Tag: news

Did the FDA Approve a New HPV Vaccine for Adults?

What do you know about the HPV vaccine?

Hopefully you know that it can prevent cervical cancer and that lots of folks spread misinformation that is intended to confuse and scare you away from getting vaccinated and protected with it and other vaccines.

Did the FDA Approve a New HPV Vaccine for Adults?

News that the approved ages for Gardasil have been expanded will likely add to that confusion for a little while.

The FDA simply approved the expanded use of the existing Gardasil 9 vaccine – not a new vaccine.
The FDA simply approved the expanded use of the existing Gardasil 9 vaccine – not a new vaccine.

The first thing to understand is that the FDA did not approve a new Gardasil vaccine for older adults.

They very simply expanded the age recommendations for who should get the existing Gardasil 9 vaccine, which was approved back in 2014, replacing the original Gardasil vaccine, which was approved in 2006.

“The U.S. Food and Drug Administration today approved a supplemental application for Gardasil 9 (Human Papillomavirus (HPV) 9-valent Vaccine, Recombinant) expanding the approved use of the vaccine to include women and men aged 27 through 45 years.”

Why the new age indication?

“In a study in approximately 3,200 women 27 through 45 years of age, followed for an average of 3.5 years, Gardasil was 88 percent effective in the prevention of a combined endpoint of persistent infection, genital warts, vulvar and vaginal precancerous lesions, cervical precancerous lesions, and cervical cancer related to HPV types covered by the vaccine.”

But isn’t the whole point of giving the HPV vaccine to preteens that you want to get them vaccinated and protected before they are sexually active and exposed to and infected by HPV?

Sure, but if you didn’t, and unless you are sure that you have been exposed to and have been infected by all 9 types of HPV strains that Gardasil 9 protects you against, then the vaccine is still a good idea when you are older.

Except FDA approval doesn’t automatically mean that your insurance company will pay for it.

That usually comes once a vaccine is formally added to the immunization schedule by the ACIP.

“In a 2005 study, 92% of insurance plans reported following Advisory Committee on Immunization Practices recommendations to determine covered vaccines; of those, 60% could extend coverage within 3 months after issuance of recommendations and 13% in 1 month.”

Lindley et al on Financing the Delivery of Vaccines to Children and Adolescents: Challenges to the Current System

And Obamacare still requires insurance plans to provide ACIP-recommended vaccines at no charge.

Will Gardasil 9 be added to the immunization schedule for adults?

The extended age indication for Gardasil 9 will be discussed at the next ACIP meeting.
The extended age indication for Gardasil 9 will be discussed at the next ACIP meeting.

We should know sooner, rather than later. It is on the agenda for the next ACIP meeting on October 25…

More on Gardasil for Older Adults

A History of Measles Outbreaks in United States

We have come a long way since the development of the first measles vaccines in the early 1960s…

Pre-Vaccine Era Measles Outbreaks

Unvaccinated children exposed to measles are quarantined for at least 21 days.
Unvaccinated children exposed to measles are quarantined for at least 21 days.

In the pre-vaccine era, measles was a very common childhood disease.

As it is now, it was also a deadly disease.

In the 1950s, there were 5,487,332 cases (just under 550,000 a year) and 4,950 deaths (about 500 each year).

In 1962, there were 469,924 cases of measles in the United States and 432 deaths.

Post-Vaccine Era Measles Outbreaks

The first measles vaccines were licensed between 1963 and 1965, but it was the first national measles eradication campaign in 1966 that got people vaccinated and measles rates down.

In 1970, there were only 47,351 cases and 89 deaths.

Rates continued to drop until the large outbreaks between 1989 to 1991, when there were 55,622 cases and 123 deaths. The addition of a measles booster shot got measles outbreaks under control again. By 2000, when measles was declared eliminated in the United States, there were just 86 cases and one death.

Post-Elimination Era Measles Outbreaks

Measles cases usually begin increasing in April and May. How many cases will we see this year?
Measles cases usually begin increasing in April and May. How many cases will we see this year?

Declaring measles eliminated in the United States didn’t mean that we didn’t have any more measles, after all, it hasn’t been eradicated yet. It just that we are no longer seeing the endemic spread of measles. Since 2000, all of the latest measles outbreaks have been imported from outside the country, or at least they are started by cases that are imported.

