New York State Immunization Requirements for School Entrance/Attendance
Requisitos de vacunación del estado de Nueva York para el ingreso/asistencia a la escuela

Information from FDA and CDC on Gardasil and its Safety -- July 22, 2008

HealthDay (11/14/07, Gordon) reports, "The incidence of vaccine-preventable deaths has reached an all-time low in the United States," according to data published in today's issue of the Journal of the American Medical Association.  The Centers for Disease Control and Prevention (CDC) study "found that childhood vaccinations have reduced the death rates from seven previously common childhood illnesses, such as diphtheria, mumps, and measles, by 100 percent."  Investigators "compared the number of cases and deaths for 13 vaccine-preventable deaths," using the latest illness data from 2006, and death rates from 2004, "to pre-vaccination rates. Overall, for immunizations developed prior to 1980, there was a 92 percent reduction in vaccine-preventable illnesses, and a 99 percent or greater decline in deaths due to vaccine-preventable diseases."  Those inoculations that became available "after 1980, including the hepatitis vaccines," Haemophilus influenza type b, "and chickenpox," experienced "an 80 percent or greater decline in illness and deaths."

        The New York Times (11/14/07, A18, McNeil Jr.) notes that the prior to this study, the CDC had "never before searched historical records going back to 1900 to compile estimates of cases, hospitalizations, and deaths for all the diseases that children are routinely vaccinated against."  Furthermore, "Public health officials are involved in a continuing struggle with anti-vaccine activists who contend that the shots given to children trigger autism, seizures, or other serious side effects."  Curtis Allen, a spokesman for the CDC, said that "the new study was not done specifically to counter the anti-vaccine movement, 'but it does show conclusively the value of vaccines.'"

        And, Time (11/13/07, Blue) added, "In the U.S., few health issues get people as riled up as the persistent, though almost completely discredited, argument that routine childhood immunizations cause autism."  At present "[i]n the U.K., doctors and policy makers are debating whether to encourage universal vaccination against chickenpox, a step that U.S. medical authorities took in 1995.  Even that debate -- focused not on the vaccine's safety, but on whether it's really necessary -- has become surprisingly bitter."  However, the researchers "cite a 2001 paper [which] estimat[ed] that every year, seven of the 12 routine childhood vaccinations given in the U.S. prevent 14 million disease cases and 33,000 deaths."  In light of those estimates, "[t]he JAMA authors believe their own death-rate reduction figures may in fact underestimate the true benefits of vaccination."
 

Evidence-Based Medicine: MMR Vaccine Not Linked to Autism

• JAMA: Association Between Thimerosal-Containing Vaccines and Autism
  "In a six-year Danish population-based cohort study, children given a thimerosal-based vaccine were compared with those receiving a thimerosal-free version of the same vaccine. The risk of autism and autism-spectrum disorders did not differ significantly between the two groups."

• AAP: Study fails to show a connection between thimerosal and autism
  "AAP provides the following information for clinicians who may be aware of recent press surrounding an article that claims to show a correlation between thimerosal and autism.  This paper uses data from the Vaccine Adverse Event Reporting System (VAERS) inappropriately and contains numerous conceptual and scientific flaws, omissions of fact, inaccuracies, and misstatements."
  AAP Press Release: http://www.aap.org/profed/thimaut-may03.htm

• JAMA Editorial: 
  Congressional Autism Hearings Continue: No Evidence MMR Vaccine Causes Disorder

• AAP Press Release:
  http://www.aap.org/advocacy/washing/23apr01.htm

• Institute of Medicine Immunization Safety Review:
  http://www.nap.edu/books/0309074479/html/

• Journal of the American Medical Association - Time Trends in Autism and in MMR Immunization Coverage in California (JAMA. 2001;285:1183-1185)
  http://jama.ama-assn.org/issues/v285n9/abs/jbr00284.html

• Pediatrics Electronic Article:  Measles-Mumps-Rubella Vaccine and Autistic Spectrum Disorder: Report From the New Challenges in Childhood Immunizations Conference Convened in Oak Brook, Illinois, June 12-13, 2000  Vol. 107 No. 5 May 2001, p. e84
  http://www.pediatrics.org/cgi/content/abstract/107/5/e84

• British Medical Journal 2001;322:460-463 (24JFebruary) Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis
  http://www.bmj.com/cgi/content/full/322/7284/460

• WebMD: Autism Debate May End Up Harming Children - There's No Evidence Vaccine Is Linked to the Disorder
  http://webmd.lycos.com/content/article/1728.57049

• Autism Research Must Continue - AAP to issue autism policy statement on diagnosis and treatment
  http://www.aap.org/advocacy/washing/25apr01.htm

Varicella

Decline in Annual Incidence of Varicella - Selected States, 1990--2001
   "The findings in this report suggest that the steady decline in reported varicella incidence during 1999-2001 resulted from the increased use of varicella vaccine and not a decrease in reporting.  These findings are consistent with data from three active surveillance sites at which individual cases are investigated (Antelope Valley, California; West Philadelphia, Pennsylvania; and Travis County, Texas).  During 1995-2000, incidence of varicella for all age groups in these three sites declined substantially (range: 76%-87%), corresponding with the high average vaccination coverage of 80%."
MMWR September 19, 2003 / 52(37);884-885

