1
|
McGrath E. Emergence of Vaccine-Preventable Diseases: The Perfect Storm of Hesitancy, Refusal, a Pandemic, and War. Pediatr Ann 2022; 51:e426-e430. [PMID: 36343179 DOI: 10.3928/19382359-20220913-03] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The landscape of pediatric vaccination has changed dramatically due to changing attitudes toward immunizations and recent world events. The rise of vaccine hesitancy and refusal related to the concurrent rise of social media and anti-vaccination messages with misinformation campaigns have led to populations of children being unimmunized or under-immunized. These populations have been left vulnerable to the rapid spread of vaccine-preventable infection. Additionally, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the clinical syndrome known as coronavirus disease 2019 (COVID-19) resulted in the emergence of a worldwide pandemic. Control measures to mitigate the spread of COVID-19 resulted in numerous reports of children missing routine vaccines along with the stopping of many public health immunization programs. Finally, armed conflicts and war have led to large family migrations from their homelands to various countries and regions leading to increased risk for missed maternal and child immunization as well as difficulty in keeping vaccination records. [Pediatr Ann. 2022;51(11):e426-e430.].
Collapse
|
2
|
Chen CC, Whitehead A. Emerging and Re-emerging Infections in Children: COVID/ MIS-C, Zika, Ebola, Measles, Varicella, Pertussis ... Immunizations. Emerg Med Clin North Am 2021; 39:453-465. [PMID: 34215396 PMCID: PMC8190456 DOI: 10.1016/j.emc.2021.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The role of the emergency provider lies at the forefront of recognition and treatment of novel and re-emerging infectious diseases in children. Familiarity with disease presentations that might be considered rare, such as vaccine-preventable and non-endemic illnesses, is essential in identifying and controlling outbreaks. As we have seen thus far in the novel coronavirus pandemic, susceptibility, severity, transmission, and disease presentation can all have unique patterns in children. Emergency providers also have the potential to play a public health role by using lessons learned from the phenomena of vaccine hesitancy and refusal.
Collapse
Affiliation(s)
- Carol C. Chen
- Department of Emergency Medicine, Division of Pediatric Emergency Medicine, University of California San Francisco, 550 16th Street, Box 0632, San Francisco, CA 94143, USA,Corresponding author
| | - Anne Whitehead
- Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Indiana University School of Medicine, 720 Eskenazi Avenue, FT 3rd Floor, FOB, Indianapolis, IN 46202, USA
| |
Collapse
|
3
|
Agopian A, Lopez A, Wilson D, Peralta V, El Amin AN, Bialek S. Varicella hospitalizations in Los Angeles during the varicella vaccination era, 2003-2011: are they preventable? Vaccine 2014; 32:5353-6. [PMID: 25087675 DOI: 10.1016/j.vaccine.2014.07.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 06/11/2014] [Accepted: 07/09/2014] [Indexed: 11/30/2022]
Abstract
Characteristics of varicella-related hospitalizations in the mature varicella vaccination era, including the proportion vaccinated and the severity of disease, are not well described. We present the vaccination status, severity and reasons for hospitalization of the hospitalized varicella cases reported to the Los Angeles County Health Department from 2003 to 2011, the period which includes the last 4 years of the mature one-dose program and the first 5 years after introduction of the routine two-dose program. A total of 158 hospitalized varicella cases were reported overall, of which 52.5% were potentially preventable and eligible for vaccination, 41.8% were not eligible for vaccination, and 5.7% were vaccinated. Most hospitalizations (72.2%) occurred among healthy persons, 54.4% occurred among persons ≥20 years of age, and 3.8% of hospitalizations resulted in death. Our data suggest that as many as half of the hospitalized varicella cases, including half of the deaths, may have been preventable given that they occurred in persons who were eligible for vaccination. More complete implementation of the routine varicella vaccination program could further reduce the disease burden of severe varicella.
Collapse
Affiliation(s)
- Anya Agopian
- Los Angeles County, Department of Public Health Immunization Program, 3530 Wilshire Boulevard, Suite 700, Los Angeles, CA 90001, United States.
| | - Adriana Lopez
- National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop A-34, Atlanta, GA 30333, United States
| | - Dulmini Wilson
- Los Angeles County, Department of Public Health Immunization Program, 3530 Wilshire Boulevard, Suite 700, Los Angeles, CA 90001, United States
| | - Vi Peralta
- Los Angeles County, Department of Public Health Immunization Program, 3530 Wilshire Boulevard, Suite 700, Los Angeles, CA 90001, United States
| | - Alvin Nelson El Amin
- Los Angeles County, Department of Public Health Immunization Program, 3530 Wilshire Boulevard, Suite 700, Los Angeles, CA 90001, United States
| | - Stephanie Bialek
- National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop A-34, Atlanta, GA 30333, United States
| |
Collapse
|
4
|
Baxter R, Tran TN, Ray P, Lewis E, Fireman B, Black S, Shinefield HR, Coplan PM, Saddier P. Impact of vaccination on the epidemiology of varicella: 1995-2009. Pediatrics 2014; 134:24-30. [PMID: 24913796 DOI: 10.1542/peds.2013-4251] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND When varicella vaccine was licensed in the United States in 1995, there were concerns that childhood vaccination might increase the number of adolescents susceptible to varicella and shift disease toward older age groups where it can be more severe. METHODS We conducted a series of 5 cross-sectional studies in 1994 to 1995 (prevaccine), 2000, 2003, 2006, and 2009 in Kaiser Permanente of Northern California to assess changes in varicella epidemiology in children and adolescents, as well as changes in varicella hospitalization in people of all ages. For each study, information on varicella history and varicella occurrence during the past year was obtained by telephone survey from a sample of ∼8000 members 5 to 19 years old; varicella hospitalization rates were calculated for the entire membership. RESULTS Between 1995 and 2009, the overall incidence of varicella in 5- to 19-year-olds decreased from 25.8 to 1.3 per 1000 person-years, a ∼90% to 95% decline in the various age categories (5-9, 10-14, and 15-19 years of age). The proportion of varicella-susceptible children and adolescents also decreased in all age groups, including in 15- to 19-year-olds (from 15.6% in 1995 to 7.6% in 2009). From 1994 to 2009, age-adjusted varicella hospitalization rates in the general member population decreased from 2.13 to 0.25 per 100,000, a ∼90% decline. CONCLUSIONS In the 15 years after the introduction of varicella vaccine, a major reduction in varicella incidence and hospitalization was observed with no evidence of a shift in the burden of varicella to older age groups.
Collapse
Affiliation(s)
- Roger Baxter
- Kaiser Permanente Vaccine Study Center, Oakland, California;
| | - Trung N Tran
- Department of Epidemiology, Merck Sharp & Dohme Corp, Whitehouse Station, New Jersey
| | - Paula Ray
- Kaiser Permanente Vaccine Study Center, Oakland, California
| | - Edwin Lewis
- Kaiser Permanente Vaccine Study Center, Oakland, California
| | - Bruce Fireman
- Kaiser Permanente Vaccine Study Center, Oakland, California
| | - Steve Black
- Center for Global Health, Cincinnati Children's Hospital, Cincinnati, Ohio; and
| | - Henry R Shinefield
- University of California San Francisco Medical Center, San Francisco, California
| | - Paul M Coplan
- Department of Epidemiology, Merck Sharp & Dohme Corp, Whitehouse Station, New Jersey
| | - Patricia Saddier
- Department of Epidemiology, Merck Sharp & Dohme Corp, Whitehouse Station, New Jersey
| |
Collapse
|
5
|
Gowin E, Wysocki J, Michalak M. Don’t forget how severe varicella can be—complications of varicella in children in a defined Polish population. Int J Infect Dis 2013; 17:e485-9. [DOI: 10.1016/j.ijid.2012.11.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 11/21/2012] [Accepted: 11/29/2012] [Indexed: 10/27/2022] Open
|
6
|
|
7
|
|
8
|
Conway JH, Green T. Childhood immunization policies and the prevention of communicable disease. Pediatr Ann 2011; 40:136-43. [PMID: 21417204 PMCID: PMC6267946 DOI: 10.3928/00904481-20110217-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CME Educational Objectives
1.
Review the process through which vaccines are licensed and recommendations are developed for routine use.
2.
Discuss immunization coverage rates.
3.
Review possible strategies to improve immunization coverage rates.
