Flu season is up us. Please see these guidelines for this season from Infectious Disease Society of America for current updates.
Two cases of mumps, a vaccine preventable communicable viral disease, were identified in Morgan County.
Mumps, an acute vaccine-preventable viral illness transmitted by respiratory droplets and saliva, has an incubation period of 16–18 days (12–25 days min/max respectively). A statewide notification is being sent since the cases are widespread across the Morgan County community and a common exposure has not been identified. Continue reading
The addition of Prevnar 13 to the pneumococcal vaccination protocol has certainly made the algorithm a bit more complicated. This is the updated workflow.
The Infectious Disease Society of America has published the 2013 IDSA Clinical Practice Guideline for Vaccination of the Immunocompromised Host
In our effort to enhance patient and healthcare provider safety, last year Centegra Health System (CHS) made the influenza vaccination mandatory for all Associates. The program was a huge success in vaccinating over 95% of associates. This season all physicians are expected to participate in this Medical Executive Committee (MEC) approved initiative to increase our patient safety.
Research shows that vaccination is the single most important measure for reducing the impact of influenza not only on ourselves but our community as well. It is therefore our responsibility as healthcare workers to do the right thing for our patients. The Center for Disease Control, IDPH and The Joint Commission both highly recommend flu shots for all health care workers and many progressive healthcare organizations both locally and nationally have seen positive outcomes as a result of mandatory flu shot programs.
CHS requires all associates, physicians, volunteers, students, clinical contract workers, and identified vendors to receive an influenza vaccination in order to protect patients, Associates, family members, and the community from influenza. Exceptions will only be granted for medical conditions and religious beliefs. Both will require written documentation. Associates previously granted exemptions are required to complete a exemption renewal. Please review the updated CHS Influenza Immunization Program policy for details.
In that regard we are offering influenza vaccinations free to all Physicians, Licensed Independent Practitioners, Associates, volunteers, and students. Please review the attached poster detailing the vaccination schedule.
If you will be receiving your vaccination through your practice we will need you to complete the attached form and submit it to the Medical Staff Office.
- Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2013–2014
- Influenza Vaccination Coverage Among Health-Care Personnel — United States, 2012–13 Influenza Season
CDC MMWR September 27, 2013 / 62(38);781–786
- Fluvax View National Influenza Vaccination Converage
- List of medical organizations that approve mandatory vaccination of healthcare workers
- State of New York makes vaccination of healthcare workers mandatory
- Preventinfluenza.org – information for healthcare worker vaccination
This lecture was presented at the July 2013 Centegra summer symposium. Continue reading
The risk of Guillain-Barre is often viewed as an obstacle to influenza vaccination.
A recent study by Kwong et al published in the June 28th issue of the Lancet identified cases of Guillain-Barre that occurred with 6 weeks of vaccination and found that more cases occurred in the control group (not vaccinated) than in those who were vaccinated. Far greater number of Guillain-Barre cases were identified in the non-vaccinated group than in the ones vaccinated.
The conclusion reached was that the attributable risk for Guillain-Barre after seasonal inflluenza vaccination is lower than those after influenza disease itself. This study was funded by the Canadian Institute of Health Research.
Risk of Guillain-Barré syndrome after seasonal influenza vaccination and influenza health-care encounters: a self-controlled study; Dr Jeffrey C Kwong MD,Priya P Vasa MD,Michael A Campitelli MPH,Steven Hawken MSc,Kumanan Wilson MD,Laura C Rosella PhD,Prof Therese A Stukel PhD,Natasha S Crowcroft MD(Cantab),Prof Allison J McGeer MD,Lorne Zinman MD,Shelley L Deeks MD The Lancet Infectious Diseases – 28 June 2013 DOI: 10.1016/S1473–3099(13)70104-X]
Since the introduction of 7-valent pneumoccal vaccine (PCV 7) in the US immunization schedule there has been a steady decline in the number of invasive pneumococcal disease as reported in the July 11th issue of the New England Journal of Medicine by Griffen et al.
The annual rate of hospitalization for pneumonia among children younger than 2 years of age declined by 551.1 per 100,000 children (95% confidence interval [CI], 445.1 to 657.1), which translates to 47,000 fewer hospitalizations annually than expected on the basis of the rates before PCV7 was introduced. The rate for adults 85 years of age or older declined by 1300.8 per 100,000 (95% CI, 984.0 to 1617.6), which translates to 73,000 fewer hospitalizations annually. For the three age groups of 18 to 39 years, 65 to 74 years, and 75 to 84 years, the annual rate of hospitalization for pneumonia declined by 8.4 per 100,000 (95% CI, 0.6 to 16.2), 85.3 per 100,000 (95% CI, 7.0 to 163.6), and 359.8 per 100,000 (95% CI, 199.6 to 520.0), respectively. Overall, we estimated an age-adjusted annual reduction of 54.8 per 100,000 (95% CI, 41.0 to 68.5), or 168,000 fewer hospitalizations for pneumonia annually. 
Myths of immunization
This lecture was presented at the recent fall nursing symposium.
References and links
- Inflammation described by Celsus
- What is an antigen?
- Types of immunity
- Plague in the middle ages
- How India has defeated Polio, a BBC report
- Edward Jenner – the man who saved more lives than any other man
- Herd immunity
- Algorithm for immunizing persons with egg allergies
- Influenza vaccination in individuals with egg allergies
- Ileal-lymphoid nodular hyperplasia, non-specific colitis and pervasive developmental disorder in children, Lancet 1998- the original article by AJ Wakefield that started the controversy over vaccination in the late 1990s
- Wikipedia article on Andrew Wakefield
- My comments on Wakefield findings dated January 2011
- Article in The Telegraph reporting on the outbreak of Measles in Liverpool
- Risk of seizures after whole cell pertussis or Measles, Mumps, and Rubella vaccine
- Gates foundation and vaccination