Guilford County Department of Public Health would like to remind the community of the important role immunizations play in the fight against life-threatening illness and disease during National Immunization Awareness Month, and encourage all residents to check their vaccination status.

Immunizations are one of the greatest public health accomplishments of the 20^th century.  There are many vaccines available today for babies, children and adults. Many are required for childcare, school and work attendance.  Some vaccinations are needed for travel.

Some areas of our country are experiencing outbreaks of a vaccine-preventable disease called Pertussis (Whooping Cough).  Make sure your child and teen are protected against this illness and other diseases by vaccinating them with Tdap (the vaccine for tetanus-diptheria-pertussis). New parents, grandparents and those individuals who work with infants also need protection against Whooping Cough.

If you are not sure of your current immunization status, contact your health care provider or the Guilford County Department of Public Health.  We can review your record with you and help you secure the vaccinations you need to stay healthy.

For more information about immunizations, call 641-7777. To make an appointment at the Department of Public Health’s Greensboro office, call 641-5563.  Call 845-7655 for an appointment in High Point.

The U.S. Food and Drug Administration announced today that it has approved vaccines for the 2010-2011 influenza season in the United States.

FDA Approves Vaccines for the 2010-2011 Influenza Season

There is new buzz about problems with Rotarix vaccine. It has been held for the next several months while pediatricians, the vaccine manufacturer and federal agencies knuddle over the problems.

The basis of their concerns are:

Rotavirus is a virus that causes diarrhea and is the single most common cause of GI illnesses worldwide.  Infection with rotavirus leads to half a million deaths each year due to dehydration and malnutrition.  Infants and children suffer the most from the infection.

Universal infant immunization against rotavirus has been recommended by CDC, the American Academy of Pediatrics and the American Academy of Family Physicians as a means of preventing disease, suffering and death.

Two vaccines are available in the United States, RotaTeq and Rotarix.

Rotarix is derived from the most common human strain of rotavirus that has been passaged in cell cultures until it is no longer virulent.  It was licensed for use in the US in 2008.
It is given orally at 2 and 4 months of age.

Studies to date show Rotarix to be effective in preventing rotavirus infection without side effects.

BUT A university research team was testing out a new highly sensitive assay to detect viruses and tried it on Rotarix. They were surprised to find pieces of the virus, porcine circovirus, in samples of the rotavirus vaccine.  The manufacturer, GlaxoSmithKline and FDA have found that the viral contaminant has been present in early batches of the vaccine including those that have been used in clinical studies. Those studies have shown no unexpected problems.

The Food and Drug Administration has asked that administration of rotarix be halted until the significance of this finding is clear.

Porcine circovirus causes a wasting illness in weaned pigs (postweaning multisystemic wasting syndrome).  Laboratory experiments have shown porcine circovirus can infect human cells in culture.   But human disease in nature has never been detected nor is there currently scientific speculation that human illness could occur after exposure. 

If your child received rotarix, you don’t have to worry about it, nor do anything about it. If you want to read the official reports and recommendations, they are available here and here and here and here and here and here and here.

Although North Carolina’s snow and ice have been replaced by flowering trees and blue skies, one characteristic of winter is still with us:  influenza (flu).  The North Carolina Division of Public Health is reporting 5 deaths from influenza in the state in the last reported week ending 20 March. There have been 98 deaths from influenza so far this year.  Some areas of the United States are reporting increases in severe illness and hospitalizations due to H1N1.  These illnesses are mostly in middle aged adults with underlying medical conditions, especially lung diseases.  There are certain risk factors that can make having the flu even worse.  These include asthma, chronic lung disease, conditions which result in a weakened immune system (like cancer or cancer treatment, HIV, etc.), obesity, and pregnancy.

It is absolutely not too late to get your flu shot. We have both seasonal and H1N1 influenza vaccines ready to give, besides getting the H1N1 vaccine now will make any immune response to next year’s seasonal flu vaccine that much more protective.”

The H1N1 flu vaccine is available for persons 6 months of age and older.  Seasonal flu vaccine is available for persons 4 years of age and older. Call 641-5563 for an appointment at the 1100 E. Wendover Avenue, Greensboro site or 845-7655 for the 501 E. Green, High Point location. There is no out of pocket cost for the vaccines but do please bring your insurance, Medicaid, or Medicare card at the time of your appointment, if you have one.

The CDC announced two major changes for next season’s influenza vaccination campaign.

First, EVERYONE is now in the “eligible and should get vaccinated” group.  Recognizing that the population outside of the recommended lists was growing smaller and smaller with each added risk group, CDC decided to encourage everyone to get one next year.  For those of us in public health, this is great news and will make decisions very quick.  ”Are you alive and older than 6 months? Then, yes…you get the vaccine.”

Second, they decided on the composition of next season’s trivalent vaccine.  To no surprise, the H1N1 component will be the currently circulating “swine flu” strain.  The components will be an A/California/7/2009 (H1N1)-like virus, an A/Perth/16/2009 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus.

One vaccine and everyone gets it! Sounds like a breeze, doesn’t it?

Although some of our allotments of vaccine has expired last month (February), we still have active, potent vaccine to give anyone who wants one.

Please call 641-7777 for an appointment.

As I mentioned in the post earlier this week, the CDC has published details on the ongoing epidemic of mumps occurring in Brooklyn, New York.  Although I anticipated that the community involved might have a low vaccination rate, it’s actually quite good with childhood vaccinations in the 90% range.  So the mumps portion of the measles, mumps, rubella vaccine seems to be less than optimal in providing long standing protective immunity.  The lessons drawn from the New York epidemic may well change how we recommend vaccine schedules in the future.  For the moment, we need to pay attention to further communications from our state and federal experts.

H1N1 Immunization Campaign Targets College Students

RALEIGH — In response to continued cases of H1N1 on college campuses across the state, the N.C. Division of Public Health is sponsoring a college immunization campaign during the month of February to protect young people against the flu. “While flu cases are not at the level they were back in the fall, we are seeing clear evidence that H1N1 is still striking young people,” said Zack Moore, M.D., public health epidemiologist.

From late January through early February, student health centers outpaced other providers in cases of influenza-like illness. A similar trend was evident during the fall wave of H1N1, with student health centers consistently seeing higher-than-average rates of flu. However, statistics from the state’s Immunization Branch show college-age individuals remain the least immunized overall in the state. As of Jan. 30, only 5 percent of 19- to 24-year-olds had received vaccine distributed to colleges through the N.C. Division of Public Health.

“Students appear to be less interested now because H1N1 is not getting the publicity it did in the fall,” said Katrin Wesner, director of Abrons Student Health Center at the University of North Carolina at Wilmington. “This campaign will help us re-energize our efforts and remind people that it is not too late to be vaccinated.”

College mascots are joining the campaign to encourage students to get immunized. Mascots from eight colleges and universities will be sporting bandages with the message “The Flu Stops With Me” at selected basketball games during February. In addition to their campus efforts, student health services personnel will offer immunization clinics at games to reach students and others who have not yet been vaccinated.

“This is a great opportunity for us to reach one of our most at-risk populations,” said State Health Director Jeffrey Engel, M.D. “We appreciate the support of our colleges and universities in helping us get the message out about the importance of immunization.”

Colleges involved in the campaign include N.C. State University, Fayetteville State University, UNC-Chapel Hill, UNC-Charlotte, North Carolina A&T, UNC-Wilmington, East Carolina University and Winston-Salem State University.

For information about H1N1 and immunization clinics, see flu.nc.gov. Students may also check with the student health center at their college or university.

I’m certain that the CDC will report the details of the epidemic of mumps currently ongoing in New York within the next several weeks.  Suffice it to say that there is price to pay when a community forgoes vaccinations for childhood diseases,such as measles, mumps and rubella.  In our global world and international travel, diseases that are rare in present society can be introduced in one plane flight.  If the disease finds a susceptible community, then it will spread unabated.

As an Infectious Diseases consultant for two and a half decades I prescribed antibiotics to people with life threatening infections.

I acknowledged that each time I gave an antibiotic there was a risk that rather than make someone better, that the antibiotic might cause a side effect. I made a habit of informing patients and family members that the antibiotic could cause an allergic reaction, or an upset stomach, or diarrhea, or a rash, or difficulty sleeping, or make them fat. Some side effects might mean they needed to stop the drugs. Other side effects would go away with time even if you continued the drug.

If bad side effects occurred then there would usually be alternatives to prescribe. But at that moment in time, it seemed better for them to take the antibiotic rather than to allow the infection to continue.

Some antibiotics are so toxic that I wouldn’t start them until I was close
to absolute certainty that they had the disease the antibiotics were designed to treat. Once I was convinced…by biopsy or culture…that the disease was present I would hold my breath and give the antibiotics…while maintaining vigilance for problems.

I’m recounting these experiences to tell you it is NORMAL and EXPECTED for doctors to tell people of potential problems with medicines. Side effects happen. Side effects can be measured and quantified. But with experience, doctors come to know what side effects will happen with each antibiotic or drug.

We know penicillins can cause a rash. They don’t affect sleep.

Sustiva (an HIV treatment) can cause a rash AND can cause wicked dreams.

So if vaccines caused autism, why would I not tell people? I don’t have stock in vaccine companies. I don’t get paid to give vaccines that aren’t safe. It’s always easier to tell the truth…you don’t have to remember what you said each time because the next time you’ll say the same thing.

It comes as no surprise therefore to read yesterday that the centerpiece in the “vaccine causes autism” argument has been retracted both on scientific and ethical grounds. If a scientist is so convinced in the outcome of the study that they are willing to stack the deck and experiment on children without ethical review panel permission, then one should question their conclusions. Twelve years after the event, the editors of the journal are playing the disappointed parent and saying to their miscreant son, “You are dead to me”.

Of course that plays well in the mafia movies, rarely happens in scientific literature, and doesn’t really help the arguments too much. They are twelve years after the publication…twelve years of misdirection to many.

The medical and scientific communities have found no evidence that autism is due to vaccines. There is mounting evidence that autism has a genetic base.

So by blaming the wrong culprit and avoiding vaccinations, one risks allowing children to get sick with a vaccine preventable illness. AND we waste time going down a wrong path, when focusing on the actual cause of autism is overlooked.