Posted: 28 Feb 2020 03:22 PM PST

The pediatric monovalent hepatitis B vaccine shortage is ending March 9 for the private sector, a bit of good news from the Feb. 26-27 meeting of the Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP).

Merck plans to begin distributing pediatric monovalent hepB vaccine in the private sector on March 9. The vaccine supply is projected to be sufficient to meet historical demand in the private and public sectors. For updates on shortages, visit https://www.cdc.gov/vaccines/hcp/clinical-resources/shortages.html.

Other infectious disease topics discussed were the novel coronavirus (COVID-19), polio eradication, dengue virus, Ebola virus and influenza.

COVID-19

Nancy Messonnier, M.D., director of the CDC's National Center for Immunization and Respiratory Diseases, emphasized the importance of readiness.

"Prepare for something serious," she said. "Many of you have been planning for a pandemic for your whole careers. That planning is exactly what we're depending on here."

Dr. Messonnier said first responders, health care providers and health care systems should do the following to prepare:

establish plans to understand use and potential surges,
develop guidance on infection control, hospital preparedness assessments, personal protective equipment supply planning and clinical evaluation and management,
reinforce infection control principles,
leverage telehealth tools and
engage with supply chain partners to understand use and needs.

At the state and local levels, she urged readiness preparedness that includes monitoring health of travelers from China, assessing readiness to implement community mitigation measures, identifying and mitigating gaps in readiness, and linking public health agencies and health care systems to identify and mitigate stressors.

Polio eradication

Polio eradication efforts made some progress in 2019 but encountered "serious challenges," including circulation of wild poliovirus and outbreaks of community vaccine-derived poliovirus 2. A more genetically stable novel oral polio vaccine type 2 has been developed, according to Stephen L. Cochi, M.D., FAAP, senior adviser to the director, CDC Global Immunization Division. The vaccine is being evaluated for approval under the World Health Organization (WHO) Emergency Use Listing and would replace monovalent type 2 oral polio vaccine. About 4 million to 8 million doses could be available for pilot use in mid-2020 and an estimated 200 million more by year's end.

Dengue vaccine

Despite low mortality rate, dengue is a public health priority and one of the top 10 threats in 2019, according to the WHO.

In May 2019, the Food and Drug Administration (FDA) approved Dengvaxia for 9- to 16-year-olds who live in an area where dengue is common and have laboratory-confirmed prior dengue virus infection. Ines Esquilin, M.D., of the University of Puerto Rico Department of Pediatrics, shared focus group study results on pediatrician and parent attitudes about the vaccine in Puerto Rico.

The island's segmented system requires patients to make separate visits to the pediatrician, the laboratory for testing and the clinic for immunizations. Testing is required before receiving the dengue vaccine, because people who receive the vaccine and have not been infected with a dengue virus may be at risk of developing severe dengue.

The committee agreed to revisit a possible recommendation if a laboratory test with acceptable specificity were available to document prior dengue infection. Other necessary steps would include lab test and vaccine insurance coverage and parent and physician education about the importance of the vaccine.

Ebola vaccine

The ACIP voted to recommend use of rVSV-ZEBOV (Ervebo), a single-dose vaccine against the Zaire ebolavirus species of ebolavirus. The vaccine was approved by the FDA in December for use in individuals 18 years and older.

The ACIP voted to recommend the vaccine for those responding to an outbreak of Ebola virus disease, health care personnel at a federally designated Ebola Treatment Center in the U.S., and laboratorians and staff at biosafety level 4 facilities in the U.S. who are at potential risk for occupational exposure.

If the CDC director approves ACIP's recommendations, they will be published as official recommendations in the Morbidity and Mortality Weekly Report. The AAP reviews pediatric-relevant guidance and make its own recommendations.

Influenza 2020-'21

Recommended strains for the 2020-'21 season's northern hemisphere influenza vaccines were not available from the WHO until after the ACIP meeting. The U.S. influenza strain selection will be voted on during the FDA Vaccines and Related Biological Products Advisory Committee meeting on March 4.

Practice guidelines

Pediatricians with practice-related questions that are not directly addressed in vaccine recommendations can access the General Best Practice Guidelines for Immunizationat http://bit.ly/CDCbestpracticeiz. Three sections have been updated:

Timing and Spacing: Two-dose series of HPV was added to the interval table; HIV was added as an indication for which PCV13 and Menactra must be spaced by an interval; and there is no need for interval between recombinant zoster vaccine and anti-herpes antivirals.
Contraindications and Precautions: Yeast is acknowledged as a component of PCV13, and pregnancy is listed as a reason not to administer HPV vaccine.
Storage and Handling: Information was added about when to repeat doses that were later found to be expired.

ACIP membership

The ACIP is seeking membership applications for a four-year term beginning July 1, 2021. Candidates must have a broad range of expertise and interest in vaccines and immunizations and meet criteria listed in the online application. Apply by July 1, 2020, at http://bit.ly/ACIPmembers2021. The committee's next meeting is June 24-25.

Republic of Congo steps up polio vaccination in border region - Congo - ReliefWeb

Posted: 11 Feb 2020 12:00 AM PST

Ouesso, (Congo), 11 February 2020 - Under a sultry and showery sky, small teams fanned out across villages in Sangha, a department in the far north of Republic of the Congo, vaccinating children against wild poliovirus in the country's latest campaign to boost immunization and suppress the risk of cross-border transmission.

Sangha borders Cameroon and Central African Republic, where circulating vaccine-associated poliovirus was detected in 2019. Vaccinator Yvonne Komba and her team visited over 16 villages and vaccinated more than 30 children on the third and last day of the campaign. Unlike years past, Ms Komba recounted, communities are more receptive to vaccinations thanks largely to public health education and regular immunization campaigns.

"Parents are now conscious about the dangers of failing to vaccinate children against polio," said Ms Komba, but pointed out that at times they have worked with village leaders when some families refuse to have their children immunized.

Mother of two Christelle Bangondo readily brought her children for vaccination when Ms Komba's team came to her village, saying she trusted vaccines after a previous immunization against diphtheria, tetanus and whooping cough made her children less prone to coughing.

Low immunization risks

Congo's last major wild polio outbreak was in 2010. The poliovirus type 1 (there are three types) epidemic infected more than 180 people and killed 85, mostly in the Atlantic port city of Pointe Noire in an outbreak found to be linked to one that was going on in neighbouring Angola. The majority of the infections and deaths were in people over 15 years.

No outbreak of such scale has since occurred in Congo. The country has stepped up polio control measures, but the rate of vaccination was still below 80% in 2019, although up from 68% the year before. Low immunization coverage and poor sanitation puts Congo at risk of circulating vaccine-derived poliovirus

In such settings the virus excreted by children after oral polio vaccination can be transmitted, leading to genetic changes and emergence of circulating vaccine-derived poliovirus. When enough people in a community are immunized, the virus is deprived of susceptible hosts and will die out. High levels of vaccination coverage must be maintained to stop transmission and prevent outbreaks. The virus can easily be imported into a polio-free country and can spread rapidly amongst unimmunized populations. So far Congo has not had a vaccine-derived poliovirus case.

The vaccination drive in Sangha targeting more than 24 000 children was the second in 2019. A countrywide one was held six months earlier. Two campaigns are planned in 2020. The mass immunizations are in addition to routine vaccinations.

Dr Edouard Ndinga, who heads the polio programme at World Health Organization in Congo, noted that the country's current polio vaccination rate "does not ensure full immunity for all children."

Weak public health system, inadequate personnel, logistical challenges and difficulty in reaching some localities are among the impediments to comprehensive polio vaccination efforts in Congo.

Polio has no cure. It can only be prevented. The polio vaccine can protect a child for life.

At the end of the campaign in Sangha, more than 19 000 children were vaccinated. Some far-flung localities were, however, not reached due to logistical difficulties. "The response by the communities during the vaccination campaign was impressive," said Dr Rene Malhela, director of the public health department in Sangha. A few months before the vaccination drive, four suspected polio cases were reported in Sangha, but they turned out negative, Dr Malhela said, pointing out that educating the population, disease surveillance and vaccinations have helped curb the virus.

"It's been more than 20 years since we had a child paralysed by polio. Vaccinations have made a huge impact. said Dr Malhela.

The world has made major progress towards wild polio eradication. In October 2019, an independent expert commission certified wild poliovirus type 3 as eradicated. Type 2 has been eradicated.

This year, Africa is on the cusp of a monumental public health success. With no cases of wild polio virus type 1 reported since August 2016, the region is on track to be certified to have eradicated wild polioviruses in 2020.

Press Herald - - Press Herald

Posted: 29 Feb 2020 01:00 AM PST

Last year the Maine Legislature enacted a law requiring students in public and private schools to have vaccinations unless a medical professional finds it to be a danger to the student's health. These vaccinations protect against mumps, measles, chickenpox, polio, rubella, whooping cough, diphtheria and tetanus.

Now we have Question 1 – a proposal to do away with the new law – to be voted on March 3.

To keep this law, vote "no" on Question 1.

These diseases can be transferred everywhere you go: at restaurants, at the mall, at church, at the movies. The spread of these diseases can cause death for children and adults who have certain medical conditions. Since the elderly have weakened immune systems, they are especially vulnerable to these diseases.

Years ago, when the polio vaccine first came out, my mother was afraid that the vaccine itself would cause harm to me and actually cause me to get polio. Fortunately for me, she finally decided to listen to the doctors and she put aside her fears to protect me. And I have always been grateful for her decision.

Now that I am a "senior citizen," I ask for help to protect others like me by voting "no" to keep the new law in place.

Please vote "no" on Question 1.

Barbara Feltes

Portland

Invalid username/password.

Please check your email to confirm and complete your registration.

Use the form below to reset your password. When you've submitted your account email, we will send an email with a reset code.

« Previous

Letter to the editor: The facts on vaccines call for a 'no' vote on 1

filed under: