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CDC’s Advisory Committee Recommends Changes in Varicella Vaccinations

Second dose of varicella vaccine to offer more protection for children, adolescents, and adults

The Advisory Committee on Immunization Practices (ACIP) to the Centers for Disease Control and Prevention (CDC), in its meeting in Atlanta today, voted to recommend a second dose of varicella (chickenpox) vaccine for children four to six years old to further improve protection against the disease. The first dose of varicella vaccine is recommended at 12 to 15 months old.

Fifteen to 20 percent of children who have received one dose of the vaccine are not fully protected and may develop chickenpox after coming in contact with varicella zoster virus. Additionally, one dose of the vaccine may not continue to provide protection into adulthood when chickenpox is more severe. A second dose of varicella vaccine provides increased protection against varicella disease compared to one-dose. The ACIP also recommended that children, adolescents and adults who previously received one dose should receive a second dose.

“We have made great progress in reducing chickenpox during the past ten years,” said Dr. Anne Schuchat, director of CDC’s National Center for Immunization and Respiratory Diseases. “This recommendation will further reduce outbreaks of chickenpox and provide better individual protection.”

Before licensure of the varicella vaccine in 1995, each year there were about four million cases of varicella, 13,500 hospitalizations and 150 deaths. Cases of varicella have steadily declined 80 to 85 percent in surveillance sites since the licensure. From 1995 to 2001, varicella hospitalizations declined by 72 percent and deaths, among those 50 years old and younger, decreased by 75% or more.

However, in recent years varicella outbreaks have continued to occur among vaccinated school children. During these chickenpox outbreaks, between 11 and 17 percent of vaccinated children developed varicella. Varicella in vaccinated children is usually mild, but the children are contagious and can transmit the virus to others including their parents who are at higher risk of severe disease.

The ACIP, consisting of 15 members appointed by the Secretary of the Department of Health and Human Services (HHS), advises the director of CDC and Secretary of HHS on control of vaccine-preventable disease and vaccine usage. Recommendations of the ACIP become CDC policy when they are accepted by the director of CDC and are published in CDC’s Morbidity and Mortality Weekly Report (MMWR). There are no federal laws requiring the immunization of children. All school and daycare entry laws are state laws and vary from state to state.

For more information, visit www.cdc.gov.

CDC’s Advisory Committee Recommends Human Papillomavirus Virus Vaccination

CDC’s Advisory Committee Recommends Human Papillomavirus Virus Vaccination Vaccine considered highly effective in preventing infections that are the cause of most cervical cancers.

The Advisory Committee on Immunization Practices (ACIP) voted Thursday to recommend that a newly licensed vaccine designed to protect against human papillomavirus virus (HPV) be routinely given to girls when they are 11-12 years old. The ACIP recommendation also allows for vaccination of girls beginning at nine years old as well as vaccination of girls and women 13-26 years old. HPV is the leading cause of cervical cancer in women.

According to the ACIP’s recommendation, three doses of the new vaccine should be routinely given to girls when they are 11 or 12 years old. The advisory committee, however, noted that the vaccination series can be started as early as nine years old at the discretion of the physician or health care provider. The recommendation also includes girls and women 13-26 years old because they will benefit from getting the vaccine. The vaccine should be administered before onset of sexual activity (i.e., before women are exposed to the viruses), but females who are sexually active should still be vaccinated.

“This vaccine represents an important medical breakthrough,” said Dr. Anne Schuchat, director of CDC’s National Center for Immunization and Respiratory Diseases. “As a result, these vaccine recommendations address a major health problem for women and represent a significant advance in women’s health. It has been tested in thousands of women around the world and has been found to be safe and effective in providing protection against the two types of HPV that cause most cervical cancers.”

Gardasil®, manufactured by Merck, is the first vaccine developed to prevent cervical cancer, precancerous genital lesions and genital warts due to HPV -- `HPV causes genital warts in men and women. The vaccine is highly effective against four types of the HPV virus, including two that cause about 70 percent of cervical cancer. Those who have not acquired HPV would get the full benefits of the vaccine. On average, there are 9,710 new cases and 3,700 deaths from cervical cancer in the United States each year.

HPV is the most common sexually transmitted infection in the United States, More than 20 million men and women in the United States are currently infected with HPV and there are 6.2 million new infections each year. HPV is most common in young women and men who are in their late teens and early 20s. By age 50, at least 80 percent of women will have acquired HPV infection.

“Although an effective vaccine is a major advance in the prevention of genital HPV and cervical cancer, it will not replace other prevention strategies, such as cervical cancer screening for women or protective sexual behaviors,” said Dr. Schuchat “Women should continue to get pap tests as a safeguard against cervical cancer.”

The ACIP, consisting of 15 members appointed by the Secretary of the Department of Health and Human Services (HHS), advises the director of CDC and Secretary of HHS on control of vaccine-preventable disease and vaccine usage. Recommendations of the ACIP become CDC policy when they are accepted by the director of CDC and are published in CDC’s Morbidity and Mortality Weekly Report (MMWR). There are no federal laws requiring the immunization of children. All school and daycare entry laws are state laws and vary from state to state.

For more information, visit www.cdc.gov.

 
 
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