M-M-R II Vaccine

Health officials confirm two cases of measles in Hennepin County siblings

Holly Lutmer PharmD

The Minnesota Department of Health (MDH) announced today it is investigating two measles cases in unvaccinated, pre-school children who are siblings.

The children developed measles symptoms shortly after returning to Hennepin County after visiting an unidentified country where measles is endemic.

One child was hospitalized due to measles complications.

The children were isolated when symptoms started, so exposures were limited to health care and family settings.

It generally takes eight to 12 days from exposure to someone with measles to develop the first symptom, usually fever.

The MDH, Hennepin County Public Health, and local staff are working to notify people who may have been exposed to the vaccine-preventable measles virus in Minnesota or while flying.

The MDH stated on June 14, 2022, that the measles risk to the general public is low. However, the measles virus spreads quickly by coughing, talking, or being in the same room with someone who has measles.

If additional measles cases develop due to these cases, they will likely occur before July 1, 2022, health officials said.

Some communities in Minnesota continue to have low vaccination rates for measles, mumps, and rubella (MMR).

According to recent data, the percentage of 2-year-olds who had received at least one dose of MMR vaccine by 24 months declined from 81.4% in 2019 to 79.3% in 2021.

State Epidemiologist Dr. Ruth Lynfield commented in a related press release, “Vaccines are extremely effective for preventing measles.”

“It’s important that we work on getting our immunization rates back up where they need to be so that all children in Minnesota are protected.”

Minnesota has had four cases of measles since a significant outbreak in 2017.

In a typical year, Minnesota sees one to four cases of measles, generally in people who traveled to countries where measles is more common.

The World Health Organization recently reported measles cases increased by 79% in the first two months of 2022, compared to the same period in 2021.

“We need to maintain our high vaccination rates in the United States to make sure measles does not make a comeback in Minnesota,” added Margaret Roddy, section manager for vaccine-preventable diseases at MDH.

“As long as there is measles somewhere in the world and people travel, the risk to Minnesota remains.”

“The measles vaccine is safe and effective. Without it, the risk of disease is real.”

The U.S. CDC says ‘measles was declared eliminated in the U.S. in 2000, but it is still common in other parts of the world.’

As of June 3, 2022, only three measles cases were reported by two jurisdictions this year. This improved from 2021, when five U.S. jurisdictions reported 49 measles cases.

The best way to prevent measles is through vaccination.

The CDC says children should receive two doses of MMR vaccine: the first at 12 to 15 months of age and the second at 4 to 6 years of age. Children 6 to 12 months should get an early dose of the MMR vaccine if they are traveling to a country where measles is common.

And on June 6, 2022, the U.S. FDA approved GSK’s Priorix MMR vaccine. This is the third approved MMR vaccine. These vaccines are generally available at local pharmacies and health clinics.

Breaking measles outbreak news is posted at this link.

Vax-Before-Travel publishes fact-checked, research-based travel vaccine news curated for mobile readership.

Sub Title:

Measles outbreaks can be found in many countries in 2022

References:

CDC: Measles

Priorix Vaccine

Measles Vaccines

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Minneapolis-St. Paul Airport

Vaccine-Preventable Disease Outbreaks Increase in Africa

Karen McClorey Hackett — Thu, 28 Apr 2022 17:41:16 +0000

Reviewer:

WHO: Vaccine-preventable disease outbreaks on the rise in Africa

Holly Lutmer PharmD

Africa has been witnessing a surge in outbreaks of vaccine-preventable diseases over the past year, announced the World Health Organization (WHO).

Disruptions by the COVID-19 pandemic impaired routine immunization services in many African countries and forced the suspension of vaccination drives.

In 2020, 23 million children missed out on childhood vaccines, the highest number since 2009 and 3.7 million more than in 2019.

One of the diseases is measles.

Twenty African countries reported measles outbreaks in the first quarter of 2022.

As of April 28, 2022, about 17,500 cases of measles were recorded in the African region between January and March 2022, marking a 400% increase compared with the same period in 2021.

Apart from its direct effect on the body, which can be lethal, the measles virus also weakens the immune system and makes a child more vulnerable to other infectious diseases like pneumonia, says the WHO.

“Measles is more than a dangerous and potentially deadly disease. But, unfortunately, it is also an early indication that there are gaps in our global immunization coverage, gaps vulnerable children cannot afford,” commented Catherine Russell, UNICEF Executive Director.

Fortunately, the U.S. has avoided the measles outbreak.