We have seen more than a few records in the post-elimination era, including:

  • the year with the historic low number of measles cases – 37 cases in 2004
  • the year with the largest number of cases since 1994 – 667 cases in 2014
  • the largest single outbreak since the endemic spread of measles was eliminated – 377 cases in Ohio in 2014

In 2015, we got a reminder of how deadly measles can be. Although there have been other measles deaths and SSPE deaths in the past ten years, unlike the 2015 death, they are usually buried in CDC reports and aren’t published in the newspaper.

2017 Measles Outbreaks

An infant hospitalized during a measles outbreak in the Philippines in which 110 people died.
An infant hospitalized during a measles outbreak in the Philippines in which 110 people died. Photo by Jim Goodson, M.P.H.

The first new case of 2017 was an unvaccinated adult in San Luis Obispo County, California who was exposed to international travelers over the holidays. The person exposed others to measles at the Twin Cities Community Hospital emergency department in Templeton while contagious in early January.

The second case of 2017 was related to an LA county outbreak that started at the end of 2016 – a resident of Ventura County.

And it went on, with other measles cases in 2017 including:

  • at least 122 cases
  • cases in 16 states, including California, Florida, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Utah, and Washington
  • an infant in San Luis Obispo County that was too young to be vaccinated and who had contact with an unvaccinated adult with measles
  • one new case in the Los Angeles County outbreak, which is now up to 20 confirmed measles cases (including 18 in LA County), all unvaccinated
  • four new cases in Ventura County, California that are linked to another Ventura County measles case and the LA County outbreak, which is now up to 24 cases
  • a case in Jersey City, New Jersey following international travel who exposed people at multiple places, including a hospital, pharmacy, mall, and on a commuter train
  • an infant in Suffolk County, New York who had been overseas
  • an unvaccinated 7-month-old baby from Passaic County, New Jersey who had been traveling out of the country and may have exposed others at area hospitals (a good reminder that infants who are at least 6 months old should get an MMR vaccine before leaving the country)
  • two cases in Salt Lake County, Utah – which began in a resident who had “received all appropriate vaccinations” and developed measles after traveling outside the US and then spread to another person “who had contact with the first case.” According to the SLCoHD, “One of the two individuals with measles had received one MMR vaccine.”
  • two cases in King County, Washington – a man and his 6-month-old infant, both unvaccinated, developed measles after traveling to Asia, and exposed many others around Seattle, including at a Whole Foods, a sandwich shop, their apartment building, and two Amazon buildings.
  • a confirmed case in Omaha, Nebraska, who exposed people on a Delta flight and multiple places in Douglas and Sarpy counties, including the Bergan Mercy Hospital Emergency Room.
  • a young child in Macomb Count, Michigan who required hospitalized and has been linked to international travel
  • a suspected case at William Allen White Elementary School in Lyon County, Kansas which has led to the quarantine of unvaccinated students for 3 weeks
  • an unvaccinated student at Laguna Beach High in Orange County, California, which led to the quarantine of at least 6 unvaccinated students
  • a staff member at Discovery Academy of Lake Alfred in Florida
  • an unconfirmed case in an infant who attended the College of Staten Island Children’s Center in New York
  • two children in Minnesota without a known source of infection
  • another child in Minnesota – among the three Somali Minnesotans in this outbreak are two children who are just two years old – all of the cases were unvaccinated and two required hospitalization, although the common source is still not known. Vaccine hesitancy has been a problem among the Somali Minnesotans because of Wakefield‘s MMR study.
  • five more unvaccinated children in Minnesota, as the outbreak grows to 8.
  • a confirmed case in North Platte, Nebraska who may have exposed others at a middle school, church youth group, the Great Plains Health Emergency Room, a medical office, and a lab.
  • a resident of Livingston County, Michigan who exposed others at area restaurants and St. Joseph Mercy Brighton Hospital after getting measles on a plane ride with an unvaccinated child
  • another case in Minnesota, bringing the outbreak count to 9 unvaccinated children.
  • three more cases in Minnesota, bringing this outbreak case count to 12, with at least 200 people in quarantine.
  • four possible cases in Nebraska
  • eight more cases in Minnesota, bringing this outbreak case count to 20 young children under age 5 years, and now including an infant under age 12 months.
  • four more cases in Minnesota, bringing this outbreak case count to 24 young children under age 5 years and surpassing the size of the 2011 measles outbreak in the Somali community in the same area, which was also mostly among intentionally unvaccinated children.
  • five more cases in Minnesota, including the first outside of Hennepin County – spreading to nearby Stearns County, bringing this outbreak case count to 29 young children under age 5 years, with only one that was vaccinated.
  • three more cases in Minnesota, as the outbreak spreads to the third county – Ramsey County.
  • more measles (2 new cases) in Minnesota (Hennepin County, Ramsey County, Crow Wing County, and now Le Sueur County), where the ongoing outbreak is up to 66 cases, almost all unvaccinated children and where there has been a call to accelerate the two dose MMR schedule for kids over age 12 months.
  • a teen visiting the United States from India who developed measles and exposed others at a hotel and a hospital in Bergen County, New Jersey and in upstate New York.
  • a child in Maryland who was admitted to Children’s National Medical Center in Washington, D.C.
  • more measles (3 new cases) in Minnesota (Hennepin County, Ramsey County, Crow Wing County, and Le Sueur County), where the ongoing outbreak that has been confirmed to be from the wild type B3 strain is up to 68 cases, almost all unvaccinated children.
  • a case in Pennsylvania who exposed others at a visitor center
  • someone who visited the MIT Museum in Cambridge, Massachusetts.
  • two new cases in Minnesota, ending speculation that the outbreak, now up to 70 cases, was over…
  • one new case in Minnesota, raising the number of cases in this ongoing outbreak to 78 cases.
  • a healthcare worker in New York who is employed by Hudson Headwaters Health Network and also works at a Warren County medical practice.
  • someone in Franklin County, Maine (their first case in Maine in 20 years!) who traveled out of the country and caught measles, returning home and possibly exposing others at a movie theater, restaurant, farmers market, and hospital.
  • A case in Butler County, Kansas. Many remember that one of the largest outbreaks of 2014 was in Kansas.
  • an unvaccinated man who lives in Hennepin County, raising the number of cases in this ongoing outbreak (an outbreak that has already cost over $500,000 to contain and which many hoped would soon be over) that started in March to at least 79 cases. With the new case, the clock starts ticking again and Minnesota will have to wait to see if new cases appear over the next 3 weeks.
  • passengers from 13 states on an American Airlines flight from New York to Chicago were exposed to a person with measles in early July, including a 12-week-old infant who required preventative treatment with immune globulin (IG), as she was too young to be vaccinated.
  • a fully vaccinated resident of Onondaga County, New York who was exposed on a domestic flight, only developed mild symptoms, but did expose others.
  • someone who exposed others at the Penn State University Hetzel Union Building Bookstore and other places in State College, Pennsylvania.
  • a second case in the Wichita, Kansas area, this time in Sedgwick County, with exposures at a church, dental office, elementary school, and multiple stores over at least 3 days.
  • a possible case in Sedgwick County, Kansas, a child too young to be vaccinated who may have been exposed at a church. Three other exposed infants who were too young to be vaccinated and who were considered at risk to get measles in this outbreak received immunoglobulin treatment.
  • a traveler who spent time in Hampton Beach in New Hampshire, exposing others.
  • a 46-year-old male in Ohio that got the disease while traveling internationally.

