Posts Tagged ‘vaccine’

New Research Reconfirms Vaccine Safety

April 8th, 2013

Fifteen years ago The Lancet published a case study that erroneously suggested that there could be a link between the MMR vaccine and autism.  That letter has long since been discredited, and back in 2010 The Lancet retracted the article.  Anti-vaccine advocates have been pointing to that long-since discredited 1998 case study to argue that there is some kind of link between vaccines and autism… even though numerous articles published in the last several years have all concluded that there is no such link.  

The Journal of Pediatrics just released another new study that again demonstrates that there’s no association between vaccines and autism development in children.  This new study looked at the number of antigens from vaccines that children receive (antigens are the things in vaccines that help our immune systems make the antibodies needed to fight disease).  This look at antigens was important because different shots have different amounts of antigens in them, so looking at the number of antigens kids received is more thorough than just looking at the total number of shots they got. 

This new study concluded that…  “These results indicate that parental concerns that their children are receiving too many vaccines in the first 2 years of life or too many vaccines at a single doctor visit are not supported in terms of an increased risk of autism.” 

 

H7N9 Influenza

April 5th, 2013

This week the WHO announced that several people in eastern China are infected with a newly mutated bird influenza virus called H7N9. All are in critical condition and some have died… but importantly the cases don’t appear to be linked- meaning it’s probably not from human to human transmission (that’s good). The World Health Organization website has more detail including answers to some Frequently Asked Questions

Global Influenza surveillance is a key public health tool… because early warning gives the global public health system an opportunity to squelch the outbreak before it breaks loose and causes a pandemic. It also gives us a head start on interventions and planning.   BTW… in case you were wondering, the H stands for hemagglutinin and N stands for neuraminidase- which are proteins on the virus’s surface. The numbers stand for the kind of protein for each letter.

Whooping Cough Booster & Pregnancy

April 4th, 2013

Whooping cough (pertussis) is a growing problem in the US and Arizona.  There were 41,880 cases and 14 infant deaths from pertussis in the US last year…  which is the largest number of cases since the vaccine became available in the 50s.  In Arizona there were 988 cases in 2012 and there’s a pretty substantial outbreak going on right now in Colorado City.  Anyone can get infected with whooping cough, but infants are most likely to die from it and family member – especially the infant’s mother – are the most likely to give it to infants. 

New data shows that a mother’s antibodies against pertussis are short-lived.  Therefore, giving pregnant women a booster shot in one pregnancy might not provide protection for the next.  In fact, new recommendations from the CDC’s Advisory Committee on Immunization Practices say that every pregnant woman should get a pertussis booster during every pregnancy.  Places to find vaccines can be found at The Arizona Partnership for Immunization (TAPI) website.

Next Season’s Influenza Vaccine

March 5th, 2013

Just as our influenza season winds down (and it is), it’s time to plan for the next one.  Every February the World Health Organization convenes a panel of experts to look at the most current data on the circulating flu strains from around the world and makes recommendations for the next season’s Northern Hemisphere flu vaccine.  At this week’s meeting in Geneva, the group recommended changing a B component of the vaccine, but sticking with the A/H3N2 and A/H1N1 components for next year. 

It may seem too early to be thinking about next year’s flu vaccine, but planning in February allows time for vaccine companies to grow the viruses and process the vaccine. The vaccine-making process still takes about 6 months… so it’s important to start as early as possible to ensure that vaccine is available for the start of the next flu season. Getting vaccinated against the flu every year is important, especially because the vaccine strains can change from year to year, as will happen for the 2013-2014 season.

Solve the Outbreak

March 4th, 2013

Check out CDC’s new iPad App, Solve the Outbreak, which lets you pretend you’re a disease outbreak investigator in the world-class Epidemic Intelligence Service by solving outbreaks based on real-life.  When new outbreaks happen, disease detectives are sent in to figure out how they started, before they can spread.  You get to investigate the outbreak and make decisions about confirming cases and implementing public health interventions like isolation and quarantine, social distancing, vaccine prioritization etc.  

The better your answers, the higher your score – and the more quickly you’ll save lives. You’ll start out as a Trainee and will earn badges by solving cases, with the goal of earning the top rank: Disease Detective.  Post your scores on Facebook or Twitter and challenge your friends to do better.  Download the free app today!  

BTW: Dr. Frieden (the CDC Director) paid us a visit during our monthly Local Health Officers meeting on Wednesday afternoon.  Check out the pictures on the Facebook.

Studying Vaccine Choice

January 25th, 2013

As I mentioned in a blog post a few weeks ago, more AZ parents are choosing not to vaccinate their kids- and using “personal exemptions” when they enroll their kids in school.  If the trend continues, we could jeopardize our immunization rates enough so that we’d see long gone diseases like measles and mumps return in AZ.  In order to figure out why more parents are making this choice, we asked Dr.’s Ernst & Jacobs at the UA’s College of Public Health to look into the “who, what, when, where and why” of this trend toward more personal belief exemptions.  I talked about the where exemptions are more common in my earlier blog, but now we have a better idea of why those rates have been growing – convenience, fear and recordkeeping.

One of the key tasks we asked the UA to look into is why more and more parents are choosing not to vaccinate their kids.  During town hall sessions with parents whose kids attended schools with high exemption rates… 62% of exempting parents said they had heard of someone who had a reaction to a vaccine. Parents who chose exemptions were concerned with the possible side-effects of immunizations and didn’t always trust information provided by the government and pharmaceutical companies.  A statewide survey of 131 clinicians found the main reasons parents refuse or delay immunizations is the unfounded fear their child will suffer long-term consequences from vaccine side-effects. The doctors cited personal conversations with parents as the most effective tool in educating parents about vaccines.

The studies done by the UA include recommendations about how to overcome some of the issues…  but much of it boils down to better education about vaccinations. Our Immunization Program website includes the findings and recommendations from the UA study.  I’ve also asked our immunization and maternal and child health teams to examine this new data and provide me with some intervention recommendations moving forward.

Influenza Going Gangbusters in US and AZ

January 10th, 2013

During the 2009- 2010 influenza pandemic, we saw how influenza can be unpredictable in terms of who it affects most, when it occurs, and what strains will circulate. This season is no exception. While the circulating strains are exactly what we predicted, the peak of the flu season is hitting earlier than usual (now) and it’s really spreading fast.  In fact, this week’s new Influenza Activity Report moved us into the “Widespread” category along with just about all the other states.  The CDC Summary Site will probably be updated today with the latest US data.  I bet just about every state will be on widespread status. 

In AZ, a few of our licensed medical facilities are currently on “Divert or Caution” meaning that they are at or near capacity with sick folks.  Our Licensing team will be in contact with several hospitals today.  Many are managing patient flow by prioritizing medical procedures and postponing those that are optional in order to save space and staffing for acutely sick folks.  We’ve given a couple of facilities permission to make adjustments to their normal procedures to better serve sick patients.

Preparedness is working on bed polls and communication with the county health officers/counties and media. We’ll continue to reach out to facilities to find out about capacity issues and work with them on messaging for alternate care sites and transferring patients within their own facilities. 

It’s too late to get the flu shot for the folks that are sick with influenza right now.  But if you haven’t gotten sick yet and have been putting it off- you better get on the stick

 

‘Tis the Season to Be Vaccinated…

December 19th, 2012

The CDC’s Advisory Committee on Immunization Practices released issued new recommendations to encourage pregnant women to get the whooping cough (pertussis) vaccine (Tdap) during their pregnancy.  Since most kids get whooping cough from a close family member, vaccinating parents (and teens) is one of the best ways to prevent infants, especially those who are too young to be fully protected from this life threatening infection.  Whooping cough cases have been increasing in AZ again this year, with over 900 cases as of a couple of weeks ago…  103 more than during the same time last year and 4 times more than we have in a typical year. 

There are many things contributing to the high rate of whooping cough in AZ and nationally. Symptoms are non-specific during the first two weeks- usually just a cough that won’t go away. Providers might not identify the case until weeks later when cough intensifies and the more classic signs like “whoop” are noticed. Even then, doc’s may not be able to diagnose it if the sick person looks fine during the office visit (if they’re between coughing fits). Whether the doctor is able to diagnose the patient or not, the person may have already infected others and the disease continues to spread. 

This leads to school or community outbreaks, especially in areas with low vaccination rates. This year, one outbreak has been ongoing since May.  Routine vaccination – given as DTaP in children or Tdap in adults – is important for preventing future outbreaks from occurring.  Talk to your doctor about pertussis vaccine – particularly if you spend a lot of time with babies.  Remember, the best gift for your children this holiday is to get vaccinated!

Vaccines & the Social Contract

December 14th, 2012

At the core- vaccines are really about community protection.  Our public health system depends on a solid network of providers that are available to vaccinate kids for all of the nasty infectious diseases that have plagued humanity for millennium. It’s not just access to care and a solid network of providers that vaccinate that are important- we also need folks to fulfill their social contract. In other words, we need just about everybody to participate and get vaccinated in order to get the herd immunity we all need to eliminate the spread of infectious vaccine-preventable diseases.  Vaccinating yourself and your kids is more about community protection than personal protection.  It’s a social contract that we have with each other to keep all of us healthy- just like it’s everyone’s responsibility to be a Good Samaritan when you see a car crash. 

For decades vaccination rates in the US and AZ have been pretty good.  The problems we had were due to the lack of access to care.  Low vaccination rates were mainly in low income areas where folks weren’t able to get to the doctor on time to get their shots or didn’t have insurance.  Over the decades, the public health and healthcare systems have closed many of those gaps- and immunization rates responded.  But now we have a new problem- more and more parents are purposely deciding to not vaccinate their kids.  The trend is increasingly jeopardizing us all.  It’s called a “personal exemption”. 

In order to figure out what to do next, we began working with the UA College of Public Health to find out the who, what, when, where, and why of this group of parents that are increasingly deciding to not vaccinate their kids.   Today the UA investigators published a preliminary report in the Journal Vaccine that gives us some insight into this population. 

The research team used data about personal exemptions from our 2010- 2011 kindergarten Immunization Data Report and linked it to data about education statistics to determine if there are similarities between the areas where there are more exemptions.  They found that schools where mostly white students attended, those with fewer students who use free and reduced lunch, and charter schools were more likely to have high exemption rates.  There are geographic differences too – those in the northern part of the state were more likely to have personal exemptions than those in the south – and the number of exemptions increased from west to east. 

These geographic and demographic details are important in designing the right intervention to help bring up herd immunity in the state.  This information will help the AZ public health system to improve the vaccination uptake and pay close attention to those areas if there is a disease outbreak.  A follow-up study is on the way that’ll look in more depth into why parents are increasingly choosing “personal exemptions” over vaccination.  We hope to use the combined data to develop intervention strategies to improve immunization rates moving forward.

RSV on the Upswing in AZ

December 12th, 2012

We’re off to an early start with the flu and RSV season this year with more cases reported in November than in previous seasons. Respiratory syncytial virus (or RSV) is a respiratory virus that mainly affects little kids and circulates during the winter. There’s no vaccine for RSV- but for those babies that are at highest risk (premature infants), doctors can give a preventive treatment throughout the season. The number of cases is still pretty small (about 100 so far this year), but we’ve had a 40% increase in cases over last year. That doesn’t always mean that there will be more cases this season, but it may just be a sign that our cases will happen earlier. 

Once RSV infections begin to increase we usually have high levels for a few months. Doctors who give RSV antibody to high-risk infants might want to start incorporate this info into their treatment plans soon- and it’s time for hospitals to start thinking about implementing their RSV prevention plans. Our flu numbers have also been high for this season (cases this week double from last week), so now is the perfect time to go out and get your flu shot. If you want to keep a watch on the numbers, our flu and RSV website has a host of useful information including periodic reports.