There
are a number of exciting developments in immunizations. Nine new
vaccines have been licensed since January 2005. Expanded use of
these vaccines was also approved during that time. Included are
vaccines which provide protection to older children and adults against
pertussis (as well as tetanus and diphtheria) and meningococcal
disease. Also available are vaccines which help protect against
rotavirus, a disease which causes severe diarrhea in young babies;
human papilloma virus, which can cause some forms of cervical cancer;
and shingles.
New Vaccine Information:
Tetanus,
Diphtheria and Pertussis (Tdap) Vaccines
Pertussis is a highly contagious and potentially serious illness
in adolescents and adults and can cause prolonged cough and missed
days at school and work. In young infants, pertussis is often severe
and can be fatal, particularly in those too young to have received
the primary series of 3 pertussis shots. Since 1980, the rates of
reported pertussis cases have been increasing in adolescents and
adults, as well as in young infants. It is believed that adolescents
and adults are contracting pertussis and spreading it to babies
and young children. It is important for parents, grandparents and
adolescents to be vaccinated, to prevent the spread of pertussis
to babies, where the disease is more severe.
For more information on pertussis and why it’s important to
get vaccinated:
http://www.dhs.ca.gov/ps/dcdc/izgroup/pdf/IMM-843.pdf
and
http://www.dhs.ca.gov/ps/dcdc/izgroup/pdf/IMM-847.pdf
In 2005, FDA approved two vaccines to protect against tetanus, diphtheria
and pertussis (whooping cough). One Tdap vaccine was licensed for
use in adolescents ages 10-18 years, and the other for use in individuals
11-64 years of age.
Approval of these Tdap vaccines is very timely, since reported pertussis
cases have been increasing across the US in recent years. In 2005
San Diego County saw 371 cases of pertussis - more than three times
the previous year’s total. Of these, 90 (24%) were less than
one year of age, 74 (20%) were children ages 1-9, 102 (28%) were
children or adolescents ages 10-19, and 105 (28%) were adults over
20 years of age.
For more information,
visit:
http://www.cdc.gov/vaccines/vpd-vac/combo-vaccines/DTaP-Td-DT/tdap.htm
To access the 7/12/06 interim Vaccine Information Statement (VIS)
from the National Immunization Program (NIP) website, go to:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-tdap.pdf
In March 2006, the federal Centers for Disease Control and Prevention
(CDC) published the Advisory Committee on Immunization Practices
(ACIP) recommendation “Preventing Tetanus, Diphtheria, and
Pertussis Among Adolescents: Use of Tetanus Toxoid, Reduced Diphtheria
Toxoid, and Acellular Pertussis Vaccines.” The recommendation
can be viewed online at:
http://www.cdc.gov/mmwr/pdf/rr/rr5503.pdf
Most recently, a new recommendation to vaccinate adults has recently
been made official by publication in the CDC’s Morbidity and
Mortality Weekly Report (MMWR). It is available at:
http://www.cdc.gov/mmwr/pdf/rr/rr5517.pdf
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Meningococcal Conjugate Vaccine
(MCV 4)
The CDC’s Advisory Committee on Immunization Practices (ACIP)
and the American Academy of Pediatrics (AAP) both recommend that
young adolescents, college freshmen and other groups at higher risk
of contracting meningococcal disease or of suffering complications
from the disease be immunized against it. Meningococcal disease
can cause a potentially fatal bacterial infection. Although rare,
meningococcal disease is dangerous because the disease progresses
rapidly, and within hours of the onset of symptoms it may cause
permanent disability or death. Immunization with the Meningococcal
Conjugate Vaccine (MCV4) protects against the disease.
The ACIP recommends routine meningococcal vaccination (MCV4) for
certain age groups:
- Young adolescents
(11-12 years of age)
- Adolescents
at high school entry or 15 years of age (whichever comes first)
for those who have not previously been vaccinated
- All college
freshmen living in dormitories
- Other groups
at high risk such as those with underlying medical conditions
or travelers to areas with high rates of meningococcal disease
To access the
CDC’s Vaccine Information Statement (VIS) on MCV, go to:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf
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Rotavirus
Vaccine
In early 2006, FDA licensed a live, oral vaccine for use in preventing
rotavirus gastroenteritis in infants and children. On February 21,
2006, ACIP voted to recommend the use of the newly licensed rotavirus
vaccine in infants at ages 2, 4, and 6 months. This vaccine series
must be completed before the child is 32 weeks of age.
Rotavirus
is a serious disease which causes severe diarrhea, mostly in babies
and young children. Each year in the U.S., rotavirus is responsible
for more than 400,000 doctor visits, 200,000 emergency room visits,
55,000 to 70,000 hospitalizations and 20-60 deaths. Almost all children
in the U.S. are infected with rotavirus before their 5th birthday.
To access the CDC’s Vaccine Information Statement (VIS) on
Rotavirus, go to:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-rotavirus.pdf
For more information, visit:
http://www.cdc.gov/vaccines/vpd-vac/rotavirus/dis-faqs.htm
Rotavirus Vaccine Fact Sheet
(download PDF in English)
Rotavirus-Fact-Sheet-for-Providers.pdf
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Human
Papillomavirus Vaccine (HPV)
In June 2006 the Food and Drug Administration (FDA) announced the
approval of a human papillomavirus (HPV) vaccine. This is the first
vaccine developed to prevent cervical cancer, precancerous genital
lesions and genital warts due to HPV types 6, 11, 16 and 18. Types
16 and 18 are the cause of 70% of cervical cancers and types 6 and
11 cause 90% of genital warts. The vaccine will have the biggest
impact if given before a women becomes sexually active. All women,
even if vaccinated, should follow recommendations for routine PAP
testing. The vaccine is approved for use in females 9-26 years of
age. The ACIP has recommended routine vaccination
for 11-12-year-old girls and catch-up vaccination for 13-26 year-old
girls who have not been vaccinated previously or who have not completed
the full three-dose series.
On
average, there are 9,710 new cases of cervical cancer and 3,700
deaths attributed to it in the United States each year. Worldwide,
cervical cancer is the second most common cancer in women; and is
estimated to cause over 470,000 new cases and 233,000 deaths each
year. HPV is the most common sexually-transmitted infection in the
United States. The Centers for Disease Control and Prevention estimates
that about 6.2 million Americans become infected with genital HPV
each year and that over half of all sexually active men and women
become infected at some time in their lives.
To access the CDC’s Vaccine Information Statement (VIS) on HPV, go to:
http://www.immunize.org/vis/hpv.pdf
HPV Vaccine Fact Sheet
(download PDF in English)
HPV-Fact-Sheet-for-Providers.pdf
For more information on these recommendations, please
visit:
http://www.cdc.gov/mmwr/PDF/rr/rr5602.pdf
For more information, visit:
http://www.cdc.gov/vaccines/vpd-vac/hpv/default.htm
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Zoster
(Shingles) Vaccine
This year, the
Food and Drug Administration (FDA) licensed a new vaccine to reduce
the risk of shingles (herpes zoster) for use in people 60 years
of age and older. Children should not receive shingles
vaccine.
Shingles is a disease caused by the varicella-zoster virus, the
same virus that causes chickenpox. After an attack of chickenpox,
the virus lies dormant in certain nerve tissue. As people age, it
is possible for the virus to reappear in the form of shingles, which
is estimated to affect 2 in every 10 people in their lifetime. Shingles
is characterized by clusters of blisters, which develop along a
nerve pathway and can cause severe pain (post-herpetic neuralgia)
that may last for weeks, months, or years after the virus reappears.
The vaccine was shown to boost immunity against varicella-zoster
virus. This is thought to be the way by which the vaccine protects
against shingles and its complications. During the study period,
the vaccine reduced the occurrence of shingles by 51% and reduced
the duration of pain in people who developed the disease despite
being vaccinated.
To access the CDC’s Vaccine Information Statement (VIS) on
shingles vaccine, go to:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-shingles.pdf
To
read questions and answers about the disease and the vaccine, go
to:
http://www.fda.gov/cber/products/zosmer052506qa.htm
Zoster
(Shingles) Vaccine Fact Sheet
(download PDF in English)
Shingles-Fact-Sheet-for-Providers.pdf
If you have additional questions about these vaccines, please call the Immunization Branch at (619) 692-8661.
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