Category Archives: Vaccines

Oct 9 2013
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In a Government Shutdown, Who’s Tracking the Flu?

Add flu surveillance to the list of casualties of the current government shutdown.

Every flu season, states collect data on flu cases — including case reports and viral specimens — and send those to the Centers for Disease Control and Prevention (CDC) in Atlanta for recording and tracking. That tracking is critical in order to:

  • provide information on how well-matched the seasonal flu vaccine is to the flu viruses found in the community;
  • identify severe outbreaks that require increased supplies of antiviral medicines for people who contract the flu; and
  • identify emerging strains that might require a new vaccine to be developed this season, which is what happened several years ago when CDC identified the H1N1 influenza virus toward the end of the flu season, and quickly ramped up for a new vaccine.

Flu season generally runs October through April, with the peak from about January to March. If the shutdown continues then, “as the flu season goes on, our knowledge of what’s happening will be impaired,” says William Schaffner, MD, Professor of Preventive Medicine and Infectious Diseases, Vanderbilt University School of Medicine, and the immediate past president of the National Foundation for Infectious Diseases.

CDC director Thomas Frieden, MD, MPH, underscored his concern in a tweet on the first day of the government shutdown: “CDC had to furlough 8,754 people. They protected you yesterday, can't tomorrow. Microbes/other threats didn't shut down. We are less safe.”

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Oct 1 2013
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Public Health News Roundup: October 1

Health Insurance Marketplaces Under the Affordable Care Act Open Today in Every State
Health insurance marketplaces, also known as health insurance exchanges, open today in every state under the Patient Protection and Affordable Care Act, which was signed into law three years ago. Coverage obtained through the exchanges gives purchasers guaranteed access to health care and a range of preventive services, including cancer screenings; vaccinations; care for managing chronic diseases; and mental health and substance use services. “Most importantly…coverage will translate into more opportunities to live longer, healthier and fuller lives,” saidRisa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, which has launched a comprehensive resource site to help individuals, families and small businesses learn about coverage options available to them, and enroll. Read more on the Affordable Care Act.

2010 California Pertussis Outbreak Linked to ‘Personal Belief Exemptions’ to Vaccines
Researchers have linked the 2010 California pertussis—or “whopping cough”—outbreak to parents who refused to have their children vaccinated for other than medical reasons. During the outbreak, 9,120 people became sick and 10 infants died. The study, which was published in the journal Pediatrics, looked at both outbreaks and filed personal belief exemptions, finding that people who lived in areas with high rates of such exemptions were about 2.5 times more likely to live in an area with many cases of pertussis. Approximately 95 percent of a population must be vaccinated in order for it to maintain herd immunity. Read more on vaccines.

Study: Against Medical Advice, 14 Percent of Infants Sleep in the Same Bed as Parents, Caregivers
Despite the associated risks, many infants still sleep in the same bed as parents, other adults and or children, according to a new study in the journal JAMA Pediatrics. The rate has more than doubled since the early 1990s and now stands at about 14 percent. Such sleeping arrangements increase the risk of sudden infant death syndrome (SIDS) or death from other sleep-related causes. Study co-author Marian Willinger, special assistant for SIDS at the U.S. National Institute of Child Health and Human Development, said it is important for doctors to discuss proper sleep-time habits with new parents; the study found that parents who receive advice against sleeping in the same bed as infants are 34 percent less likely to do so. Read more on maternal and infant health.

Aug 28 2013
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Public Health News Roundup: August 28

Rotavirus Vaccinations for Babies Also Reduce Disease in Older Children, Adults
Regular rotavirus vaccinations for babies have also helped lower the rate of rotavirus-related hospitalizations for older children and adults since 2006, according to a new study in the Journal of the American Medical Association. Rotavirus can cause gastroenteritis, leading to severe diarrhea, vomiting, fever and abdominal pain. Ben Lopman, who worked on the study at the U.S. Centers for Disease Control and Prevention, told Reuters that the improved rates for older children and adults was an unexpected benefit of the vaccinations. An oral form of the vaccination became routine in 2007, after which rotavirus-related hospital discharges dropped by 70 percent for children ages 5-14, by 53 percent for people ages 15-24 and by 43 percent for adults ages 25-44. "This is one example of what we call herd immunity," he said. "By vaccinating young children you prevent them from getting sick, but you also prevent them from transmitting (rotavirus) to their siblings and their parents." Read more on vaccines.

