With September just around the corner and school physicals due soon, many children will have their medical and immunization records reviewed. With immunization programs so successful and many once common illnesses now rare, families often wonder why there are so many vaccines and who decides what is new. We need to continue immunizing ourselves and our children to keep vaccine preventable disease incidence low. The last two years have brought several new updates and new vaccines and their use is guided by national advisory committees.

The Advisory Committee on Immunization Practices (ACIP) is a group of experts who advises the nation via the Secretary of Health and Human Services and the Centers for Disease Control (CDC) in order to reduce the incidence of vaccine preventable diseases and to increase the safe usage of vaccines and related biological products (as taken from their Web site). The ACIP meets several times a year to review immunization practices and provides current recommendations based on updated research. This group collaborates with physician groups, such as the American Academy of Pediatrics and the American Academy of Family Physicians, to support immunization practices and help keep our nation healthy. Many of the diseases against which we immunize are no longer commonly seen because vaccine programs are so effective.

The first new vaccine to discuss is Tdap, recommended by the ACIP in October 2005, and marketed as Boostrix and Adacel. The Td booster, known as the tetanus shot, provided immunity against tetanus and diphtheria and was a booster of the childhood vaccines. This was given every 10 years starting around age 11-12 years. We now can get protection against tetanus, diphtheria, and pertussis in the new booster shots. Pertussis is a bacterial disease otherwise known as whooping cough, which causes cold symptoms and prolonged cough in adolescents and adults. In very young infants this can be a very severe respiratory illness that causes deaths every year. Most of the infants contract the disease from their parents, grandparents or older siblings who no longer have immunity against it. This vaccine is given around age 10-12 years as well as to older adolescents and adults under age 65 to help prevent the increase in pertussis that we have seen in recent years.

The second new vaccine is against meningococcus, which causes meningococcal meningitis. This can be a swiftly moving illness that can cause serious illness and even death. The vaccine, known as Menactra, was recommended by the ACIP after the February 2005 meeting. The recommendation is to administer this one-time vaccine to adolescent’s age 11-12 years old, or at high school or college entry.

The third new vaccine protects against certain strains of the human papilloma virus or HPV, which can cause cervical cancer. The three-dose series is given to girls starting at age 11 years through 26 years but can be started as early as age 9 years in high-risk persons. Immunizing prior to onset of sexual activity provides protection before exposure to this virus. The vaccine was licensed by the FDA in June 2006 and recommended by the ACIP later the same month.

The last newer vaccine is an oral vaccination given to infants at age 2 months, 4 months and 6 months to protect against rotavirus. The vaccine, Rotateq, was recommended for routine use by the ACIP in August of 2006. Rotavirus is an illness that causes fever, vomiting, and diarrhea and is especially common in the winter months. Each year, thousands of children are hospitalized with this highly contagious virus and even more require emergency room visits for rehydration.

Finally, the ACIP has updated recommendations for administration of two existing vaccines. The first is a booster shot for the chickenpox vaccine, known as the varicella vaccine or Varivax, which is now on the new immunization schedule due to concerns over incomplete immunity in some individuals after only one dose and to have more rapid impact on school outbreaks. The new schedule has the first dose at 12 to 15 months of age and the second with the booster shots given between the ages of 4 and 6, providing better protection into the adult years when the illness can be more severe. The second update is the universal Hepatitis A vaccination. Hepatitis A is a viral infection which affects the liver and causes a flu-like illness associated with stomach pain and diarrhea. Previous immunization programs targeted high risk locations and high risk populations and we have now reduced the numbers of cases nationwide. This overall reduction in disease prevalence has proven the success of the immunization’s effectiveness and moving to universal Hepatitis A vaccination will further reduce the numbers of cases with potential for eradication.

Your family physician or pediatrician can discuss these new vaccines with you and whether you or your child should receive any or all of these. Further information on recommended vaccine schedules for children and adults can be found on the CDC Web site at www.cdc.gov.

Sharon McIntyre is Naval Hospital Oak Harbor Community Relations Officer.