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Highlights from the 2013 Adult Immunization Schedule

The Advisory committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention has issued the 2013 adult immunization schedule, posted online this week in the Annals of Internal Medicine. Because current levels of vaccine uptake for adult vaccines are low, the recommendations stress the importance of providers routinely assessing patients’ vaccination histories and providing routinely recommended vaccines. A strong recommendation from physicians offering vaccination has been associated with increased uptake of vaccines. Physicians are also encouraged to implement reminder/recall systems and standing orders. View figure of the Recommended Adult Immunization Schedule, or click here to download. Changes in the 2013 vaccination schedule include the following: PCV13. Updates have been added for the first time on the use of 13-valen pneumococcal conjugate vaccine (PCV13) and the timing of administration of PCV13 relative to the 23-valent pneumococcal polysaccharide vaccine (PPSV23) in adults. PC13 is recommended for immunocompromised adults aged 19 and older. The schedule also clarifies which adults would need 1 or 2 doses of PPSV23 before age 65. Tdap. Recommendations have been expanded to include routine administration of Tdap vaccination to adults age 65 and older as well as pregnant women. Pregnant women should receive the Tdap vaccine during each pregnancy, ideally between 27 and 36 weeks’ gestation to increase the likelihood of optimal protection for the woman, the fetus during pregnancy, and the first few months of the infant’s life. Influenza. The guidelines continue to recommend influenza vaccination for patients 6 months and older. Mild allergy to eggs is no longer a contraindication for the influenza vaccination – but patients with this allergy should receive the...

Protecting Older, Vulnerable Patients From the Flu

People aged 65 and older account for more than 60% of the estimated 226,000 flu-related hospitalizations and 90% of the 3,000 to 49,000 flu-related deaths in the United States each year. This age group is at highest risk for contracting influenza and developing its potentially serious complications, including pneumonia, bronchitis, sinus and ear infections, and coronary problems. Flu symptoms can even exacerbate other comorbid conditions. This puts patients at greater risk for complications and reduces quality of life. Collectively, these health issues can result in hospitalization and even death in older patients. Be Vigilant of Those at Higher Risk for Flu As the 2012-2013 influenza season continues and we look ahead to the next, it’s important to improve community-wide vaccination rates so that we can protect public health, especially when treating adults aged 65 and up. Seniors are at higher risk for influenza because the immune system weakens with age. In turn, the body’s ability to produce a sufficient amount of protective antibodies is reduced. When considering influenza vaccine resources for the season, it’s important to offer a variety of vaccine options and newer delivery systems. Merle C. Turner, DO A few years ago, the healthcare world received good news when a higher dose of the influenza vaccine was approved by the FDA for older patients. Designed for those aged 65 and older, the vaccine generates a stronger immune response because it contains four times the amount of antigen as the standard dose. While the high-dose vaccine has shown a higher risk for side effects at the injection site, there is no greater risk of a systemic reaction than...

Leading the Fight Against Flu

In 2009, the H1N1 influenza virus significantly changed the way most healthcare workers in the United States think about the flu. Collectively, we learned once again that the influenza virus is an unpredictable and serious threat to our patients’ health and well-being. Every year, influenza sickens 5% to 20% of all Americans, sending about 200,000 people to the hospital. What’s worse is that thousands die from the flu each year. The best means to prevent influenza illness is vaccination. This flu season, the Department of Health and Human Services is recommending seasonal influenza vaccination for everyone 6 months of age and older. Moreover, the CDC and the Advisory Committee on Immunization Practices continue to recommend that immunization programs focus initially on providing protection for people at greater risk for influenza-related complications, including: Pregnant women. Children younger than 5, but especially children younger than 2. Adults aged 65 and older. People with chronic medical conditions (eg, asthma, diabetes, or heart disease) associated with greater risk for medical complications from influenza. People working in healthcare settings are also among those at high-risk of getting and spreading influenza. Lead By Example Healthcare workers can serve as role models for vaccination because they can provide vaccines and set an example by getting vaccinated themselves. Research continues to show that the flu can spread rapidly throughout healthcare settings if proper precautions aren’t taken. Vaccination of healthcare workers reduces influenza infection and absenteeism, prevents mortality in other patients, and results in financial savings to sponsoring health institutions. However, influenza vaccination coverage among healthcare workers in the U.S. remains low. Recent mid-season estimates suggest that approximately...

IDWeek 2012: Study Shows Flu Deadly in Otherwise Healthy Kids

New data being presented at IDWeek 2012 shows the fatal risk that influenza poses even for children without underlying health conditions and the effectiveness of school-based vaccination programs in protecting student populations. Together, these findings support the crucial public health message that families should take the flu virus seriously every year. One study viewed influenza from an epidemiological perspective, analyzing U.S. pediatric influenza-associated deaths over an eight-year period and finding that 43 percent of the deaths occurred in children with no health conditions, such as asthma or diabetes, that would have predisposed them to being at high risk of serious flu complications. Moreover, the study found that those young, previously healthy patients succumbed faster. The median duration of illness from onset of initial symptoms to death was four days in children with no underlying high-risk health conditions compared with seven days in children with at least one such condition. “During the 2004-2012 influenza seasons, almost half the children who died had been previously healthy,” said Karen K. Wong, MD, an Epidemic Intelligence Service officer with the Centers for Disease Control and Prevention (CDC) and the study’s lead researcher. “The numbers demonstrate how important it is for all children, even children who are otherwise healthy, to get a flu vaccine every year, and underscore why all children with severe illness should get treated early with influenza antiviral medications.” The other study looked at influenza from a proactive perspective, assessing the impact of immunization programs in elementary schools in the Los Angeles area and finding lower rates of flu and higher rates of attendance. At one school where nearly half of...

Leading the Fight Against Flu

In 2009, the H1N1 influenza virus significantly changed the way most healthcare workers in the United States think about the flu. Collectively, we learned once again that the influenza virus is an unpredictable and serious threat to our patients’ health and well-being. Every year, influenza sickens 5% to 20% of all Americans, sending about 200,000 people to the hospital. What’s worse is that thousands die from the flu each year. The best means to prevent influenza illness is vaccination. This flu season, the Department of Health and Human Services is recommending seasonal influenza vaccination for everyone 6 months of age and older. Moreover, the CDC and the Advisory Committee on Immunization Practices continue to recommend that immunization programs focus initially on providing protection for people at greater risk for influenza-related complications, including: Pregnant women. Children younger than 5, but especially children younger than 2. Adults aged 65 and older. People with chronic medical conditions (eg, asthma, diabetes, or heart disease) associated with greater risk for medical complications from influenza. People working in healthcare settings are also among those at high-risk of getting and spreading influenza, often to vulnerable populations. Lead By Example Healthcare workers can serve as role models for vaccination because they can provide vaccines and set an example by getting vaccinated themselves. Research continues to show that the flu can spread rapidly throughout healthcare settings if proper precautions aren’t taken. Vaccination of healthcare workers reduces influenza infection and absenteeism, prevents mortality in other patients, and results in financial savings to sponsoring health institutions. However, influenza vaccination coverage among healthcare workers in the U.S. remains low. Recent mid-season estimates suggest...
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