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Posts for category: Immunizations

By contactus@priority-pediatrics.com
August 26, 2019
Category: Immunizations
Tags: DTaP   Tdap   tetanus   spores   Diseases  
July 3, 2019 from AAP News

Tetanus spores lie in wait for unvaccinated children

Satoshi KamidaniM.D., FAAP and Larry K. PickeringM.D., FIDSA, FPIDS, FAAP
 

Tetanus is caused by a neurotoxin called tetanospasmin produced by the anaerobic, spore-forming, gram-positive bacillus Clostridium tetani. Tetanospasmin affects the nerve endings at the nerve-muscle junction, leading to severe skeletal muscle spasms and convulsions.

The dormant spores are everywhere in soil and intestinal tracts of mammals and can survive for months to years. The spores germinate and begin to produce the neurotoxin under favorable conditions, which include contaminated wounds due to traumatic injury, deep puncture wounds caused by dirty nails or animal bites, inappropriate umbilical cord care in the neonate or a foreign body in the skin.

Pediatric tetanus case

In 2017, an unvaccinated 6-year-old boy developed tetanus following a forehead cut he sustained while playing outdoors on a farm. It was the first pediatric tetanus case reported in more than 30 years in Oregon.

The patient had jaw spasms and involuntary arm muscle spasms and subsequently developed body stiffness and difficulty breathing due to diaphragm and voice box spasms.

He was air-transported to a pediatric medical center where he received intensive care, including sedation, analgesia, endotracheal intubation (followed by tracheostomy), mechanical ventilation and neuromuscular blockage in an environment with minimal stimulation (a darkened room and ear plugs). He also developed nervous system (hypertension, tachycardia and body temperature instability).

Antibiotics, tetanus immune globulin and diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) were administered. The wound was irrigated and debrided. He required approximately eight weeks of inpatient care (including six weeks of intensive care), followed by one month of rehabilitation before he fully recovered. The inpatient charges were $811,929.

Although physicians discussed the risks and benefits of tetanus vaccination with his parents, they declined any recommended immunizations, including the second dose of DTaP.

Tetanus worldwide

Although the tetanus toxoid vaccination has contributed significantly to dramatic reduction of the incidence of tetanus, the disease remains a public health problem worldwide. The World Health Organization (WHO) reported that approximately 34,000 newborns died worldwide from neonatal tetanus in 2015, while 86% of infants worldwide were vaccinated with three doses of diphtheria-tetanus-pertussis (DTP) vaccine in 2016.

According to Centers for Disease Control and Prevention (CDC) surveillance, 197 cases and 16 deaths from tetanus were reported in the United States from 2009-’15. While most cases were adults and all tetanus-related deaths occurred in elderly adults, 24 (12%) cases were in patients younger than 20 years of age, including two cases of neonatal tetanus (see figure).

 

 

Based on National Immunization Surveys, estimated DTaP vaccination coverage with at least three doses among U.S. children ages 19-35 months was 94% in 2017, whereas coverage with at least four doses was as low as 83%. Importantly, the coverage among uninsured children 19-35 months of age was significantly lower (78% with at least three doses and 62% with at least four doses, which is below the average worldwide) than insured children.

It is crucial to inform caregivers that uninsured or underinsured eligible children can receive vaccines at no cost through the Vaccines for Children (VFC) program (https://www.cdc.gov/vaccines/programs/vfc/index.html). 

Tetanus vaccination and safety

One of the striking facts about tetanus is that people cannot naturally acquire immunity to tetanus even after recovery from tetanus disease. This is likely because people can develop tetanus from a small amount of toxin production, which usually is not sufficient to elicit an immune response. In addition, there is no herd protection against tetanus since this is not a communicable disease. Therefore, tetanus vaccination of each child is the only way to provide protective tetanus immunity.

The Recommended Child and Adolescent Immunization Schedule calls for children to receive a five-dose series of DTaP at 2, 4, 6 and 15-18 months and 4-6 years of age. Adolescents should receive a single dose of Tdap at 11-12 years of age.

In addition, adults should receive a Td booster every 10 years, and pregnant women should receive a single dose of Tdap during every pregnancy, preferably during the early part of gestational weeks 27-36.

Information on use of Tdap or Td as tetanus prophylaxis in wound management is available at www.cdc.gov/mmwr/volumes/67/rr/rr6702a1.htm.

Tetanus toxoid-containing vaccines are highly effective and safe. Mild local reactions or fevers are commonly seen, but severe reactions including neurologic or anaphylactic reactions are rare.