As of April 1, 2022, a total of 2 measles cases were reported by U.S. jurisdictions to the CDC.

Outbreaks of other vaccine-preventable diseases have also become more common.

Twenty-four countries confirmed outbreaks of a variant of polio in 2021, which is four more than in 2020.

And in 2021, 13 countries reported yellow fever outbreaks in the African region, compared to nine in 2020 and just three in 2019.

“The rise in outbreaks of other vaccine-preventable diseases is a warning sign. As Africa works hard to defeat COVID-19, we must not forget other health threats,” said Dr. Matshidiso Moeti, the WHO Regional Director for Africa, in a related press release.

“Health systems could be severely strained not only by COVID-19 but by other diseases.”

“Vaccines are at the heart of a successful public health response, and as countries restore services, routine immunization must be at the core of revived and resilient health systems.”

To urgently scale up coverage and protect children, the WHO and partners are supporting African countries to carry out catch-up routine vaccination campaigns, with more than 90% of the 38 African countries responding to a global survey reporting that they implemented at least one routine catch-up immunization campaign in the second half of 2021.

Some countries have successfully integrated other critical immunization campaigns with COVID-19 vaccination.

For example, Nigeria recently launched a vaccine scale-up strategy that guides the integration of routine immunization with COVID-19 vaccination for mothers and their babies.

Between January and April 2022, the percentage of Africans fully vaccinated against the coronavirus rose to 17.1% from 11.1%.

“In the wake of this pandemic, we are committed to support countries to devise smart approaches to scale up COVID-19 vaccination and restore and expand routine immunization services,” added Dr. Benido Impouma, Director, Communicable and Noncommunicable Diseases Cluster at WHO Regional Office for Africa.

For example, Ghana integrated COVID-19 vaccination with yellow fever campaigns in December 2021 to curb an outbreak that erupted a month earlier.

PrecisionVaccinations publishes fact-checked research-based vaccine news.

Note: The WHO announcement was edited for clarity and manually curated for mobile readership.

Sub Title:

Measles cases increase 400 percent in Africa in 2022

References:

UNICEF and WHO warn of ‘perfect storm’ of conditions for measles outbreaks, affecting children

Measles Vaccines

Yellow Fever Vaccines 2022

Polio Vaccines for 2022

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Should Vaccine Passports Include Measles in 2022

Karen McClorey Hackett — Sun, 06 Mar 2022 13:29:57 +0000

Reviewer:

CDC: Top 10 Countries with Global Measles Outbreaks

While the world continues debating the benefits of COVID-19 vaccine passports, other serious diseases spread to international travelers, such as measles.

Measles is common in many parts of the world, including popular tourist destinations.

The U.S. Centers for Disease Control and Prevention (CDC) recently confirmed measles outbreaks are ongoing in various African countries during 2022.

To alert international travelers, the CDC issued a Watch - Level 1, Practice Usual Precautions, on March 4, 2022, saying prospective visitors to Africa, including infants and children, should be fully vaccinated against measles, according to the CDC’s 2022 immunization schedule.

The CDC’s updated map indicates which African countries are confronting measles outbreaks as of March 4, 2022.

Keep in mind that destinations reporting measles outbreaks are not the only places where the infection is a risk.

For example, the U.K. recently confirmed an under-vaccination situation near London.

And as of February 8, 2022, the CDC confirmed three other countries are battling measles outbreaks: India (4,259), Nigeria (4,114), and Somalia (2,908).

Furthermore, measles cases continue to be identified in the U.S.

On February 7, 2022, Fairfax Health District in northern Virginia, near Dulles International Airport, identified measles amongst an unvaccinated individual with recent international travel.

Additionally, multiple exposure locations were identified in the Fairfax Health District.

In 2021, the Virginia Department of Health reported Fairfax County (12) and Prince William County (7) met the measles outbreak definition.

Moreover, during the 2018-2019 measles outbreak in the U.S., most cases were traced back to unvaccinated international travelers.

Measles is a vaccine-preventable disease, says the CDC.

There are two U.S. FDA Approved measles vaccines in 2022:

Merck’s M-M-R-II for use in people ages 12 months and older
Proquad with an integrated Varicella Virus Vaccine, which is Approved for children ages 1 through 12 years

And the Priorix and Tresivac vaccines are authorized in various countries.

Since many travelers have already secured International Certificates of Vaccination or Prophylaxis for yellow fever, meningococcal meningitis, and polio immunization, perhaps measles will be added to this program in 2022.