2017 would have been a mild year for measles, except for the really big outbreak in Minnesota… 79 people got measles, 71 were unvaccinated, more than 500 people were quarantines, and the outbreak cost over $1.3 million to contain.

2016 Measles Outbreaks

Starting slow, 2016 ended as a fairly average year for measles:

  • 83 cases
  • cases in 17 states, including Alabama, Arizona, California, Colorado, Connecticut, Florida, Georgia, Hawaii, Illinois, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon, Tennessee, Texas, and Utah
  • a large outbreak in Arizona, 23 cases, linked to a private detention center
  • a large outbreak in Shelby County, Tennessee, at least seven cases, including six unvaccinated and one partially vaccinated child
  • an ongoing measles outbreak in Los Angeles County and Santa Barbara County that has been linked to the Los Angeles Orthodox Jewish community
  • a case in Colorado in which an unvaccinated adult traveled internationally and ended up exposing many people “from Dec. 21 to 29, 2016, who was at a wide variety of locations in the Denver-Boulder area,” including an Urgent Care center and the Parker Adventist Hospital Emergency Department

As in other years, many of these outbreaks involved unvaccinated children and adults. One case involved a child at the Yuba River Charter School in California, a Waldorf School with very high rates of unvaccinated children.

2015 Measles Outbreaks

With a large outbreak in California, 2015 got off to a very strong start.

Most concerning, more and more, cases don’t seem to have an source that is easy to find, which could mean that the endemic spread of measles has returned in the United States. So instead of having to travel out of the country or be exposed to someone who got measles with a link to international travel, you could get measles just by going to a ball game, a movie theater, or to Disneyland. That makes it more important than ever to learn how to avoid measles.