Rise of vaccine hesitancy

Vaccine hesitancy and refusal are growing rapidly and are considered one of the major threats to global health by the WHO. Most cases of tetanus in the United States occur in unvaccinated people.

Since vaccine-preventable diseases (VPDs) are uncommon, it is important for health care professionals and the public to be reminded of how devastating VPDs are and that vaccinations are the best way to prevent them. Infants and children are susceptible to all diseases in the immunization schedule if not properly immunized.

Dr. Kamidani is a pediatric infectious diseases fellow at Emory University School of Medicine. Dr. Pickering is adjunct professor of pediatrics at Emory University School of Medicine.

By contactus@priority-pediatrics.com
May 31, 2019
Category: Immunizations
Tags: immunizations   Vaccines   Facts   History   Timeline  

Here's a look at information and statistics concerning vaccines in the United States.

Facts:

There are 14 different vaccines that are recommended for childrenbetween birth and age six, including those for diphtheria, pertussis, tetanus, influenza, measles, mumps and rubella.

For more than 100 years, there has been public discord regarding vaccines based on issues like individual rights, religious freedoms, distrust of government and the effects that vaccines may have on the health of children.

Exemptions to vaccines fall into three general categories: medical, religious and philosophical.


Median immunization coverage for state-required vaccines was approximately 94.3% for children entering kindergarten during the 2017-2018 school year, according to the Centers for Disease Control and Prevention (CDC).

As of May 2019, 47 states and the District of Columbia allow religious exemptions from vaccines, and 16 states allow philosophical (non-spiritual) exemptions.

Timeline:

1855 - Massachusetts mandates that school children are to be vaccinated (only the smallpox vaccine is available at the time).

February 20, 1905 - In Jacobson v. Massachusetts, the US Supreme Court upholds the State's right to compel immunizing against smallpox.

November 13, 1922 - The US Supreme Court denies any constitutional violation in Zucht v. King in which Rosalyn Zucht believes that requiring vaccines violates her right to liberty without due process. The High Court opines that city ordinances that require vaccinations for children to attend school are a "discretion required for the protection of the public health."

1952 -Dr. Jonas Salk and his team develop a vaccine for polio. A nationwide trial leads to the vaccine being declared in 1955 to be safe and effective.

1963 - The first measles vaccine is released.

1983 - schedule for active immunizations is recommended by the CDC.

March 19, 1992 - Rolling Stone publishes an article by Tom Curtis, "The Origin of AIDS," which presents a theory that ties HIV/AIDS to polio vaccines. Curtis writes that in the late 1950s, during a vaccination campaign in Africa, at least 325,000 people were immunized with a contaminated polio vaccine. The article alleges that the vaccine may have been contaminated with a monkey virus and is the cause of the human immunodeficiency virus, later known as HIV/AIDS.

August 10, 1993 - Congress passes the Omnibus Budget Reconciliation Act which creates the Vaccines for Children Program, providing qualified children free vaccines.

December 9, 1993 - Rolling Stone publishes an update to the Curtis article, clarifying that his theory was not fact, and Rolling Stone did not mean to suggest there was any scientific proof to support it, and the magazine regrets any damage caused by the article.

1998 - British researcher Andrew Wakefield and 12 other authors publish a paper stating they had evidence that linked the vaccination for Measles, Mumps and Rubella (MMR) to autism. They claim they discovered the measles virus in the digestive systems of autistic children who were given the measles, mumps and rubella (MMR) vaccine. The publication leads to a widespread increase in the number of parents choosing not to vaccinate their children for fear of its link to autism.

2000 - The CDC declares the United States has achieved measles elimination, defined as "the absence of continuous disease transmission for 12 months or more in a specific geographic area."

2004 - Co-authors of the Wakefield study begin removing their names from the article when they discover Wakefield had been paid by lawyers representing parents who planned to sue vaccine manufacturers.

May 14, 2004 - The Institute of Medicine releases a report "rejecting a causal relationship between the MMR vaccine and autism."

February 2010 - The Lancet, the British medical journal that published Wakefield's study, officially retracts the article. Britain also revokes Wakefield's medical license.

2011 - Investigative reporter Brian Deer writes a series of articles in the BMJ exposing Wakefield's fraud. The articles state that he used distorted data and falsified medical histories of children that may have led to an unfounded relationship between vaccines and the development of autism.

2011 - The US Public Health Service finds that 63% of parents who refuse and delay vaccines do so for fear their children could have serious side effects.

2014 - The CDC reports the highest number of cases at 667 since declaring measles eliminated in 2000.

June 17, 2014 - After analyzing 10 studies, all of which looked at whether there was a link between vaccines and autism and involved a total of over one million children, the University of Sydney publishes a report saying there is no correlation between vaccinations and the development of autism.

December 2014 - A measles outbreak occurs at Disneyland in California.

2015 - In the wake of the theme park outbreak, 189 cases of measles are reported in 24 states and Washington, DC.

February 2015 - Advocacy group Autism Speaks releases a statement, "Over the last two decades, extensive research has asked whether there is any link between childhood vaccinations and autism. The results of this research are clear: Vaccines do not cause autism. We urge that all children be fully vaccinated."

May 28, 2015 - Vermont Gov. Peter Shumlin signs a bill removing the philosophical exemption from the state's vaccination law. Parents may still request exemptions for medical or religious reasons. The law goes into effect on July 1, 2016.

June 30, 2015 - California Gov. Jerry Brown signs legislation closing the "vaccine exemption loophole," by eliminating any personal or religious exemptions for immunizing children who attend school. The law takes effect on July 1, 2016.

January 10, 2017 - Notable vaccine skeptic Robert F. Kennedy Jr. meets with President-elect Donald Trump. Afterwards, Kennedy tells reporters he agreed to chair a commission on "vaccination safety and scientific integrity." A Trump spokeswoman later says that no decision has been made about setting up a commission on autism.

August 23, 2018 -A study published in the American Journal of Public Health finds that Twitter accounts run by automated bots and Russian trolls masqueraded as legitimate users engaging in online vaccine debates. The bots and trolls posted a variety of anti-, pro- and neutral tweets and directly confronted vaccine skeptics, which "legitimize" the vaccine debate, according to the researchers.

October 11, 2018 - Two reports published by the CDC find that vaccine exemption rates and the percentage of unvaccinated children are on the rise.

2019 - As of May 24, the CDC has reported 940 individual cases of measles confirmed in 26 states.

January 2019 - The World Health Organization names vaccine hesitancy as one of 10 threats to global health in 2019.

March 26, 2019 - Rockland County, New York announces the "extremely unusual" step of banning unvaccinated individuals under age 18 from public places. One week later, a judge puts a hold on that and prohibits the county from enforcing the ban.

May 10, 2019 - Washington Gov. Jay Inslee signs legislation removing the philosophical exemption for the MMR vaccine from the state's school immunization requirements.

May 24, 2019 - Maine Gov. Janet Mills signs a bill into law removing all non-medical exemptions to vaccinations. The law will take effect in September 2021, and schoolchildren who claim a non-medical exemption prior to the law taking effect will be allowed to attend school if their parent or guardian provides a written statement from a healthcare professional indicating they've been informed of the risks of refusing immunization.

By contactus@priority-pediatrics.com
May 14, 2019
Category: Immunizations
Tags: immunizations   Vaccines   Autism   Sc ience  

Blume is living proof that the antidote to misinformation about vaccines is science. "I was relieved," she said, "because I didn't hurt him. His autism wasn't my fault."

The current outbreaks of measles around the country are largely a result of parents being afraid to vaccinate their children against the virus. The number one concern? Autism.

This is a show worth watching!

https://www.cbsnews.com/news/mmr-vaccine-teaching-anti-vax-parents-to-trust-science/

http://www.boostoregon.org/

By contactus@priority-pediatrics.com
May 14, 2019
Category: Immunizations
Tags: immunizations   Vaccines   fear   Pediatricians   Worry  

Pediatricians Working To Educate Parents Who Worry About Vaccines.

 

CBS News (5/12) reports on different efforts to persuade parents to vaccinate their children, particularly by dispelling misinformation that vaccines cause autism. The article quotes pediatricians discussing how they approach the matter and how they talk with parents who might be concerned about the safety of vaccines. The article also suggests that as research reveals more about the true causes of autism, the debunked link to vaccines might lose more of its potency.

 

By contactus@priority-pediatrics.com
March 28, 2019
Category: Immunizations
Tags: immunizations   Vaccines   cdc   video   kids  

CDC launches new video series for parents, "How Vaccines Work"

The CDC National Center for Immunization and Respiratory Diseases is launching the first video of its newest, animated video series for parents, "How Vaccines Work."  In these short videos, viewers follow baby Jack and his parents as they get answers to common vaccine-related questions and learn more about the importance of vaccinating on schedule. The first video "How Vaccines Work: How Do Germs Make Your Baby Sick?" describes how vaccines fight germs and provide long-lasting protection against 14 serious diseases. The CDC launched two additional videos in February and March covering topics including "Vaccines and Your Baby's Immune System" and "What to Expect When Your Child is Vaccinated."