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Effectiveness of influenza vaccine against life-threatening RT-PCR-confirmed influenza illness in US children, 2010-2012

April 4, 2014 Comments off

Effectiveness of influenza vaccine against life-threatening RT-PCR-confirmed influenza illness in US children, 2010-2012
Source: Journal of Infectious Diseases

Background. 
No studies have examined the effectiveness of influenza vaccine against ICU admission associated with influenza virus infection among children.

Methods. 
In 2010-11 and 2011-12, children aged 6 months to 17 years admitted to 21 US pediatric intensive care units (PICUs) with acute severe respiratory illness and testing positive for influenza were enrolled as cases; children who tested negative were PICU controls. Community controls were children without an influenza-related hospitalization, matched to cases by comorbidities and geographic region. Vaccine effectiveness was estimated with logistic regression models.

Results. 
We analyzed data from 44 cases, 172 PICU controls, and 93 community controls. Eighteen percent of cases, 31% of PICU controls, and 51% of community controls were fully vaccinated. Compared to unvaccinated children, children who were fully vaccinated were 74% (95% CI, 19 to 91%) or 82% (95% CI, 23 to 96%) less likely to be admitted to a PICU for influenza compared to PICU controls or community controls, respectively. Receipt of one dose of vaccine among children for whom two doses were recommended was not protective.

Conclusion. 
During the 2010-11 and 2011-12 US influenza seasons, influenza vaccination was associated with a three-quarters reduction in the risk of life-threatening influenza illness in children.

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Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years — United States, 2014

February 21, 2014 Comments off

Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years — United States, 2014
Source: Morbidity and Mortality Weekly Report (CDC)

Each year, the Advisory Committee on Immunization Practices (ACIP) reviews the recommended immunization schedules for persons aged 0 through 18 years to ensure that the schedules reflect current recommendations for Food and Drug Administration–licensed vaccines. In October 2013, ACIP approved the recommended immunization schedules for persons aged 0 through 18 years for 2014, which include several changes from the 2013 immunization schedules.

See also: Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older — United States, 2014

Underlying issues are key to dispelling vaccine doubts

February 18, 2014 Comments off

Underlying issues are key to dispelling vaccine doubts (PDF)
Source: World Health Organization

Why is the same vaccine accepted in one part of the world and rejected in another? Heidi Larson tells Fiona Fleck why communicating the benefits versus the risks of vaccination is just part of the battle to gain public confidence in vaccines.

Heidi Larson is an anthropologist who has devoted the last two decades to bridging the gap between health providers and the public. In the last decade, her work has focused on increasing public confidence in vaccines. She leads the Vaccine Confidence Project at the London School of Hygiene & Tropical Medicine and is a member of the Vaccine Hesitancy Working Group of the Strategic Advisory Group of Experts (SAGE) on Immunization. She is also an associate professor in the Department of Global Health at the University of Washington, Seattle. From 2000 to 2005, she was head of communications for global immunization at the United Nations Children’s Fund (UNICEF), in particular supporting the introduction of new vaccines and chairing the advocacy taskforce for the GAVI Alliance.

Global Control and Regional Elimination of Measles, 2000–2012

February 14, 2014 Comments off

Global Control and Regional Elimination of Measles, 2000–2012
Source: Morbidity and Mortality Weekly Report (CDC)

In 2010, the World Health Assembly established three milestones toward global measles eradication to be reached by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged 1 year to ≥90% nationally and ≥80% in every district, 2) reduce and maintain annual measles incidence at <5 cases per million, and 3) reduce measles mortality by 95% from the 2000 estimate (1).* After the adoption by member states of the South-East Asia Region (SEAR) of the goal of measles elimination by 2020, elimination goals have been set by member states of all six World Health Organization (WHO) regions, and reaching measles elimination in four WHO regions by 2015 is an objective of the Global Vaccine Action Plan (GVAP).† This report updates the previous report for 2000–2011 (2) and describes progress toward global control and regional elimination of measles during 2000–2012.

During this period, increases in routine MCV coverage, plus supplementary immunization activities (SIAs)§ reaching 145 million children in 2012, led to a 77% decrease worldwide in reported measles annual incidence, from 146 to 33 per million population, and a 78% decline in estimated annual measles deaths, from 562,400 to 122,000. Compared with a scenario of no vaccination, an estimated 13.8 million deaths were prevented by measles vaccination during 2000–2012. Achieving the 2015 targets and elimination goals will require countries and their partners to raise the visibility of measles elimination and make substantial and sustained additional investments in strengthening health systems.

Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Empirical Assessment

January 29, 2014 Comments off

Vaccine Risk Perceptions and Ad Hoc Risk Communication: An Empirical Assessment
Source: Social Science Research Network

This Report presents empirical evidence relevant to assessing the claim—reported widely in the media and other sources—that the public is growing increasingly anxious about the safety of childhood vaccinations. Based on survey and experimental methods (N = 2,316), the Report presents two principal findings: first, that vaccine risks are neither a matter of concern for the vast majority of the public nor an issue of contention among recognizable demographic, political, or cultural subgroups; and second, that ad hoc forms of risk communication that assert there is mounting resistance to childhood immunizations themselves pose a risk of creating misimpressions and arousing sensibilities that could culturally polarize the public and diminish motivation to cooperate with universal vaccination programs. Based on these findings the Report recommends that government agencies, public health professionals, and other constituents of the public health establishment (1) promote the use of valid and appropriately focused empirical methods for investigating vaccine-risk perceptions and formulating responsive risk communication strategies; (2) discourage ad hoc risk communication based on impressionistic or psychometrically invalid alternatives to these methods; (3) publicize the persistently high rates of childhood vaccination and high levels of public support for universal immunization in the U.S.; and (4) correct ad hoc communicators who misrepresent U.S. vaccination coverage and its relationship to the incidence of childhood diseases.

Issue Brief: As Flu Season Ramps Up, Adults 18-64 Years Old Least Likely to Get Flu Shots

January 17, 2014 Comments off

Issue Brief: As Flu Season Ramps Up, Adults 18-64 Years Old Least Likely to Get Flu Shots
Source: Trust for America’s Health

An analysis by the Trust for America’s Health (TFAH) found that only 35.7 percent of adults ages 18 to 64 years old got the flu shot last season (the most recent period data with available data). By comparison, 56.6 percent of children (ages 6 months to 17 years old) and 66.2 percent of seniors (ages 65 and older) were vaccinated. The U.S. Centers for Disease Control and Prevention (CDC) recommends all American 6 months and older get vaccinated each year.

According to the CDC, the flu season in the United States is beginning to “ramp” up and flu is now widespread in 35 states. Rates are particularly high in 13 Southern and Central/Western states (Alabama, Arkansas, Indiana, Kansas, Louisiana, Mississippi, Missouri, Nevada, New Mexico, North Carolina, Oklahoma, Texas and Utah).

H1N1 is the most prevalent flu strain this season, which can disproportionately and adversely impact otherwise healthy children and young adults, according to the CDC.

Estimated Influenza Illnesses and Hospitalizations Averted by Influenza Vaccination — United States, 2012–13 Influenza Season

December 24, 2013 Comments off

Estimated Influenza Illnesses and Hospitalizations Averted by Influenza Vaccination — United States, 2012–13 Influenza Season
Source: Morbidity and Mortality Weekly Report (CDC)

Influenza is associated with substantial morbidity and mortality each year in the United States. From 1976 to 2007, annual deaths from influenza ranged from approximately 3,300 to 49,000 (1). Vaccination against influenza has been recommended to prevent illness and related complications, and since 2010, the Advisory Committee on Immunization Practices has recommended that all persons aged ≥6 months be vaccinated against influenza each year (2). In 2013, CDC published a model to quantify the annual number of influenza-associated illnesses and hospitalizations averted by influenza vaccination during the 2006–11 influenza seasons (3). Using that model with 2012–13 influenza season vaccination coverage rates, influenza vaccine effectiveness, and influenza hospitalization rates, CDC estimated that vaccination resulted in 79,000 (17%) fewer hospitalizations during the 2012–13 influenza season than otherwise might have occurred. Based on estimates of the percentage of influenza illnesses that involve hospitalization or medical attention, vaccination also prevented approximately 6.6 million influenza illnesses and 3.2 million medically attended illnesses. Influenza vaccination during the 2012–13 season produced a substantial reduction in influenza-associated illness. However, fewer than half of persons aged ≥6 months were vaccinated. Higher vaccination rates would have resulted in prevention of a substantial number of additional cases and hospitalizations.

Rubella and Congenital Rubella Syndrome Control and Elimination — Global Progress, 2000–2012

December 10, 2013 Comments off

Rubella and Congenital Rubella Syndrome Control and Elimination — Global Progress, 2000–2012
Source: Morbidity and Mortality Weekly Report (CDC)

Rubella virus usually causes a mild fever and rash in children and adults.* However, infection during pregnancy, especially during the first trimester, can result in miscarriage, stillbirth, or infants with congenital malformations, known as congenital rubella syndrome (CRS). In 2011, the World Health Organization (WHO) updated guidance on the preferred strategy for introduction of rubella-containing vaccine (RCV) into national routine immunization schedules with an initial wide-age-range vaccination campaign that includes children aged 9 months–15 years (1). WHO also urged all member states to take the opportunity offered by accelerated measles control and elimination activities as a platform to introduce RCVs (1). The Global Measles and Rubella Strategic Plan (2012–2020) published by the Measles Rubella Initiative partners in 2012 and the Global Vaccine Action Plan endorsed by the World Health Assembly in 2012 include milestones to eliminate rubella and CRS in two WHO regions by 2015, and eliminate rubella in five WHO regions by 2020. This report summarizes the global progress of rubella and CRS control and elimination during 2000–2012. As of December 2012, a total of 132 (68%) WHO member states had introduced RCV, a 33% increase from 99 member states in 2000. A total of 94,030 rubella cases were reported to WHO in 2012 from 174 member states, an 86% decrease from the 670,894 cases reported in 2000 from 102 member states. The WHO Region of the Americas (AMR) and European Region (EUR) have established rubella elimination goals of 2010 and 2015, respectively. AMR has started to document the elimination of measles, rubella, and CRS; in EUR, rubella incidence has decreased significantly, although outbreaks continue to occur.

The Role of Conspiracist Ideation and Worldviews in Predicting Rejection of Science

October 16, 2013 Comments off

The Role of Conspiracist Ideation and Worldviews in Predicting Rejection of Science
Source: PLoS ONE

Background
Among American Conservatives, but not Liberals, trust in science has been declining since the 1970′s. Climate science has become particularly polarized, with Conservatives being more likely than Liberals to reject the notion that greenhouse gas emissions are warming the globe. Conversely, opposition to genetically-modified (GM) foods and vaccinations is often ascribed to the political Left although reliable data are lacking. There are also growing indications that rejection of science is suffused by conspiracist ideation, that is the general tendency to endorse conspiracy theories including the specific beliefs that inconvenient scientific findings constitute a “hoax.”

Methodology/Principal findings
We conducted a propensity weighted internet-panel survey of the U.S. population and show that conservatism and free-market worldview strongly predict rejection of climate science, in contrast to their weaker and opposing effects on acceptance of vaccinations. The two worldview variables do not predict opposition to GM. Conspiracist ideation, by contrast, predicts rejection of all three scientific propositions, albeit to greatly varying extents. Greater endorsement of a diverse set of conspiracy theories predicts opposition to GM foods, vaccinations, and climate science.

Conclusions
Free-market worldviews are an important predictor of the rejection of scientific findings that have potential regulatory implications, such as climate science, but not necessarily of other scientific issues. Conspiracist ideation, by contrast, is associated with the rejection of all scientific propositions tested. We highlight the manifold cognitive reasons why conspiracist ideation would stand in opposition to the scientific method. The involvement of conspiracist ideation in the rejection of science has implications for science communicators.

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2013–2014

October 3, 2013 Comments off

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2013–2014
Source: Morbidity and Mortality Weekly Report (CDC)

This report updates the 2012 recommendations by CDC’s Advisory Committee on Immunization Practices (ACIP) regarding the use of influenza vaccines for the prevention and control of seasonal influenza (CDC. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2012;61:613–8). Routine annual influenza vaccination is recommended for all persons aged ≥6 months. For the 2013–14 influenza season, it is expected that trivalent live attenuated influenza vaccine (LAIV3) will be replaced by a quadrivalent LAIV formulation (LAIV4). Inactivated influenza vaccines (IIVs) will be available in both trivalent (IIV3) and quadrivalent (IIV4) formulations. Vaccine virus strains included in the 2013–14 U.S. trivalent influenza vaccines will be an A/California/7/2009 (H1N1)–like virus, an H3N2 virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011, and a B/Massachusetts/2/2012–like virus. Quadrivalent vaccines will include an additional influenza B virus strain, a B/Brisbane/60/2008–like virus, intended to ensure that both influenza B virus antigenic lineages (Victoria and Yamagata) are included in the vaccine. This report describes recently approved vaccines, including LAIV4, IIV4, trivalent cell culture-based inactivated influenza vaccine (ccIIV3), and trivalent recombinant influenza vaccine (RIV3). No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one product is otherwise appropriate. This information is intended for vaccination providers, immunization program personnel, and public health personnel. These recommendations and other information are available at CDC’s influenza website (http://www.cdc.gov/flu); any updates also will be found at this website. Vaccination and health-care providers should check the CDC influenza website periodically for additional information.

Influenza Vaccination Coverage Among Health-Care Personnel — United States, 2012–13 Influenza Season

September 30, 2013 Comments off

Influenza Vaccination Coverage Among Health-Care Personnel — United States, 2012–13 Influenza Season
Source: Morbidity and Mortality Weekly Report (CDC)

Routine influenza vaccination of health-care personnel (HCP) every influenza season can reduce influenza-related illness and its potentially serious consequences among HCP and their patients (1–5). To protect HCP and their patients, the Advisory Committee on Immunization Practices (ACIP) recommends that all HCP be vaccinated against influenza during each influenza season (5). To estimate influenza vaccination coverage among HCP during the 2012–13 season, CDC conducted an opt-in Internet panel survey of 1,944 self-selected HCP during April 1–16, 2013. This report summarizes the results of that survey, which found that, overall, 72.0% of HCP reported having had an influenza vaccination for the 2012–13 season, an increase from 66.9% vaccination coverage during the 2011–12 season (6). By occupation type, coverage was 92.3% among physicians, 89.1% among pharmacists, 88.5% among nurse practitioners/physician assistants, and 84.8% among nurses. By occupational setting, vaccination coverage was highest among hospital-based HCP (83.1%) and was lowest among HCP at long-term care facilities (LTCF) (58.9%). Vaccination coverage was higher for HCP in occupational settings offering vaccination on-site at no cost for one (75.7%) or multiple (86.2%) days compared with HCP in occupational settings not offering vaccination on-site at no cost (55.3%). Widespread implementation of comprehensive influenza vaccination strategies that focus on improving access to vaccination services is needed to improve HCP vaccination coverage. Influenza vaccination of HCP in all health-care settings might be increased by providing 1) HCP with information on vaccination benefits and risks for themselves and their patients, 2) vaccinations in the workplace at convenient locations and times, and 3) influenza vaccinations at no cost (7,8).

National, State, and Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2012

September 19, 2013 Comments off

National, State, and Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2012
Source: Morbidity and Mortality Weekly Report (CDC)

The National Immunization Survey (NIS) is a random-digit–dialed telephone survey used to monitor vaccination coverage among U.S. children aged 19–35 months. This report describes national, state, and selected local area vaccination coverage estimates for children born during January 2009–May 2011, based on results from the 2012 NIS. Healthy People 2020* objectives set childhood vaccination targets of 90% for ≥1 doses of measles, mumps, and rubella vaccine (MMR); ≥3 doses of hepatitis B vaccine (HepB); ≥3 doses of poliovirus vaccine; ≥1 doses of varicella vaccine; ≥4 doses of diphtheria, tetanus, and pertussis vaccine (DTaP); ≥4 doses of pneumococcal conjugate vaccine (PCV); and the full series of Haemophilus influenzae type b vaccine (Hib). Vaccination coverage remained near or above the national Healthy People 2020 target for ≥1 doses of MMR (90.8%), ≥3 doses of poliovirus vaccine (92.8%), ≥3 doses of HepB (89.7%), and ≥1 doses of varicella vaccine (90.2%). Coverage increased from 68.6% in 2011 to 71.6% in 2012 for the birth dose of HepB.† Coverage was below the Healthy People 2020 target and either decreased or remained stable relative to 2011 for ≥4 doses of DTaP (82.5%), the full series of Hib (80.9%), and ≥4 doses of PCV (81.9%). Coverage also remained stable relative to 2011 and below the Healthy People 2020 targets of 85% and 80%, respectively, for ≥2 doses of hepatitis A vaccine (HepA) (53.0%), and rotavirus vaccine (68.6%). The percentage of children who had not received any vaccinations remained <1.0%. Although disparities in coverage were not observed for most racial/ethnic groups, children living in families with incomes below the federal poverty level had lower coverage than children living in families at or above the poverty level for ≥4 doses of DTaP (by 6.5 percentage points), the full Hib series (by 7.6 percentage points), ≥4 doses of PCV (by 8.6 percentage points), ≥2 doses of HepA (by 6.0 percentage points), and rotavirus vaccine (by 9.5 percentage points). Maintaining high coverage levels is important to maintain the current low burden of vaccine-preventable diseases in the United States and prevent their resurgence (1).

