immunizations in 2014
Download
Skip this Video
Download Presentation
IMMUNIZATIONS IN 2014

Loading in 2 Seconds...

play fullscreen
1 / 43

IMMUNIZATIONS IN 2014 - PowerPoint PPT Presentation


  • 87 Views
  • Uploaded on

IMMUNIZATIONS IN 2014 . Head to toe conference may 2014. Lance Chilton, M.D. Professor, Pediatrics University of New Mexico. The reason we immunize. Achievements in Public Health, 1900-1999 Impact of Vaccines Universally Recommended for Children -- United States, 1990-1998

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about ' IMMUNIZATIONS IN 2014 ' - liluye


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
immunizations in 2014

IMMUNIZATIONS IN 2014

Head to toe conference may 2014

Lance Chilton, M.D.

Professor, Pediatrics

University of New Mexico

the reason we immunize
The reason we immunize

Achievements in Public Health, 1900-1999 Impact of Vaccines Universally Recommended for Children -- United States, 1990-1998

At the beginning of the 20th century, infectious diseases were widely prevalent in the United States and exacted an enormous toll on the population. For example, in 1900, 21,064 smallpox cases were reported, and 894 patients died (1). In 1920, 469,924 measles cases were reported, and 7575 patients died; 147,991 diphtheria cases were reported, and 13,170 patients died. In 1922, 107,473 pertussis cases were reported, and 5099 patients died (2,3).

Dramatic declines in morbidity have been reported for the nine vaccine-preventable diseases for which vaccination was universally recommended for use in children before 1990 (excluding hepatitis B, rotavirus, and varicella) . Morbidity associated with smallpox and polio caused by wild-type viruses has declined 100% and nearly 100% for each of the other seven diseases.

MMWR, April 2, 1999

a influenza aka just the flu
A: influenzaAKA: “Just the flu”

Molinari et al. Vaccine 25 (2007) 5086–5096

new mexico s school kids influenza immunization project
New mexico’s school kids’ influenza immunization project

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

X

early albuquerque data flu school absences
Early Albuquerque data: Flu  school absences

Gurule, Escareno, Dharas, Pentler, Skipper and Chilton, unpublished

where do immunization recs come from
Where do immunization recs come from?
  • American Academy of Pediatrics Committee on Infectious Diseases (Red Book Committee) : meets twice a year, produces Red Book every 3 years
  • ACIP – Next Meeting: June 25-26, 2014, Atlanta
      • Informational items
      • Votes
slide12

Screen for Powerpoints

Podium

Larry Pickering

Jonathan Tempte

Head Table

Audience

Audience

L

L

M

M

ACIP

Members

Liaisons

Audience

slide13

ACIP Products

www.cdc.gov/vaccines

are vaccines safe and what s vaers anyway
Are vaccines safe?AND WHAT’S VAERS ANYWAY?

Vaccine Adverse Effects Reporting System

the v accine s afety d atalink
The vaccine safety datalink

This is the most robust vaccine safety system; there are others (example: military).

the rotashield story born 1998 died 1999
The rotashield® story (born 1998, died 1999)
  • Rotavirus kills some 450,000 children per year around the world; 20-60 in the United States
  • Early 1990s , clinical trials showed 80-100% effectiveness against severe rotavirus diarrhea and excellent safety profile
  • 1998: RotaShield licensed
  • Late 1998: reports to VAERS of many cases of intussusception after RotaShield receipt
  • VAERS Signal reported to VSD, which affirmed the hypothesis that RotaShield associated with intussusception
  • 1999: Rotashield removed from market.
  • Early 2000s, clinical trials on far more children showed no association with intussusception for two new vaccines, Rotarix® and Rotateq®
  • 2006: Rotarix and Rotateq approved by FDA and recommended by ACIP

SUCCESS

OR FAILURE OF THE VACCINE SAFETY SYSTEM?

too many antigens
Too many antigens?
  • 2012: 2 month shots:
  • Antigens:
  • Rotavirus 5
  • Pediarix
    • Diphtheria 1
    • Tetanus 1
    • Pertussis 3
    • Polio 3
    • Hepatitis B 1
  • H. Influenzae B 1
  • Pneumococcal 13
  • Total 28

Streptococcal Infection =

25-50 antigens

Upper respiratory

infection =

4-10 antigens

In the old days:

Smallpox vaccine =

~200 antigens

Whole cell pertussis vaccine =

~3000 antigens

vaccines aren t free
Vaccines aren’t free
  • But no, folks, you won’t have to pay for vaccines in New Mexico (yet).
in 42 states
In 42 states…
  • But only for
  • Uninsured
  • Native Americans/Alaska Natives
  • Medicaid insured
  • Underinsured
      • But only in FQHC or RHC
in 6 states nh ri vt wi wy and
In 6 states (NH, RI, VT, WI, WY and…

New mexico!)

  • For all children and adolescents before their 19th birthday

Alaska, Hawaii, Maine, Massachusetts, South Dakota, Washington cover most but not all childhood vaccines

are these vaccines affordable
Are these vaccines affordable?
  • In Arizona, Colorado, Utah, Texas and most other states, the total private sector price of all vaccines for each person (except influenza) through age 18 was $2171 + vaccine administration as of April 2014.
  • In New Mexico, the price to patients is $0 + vaccine administration

Vaccines for Children for everyone in New Mexico is under attack!

why is this important
Why is this important?

Vaccines for the first five years

Vaccines for adolescence

April 1, 2014, CDC data

is it worth it figures for one birth cohort 2009 4 26 million births
Is it worth it? FIGURES FOR ONE BIRTH COHORT – 2009: 4.26 MILLION BIRTHS

Cost:benefit ratio

Direct costs only: 3.0

Total societal costs: 10.1

THAT’S $20 BILLION and $76 BILLION!

DEATHS

Zhou F et al. Economic Evaluation of the Routine Childhood Immunization Program in the US, 2009. Pediatrics, 2014. 133:577.

results
RESULTs…

VACCINE

for everyone else

VFC

VACCINE

$90,000

how re we doing on individual adolescent vaccines
How’re we doing on individual adolescent vaccines?

90

80

70

60

50

40

30

20

10

HOW DO THEY DO THAT?

UK

Vaccines for Children for everyone in New Mexico is under attack!

?

CDC 2012 NIS data in MMWR, Aug. 30, 2013

cervical cancer in new mexico
Cervical cancer in new mexico

New Mexico Tumor Registry, 2006-2010 data

slide40

Prevalence of individual human papillomavirus (HPV) types among females aged 14–19 years, 2003–2006 and 2007–2010.

Markowitz L E et al. J Infect Dis. 2013;208:385-393

Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2013.

special communiqu from the front
Special communiqué from the front

HPV vaccination does not cause teenagers to have sex

Mayhew A et al. Sexual Behaviors after HPV Vaccination. Pediatrics, 2014. 133:404.

should we give more vaccines in new mexico schools
SHOULD WE GIVE MORE VACCINES IN NEW MEXICO SCHOOLS?
  • No
  • School nurses already have too many tasks
  • Some vaccines are too controversial
  • Yes
  • That’s where the kids are!
  • We could teach about the diseases prevented
thank you for all you do
Thank you for all you do!
  • "Schools have a wealth of potential for ensuring the future well-being of young people. You can\'t educate a child who isn\'t healthy, and you can\'t keep a child healthy who isn\'t educated."
  • -- M. Jocelyn Elders, MD
ad