For additional measles vaccine information, please visit this webpage.

Vax-Before-Travel publishes fact-checked research-based travel vaccine news.

Sub Title:

International Certificates of Vaccination or Prophylaxis include yellow fever, meningococcal meningitis, and polio vaccinations

References:

CDC: Measles in Africa

Confirmed measles cases in Fairfax Health District associated with an unvaccinated individual with recent international travel

England’s Under-Vaccinated Children Could Create the Next Measles Outbreak

Travel vaccination certificates: why you may need them

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Adolescents and Children Immunization Schedules Updated for 2022

Karen McClorey Hackett — Thu, 17 Feb 2022 22:48:52 +0000

Reviewer:

Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children Aged 18 years or younger

The U.S. CDC issued a Morbidity and Mortality Weekly Report today highlighting the Advisory Committee on Immunization Practices (ACIP) recommended immunization schedule for children and adolescents for 2022.

Found on the CDC’s immunization schedule website, the ACIP recommendations issued on February 18, 2022, include several changes from the 2021 immunization schedule.

Vaccine-specific changes include new or updated ACIP recommendations for influenza, dengue, and COVID-19 vaccines.

Changes also include clarification of the recommendations for Haemophilus influenzae type b vaccine, hepatitis A vaccine, hepatitis B vaccine, human papillomavirus vaccine, measles, mumps, and rubella vaccine (MMR); meningococcal serogroups A, C, W, Y vaccine (MenACWY); tetanus, diphtheria, and pertussis vaccine (Tdap); and varicella vaccine (VAR).

Dengue: This new section was added to provide details for routine dengue vaccination in areas with endemic dengue. In addition, a hyperlink referring health care providers to the latest guidance on areas with endemic dengue and prevaccination laboratory testing is included.
Hib: The note was updated to include the recommendations for routine and catch-up vaccination when DTaP-IPV-Hib-HepB (Vaxelis) is used.
HepA: The note was revised to clarify that routine vaccination is at 12–23 months.
HepB: In the “Special situations” section, the text has been revised to clarify and emphasize post-vaccination serology and revaccination recommendations.
HPV: In the “Special situations” section, the text for immunocompromising conditions has been revised to clarify that three doses should be administered regardless of age at initial vaccination.
Influenza: The note has been updated to reflect the recommendations for the 2021–22 influenza season. The “Special situations” section was condensed by moving information on contraindications and precautions for influenza vaccines to the newly created appendix.
MMR: The note on routine vaccination was updated to include recommendations for the use of measles, mumps, rubella, and varicella vaccine (MMRV).
MenACWY: Language was added to the notes regarding the recommendation for simultaneous administration with the meningococcal serogroup B vaccine (MenB). The text reads, “MenACWY vaccines may be administered simultaneously with MenB vaccines if indicated, but at a different anatomic site, when feasible.
VAR: The note has been updated to include recommendations for using MMRV and to clarify that a second dose inadvertently administered after at least a 4-week interval may be counted as a valid dose.

Previously, the CDC published interim clinical considerations for the use of COVID-19 vaccines on February 11, 2022. These considerations include updated contraindication and precaution section for myocarditis or pericarditis cases following an mRNA COVID-19 vaccination.

And for people, ages 5 years and older who are moderately or severely immunocompromised, a 3-dose primary mRNA COVID-19 vaccine series is recommended, followed by a booster (4th) dose for those ages 12 years and older.

The Recommended Child and Adolescent Immunization Schedule, United States, 2022 is available here. In addition, the ACIP recommendations for each vaccine are also available.

Furthermore, a newly created appendix was added that lists the contraindications and precautions for each vaccine type included in the schedule.

Separately, the CDC published an update to the Adult Vaccination schedule for 2022.

PrecisionVaccinations publishes fact-checked, research-based antibody, antiviral, and vaccine news.

Sub Title:

Vaccine contraindications and precautions are included in the CDC schedule for 2022

References:

CDC: Interim Clinical Considerations

CDC: Adult Immunization Schedule

PV Vaccine Library

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Under-Vaccinated Children At-Risk During Measles Outbreaks

Don Hackett — Thu, 18 Nov 2021 20:07:47 +0000

Reviewer:

CDC: Progress Toward Regional Measles Elimination 2000-2020

While reported measles cases have fallen compared to previous years, progress toward measles elimination has also declined.

In addition, the risk of future measles outbreaks is mounting, according to a new report from the World Health Organization (WHO) and U.S. Centers for Disease Control and Prevention (CDC).