Predicting the public health benefit of vaccinating cattle against Escherichia coli O157

September 18, 2013 Comments off

Predicting the public health benefit of vaccinating cattle against Escherichia coli O157
Source: Proceedings of the National Academy of Sciences

Identifying the major sources of risk in disease transmission is key to designing effective controls. However, understanding of transmission dynamics across species boundaries is typically poor, making the design and evaluation of controls particularly challenging for zoonotic pathogens. One such global pathogen is Escherichia coli O157, which causes a serious and sometimes fatal gastrointestinal illness. Cattle are the main reservoir for E. coli O157, and vaccines for cattle now exist. However, adoption of vaccines is being delayed by conflicting responsibilities of veterinary and public health agencies, economic drivers, and because clinical trials cannot easily test interventions across species boundaries, lack of information on the public health benefits. Here, we examine transmission risk across the cattle–human species boundary and show three key results. First, supershedding of the pathogen by cattle is associated with the genetic marker stx2. Second, by quantifying the link between shedding density in cattle and human risk, we show that only the relatively rare supershedding events contribute significantly to human risk. Third, we show that this finding has profound consequences for the public health benefits of the cattle vaccine. A naïve evaluation based on efficacy in cattle would suggest a 50% reduction in risk; however, because the vaccine targets the major source of human risk, we predict a reduction in human cases of nearly 85%. By accounting for nonlinearities in transmission across the human–animal interface, we show that adoption of these vaccines by the livestock industry could prevent substantial numbers of human E. coli O157 cases.

Measles — United States, January 1–August 24, 2013

September 13, 2013 Comments off

Measles — United States, January 1–August 24, 2013
Source: Morbidity and Mortality Weekly Report (CDC)

Measles is a highly contagious, acute viral illness that can lead to complications and death. Although measles elimination (i.e., interruption of continuous transmission lasting ≥12 months) was declared in the United States in 2000 (1), importation of measles cases continues to occur. During 2001–2012, the median annual number of measles cases reported in the United States was 60 (range: 37–220), including 26 imported cases (range: 18–80). The median annual number of outbreaks reported to CDC was four (range: 2–16). Since elimination, the highest numbers of U.S. cases were reported in 2008 (140 cases) and 2011 (220) (Figure 1) (2,3). To update measles data, CDC evaluated cases reported by 16 states during January 1–August 24, 2013. A total of 159 cases of measles were reported during this period. Most cases were in persons who were unvaccinated (131 [82%]) or had unknown vaccination status (15 [9%]). Forty-two importations were reported, and 21(50%) were importations from the World Health Organization (WHO) European Region. Eight outbreaks accounted for 77% of the cases reported in 2013, including the largest outbreak reported in the United States since 1996 (58 cases) (4). These outbreaks demonstrate that unvaccinated persons place themselves and their communities at risk for measles and that high vaccination coverage is important to prevent the spread of measles after importation.

CDC Releases 2014 Edition of “Yellow Book”

August 30, 2013 Comments off

CDC Releases 2014 Edition of “Yellow Book”
Source: Centers for Disease Control and Prevention

The Centers for Disease Control and Prevention today released the online version of the 2014 edition of CDC Health Information for International Travel, commonly known as the “Yellow Book.” Nicknamed for its yellow cover, this is the ultimate guide for healthy international travel. The most recent version includes special guidance for people who will be living long-term in areas with malaria. The 2014 edition also expanded its chapter on select destinations, providing insiders’ knowledge and specific health risks about popular tourist destinations.

A team of almost 200 experts update this health guide every two years. The Yellow Book provides the latest official CDC recommendations to keep international travelers safe and healthy. It includes a complete catalog of travel-related diseases and up-to-date vaccine and booster recommendations. The information in the book does not just stop with infectious diseases; it also includes advice about preventing and treating common travel-related ailments such as altitude illness, motion sickness, and jet lag. The book offers useful tips on topics such as traveling with pets, packing a travel health kit, avoiding counterfeit medications in foreign countries, and getting travel health and evacuation insurance for emergencies. In addition, the Yellow Book provides advice for people traveling with young children, individuals with disabilities or chronic illnesses, and those traveling for humanitarian aid work or study abroad.

Ischaemic heart disease, influenza and influenza vaccination: a prospective case control study

August 22, 2013 Comments off

Ischaemic heart disease, influenza and influenza vaccination: a prospective case control study
Source: Heart (BMJ)

Background
Abundant, indirect epidemiological evidence indicates that influenza contributes to all-cause mortality and cardiovascular hospitalisations with studies showing increases in acute myocardial infarction (AMI) and death during the influenza season.

Objective
To investigate whether influenza is a significant and unrecognised underlying precipitant of AMI.

Design
Case-control study.

Setting
Tertiary referral hospital in Sydney, Australia, during 2008 to 2010.

Patients
Cases were inpatients with AMI and controls were outpatients without AMI at a hospital in Sydney, Australia.

Main outcome measures
Primary outcome was laboratory evidence of influenza. Secondary outcome was baseline self-reported acute respiratory tract infection.

Results
Of 559 participants, 34/275 (12.4%) cases and 19/284 (6.7%) controls had influenza (OR 1.97, 95% CI 1.09 to 3.54); half were vaccinated. None were recognised as having influenza during their clinical encounter. After adjustment, influenza infection was no longer a significant predictor of recent AMI. However, influenza vaccination was significantly protective (OR 0.55, 95% CI 0.35 to 0.85), with a vaccine effectiveness of 45% (95% CI 15% to 65%).

Conclusions
Recent influenza infection was an unrecognised comorbidity in almost 10% of hospital patients. Influenza did not predict AMI, but vaccination was significantly protective but underused. The potential population health impact of influenza vaccination, particularly in the age group 50–64 years, who are at risk for AMI but not targeted for vaccination, should be further explored. Our data should inform vaccination policy and cardiologists should be aware of missed opportunities to vaccinate individuals with ischaemic heart disease against influenza.

See: Flu Shot May Halve Heart Attack Risk in Middle Aged With Narrowed Arteries (Science Daily)

Vaccination Coverage Among Children in Kindergarten — United States, 2012–13 School Year

August 3, 2013 Comments off

Vaccination Coverage Among Children in Kindergarten — United States, 2012–13 School Year
Source: Morbidity and Mortality Weekly Report (CDC)

State and local school vaccination requirements are implemented to maintain high vaccination coverage and minimize the risk from vaccine preventable diseases (1). To assess school vaccination coverage and exemptions, CDC annually analyzes school vaccination coverage data from federally funded immunization programs. These awardees include 50 states and the District of Columbia (DC), five cities, and eight U.S.-affiliated jurisdictions.* This report summarizes vaccination coverage from 48 states and DC and exemption rates from 49 states and DC for children entering kindergarten for the 2012–13 school year. Forty-eight states and DC reported vaccination coverage, with medians of 94.5% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 95.1% for local requirements for diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccination; and 93.8% for 2 doses of varicella vaccine among awardees with a 2-dose requirement. Forty-nine states and DC reported exemption rates, with the median total of 1.8%. Although school entry coverage for most awardees was at or near national Healthy People 2020 targets of maintaining 95% vaccination coverage levels for 2 doses of MMR vaccine, 4 doses of DTaP† vaccine, and 2 doses of varicella vaccine (2), low vaccination and high exemption levels can cluster within communities, increasing the risk for disease. Reports to CDC are aggregated at the state level; however, local reporting of school vaccination coverage might be accessible by awardees. These local-level data can be used to create evidence-based health communication strategies to help parents understand the risks for vaccine-preventable diseases and the benefits of vaccinations to the health of their children and other kindergarteners.