Report: Fewer Kids Illegally Buying Tobacco Products
The Synar Amendment Program was started 16 years ago in an effort to prevent the sale of tobacco products to people under the age of 18. A new report from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) shows that it’s working, with only about 9 percent of retailers violating the ban, the second lowest rate since the law was enacted and far better than SAMHSA’s goal of 20 percent. In addition, 33 states and the District of Columbia now have local violation rates below 10 percent; and nine states have statewide violation rates below 5 percent. Still, Frances Harding, director of SAMHSA's Center for Substance Abuse Prevention, said that "Far more needs to be done to prevent kids and young adults from using tobacco, which is still the nation's leading cause of preventable death.” Read more on tobacco.

High Cholesterol Levels Dramatically Increases Heart Attack Risk in Middle-aged Men
While high cholesterol levels are dangerous for both men and women, middle-aged men with high levels have three times the risk of heart attack, according to a new study in the journal Epidemiology. Lead researcher Erik Madssen, MD, of the department of circulation and medical imaging at the Norwegian University of Science and Technology, said this means men with high cholesterol levels should be receiving more aggressive treatment than is currently common. The reason for the difference in risk still isn’t known, though Madssen said one possibility is the positive effects of estrogen. Both men and women can reduce the risk of heart attack by making lifestyle changes such as improved diet and exercise, as well as through medication; preventative efforts are especially important for people with a family history of heart disease. Read more on heart health.

Aug 20 2013
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Mumps Alert For College Campuses This Fall

Following several outbreaks of mumps cases on college and university campuses this past spring, the American College Health Association (ACHA) recently issued an alert urging institutes of higher education to keep mumps on their radar and require proof of complete mumps vaccination coverage for all students, which means having received two doses of MMR (measles, mumps and rubella) usually between 12 to 15 months and then again between the ages of 4 and 6.

According to the Centers for Disease Control and Prevention (CDC), up to half of people who contract mumps show very mild to no symptoms. However, the most common symptoms of mumps that may appear after 12 to 18 days of incubation include:

  • Fever
  • Headache
  • Muscle aches
  • Fatigue
  • Loss of appetite
  • Swollen and tender salivary glands under the ears

While mumps is usually a mild disease in children, contracting mumps after puberty can have adverse effects on both the male and female reproductive systems and in some cases can affect the central nervous system.

According to the chair of ACHA’s Vaccine Preventable Diseases Committee, Susan Even, MD, most colleges and universities already require two doses of the MMR vaccine for enrolled students. Even is also the executive director of the student health center at the University of Missouri, where she says the health center participates in new student orientation. Incoming students who are behind on immunizations including the full course of MMR are directed to come in to the health center and receive the appropriate boosters, which they can charge to their campus account.

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Jul 26 2013
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Recommended Reading: HHS Working to Improve Global Health

Even as the global population continues to grow, technological and societal advances mean that our world is constantly getting smaller. Or at least that we are becoming more interconnected.

Understanding this—that a person in a Midwestern U.S. state is better off when a person on the other side of the world has access to quality health care—the U.S. Department of Health and Human Services’ (HHS) Global Health Strategy is working with partners across the globe to improve the health of everyone.

"Although the chief mission of [HHS] is to enhance the health and well being of Americans, it is critically important that we cooperate with other nations and international organizations to reduce the risks of disease, disability, and premature death throughout the world," said HHS Secretary Kathleen Sebelius.

One of the most powerful initiatives has been the push toward greater immunization rates. Immunizations alone saved 3 million children’s lives in 2011. Over the past decade, premature deaths from measles have been cut by 71 percent and from tetanus by more than 90 percent. And polio is closer and closer to complete eradication.

Still, vaccine-preventable diseases still account for approximately one in four global deaths of children under the age of 5. And of the 22 million children who go without the full benefits of vaccines each year, it is often the poorest that are most affected.

Among the greatest continuing obstacles are the persistent myths surrounding vaccinations, such as the false and repeatedly debunked belief that they cause autism.

“Overcoming these mistaken beliefs has become an integral part of our work towards global vaccine access. Until we reach the day when no lives are lost to vaccine-preventable diseases, we will aggressively continue to develop new and improved vaccines and ensure they are available to everyone in every country.”

>> Read the full “Beyond our borders: Why the U.S. Department of Health and Human Services invests in global efforts” at DefeatDD.org.

Jul 26 2013
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Public Health News Roundup: July 26

MERS Unlikely to Cause Pandemic; Global Cooperation Still Needed
Middle East respiratory syndrome (MERS), which emerged last year in Saudi Arabia, was compared to severe acute respiratory syndrome (SARS) and found to be less infectious, in a new study published in The Lancet Infectious Diseases. The study examined the question of whether MERS has the potential to cause a pandemic, and how quickly. The study authors concluded that MERS does not yet have pandemic potential, and in fact appears to be less infectious than SARS. There have been 81 laboratory-confirmed cases of MERS infections, 45 of which were fatal. MERS is more likely to affect older men with chronic disease, and were most often transmitted in health care settings—but unlike SARS, the virus was less likely to also infect healthy health care workers. Researchers call for healthcare facilities to prepare to provide safe care for patients with acute respiratory infections, and take measures to help prevent the spread of the disease. Read more on infectious disease.

CDC: HPV Vaccination Rates for Adolescent Girls Remain Stagnant
Just over half (53.8%) of girls age 13-17 years old received the human papilloma virus (HPV) vaccine in 2012, with no increase over the rate in 2011. Since 2006, the Advisory Committee on Immunization Practices has recommended routine vaccination of adolescent girls at ages 11 or 12 years with 3 doses of HPV vaccine. HPV causes 70 percent of cervical cancers. If HPV vaccine had been offered during healthcare visits when girls were already in the office to get a different vaccine, HPV vaccination coverage could have reached 90 percent. Approximately 79 million persons in the United States are infected with HPV, and approximately 14 million will become newly infected each year. Each year, 26,000 new cases of cancer are diagnosed that can be traced back to HPV infection. Read more on vaccines.

New Breathalyzer-like Device Tells You If Your Workout is Working
New technology being prototyped in Japan measures how well you're burning body fat and help you gauge the success of your diet and exercise program, using a smartphone and pocket-sized, bluetooth enabled device. The device measures exhaled breath for acetone, a metabolite produced from fat burning. The researchers tested the device in 17 healthy men and women, reporting their findings online July 25 in the Journal of Breath Research, and finding that the device was as effective as more established "gold standard" measures. Further research is needed on larger, more diverse populations, but if it pans out, "Enabling users to monitor the state of fat burning could play a pivotal role in daily diet management," Hiyama said in a journal news release. Read more on technology.

Jul 24 2013
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Public Health News Roundup: July 24

Study: Pertussis Booster Only ‘Moderately’ Effective
The “booster” vaccine for pertussis—or whooping cough—is only “moderately” effective in preventing the disease in adolescents and adults, according to a new study in the journal BMJ. The Kaiser Permanente-backed study, which is the first to look at the effectiveness of the Tdap booster shot in the new generation that has only received acellular vaccines, found the effectiveness to be between 53 and 64 percent. This indicates that additional vaccinations may be required to adequately prevent outbreaks according to lead author Roger Baxter, MD, co-director of the Kaiser Permanente Vaccine Study Center. The state of California saw its highest number of cases of pertussis in more than 60 years in 2010, when it had more than 9,000 cases that led to 809 hospitalizations and 10 deaths, according to the National Center for Biotechnology Information. Read more on vaccines.

NYC Hospitals Prescribing Fruits, Vegetables to At-risk Youth
An apple a day to keep the doctor away? At two New York City hospitals, you can get a prescription for just that. Under a four-month pilot program, doctors at Lincoln Medical Center in the Bronx and Harlem Hospital are giving prescriptions for fruits and vegetables to at-risk youths. The kids and their families receive coupons which can be redeemed for product at local farmers markets and city green carts. “This is probably going to prevent an awful lot more disease over the long-term than a lot of the medicines we tend to write for,” said New York City Health Commissioner Thomas Farley, MD, said Tuesday in the green market outside Lincoln Medical Center. Read more on nutrition.

Breast Cancer Survival Times Shorter for Black Women
The fact that black women receive less health care overall than their white counterparts, combined with the lack of early screening and detection programs in many black communities, means they live an average of three fewer years with a breast cancer diagnosis, according to a new study in The Journal of the American Medical Association. Researchers at the University of Pennsylvania found that black women were less likely to receive an early diagnosis when the cancer was more treatable; they also found that quality of care was in general lower, though not enough to explain the survival gap. Data showed that 70 percent of white women lived at least five years after a breast cancer diagnosis, compared to 56 percent of black women. “Something is going wrong,” said Jeffrey H. Silber, MD, a professor at the University of Pennsylvania and the director of the Center for Outcomes Research at the Children’s Hospital of Philadelphia, which studies disparities in health care. “These are huge differences. We are getting there too late. That’s why we are seeing these differences in survival.” Read more on cancer.

Jul 19 2013
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“View” Co-Host Appointment Brings Media Flurry to Back to School Vaccines

The decision by the ABC Network to hire former model and MTV celebrity Jenny McCarthy to be a host on “The View,” a weekday talk show aimed at women, had vaccines in the news this week. It remains to be seen whether the increased attention will have an impact on the number of kids getting their shots, and getting them on time this year. In her book and in a myriad of interviews, McCarthy has linked her son’s diagnosis of autism with the Measles/Mumps/Rubella (MMR) vaccines he received as a baby. In a 2008 USA TODAY/Gallup Poll, a quarter of people surveyed said they were familiar with McCarthy’s views and of those respondents, 40 percent said her views would make them more likely to question the safety of vaccines.

As parents start setting up back to school visits, including many immunizations, for kids, Kristine Sheedy, PhD, associate director of communication science at the Centers for Disease Control and Prevention (CDC) National Center for Immunization and Respiratory Diseases, answered questions for NewPublicHealth about the impact of parents skipping or delaying childhood vaccines.

NewPublicHealth: What are the most common vaccines parents skip for their kids, and why? 

Kristine Sheedy: We know that parents and health care professionals across the U.S. are doing a good job protecting babies and young children from vaccine-preventable diseases because data from our 2011 National Immunization Survey (NIS) shows immunization coverage among children 19 to 35 months remained stable or increased for all recommended vaccines. In fact, coverage for most of the routine vaccines remains at or over 90 percent, and less than 1 percent of young children get no vaccinations.

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Jul 12 2013
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NACCHO Annual 2013: Immunizations as a Model for Integrating Public Health and Health Care

While immunizations are a ubiquitous symbol of public health, in the last decade or so many public health departments have shied away from using the icon on their home pages or even adding it to a top ten list of what they do in the hopes of making both citizens and policymakers realize that public health extends far beyond infectious disease. Yet as public health departments integrate their work with the private sector, who will do the vaccinating, how immunization records will be kept and who gets paid for the work are pivotal issues that local health officials are grappling with.

A well-attended session at the NACCHO Annual conference yesterday provided a few more questions than answers, but armed attendees with new information as implementation of the Affordable Care Act (ACA) begins and both public health and private providers see their roles change and merge. Significantly, the ACA is expected to enroll millions of children, and under new rules the Vaccines for Children program will no longer cover the cost for vaccines for children who can receive immunizations under their own insurance. That will reduce funding for some health departments.

Other changes ahead for vaccination coordination include the role of accountable care organizations (ACOs) in coordinating care under the ACA, electronic registries and billing for public health services, said Paul Etkind, MPH, DrPH, head of infectious diseases at NACCHO.

“Much of this has yet to play out, so there are many unknowns,” said Etkind, who added that vaccines are a good example of the need for up front conversations with providers about what public health has to offer and a good way for health departments to become part of ACOs. “Going forward there will be a greater emphasis on coordinating care between the public and private sectors, than in delivering the care in many cases and public health needs to be active players in this process.”

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Jul 9 2013
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Public Health News Roundup: July 9

Percentage of Single-father Households Up Dramatically
In 1960 only about 1 percent of households with children under the age of 18 were headed by single fathers. Today that number is a record 8 percent, or about 2.6 million in 2011. About one quarter of all single-parent households are headed by fathers. The climb in single fathers is due to largely the same reason as the climb in single mothers, according to data from Pew Research Trends. These include a dramatic increase in non-marital births and high divorce rates. However, there are notable differences between households headed by a single father or a single mother, with perhaps the greatest being that single fathers are generally better off financially. Read more on housing.

One in Seven Skin Cancer Patients Returns to Tanning Booth
Even after being diagnosed with skin cancer, one in seven people who use indoor tanning will return to a tanning booth within the next year, according to a new study in JAMA Dermatology. Research consistently shows that indoor tanning, which can emit up to 15 times the ultraviolet A radiation of the sun, dramatically increases the risk of cancer. "The situation may be analogous to that of lung cancer patients who continue to smoke after diagnosis," said study author Brenda Cartmel, a cancer prevention researcher at the Yale School of Public Health in New Haven, Conn., to Reuters. "Just as tobacco is known to be addictive, our research suggests that some patients may become dependent on tanning, with new intervention approaches needed to change these behaviors." About 20 million American visit tanning beds each year; the majority of them are young white women. Read more on cancer.

Majority of OB/GYNs Do Not Follow Guidelines on Cervical Cancer Prevention
Fewer than one-third of U.S. obstetricians-gynecologists vaccinate eligible patients against HPV and only about half follow the guidelines for cervical cancer prevention, according to a new study in the American Journal of Preventive Medicine. The American Congress of Obstetricians and Gynecologists recommend Pap tests beginning at the age of 21 and then gradually decreasing the rate of testing, depending on patient age and history. "In the current survey and others, providers stated that the largest barrier to HPV vaccination was patients and parents declining to receive the vaccine," said lead investigator Rebecca Perkins, MD, of the Boston University School of Medicine, in a release. "However, studies indicate that most patients support HPV vaccination, and that a strong physician recommendation is the most important determinant of vaccine uptake in young women." Read more on vaccines.