News and Updates to Vaccines & Immunizations
January 2012
Measles Outbreak in 2009. 1/20/2012. The CDC is reporting on a measles outbreak that began with transmission in a healthcare setting and are reminding reminding healthcare workers of this potential. On March 10, 2009 an unvaccinated child who arrived recently from India was brought to an emergency department in Pennsylvania was treated for viral exanthema and discharged. This child was later diagnosed with measles as were five other patients who also visited the same ED the same day. Although endemic measles transmission has been interrupted in the United States, importations of this highly infectious virus continue, and the CDC is reminding healthcare workers of the potential for measles transmission in health-care settings. To decrease transmission, clinicians should know the signs and symptoms of measles, request travel histories of patients suspected of any infectious disease, and isolate potentially infectious patients. Hospital employees should have documented immunity to measles, and employees without evidence of measles immunity should be offered vaccination in accordance with Advisory Committee on Immunization Practices (ACIP) and Hospital Infection Control Practices Advisory Committee (HICPAC) recommendations. Source: CDC
A(H1N1)pdm09 Vaccine in Jails and Prisons. 1/06/2012. The Emory University Preparedness and Emergency Response Research Center, aided by the National Commission on Correctional Health Care (NCCHC), conducted a survey to document whether jails and prisons received A(H1N1)pdm09 vaccine during the 2009-10 pandemic period and found that 55% of jails did not receive A(H1N1)pdm09 vaccine during the pandemic period, whereas only 14% of federal prisons and 11% of state prisons did not receive the vaccine. Greater inclusion of correctional facilities, especially smaller facilities, in pandemic preparedness planning might better protect correctional facility populations and the community as a whole in the event of future influenza pandemics. Source: CDC
November 2011
Expanded Indication for Herpes Zoster Vaccine. 11/11/2011. The FDA has approved an expanded indication of the use of Herpes zoster vaccine (Zostavax, Merck & Co., Inc.) to include people aged 50-59 years. The ACIP however declined to recommend its use in this population, and continues to recommend the use of Zostavax in people 60 years and older. Source: CDC
October 2011
FDA Communication on Use of Jet Injectors with Inactivated Influenza Vaccines. 10/26/2011. In response to recent questions, the FDA is clarifying that influenza vaccinations are not labeled or approved for administration by jet injector. Currently, there is only one vaccine, Measles, Mumps and Rubella (MMR), that is approved and specifically labeled for administration by jet injector. Inactivated influenza vaccines labeled for IM injection are intended for administration using a sterile needle and syringe and one inactivated influenza vaccine labeled for ID administration is supplied in its own pre-filled syringe. The live attenuated influenza vaccine is given in the nose through a sprayer, which is not a jet injector. Source: FDA
HPV Vaccination Recommended for Boys. 10/26/2011. The Advisory Committee on Immunization Practices has recommended that boys and young men aged 11-26 years be vaccinated against HPV, because vaccination participation in girls is still fairly low. There are hopes that these recommendations will encourage insurance companies to pay for the vaccination. Source: AMA
History of Intussusception Added as a Contraindication for Rotavirus Vaccination. 10/21/2011. The FDA has approved revised prescribing information and patient labeling for the monovalent rotavirus vaccine to include history of intussusception as a contraindication. Rotavirus vaccination is now contraindicated for infants with a history of severe allergic reaction after a previous dose of rotavirus vaccine or exposure to a vaccine component, infants diagnosed with severe combined immunodeficiency, and infants with a history of intussusception. Source: CDC
Updated Recommendations for Use of Tdap Vaccine in Pregnant Women and Persons in Close Contact with an Infant. 10/21/2011. ACIP made recommendations for use of Tdap in unvaccinated pregnant women and updated recommendations on cocooning and special situations in order to reduce the burden of pertussis in infants. For complete updated recommendations see: CDC
