Transcript Measles Cases in the United States - AAP Point-of

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The 2015 Childhood
Immunization
Schedule
H. Cody Meissner, MD, FAAP
Floating Hospital for Children
Tufts University School of Medicine
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Disclaimers
 Statements and opinions expressed are those of the author
and not necessarily those of the American Academy of
Pediatrics (AAP).
 I have no financial relationship with the manufacturer(s) of any
commercial product(s) discussed in this presentation.
 I may discuss the use of vaccines in a manner that is not
consistent with the Package Insert, but all recommendations
are in accordance with recommendations from the Advisory
Committee on Immunization Practices (ACIP) and the AAP.
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Title
 Text
Influenza Positive Tests Reported to Centers for Disease Control and Prevention (CDC) by
US World Health Organization (WHO) and National Respiratory and Enteric Virus
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answersCollaborating
from the American Academy
of Pediatrics.National Summary, 2014–2015
Surveillance
System Trusted
(NREVSS)
Laboratories,
Week ending February 7, 2015
Live Attenuated Influenza Vaccine (LAIV) Effectiveness
against Medically-attended Influenza among 2–18 Year Olds,
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US Flu Vaccine Effectiveness (VE) Network
Total, Flu +
LAIV, Flu +
332
12
738
61
224
34
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Summary: US Flu VE Network
 During 2011–2012 and 2012–2013, there was no
statistically significant difference in relative efficacy of LAIV
versus inactivated influenza vaccine (IIV).
 During 2013–2014, there was no statistically significant
efficacy among LAIV recipients. Efficacy of IIV was
statistically significant.
 H1N1pdm09 was the predominant virus during 2013–2014.
o Subtype analysis is consistent with lack of activity for LAIV
against H1N1pdm09.
o Cannot rule out specific issue related to 2013–2014, e.g.
study enrollees or design, unmeasured confounding or
vaccine issue.
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Licensed Human Papillomavirus (HPV) Vaccines
L1 – Major capsid protein; VLP – virus like particle
Adolescent Vaccination Coverage
United States, 2006–2013
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Elam-Evans LD, Yankey D, Jeyarajah J. National, regional, state and selected local area vaccination coverage among adolescents aged 13–17
years—United States, 2013. MMWR. 2014;63(29);625–633.
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Measles Cases in the United States
Courtesy of H. Cody Meissner, MD, FAAP
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Measles Cases in the United States, 1994–2014
Orenstein W, Seib K. Mounting a good offense against measles. N Engl J Med. 2014;371(18):1661–1663.
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Recommendations for Healthcare Providers
 Ensure all people are up to date on the measles, mumps,
and rubella (MMR) vaccine.
 All travelers ≥6 months must be protected from measles.
 Consider measles in anyone with a febrile rash illness and
cough, coryza, conjunctivitis in anyone who has recently
traveled or who has had contact with someone with a
febrile rash illness.
 The incubation period for measles, from exposure to fever,
is about 10 days (range: 7 to 12 days).
 Isolate suspected measles case and immediately report to
local health department.
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Surface Antigens, N. meningitidis
Serruto D, Bottomley MJ, Ram S. The new multicomponent vaccine against meningococcal serogroup B,
4CMenB: immunological, functional and structural characterization of the antigens. Vaccine. 2011–2012;30
(Suppl 3):B87–B97.
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Two Meningococcal Serogroup B Vaccines
 4CMenB (Bexsero, Novartis)
o Licensed by the Food and Drug Administration (FDA) in January 2015 for
a 2-dose schedule
o Genome derived Neisseria antigens (reverse vaccinology)
o Used under a CDC sponsored investigational new drug at Princeton and
University of California Santa Barbara in December 2013; approximately
30,000 doses administered
• March 2014: One death in Drexel student; no recommendation for
vaccine use at this time
o Multivalent vaccine (MenABCWY), phase II trials
 Bivalent MenB (Trumenba, Pfizer)
o Licensed by FDA in October 2014 for a 3-dose schedule
o Two highly conserved variants of factor H binding protein (fHbp)
o Multivalent vaccine (MenABCWY), phase III trials
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