February 2016
Vaccine Update for Healthcare Providers

This newsletter is meant to keep you up to date on issues related to vaccines. We welcome your comments and questions; please email us at vacinfo@email.chop.edu.

VEC Announcements

Teen booklets revised

The Vaccine Education Center’s (VEC) teen booklet, Vaccines and Teens: The Busy Social Years, is now updated to include information about HPV-9 and meningococcus B vaccines. Revised files in English and Spanish can be viewed or printed from the VEC website.

Printed versions of the booklet are also available for order online or using the PDF order form. Booklets are $1 each plus modest shipping costs. For example, shipping of one to 50 booklets is $5.

Addressing nosodes

Some people have wondered if they could replace vaccination with the homeopathic treatment called nosodes. Nosodes are made using fluid from an infected person and serial diluting it to a point at which no infectious material remains.

Because providers are being asked about this in some regions of the country, we have posted a short response to the question, “Are nosodes viable alternatives to vaccination?” on the vaccine safety portion of our website in the section titled “Immune system and health” (scroll to find the content lower on the page).

Other content related to the immune system and vaccines that you can find on this page includes:

Is natural infection better than immunization?
Are vaccines natural?
Do vaccines overwhelm the immune system? (This entry includes a list of the number of immunogenic proteins or sugars contained in vaccines over the past 100 years.)
Do vaccines weaken the immune system?
Can sick children receive vaccines?
Are children too young to receive vaccines?
Can children manage so many vaccines?

You can link to, print or photocopy these responses to share with parents as long as you indicate the VEC as the source, and on printed information include either the date the material was last updated by the VEC or the date that you accessed the information.

References for ADD/ADHD and vaccines

Although Dr. Offit had addressed the concern that vaccines might be causally associated with attention-related disorders (ADD/ADHD) in other venues, we did not address it on our website. Therefore, we recently added information summarizing the main studies related to this concern. The new information has been added on a new page in the Vaccines and Other Conditions section of our website.

As with the previous section, you can link to, print or photocopy this information to share with parents provided that any handouts include source and date information.

Webinar announcements

Please read these two important announcements related to our webinar program:

March 23 webinar registration is open — Registration is now open for the next Current Issues in Vaccines webinar. Scheduled for Wednesday, March 23, at noon ET, Dr. Offit will discuss the following topics:

HPV vaccine: Is it time for a two-dose schedule?
Meningococcal serogroup B vaccines: The latest evidence
Influenza vaccines and egg allergy: An update

Webinars are free of charge and continuing education credits (CME, CEU and CPE) will be available.

Change of date for September webinar — Due to a conflict with the National Immunization Conference (scheduled for Sept. 13 – 15, 2016, in Atlanta, GA), the September Current Issues in Vaccines webinar will be presented on Wednesday, Sept. 21, 2016. The webinar was originally announced for the Wednesday during the conference. Please be sure to change this date on your calendars.

Medscape video about use of HPV-4 or HPV-9

Dr. Offit recently addressed a question he has been asked lately related to HPV vaccination. Specifically, is it OK to continue using HPV-4 supplies or should providers use HPV-9 only? View the Medscape video, published on Feb.16, 2016, to hear his thoughts on this matter.

News and Views: Zika virus

Charlotte A. Moser, Assistant Director, and Paul A. Offit, Director, Vaccine Education Center at The Children’s Hospital of Philadelphia

Zika virus has been in the media recently and, even if your patients have not been asking about it, you might still be interested in following this developing story. Zika infections, in and of themselves, are not typically severe; however, the major concern is a proposed relationship between Zika virus infection during pregnancy and a baby born with microcephaly. So, what do we know?

In this section, we cover:

Zika virus — the biology
Zika virus — the infection
Zika virus and microcephaly
Resources about Zika

In the Journals: Waning Tdap effectiveness in adolescents

Paul A. Offit, MD, Director, Vaccine Education Center at The Children’s Hospital of Philadelphia

The pertussis vaccine, which was first introduced in combination with diphtheria and tetanus vaccines in the 1940s, consisted of whole pertussis bacteria inactivated with formaldehyde. This vaccine, which contained about 3,000 structural and non-structural proteins from the bacteria as well as inactivated pertussis toxins (i.e., toxoids), was phased out in the late 1990s in favor of a vaccine containing only two to five inactivated pertussis proteins (the so-called acellular vaccine). The result was a much better safety profile. But, as we’re learning over the past few years, the switch has also resulted in a decrease in vaccine efficacy.

Recently, Nicola Klein and colleagues at Kaiser Permanente in Northern California investigated the effectiveness of the Tdap adolescent booster during a pertussis epidemic in 2014 (Klein N, Bartlett J, Fireman B, Baxter R. Waning Tdap Effectiveness in Adolescents. Pediatrics doi: 10.1542/peds.2015-3326).

Read more about their findings »

Technically Speaking: Just released! CDC’s official immunization schedules for 0- to 18-year-olds and for adults

Deborah L. Wexler, MD, Executive Director, Immunization Action Coalition

At the beginning of each year, the Centers for Disease Control and Prevention (CDC), in collaboration with several professional societies, releases updated versions of the recommended U.S. immunization schedules for children and teens, as well as for adults. These updated schedules reflect changes that were made in official vaccination recommendations during the previous year.

Find out more about the changes and resources related to the immunization schedules »

From the Media: Presidential candidates on vaccines and other areas of science

The American Association for the Advancement of Science (AAAS) recently published an article summarizing where the presidential candidates come down on a variety of science-related issues including vaccines, genetically modified organisms (GMOs) and climate change.

The article, Science on the campaign trail: Where the presidential candidates stand, was written by Puneet Kollipara and published on Feb. 1, 2016. It is accessible to non-subscribers.

On the Calendar

Check the calendar for an expanded list of health observances for the upcoming year. Health observances provide a good opportunity to show your support for important health measures and to leverage them for thematic activities or parallel messaging in your office, newsletters or other patient interaction venues.

Resources: Take a Stand™ reminder, You Call the Shots modules, and useful blog posts

Take a Stand™ reminder

The Immunization Action Coalition, with support from Pfizer, is continuing to offer Take a Stand workshops around the U.S. with the goal of improving adult immunization rates by increasing the use of standing orders in medical practices. The no-cost, four-and-a-half hour interactive workshops are led by national experts and include one year of free direct support for attendees as they install or enhance a standing orders program in their practices.

Responses from early workshop attendees have been overwhelmingly positive. Don’t miss your opportunity to benefit from this program. Space in each workshop is limited. To find out where upcoming events are scheduled, get more information or register, visit the program website at www.standingorders.org.

You Call the Shots modules

The Centers for Disease Control and Prevention (CDC) has recently updated several modules in the You Call the Shots training modules. This Web-based course covers a variety of topics, such as vaccine storage and handling, Vaccines for Children (VFC) program, general recommendations and vaccine-specific modules. Continuing education credits are free and available for a variety of different professionals (CME, CNE, CEU, CECH, CPE, and CPH) upon successful completion of modules.

Useful blog posts

A series of recent blog posts may be of general interest or of particular use when responding to patient concerns:

NVICP Compensation for Guillain-Barré Syndrome – Facts — by Dorit Rubinstein Reiss, published Jan. 26, 2016, on www.skepticalraptor.com.
Small Pediatricians Group Promotes Ideology, Not Evidence — by Tara Haelle, published on Jan. 29, 2016, on www.redwineandapplesauce.com. This blog describes the American College of Pediatricians in contrast to the well-established American Academy of Pediatricians.
Zika virus — Conspiracy theories and anti-vaccine rhetoric addressed:
- Zika virus and microcephaly: The conspiracy theories flow fast and furious.
- Zika virus and microcephaly: Antivaccine warriors say it’s vaccines that did it!

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February 2016 Vaccine Update for Healthcare Providers