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National Immunization Partners’ Program.
Interamerican College of
Physicians and Surgeons
ICPS
• Not for Profit (501-C-3)
• Established in 1979
• Incorporated in the District of Columbia
• National Hispanic Medical Society
• Monthly Medical Journal
• Monthly Health Awareness Digest
• Grants - Government and Private
Major Programs
Continuing Medical Education
Academic Detailing
National Immunization Partner’s Program
Meetings and Congresses
National Summit on Health Disparities
Interamerican Medical Summit
National Hispanic Academic Network
National Hispanic Youth Initiative
Electronic Medical Records
Physician Recognition Awards
PBS Series on Minority Health Disparities
Database and Website Update
Hispanic Research Network
Health Link for the Americas
Know Your Numbers
Immunization Program
Continuing Medical Education Program
sponsored by the Center for Disease Control
and Prevention (CDC)
8 hours of category 1 credit toward the AMA
Physicians Recognition Award™
Target Population: Hispanic physicians and
physicians who serve the Hispanic community
Program Evaluation
Pre and post-course practice
questionnaires
Pre and post-course surveys
Educational Objectives
To educate Hispanic physicians and
physicians who serve the Hispanic
community about the Immunization
Partners’ Program
To improve the participation of Hispanic
physicians in providing increased
immunization services for the Hispanic
community
Summary
Visit- 1 hour
Independent study - 7 hours
8 hours of category 1 credit toward the
AMA Physicians Recognition Award™
Physicians should claim only the hours
spend on the program.
Topics
Data and Statistics
Principles of Vaccination
General Recommendations on Immunization
Healthcare Personnel Vaccination Recommendations
2009 Child & Adolescent Immunization Schedules
The Vaccine Adverse Event Reporting System
Catch-up Immunization Schedule for Persons Aged 4 Months
Through 18 Years Who Start Late or Who Are More Than 1 Month
Behind—United States • 2009
Diseases & Vaccines Facts
Vaccines for Children Program (VFC)
Vaccine Myths
Immunization Resources
Independent Study Material
Website Recommended to book mark in your Computer
National Estimated Vaccination Coverage
Immunization Survey
http://www.cdc.gov/vaccines/stats-surv
Impact of Influenza
36,000 influenza-associated pulmonary and
circulatory deaths occurred during each
influenza season
Persons 65 years of age and older account for
more than 90% of deaths
More than 200 thousand influenza-related
hospitalizations per year
http://www.cdc.gov/flu/weekly/fluactivity.htm
Avian Influenza (H5N1)
421 human infections with 257 (61%) deaths (WHO April 23, 2009)
To date, human cases have been reported in six
countries, most of which are in Asia.
To date, no infections caused by H5N1 have been
reported in the United States
Contact with dead or sick birds is the principal source
of human infection
www.who.int/topics/avian_influenza
Swine Influenza (Flu)
Is a respiratory disease of pigs caused by type A
influenza viruses that causes regular outbreaks in
pigs.
People do not normally get swine flu, but human
infections can and do happen.
This new virus was first detected in people in the
United States in April 2009.
CDC recommends the use of Oseltamivir or
Zanamivir for the treatment and/or prevention of
infection with these swine influenza viruses.
http://www.cdc.gov/h1n1flu
Principles of Vaccination
Immunity & the immune system
Active immunity
Passive immunity
Factors may influence the immune response to
vaccination
Classification of vaccines
Live attenuated vaccines
Inactivated vaccines
Types of Immunity
Active Immunity
Protection produced by the person's own immune
system
Usually permanent
Another way to produce active immunity is by
vaccination
Passive Immunity
Protection transferred from another person or animal
Temporary protection that wanes with time
Transplacental most important source in infancy
The Immune system complex
Antigen
A live or inactivated substance (e.g., protein,
polysaccharide) capable of producing an
immune response
Antibody
Protein molecules (immune-globulin)
produced by B lymphocytes to help
eliminate an antigen
Factors may influence the immune
response to vaccination
Presence of maternal antibody
Nature and dose of antigen
Route of administration
Presence of adjuvant (e.g., aluminum-containing
materials added to improve the immunogenic of the
vaccine)
Host factors such as age, nutritional factors,
genetics and coexisting disease, may also
affect the response.