This report found in 2020, more than 22 million infants missed their first dose of the measles vaccine, an increase of 3 million compared to 2019.

And measles outbreaks occurred in 26 countries.

And these outbreaks have continued into 2021. The top countries reporting measles outbreaks are as follows:

Nigeria: 6,595
Pakistan: 6,395

While in the U.S., the CDC confirmed very few measles cases in 2020 (13) and during the first half of 2021.

However, as of November 10, 2021, the CDC reported four jurisdictions had reported 47 measles cases. With Northern Virginia confirming about half of the recent measles cases.

This data represents the most significant under-vaccination increase in two decades and creates dangerous conditions for measles outbreaks to occur.

“Large numbers of unvaccinated children, outbreaks of measles, and disease detection and diagnostics diverted to support COVID-19 responses are factors that increase the likelihood of measles-related deaths and serious complications in children,” said Kevin Cain, MD, CDC’s Global Immunization Director.

“We must act now to strengthen disease surveillance systems and close immunity gaps, before travel and trade return to pre-pandemic levels, to prevent deadly measles outbreaks and mitigate the risk of other vaccine-preventable diseases.”

According to the CDC and WHO, measles surveillance also deteriorated in 2020.

The number of specimens submitted was the lowest in over a decade. Many countries did not report, and a few countries (32%) achieved the measles surveillance sensitivity indicator.

Increased population susceptibility and suboptimal measles surveillance portend an immediate elevated risk for measles transmission and outbreaks, threatening the already fragile progress toward regional elimination goals.

The Measles Outbreaks Strategic Response Plan 2021–2023 recommends annual risk assessments to strengthen preparedness and response, investigation of every outbreak, rapid implementation of effective interventions to stop transmission, and root cause analysis to close immunity gaps and prevent future episodes through tailored approaches.

Progress toward measles elimination during the COVID-19 pandemic and beyond necessitates robust case-based surveillance systems to document immunity gaps and quickly identify cases and outbreaks.

Outbreaks should be viewed as opportunities to identify weaknesses across the immunization system and develop tailored strategies to close immunity gaps. Together, these actions will bolster measles elimination efforts while strengthening immunization systems, concluded the CDC and WHO statements.

In the U.S., the M-M-R vaccine is most often available at clinics, community centers, and local pharmacies.

PrecisionVaccinations publishes fact-check, research-based vaccine news.

Sub Title:

Measles elimination requires strengthening immunization information systems

References:

WHO:Global progress against measles threatened amidst COVID-19 pandemic

CDC: Measles cases in 2021

CDC: Top 10 Countries with Global Measles Outbreaks

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Friday, November 19, 2021 - 05:00

Northern Virginia Leads Measles Outbreak

Don Hackett — Thu, 21 Oct 2021 17:36:38 +0000

Reviewer:

CDC: Measles cases in 2021

The U.S Centers for Disease Control and Prevention (CDC) recently confirmed forty-two measles cases had been confirmed in 2021.

This CDC data published on October 13, 2021, indicates an over 100% increase in measles cases in just two weeks when twenty cases were confirmed.

Measles outbreaks can happen in areas where people may be unvaccinated or under-vaccinated, including the United States.

Last year, the CDC confirmed only thirteen measles cases in the U.S.

The new measles outbreak (as defined by 5+ cases) is centered in three jurisdictions, says the CDC.

Unfortunately, one of these jurisdictions is the very populated northern Virginia.

The Virginia Department of Health (VDH) reported on October 18, 2021, Fairfax County (12) and Prince William County (7) met the measles outbreak definition.

All of these measles cases have been identified in people younger than 20 years of age.

To date, no community transmission has been identified at this time in Virginia.

However, all people confirmed to have measles in Virginia recently traveled from Afghanistan as part of the United States government’s emergency evacuation efforts known as Operation Allies Welcome.

Afghanistan has already reported 1,298 measles cases in 2021.

The virus is released when an infected person breathes or coughs. It spreads quickly from person to person through the air or by direct contact with nose or throat discharges from someone infected.

The VDH says because measles is so contagious, it is likely that healthcare providers will find more cases and report them to VDH, as they are required to do.

Moreover, VDH is working closely with local, state, and federal partners to stop the outbreak as quickly as possible.

When VDH receives a measles case report, public health officials interview the people with measles to trace their steps and identify others who might have been exposed to the virus. When possible, VDH notifies these people of their potential exposure.

However, sometimes it is not possible to notify individuals directly.

In these situations, VDH notifies the public who might have been at a particular location at a specific date and time. Instructions are provided on what to do next, depending on the person’s measles vaccination status.

Safe and effective vaccines that prevent measles, mumps, and rubella (MMR) vaccine, and one vaccine that includes varicella (MMRV) vaccine series.

Two doses of the measles vaccine are given to provide lifetime protection.

Over 90% of the U.S. population is vaccinated against measles, and approximately 95% of kindergarteners in Virginia are vaccinated against measles.

However, infants younger than 12 months old are too young to be vaccinated. These infants and others who are not vaccinated are very susceptible to infection if exposed to someone with measles.

Note: Since the CDC Health Alert Network issued a Health Advisory CDCHAN-00452 on September 20, 2021, the CDC has yet to disclose the two other jurisdictions reporting measles cases.

PrecisionVaccinations publishes fact-checked research-based vaccine news.

Sub Title:

Measles is preventable with safe vaccines

References:

VDH: Measles Outbreaks

CDC: Global Measles Outbreaks

CDC: Guidance for Clinicians Caring for Individuals Recently Evacuated from Afghanistan

America’s Quiet Measles Outbreak

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Friday, October 22, 2021 - 05:45

America’s Quiet Measles Outbreak

Don Hackett — Thu, 30 Sep 2021 21:02:44 +0000

Reviewer:

CDC:Measles cases in 2021

Since measles is a reportable disease, the US Centers for Disease Control and Prevention (CDC) usually keeps everyone informed regarding an outbreak.

The CDC updated its website today with new measles outbreak information. However, the CDC did not issue an updated Health Advisory, as it did on September 20, 2021.

Today’s data indicates there have been a total of 20 measles cases reported by three jurisdictions as of September 29, 2021.

The CDC says in a given year, more measles cases can occur for any of the following reasons:

an increase in the number of travelers who get measles abroad and bring it into the U.S., and/or
further spread of measles in U.S. communities with pockets of unvaccinated people.

For example, the Virginia Department of Health (VHD) issued a warning on September 14, 2021, of a measles outbreak following the arrival of people from Afghanistan. They identified five individuals diagnosed with measles and began reaching out to people in the Central Health Region and the Northern Health Region who may have been exposed to those individuals.

The VHD recently indicated ‘all patients who have been confirmed with measles have been isolated, and their contacts have been quarantined.’

The CDC’s CDCHAN-00452 Advisory stated the U.S. government is in the process of resettling approximately 124,000 people, including about 6,000 American citizens from Afghanistan. Many of the evacuees are from areas with limited access to healthcare and vaccinations.

As of September 20, 2021, CDC has been notified by public health departments of 16 measles cases.

Furthermore, the CDC reported in early August that 1,273 people in Afghanistan had been confirmed with measles in 2021.

On September 24, 2021, Secretary of Homeland Security Alejandro Mayorkas confirmed during an Operation Allies briefing that ‘Afghan nationals who are paroled into the United States — the means by which we admit them here are the humanitarian discretionary authority — are required to take the vaccinations for measles, mumps, rubella, polio, and COVID-19, amongst others, as conditions of their humanitarian parole.’

‘U.S. citizens and lawful permanent residents who have arrived are returning directly to their home communities.’

And ‘the Department of Defense is providing temporary housing facilities for SIV applicants and other vulnerable Afghans at eight installations: Marine Corps Base Quantico, Virginia; Fort Pickett, Virginia; Fort Lee, Virginia; Holloman Air Force Base, New Mexico; Fort McCoy, Wisconsin; Fort Bliss, Texas; Joint Base McGuire-Dix-Lakehurst, New Jersey; and Camp Atterbury, Indiana.’

While the magnitude of this measles outbreak remains unknown, many people are concerned that a repeat of 2019 is pending when 1,282 individual measles cases were confirmed in 31 states.

The 2019 measles outbreak was traced back to the arrival of international travelers carrying the measles virus and quickly infected people in New York, New Jersey, and Michigan.

The CDC says two doses of an MMR (measles, mumps, and rubella) vaccine are about 97% effective at preventing measles and are safe.

And children through one year to 12 years of age have the option of getting MMRV vaccine, which also protects from varicella (chickenpox).

The CDC and states such as Virginia are urging public health officials to continue to look for people with measles symptoms, isolate those with symptoms and contact their local and state health departments of any suspected cases.

Note: Content updated for clarity on October 1, 2021.

PrecisionVaccinations publishes fact-checked research-based vaccine news.

Sub Title:

Confirmed measles cases increase in the USA

References:

CDC: Guidance for Clinicians Caring for Individuals Recently Evacuated from Afghanistan

WH.GOV White House Briefing

CDC: Global Measles Outbreaks

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Friday, October 1, 2021 - 10:15

Measles Under-Vaccinations Forecast Health Risks in the Americas

Don Hackett — Sun, 25 Apr 2021 09:46:13 +0000

Reviewer:

PAHO calls for closing vaccination gap generated by COVID-19 pandemic disruption

As Vaccination Week in the Americas 2021 prepares to launch, the WHO’s PAHO urges countries to close the immunization gap that resulted in hundreds of thousands of children missing vaccinations in 2020.

The 2021 theme – “Vaccines bring us closer” – needs to focus on closing the current immunization breach.

The PAHO’s call for stepped-up immunization coincides with the Vaccination Week in the Americas and World Immunization Week immunization campaigns during April 24-30, 2021.

In 2020, the PAHO reported 13.9 percent fewer children (379,208 in total) received their dose of MMR1 vaccine against measles, mumps, and rubella, compared to the year before.

Furthermore, in 2019, endemic transmission of measles was reestablished in Brazil.

A recent study found 32.9% of individuals in Brazil aged 10–40 years old had no antibodies against measles; 39.3% of total individuals with documented evidence of measles vaccination did not have anti-measles IgG, though only 20.2% of individuals with documented evidence of rubella vaccination lacked anti-rubella IgG.

And the United States is facing a re-emergence of measles, particularly among populations with low vaccination coverage. Measles outbreaks occurred in multiple states in 2017–19, following imported cases in travelers arriving from countries with active local transmission.

In the USA, the M-M-R-II vaccine is commonly available. It is indicated for simultaneous vaccination against measles (rubeola), mumps, and rubella (German measles). This vaccine is usually given to people 1-year-old or older.

“The Americas has been at the forefront of reducing deadly and life-altering disease through vaccination,” said Dr. Cuauhtemoc Ruiz Matus, Chief of PAHO’s Immunization Unit, in a press release issued on April 23, 2021.

“In recent years, we have seen a dangerous decline. This year’s Vaccination Week in the Americas is a chance not only to celebrate the availability of immunization but also to get vaccination back on track.”

According to PAHO reporting, between 2013 and 2019, the number of countries and territories reporting that 95% of children under 1 year of age had received all three DTP vaccine doses declined from 19 to 13.

In 2020 in the WHO Region of the Americas, 18.2% fewer children (474,395 in total) received all three shots of DPT3 vaccines against diphtheria, tetanus, and pertussis, compared to 2019.

Amid the decline in immunization in 2020, there was good news.

During the 2020 vaccination week, sixteen countries immunized populations against influenza, prioritizing health care workers, older adults, and people with chronic illness. More than 100 million people were vaccinated, reducing the potential that health systems already taxed by COVID-19 could be overwhelmed by flu patients.

Dr. Etienne called for government policies to strengthen public confidence in vaccination. She urged the promotion of immunization during the COVID-19 pandemic and supported the introduction of COVID-19 vaccines.

Measles is a highly contagious but vaccine-preventable disease. Its symptoms include acute rash, cough, and enanthem (including Koplik’s spots) on the oral mucosa. Its most common complications include diarrhea, pneumonia, otitis media, laryngotracheobronchitis, and encephalitis.

For over 40 years, PAHO’s Expanded Program on Immunization (EPI) has helped make the Americas a global leader in eliminating and controlling vaccine-preventable diseases, such as rubella, congenital rubella syndrome, measles, and neonatal tetanus. Since the creation of the EPI in 1977, countries have moved from using six vaccines in their national vaccination schemes to an average of more than 16 vaccines, which represents greater protection for the population.

PrecisionVaccinations publishes research-based news.

Sub Title:

The M-M-R II vaccine is indicated for simultaneous vaccination against measles, mumps, and rubella

References:

Outbreak response operations during the US measles epidemic, 2017–19

Prevalence of Measles Antibodies in São José do Rio Preto, São Paulo, Brazil: A serological survey model

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Sunday, April 25, 2021 - 05:00

Facial Biometric Comparison Technology Expands at Texas Port of Entry

Don Hackett — Tue, 09 Mar 2021 20:52:27 +0000

Reviewer:

CBP Announces Simplified Arrival, Using Facial Biometric Comparison Technology at Hidalgo Port of Entry

The U.S. Customs and Border Protection (CBP) agency announced the implementation of Simplified Arrival at the international bridges within the Hidalgo/Pharr/Anzalduas Port of Entry in south Texas.

