – especially during the busy summer travel season – of the presence of certain vaccine preventable diseases, such as measles, that are prevalent in other countries.
But what about the people who purposely choose to refrain from being vaccinated? This is something we are seeing more recently, as opposed to when ECBT began 20 years ago. Despite the fact that CDC reports have shown that widespread use of measles vaccine has led to a greater than 99% reduction in measles cases in the United States compared with the pre-vaccine era, we still have 89% of the current measles cases occurring in unvaccinated individuals. Measles was once considered unheard of in the US, but now, the rise in cases demands close moderation to ensure that the decisions of the unvaccinated few are contained so as not to negatively impact the health of the many.
Perhaps today’s featured Shot By Shot video will help remind readers of the simple precaution you can take to avoid measles. Certainly, this mother would have prefered to have her child vaccinated than to watch her suffer with measles, which ultimately resulted in her hearing loss.
With measles showing up here and there, be sure to take precautions for yourself and your family. Check to make sure you are up-to-date on your vaccinations and talk to you doctor, especially if you are planning to travel outside the United States any time soon.
They’re something many parents are concerned about, and many want to be informed about.
Just this week, the Centers for Disease Control and Prevention issued their latest report on Vaccination Coverage Among Children in Kindergarten in the US for the 2009–10 School Year. Upon first glance, the report looks pretty good. More than half of the states reporting vaccination information to the CDC indicated that their overall exemption rates were around 1% or less. A few states, like Mississippi, Alabama and Tennessee reported less that 1% medical or non-medical exemptions.
However, upon closer examination, there are some definite areas of concern. Four states — Washington, Alaska, Oregon, and Vermont — had exemptions above 5%. While that may not sound like a large percentage, it’s dangerously close to the herd immunity threshold for certain vaccine preventable diseases. Take for instance the numbers in Washington State. With the highest percentage of exemptions, the report indicates that 6.2% of WA state’s children had a parent-signed exemption form recorded for one or more vaccines. But that is an overall state statistic. The Seattle Time’s reports that one county in particular – Ferry County – has nearly 20% of Kindergarteners opt out in 2009-2010.
As I engage in discussions with other parents, I have heard various concerns regarding vaccine exemptions. While reports like those we’ve seen from the CDC this week are certainly important for public health officials to get a snapshot of where we stand – state by state, and as a nation overall – parents are more interested in specific data for their own area. In other words, they are concerned about how exemptions relate to them personally, in their own schools. Read more…