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Division of Bacterial Diseases (DBD) News Bulletin

Fall 2011

CDC Seeks Input on Use of Vaccines in Infants

CDC held four community meetings (organized by contractors, FHI360 and The Keystone Center in collaboration with state and local health departments) this summer to give parents, healthcare providers, health plan administrators and public health officials an opportunity to give their input regarding how to use vaccines that can help protect infants and young children from meningococcal disease. Meningococcal disease is a relatively rare, but often severe illness that can involve swelling of the membranes around the brain as well as loss of limbs from bloodstream infections.

“ACIP and CDC have to consider many things when it comes to determining whether some or all children should be vaccinated against a disease,” said senior advisor Glen Nowak, the CDC person overseeing the project. “This includes how well the vaccine works, how much disease can be prevented, how many children are affected, and the costs and benefits associated with vaccination. This project sought to find out how those involved in providing immunizations – doctors, nurses – and members of the public view those factors.”

In April, the Food and Drug Administration (FDA) granted a license to Sanofi Pasteur to expand use of its meningococcal conjugate vaccine, Menactra®, to include a two-dose schedule for children 9 months through 23 months of age. This was the first U.S. approval of a meningococcal vaccine for this age group, and two other companies have submitted license applications to FDA. Doctors are permitted to use a vaccine after it has received FDA licensure.

Currently there is no routine recommendation regarding the use of meningococcal conjugate vaccines for healthy children under age 2, but CDC’s Advisory Committee on Immunization Practices (ACIP) is likely to soon be evaluating options for vaccine recommendations for this group.

CDC’s National Center for Immunization and Respiratory Diseases held four community meetings in Concorde, NH, Seattle, WA, Chicago, IL, and Denver, CO, this summer to introduce participants to the issues involved in developing immunization recommendations and to seek their views on how best to consider the issues around vaccines that protect children from rare but severe illness. The locations were selected so different parts of the country could be included and because state or local health officials were interested in hosting. DBD’s Amanda Cohn, Tom Clark, and Nancy Messonnier each presented scientific information at these meetings.

Prior to the four community meetings, a stakeholder meeting was held in Washington, DC with representatives from around 20 national organizations and interested parties. NCIRD’s Anne Schuchat and Glen Nowak, and DBD’s Amanda Cohn introduced participants to the public engagement process and provided specific scientific information about meningococcal vaccines and current ACIP recommendations.

This public engagement process had limitations including that the participants in the four community meetings were not necessarily representative of the general public. The meetings did, however, bring together interested people with divergent views and engaged them in a productive dialogue.

A final stakeholder meeting was held October 5th in Atlanta, GA. During this meeting discussions were held to share key findings from the four community meetings, to get input from the stakeholders on the economic and resource factors that should be considered when making immunization policy decisions, and to discuss how methods and approaches like public engagement should be considered in the future to inform ACIP and CDC.

Awards

LCDR Lara Misegades was awarded the USPHS Achievement Medal for “Substantial scientific contributions toward understanding and controlling epidemic meningitis in West Africa as an EIS Officer.”

LCDR Lee Hampton was awarded the USPHS Achievement Medal for “Outstanding contributions to improving surveillance for serious pneumococcal disease and for developing national standards for pneumococcal disease reductions in the United States while serving as an EIS Officer.”

Keith Klugman, pneumococcal disease expert and regular collaborator with DBD, was honored by the Royal Society of South Africa with the John FW Herschel Medal for contributions to multidisciplinary science in South Africa and in particular for his contribution to the development of conjugate pneumococcal vaccines for Africa and developing countries.

Elizabeth Zell was honored with the 2011 Statistical Science Award honorable mention for demonstrating excellence in science. This was in recognition of the theoretical paper entitled, “Multiple imputation in the anthrax vaccine research program.”

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