Simplified Arrival, an enhanced international arrival process that uses facial biometrics to automate the manual document checks that are already required for admission into the USA.

This will be the third location in the Rio Grande Valley area to implement Simplified Arrival. In 2020, Simplified Arrival was deployed at the Progreso/Donna Port of Entry, located slightly downriver from Hidalgo, followed by the Brownsville Port of Entry located about an hour away.

Previously, CBP had launched Simplified Arrival at the Dallas/Fort Worth International Airport and at the Houston, Texas airports.

Since September 2018, CBP has leveraged facial biometrics to prevent more than 400 imposters from illegally entering the USA by using genuine travel documents issued to other people.

Located near McAllen, Texas, the Hidalgo Port of Entry crosses between Reynosa, Mexico, and the USA. Hidalgo is one of the ten busiest ports of entry in the USA, processing more than 1.6 million pedestrians and nearly 2.9 million vehicles in Fiscal Year 2020.

Simplified Arrival only uses the biometric facial comparison process at a time and place where travelers are already required by law to verify their identity by presenting a travel document.

When travelers arrive at the pedestrian lanes or undergo I-94 processing at any bridge in Hidalgo, they will pause for a photo at the primary inspection point.

A CBP officer will review and query the travel document, which will retrieve the traveler’s passport or visa photo from government holdings. The new image of the traveler will be compared to the photo previously collected.

The facial comparison process only takes a few seconds and is more than 98 percent accurate.

Also, foreign travelers who have traveled to the U.S. previously may no longer need to provide fingerprints, as their identity will be confirmed through the touchless facial comparison process.

If a traveler cannot be matched to a photo on record using the Simplified Arrival process, the traveler will proceed through the traditional inspection process consistent with existing requirements for entry into the USA.

Randy J. Howe, Director, Field Operations, Laredo Field Office, stated in a press release issued on March 9, 2021, “CBP has evaluated and fine-tuned the biometric facial comparison technology we have been testing at the Southwest Border since the summer of 2018 to deliver a secure, streamlined travel experience that will also support travel recovery efforts.”

U.S. travelers and those foreign nationals who are not required to provide biometrics and wish to opt-out of the new biometric process may notify a CBP officer as they approach the primary inspection point. These travelers will be required to present a valid travel document for inspection by a CBP officer. They will be processed consistent with existing requirements for admission into the United States.

CBP is committed to its privacy obligations and has taken steps to safeguard the privacy of all travelers. CBP has employed strong technical security safeguards and has limited the amount of personally identifiable information used in the facial biometric process.

New photos of U.S. citizens will be deleted within 12 hours. Pictures of most foreign nationals will be stored in a secure Department of Homeland Security system.

More information about CBP’s efforts to secure and streamline travel through facial biometrics can be found here.

U.S. Customs and Border Protection is the unified border agency within the Department of Homeland Security charged with the management, control, and protection of national borders at and between official ports of entry.

Vax-Before-Travel publishes research-based news.

Sub Title:

Simplified Arrival uses facial biometrics during the international arrival process in Texas

References:

Collection of Biometric Data From Aliens Upon Entry to and Departure From the United States

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Vaccinations Save Lives Everywhere

Don Hackett — Sun, 31 Jan 2021 15:37:45 +0000

Reviewer:

Estimating the health impact of vaccination against ten pathogens in 98 low-income and middle-income countries from 2000 to 2030

According to new modeling research, vaccinations against 10 major pathogens substantially impact public health in low-income and middle-income countries (LMICs).

Published in The Lancet on January 30, 2021, this study estimated that from 2000 to 2019, vaccinations prevented 37 million fatalities. Most of this impact is estimated to be among children younger than five years, most notably from measles vaccinations.

These results demonstrated that between 2000 and 2019, there was an increase in the average number of vaccines received per child, both for existing vaccines such as measles and for new vaccines such as rotavirus.

And this estimate by 16 independent research groups modeling the impact of childhood vaccination programs in 98 LMICs could increase to 69 million fatalities for the period 2000-2030.

The study assessed the impact of vaccination programs against ten pathogens: hepatitis B (HepB), Haemophilus influenzae type b (Hib), human papillomavirus (HPV), Japanese encephalitis (JE), measles, Neisseria meningitidis serogroup A (MenA), Streptococcus pneumoniae, rotavirus, rubella virus, and yellow fever virus (YF).

