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Immunization Update

Immunization Update. Winton G. King, M.D. Region III Medical Consultant Job Corps Health and Wellness Conference June 7, 2005. Presentation Outline. Overview of Immunization Program TagB CDC Guidelines for Children, Adolescents, and Adults VFC Program Proposed Changes New Vaccines.

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Immunization Update

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  1. Immunization Update Winton G. King, M.D. Region III Medical Consultant Job Corps Health and Wellness Conference June 7, 2005

  2. Presentation Outline • Overview of Immunization Program • TagB • CDC Guidelines for Children, Adolescents, and Adults • VFC Program • Proposed Changes • New Vaccines

  3. Overview of Immunization Program Purpose of Program • Avoid outbreaks of communicable disease to protect against loss of life and loss of time from work and training. • Support the federal government public health effort in maintaining high levels of immunization in the community.

  4. TAG B • Required basic immunizations • Td • IPV • MMR • Mantoux tuberculin skin test

  5. Immunizations required at enrollment without documentation • Td booster • IPV booster [<18 years] • MMR 1 Dose • NOTE STUDENTS RAISED OUTSIDE OF USA RECEIVE PRIMARY SERIES

  6. Required immunizations for students on entry with documented proof of prior immunizations • Td within 10 years none over 10 years booster • IPV <18years <3 doses booster 3 doses none • IPV >18Years none • MMR 1dose after 12 months 1dose 2 doses after 12 months none

  7. CDC Guidelines(see handout) • Children • Adolescents • Adults

  8. VFC Program What is the VFC Program? • Established in 1994 to provide vaccinations to children as part of routine care • Covers underinsured children • Children on Medicaid • Native Americans • Alaska natives at their doctor`s office • Provides free vaccines to doctors who serve eligible children • Administered by the CDC who contracts w/ manufacturers to buy at a reduced rate

  9. VFC Program How to Join the VFC Program? • Contact State VCF Program • Ask for Provider Enrollment Package • Complete form and return promptly • Prepare for site visit • Inform patients of VCF program

  10. VFC Program Why should Job Corps join? • Reduce out of pocket costs • Provide all ACIP-recommended vaccines • Receive customer service • Minimize paperwork • Order vaccines easily

  11. CDC Vaccine Price List

  12. CASE FOR CHANGE • CDC RECOMMENDS • IT IS GOOD MEDICAL PRACTISE • DECREASES MEDICAL LIABILITY

  13. Medical facts re Meningoccocal Disease • Meningoccocal disease fatality rate can be as high as 25% in the 15 –24 age group. • 83% of cases in the 15-24 age group are caused by the four serotypes in Menectra

  14. Medical facts re Pertussis • 20,000 cases reported in 2004 the highest number of cases in 40years • 40% of those cases were in 10-19 year olds • In the last decade, 700% increase in reported cases of adolescent pertussis. • It is estimated that over a ten year period,if this vaccine is instituted in the USA,there will be a decrease of 1.8 million cases of pertussis and a subsequent savings of 1.6 billion dollars

  15. New vaccines • Menectra: • newly licensed meningoccocal • conjugate vaccine • recommended for adolescents and college students • Targeted groups: • 11-12 year olds • 15 year olds • College freshmen in dorms • other groups at high risk[military recruits]

  16. New vaccines cont`d • Boostrix Tdap • containing tetanus toxoid, acellular pertussis and low dose diphtheria. • Licensed to be given to individuals10-18 as a single dose. • Produced by GlaxoSmith Kline

  17. FUTURE NEW VACCINES • By 2010 vaccines against meningitis pneumonia,rotavirus caused diarrhea and human papilloma virus • By 2015 vaccines against HIV/AIDS Malaria and pulmonary tb

  18. Case for new recommendations • Follow CDC guidelines in toto • Add the following immunizations • HepB • Varicella • Menectra • Boostrix

  19. 50-Year Timeline in Immunization 1950s – 1960s • 1955 Inactivated Polio Vaccine Licensed • 1961 Monovalent OPV • 1963 Trivalent OPV Licensed • 1st Measles Vaccine • 1964 ACIP Formed • 1964 20 cases of Congenital Rubella Syndrome • 1967 Mumps vaccine licensed • 1969 Rubella vaccine licensed

  20. 50-Year Timeline in Immunization 1970s • MMR vaccine licensed • Smallpox vaccination ceases in the US • 1977 Last indigenous case smallpox (Somalia) • 1979 Last case of wild virus polio (US)

  21. 50-Year Timeline in Immunization 1980s • 1980 Smallpox declared eradicated from the world • 1982 Hepatitis B vaccine becomes available • 1986 The National Childhood Vaccine Injury Act established. • 1989-1991 Major resurgence of measles in USA.55,000 cases compared to a low of 1497 cases in 1983.Two dose MMR is recommended

  22. 50-Year Timeline in Immunization 1990s • 1990 The Vaccine Adverse Reporting System [VAERS] Established • 1990 HIB polysaccharide conjugate vaccine licensed for infants. • 1991 Hep B recommend for all infants. • 1994 VFC program established • Polio elimination in USA certified

  23. 50-Year Timeline in Immunization 1990s (cont’d) • 1995 1st harmonized childhood immunization endorsed by ACIP,AAPAND AAFP is published • Varicella vaccine licensed • Hep A vaccine licensed • 1996 A cellular Pertussis vaccine licensed for use in infants • 1998 1st rotavirus vaccine licensed • 1999 FDA recommends removing mercury and thimerosol from vaccines

  24. 50-Year Timeline in Immunization 2000s • 2000 800,000 children die from measles annually.Measles declared no longer endemic in USA • Pneumococcal conjugate vaccine recommended for all young children • 2003 Measles declared no longer endemic in USA

  25. 50-Year Timeline in Immunization 2000s (cont’d) • 1ST Live attenuated flu vaccine licensed for use in 5-49 year old persons • 2004 Inactivated flu vaccine recommended for all children 6-23 months • 2005 rubella no longer endemic in USA • April 12,2005 marks the 50th anniversary of the 1st Polio vaccine

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