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Notes from the Field: Hospitalizations for Respiratory Disease Among Unaccompanied Children from Central America — Multiple States, June–July 2014

August 18, 2014 Comments off

Notes from the Field: Hospitalizations for Respiratory Disease Among Unaccompanied Children from Central America — Multiple States, June–July 2014
Source: Morbidity and Mortality Weekly Report (CDC)

During October 2013–June 2014, approximately 54,000 unaccompanied children, mostly from the Central American countries of El Salvador, Guatemala, and Honduras, were identified attempting entry into the United States from Mexico, exceeding numbers reported in previous years (1). Once identified in the United States, U.S. Customs and Border Protection, an agency of the U.S. Department of Homeland Security, processes the unaccompanied children and transfers them to the Office of Refugee Resettlement (ORR), an office of the Administration for Children and Families, U.S. Department of Health and Human Services. ORR cares for the children in shelters until they can be released to a sponsor, typically a parent or relative, who can care for the child while their immigration case is processed. In June 2014, in response to the increased number of unaccompanied children, U.S. Customs and Border Protection expanded operations to accommodate children at a processing center in Nogales, Arizona. ORR, together with the U.S. Department of Defense, opened additional large temporary shelters for the children at Lackland Air Force Base, Texas; U.S. Army Garrison Ft. Sill, Oklahoma; and Naval Base Ventura County, California.

On July 10, 2014, CDC was informed by the California Department of Public Health and ORR about four unaccompanied male children aged 14–16 years with respiratory illnesses at Naval Base Ventura County, three of whom were hospitalized with pneumonia. Among the three patients with pneumonia, two were bacteremic with Streptococcus pneumoniae, ultimately determined to be serotype 5, one of whom also had laboratory-confirmed influenza B virus by polymerase chain reaction (PCR). The fourth patient, without pneumonia, had PCR-confirmed influenza A(H1N1)pdm09. Pneumococcal bacteremia is uncommon among U.S. adolescents, particularly serotype 5, with only three such cases identified in the past 10 years by CDC (2). In addition, influenza activity in the United States is typically lowest in the middle of summer, and Ventura County had no reports of an unusual increase in influenza activity in the community at the time. ORR asked CDC to investigate the scope of this apparent outbreak and implement measures to interrupt transmission.

During July 6–19, 2014, CDC was informed of other clusters of hospitalized children with respiratory disease, increasing the total to 16 cases. The cases were from Naval Base Ventura County (eight cases), Ft. Sill (three), Lackland Air Force Base (two), a standard ORR shelter near Houston, Texas (two), and the Nogales processing center (one). Cases were in persons aged 14–17 years. Diagnoses included laboratory-confirmed pneumococcal pneumonia with laboratory-confirmed influenza (three cases) and without laboratory-confirmed influenza (four cases), influenza pneumonia (one case), and pneumonia with no identified etiology (eight cases). Five patients experienced septic shock requiring intensive care. No case was fatal. All six cases for which pneumococcal isolates were available were identified as serotype 5, a serotype included in 13-valent pneumococcal conjugate vaccine (PCV13) (Prevnar-13, Pfizer). Of the 16 patients identified in this cluster, 11 were tested for influenza viruses; four (36%) were positive (two for influenza A[H1N1]pdm09, one for influenza B, and one for influenza A by rapid test).

Because of the concern that unaccompanied children were at increased risk for influenza and pneumococcal pneumonia in this outbreak setting and the clinically important interaction between influenza and pneumococcal infections (3), CDC recommended that all children residing in temporary or standard ORR shelters receive influenza vaccine and PCV13 in addition to routinely recommended vaccines. Approximately 2,000 children in four affected shelters were vaccinated during July 18–30 with PCV13 and with Food and Drug Administration–approved extended expiration date–specific lots of 2013–14 seasonal influenza vaccine, which includes influenza A(H1N1)pdm09 and influenza B viruses. The shelters reported no serious adverse events.

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Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) — United States, 2014–15 Influenza Season

August 15, 2014 Comments off

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) — United States, 2014–15 Influenza Season
Source: Morbidity and Mortality Weekly Report (CDC)

This report updates the 2013 recommendations by the Advisory Committee on Immunization Practices (ACIP) regarding use of seasonal influenza vaccines (1). Updated information for the 2014–15 influenza season includes 1) antigenic composition of U.S. seasonal influenza vaccines; 2) vaccine dose considerations for children aged 6 months through 8 years; and 3) a preference for the use, when immediately available, of live attenuated influenza vaccine (LAIV) for healthy children aged 2 through 8 years, to be implemented as feasible for the 2014–15 season but not later than the 2015–16 season. Information regarding issues related to influenza vaccination not addressed in this report is available in the 2013 ACIP seasonal influenza recommendations (1).

Notes from the Field: Outbreak of Pertussis in a School and Religious Community Averse to Health Care and Vaccinations — Columbia County, Florida, 2013

August 3, 2014 Comments off

Notes from the Field: Outbreak of Pertussis in a School and Religious Community Averse to Health Care and Vaccinations — Columbia County, Florida, 2013
Source: Morbidity and Mortality Weekly Report (CDC)

On August 30, 2013, the Florida Department of Health in Columbia County was notified of a Bordetella pertussis laboratory-positive unimmunized child attending a local charter school (316 students from pre-K through 8th grade) in a large religious community averse to health care and vaccinations. Kindergarten immunization records showed that only five (15%) of 34 students were fully immunized with pertussis-antigen–containing vaccines. In seventh grade, only one (5%) of 22 students was fully immunized with pertussis-antigen–containing vaccines. Of the children who were not fully immunized in these two grades, 84% had religious exemptions (1).

Interviews confirmed that a sibling of the patient had symptoms consistent with pertussis. By September 3, two additional children from the same school were confirmed by polymerase chain reaction to have pertussis. On September 12, the Florida Department of Health in Columbia County declared a communicable disease emergency; children with cough illness were excluded from school, and reentry required an evaluation by a health care provider. After this declaration, 38 additional students were excluded. Prophylaxis or treatment with antibiotics following current guidelines were provided to patients and household contacts (2). The local health department offered to provide these services free of charge to persons without health care coverage. Pertussis vaccine administered at the health department was available; however, fewer than five persons from the community used this opportunity for vaccination.

Human Papillomavirus Vaccination Coverage Among Adolescents, 2007–2013, and Postlicensure Vaccine Safety Monitoring, 2006–2014 — United States

July 30, 2014 Comments off

Human Papillomavirus Vaccination Coverage Among Adolescents, 2007–2013, and Postlicensure Vaccine Safety Monitoring, 2006–2014 — United States
Source: Morbidity and Mortality Weekly Report (CDC)

Since mid-2006, a licensed human papillomavirus (HPV) vaccine has been available and recommended by the Advisory Committee on Immunization Practices (ACIP) for routine vaccination of adolescent girls at ages 11 or 12 years (1). Two vaccines that protect against HPV infection 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; HPV4 also protects against HPV types 6 and 11, which cause 90% of genital warts (1,2). In 2011, the ACIP also recommended HPV4 for the routine vaccination of adolescent boys at ages 11 or 12 years (3). HPV vaccines can be safely co-administered with other routinely recommended vaccines, and ACIP recommends administration of all age-appropriate vaccines during a single visit (4). To assess progress with HPV vaccination coverage among adolescents aged 13–17 years,* characterize adherence with recommendations for HPV vaccination by the 13th birthday, and describe HPV vaccine adverse reports received postlicensure, CDC analyzed data from the 2007–2013 National Immunization Survey-Teen (NIS-Teen) and national postlicensure vaccine safety data among females and males. Vaccination coverage with ≥1 dose of any HPV vaccine increased significantly from 53.8% (2012) to 57.3% (2013) among adolescent girls and from 20.8% (2012) to 34.6% (2013) among adolescent boys. Receipt of ≥1 dose of HPV among girls by age 13 years increased with each birth cohort; however, missed vaccination opportunities were common. Had HPV vaccine been administered to adolescent girls born in 2000 during health care visits when they received another vaccine, vaccination coverage for ≥1 dose by age 13 years for this cohort could have reached 91.3%. Postlicensure monitoring data continue to indicate that HPV4 is safe. Improving practice patterns so that clinicians use every opportunity to recommend HPV vaccines and address questions from parents can help realize reductions in vaccine-preventable infections and cancers caused by HPV.

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2013

July 30, 2014 Comments off

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2013
Source: Morbidity and Mortality Weekly Report (CDC)

