OVERVIEW 2018 VACCINE UPDATE 3/19/ VACCINE SCHEDULE

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1 2018 VACCINE UPDATE Mick Bolduc Epidemiologist/Vaccine Coordinator Connecticut Immunization Program March 22, OVERVIEW - Immunization Schedule - New ACIP Recommendations - Religious & Medical Exemptions - Connecticut Immunization Rates - Flu Requirements for Daycare & Pre-K - Flu Vaccine Effectiveness for Vaccine Outbreaks - New Immunization Registry VACCINE SCHEDULE 3 1

2 2018 VACCINE SCHEDULE CATCH UP SCHEDULE u Vaccine is provided universally for all children 6 months through 59 months old Flu vaccine is provided for VFC-eligible children 5-18 years old VFC eligible children: -uninsured -Medicaid enrolled -underinsured -Alaskan Native/American Indian SCHEDULE-HIGH RISK 6 2

3 MINIMUM SPACING INTERVALS - 7 MAJOR CHANGES FOR rd dose of Mumps can be administered during outbreaks -LAIV licensed for use for flu season -New Shingles vaccine (Shingrix) licensed for use for adults 50 years of age and older 8 SCHOOL IMMUNIZATION REQUIREMENTS a General Statutes requires all students to be adequately immunized before being permitted to enroll in a public or non-public school or submit a medical or religious exemption. 9 3

4 MEDICAL EXEMPTIONS -Student must present a document from a physician, physician assistant or APRN that a vaccine(s) is medically contraindicated and consistent with national standards -Child had a reaction to a previous dose -Child is allergic to a vaccine component -Child is immunocompromised 10 RELIGIOUS EXEMPTIONS Parent/guardian must submit a statement upon initial entry into the school and again at 7 th grade entry that immunization is contrary to the religious beliefs of the child or the parent/guardian. The statement must be acknowledged by one of the following: 11 RELIGIOUS EXEMPTION -Judge -Court clerk or deputy clerk -Town clerk -Notary public -Justice of the peace -Attorney -School nurse 12 4

5 CONNECTICUT IMMUNIZATION RATES: K POLIO 96.8 DTAP 96.7 MMR 96.7 HEP B 97.1 HEP A 96.7 VARICELLA TH POLIO 98.6 DTAP 98.6 MMR 98.6 HEP B 98.5 VARICELLA 98.3 MCV 95.9 TDAP CONNECTICUT IMMUNIZATION RATES: K Exemptions Religious 1.8 % Medical 0.3 % Total 2.1 % 7 th Exemptions Religious 0.9 % Medical 0.3 % Total 1.2 % 14 INFLUENZA REQUIREMENT -In 2010, Connecticut implemented an influenza vaccine requirement for all children 6 59 months attending child day care centers, group day care homes, or family day care homes. -The influenza requirement expanded in 2011 to include all children aged months enrolled in a preschool program. After implementation of the influenza requirements, vaccination rates among Connecticut children up through 59 months of age increased from 67.8% in to 87 % by

6 CONNECTICUT IMMUNIZATION RATES: Pre-K Influenza: Vaccinated 87.0 Exemptions Religious-Flu only 3.6 Religious-All 1.7 Medical INFLUENZA EFFECTIVENESS 17 INFLUENZA EFFECTIVENESS 18 6

7 INFLUENZA EFFECTIVENESS 19 VACCINE OUTBREAKS 2015 Disneyland Measles -147 Cases in 6 states plus Mexico & Canada 2017 Minnesota Measles -79 cases mostly affecting children under 10 years of age and largely in the unvaccinated Somali community -Cost to contain the outbreak was estimated to be $1.3 million 20 VACCINE OUTBREAKS Hepatitis A -San Diego cases 396 hospitalizations 20 deaths -Michigan cases 25 deaths -Kentucky cases 1 death 21 7

8 VACCINE OUTBREAKS -Measles in Europe 2016: 5,273 cases 2017: 21,315 cases -Romania & Italy > 5000 cases -Ukraine > 4700 cases -Belgium, France, Germany, Greece, Russia, Tajikistan all >1000 cases 22 VACCINE OUTBREAKS Influenza Connecticut : 48 deaths-all ages : 37 deaths-all ages : 65 deaths-all ages : 112 deaths-all ages United States : 148 deaths-pediatric : 93 deaths-pediatric : 110 deaths-pediatric : 119 deaths-pediatric 23 CT CASE OCCURENCES OF SELECTED DISEASES YEAR MEASLES RUBELLA MUMPS PERTUSSIS* TETANUS HIB VARICELLA*

9 CT CASE OCCURENCES OF SELECTED DISEASES YEAR MEASLES RUBELLA MUMPS PERTUSSIS TETANUS HIB VARICELLA Diphtheria last case 1962 Polio last case OUTBREAKS Pediatrics February Influenza associated pediatric deaths reported deaths in children <18 years old -only 31 % of those children 6 months of age and older had received a flu vaccine -almost half of these children had no pre-existing medical condition 26 WHAT CAN BE DONE? -Italy: Summer 2017 law authorizing a fine of $600 to parents of non-compliant students up to age 16 -Germany: kindergartens obliged to report parents who refuse counseling from doctors about vaccinations. Parents subject to $3000 fine -France: now making 11 vaccines mandatory up from the current number of 3 -New South Wales Australia: no jab, no play bans unvaccinated children from pre-school and day care and fines directors who admit such children $

10 NEW IMMUNIZATION REGISTRY -New Web based registry rollout summer New registry will provide one stop shopping : vaccine ordering, doses administered, transfers, returns, bi-directional data exchange between IIS and Electronic Health Records (EHRs) 28 FUTURE LEGISLATION?? -Influenza for 5-18 year olds -HPV for 7 th grade entry -Group B Meningococcal for college 29 Contact Information Mick Bolduc PHONE: (860) FAX: (860)

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