understanding changes to the 2018 immunization schedule · treat with confidence. trusted answers...
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Understanding Changes to the 2018
Immunization Schedule
H. Cody Meissner, MD, FAAP Professor of Pediatrics Tufts University School of Medicine
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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.
Treat with confidence. Trusted answers from the American Academy of Pediatrics.Treat with confidence. Trusted answers from the American Academy of Pediatrics.
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.
Treat with confidence. Trusted answers from the American Academy of Pediatrics.Treat with confidence. Trusted answers from the American Academy of Pediatrics.
Treat with confidence. Trusted answers from the American Academy of Pediatrics.Treat with confidence. Trusted answers from the American Academy of Pediatrics.
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Treat with confidence. Trusted answers from the American Academy of Pediatrics.Treat with confidence. Trusted answers from the American Academy of Pediatrics.
Title
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Treat with confidence. Trusted answers from the American Academy of Pediatrics.Treat with confidence. Trusted answers from the American Academy of Pediatrics.
Title
Text
Treat with confidence. Trusted answers from the American Academy of Pediatrics.Treat with confidence. Trusted answers from the American Academy of Pediatrics.
Changes to 6 Footnotes in the 2018 Schedule
Simplification of footnotes Changes to the following footnotes:
o Hepatitis B vaccineo Haemophilus influenzae type b vaccineo Polio vaccineso Influenza vaccineso Meningococcal vaccines o MMR (MMRV) vaccines
Reasons we vaccinate
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Percentage of children aged <5 years withinvasive Haemophilus influenzae type b disease,
by vaccine status, 2002–2012
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Polio Virus: The End Game Strategy
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Global Polio Cases as of January 27, 2018
Endemic countries: Afghanistan, Nigeria, PakistanNon-endemic countries: Lake Chad Basin, Central Africa, Syrian Arab Republic
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2017-18 Influenza Season Week Ending January 20, 2018
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What’s New in 2017-18 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?
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Mumps in the National Hockey League
Sidney Crosby in December 2015, Pittsburgh Penguins star
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Complications of Mumps, Time Period Comparison
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Mumps Viruses in US: 2015-3/2017
*as of March 1K: previously named K/MA: Jeryl-Lynn, vaccine (Merck)N: Leningrad-Zagreb (SII)
Genotype 2015 2016 2017* Total
G 112 623 160 895
C 2 3 5
H 3 1 4
K 2 1 1 4
N 3 1 4
A 1 1
Total 128 630 164 913
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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 virus-containing vaccine in persons at increased risk for mumps during an outbreak. MMWR. 2018;67(1):33–38
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Four Meningococcal Vaccines
1 Administer at least 4 weeks after all PCV doses2 May be given to people 56 years or older3 May be given to people 26 years or older
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What is Required to Achieve Community Protection?
(Community or Herd or Indirect Immunity)
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Community Protection (Herd Immunity)
Blue = not immunized but still healthy
Yellow = immunized but healthy
Red = not immunized, sick and contagious
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Community Protection Important for: 1. Children/infants too young to be vaccinated2. Pregnant women 3. People in whom vaccine-induced immunity has waned4. Immunosuppressed patients who cannot be vaccinated5. Elderly people who may not mount an adequate immune
response to a vaccine6. People with inadequate access to vaccinations7. People who remain unvaccinated by choice
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The End
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