Understanding Changes to the 2018 Immunization Schedule. H. Cody Meissner, MD, FAAP Professor of Pediatrics Tufts University School of Medicine

Transcription

1 Understanding Changes to the 2018 Immunization Schedule H. Cody Meissner, MD, FAAP Professor of Pediatrics Tufts University School of Medicine

2 Disclaimer I have no financial relationships with the manufacturer(s) of any commercial product(s) discussed in the presentation. I will discuss the use of certain vaccines in a manner not consistent with the Package Insert, but all recommendations are in accordance with recommendations from the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC). Statements and opinions expressed are those of the author and not necessarily those of the AAP.

3 Objectives of Today s Presentation Understand the reason for change in timing of hepatitis B vaccine. Review clarification of polio vaccine use relative to changes in global polio. Discuss the current influenza season and recommendations for influenza vaccination. Present basis for a 3rd dose of mumps-containing vaccine.

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8 Changes to 6 Footnotes in the 2018 Schedule Simplification of footnotes Changes to the following footnotes: o Hepatitis B vaccine o Haemophilus influenzae type b vaccine o Polio vaccines o Influenza vaccines o Meningococcal vaccines o MMR (MMRV) vaccines Reasons we vaccinate

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10 Percentage of children aged <5 years with Treat with confidence. Trusted answers from the American Academy of invasive Haemophilus influenzae type b disease, Pediatrics. by vaccine status,

11 Polio Virus: The End Game Strategy

12 Global Polio Cases as of January 27, 2018 Endemic countries: Non-endemic countries: Afghanistan, Nigeria, Pakistan Lake Chad Basin, Central Africa, Syrian Arab Republic

13 Influenza Season Week Ending January 20, 2018

14 What s New in for Influenza Vaccine Recommendations? Who should be vaccinated? Is LAIV recommended this season? Is vaccine recommended for pregnant women? What is the latest guidance for people with egg allergy? Why isn t quadrivalent vaccine recommended over trivalent vaccine? Does simultaneous administration of IIV and PCV13 increase the risk of febrile seizure?

15 Mumps in the National Hockey League Sidney Crosby in December 2015, Pittsburgh Penguins star

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17 Complications of Mumps, Time Period Comparison Treat with confidence. Trusted answers from the American Academy of Pediatrics.

18 Mumps Viruses in US: /2017 Genotype * Total G C H K N A 1 1 Total *as of March 1 K: previously named K/M A: Jeryl-Lynn, vaccine (Merck) N: Leningrad-Zagreb (SII)

19 3rd Dose Mumps Virus-Containing Vaccine a 3rd dose of a mumps virus-containing vaccine should be administered to persons previously vaccinated with 2 doses who are identified by public health authorities as being part of a group at increased risk for acquiring mumps because of an outbreak. Marin M, Marlow M, Moore KL, Patel M. Recommendation of the Advisory Committee on Immunization Practices for use of a third dose of mumps viruscontaining vaccine in persons at increased risk for mumps during an outbreak. MMWR. 2018;67(1):33 38

20 Four Meningococcal Vaccines 1 Administer at least 4 weeks after all PCV doses 2 May be given to people 56 years or older 3 May be given to people 26 years or older

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22 Treat with confidence. Trusted answers from the American Academy of Pediatrics. What is Required to Achieve Community Protection? (Community or Herd or Indirect Immunity)

23 Community Protection (Herd Immunity) Blue = not immunized but still healthy Yellow = immunized but healthy Red = not immunized, sick and contagious

24 Community Protection Important for: 1. Children/infants too young to be vaccinated 2. Pregnant women 3. People in whom vaccine-induced immunity has waned 4. Immunosuppressed patients who cannot be vaccinated 5. Elderly people who may not mount an adequate immune response to a vaccine 6. People with inadequate access to vaccinations 7. People who remain unvaccinated by choice

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