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Children's Hospital of Philadelphia HCP Vaccine Update
Vaccine Update for Providers
May 2017

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

News and views: The bigger implications of anti-vaccine sentiment

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

Almost 17 years ago, we launched the Vaccine Education Center at the Children’s Hospital of Philadelphia (VEC) to help explain the science of vaccines, particularly as it related to vaccine safety concerns. We started the VEC as a side project while working in the lab. The plan was to return to the lab full time a few years later. Instead, after five years, we closed the lab and have been working to communicate vaccine science full time ever since.

While some things have improved, such as media coverage of vaccines, particularly by national media sources, and development of a strong national network of vaccine stakeholders, the situation is still perilous. People who don’t trust that vaccines are safe or necessary are able to more easily find one another as well as “information” that supports their biases on the internet. In addition, an overarching anti-science agenda has converged among sectors of society and more recently, has been empowered by anti-science sentiment at the highest levels of office.

This means we need to keep working – and we need your help.
 

In the journals: Influenza vaccine efficacy among children

 Paul A. Offit, MD, Director, Vaccine Education Center at Children’s Hospital of Philadelphia
 
From 1976 to 2007, public health officials estimated that influenza infections accounted for about 100 deaths annually among children and adolescents. Since 2004, when influenza deaths among children became a reportable disease, the numbers of deaths have ranged from 37 in the 2011-2012 season to 358 during the 2009 influenza pandemic.
 
In 2010, the Advisory Committee on Immunization Practices (ACIP) to the Centers for Disease Control and Prevention (CDC) recommended that all children older than 6 months of age receive an annual influenza vaccine. Nonetheless, to date no study has examined the effectiveness of influenza vaccine against laboratory confirmed influenza deaths in children.
 
In the April 2017 issue of Pediatrics, Brenan Flannery and coworkers at the CDC examined the effectiveness of influenza vaccine on prevention of influenza mortality (Flannery B, Reynolds SB, Blanton L, et. al. Influenza Vaccine Effectiveness Against Pediatric Deaths. Pediatrics. 2017. DOI: 10.1542/peds.2016-4244.
 

Technically speaking: ACIP has updated its recommendations on the use of Tdap vaccine in pregnant women and children

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

At its October 2016 meeting, the Advisory Committee on Immunization Practices (ACIP) voted to update two of its recommendations for the use of Tdap vaccine (tetanus-, diphtheria-, pertussis-containing vaccine).
  1. For all pregnant women, Tdap vaccine is now recommended to be administered "early" in the 27- through 36-week gestational age window to maximize passive antibody transfer to the infant. Previously, the recommendation was to vaccinate women at any time between 27 and 36 weeks' gestation.
  2. Children 7 to 10 years of age who receive a dose of Tdap as part of a catch-up series may be given an additional dose of Tdap for the routinely recommended adolescent dose at 11 to 12 years of age. Previously the recommendation was to not give an additional dose of Tdap at age 11 to 12 years in this situation.
Both recommendations are included in the 2017 U.S. immunization schedules, which means they are officially recommended by the Centers for Disease Control and Prevention (CDC).

From the media: Anti-vaxxers continue to mislead Somali population in Minnesota

“I don’t feel responsible at all,” said Andrew Wakefield in response to the measles outbreak in the Minnesota Somali population.
 
The above quote was Andrew Wakefield’s response during an interview by Lena H. Sun for an article published on May 5, 2017, in the Washington Post. Indeed, despite a measles outbreak that has now sickened at least 50 people, anti-vaccine activists continue to visit this community of immigrants and discourage them from having their children vaccinated — on at least one occasion barring public health officials from even attending the event.
 
Dr. Offit discussed the history of anti-vaccine efforts in the Somali community in a recent Daily Beast column, published on May 13.

On the calendar

Check the calendar for newly added (free) on-demand webinars including:
  • Vaccines and the New Administration (offered by the IZ Coalitions network)
  • There Never Was an Age of Reason: Vaccines, Vaccine Hesitancy and Vaccine Decision Making (offered by WithinReach)
  • You Are the Key to HPV Cancer Prevention (offered by WithinReach and Cardea)

Resources

CDC immunization recommendations

The Centers for Disease Control and Prevention (CDC) recently released an updated version of the General Best Practice Guidelines for Immunization. The 194-page document outlines the specific recommendations related to vaccine administration including timing and spacing of vaccines, contraindications and precautions, preventing and managing adverse reactions, vaccine administration, storage and handling of immunobiologics, altered immunocompetence, special situations, vaccination records, vaccination programs, and vaccine information sources. This document is a must-have reference for anyone who gives immunizations.
 

WHO position papers on measles and HPV

As part of its mandate, the World Health Organization (WHO) periodically issues position papers related to health policy matters as a means of guidance for its member states. The documents are prepared following systematic (GRADE) assessment of the latest scientific information on the subject and are reviewed by WHO staff and external experts. These documents provide useful information related to the most updated global information about the disease and any vaccines available as well as WHO recommendations for vaccine use. It is important to realize that the WHO recommendations are described in such a way as to be pertinent for both resource-rich and resource-poor settings.

Recently, they released two related to vaccine-preventable diseases:
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