Immunization
Practices (ACIP) to the Centers for Disease
Control and Prevention (CDC) has recommended
that children 11-12 and teens entering
high school, as well as college freshman
living in dormitories receive a newly
licensed meningococcal vaccine.
Meningococcal
disease is caused by bacteria that infect
the bloodstream, lining of the brain
and spinal cord, often causing serious
illness. Every year in the U.S., 1400
to 2800 people get meningococcal disease.
Ten to 14 percent of people with meningococcal
disease die, and 11-19 percent of survivors
have permanent disabilities (such as
mental retardation, hearing loss, and
loss of limbs). The disease often begins
with symptoms that can be mistaken for
common illnesses, such as the flu. However,
meningococcal disease is particularly
dangerous because it progresses rapidly
and can kill within hours.
The
ACIP has an existing recommendation for
a routine doctor’s visit for 11-12
year olds, at which they may receive
a tetanus-diphtheria booster shot. With
the new recommendation, 11-12 year olds
will also receive the meningococcal vaccine
at this routine visit. In order to foster
the most rapid reduction of meningococcal
disease following this recommendation,
the committee also recommended that for
the next 2-3 years teens entering high
school also be vaccinated. College freshman
who live in dormitories are at higher
risk of meningococcal disease than other
college students and should also be vaccinated.
Meningococcal vaccine may also be provided
to college students who do not live in
dormitories and adolescents who want
to reduce their risk for meningococcal
disease.
The
vaccine is highly effective. However,
it does not protect people against meningococcal
disease caused by “type B”
bacteria. This type of bacteria causes
one-third of meningococcal cases. More
than half of the cases among infants
less than 1 year of age are caused by
“type B,” for which no vaccine
is licensed or available in the United
States. The new meningococcal vaccine
was licensed by the U.S. Food and Drug
Administration (FDA) on January 14, 2005
for use in people 11-55 years of age.
It is manufactured by sanofi pasteur
and is marketed as Menactra.
For
more information visit
www.cdc.gov/nip/vaccine/meningitis/mcv4/mcv4_acip.htm
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Influenza
Vaccination on Seasonal Mortality among the Elderly
This week, a study published in Archives of Internal Medicine,
"Impact of Influenza Vaccination on Seasonal Mortality
in the US Elderly Population" by Simonsen et al. (2005),
reports that vaccination of the elderly population against
influenza may be less effective in preventing death among
the elderly than previously assumed. This study's findings
have caused some confusion about whether people 65 years old
and older should receive an influenza vaccination.
CDC
and NIH continue to support the Advisory Committee on Immunization
Practices (ACIP) recommendation that people aged 65 and older
get vaccinated against influenza each year. People aged 65
and older are at highest risk for complications, hospitalizations,
and deaths from influenza. Vaccination remains the best protection
from influenza available for people 65 and older and their
loved ones.
Numerous
studies have shown that influenza vaccination works- including
to help protect the elderly from serious illness and hospitalizations-
but the degree to which it works varies from year to year
and can be difficult to measure. For example, influenza seasons
differ each year in length and severity, and the health status
of individuals also matters.
In
the current study by Simonsen et al, the authors in no way
imply that the elderly should not receive influenza vaccine.
Rather, the study concludes that the vaccine may prevent fewer
deaths among the elderly than previous studies would have
suggested. Therefore, the authors note that there is room
for improvement in influenza prevention efforts, including
research into developing more effective vaccines for the elderly
and the increased use of medicines to treat flu.
In
addition, recently published studies raise the possibility
that it may be beneficial to vaccinate larger numbers of healthy
persons, including children, to prevent transmission of influenza
viruses to high-risk persons such as the elderly.
Expansion
of groups for whom influenza vaccination is recommended is
under discussion by the ACIP and CDC, and is partly contingent
on adequate vaccine supply in the future.
The
CDC and ACIP continually review their influenza vaccine recommendations
as well as studies and published research in order to develop
the best recommendations for protecting all Americans from
influenza. This study is a reminder that there is room for
improvement in how we protect the elderly from influenza,
and CDC and NIH encourage research that strengthens our ability
to do so.
Survey
Indicates Influenza Vaccine Used for Priority Groups
The CDC announced last week that influenza
vaccine was used during the first part of the 2004-2005 flu
season to vaccinate those at highest risk of serious complications
for influenza, including young children, the elderly, those
with chronic health conditions, and health-care workers.
Data
collected during the first three weeks of January by the Behavioral
Risk Factor Surveillance System (BRFSS) indicated that 57.3
percent of children aged six to 23 months were vaccinated
during September through December 2004, the first year that
influenza vaccination was added to the childhood immunization
schedule. A 2002 survey indicated only 7.7 percent in the
same age group were vaccinated for influenza. Influenza vaccine
has a higher first year vaccination coverage than the pneumococcal
vaccine (PCV) at 40.9 percent in 2002 or the varicella vaccine
at 16 percent in 1996.
The
BRFSS survey results show that influenza vaccination continued
during the month of December and was concentrated in the vaccination
priority groups outlined for the 2004-2005 season. Vaccination
coverage among adults in priority groups was 43.1 percent
compared with 8.3 percent vaccination coverage for adults
not in priority groups. To date in this influenza season,
nearly 59 percent of persons aged 65 years and older reported
influenza vaccination through December 2004 compared to 65.5
percent in persons in this age group who reported influenza
vaccination in the 2003 National Health Interview Survey.
National
Infant Immunization Week
National Infant Immunization Week (NIIW) will be held April
24-30, 2005. This week is an annual observance to promote
the benefits of immunizations and highlight the importance
of vaccinating children by the age of two through various
events held throughout the country. This year, NIIW will again
be held in conjunction with the Pan American Health Organization’s
Vaccination Week in the Americas (VWA), April 23-30, 2005.
The U.S. will join together with 35 countries in the Western
Hemisphere to concurrently promote the need for routine vaccinations
for infants and children during the last week in April.
Communities
from across the United States are expected to participate
in NIIW-VWA by planning community awareness and media events
to promote infant immunizations to parents, caregivers, healthcare
providers, and their communities. Bi-national awareness and
education events in sister city sites along the US-Mexico
border are being planned this year to celebrate NIIW and VWA
in partnership with PAHO US-Mexico Border Health Commission
(USMBHC), CDC, state and local health departments, and other
immunization partners. Special NIIW kick off events will be
held in Las Cruces, New Mexico and Louisiana.
To
assist communities in promoting infant immunization, CDC has
web-based technical assistance materials. Visit www.cdc.gov/nip/events/niiw/2005/05default.htm
for ideas on creating an NIIW event for parents, providers
and community leaders, as well as sample planning tools, campaign
materials, and public relation materials.
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