Flu vaccine recommendation expanded through age 18

News out of this week's ACIP meeting in Atlanta that the committee voted today to expand its influenza vaccine recommendation to include all children and teenagers up to age 18. Previously, the recommended pediatric population only included children between 6 months and 5 years of age. Here's the CDC announcement about the expanded recommendation; it notes that approximately 30 million children are affected.

Here's coverage from the New York Times, CIDRAP News, and the Associated Press. The AP story reports that of the 36,000 annual influenza deaths in the U.S., only 25-50 occur in the 5-18 population. (Of course, preventing deaths is only one goal of expanded vaccination efforts.)

With some in the medical and public health communities advocating a universal recommendation, i.e., that all Americans receive the vaccine annually, the new recommendations (once fully implemented) will include essentially all Americans under age 18 and over age 50, in addition to a host of specific groups at higher risk of influenza morbidity or mortality.

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Today's announcement follows several weeks of bad news about the severity of the current flu season and issues with this year's vaccine failing to match a significant percentage of the circulating strains. Earlier this month, WHO recommended a wholesale redesign of the composition of the 2008-9 influenza vaccine -- replacing all three strains in the current season's vaccine. Here's the WHO report (pdf) and a CDC Q&A explaining the process by which the annual composition of the vaccine is determined. As is standard practice, the identical three strains were also recommended by the relevant FDA advisory committee at their meeting last week. Here's a related CIDRAP News story.

This link includes the most recent weekly report from CDC on influenza activity in the U.S., just part of the vast amount of information and resources available at its seasonal flu website.

FDA: GSK rotavirus vaccine appears safe and effective

Rotarix, the rotavirus vaccine developed by GSK, moved closer to U.S. licensure on Friday, as an FDA staff report stated that clinical trial results suggest that the vaccine is safe and effective.

Here is coverage of the news from The Wall Street Journal, Associated Press and Dow Jones. Rates of intussusception -- the gastrointestinal condition that doomed the first rotavirus vaccine, Rotashield, in 1999 -- were not significantly different in those receiving Rotarix versus control groups receiving a placebo.

A positive recommendation from government advisors at next week's meeting of FDA's Vaccines and Related Biological Products Advisory Committee would likely be the final step prior to licensure in the U.S. Rotarix is already approved in over 90 countries, according to GSK.

Merck's rotavirus vaccine, RotaTeq, was approved in February 2006 and is currently recommended for all infants at 2, 4, and 6 months of age

N.Y. Times public editor examines coverage of vaccine-autism link

In today's New York Times, Public Editor Clark Hoyt takes a look at questions surrounding reporters' handling of contested topics (at least by some) in science and medicine, including allegations of the link between vaccines and autism.

As we wrote last month, the New York Times broke the story about the content of the premiere episode of ABC drama "Eli Stone", triggering a flurry of protest by the American Academy of Pediatrics and others. In his stories, Times reporter Edward Wyatt wrote that the issue was all but settled within the scientific and medical communities, with the possible link between vaccines and autism largely rejected. (A Times editorial published after the episode aired offered a similar point-of-view.)

In his piece today, Hoyt writes:

"Wyatt’s article made clear that there is a debate but did not give equal weight to the two sides. The Times has not since 2005, when two reporters investigated every scientific study and thousands of documents from parents convinced of a link between autism and vaccines, and came down pretty clearly on the side of the scientists.

Wyatt said he relied on that report and read extensively about autism when he got the first hint of what the “Eli Stone” episode would say. "The show seems to portray it as, ‘No one knows,’" he said. “My conclusion was that that is not the case."

Proponents of a possible link were not pleased with Wyatt's portrayal of the scientific debate last month and are likely to be similarly displeased with the concurrence of the Times' public editor today.

Rare Paraguay yellow fever outbreak prompts vaccine demand

In over 220 posts in the 24-month history of this site, we haven't mentioned yellow fever once, a disease and a vaccine that, in the United States, are largely limited to historical narratives featuring Walter Reed or requirements for international travel. In parts of Central and South America and Africa, however, the disease is still a very real health threat. In Paraguay this week, the first yellow fever outbreak there in over 30 years has prompted the rapid delivery of several hundred thousand vaccine doses from countries throughout Latin America.

As this AP story reports, Brazil, Peru, and other countries have committed to deliver vaccine supplies to Paraguay to assist vaccination efforts in effected areas. (Public demand for the vaccine has led to street protests, according to many reports.) This ABC News (Australia) story notes that one death and 10 other cases of the mosquito-transmitted disease have been confirmed to date. This Guardian story adds that 30,000 deaths are caused by yellow fever annually, according to WHO.

More information about yellow fever and the vaccine available against it can be found at this CDC site and this WHO site.

Fifth edition of "Vaccines" published

The 5th edition of Vaccines, the magisterial textbook covering all aspects of vaccines and vaccination, was published this month. Edited by Stanley Plotkin, Walter Orenstein, and Paul Offit, everything about the newly revised and expanded text is impressive: 1748 pages, 76 chapters, several hundred contributors, and tens of thousands of references to other published materials. Already long viewed as the standard reference work on vaccines, the new edition adds to this unmatched reputation.

Chapters cover every vaccine developed or in development and several dozen topics related to infrastructure, regulation, and policy considerations. We were pleased to co-author one of the chapters new to the 5th edition, one titled "Ethics". In it, we provide a necessarily brief overview of the many (largely unexplored) ethical issues that arise throughout the vaccine life-cycle -- from the earliest stages of research through the implementation of national and international vaccination programs.

Overall, Vaccines is the first place to turn for answers to just about any question about a specific vaccine or vaccination programs more generally. More information about the book can be found at the Elsevier web site.