The drastic reduction in the incidence of vaccine-preventable diseases through childhood immunization represents one of public health’s greatest achievements. The social and economic benefits gained through the prevention of mortality and morbidity caused by infectious diseases have dramatically improved the lives of people around the world. The most impressive gains have been in developed countries, where abundant economic resources and extensive healthcare systems have supported the development and implementation of increasingly sophisticated and expensive vaccines.
Collapse
Affiliation(s)
- James H Conway
- University of Wisconsin School of Medicine and Public Health, Department of Population Health Sciences, Madison, WI 53792, USA.
| | | |
Collapse
|
9
|
Lopez AS, Zhang J, Brown C, Bialek S. Varicella-related hospitalizations in the United States, 2000-2006: the 1-dose varicella vaccination era. Pediatrics 2011; 127:238-45. [PMID: 21199857 PMCID: PMC4865884 DOI: 10.1542/peds.2010-0962] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To describe the effect of the mature 1-dose varicella vaccination program on varicella morbidity, we analyzed 2 national databases for varicella-related hospitalizations in the United States since implementation of the varicella vaccination program in 1995. PATIENTS AND METHODS Data from the National Hospital Discharge Survey and Nationwide Inpatient Sample were analyzed to describe trends in varicella-related hospitalizations during the 1-dose vaccination era (2000-2006) compared with those in the prevaccination era (1988-1995). Varicella-related hospitalizations were defined by using International Classification of Diseases, Ninth Revision codes. Results were extrapolated to represent national estimates. RESULTS Using National Hospital Discharge Survey data, 24,488 varicella-related hospitalizations were estimated to occur in the United States during the 1-dose vaccination era. The varicella-related hospitalization rate was 0.12 per 10,000 population during the 1-dose vaccination era versus 0.42 per 10,000 population in the prevaccination era (P < .01). During the 1-dose vaccination era, the estimated annual average number of varicella-related hospitalizations was significantly lower and decreased by ≥ 65% in all age groups compared with those in the prevaccination era (P < .001 in all age groups). The varicella-related hospitalization rate during the 1-dose vaccination era estimated from the Nationwide Inpatient Sample was 0.09 per 10,000 population. CONCLUSIONS Varicella-related hospitalization numbers and rates declined significantly during the 1-dose varicella vaccination era. Assuming declines in varicella-related hospitalizations are due, mainly, to the routine childhood varicella vaccination program, these data suggest that varicella vaccination prevented ∼ 50,000 varicella-related hospitalizations in the United States from 2000 to 2006.
Collapse
Affiliation(s)
- Adriana S. Lopez
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - John Zhang
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cedric Brown
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephanie Bialek
- National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| |
Collapse
|
10
|
Cook RL, Zhang J, Mullins J, Kauf T, Brumback B, Steingraber H, Mallison C. Factors associated with initiation and completion of human papillomavirus vaccine series among young women enrolled in Medicaid. J Adolesc Health 2010; 47:596-9. [PMID: 21094437 DOI: 10.1016/j.jadohealth.2010.09.015] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 09/21/2010] [Accepted: 09/21/2010] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine age- and race-specific uptake rates of human papillomavirus (HPV) vaccine among females aged 9-20 years who participated in the Florida Medicaid during the first 2 years after approval by the Food and Drug Administration, and to identify factors associated with HPV vaccine initiation and series completion. METHODS Medicaid administrative data were used to identify claims for HPV vaccination together with individual, provider, and practice characteristics linked to each vaccination. RESULTS As of June 2008, 9.4% of females aged 11-18 years had ever received an HPV vaccination, and 1.8% had completed the three-vaccine series. In multivariate analysis, receipt of an HPV vaccination was found to be associated with age and race/ethnicity. In comparison with their white counterparts, black females were approximately half as likely to complete the three-vaccine series after initiation. CONCLUSIONS The data obtained suggest relatively slow initial uptake and completion of the HPV vaccine series in this population who are at an increased risk for cervical cancer, with racial disparities in vaccine uptake and vaccine series completion.
Collapse
Affiliation(s)
- Robert L Cook
- Department of Epidemiology and Biostatistics, University of Florida, Gainesville, Florida 32610, USA.
| | | | | | | | | | | | | |
Collapse
|
11
|
Decline in varicella-related ambulatory visits and hospitalizations in the United States since routine immunization against varicella. Pediatr Infect Dis J 2010; 29:199-204. [PMID: 19949362 PMCID: PMC2924155 DOI: 10.1097/inf.0b013e3181bbf2a0] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Widespread varicella vaccination has led to substantial decreases in varicella-related mortality and hospitalizations. The effect of the vaccine on ambulatory care utilization is poorly defined. OBJECTIVE To determine trends in varicella-related ambulatory care and hospital discharges before and after vaccine licensure. DESIGN, SETTING, AND PARTICIPANTS Estimates of varicella-related ambulatory and hospital discharges were calculated for the pre- (1993-1995) and post- (1996-2004) vaccine licensure periods using the National Ambulatory Medical Care Survey, National Hospital Ambulatory Medical Care Survey, and National Hospital Discharge Survey. MAIN OUTCOME MEASURE Ambulatory and hospital discharge rates for varicella. RESULTS The rate of varicella-related ambulatory discharges decreased by 66% from 106.6 per 100,000 (95% confidence interval [CI]: 80.5-132.6) in the prelicensure period to 36.4 per 100,000 population (95% CI: 29.3-43.5) in the post-licensure period (P < 0.001). The decrease was significant across all age groups <45 years, with the greatest reduction (98%) occurring among patients 0 to 4 years of age. The incidence of varicella-related hospital discharges decreased by 53% from 30.9 per 100,000 (95% CI: 24.4-37.3) to 14.5 per 100,000 population (95% CI: 12.1-16.8; P < 0.001). This difference was significant among patients <14 years of age. Rates of varicella-related ambulatory discharges decreased significantly for both whites and non-whites in the postlicensure period, but postlicensure ambulatory discharge rates remained higher for non-whites than for whites. Decreases in varicella-related hospital discharges were statistically significant for whites and non-whites. Racial differences in the incidence of varicella-related hospital discharges also persisted following vaccine licensure. CONCLUSIONS Varicella-related ambulatory visits and hospitalizations have decreased significantly in the period after licensure of the varicella vaccine.
Collapse
|
12
|
|
13
|
Varicella infection – Evidence for peak activity in summer months. J Infect 2008; 56:360-5. [DOI: 10.1016/j.jinf.2008.01.050] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2007] [Revised: 01/05/2008] [Accepted: 01/29/2008] [Indexed: 11/21/2022]
|
14
|
Shapiro E. Second Dose of Varicella Vaccine for Children: Are We Giving It Too Late? J Infect Dis 2008; 197:935-7. [DOI: 10.1086/529044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
|
15
|
Reynolds MA, Watson BM, Plott-Adams KK, Jumaan AO, Galil K, Maupin TJ, Zhang JX, Seward JF. Epidemiology of Varicella Hospitalizations in the United States, 1995–2005. J Infect Dis 2008; 197 Suppl 2:S120-6. [PMID: 18419384 DOI: 10.1086/522146] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
16
|
Vacunas frente al virus de la varicela zóster. Enferm Infecc Microbiol Clin 2008. [DOI: 10.1016/s0213-005x(08)76223-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
17
|
|
18
|
Jean-Philippe P, Freedman A, Chang MW, Steinberg SP, Gershon AA, LaRussa PS, Borkowsky W. Severe varicella caused by varicella-vaccine strain in a child with significant T-cell dysfunction. Pediatrics 2007; 120:e1345-9. [PMID: 17974726 DOI: 10.1542/peds.2004-1681] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In March 1995, the US Food and Drug Administration approved a live attenuated varicella vaccine for use in healthy children 12 months to 12 years old. We report here an 18-month-old girl with cell-mediated immunodeficiency who developed a severe vaccine-associated rash and clinical evidence of vaccine-associated pneumonia 1 month after inadvertent receipt of varicella vaccine.
Collapse
Affiliation(s)
- Patrick Jean-Philippe
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA.
| | | | | | | | | | | | | |
Collapse
|
19
|
Saks MA, Karras DJ. Commentary. Ann Emerg Med 2007; 49:99-102. [PMID: 17197292 DOI: 10.1016/j.annemergmed.2006.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Mark A Saks
- Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
| | | |
Collapse
|