Recommendations for Use of Quadrivalent Meningococcal Conjugate Vaccine (MenACWY-D) Among Children Aged 9 Through 23 Months at Increased Risk for Invasive Meningococcal Disease. 10/14/2011. The FDA approved the use of a quadrivalent meningococcal conjugate vaccine (MenACWY-D) (Menactra, Sanofi Pasteur) as a 2-dose primary series among children aged 9 through 23 months. Vaccination with meningococcal polysaccharide vaccine (MPSV4) is not recommended for children aged under 2 years because of low immunogenicity and short duration of protection in this age group. ACIP recommended that children aged 9 through 23 months with certain risk factors for meningococcal disease including children who have persistent complement component deficiencies, who are traveling to or residents of countries where meningococcal disease is hyperendemic or epidemic, and who are in a defined risk group during a community or institutional meningococcal outbreak, receive a 2-dose series of MenACWY-D, 3 months apart. Because of their high risk for invasive pneumococcal disease, children with functional or anatomic asplenia should be vaccinated with MenACWY-D beginning at age 2 years to avoid interference with the immunologic response to the infant series of PCV. If children older than 2 years with functional or anatomic asplenia have not yet received all recommended doses of PCV, they should receive all recommended doses separated from MenACWY-D by at least 4 weeks. Source: CDC
September
2011
Expanded
Age Indication for a Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular
Pertussis Vaccine. 9/14/2011. On July 8, 2011, the FDA expanded the age
indication for the tetanus toxoid, reduced diphtheria toxoid and acellular
pertussis vaccine (Tdap) Boostrix to include persons aged 10 years and older. Source: FDA
August
2011
Adolescent
Vaccination Coverage Report. 8/26/2011. The
ACIP recommends that adolescents routinely receive meningococcal
conjugate (MenACWY, 2 doses), tetanus, diphtheria, acellular pertussis (Tdap, 1
dose), and human papillomavirus (HPV, 3 doses) vaccines, and the CDC analyzed
National Immunization Survey data to track vaccination coverage among
adolescents 13 through 17 years of age. The analysis found that coverage
increased for all three vaccines: Tdap from 55.6% to 68.7%, MenACWY from 53.6%
to 62.7%, one dose or greater of HPV from 44.3% to 48.7%, and three doses or
greater of HPV from 26.7% to 32.0%. Source: CDC
Influenza
Vaccination Recommendations. 8/26/2011. The ACIP continues to recommend routine annual influenza vaccination
for all persons aged 6 months or older.
To permit
time for production of protective antibody levels, vaccination should optimally
occur before onset of influenza activity in the community. Children aged 6
months through 8 years require 2 doses of influenza vaccine administered a
minimum of 4 weeks apart during their first season of vaccination to optimize
immune response. A prior severe allergic reaction to influenza vaccine,
regardless of the component suspected to be responsible for the reaction, is a
contraindication to receipt of influenza vaccine. Source: CDC
Influenza
Vaccination Coverage Among Pregnant Women. 8/19/2011. Estimated influenza vaccination
coverage among pregnant women increased from 15% to nearly 50% in response to
the 2009 influenza A (H1N1) pandemic. To estimate influenza vaccination
coverage among pregnant women for the 2010-11 season, CDC analyzed data from an internet panel survey conducted in April 2011 among women who were pregnant any
time during October 2010-January 2011. Among 1,457 survey respondents, 49%
reported that they had received influenza vaccination: 12% were vaccinated before
pregnancy, 32% during pregnancy, and 5% after pregnancy. Women offered
influenza vaccination by a health-care provider were more likely to be
vaccinated (71%) than other women (14%) and were more likely to have positive
attitudes about vaccine effectiveness and safety. Source: CDC
Influenza Vaccination
Coverage Among Healthcare Personnel. 8/19/2011. The results of an internet-based
survey of 1,931 healthcare personnel conducted by the CDC indicated that
overall influenza vaccination coverage among personnel was 63.5% during the
2010-11 influenza season. Among healthcare
personnel working at a facility where vaccination was required by their
employer, 98.1% were vaccinated. Among healthcare personnel without such an
employer requirement but who were offered vaccination onsite, 69.9% coverage
was associated with a personal reminder from the employer to get vaccinated, 67.9%
coverage with vaccination availability at no cost, and 68.8% coverage with vaccination
availability for more than one day. Source: CDC
Tdap Vaccination
Recommendations for Pregnant Women. 8/5/2011. The ACIP has approved new recommendations for
the use of tetanus
toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) for
pregnant women and persons in contact with infants and special situations.
Pregnant women who have not previously received Tdap should be administered
Tdap preferably during the third or late second trimester. If not received
during pregnancy, Tdap should be administered immediately postpartum.
Adolescents and adults who have close contact with an infant younger than 12
months and have not previously received Tdap should receive a single dose at
least 2 weeks before close contact with the infant. If a Td booster is
indicated for a pregnant woman who has not previously received Tdap, healthcare
providers should administer Tdap. Pregnant women who never have been vaccinated
against tetanus should receive three vaccinations containing tetanus and
reduced diphtheria toxoids during pregnancy. Source: CDC
Meningococcal Disease Vaccination Guidelines. 8/05/2011. The Advisory Committee on Immunization Practices
(ACIP) recommends that persons aged 2 through 55 years at increased risk for
meningococcal disease and all adolescents aged 11 through 18 years be immunized
with meningococcal conjugate vaccine. The two licensed quadrivalent
meningococcal conjugate vaccines are MenACWY-CRM (Menveo, Novartis Vaccines and
Diagnostics) and MenACWY-D(Menactra, Sanofi Pasteur). ACIP also recommends that
all adolescents receive a booster dose of quadrivalent meningococcal conjugate
vaccine at age 16 years. Source: CDC
July
2011
Influenza
Vaccination of Schoolchildren. 7/15/2011. Background: The purpose of this study was
to determine whether the universal influenza vaccination for schoolchildren was
effective in controlling influenza outbreaks in a school. Methods:
In this retrospective descriptive study Influenza
vaccine coverage rates, total numbers of class cancellation days, and absentee
rates were reviewed in a single elementary school during a 24-year period from
1984-2007. Results: The mean
number of class cancellation days and the mean absentee rate in the compulsory
vaccination period (1984-1987; mean vaccine coverage rate, 96.5%) were 1.3 days
and 2.5%, respectively; 8.3 days and 3.2% during the quasi-compulsory
vaccination period (1988-1994; vaccine coverage, 66.4%), respectively; 20.5
days and 4.3% during the no-vaccination period (1995-1999; vaccine coverage,
2.4%), respectively; and 7.0-9.3 days and 3.8%-3.9% during the voluntary
vaccination period (2000-2007; vaccine coverage, 38.9-78.6%), respectively. Author's
Conclusion: The universal influenza vaccination for
schoolchildren was effective in reducing the number of class cancellation days
and absenteeism in the school. Source: CID
May
2011
Meningococcal Vaccine for High-Risk Infants. 6/23/2011. The Advisory Committee on
Immunization Practices of the Centers for Disease Control
and Prevention recommends that children ages 9 to 23 months who are at
high risk for meningococcal disease, including
those with complement component deficiencies, infants
in a defined risk group for a community or institutional outbreak,
and those traveling to areas where meningococcal disease is
epidemic or highly endemic, should be vaccinated with the quadrivalent
meningococcal vaccine. This specific group of high-risk children
would be administered vaccine in two doses three months apart. Source: AAP
Japanese
Encephalitis Vaccine No Longer Available for Children. 5/27/2011. Inactivated mouse brain-derived Japanese
encephalitis (JE) vaccine (JE-MB [manufactured as JE-Vax]), the only JE vaccine
that is licensed for use in children in the United States, is no longer
available as it is no longer being produced and all remaining doses expired in
May 2011. One pediatric dose-ranging
study for an inactivated
Vero cell culture-derived JE vaccine (JE-VC [manufactured as Ixiaro]) has been completed and 2 safety and immunogenicity studies
are ongoing. Currently for pediatric
patients determined to be at risk may enroll in the ongoing clinical trial,
receive JE-VC off-label, or receive JE vaccine at an international
travelers' health clinic in Asia, and should take precautions listed on the
CDC's website. Source: CDC
Booster Dose Recommended for Japanese Encephalitis Vaccine. 5/27/2011. New data about the inactivated, Vero cell
culture-derived JE vaccine (JE-VC [manufactured as Ixiaro]) regarding the
persistence of neutralizing antibodies following primary vaccination and the
safety and immunogenicity of a booster dose is available. Based on this new information, the Advisory
Committee on Immunization Practices is recommending that if the primary
series of JE-VC was administered more than 1 year previously, a booster dose
may be given to U.S. travelers and laboratory personnel who are at risk for potential
JE virus exposure. Source: CDC
2011 Child and Adolescent
Immunization Schedules Updated. 5/19/2011. The CDC's Childhood and Adolescent Immunization
Schedule, which applies to children from birth to 18 years of age, has been
updated. For the updated schedules, and "catch-up schedules" see: CDC
Potential Safer Alternative
to
Live Attenuated 17D Vaccine. 5/01/2011. Background: This study evaluated the safety and
immunogenicity of XRX-001 purified whole-virus, β-propiolactone-inactivated
yellow
fever
vaccine produced in Vero cell cultures and adsorbed to aluminum hydroxide
(alum)
adjuvant as an alternative
to
the highly effective live yellow fever vaccine (17D) which
can
cause serious adverse events, including viscerotropic disease, which is
associated
with a high rate of death. Methods: In this double-blind,
placebo-controlled,
dose-escalation, phase 1 study, 60 healthy subjects between
18
and 49 years received intramuscular injections of vaccine that contained
0.48
μg or 4.8 μg of antigen on two visits 21 days apart. Levels of neutralizing
antibodies
were measured at baseline and on days 21, 31, and 42. Results: The vaccine induced
the
development of neutralizing antibodies in 100% of subjects receiving 4.8 μg
of
antigen in each injection and in 88% of subjects receiving 0.48 μg of
antigen
in each injection. Adverse events that occurred at a higher incidence
in
the two vaccine groups than in the placebo group included mild pain,
tenderness,
and itching at the injection site, as well as one case of urticaria. Author's
Conclusion: A two-dose regimen of the XRX-001
vaccine,
containing inactivated yellow fever antigen with an alum adjuvant, has
the
potential to be a safer alternative to live attenuated 17D vaccine. Source: NEJM
April
2011
Menactra
Approved for use in Children as Young as 9 Months. 4/22/2011. The FDA has approved the use of Menactra in
children as young as 9 months as the first vaccine in
toddlers and infants for the prevention of invasive meningococcal disease. Menactra is given as a
two-dose series beginning at 9-months, three months apart. The most common
adverse events reported in children who received Menactra at 9 months and 12
months of age were injection-site tenderness and irritability and fever
comparable to other vaccines routinely recommended for young children. Source: FDA
Tdap
Recommendations Updated. 4/04/2011. The ACIP approved revised recommendations for healthcare personnel on use
of tetanus toxoid, which include that
all healthcare personnel should receive a single does of Tdap as soon as
feasible and should receive routine booster immunizations against tetanus and
diptheria, and that hospitals should provide
Tdap for healthcare providers using approaches that maximize vaccination rates.