Among the 189 measles cases and outbreaks in 2015 were:

  • 113 cases that were associated with a multi-state outbreak that was linked to Disneyland in California. Before it was declared over on April 17, a few unvaccinated travelers also help spread measles from this outbreak to large outbreak in Quebec, Canada. All in all, the outbreak was linked to at least 113 cases in California and an additional 169 cases in Arizona (5), Nebraska (1), Utah (3), Colorado (1), Washington (2), Oregon (1), Mexico (1), and Canada (155).
  • 13 cases, including an adult worker and 12 infants too young to be vaccinated at the KinderCare Learning Center in Illinois.
  • At least 13 cases, all intentionally unvaccinated, in a South Dakota outbreak that started with an unvaccinated adult traveling to India.
  • Five cases in Clallam County, Washington, including four who were not vaccinated, which cost at least $36,000 to contain and led to the death of an immunosuppressed woman.

In addition to these large outbreaks, 2015 also saw a number of quarantines for unvaccinated students, closing of daycare centers, and a recommendation from a California Department of Health state epidemiologist that people who are not vaccinated against measles “avoid visiting Disney” and “crowded places with a high concentration of international travelers, such as airports.”

Other measles cases in 2015 include:

  • A student at UC Berkeley who may have exposed others to measles on a public bus.
  • A confirmed case in Fairbanks, Alaska – their first case in 15 years, who flew in from Seattle (and is probably the King County case discussed below) and may have exposed others at an area Walmart, Home Depot, Walgreens, several supermarkets, the airport, and hospital, etc.
  • A confirmed case in King County, Washington, who may have exposed others in Seattle, including at an area McDonalds, the Baroness Hotel, a drug store, and the Sea-Tac Airport.
  • A confirmed case in Branson, Missouri, a traveler from Asia, who was contagious when visiting the ER, three local businesses, and perhaps his flight to town.
  • A confirmed case in the Washington D.C. area.
  • Another case of measles in Spokane County, Washington – an unvaccinated person that was exposed to the other case in the area.
  • An unvaccinated student from Europe in Boston, Massachusetts who also traveled to Maine and New Hampshire.
  • Another unvaccinated child in St. Lucie County, Florida – bringing the total to five cases in central Florida in what so far looks like two separate outbreaks.
  • Another case in Indian River County, Florida – an unvaccinated child.
  • An unvaccinated adult in Spokane, Washington – the first case in the area since 1994.
  • Two unvaccinated adults in Indian River County, Florida, one of whom contracted measles while traveling out of the country.
  • An unvaccinated 6-year-old in St. Lucie County, Florida who attended Fairlawn Elementary School in Fort Pierce – leading to five unvaccinated students being kept out of school until early May.
  • The first case in Oklahoma since 1997, a case in Stillwater.
  • A case in Florida, a traveler who was contagious while attending a conference at the Gaylord Palms Resort and Convention Center and also in Maimi-Dade, Orange, and Sarasota counties.
  • A new case in Illinois, the 15th – and so far not linked to the other two outbreaks in the state.
  • A student at Princeton University in New Jersey.
  • Another case of measles in the Washington D.C. area, a case without a known source.
  • A case in a student at Elgin Community College in Kane County, Illinois.
  • A hospitalized infant in Atlanta, Georgia.
  • An unvaccinated 1 year old in Jersey City, New Jersey.
  • A traveler in King County, Washington that may have exposed others in Seattle. The unvaccinated visitor is from Brazil, where there was a large outbreak of measles last year (almost 400 cases).
  • At least one more case in Clark County, Nevada and four more possible cases in Southern and Northern Nevada, which led to the quarantine of at least 11 students at the Spanish Springs Elementary School.
  • A case in Franklin County, Pennsylvania.
  • Four cases of measles in travelers, including two international travelers, who visited Florida.
  • A case in Washington D.C.
  • A student at Bard College in Dutchess County, New York, who exposed many people while traveling on an Amtrak train to Penn Station in New York City.
  • An unvaccinated woman in New Castle County, Delaware who had recently traveled out of the country.
  • A case on the University of Minnesota Twin Cities campus in a student that had recently returned from out of the country. Although others were exposed, it is considered to be a “highly immunized” population, so hopefully the outbreak won’t spread.
  • Two more cases in Arizona that are tied to the Disneyland outbreak, including a woman in Phoenix who may have exposed others up to 195 children at the Phoenix Children’s East Valley Center, including a 3-year-old getting chemotherapy for leukemia.
  • An adult in Cook County, Illinois which in not linked to Disneyland.
  • A student at Valley High School in Las Vegas which led to the quarantine of 36 unvaccinated students until early February.
  • Four cases among an unvaccinated family in Kearny, Arizona that is directly linked to the Disneyland outbreak.
  • A child in Sioux Falls, South Dakota that is unrelated to 13 recent cases in the area and which has no link to travel out of the area.
  • A new case in Oakland County, Michigan that is likely linked to the Disneyland measles outbreak, meaning that the outbreak has now spread to include 7 states and 2 countries.
  • A case in Maricopa County, Arizona has been linked to the Disneyland outbreak.
  • A person in Nebraska who could have exposed others in Omaha and Blair, including at the Omaha Children’s Museum.
  • A case in Lane County, Oregon that has been linked to the Disneyland measles outbreak.
  • A resident of Tarrant County in North Texas who developed measles after a trip to India.
  • Another unvaccinated person in Utah with links to the Disneyland outbreak has tested positive for measles, bringing the total in that state to 3 cases.