Classification of Vaccines
There are two basic types of vaccines:
live attenuated and inactivated
Their characteristics are different, and
these determine how the vaccine is used
Classification of Vaccines
Live attenuated Inactive
1. Viral 1. Whole
- Virus
- Bacterial
2. Fractional
2. Bacterial
- Protein based
- Polysaccharide
based
Live attenuated vaccines
Virus: Measles, Mumps, Rubella, Yellow
fever, intranasal Influenza, Rotavirus
and oral Polio (not in US)
Bacterium: BCG, oral Typhoid.
Live Attenuated Vaccines
Characteristic
The resulting vaccine organism retains the
ability to replicate and produce immunity,
but does not cause illness.
Must replicate to be effective.
Immune response similar to natural
infection.
Usually effective with one dose, except those
administrated orally.
Can have interference from circulating
antibody.
Must be stored and handled carefully.
Inactivated vaccines
Whole Fractional
1. Protein Based
Toxoid: Diphtheria
1. Whole viruses: Tetanus
Polio,
Hepatitis A, Subunit: Hepatitis B
Rabies, Influenza A
Influenza Cellular Pertussis
(Lyme), (HPV)
2. Polysaccharide based
2. Whole bacteria:
Pure: Pneumococcal
(Pertussis) Meningococcal
(Typhoid)
Salmonella Typhi (VI)
(Cholera),
(Plague) 3. Conjugate : H influenzae Type b
Pneumococcal
Meningococcal
Inactivated vaccines Characteristics
Cannot replicate
Generally not as effective as live vaccines
Less interference from circulating antibody than
live vaccines
Generally require 3-5 doses
Immune response mostly humoral
Antibody titer may diminish with time
Antibody–Vaccine Interactions
Inactivated vaccines generally are not affected
by circulating antibody to the antigen
Live attenuated vaccines may be affected by
circulating antibody to the antigen.
When give vaccine first: wait 2 weeks before
giving antibody
When give antibody first: wait more than 3
months before giving antibody vaccine*
*Except rotavirus vaccine, which should be delayed for 6 weeks
Interval between subsequent doses
of the same vaccine
Increasing the interval between doses of a
multidose vaccine does not diminish the
effectiveness of the vaccine.
Decreasing the interval between doses of a
multidose vaccine may interfere with antibody
response and protection.
Vaccine doses should not be administered at
intervals less than the recommended
minimum intervals or earlier than the
minimum ages.
The Vaccine Adverse Event
Reporting System
The Vaccine Adverse Event Reporting System
(VAERS) is a national reporting system, jointly
administered by CDC and FDA.
For more information go to
http://vaers.hhs.gov
Phone at 800-553-6847
Mail to : VAERS
P.O. Box 1100
Rockville, MD 20849-1100
Contraindications
and Precautions
Serious allergic reaction (e.g., anaphylaxis) after a
previous vaccine dose or to a vaccine component.
Encephalopathy within 7 days of administration
of previous dose of DTP or DTaP
Moderate or severe acute illness with or without
fever
Guillain-Barré syndrome <6 weeks after previous
dose of tetanus toxoid-containing vaccine
Known severe immunodeficiency
http://www.cdc.gov/vaccines/recs/vac-admin/contraindications-vacc.htm
Invalid Contraindications
to Vaccination
Mild illness
Antimicrobial therapy
Disease exposure or convalescence
Pregnant or immunosuppressed person in
the household
Breastfeeding
Preterm birth
Allergy to products not present in vaccine or
allergy that is not anaphylactic
Family history of adverse events
Tuberculin skin testing
Multiple vaccines
Screening Questions
Is the child (or are you) sick today?
Does the child have an allergy to any medications,
food, or any vaccine?
Has the child had a serious reaction to a vaccine in
the past?
Has the child had a seizure, brain or nerve
problem?
Does the child have cancer, leukemia, AIDS, or any
other immune system problem?
Standardized screening questionnaires are available
at http://www.immunize.org (bottom-left of webpage)
Immunization
Registries
Single data source for all providers
Reliable immunization history
Produce records for patient use
Key to increasing immunization levels
http://www.cdc.gov/vaccines/programs/iis
Reminders and recall to Patients
Reminder- notification that
immunization is due soon
Recall- notification that
immunization are past due
Content of message and technique of
delivery vary
Reminders and recalls have been
found to be effective
Reminders and recall to Providers
Communication to healthcare providers that an
individual client’s immunizations are due soon or
past due
Example:
Computer-generated list
Stamped note in chart
Immunization due clip on chart
Reasons for Missed Opportunities
Lack of simultaneous administration
Unaware patient needs additional
vaccines
Invalid contraindications
Inappropriate clinic policies
Reimbursement deficiencies
Reduction to barriers to
Immunization
Physical barriers
-waiting time
-distance
Psychological barriers
-unpleasant experience
-safety concerns
Healthcare Personnel Vaccination
Recommendations
Hepatitis B
Influenza
MMR
Varicella
Chickenpox
Tetanus, diphtheria, Pertussis.
Meningococcal
For more info go to http://www.immunize.org
2009 Child & Adolescent
Immunization Schedules
Recommended Immunization Schedule
for children from birth through 6 Years
Recommended Immunization Schedule
for persons aged 7 through 18 Years
www.cdc.gov/vaccines/recs/schedules/child-schedule.htm
Recommended Immunization Schedule for Persons Aged
0 Through 6 Years
www.cdc.gov/vaccines/recs/schedules/child-schedule.htm
Recommended Immunization Schedule for Persons
Aged 7 Through 18 Years
Catch-up Immunization Schedule for Persons
Aged 4 Months Through 6 Years
CATCH-UP SCHEDULE FOR PERSONS AGED 7
THROUGH 18 YEARS
Diseases & Vaccines Facts
1. Diphtheria and Diphtheria Toxoid Vaccine
2. Tetanus and Tetanus Toxoid Vaccine
3. Pertussis and Pertussis Vaccine
4. Rotavirus and Rotavirus vaccine
5. Polio and Polio Vaccine
6. Haemophilus influenzae type B and Hib Vaccine
7. Influenza and Influenza vaccine
8. Measles and Measles Vaccine
9. Mumps and Mumps Vaccine
10. Rubella and Rubella Vaccine
11. Varicella and Varicella Vaccine
12. Herpes zoster and Single vaccine
13. Hepatitis A and Hepatitis A Vaccine
14. Hepatitis B and Hepatitis B Vaccine
15. Human papilloma virus vaccine and HPV Vaccine
16. Pneumococcal Disease and Pneumococcal Vaccine
17. Meningococcal Disease and Meningococcal Vaccine
Corynebacterium Diphtheriae
http://www.cdc.gov/vaccines/vpd-vac/diphtheria/default.htm
Membrane may cause Respiratory
•Aerobic gram-positive obstruction
bacillus
•This germ produces a
poisonous toxin which
frequently causes heart and
nerve problems
•Insidious onset of exudative
pharyngitis
•Exudates spreads within 2-3
days and may form adherent
membrane
•Fever usually not high but
patient appears toxic
Clostridium Tetani
http://www.cdc.gov/vaccines/vpd-vac/tetanus/default.htm
•Anaerobic gram + spore-
forming bacteria
•Generalized tetanus:
descending symptoms of
trismus (lockjaw), difficulty
swallowing, muscle rigidity
and spasms
Pertussis Pathogenesis
http://www.cdc.gov/vaccines/vpd-vac/pertussis/default.htm
Highly contagious respiratory infection caused
by Bordetella Pertussis
Attachment to cilia of ciliated epithelial cells
in respiratory tract
Local tissue damage in
respiratory tract
Systemic disease may
be toxin mediated
Vaccine Dtap, Tdap
DTaP and pediatric DT used through age 6 years
Tdap Td for person > 7 years
One dose of DTap, at each of the following ages: 2, 4, 6,
and 15-18 months and 4-6 years
A single dose of Tdap is recommended for adolescents
11 or 12 years of age, or in place of one Td booster in
older adolescents and adults age 19 through 64
Td is a tetanus-diphtheria vaccine given to
adolescents and adults as a booster shot every
10 years
Tdap is similar to Td but also protects against
Pertussis
Rotavirus Disease
http://www.cdc.gov/vaccines/vpd-vac/rotavirus/default.htm
In the United States annually responsible for:
More than 400,000 physician visits
55,000-70,000 hospitalizations
More than 200,000
emergency dept. visits
20-60 deaths
Rotavirus vaccine (Rota)
The new rotavirus vaccine is recommended in a
3-dose schedule at ages of:
2-4-6 months of age
Administer the first dose at age 6–12 weeks
Do not start the series later than age 12 weeks
Administer the final dose in the series by age 32 weeks
Do not administer a dose later than age 32 weeks
Data on safety and efficacy outside of these age ranges
are insufficient
Poliovirus
http://www.cdc.gov/vaccines/vpd-vac/polio/default.htm
Entry into mouth
Enterovirus (RNA)
Three serotypes: 1, 2, 3
Replication in pharynx, GI
tract, local lymphatic
Hematology spread to
lymphatic and central
nervous system
Viral spread along nerve
fibers
Destruction of motor
neurons
Inactivated Polio Vaccine
Contains 2-phenoxyethanol, neomycin, streptomycin,
polymyxin B
Only IPV is available in the United States
Schedule begun with OPV should be completed with IPV
Any combination of 4 doses of IPV and OPV by 5 years
constitutes a complete series
Routine vaccination of US residents > 18 years of age not
necessary or recommended
May consider vaccination of travelers to polio-endemic
countries and selected laboratory workers
Administer at 2-4-6(to 18) months of age with a booster at
4-6 years of age
Haemophilus influenzae type b
http://www.cdc.gov/vaccines/vpd-vac/hib
Severe bacterial infection,
Epiglottitis particularly among infants
17%
Aerobic gram Negative bacteria
Meningitis
50% Polysaccharide capsule
Pneumonia Six different serotypes (a-f) of
15%
polysaccharide capsule
95% of invasive disease caused
Osteomyelitis
2%
Arthritis
by type b
8% Cellulitis Bacteremia
6%
Cause 3 million cases of meningitis
2%
and severe pneumonia,
approximately 386,000 deaths
worldwide per year in children
aged <5 years
Haemophilus influenzae type b Vaccine
Routine Schedule
Minimum age: 6 weeks
• If PRP-OMP (PedvaxHIB® or Comvax®
[HepB-Hib]) is administered at ages 2 and 4
months, a dose at age 6 months is not
indicated.
• TriHiBit® (DTaP/Hib) should not be used
for doses at ages 2, 4, or 6 months but can be
used as the final dose in children aged 12
months or older.
Influenza
http://www.cdc.gov/vaccines/vpd-vac/flu
Who should get vaccinated each year
Children aged 6 months until their 19th birthday, Pregnant women
People 50 years of age and older
People of any age with certain chronic medical conditions
People who live in nursing homes and other long term care facilities
Healthcare workers
Who Should Not Be Vaccinated
People who have a severe allergy to chicken eggs
People who have had a severe reaction to an influenza vaccination in the past
People who developed Guillain-Barre Syndrome (GBS) within 6 weeks of
getting an influenza vaccine
Children less than 6 months of age
People who have a moderate or severe illness with a fever should wait to get
vaccinated until their symptoms lessen
Timing of Influenza Vaccine Programs
Providers should begin offering vaccine soon
after it becomes available, if possible by
October
To avoid missed opportunities for vaccination,
providers should offer vaccine during routine
healthcare visits or during hospitalizations
whenever vaccine is available
Inactivated Influenza Vaccines (TIV) &
Live, attenuated influenza vaccine (LAIV)
Minimum age: 6 months for trivalent inactivated influenza
vaccine [TIV]; 2 years for live, attenuated influenza vaccine
[LAIV)
Administer annually to children aged 6 months through 18 years
For healthy non-pregnant persons: aged 2 through 49 years,
either LAIV or TIV may be used
Children receiving TIV should receive 0.25 ml if aged 6 through
35 months or 0.5 ml if aged 3 years or older
Administer 2 doses (separated by at least 4 weeks) to children
aged younger than 9 years who are receiving influenza vaccine
for the first time or who were vaccinated for the first time during
the previous influenza season but only received 1 dose
Measles Clinical Features
http://www.cdc.gov/vaccines/vpd-vac/measles
Maculopapular, becomes confluent
Begins on face and head
Persists 5-6 days
Highly contagious viral illness
Paramyxovirus (RNA)
Hemagglutinin important surface antigen
One antigenic type
Rapidly inactivated by heat and light
Mumps Clinical Features
http://www.cdc.gov/vaccines/vpd-vac/mumps
Incubation period 14-18 days
Prodrome of myalgia, malaise
headache, low-grade fever
Parotitis in 30%-40%
Paramyxovirus
Respiratory transmission of virus
Replication in nasopharynx and regional
lymph nodes
Viremia 12-25 days after exposure with spread
to tissues
Multiple tissues infected during viremia
Rubella Clinical Features
http://www.cdc.gov/vaccines/vpd-vac/rubella
Toga virus
Respiratory transmission
of virus
Incubation period 14 days
Maculopapular rash 14-17
days after exposure
Replication in
nasopharynx and regional
lymph nodes
Congenital Rubella Syndrome
Deafness, Cataracts
Heart defects
Microcephaly, Mental
retardation
May lead to fetal death or
premature delivery
Severity of damage to fetus
depends on gestational age
Up to 85% of infants affected if
infected during first trimester
Most reported rubella in the
U.S. since the mid-1990s has
occurred among foreign-born
Hispanic adult
Measles, Mumps, Rubella
MMR Vaccine indications :
First dose to all infants >12 months of age
Second dose is recommended routinely at age 4-6
years
Adult born before 1957 can be considered immune to
measles
Adult born during or after 1957 should received >1 dose
Second dose is for the adult who have recently
exposed to measles, mump outbreak
Autism Controversy
http://www.cdc.gov/autism
To date there is no convincing evidence that any vaccine causes
autism or autism spectrum disorder.
Concern has been raised about a possible relation between MMR
vaccine and autism by some parents of children with autism.
“Removed thimerosal (mercury) from childhood vaccines was done in
1999, Thimerosal was removed from vaccines due to concerned about
mercury”. The U.S. Public Health Service and the American Academy
of Pediatrics called to be removed from vaccines administered to
young children.
“The only vaccine we routinely give to young children that still
contains thimerosal as a preservative is some formulations of
influenza vaccine”
Decisions of the U.S. Court of Federal Claims in Omnibus Autism
Proceeding February 12, 2009
The U.S. Court of Federal Claims divided the claims into
three different theories:
Theory 1: MMR in combination with thimerosal-
containing vaccines can cause autism.
Theory 2: Thimerosal-containing vaccines alone can cause
autism.
Theory 3: The MMR vaccine alone can cause autism
Each of the Special Masters ruled that the measles-
mumps-rubella vaccine, whether administered alone or in
conjunction with thimerosal-containing vaccines,
were not causal factors in the development of autism or
autism spectrum disorders
Varicella Clinical Features
http://www.cdc.gov/vaccines/vpd-vac/varicella
Herpes virus (DNA)
Incubation period 14-16 days
Generally appear first on head; most concentrated on
trunk
Successive crops (2-4 days) of pruritic vesicles
Primary infection results in varicella (chickenpox)
Recurrent infection results in herpes zoster (shingles)
Respiratory transmission of virus
Replication in nasopharynx and
regional lymph nodes
Congenital Varicella Syndrome
Results from maternal infection during
pregnancy
Period of risk may extend through first 20
weeks of pregnancy
Low birth weight, atrophy of extremity with
skin scarring, eye and neurologic
abnormalities
Varicella Vaccine-MMRV (ProQuad)
Combination measles, mumps, rubella and varicella
vaccine
Titer of varicella vaccine virus in MMRV is more than 7
times higher than standard varicella vaccine
In Children
Routine Vaccination at 12-18 months of age
Recommended for all children without evidence of varicella
Immunity by 13th birthday
Adolescents and adults
All persons > 13 years of age without evidence of varicella
Immunity
Two doses separately by 4-8 weeks
Do not repeat first dose because of extended interval between
doses
Shingles
http://www.cdc.gov/vaccines/vpd-vac/shingles
Shingles is a painful skin rash caused by the varicella zoster virus
(VZV)
Pain, itching or tingling of the skin which is followed by a painful
skin rash of blister-like lesions, usually localized to a small area
on one side of the body
Anyone who has recovered from chickenpox may develop
shingles, including children. However, shingles most commonly
occurs in people 50 years old and older
Hepatitis A Clinical Features
http://www.cdc.gov/vaccines/vpd-vac/hepa
Picornavirus (RNA)
Entry into mouth
Viral replication in the liver
Virus present in blood and feces 10-12 days
after infection
Virus excretion may continue for up to 3
weeks after onset of symptoms
Incubation period 28 days
Children generally asymptomatic, adults
symptomatic
Recommendation for Routine Hepatitis A
Vaccination
Adult 1 dose and 1 booster dose 6-18 months after first dose
Children and adolescent 1 dose and 1 booster doses 6-18 months
after first dose
International travelers
Men who have sex with men
Persons who use illegal drugs
Persons who have clotting-factor disorders
Persons with occupational risk
Persons with chronic liver disease
All children should receive hepatitis A vaccine at 12-23 months age
Children who are not vaccinated by 2 years of age can be vaccinated
at subsequent visits
Hepatitis B Virus Infection
http://www.cdc.gov/vaccines/vpd-vac/hepb
Hepadnaviridae family (DNA)
>300 million chronically infected worldwide
Established cause of chronic hepatitis and
cirrhosis
Human carcinogen—cause of up to 80% of
hepatocellular carcinomas
Hepatitis B Complications
Fulminant hepatitis
Hospitalization
Cirrhosis
Hepatocellular carcinoma
Death
Hepatitis B Perinatal
Transmission
If mother is positive for HBsAg and HBeAg
70%-90% of infants infected
90% of infected infants become
chronically infected
If positive for HBsAg only
10% of infants infected
90% of infected infants become
chronically infected
Hepatitis B Vaccine
Doses at Birth or 1-2 months and 6-18 months with
interval 4, 4 and 8 wks
Infants who mothers are HBsAg + or unknown should
receive the third dose at 6 months of age and least 16
wks of interval of first
Dose Routine vaccination recommended through age
18 years
Integrate into routine adolescent immunization visit
Three doses (first one, 1month, 5months)
Third dose must be separated from first dose by at
least 16 wks
Human Papiloma Virus associated cancer
lesions
www.cdc.gov/cancer/hpv/statistics/
Human Papilloma Virus vaccine
http://www.cdc.gov/std/HPV
Give the first dose of the HPV vaccine series
to females at age 11–12 years
Give the second dose 2 months after the first
dose
The third dose 6 months after the first dose
Give the HPV vaccine series to females at age
13–18 years if not
previously vaccinated
Neisseria Meningitidis
http://www.cdc.gov/vaccines/vpd-vac/mening
Aerobic gram-negative bacteria
Severe acute bacterial infection
Cause of meningitis, sepsis, and focal infections
Abrupt onset of fever, meningeal symptoms,
hypotension and rash
Fatality rate 9%-12%; up to 40% in meningococcemia
At least 13 Sero groups based on characteristics of the
polysaccharide capsule
Most invasive disease caused by sero groups A, B, C, Y,
and W-135
Meningococcal vaccine
http://www.cdc.gov/vaccines/vpd-vac/mening
Meningococcal Polysaccharide Vaccine (MPSV)
Quadrivalent polysaccharide vaccine (A, C, Y, W-135)
Approved for persons 2 years of age and older
Administered by subcutaneous injection
Meningococcal Conjugate Vaccine (MCV)
Quadrivalent polysaccharide vaccine (A, C, Y, W-135)
Conjugated to diphtheria toxoid
Approved for persons 11 through 55 years of age
Administered by intramuscular injection
Streptococcus Pneumoniae
http://www.cdc.gov/vaccines/vpd-vac/pneumo
Gram-positive bacteria
More than 80 serotypes described by 1940
First U.S. vaccine in 1977
90 known serotypes
Polysaccharide capsule important virulence
factor
Pneumococcal Pneumonia, Bacteremia,
Meningitis
Pneumococcal Meningitis
Estimated 3,000 - 6,000 cases per year
in the United States
Case-fatality rate ~30%, up to 80% in
the elderly
Neurologic sequelae common among
survivors
Children at Increased Risk of Invasive
Pneumococcal Disease
Functional or anatomic asplenia,
especially sickle cell disease
HIV infection
Alaska Native, African-American,
American-Indian
Child care attendance
Pneumococcal
Vaccine
Recommended for all children less than 24 months old
For children between 24 and 59 months old who are at high risk of disease
Older children and adults with risk factors
Alaskan Native or from certain Native American populations may receive the
Pneumococcal polysaccharide vaccine, (Pneumovax® and Pnu-Immune®).
Revaccination with pneumococcal polysaccharide vaccine:
One-time revaccination after 5 years for persons with:
-Chronic renal failure or nephrotic syndrome;
-Functional or anatomic asplenia
-Immunosuppressive conditions.
For persons aged >65 years, one-time revaccination if they were vaccinated >5
years previously and were aged <65 years at the time
Vaccines for Children Program
http://www.cdc.gov/vaccines/programs/vfc/contacts-state.htm
• VFC helps families of children who may not
otherwise have access to vaccines by providing
free vaccines to doctors who serve them.
• Any provider authorized to prescribe vaccines
under your state law can be a VFC Provider. .
• VFC is administered at the national level by
the CDC contracts with vaccine manufacturers
to buy vaccines at reduced rates.
Common Vaccine Questions
Is it okay for my baby to have so many shots at once?
Don’t infants have natural immunity?
Haven’t we gotten rid of most of these diseases in this
country?
I heard that some vaccines can cause autism. Is this
true?
Can’t I just wait until my child goes to school to catch
up on immunizations?
Why does my child need a chickenpox shot? Isn’t it a
mild disease?
My child is sick right now. Is it okay for her to still get
shots?
Where can I get more information?
Independent Study Material
Epidemiology and Prevention of Vaccine-
Preventable Disease, The Pink Book, 11Th edition,
National Immunization Program
http://www.cdc.gov/vaccines/pubs/pinkbook
Chapters 1 through 20
Appendices A through H
Websites to bookmark
www.cdc.gov/mmwr/PDF/wk/mm5753-Immunization.pdf
www.cdc.gov/vaccines/pubs/pinkbook/pink-slides.htm
www.cdc.gov/vaccines
www.cdc.gov/vaccinesafety
www.cdc.gov/vaccines/programs/vfc/default.htm
www.icps.org/index/article_list.php?type=son&id=40
For more Information
Contact the National
Immunization Program (NIP):
E-mail NIPInfo@cdc.gov
Hotline 1-800-CDC-INFO
Website www.cdc.gov/nip