The recommendations on the use of postexposure antimicrobial prophylaxis have
also been updated: Healthcare facilities should maximize efforts to prevent
transmission of Bordetella pertussis taking respiratory precautions and
all healthcare providers who have unprotected exposure to pertussis should
receive postexposure antimicrobial prophylaxis if they are likely to expose a
patient at risk for severe pertussis or be monitored daily for 21 days after
pertussis exposure and treated at the onset of signs and symptoms of pertussis
if otherwise. Source: CDC
February 2011
Updated Immunization Schedules. 2/11/2011. The Advisory Committee on Immunization Practices have published this years immunization schedules to reflect current recommendations for the licensed vaccines. Both schedules include several changes and can be viewed at the following.
Recommended Immunization Schedule
for Persons 0-18 Years
Recommended Immunization Schedule
for Adults
Updated
Recommendations for Use of Meningococcal Conjugate Vaccines. 1/28/2011. The Advisory Committee on Immunization Practices
approved updated recommendations for the use of quadrivalent (serogroups A, C,
Y, and W-135) meningococcal conjugate vaccines (Menveo, Novartis; and Menactra,
Sanofi Pasteur) in adolescents and persons at high risk for meningococcal
disease to supplement previous recommendations for meningococcal vaccination. Two new recommendations include routine vaccination of adolescents,
preferably at age 11 or 12 years, with a booster dose at age 16 years, and a
2-dose primary series administered 2 months apart for persons aged 2 through 54
years with persistent complement component deficiency (e.g., C5--C9,
properidin, factor H, or factor D) and functional or anatomic asplenia, and for
adolescents HIV. View Full Report at: CDC
January 2011
Diarrhea-Associated Hospitalizations After Rotavirus
Vaccine Introduction. 1/01/2011. Background: This study aimed to ascertain whether decreases
in severe diarrhea among children were sustained over 2 postvaccine rotavirus
seasons. Methods: The number of all-cause diarrhea-related and
rotavirus-specific hospitalizations were examined, comparing 3 prevaccine
seasons (2003-2006) to 2 postvaccine seasons (2007-2009). Results:
The median of all-cause diarrhea-related hospitalizations decreased by 50% (n =
7760) in 2007-2008 and by 29% (n = 11 039) in 2008-2009. Author's
Conclusion: ompared with prevaccine seasons, decreases in diarrhea-
and rotavirus-associated hospitalizations seen in 2007-2008 were sustained in
2008-2009 but were somewhat smaller. Source: AAP
December 2010
Influenza
Vaccine in Pregnant Women Reduces Hospitalization of their Infants Due to
Influenza. 12/15/2010. Background: This study assessed the efficacy of a vaccination
strategy in which pregnant women receive the influenza vaccination, thus
transferring the antibodies to their infants. Methods: In a matched case‐control study, vaccine effectiveness was
calculated on the basis of matched odds ratios of a case group, infants under 1
year of age admitted to a large urban hospital in the northeastern United
States because of laboratory‐confirmed influenza, and a control group, infants
who tested negative for influenza and matched cases by date of birth and date
of hospitalization within 4 weeks. Results: The mothers of 2 of 91 case subjects and 31 of 156 control subjects younger
than 6 months, and 1 of 22 case subjects and 2 of 36 control subjects aged 6
months, had received influenza vaccine during pregnancy. The effectiveness of
influenza vaccine given to mothers during pregnancy in preventing
hospitalization among their infants, adjusted for potential confounders, was
91.5% (95% CI, 61.7%-98.1%; p=0.001) for infants aged younger than 6 months of
age. Author's Conclusion: Influenza vaccine given to pregnant women
is 91.5% effective in preventing hospitalization of their infants for influenza
during the first 6 months of life. Source: CID
October 2010
Immunogenicity and Safety of
13-Valent Pneumococcal Conjugate Vaccine. 9/03/2010. Background: A Clinical trial was performed to
evaluate the immunogenicity and safety of 13-Valent pneumococcal conjugate
vaccine (PCV13) as compared with 7-Valent pneumococcal
conjugate vaccine (PCV7). Methods: Infants were assigned to receive
routine vaccinations of either PCV7 or PCV13 and then assessed to evaluate pneumococcal
anticapsular polysaccharide-binding
immunoglobulin G responses and functional antipneumococcal
opsonophagocytic activity. Results: PCV13-elicited immunoglobulin G titers
and functional opsonophagocytic activity were comparable to those of PCV7 for
the 7 common stereotypes and greater for the 6 additional stereotypes. Author's
Conclusion: PCV13
will be as effective as PCV7 in the prevention of pneumococcal disease caused
by the 7 common stereotypes, and may extend protection against the 6 additional
stereotypes. Source: AAP
September 2010
Vaccination
Coverage Among Children 19 to 35 Months. 9/17/2010. The National Immunization Survey (NIS)
published a report evaluating the 2009 coverage estimates for children aged 19
to 35 months. The report focuses on more recently recommended vaccines and
indicates that the percentage of children in the United States who have not
received any vaccines remains less than 1%. Source:CDC
Updated
Recommendation for Prevention of Invasive Pneumococcal Disease. 9/03/2010. The Advisory Committee on Immunization Practices
(ACIP) published updated recommendations to prevent invasive disease from Streptococcus
pneumoniae (pneumococcus) through the use of the 23-valent pneumococcal
polysaccharide vaccine (PPSV23) among all adults over 65 years of age, and all
adults at greater risk for serious pneumococcal infection. The updates changed
the recommendations to include smoking and asthma in the indications for which
PPSV23 vaccination is recommended, and no longer recommend routine use of
PPSV23 for Alaska Natives or American Indians younger than 65 years unless they
have medical or other indications for PPSV23. Source:CDC
Changes in Measurement of Haemophilus
influenzae serotype b (Hib) Vaccination Coverage. 8/27/2010.
The National Immunization Survey (NIS) introduced a new method for measuring Haemophilus
influenzae serotype b (Hib) vaccination coverage distinguishing between
having a primary series completed and being fully vaccinated (primary series
completed plus booster dose). This revision was made in light of the findings
that some product types require 4 doses to be fully vaccinated. As determined
by this new method 56.9% of children in the United States aged 19-35 months are
fully vaccinated. Source: CDC
Immunogenicity and Safety of 13-Valent
Pneumococcal Conjugate Vaccine. 8/23/2010.Background: This trial was designed to assess the safety and
efficacy of the 13-Valent pneumococcal conjugate vaccine (PCV13) as compared to
the 7-Valent pneumococcal conjugate vaccine (PCV7). Methods:
Infants received PCV13 or PCV7 at ages 2, 4, 6, and 12 to 15 months with
routine pediatric vaccinations. Pneumococcal anticapsular
polysaccharide-binding immunoglobulin G responses and functional antipneumococcal
opsonophagocytic activity were assessed 1 month after dose 3, before the
toddler dose, and 1 month after the toddler dose. Results: For
the 7 common serotypes, PCV13 elicited immunoglobulin G titers and functional
opsonophagocytic activity, which were not inferior to those elicited by PCV7. Author's
Conclusion: PCV13 will be as effective as PCV7 in the prevention of
pneumococcal disease caused by the 7 common serotypes. Source:AAP
August 2010
Vaccination Coverage Among Adolescents. 8/20/2010. The CDC provides a general summary of its National Immunization Survey-Teen (NIS-Teen) results regarding national, state, and local area vaccination coverage among adolescents between 13 and 17 years of age. Based on these results, the Advisory Committee for Immunization Practices (ACIP) recommends that adolescents routinely receive the meningococcal conjugate (MenACWY), tetanus, diphtheria, and acellular pertussis (Tdap), and human papillomavirus (HPV) (for females) vaccinations. The measles, mumps, and rubella (MMR), hepatitis B (HepB), and varicella (VAR) vaccinations should also be administered to adolscents who missed them during childhood. Source: CDC
Influenza Vaccine Recommendations. 8/06/2010. The CDC has published updates to the Influenza vaccine recommendations. Key updates: 1) annual vaccination should be administered to all persons aged 6 months and older; 2) children aged 6 months to 8 years whose vaccination status is unknown, who have never received seasonal influenza vaccine, or who did not receive at least 1 dose of an influenza A (H1N1) 2009 monovalent vaccine should receive 2 doses of a 2010-11 seasonal influenza; 3) vaccines containing the 2010-11 trivalent vaccine virus strains A/California/7/2009 (H1N1)-like (the same strain as was used for 2009 H1N1 monovalent vaccines), A/Perth/16/2009 (H3N2)-like, and B/Brisbane/60/2008-like antigens should be used; 4) information about Fluzone High-Dose, a newly approved vaccine for persons aged ≥65 years; and 5) information about other standard-dose newly approved influenza vaccines and previously approved vaccines with expanded age indications. Source: CDC
Hepatitis B Vaccination Proposed for All Diabetic Adults. 7/30/2010. In response to new, unpublished data revealing a higher risk for hepatitis B contraction in diabetic adults, an advisory group at the CDC proposes that all adults with diabetes be vaccinated. A vaccination program including better labeling, cleaning, and design of blood glucose monitoring devices, is also being recommended because of a suggested correlation between hepatitis B outbreaks and glucose meter practices. Source: Family Practice News
Yellow Fever Vaccine Recommendations. 7/30/2010. The CDC has published updates to the yellow fever vaccine recommendations, which were last published in 2002. Yellow fever is endemic to sub-Saharan Africa and tropical South America, has no known treatment, and is fatal in 20-50% of persons with severe disease. All travelers to such countries should be advised of the risks and prevention methods; vaccination of these travelers 9 months and older is recommended. Source: CDC
Emphasis to Continue Polio Vaccinations. 7/15/2010. Polio immunization rates in many areas of the United States have fallen below the WHO's recommended 90%. In light of this and a recent polio outbreak in Tajikistan, which, like the US, is a certified polio-free country, the American Academy of Pediatrics is emphasizing the need to ensure that patients are fully vaccinated against polio. Source: AAP
Henoch-Schönlein Purpura (HSP) Not Associated with Meningococcal Polysaccharide Vaccine for Ages 16-20 Years. 7/12/2010. Background: Periodic case reports link Henoch-Schönlein purpura (HSP) to vaccine administration. This study assessed the potential risk of HSP associated with the meningococcal polysaccharide vaccine Methods: Vaccine Safety Datalink (VSD) data was gathered for all subjects between 16 and 20 years who received a meningococcal polysaccharide vaccine and were followed for evidence of HSP for the 42 days after vaccination. Results: No cases of HSP were found. Author's Conclusion: This data shows no relation between the meningococcal polysaccharide vaccine and HSP in persons aged 16-20 years. Source: AAP
July 2010
MMRV Vaccine Associated with Increased Risk of Febrile Seizures.6/29/2010. According to a clinical trial that assessed Vaccine Safety Datalink data collected over 8 years, seizure and fever risk in 12- to 23-month-olds is increased after administration of the combination measles-mumps-rubella-varicella (MMRV) vaccine as compared with separate measles-mumps-rubella (MMR) and varicella vaccines (relative risk: 1.98 [95% CI: 1.43-2.73]). It was determined that the MMRV vaccination results in 1 additional seizure for every 2300 doses given instead of separate MMR and varicella vaccines, and parents should therefore be informed of the increased risk when considering the vaccine for their infants.Source: AAP
Vaccinia Virus Infection Resulting from Contact with Smallpox Vaccinee.7/02/2010. The CDC reminds healthcare providers caring for U.S. military personnel and their contacts to consider vaccinia virus in diagnoses due to the reinstatement of routine smallpox vaccination of service members in 2002. Several cases of transmission of vaccinia virus have been reported in the past 12 months from sexual contact with a smallpox vaccinee, but are also common from any contact of the face, nose, mouth, lips, genitalia, anus, and eye with the inoculation site within 2-3 weeks of administration. Vaccinees should be educated about transmission and autoinoculation prevention methods such as frequent hand washing, covering vaccination site with bandage, and not sharing linens or clothing with unvaccinated persons.Source: CDC
Hepatitis A Vaccination Encouraged.7/02/2010. Records from Immunization Information System sentinel sites show that there was a significant improvement in Hepatitis A vaccination coverage from 17% in 2006 to 47% in 2009, but that it has now plateaued. Due to the historic low of Hepatitis A incidence reached in 2007, which is attributed to this increase in coverage, the CDC is encouraging Hepatitis A vaccination of all children beginning at the age of 12 months.Source: CDC
Pentavalent Rotavirus Vaccine (RV5) Associated with Reduction in Gastroenteritis.6/29/2010. Surveillance of 16,000 children under the age of 5 years, in a pediatric practice in New Orleans, beginning in 2004, revealed that an increase in the use of RV5 (from 11.1% to 45.6%) was associated with a 67% decease in RV-positive acute gastroenteritis (AGE) emergency department visits & hospitalizations and a 50% decrease in all-cause AGE hospitalizations. The reduction was seen among children targeted for immunization as well as older groups, suggesting a herd-immunity effect.Source: AAP
Vaccination-Induced HIV Seropositivity/Reactivity. 7/21/2010. Background: HIV vaccination can cause a reactive result in HIV testing in the absence of infection known as vaccine-induced seropositivity/reactivity (VISP). Methods: HIV-seronegative adults who completed phase 1 and phase 2a vaccine trials were evaluated using 3 common FDA approved enzyme immunoassay (EIA) HIV antibody kits to determine the frequency of VISP occurrence. Results: 908 of 2176 participants had VISP (41.7%; 95% CI, 39.6%-43.8%). 399 of 460 (86.7%; 95% CI, 83.3%-89.7%) adenovirus 5 product recipients, 295 of 552 (53.4%; 95% CI, 49.2%-57.7%) recipients of poxvirus alone or as a boost, and 35 of 555 (6.3%; 95% CI, 4.4%-8.7%) of DNA-alone product recipients developed VISP. The types EIA assays used presented varying results, however, all recipients of a glycoprotein 140 vaccine (n = 70) had VISP, with 94.3% testing reactive with all 3 EIA kits tested. Author's Conclusion: The induction of VISP is very common; development and detection appear to be associated with the immunogenicity of the vaccine and the EIA assay used.Source: JAMA
Need for Better Pneumococcal Vaccines. 7/01/2010. Background: There is a debate surrounding the efficacy of the 23-valent pneumococcal polysaccharide vaccine (PPV) and whether it reduces mortality and hospitalization for vaccine-preventable infections following community-acquired pneumonia (CAP). Methods: A population-based cohort study in Canada followed 2,950 hospitalized CAP patients and their post discharge outcomes for 5 years. Results: 48% of the patients died after discharge and 17% were readmitted with vaccine-preventable infections. Overall, 55%, or 1,626 of the 2,950 patients, reached the composite outcome of death or infection. Conclusions: PPV was not associated with a reduced mortality or hospitalization rate, and half of patients discharged from the hospital after pneumonia die or are readmitted with a vaccine-preventable infection within 5 years. Source: CID
TLR9 Agonist to 7vPnC Increases Efficacy in HIV Patients. 7/01/2010. Background: HIV patients are typically under responsive to immunization, and this trial tested whether adding CPG 7909, a toll like receptor 9 (TLR9) agonist and vaccine adjuvant, to 7 valent pneumococcal conjugate vaccine (7vPnC) would increase its efficacy in these individuals. Methods: This was a double blind, placebo controlled, phase 1b/2a study in which 7vPnC (Prevnar) and 23 valent pneumococcal polysaccharide vaccine (PPV23; Pneumo Novum) doses were combined with either 1 mg of CPG 7909 or a phosphate buffered saline and randomly assigned and administered to 97 HIV positive adults. Results: The proportion of high responders at the end of the experiment were 48.8% and 25% for the CPG 7909 and phosphate buffered saline groups respectively. Mild systemic and injection site reactions to the 7vPnC were more common in the CPG 7909 group, but no adverse effects on CD4+ cell count or organ functions occurred. Conclusions: The addition of CPG 7909 to the 7vPnC greatly increased the vaccination's efficacy in HIV-infected adults. Source: CID
June 2010
Rotavirus Vaccine Contraindicated in Infants with SCID. 6/11/2010. Merck & Co. and GlaxoSmithKline Biologicals have both revised the prescribing information and patient labeling for their rotavirus vaccine products with approval from the FDA due to the eight reported cases of vaccine-acquired rotavirus infection in severe combined immunodeficiency (SCID) patients since the vaccination's introduction to the United States in 2006. The rotavirus vaccine (both RV1 and RV5) is now contraindicated in infants diagnosed with SCID. Source: CDC
May 2010
Human Papillomavirus Vaccine Guidance. 5/28/2010. The FDA approved the use of HPV2 (Cervarix) in females 10 to 25 years of age and HPV4 (Gardasil) in males and females 9 to 26 years of age. The Advisory Committee on Immunization Practices (ACIP) recommends routine and catch-up vaccinations for females only; the use of HPV4 in males to prevent the risk of acquiring genital warts is approved, however, routine use is not recommended. Source: CDC
ACIP Recommendations: Use of MMRV Vaccine. 05/07/2010. Since July 2007, supplies of combination measles, mumps, rubella, and varicella vaccine (MMRV, ProQuad) vaccine have been temporarily unavailable as a result of manufacturing constraints unrelated to efficacy or safety (i.e., lower-than-expected yields of bulk varicella-zoster virus in production lots). MMRV vaccine is expected to be available again in the United States in May 2010. ACIP recommendations for use of MMRV vaccine have been summarized. The routinely recommended ages for measles, mumps, rubella, and varicella vaccination continue to be 12--15 months for the first dose and 4--6 years for the second dose. MMRV vaccine may be administered simultaneously with other vaccines recommended for children aged 12--15 months and 4--6 years. If simultaneous administration is not possible, MMRV vaccine may be administered at any time before or after an inactivated vaccine but at least 28 days before or after another live, attenuated vaccine, except varicella vaccine, for which a minimum interval of 3 months is recommended. Source: CDC
April 2010
Vaccination Statistics in Health-care Providers (HCP) for Seasonal Flu and Influenza A H1N1: 04/02/2010: The CDC MMWR released an update to vaccination rates up until January 2010. Seasonal influenza vaccine became available in August 2009, and 2009 H1N1 vaccine became available in October. By mid-January 2010, an estimated 61.9% of HCP had received a seasonal influenza vaccination and an estimated 37.1% of HCP had received a 2009 H1N1 vaccination. Seasonal influenza vaccination coverage was substantially higher among HCP working in hospitals (71.7%) than those working in long-term care facilities (54.0%) or other settings (48.4%) (p = 0.003 and p = 0.001, respectively). 2009 H1N1 vaccination coverage also was higher among HCP working in hospitals (50.6%) than those working in outpatient clinics (39.2%), long-term care facilities (20.1%), or other settings (33.4%) (p = 0.003, p<0.001, and p = 0.015, respectively). HCP working in intensive-care, burn, or obstetric units, or around seriously ill patients were more likely to be vaccinated than other HCP for both seasonal influenza (70.2% versus 59.0%; p = 0.026) and 2009 H1N1 (48.2% versus 33.4%; p = 0.003). HCP with a bachelor's degree or higher were more likely to be vaccinated for 2009 H1N1 compared with HCP with a high school diploma or less (41.9% versus 27.6%; p = 0.014). Educational status was not associated with receipt of seasonal influenza vaccination, nor was sex, age, or race associated with coverage of either vaccine type. HCP were more likely to believe seasonal influenza vaccination was safe compared with 2009 H1N1 vaccination (80.9% versus 66.6%; p<0.001). Although HCP considered both vaccines to be protective, more HCP believed seasonal influenza vaccination was worth the time and expense (74.2%) than did those who believed 2009 H1N1 vaccination was worth the time and expense (62.8%; p<0.001). Source: CDC
March 2010
Rotarix Vaccine Suspended Due to Presence of Porcine Circovirus Type 1 Presence: 03/22/2010. The FDA is recommending that healthcare professionals temporarily suspend the use of Rotarix, a vaccine used to prevent rotavirus disease. FDA's recommendation is a precaution taken while the agency learns more about the situation. Source: FDA MedWatch
New 13-Valent Pneumococcal Conjugate Vaccine May Protect Against Invasive Pneumococcal Disease. 03/12/2010. Invasive pneumococcal disease (IPD) is known to be caused by Streptococcus pneumoniae (pneumococcus) and is still the leading cause of serious illness in children and adults. In February 2010, the Advisory Committee on Immunization Practices (ACIP) provided recommendations for use of a newly licensed 13-valent pneumococcal conjugate vaccine (PCV13). PCV13 contains the seven serotypes in PCV7 (4, 6B, 9V, 14, 18C, 19F, and 23F) and six additional serotypes (1, 3, 5, 6A, 7F, and 19A). This recommendation came after noticing that routine infant immunization with PCV7, there was noticeable increase in IPD from non-PCV7 serotypes, predominantly serotype 19A. As such, the ACIP now recommends the use of PCV13 in the routine immunization schedule since has the potential to further reduce IPD caused by the six additional serotypes (1, 3, 5, 6A, 7F, or 19A) among children aged <5 years. In addition, based on available safety, immunogenicity and disease burden data, the ACIP also recommends that a single supplemental PCV13 dose be given to healthy children aged 14--59 months and to children with underlying medical conditions up to age 71 months who already have completed a schedule of PCV7. Source: CDC
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