In addition to the 36 measles cases that have been associated with the Disneyland outbreak, California already has 5 additional measles cases this year with no link to Disney, including cases in Alameda, Orange, and Ventura Counties.

 

For More Information On Measles Outbreaks:

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Mumps Outbreaks

Pre-Vaccine Era Mumps Outbreaks

In the pre-vaccine era, mumps was a common childhood disease that could cause orchitis, meningitis, pancreatitis, deafness, and even death.

There were about 212,000 cases a year in the early 1960s, before the first mumps vaccine was licensed in 1968.

Post-Vaccine Era Mumps Outbreaks

Tips to prevent getting sick with the mumps.
A large Ohio mumps outbreak prompted an education campaign to help protect everyone from getting sick.

As with other vaccine-preventable diseases, there was a big drop in cases of mumps once the mumps vaccine was introduced.

In 1968, there were just over 152,000 cases and 25 deaths  and just ten years later, in 1978, that was down to 16,817 cases and 3 deaths.

Once the recommendation for the second dose of MMR came in 1990, it looked like mumps was on it’s way out.

We went from 5,292 cases and one death that year, to just 906 cases and no deaths in 1995. When measles hit its low point of 37 cases in 2004, there were just 258 cases of mumps.

That wasn’t the end for mumps though, as we had some up and down years, including big outbreaks in:

  • 2006 – 6,584 cases among Midwest college students and one death
  • 2008 – only 454 cases, but one death
  • 2009 – 1,991 cases and two deaths
  • 2010 – 2,612 cases mostly among Orthodox Jewish communities and two deaths
  • 2011 – 370 cases
  • 2012 – 229 cases
  • 2013 – 584 cases
  • 2014 – 1,223 cases involving a large outbreak in Ohio and in the NHL
  • 2015 – 1,057 cases mostly among university students in Iowa and Illinois
  • 2016 – 6,369 cases in 46 states (no cases in Delaware, Louisiana, Vermont, or Wyoming), with the most cases in Arkansas, Iowa, Indiana, Illinois, Maine, New York, Oklahoma, and Texas.
  • 2017 – at least 5,629 cases of mumps, with cases in all states except Wyoming and South Dakota. The latest outbreaks are at Syracuse University, in Anchorage, Alaska (many unvaccinated cases), and Hawaii.

Could this all be because of waning immunity?

The herd immunity threshold may need to be higher than the previously suggested 88%–92% to prevent community transmission and outbreaks of mumps.

Quinlisk on Mumps Control Today

Many of these outbreaks occur despite many of the cases having had two doses of the MMR vaccine. A third dose is sometimes recommended during these outbreaks.

That doesn’t mean that the MMR vaccine doesn’t work. After all, just compare today’s rates of mumps, even if they are a little higher than we would like, to pre-vaccine levels…

Unfortunately, this Syracuse University poster doesn't mention getting vaccinated...
Unfortunately, this Syracuse University poster doesn’t mention getting vaccinated…

And in the biggest outbreak, in Arkansas, only 71% of people were up-to-date on their vaccines!

Of course, getting two doses of the MMR vaccine is still the best way to avoid mumps.

There is no general recommendations to get an extra shot, although a third dose of MMR during an outbreak was recently recommended by the ACIP. The recommendation has not yet been formally approved though.

A recent study that was published in the New England Journal of Medicine, Effectiveness of a Third Dose of MMR Vaccine for Mumps Outbreak Control, found a lower risk of mumps in those who got a third dose of MMR.