AAP, Institute of Medicine: Vaccine Safety Report
"A vaccine safety report issued by the Institute of Medicine (IOM) contains findings and recommendations consistent with those of the AAP.  No evidence currently exists that proves a link between thimerosal-containing vaccines and autism, ADHD and speech and language delay."
AAP Press Release
IOM Online Report: Immunization Safety Review: Thimerosal-Containing Vaccines and Neurodevelopmental Disorders (2001)

 CDC Influenza Home Page

• CDC Resources for Pandemic Flu
• Influenza Summary Update - Weekly Update
• MMWR Update: Influenza Activity --- United States, February 5--11, 2006
  "...states reporting widespread influenza activity increased to 13, with 21 states reporting regional activity..."

Influenza Vaccine Shortage:

• Update on the Influenza Vaccine Supply and Distribution (Nov 10, 2005)
• Prevention of Influenza in Children during Vaccine Shortage
• Influenza Vaccine Shortage Q and A
• Information for Families About Flu Vaccine Shortage

Using Live, Attenuated Influenza Vaccine for Prevention and Control of Influenza
"This report summarizes recommendations by ACIP for using intranasally administered, trivalent, cold-adapted, live, attenuated influenza vaccine (LAIV), which was approved for use in the US on June 17, 2003 (FluMist(R), MedImmune, Inc.). LAIV is currently approved for use among healthy persons (i.e., those not at high risk for complications from influenza infection) aged 5–49 years."

Carriers Announce Coverage for Intranasal Flu Vaccine


"Administration of inactivated trivalent influenza vaccine to children aged 6 to 24 months did not reduce their burden of AOM or their utilization of selected health care and related resources."

The Safety of Inactivated Influenza Vaccine in Adults and Children with Asthma
"In a multicenter, randomized, double-blind, placebo-controlled, crossover trial in 2032 patients with asthma (age range, 3 to 64 years), patients were given injections of vaccine and placebo assigned randomly, with a mean of 22 days between the injections.  Each day during the two weeks after each injection, the patients recorded peak expiratory flow rates, symptoms thought to be related to the injection, use of asthma medications, unscheduled health care visits for asthma, and asthma-related absences from school or work.  In the two weeks after the injections.  The frequency of exacerbations of asthma was similar in the two weeks after the influenza vaccination and after placebo injection.  Among symptoms thought to be associated with the injection, only body aches were more frequent after the vaccine injection than after placebo injection.  Conclusion was: the inactivated influenza vaccine is safe to administer to adults and children with asthma, including those with severe asthma."
NEJM: Volume 345:1529-1536

ACIP Recommends Expanded Influenza Vaccinations for Children

"Do Parents Understand Immunizations? A National Telephone Survey" 

A survey of 1,600 parents reveals that the majority of parents understand the clear benefits of childhood immunization, yet many still have misconceptions that may undermine their confidence in vaccines. 

AAP Press Release
Pediatrics Vol. 106 No. 5 November 2000, pp. 1097-1102

 
ACIP Recommends Adult Vaccination: New Tetanus, Diphtheria Pertussis Vaccine (Tdap)
     "...voted to recommend that adults from 19 to 64 years of age be vaccinated with a newly licensed adult booster tetanus, diphtheria and pertussis (whooping cough) vaccine (Tdap)..."

The Risk of Seizures after Receipt of Whole-Cell Pertussis or Measles, Mumps, and Rubella Vaccine
"In a cohort study at four large HMOs, relative risks of febrile and non-febrile seizures among 679,942 children after 340,386 DTP vaccinations, 137,457 MMR vaccinations and no recent vaccination were calculated. Receipt of DTP vaccine was associated with an increased risk of febrile seizures only on the day of vaccination (adjusted relative risk, 5.70). Receipt of MMR vaccine was associated with an increased risk of febrile seizures 8 to 14 days after vaccination (relative risk, 2.83). Neither was associated with an increased risk of non-febrile seizures. The number of febrile seizures attributable to the administration of DTP and MMR vaccines was estimated to be 6-9 and 25-34 per 100,000 children, respectively. As compared with other children with febrile seizures that were not associated with vaccination, the children who had febrile seizures after vaccination were not found to be at higher risk for subsequent seizures or neuro-developmental disabilities."

The Changing Epidemiology of Rubella in the 1990's: On the Verge of Elimination and New Challenges for Control and Prevention
"The epidemiology of rubella and CRS has changed significantly in the last decade.  These changes and molecular typing suggest that the United States is on the verge of elimination of the disease.  To prevent future rubella outbreaks and CRS, current strategies must be enhanced and new strategies developed."
JAMA. 2002;287:464-472

ACIP Expands Hepatitis A Vaccination for Children
     "The recommendation for vaccination of children, between 1 and 2 years of age will be integrated into the routine childhood vaccination schedule"

ACIP Recommends New Vaccine to Prevent Rotavirus