Measles and More – Part 2

Following is the second part of a guest column by Dr. Jacob Lazarovic, senior vice president and chief medical officer, Broadspire®. Broadspire is a Crawford unit and a leading third-party administrator of workers compensation claims, liability claims and medical management services.

JUST WHAT THE DOCTOR ORDERED – Continued 

Dr. Jacob Lazarovic

Dr. Jacob Lazarovic

However, influenza is certainly not the only condition that is addressed in an adult immunization program. Based on recommendations from the National Advisory Committee on Immunization Practices (ACIP), current guidelines include:

  • Diphtheria and tetanus (Td) booster every 10 years for persons younger than 65 ye One of the Td boosters should be replaced with tetanus/diphtheria/acellular pertussis (Tdap) to provide protection against pertussis (whooping cough).
  • Influenza (annually for adults age 50 years and older)
  • Human papillomavirus (HPV) for women ≤ 26 years of age
  • Varicella (chickenpox) immunization (2 doses) for people with no evidence of immunity such as a history of varicella infection. Very few adults actually need the varicella vaccine because most adults had chickenpox as children
  • Zoster (shingles) for adults age 60 years and olde Shingles can be extremely painful and debilitating.
  • Pneumococcal (for adults age 65 years and older). One major change in the 2015 schedule is that it is now recommended that two types of pneumococcal vaccines be administered: the traditional PPSV23, as well as the newer conjugate vaccine, PVC13.
  • Other immunizations, such as hepatitis A and B; pneumococcal (for persons younger than 65 years based on high risk conditions such as diabetes); measles, mumps, and rubella (1-2 doses for persons born after 1957); and meningococcal vaccines

http://www.cdc.gov/vaccines/schedules/downloads/adult/adult-schedule-easy-read.pdf

Business travelers going abroad should be aware of destination-specific initial vaccinations and boosters, as recommended by the CDC, to maximize protection from locally prevalent infections, e.g. hepatitis A and B, typhoid, rabies, polio, yellow fever, meningitis, encephalitis and others.

Health care workers also have special needs with respect to their immunization schedules, related to potential blood-borne exposures.

Employees should encourage and facilitate employees’ compliance with the ACIP immunization guidelines, and employees should discuss this with their primary care physicians to ensure a safe and effective vaccination protocol.

CIRCULATING IN THE PRESS

“Anti-Vaccine Movement Causes Worst Measles Epidemic in 20 Years”
Steven Salzberg, Contributor, Pharma & Healthcare, 2/1/15, Forbes.com.

Measles is now spreading outward from Disneyland in California, in the worst outbreak in years. The epidemic is fueled by growing enclaves of unvaccinated people.

The CDC reports that in just the past month, 84 people from 14 states contracted measles, a number that is certainly an under-estimate, because the CDC doesn’t record every case. California alone has

59 confirmed cases, most of them linked to an initial exposure in Disneyland. A majority of people who have gotten sick were not vaccinated.

For years, scientists (including myself) have warned that the anti-vaccination movement was going to cause epidemics of disease. Two years ago I wrote that the anti-vaccine movement had caused the worst whooping cough epidemic in 70 years. And now it’s happening with measles.

Finally, though, the public seems to be pushing back. Parents are starting to wake up to the danger that the anti-vax movement represents to their children and themselves.

What’s sad about this – tragic, really – is that we eliminated measles from the U.S. in the year 2000, thanks to the measles vaccine.

But we had 644 cases in 27 states in 2014, the most in 20 years. And 2015 is already on track to be worse. Measles may become endemic in the U.S., circulating continually, thanks to the increasing numbers of unvaccinated people. Until now, each outbreak was caused by someone traveling from abroad and bringing measles to us. The anti-vaccine movement has turned this public health victory into defeat.

Anti-vaxxers have been relentless in the efforts to spread misinformation. Despite overwhelming scientific evidence that vaccines are beneficial, they endlessly repeat a variety false claims, such as:

  •  Vaccines cause autism. They don’t.
  • The preservative thimerosal in vaccines causes autism. It doesn’t.
  • Natural immunity is all you need. It isn’t. Measles infects 90% of people exposed to it unless they are vaccinated.
  • A healthy lifestyle will protect you from measles. It won’t.

Where does this breathtaking science denialism come from? It’s been building for years, as I and many others have written. The wave began with a 1998 paper published in The Lancet by Andrew Wakefield, claiming that the MMR vaccine was linked to autism. Wakefield’s work was later shown to be fraudulent, and his claims about the vaccine “dishonest and irresponsible.” After lengthy investigations, the paper was retracted and Wakefield lost his medical license. Despite this very public repudiation, Wakefield has stuck to his claims, though, and has spent much of the past 15 years speaking (or perhaps “preaching” would be a better term) to anti-vaccine groups, to whom he is a kind of folk hero.

Make no mistake, measles is a very dangerous infection.  In the current outbreak, 25% of victims have ended up in the hospital. And it is extremely infectious: the Center for Disease Control’s Anne Schuchat explained that:

“You can catch it [measles] just by being in the same room as a person with measles even if that person left the room because the virus can hang around for a couple of hours.”

REFERENCES:

http://www.cdc.gov/workplacehealthpromotion/model/index.html

http://wwwnc.cdc.gov/travel/destinations/list

 

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