Not surprisingly, the study also found a much higher risk of mumps, with the highest attack rates, in those who were unvaccinated or who had just one dose!

Keep in mind that the MMR vaccine isn’t just for kids. Adults who didn’t have mumps when they were kids (or who were born before 1957, when most kids got mumps), should make sure they are vaccinated (at least one dose) and protected too.

Vaccines work. They just aren’t perfect…

And these outbreaks show that they are definitely still necessary. In the latest outbreak in Hawaii, where “has been confirmed in children and adults, both vaccinated and unvaccinated,” there have been at least “16 reports of complications due to mumps infection,” including orchitis and hearing loss.

What to Know About Mumps Outbreaks

Although mumps outbreaks are occurring among those who are vaccinated, you still have a much higher chance of getting mumps if you are unvaccinated and unprotected.

For More Information on Mumps Outbreaks:

Updated on January 7, 2018

Who is Tom Frieden?

CDC Director Tom Frieden in West Africa during the Ebola epidemic.
CDC Director Tom Frieden in West Africa during the Ebola epidemic.

Thomas Frieden, MD, MPH has had a long career in public health, working as Commissioner of the New York City Health Department and most recently as the Director of the Centers for Disease Control and Prevention.

Dr Frieden went to Oberlin College, Columbia University College of Physicians and Surgeons, and did his residency in internal medicine at Yale University.

The field of public health aims to improve the health of as many people as possible as rapidly as possible.

A responsive government can maintain that people are responsible for their own health while also taking public health action that changes default choices to make it easier for people to stay healthy.

Dr. Frieden on The Future of Public Health

During his career, he:

  • worked to reduce rates of cases of multidrug-resistant tuberculosis by 80 percent in New York City
  • assisted the national tuberculosis control program in India
  • directed efforts to reduce smoking, including teen smoking, in New York City
  • led the response to the 2009 H1N1 flu pandemic in the US
  • has pushed for more funding to help control and treat Zika, which he says will likely “become endemic in this hemisphere”

Perhaps most importantly, and despite some criticism, Dr. Frieden led the CDC during the Ebola epidemic in West Africa. An epidemic that spread to the US and other countries and for which the “CDC has undertaken the most intensive outbreak response in the agency’s history.”

Recently, he has also highlighted “two shortcomings of our health system,” that the upward trend in life expectancy that we have seen over the past 50 years (about 9 years), “is neither as  rapid  as  it  should  be  —  we  lag  behind  dozens  of  other  nations – nor is it uniformly experienced by people in the United States.” And that is because “life  expectancy  and  other  key health outcomes vary greatly by race, sex, socioeconomic status, and geographic location.”

And after working to eliminate trans fats from restaurants in New York City and have chain restaurants post calorie information on their menu boards, he has continued to confront many of the more modern era epidemics, like obesity, hypertension, and diabetes.

He resigned from the CDC on January 20, 2017 and was replaced by Anne Schuchat, MD, who became the  became Acting Director.

For More Information on Thomas Frieden

Updated January 22, 2017

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This Year’s Flu Season

Breaking News: Flu season is essentially over. (see below)

As we get into late spring and early summer, you can see that few states still have flu activity.
As we get into late spring and early summer, you can see that few states still have flu activity.

While flu season typically peaks in February, it is very important to understand that there are few things that are typical about the flu.

Since 1982, while we have been twice as likely to see a flu activity peak in February than other winter months, we have been just as likely to get that peak in December, January, or March. That makes it important to get your flu vaccine as soon as you can.

You really never know if it is going to be an early, average, or late flu season.

Flu Facts

There will likely be some surprises this flu season – there always are – but there are some things that you can unfortunately count on.

Among these flu facts include that:

  • there have been over 1,600 pediatric flu deaths since the 2003-04 flu season, including 110 flu deaths last year
  • about 113 kids die of the flu each year – most of them unvaccinated
  • antiviral flu medicines, such as Tamiflu, while recommended to treat high-risk people, including kids under 2 to 5 years of age, have very modest benefits at best (they don’t do all that much, are expensive, don’t taste good, and can have side effects, etc.)
  • a flu vaccine is the best way to decrease your child’s chances of getting the flu

And even in a mild flu season, a lot of kids get sick with the flu.

What about reports that the flu shot will be only 10% effective?

Don’t believe them. The flu vaccine works and besides, it has many benefits beyond keeping you from getting the flu

This Year’s Flu Season

When does flu season start?