The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents routinely receive 1 dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine, 2 doses of meningococcal conjugate (MenACWY) vaccine, and 3 doses of human papillomavirus (HPV) vaccine (1,2).* ACIP also recommends administration of “catch-up”† vaccinations, such as measles, mumps, and rubella (MMR), hepatitis B, and varicella, and, for all persons aged ≥6 months, an annual influenza vaccination (1). ACIP recommends administration of all age-appropriate vaccines during a single visit (3). To assess vaccination coverage among adolescents aged 13–17 years, CDC analyzed data from the 2013 National Immunization Survey-Teen (NIS-Teen).§ This report summarizes the results of that analysis, which show that from 2012 to 2013, coverage increased for each of the vaccines routinely recommended for adolescents: from 84.6% to 86.0% for ≥1 Tdap dose; from 74.0% to 77.8% for ≥1 MenACWY dose; from 53.8% to 57.3% for ≥1 HPV dose among females, and from 20.8% to 34.6% for ≥1 HPV dose among males. Coverage varied by state and local jurisdictions and by U.S. Department of Health and Human Services (HHS) region. Healthy People 2020 vaccination targets for adolescents aged 13–15 years (4) were reached in 42 states for ≥1 Tdap dose, 18 for ≥1 MenACWY dose, and 11 for ≥2 varicella doses. No state met the target for ≥3 HPV doses.¶ Use of patient reminder and recall systems, immunization information systems, coverage assessment and feedback to clinicians, clinician reminders, standing orders, and other interventions can help make use of every health care visit to ensure that adolescents are fully protected from vaccine-preventable infections and cancers (5), especially when such interventions are coupled with clinicians’ vaccination recommendations.

Influenza Activity — United States, 2013–14 Season and Composition of the 2014–15 Influenza Vaccines

June 9, 2014 Comments off

Influenza Activity — United States, 2013–14 Season and Composition of the 2014–15 Influenza Vaccines
Source: Morbidity and Mortality Weekly Report (CDC)

During the 2013–14 influenza season in the United States, influenza activity increased through November and December before peaking in late December. Influenza A (H1N1)pdm09 (pH1N1) viruses predominated overall, but influenza B viruses and, to a lesser extent, influenza A (H3N2) viruses also were reported in the United States. This influenza season was the first since the 2009 pH1N1 pandemic in which pH1N1 viruses predominated and was characterized overall by lower levels of outpatient illness and mortality than influenza A (H3N2)–predominant seasons, but higher rates of hospitalization among adults aged 50–64 years compared with recent years. This report summarizes influenza activity in the United States for the 2013–14 influenza season (September 29, 2013–May 17, 2014) and reports recommendations for the components of the 2014–15 Northern Hemisphere influenza vaccines.

Just Released: Measles — United States, January 1–May 23, 2014

May 29, 2014 Comments off

Measles — United States, January 1–May 23, 2014
Source: Morbidity and Mortality Weekly Report (CDC)

Measles is a highly contagious, acute viral illness that can lead to serious complications and death. Although measles elimination (i.e., interruption of year-round endemic transmission) was declared in the United States in 2000 (1), importations of measles cases from endemic areas of the world continue to occur, leading to secondary measles cases and outbreaks in the United States, primarily among unvaccinated persons (2). To update national measles data in the United States, CDC evaluated cases reported by states from January 1 through May 23, 2014. A total of 288 confirmed measles cases have been reported to CDC, surpassing the highest reported yearly total of measles cases since elimination (220 cases reported in 2011) (3). Fifteen outbreaks accounted for 79% of cases reported, including the largest outbreak reported in the United States since elimination (138 cases and ongoing). The large number of cases this year emphasizes the need for health-care providers to have a heightened awareness of the potential for measles in their communities and the importance of vaccination to prevent measles.

Benefits from Immunization During the Vaccines for Children Program Era — United States, 1994–2013

April 24, 2014 Comments off

Benefits from Immunization During the Vaccines for Children Program Era — United States, 1994–2013
Source: Morbidity and Mortality Weekly Report (CDC)

The Vaccines for Children (VFC) program was created by the Omnibus Budget Reconciliation Act of 1993 (1) and first implemented in 1994. VFC was designed to ensure that eligible children do not contract vaccine-preventable diseases because of inability to pay for vaccine and was created in response to a measles resurgence in the United States that resulted in approximately 55,000 cases reported during 1989–1991 (2). The resurgence was caused largely by widespread failure to vaccinate uninsured children at the recommended age of 12–15 months. To summarize the impact of the U.S. immunization program on the health of all children (both VFC-eligible and not VFC-eligible) who were born during the 20 years since VFC began, CDC used information on immunization coverage from the National Immunization Survey (NIS) and a previously published cost-benefit model to estimate illnesses, hospitalizations, and premature deaths prevented and costs saved by routine childhood vaccination during 1994–2013. Coverage for many childhood vaccine series was near or above 90% for much of the period. Modeling estimated that, among children born during 1994– 2013, vaccination will prevent an estimated 322 million illnesses, 21 million hospitalizations, and 732,000 deaths over the course of their lifetimes, at a net savings of $295 billion in direct costs and $1.38 trillion in total societal costs. With support from the VFC program, immunization has been a highly effective tool for improving the health of U.S. children.

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.

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).

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