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Jun 11, 2023 •240 likes •632 views

They Don t Want Them Or You t Want Them Or You They Don Don t Have Them: t Have Them: Don Vaccine Shortages and Parents Vaccine Shortages and Parents Changing Perceptions About Changing Perceptions About Vaccines

  1. They Don’ ’t Want Them Or You t Want Them Or You They Don Don’ ’t Have Them: t Have Them: Don Vaccine Shortages and Parents’ ’ Vaccine Shortages and Parents Changing Perceptions About Changing Perceptions About Vaccines Vaccines Mark H. Sawyer, MD Mark H. Sawyer, MD UCSD School of Medicine UCSD School of Medicine San Diego HHSA Immunization Branch San Diego HHSA Immunization Branch

  2. Vaccine Shortages Vaccine Shortages

  3. Vaccine Shortages Vaccine Shortages Objectives Objectives � List the vaccines currently in short supply in the List the vaccines currently in short supply in the � U.S. U.S. � Describe the factors that lead to vaccine Describe the factors that lead to vaccine � shortages shortages � Describe the things you can do in the office to Describe the things you can do in the office to � minimize the impact of vaccine shortages minimize the impact of vaccine shortages

  4. Vaccine Shortages Vaccine Shortages Recent History Recent History � 2001 DTaP 2001 DTaP � 2006 MCV4 2006 MCV4 � � � 2001 Pneumococcal 2001 Pneumococcal � 2007 MMRV 2007 MMRV � � conjugate conjugate � 2007 Hepatitis A (Merck) 2007 Hepatitis A (Merck) � � 2001 MMR 2001 MMR � � 2008 HIB (Merck) 2008 HIB (Merck) � � 2002 Varicella 2002 Varicella � � ??? ??? � � 2004 Influenza 2004 Influenza � � 2004 Pneumococcal 2004 Pneumococcal � conjugate conjugate � 2005 Typhoid 2005 Typhoid �

  5. Vaccine Shortages Vaccine Shortages Status in April 2008 Status in April 2008 � Hib vaccine ( Hib vaccine (Pedvax Pedvax HIB/Comvax) HIB/Comvax) � � Concern about vaccine sterility Concern about vaccine sterility � � Projected to last until end of 2008 Projected to last until end of 2008 � � MMRV MMRV � � Vaccine production problems (varicella vaccine and zoster Vaccine production problems (varicella vaccine and zoster � vaccine not affected) vaccine not affected) � Projected to last until 2009 Projected to last until 2009 � � Hepatitis A (VAQTA) Hepatitis A (VAQTA) � � Vaccine manufacturing Vaccine manufacturing � � Projected to last until end of 2008 Projected to last until end of 2008 �

  6. Vaccine Shortages Vaccine Shortages Why do we have them? Why do we have them? � Decrease in number of vaccine manufacturers: Decrease in number of vaccine manufacturers: � 25 in 1970’ ’s > 5 in early 2000 s > 5 in early 2000’ ’s s 25 in 1970 � Need to be absolutely sure about safety Need to be absolutely sure about safety � � Increased scrutiny by FDA Increased scrutiny by FDA � � Increasingly complex vaccines and combination Increasingly complex vaccines and combination � vaccines vaccines

  7. Vaccine Shortages Vaccine Shortages Consequences Consequences � Missed opportunities to immunize Missed opportunities to immunize � � Failed immunization and drop in coverage rates Failed immunization and drop in coverage rates � � Disease in susceptible children Disease in susceptible children- - Will Will � Haemophilus make a comeback? Haemophilus make a comeback? � Loss of public confidence Loss of public confidence � � Loss of public interest Loss of public interest �

  8. Vaccine Shortages Vaccine Shortages Actions for Your Practice Actions for Your Practice � Prioritize your existing vaccine supply Prioritize your existing vaccine supply � � Keep track of your inventory Keep track of your inventory- -Immunization Immunization � Information Systems (Immunization Registries) Information Systems (Immunization Registries) can help can help � Track children who have missed vaccines Track children who have missed vaccines � � Provide recall notices/phone calls when vaccine Provide recall notices/phone calls when vaccine � becomes available becomes available

  9. Vaccine Shortages Vaccine Shortages What can you do to prevent them? What can you do to prevent them? � Order from more than one manufacturer when possible Order from more than one manufacturer when possible � � Use vaccines as they are recommended by Use vaccines as they are recommended by � CDC/AAP/AAFP CDC/AAP/AAFP � Order influenza vaccine early each year Order influenza vaccine early each year � � Advocate for a strengthened immunization Advocate for a strengthened immunization � infrastructure in the U.S. infrastructure in the U.S. � California Immunization Coalition ( California Immunization Coalition (http://immunizeca.org/ http://immunizeca.org/) ) � � AAP ( AAP (http:// http://www.aap.org www.aap.org/ /) ) � � AAFP ( AAFP (http:// http://www.aafp.org www.aafp.org/ /) ) �

  10. Vaccine Safety Concerns Vaccine Safety Concerns

  11. Objectives Objectives � List the major concerns voiced by the List the major concerns voiced by the � community about vaccines community about vaccines � List tips in communicating about vaccine safety List tips in communicating about vaccine safety � with patients/parents with patients/parents � Identify talking points to address each of the Identify talking points to address each of the � major concerns in the community major concerns in the community � Identify useful resources on vaccine safety for Identify useful resources on vaccine safety for � providers, parents, and patients providers, parents, and patients

  12. The Issue The Issue � A growing number of people have vaccine safety A growing number of people have vaccine safety � concerns concerns � Personal belief exemptions (PBE) rates are increasing Personal belief exemptions (PBE) rates are increasing � � Several recent events have put this issue in the spotlight Several recent events have put this issue in the spotlight � of national media attention of national media attention � Jenny McCarthy book tour Jenny McCarthy book tour � � Hannah Poling Vaccine Injury Compensation Program ruling Hannah Poling Vaccine Injury Compensation Program ruling � � Measles outbreaks in U.S. Measles outbreaks in U.S. �

  14. The Controversies The Controversies � Vaccines and autism Vaccines and autism � � Thimerosal Thimerosal � � Other vaccine ingredients Other vaccine ingredients � � Vaccines in general Vaccines in general � � Too many vaccines overwhelm the immune Too many vaccines overwhelm the immune � system system � Diseases no longer exist Diseases no longer exist— —or aren or aren’ ’t that t that � dangerous dangerous � Individual rights vs. public health needs Individual rights vs. public health needs �

  16. General Talking Points General Talking Points � The diseases are here now and remain dangerous The diseases are here now and remain dangerous � � Vaccines are safe Vaccines are safe � � “ “Natural immunity is not better Natural immunity is not better” ” � � Adverse events do occur following immunization Adverse events do occur following immunization � � Protection through immunization is both an individual Protection through immunization is both an individual � and a community endeavor and a community endeavor � A choice not to immunize leaves you/your child at risk A choice not to immunize leaves you/your child at risk � and also places others at risk and also places others at risk � Know the source of the information you are receiving Know the source of the information you are receiving �

  17. The Diseases are Here The Diseases are Here Talking Points Talking Points � 15,600 cases of pertussis in U.S. in 2006 15,600 cases of pertussis in U.S. in 2006 � � 1194 cases of meningococcal disease in 2006 1194 cases of meningococcal disease in 2006 � � 3308 cases of drug 3308 cases of drug- -resistant pneumococcal resistant pneumococcal � disease in 2006 disease in 2006 � 3000 deaths from cervical cancer in U.S. in 2007 3000 deaths from cervical cancer in U.S. in 2007 � � Measles outbreak in San Diego affected 12 Measles outbreak in San Diego affected 12 � children, 3 families who were not avoiding children, 3 families who were not avoiding vaccines, and impacted many more vaccines, and impacted many more

  18. Vaccine- -Preventable Disease Are Dangerous Preventable Disease Are Dangerous Vaccine Talking Points Talking Points � 1 hospitalization out of 12 measles cases in San 1 hospitalization out of 12 measles cases in San � Diego (February 2008) Diego (February 2008) � Several deaths every year from pertussis in Several deaths every year from pertussis in � California California � At least 10% of people with meningococcal At least 10% of people with meningococcal � disease die disease die � Influenza kills thousands every year Influenza kills thousands every year �

  19. Vaccines are Safe Vaccines are Safe Talking Points Talking Points � Hundreds of millions of doses of vaccine given every Hundreds of millions of doses of vaccine given every � year in U.S. with no problem year in U.S. with no problem � Billions of vaccines are given in the world every year Billions of vaccines are given in the world every year � with no problem with no problem � Vaccine safety infrastructure is large Vaccine safety infrastructure is large � � VAERS VAERS � � VSD VSD � � CISA CISA � � FDA FDA � � CDC CDC �

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