In general, flu season starts when you begin to see people around you with signs and symptoms of the flu, including fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue, etc. To be more accurate, you can also look at reports for flu activity in your area, especially the weekly reports from the CDC. Those flu reports can also help you determine when flu season ends.

It is obvious now that this is an early flu season. And with an H3N2 predominant strain, everyone should understand that is going to be a severe season.

Worst season ever? Probably not. But this season is starting to live up to some of the hype, as influenza-like-illness (ILI) activity is at 7.5% and is approaching the 7.7 peak of the 2009 pandemic and the overall hospitalization rate is higher than the overall hospitalization rate reported during the same week of the 2014-2015 season.

That leaves the next big questions – when will flu season peak and when will it be over?

As of mid-June, the CDC reports that flu activity is low in most parts of the United States.

The CDC has also recently reported that:

  • between 151 to 166 million doses of flu vaccine will be available this year, including 130 million doses of thimerosal-free or preservative-free flu shots, so the great majority of flu shots will not contain mercury!
  • FluMist, the nasal spray flu vaccine, will return next year
  • there have already been 176 pediatric flu deaths this year, and like in other recent years, most pediatric flu deaths are in kids who are unvaccinated

Are you going to get your kids a flu vaccine next year?

“CDC recommends that everyone 6 months and older get an injectable flu vaccine as soon as possible.”

CDC Influenza Situation Update

Flu season is essentially over, although like many other flu seasons, we will likely continue to see some flu activity throughout the spring and summer months.

And remember that while this is certainly a very bad flu season, it is still comparable to other recent H3N2 seasons, especially the 2012-13 and 2014-15 seasons.

Recent Flu Seasons

Are H3N2 predominant flu seasons really worse than others?

  • 2003-04 flu season – 152 pediatric flu deaths (H3N2-predominant)
  • 2004-05 flu season – 47 pediatric flu deaths
  • 2005-06 flu season – 46 pediatric flu deaths
  • 2006-07 flu season – 77 pediatric flu deaths
  • 2007-08 flu season – 88 pediatric flu deaths (H3N2-predominant)
  • 2008-09 flu season – 137 pediatric flu deaths
  • 2009-10 flu season – 289 pediatric flu deaths (swine flu pandemic)
  • 2010-11 flu season – 123 pediatric flu deaths
  • 2011-12 flu season – 37 pediatric flu deaths
  • 2012-13 flu season – 171 pediatric flu deaths (H3N2-predominant)
  • 2013-14 flu season – 111 pediatric flu deaths
  • 2014-15 flu season – 148 pediatric flu deaths (H3N2-predominant)
  • 2015-16 flu season – 93 pediatric flu deaths
  • 2016-17 flu season – 110 pediatric flu deaths (H3N2-predominant)

In addition to high levels of pediatric flu deaths, the CDC reports that the four flu seasons that were H3N2-predominant in recent years were “the four seasons with the highest flu-associated mortality levels in the past decade.”

For More Information on the 2017-18 Flu Season

Updated July 6, 2018

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Doctors Facing Disciplinary Actions Over Vaccines

mendelsohn
Dr. Mendelsohn was the Dr. Bob of his day.

There are many doctors and other health professionals who do and recommend things that are far out of the mainstream. They may tell their patients to skip or delay vaccines, that vaccine-preventable diseases aren’t that bad, or even that vaccines don’t work, etc.

And yet, many are surprised when some of them face disciplinary actions from their state’s medical boards, such as:

Dr. Ming Te Lin, the board certified pediatrician in Illinois who:

  • was preparing alternative vaccinations for children for more than a decade
  • gave patients modified vaccinations containing cat saliva and vodka
  • was signing state forms certifying he had given pediatric patients their conventional shots
  • used a WaveFront 2000 device to detoxify vaccines of mercury

Dr. Lin’s medical license has been suspended and he  was supposed to have “a hearing before the Medical Disciplinary Board is set for Oct. 11 in Chicago.” That hearing didn’t happen though and he is now supposed to have a new hearing on November 21.

Dr. Bob Sears is also facing disciplinary action from his state’s medical board.

With a long history of recommending his own alternative immunization schedule to parents, Sears is accused of gross negligence for the way that he granted a medical exemption for vaccines to a child.

An anti-vaccine doctor in Arizona, Dr. Jack Wolfson, a holistic cardiologist, was also investigated by his state’s medical board following several complaints that were made during a recent measles outbreak.

Joseph Mercola, D.O. is another anti-vaccine doctor who has faced trouble in the past. A frequent guest on the Dr. Oz show, he has gotten several warnings from the FDA for marketing a thermal camera as a cancer screening device and making false and misleading claims about natural supplemental products he markets.

Even Dr. Oz has gotten into some trouble in recent years, testifying before Congress about weight loss scams.

For More Information On Doctors Facing Disciplinary Actions Over Vaccines:

Vaccine Recalls

comvax
Two lots of Comvax were recalled in 2007 because of contamination concerns.

Vaccines aren’t often recalled. There have been about 18 recalls of vaccines since 2006.

While that might seem like a lot, remember that at least 2.5 billion doses of vaccines have been given in that time .

When vaccines are recalled, it is typically because:

  • there is a loss of potency over time (typically flu vaccines near the middle or end of flu season)
  • there are minor production or manufacturing issues

Fortunately, these recalls don’t usually seem to involve major problems.

They are also a testament to just how closely vaccines are inspected after they are manufactured.

Vaccine Recalls

Recent vaccine recalls include:

  • Fluzone Quadrivalent – 3 lots had declined below the stability specification limit for 2 strains (2015)
  • Flulaval Quadrivalent – 13 lots of thimerosal-free pre-filled syringes were recalled because of loss of potency (2015)
  • Gardasil – one lot was recalled “due to the potential for a limited number of vials to contain glass particles” (2013)
  • Menveo – two lots were recalled “following observation of higher-than-specified levels of residual moisture within the lyophilized MenA component vial” (2013)
  • Recombivax HB – one lot was recalled “due to the potential for a limited number of cracked vials to be present in the lot.” (2013)
  • Typhim Vi – two lots of prefilled syringes and 20-dose vials because the “lots are at risk for lower antigen content” (2012)
  • MMR-II – one lot was recalled because it had not been shipped before being released. (2012)
  • Prevnar 13 – one lot was recalled because “the lot was formulated and filled with expired serotype 3 conjugate material.” (2012)
  • Fluvirin – one lot was recalled because “for a small number of vials, cracked vial necks leading to broken vials have been detected” (2010)
  • RabAvert Rabies Vaccine Kits – one lot was recalled because “as the stopper and the metal crimp dislodge from the vial completely when removing the protective cap.” (2010)
  • Prevnar 7 – 4 lots were recalled because “a potential exists for syringes to have been distributed with a rubber formulation in the syringe tip caps that was not approved for use with Prevnar.” (2010)
  • 2009 H1N1 intranasal vaccine – 13 lots were recalled because of a “slight decrease in the potency of the H1N1 component of the vaccine” (2009)
  • 2009 H1N1 vaccine – 4 lots were recalled because they were “intended for children 6 through 35 months of age” (2009)
  • Prevnar 7 – 1 lot was recalled because some of pre-filled syringes were “not intended for commercial use” (2009)
  • Fluvirin – 5 lots was recalled because of “a minor deviation in the potency of the A/Brisbane (H1N1) component of the vaccine” (2009)
  • PedvaxHib and Comvax – 13 lots were recalled because of a “lack of assurance of product sterility” (2007)
  • Fluvirin – 2 lots were recalled because they were shipped “in either a frozen state and/or below the required storage temperature” (2006)
  • Decavac – one carton (about 3000 Td shots) was recalled because it ” exceeded labeled temperature requirements during shipment” (2006)

These vaccine recalls shouldn’t scare you away from getting your kids vaccinated.

None led to “serious adverse events,” as some folks try to scare parents.

If anything, they should reassure you just how safe vaccines are. After all, from these vaccine recalls, you now know that ‘they’ are:

  • monitoring the potency of vaccines after they are manufactured
  • monitoring the temperatures of the vaccines while they are being shipped and stored
  • continuing to do quality testing, even after the vaccine is released

Remember, according to the CDC:

There have been only a few vaccine recalls or withdrawals due to concerns about either how well the vaccine was working or about its safety.  Several vaccine lots have been recalled in recent years because of a possible safety concern before anyone reported any injury.  Rather, the manufacturer’s quality testing noticed some irregularity in some vaccine vials.  In these cases, the safety of these vaccines was monitored continuously before and after they were in use.

Of these recalls, one of the largest was the 2007 recall of PedvaxHib and Comvax by Merck over concerns “about potential contamination with bacteria called B. cereus.” Fortunately, “no evidence of B. cereus infection was found in recipients of recalled Hib vaccines.”

If one of your child’s vaccines have been recalled, you will likely be notified by your pediatrician, who would have been notified by the manufacturer of the vaccine.

For More Information on Vaccine Recalls: