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New Horizons for the Vaccine-Preventable Diseases Subcommittee

Posted By Susan Lett, Friday, November 7, 2014
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While we’ve made great strides in vaccine-preventable diseases (VPD) in past years, new waves of measles, pertussis (whooping cough), and human papillomavirus (HPV) are prominently resurfacing. Imported measles is gaining prevalence this year with 594 cases and 18 outbreaks across the country in the first nine months of 2014. In 2013 the United States reported 25,000 cases of pertussis and nine deaths of infants. CDC reports suggest that by the end of 2014, the country will have experienced a 30 percent increase in cases as compared to last year.

This resurgence is due to both waning immunity to the currently licensed vaccine and the public’s outright lack of immunization. CDC’s latest public report on pertussis shows that in 2012 only 14 percent of adults had gotten sufficient immunization. Since most incidents and all mortalities due to pertussis are among infants, there’s a new emphasis on vaccinating pregnant women. It’s crucial for healthcare providers to recognize childbirth as an opportunity, not only to offer immunization to pregnant women but to their families as well. We’ve seen the Massachusetts chapter of the American Congress of Obstetricians and Gynecologists (ACOG) do commendable work in this way. The goal of present efforts is that all children under seven receive Diphtheria, Tetanus, and Pertussis (DTaP) vaccines and all adult family members receive Tetanus, Diphtheria, and Pertussis (Tdap) boosters.

I’ve chaired the CSTE Vaccine-Preventable Disease Subcommittee since its inception this fall. We’ve had two initial meetings and now begin a stage of fact finding. Members are focusing on increasing human papillomavirus (HPV) vaccination levels. Through CSTE’s collaborations with the National Foundation of Infectious Diseases (NFID), we’ve created the document Call to Action: HPV Vaccination as a Public Health Priority, which has been helpful in framing conversations with providers. Earlier this week, our CSTE/NFID webinar exploring high and low HPV vaccination rates presented the outcomes of interviews with subject matter experts. We hope to produce more webinars soon.
The VPD subcommittee over the coming year aims to shape both itself and the national VPD dialogue. Subcommittee activities have already seen great synergy as we integrate members from related organizations, such as the Association of Immunization Managers (AIM). We look forward to many potential CSTE/AIM activities at the intersection of this expertise: spreading awareness among health departments about registry functionality and electronic health record interfaces; making sure state registries are lifespan registries; ensuring linkages to surveillance databases to help identify under-immunized people during outbreaks; and using registries as total quality assurance tools within states to prevent VPDs. More and more, health departments need to be able to enhance their immunization registries to support immunization programs, both programmatically and for disease surveillance.
We’re at an opportune moment during the rollout for the Affordable Care Act. Healthcare delivery systems in each state will increasingly give adults and children access to immunizations, so we have new impetus to encourage widespread vaccination. It’s exciting that electronic health systems and registries are poised to support this broad, population-based approach to primary prevention so that everyone, regardless of age and income, can have better access to vaccines.
Susan Lett, MD, MPH is Medical Director of the Immunization Program at the Division of Epidemiology and Immunization of the Massachusetts Department of Public Health. To find out more about the new VPD subcommittee and see how members get involved, visit Vaccine-Preventable Diseases.

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