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The Children's Hospital of Philadelphia

Vaccine Update for Healthcare Providers

April 2013

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

News and Views: Measles and congenital rubella syndrome reports in MMWR

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

The March 29, 2013 issue of Morbidity and Mortality Weekly Report (MMWR) contained articles related to cases of vaccine-preventable diseases in the United States:

  • Measles outbreaks – Two measles outbreaks occurred in Utah during 2011 and both were related to importations of the disease following international travel. A total of 13 cases were confirmed. In addition, approximately 13,000 contacts had to be notified, 8,700 medical records of exposed persons reviewed, 253 laboratory tests conducted, 484 vaccines administered and 28 prophylactic treatments given.

    An accompanying editorial note reinforced the importance of vaccination and the necessary vigilance on the front lines when considering potential diagnoses of febrile rash illnesses.
     
  • Cases of congenital rubella syndrome (CRS) – Although rubella has been eliminated from the U.S., the disease continues to occur elsewhere throughout the world. In 2012, three babies were born with CRS following maternal infection during pregnancy; in all three cases, the mom had traveled to the U.S. from other countries in which rubella vaccination is not routine. One of the three babies died.

    The accompanying editorial note pointed out that of the six cases of CRS in the U.S. since 2004, five were related to travelers; therefore, healthcare providers should consider the potential for CRS in infants born with compatible congenital defects if the mother traveled to an area where rubella infections were circulating during her pregnancy. Any suspected case of CRS is required to be reported to local health department officials.
     

Despite the fact that many vaccine-preventable diseases (VPD) are no longer common in the U.S., considering the possibility that a patient with symptoms suggestive of a VPD may be infected is of the utmost importance. In addition, because many of these diseases can easily spread in communities, handling of suspected cases should include conversations with local public health officials.

Read the MMWR reports discussed in this story»

Read a story from a public health official following a measles outbreak in her community»

In the Journals: Vaccines and autism

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

In a paper published in March 2013, Frank DeStefano and colleagues addressed the relationship between vaccines and autism (DeStefano F, Price CS, Weintraub, ES. Increasing Exposure to Antibody-Stimulating Proteins and Polysaccharides in Vaccines Is Not Associated with Risk of Autism. J Pediatr. 2013 Mar 29. doi 10.1016/j.jpeds.2013.02.001).

Read more about the paper and its findings»

Technically Speaking: Recommendations for use of meningococcal vaccines in high-risk infants and children

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

The recommendations and available products for meningococcal vaccination of high-risk infants and children have evolved since 2007 when ACIP first recommended vaccination of children age 2 to 10 years who are at increased risk for meningococcal disease. Published on March 22, 2013, the current recommendations summarize and compile all previous meningococcal recommendations. The current recommendations are complex; for example, in the recommendations for vaccinating people in certain risk groups, the number of recommended vaccine doses and products varies, and includes some off-label use. This column offers an overview of the meningococcal recommendations for vaccinating high-risk infants and children, and provides links to some valuable resources that will help healthcare professionals make appropriate vaccination decisions.

Read more about meningococcal vaccine nomenclature and recommendations»

From the Media â€” H7N9 influenza in China

In the beginning of April, a novel strain of influenza, H7N9, was identified in people with severe respiratory illness and some deaths in China. Chinese officials are in the process of completing retrospective sampling to determine if others with similar symptoms were infected prior to these first cases.

Find out more»

On the Calendar

It’s National Infant Immunization Week and World Immunization Week! National Meningitis Day is Wednesday of this week as well! Find more information in the Observances section of the calendar.

New conferences have been added to the live meetings listings; find out more about conferences being held in Massachusetts and Iowa.

Check the calendar»

On the Bookshelf: The History of Vaccines

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

The History of Vaccines project at the College of Physicians of Philadelphia recently published a similarly titled companion book to their extensive website. The primary audience is high school students; however, with more than 40 illustrations and chapters related to early methods of vaccination, the fight against polio and the expansion of the childhood immunization schedule thereafter, the book offers readers from all backgrounds useful information and historical context.

Single copies of the book are available from Amazon.com and bulk orders can be arranged by contacting the History of Vaccines staff.

Resources: Global immunization educational materials and CDC updates

Global immunization educational materials
The American Academy of Pediatrics (AAP) has partnered with the United Nation Foundation’s Shot@Life campaign to offer pediatric practices materials to educate patients and their families about the importance of global immunizations. Practices can receive a free toolkit by completing a short survey. The kit includes posters, information cards for various audiences, pin drives with media for television and computers, mobile app information cards, bandages, and fundraising tools for those who may want to go a step further.

Read more from the AAP»

Check out the shot@life campaign website»

CDC updates
The Centers for Disease Control and Prevention (CDC) had updates regarding the following over the last few weeks:

  • Teen vaccines - A variety of materials to assist with teen vaccines are available on the teen-specific section of the CDC website, including information for parents, teens, healthcare providers and public health professionals. A speakers’ bureau is currently being put together for this topic as well.
  • Updated recommendations for meningococcal disease published – The March 22, 2013, issue of MMWR (Volume 62, No. RR-2) included updated meningococcal prevention and control guidance. The guidance combines previous recommendations in one reference and includes information about the use of MenHibrix®.  Read more in this month’s Technically Speaking article»
  • You Call the Shots – The hepatitis A module of the “You Call the Shots” training course was recently updated.
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