Tag: live vaccines

Rabies Vaccines

Rabies is a little different than most vaccine-preventable disease.

While we do have a rabies vaccine, in fact, one of the first vaccines when it was developed in 1885 by Louis Pasteur, it is typically given after you have been exposed to the rabies virus. Most other vaccines are routinely given before you are ever exposed to the diseases they prevent.

And the rabies vaccine has changed a lot since Pasteur’s day.

Instead of getting daily shots for 14-21 days, the rabies vaccine is now given when you are exposed, with human rabies immune globulin (HRIG), with further doses of vaccine on days 3, 7, and 14.

Do you need a rabies vaccine after getting bit by an animal?

It depends on the animal and whether or not the animal can be quarantined (confined and observed for rabies symptoms for 10 days).

And while any mammal can get rabies, the ones that are most worrisome are:

  • raccoons, skunks, bats, foxes, and coyotes
  • cats, dogs, and ferrets
  • livestock, cattle, horses

Most importantly, note that “Recent data suggest that transmission of rabies virus can occur from minor, seemingly unimportant, or unrecognized bites from bats.”

The CDC states that “Small rodents like squirrels, hamsters, guinea pigs, gerbils, chipmunks, rats, and mice) and lagomorphs including rabbits and hares are almost never found to be infected with rabies and have not been known to transmit rabies to humans.”

For Information on Rabies Vaccines:

FluMist

FluMist, the live, attenuated influenza vaccine (LAIV) that is given intranasally, instead of like a traditional flu shot, was first approved by the FDA in 2003.

At that time, it could be given to healthy, nonpregnant persons aged 5 to 49 years.

The age indication was lowered to include healthy kids between the ages of 2 to 4 years in 2007, in time for the 2007-08 flu season.

Other changes to FluMist over the years include that:

  • the dose was lowered from 0.5ml to 0.2ml in 2007
  • FluMist stopped being shipped frozen in 2007, instead being shipped at a higher 35°F to 46°F
  • Flu Quadrivalent was approved in 2012, but didn’t become available until the 2013-14 flu season
  • MedImmune, the makers of FluMist, begin to investigate reports of “lower than expected effectiveness” during the 2013-14 flu season and “possible problems with thermostability” are fixed
  • for the 2014-15 flu season, FluMist became the preferred flu vaccine for children between the ages of 2 to 8 years
  • the preferential recommendation for FluMist was removed the next year, for the 2015-16 flu season, when either inactivated flu shots or FluMist were recommended

And of course, for the 2016-17 flu season, the ACIP and AAP recommended that FluMist not be used at all.

About 14 million doses of FluMist would have been available in the United States during the 2016-17 flu season. Although a small percentage of the 171 to 176 million total doses of available flu vaccine, FluMist has been very popular with pediatricians, parents and especially children, as it helps avoid a shot.

Based on data from observational studies showing lower than expected effectiveness of FluMist Quadrivalent from 2013 through 2016, on June 22, 2016, the Advisory Committee on Immunization Practices (ACIP), an advisory committee to the Centers for Disease Control and Prevention (CDC), voted to recommend that FluMist Quadrivalent should not be used during the 2016-2017 influenza season.

There are “discordant results among” studies though and experts aren’t sure why.

If You Need More FluMist Information:

References:
  • MMWR. Notice to Readers: Expansion of Use of Live Attenuated Influenza Vaccine (FluMist®) to Children Aged 2–4 Years and Other FluMist Changes for the 2007–08 Influenza Season. November 23, 2007 / 56(46);1217-1219
  • MMWR. Recommendations of the Advisory Committee on Immunization Practices — United States, 2016–17 Influenza Season. August 26, 2016 / 65(5);1–54.

Vaccines in Pregnancy

Can children get vaccinated when their mother is pregnant?

Yes.

The CDC states that “pregnancy of recipient’s mother or other close or household contact” is not a contraindication to getting vaccinated, even for live vaccines like MMR or Varivax.

What about pregnant women? Are vaccines safe or necessary for them?

While they shouldn’t get live vaccines, like MMR, Varivax, Flumist, or the yellow fever vaccine, or the HPV vaccine, it is safe and necessary for pregnant women to get most other vaccines.

In fact, all pregnant women should get:

Getting vaccinated during pregnancy helps protect newborn babies and infants against the flu and pertussis (whooping cough).

For more information:

Shingles Vaccine

The varicella zoster virus causes chicken pox.

When chicken pox becomes reactivated, people get shingles or herpes zoster. A painful rash that can last for several weeks, shingles can be prevented with Zostavax, the shingles vaccine. Licensed in 2006, it has been recommended that all seniors who are at least 60 years old get the shingles vaccine.

For more information:

Polio Vaccines

The first polio vaccines were licensed in the 1950s and ’60s by Jonas Salk and Albert Sabin.

Together, they have helped us get to the point where we are close to eradicating polio. We are not quite there yet.

Today, in the United States, after thirty years of using the live, oral polio vaccine, we are once again using polio shots because of the risk of VAPP. Infants get their first doses at two and four months and a third dose in the primary series between six and 18 months. A booster dose is give between four to six years.

For more information:

Yellow Fever Vaccines

Although the first yellow fever vaccine was developed in 1935, a yellow fever vaccine wasn’t licensed in the United States until 1953.

It was mosquito control more than the yellow fever vaccine that helped control yellow fever in the United States though.

Unfortunately, yellow continues to be  a big problem in many parts of the world and a yellow fever vaccine is required before travel to certain countries.

For more information:

MMR Vaccines

The first vaccines to protect against measles, mumps, and rubella were developed in:

  • measles-inactivated vaccine – 1963
  • measles-live, attenuated vaccine – 1965-8
  • mumps vaccine – 1967
  • rubella vaccine – 1969

It would be a few more years until these three vaccines were combined into the single MMR vaccine (1971).

Today, all children get their first dose of one of the MMR when they are 12 to 15 months old, getting a second dose when they are four to six years old.

Infants should get a dose before 12 months, as early as six months, if they will be traveling out of the United States. And should complete the two dose series if they will be traveling out of the country before they are four years old.

For more information: