Vaccines Spring 2024

Vaccines  Vaccines Major source of primary prevention Our first line of defense for bioterrorism Many successes globally Smallpox Polio Influenza  Vaccines stimulate immunity by How do causing body to form antibodies after an...

Vaccines  Vaccines Major source of primary prevention Our first line of defense for bioterrorism Many successes globally Smallpox Polio Influenza  Vaccines stimulate immunity by How do causing body to form antibodies after an “agent” is introduced. Vaccines Work? Immune system like a watchdog Ejects intruders (bacteria and viruses) from the home (body). Video Sound immune system distinguishes intruders from cells that belong Immune system fights intruders passively or actively Spacing of vaccines is important First dose small concentrations of antibodies slowly produced. Subsequent doses body reacts quicker and more effectively. Immunity Active Passive Immunization of an Antibodies received from individual by introducing another human or animal an agent or vaccine Immunoglobulin or antiserum Individual host then Maternal antibodies creates antibodies Last only about 2 months, so Long-term protection vaccine schedule starts at 2 mos. Short term protection only Herd immunity: Immunity of a group or community - Resistance of a large proportion of members of a group to an infection -95% vaccination rate needs to be covered to ensure adequate protection for the whole community Two Main Types of Vaccines Inactivated Live Attenuated Whole or part microbes, Grown from live virus, killed weakened Weaker response, need Usually one dose for repeats lifelong (?) effect Side effects minimal Require cold chain Can be given to pregnant, Could overwhelm poor weakened immune system immune system patients Can cause mild case Two Main Types of Vaccines Inactivated Live Attenuated Influenza Measles Polio (injected) Mumps Pertussis Rubella Plague Chickenpox Hepatitis A & B Smallpox Lyme Disease Influenza inhaled Rabies Polio (oral) mRNA Messenger RNA (mRNA) vaccines teach our cells how to make a protein that will trigger an immune response inside our bodies. Harmless protein is unique to the virus. After our cells make copies of the protein, they destroy the genetic material from the vaccine. Our bodies recognize that the protein should not be there and build T-lymphocytes and B- lymphocytes that will remember how to fight the virus that causes COVID-19 if we are infected in the future. mRNA vaccines are newly available to the public. However, researchers have been studying and working with mRNA vaccines for decades. Vaccine Additives & Production Antibiotics to keep vaccine clean Preservatives decrease risk of contamination (thimerosal good but has mercury) Stabilizers against heat, light, etc New silk based additive to reduce need for refrigeration! NIH Study Flu Vaccine Contraindications and Precautions* Any prior Seizure after initial Chronic renal anaphylactic dose disease response Generalized malignancy, Moderate or severe immunosuppressive illness* therapy, recent blood or plasma transfusion ** Vaccines Recommended in Pregnancy Influenza DTaP COVID **Live vaccines not recommended National Vaccine Injury Act 1988 Requires providers to counsel parents and clients about risks/benefits of immunizing agent, and side effects. VIS provided for this purpose Vaccine Adverse Event Reporting System National safety surveillance. Requires providers and vaccine manufacturers report adverse events after vaccines.  Number of petitions filed seeking compensation for injury or death caused by select vaccines in the U.S. between 1988 and 2023, by outcome* Number of petitions filed for damages caused by vaccines U.S. 1988-2023, by outcome Compensated Dismissed DTP** 1273 2711 Hepatitis A 70 45 Hepatitis B 304 449 Human papillomavirus (HPV) 167 419 Influenza 5588 993 Measles 57 107 Mumps 1 9 Rubella 71 123 Mealses, mumps, rubella (MMR) 432 612 Pneumococcal Conjugate 136 95 Rotavirus 76 33 Varicella 72 39 32 Description: This statistic presents the number of petitions that were filed with the United States National Injury Compensation Program (VICP) seeking compensation for injury or death caused by select vaccines from October 1988 to June 2023, by outcome. Over this time period 5,588 petitions seeking damages for injury or death from the influenza vaccine were compensated and 993 were dismissed. Read more Note(s): United States; October 1, 1988 to June 1, 2023; * As of June 1, 2023. ** Diphtheria, tetanus, and pertussis. "In the majority of cases, vaccines cause no side effects, however they can occur, as with any medication-but most are mild. Very [...] Read more Source(s): HRSA Immunization Practices and Challenges Vaccine shortages Immigrant groups who come to the US unvaccinated Many children do not receive complete regimen of vaccines Lack of awareness Resistance: cultural, philosophical, religious, urban hip! Lack of access Vaccine cost for underinsured is high. ACA is changing that slowly… Limited providers in public sector Outbreaks Measle s outbrea k 2019  Mumps rising Mumps: - swollen, painful glands - inability to eat/swallow - Contagious in college age kids - Can cause infertility (commonly in males) - Spreads like mono  - Ranges from mild to death - Cough not always present Pertussis - Highly contagious before symptoms - No maternal antibodies rising - Boostering all pregnant women, or women at delivery (crosses the placenta and protects babies) Vaccine Hesitancy Exemption s& Legislation  Percentage of U.S. adults who thought the government should require vaccinations for children in 1991 and 2019 U.S. adults who felt the government should require childhood vaccinations 1991-2019 Yes, require No, should stay out of it Depends No answer 90% 81% 80% 70% Percentage of respondents 62% 60% 50% 40% 35% 30% 20% 14% 10% 3% 2% 2% 1% 0% 1991 2019 35 Description: In 2019, 62 percent of U.S. adults felt that the government should require children to get vaccinated against contagious diseases like measles, versus 81 percent in 1991. The statistic illustrates the percentage of U.S. adults who thought the government should require vaccinations for children in 1991 and 2019. Read more Note(s): United States; 1991 and 2019; over 1,000; 18 years and older Source(s): Gallup; PSRAI  State Percentage States of with the vaccinated children lowest US Average 75.8% vaccine Arizona 70.3% rates Montana 69.1% As of 2021 Missouri 69.1% *CDC immunization survey Alaska 66.6% Oregon 65%  Most common reasons given to U.S. health care professionals by families for refusing vaccines or requesting alternative schedules as of 2016 Reasons U.S. families gave health care professionals for refusing vaccinations 2016 Percentage of healthcare professionals 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Fear of connection to autism spectrum disorder 77% Concerns about added ingredients in vaccines 71% Worry child will suffer other complications from vaccine 70% Worries about "overwhelming" infant's immune system 56% Distrust of pharmaceutical industry 44% Believe child will get illness from vaccine 41% Pain/stress of multiple injections for child 37% Believe naturally acquired immunity preferable 32% Religious or political belief 31% Doubt about vaccine efficacy 23% Cost/lack of insurance coverage for vaccines 8% 24 Description: This statistic displays the most common reasons families gave to health care professionals for refusing vaccines or requesting alternative schedules for vaccines in the U.S. as of May 2016. It was found that 77 percent of health care professionals reported that a fear of connection to autism spectrum disorder was the reason families gave for refusing vaccines. Read more Note(s): United States; May 8-31, 2016; 1,551 respondents; health care professionals Source(s): Medscape  Vaccines health care professionals said families were most likely to refuse or request on an alternative schedule in the U.S. as of 2016 Vaccines families were most likely to refuse in the U.S. 2016 Percentage of healthcare professionals 0% 10% 20% 30% 40% 50% 60% 70% Human Papillomavirus (HPV) 61% Influenza 39% Measels, Mumps and Rubella (MMR) 37% Varicella 18% Hepatitis B 16% Hepatitis A 16% Meningococcal 15% DTaP 13% Rotavirus 11% Polio 10% Pneumococcal conjugate 9% Hib 6% None of the above 10% 23 Description: This statistic displays the most common vaccines health care professionals reported families refused or requested on an alternative schedule in the U.S., as of May 2016. It was found that 61 percent of health care professionals reported that the human papillomavirus (HPV) vaccine was the most likely vaccine to be refused or requested on an alternative schedule by families. Read more Note(s): United States; May 8-31, 2016; 1,551 respondents; health care professionals Source(s): Medscape  Percentage of U.S. adults who had heard a great deal about the possible disadvantages of vaccinations for children in 2001, 2015, and 2019 U.S. adults who heard a lot about the disadvantages of child vaccinations 2001-2019 2001 2015 2019 50% 45% 43% 39% 40% 40% Percentage of respondents 35% 32% 30% 30% 28% 25% 24% 20% 18% 17% 15% 15% 10% 9% 5% 3% 1% 1% 0% A great deal Fair amount Only a little Nothing at all No opinion 41 Description: This statistic shows the percentage of U.S. adults in 2001, 2015, and 2019 who had heard a great deal about the possible disadvantages of vaccinations for children. In 2001, only 15 percent of respondents had heard a great deal about the possible disadvantages of vaccinations for children, however this number was 39 percent in 2019. Read more Note(s): United States; 2001, 2015, and 2019; over 1,000; 18 years and older Source(s): Gallup  Vaccine messaging Anti-vaccine messaging on social media has tripled since the pandemic began. Common Myths 2. Immune systems can’t 3. I get ‘the flu’ 4. Vaccines are 1. Vaccines handle all of from the flu made of fetal aren’t safe that vaccine at vaccines tissues once. 5. HPV Vaccine will cause 6. It’s better to 7. Vaccines cancer? Or have ‘natural Cause Autism cause kids to immunity” have sex  VAXOPEDIA - an A to Z guide to Vaccines cdc.gov References https://www.pbs.org/wgbh/nova/video/vaccinescalling-t he-shots/ Dr. Ari Brown