Human Papillomavirus Vaccination Coverage Among Adolescent Girls, 2007–2012, and Postlicensure Vaccine Safety Monitoring, 2006–2013 — United States

July 30, 2013 Comments off

Human Papillomavirus Vaccination Coverage Among Adolescent Girls, 2007–2012, and Postlicensure Vaccine Safety Monitoring, 2006–2013 — United States
Source: Morbidity and Mortality Weekly Report (CDC)

Since mid-2006, the Advisory Committee on Immunization Practices (ACIP) has recommended routine vaccination of adolescent girls at ages 11 or 12 years with 3 doses of human papillomavirus (HPV) vaccine (1). Two HPV vaccines are currently available in the United States. Both the quadrivalent (HPV4) and bivalent (HPV2) vaccines protect against HPV types 16 and 18, which cause 70% of cervical cancers and the majority of other HPV-associated cancers; HPV4 also protects against HPV types 6 and 11, which cause 90% of genital warts.* This report summarizes national HPV vaccination coverage levels among adolescent girls aged 13–17 years† from the 2007–2012 National Immunization Survey-Teen (NIS-Teen) and national postlicensure vaccine safety monitoring. Although vaccination coverage with ≥1 dose of any HPV vaccine increased from 25.1% in 2007 to 53.0% in 2011, coverage in 2012 (53.8%) was similar to 2011. If HPV vaccine had been administered during health-care visits when another vaccine was administered, vaccination coverage for ≥1 dose could have reached 92.6%. Safety monitoring data continue to indicate that HPV4 is safe. Despite availability of safe and effective vaccines and ample opportunities for vaccine delivery in the health-care setting, HPV vaccination coverage among adolescent girls failed to increase from 2011 to 2012.

HPV vaccine acceptability among men: a systematic review and meta-analysis

July 23, 2013 Comments off

HPV vaccine acceptability among men: a systematic review and meta-analysis
Source: Sexually Transmitted Infections

Objective
To understand rates of human papillomavirus (HPV) vaccine acceptability and factors correlated with HPV vaccine acceptability.

Design
Meta-analyses of cross-sectional studies.

Data sources
We used a comprehensive search strategy across multiple electronic databases with no date or language restrictions to locate studies that examined rates and/or correlates of HPV vaccine acceptability. Search keywords included vaccine, acceptability and all terms for HPV.

Review methods
We calculated mean HPV vaccine acceptability across studies. We conducted meta-analysis using a random effects model on studies reporting correlates of HPV vaccine acceptability. All studies were assessed for risk of bias.

Results
Of 301 identified studies, 29 were included. Across 22 studies (n=8360), weighted mean HPV vaccine acceptability=50.4 (SD 21.5) (100-point scale). Among 16 studies (n=5048) included in meta-analyses, perceived HPV vaccine benefits, anticipatory regret, partner thinks one should get vaccine and healthcare provider recommendation had medium effect sizes, and the following factors had small effect sizes on HPV vaccine acceptability: perceived HPV vaccine effectiveness, need for multiple shots, fear of needles, fear of side effects, supportive/accepting social environment, perceived risk/susceptibility to HPV, perceived HPV severity, number of lifetime sexual partners, having a current sex partner, non-receipt of hepatitis B vaccine, smoking cigarettes, history of sexually transmitted infection, HPV awareness, HPV knowledge, cost, logistical barriers, being employed and non-white ethnicity.

Conclusions
Public health campaigns that promote positive HPV vaccine attitudes and awareness about HPV risk in men, and interventions to promote healthcare provider recommendation of HPV vaccination for boys and mitigate obstacles due to cost and logistical barriers may support HPV vaccine acceptability for men. Future investigations employing rigorous designs, including intervention studies, are needed to support effective HPV vaccine promotion among men.

The HPV Vaccine: Access and Use in the U.S.

July 16, 2013 Comments off

The HPV Vaccine: Access and Use in the U.S.
Source: Kaiser Family Foundation

Vaccination rates have slowly been increasing for the two vaccines that protect young people against infection by certain strains of the human papillomavirus (HPV), the most common sexually transmitted infection (STI) in the United States. The vaccines were originally recommended only for girls and young women and were subsequently broadened to include the recommendations for boys and young men. This factsheet discusses HPV and related cancers, use of the HPV vaccines for both females and males, and insurance coverage and access to the vaccines.

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