Dr. Caroline Trotter from the University of Cambridge UK, and a co-author on the study, said in a press statement, "There has been a much-needed investment in childhood vaccination programs in low-income and middle-income countries (LMICs), and this has led to an increase in the number of children vaccinated.”

“To inform future investment and ensure it continues, we need to evaluate the impact of these programs on public health. Our modeling has provided robust evidence on the effectiveness of vaccination programs in LMICs and indicated what might be lost if current vaccination programs are not sustained."

The study used two methods to assess impact to provide both a cross-sectional (yearly) and longer-term (lifetime) view of impact. The first method evaluated the difference in the number of deaths between the vaccination and no vaccination scenarios for each year and then totaled these annual results.

The second method assessed the long-term impact of vaccination by summarising the impact over the lifetime for groups of people born in the same year between 2000 and 2030 and then calculated the difference between vaccination and no vaccination scenarios.

This approach allowed for the inclusion of vaccination impact later in life, particularly relevant for diseases such as hepatitis B or HPV, where there is a long delay between infection and severe outcomes. Most of the impact of hepatitis B vaccination will be seen after 2030, whilst HPV impact will be seen after 2040.

Considering impact per year, the study estimates that from 2000 to 2030, vaccination will have prevented 69 million deaths from the ten diseases, 37 million of which were averted between 2000 and 2019. Vaccinations against measles had the most significant impact, preventing 56 million deaths between 2000 and 2030.

In terms of the impact of vaccination over the lifetime of people born between 2000 and 2030, the study estimated that vaccination would prevent 120 million deaths, of which 65 million are in children younger than five. Fifty-eight million deaths would be controlled by measles vaccines and 38 million by hepatitis B vaccines.

Considering those born in 2019, the study estimated that increases in vaccine coverage and introductions of additional vaccines resulted in a 72% reduction in lifetime mortality caused by the ten pathogens.

By taking this 2019 birth cohort and using UN World Population Prospects demographic estimates, the study estimated that mortality in children under five in the 98 countries would be 45% higher in the absence of vaccination against the ten pathogens.

The study also examined each vaccine's relative impact and demonstrated that measles, Hib, and pneumococcal conjugate vaccines (PCVs) have the largest impact on deaths of children under five.

Vaccines against HPV, hepatitis B, and yellow fever have the largest impact per person vaccinated over a lifetime.

Corresponding author, Professor Neil Ferguson from Imperial College London, UK, said: "Our study signifies the huge public health benefits that can be achieved from vaccination programs in low-income and middle-income countries.”

“By projecting up until 2030 in these 98 countries, we have provided insight on where investments in vaccine coverage should be directed to achieve further gains, for example, increasing HPV coverage in girls and pneumococcal conjugate vaccines coverage in children under five will have the most impact according to our modeling."

These researchers reported the level of uncertainty from data on disease burden and the structural assumptions of the different models. Still, they could not evaluate uncertainty in demographic estimates and estimates of past and future vaccine coverage.

In a related commentary published by The Lancet, this study underestimates vaccination impact because it includes only ten of the vaccines commonly used in routine childhood immunization programs.

Pertussis vaccination was not included and could impact pediatric mortality more than some of the other vaccines included in this analysis. Although variably used in children around the globe, the seasonal influenza vaccine was not included and would reduce severe disease and potentially mortality if used more broadly.

The study also excluded most vaccines against epidemic-prone and pandemic-prone diseases, such as cholera, Ebola virus, and typhoid, potentially saving many lives.

This study was funded by the Vaccine Alliance and The Bill and Melinda Gates Foundation. Researchers from Imperial College London conducted it, London School of Hygiene & Tropical Medicine, National University of Singapore, Public Health England, Laval University, Johns Hopkins University, Colorado State University, The Pennsylvania State University, Lafayette College, Kaiser Permanente, University of Cambridge, University of Notre Dame, Dublin City University, Harvard University, Oxford University, University of Southampton, Conservatoire national des arts et metiers, University of Hong Kong and the Center for Disease Analysis Foundation.

No researcher disclosed industry conflicts of interest.

PrecisionVaccinations publishes research-based vaccine news.

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Vaccines against 10 diseases could prevent 69 million vaccine-preventable deaths this decade

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Measles Outbreaks Returned in Every Region

Don Hackett — Thu, 12 Nov 2020 23:22:37 +0000

Reviewer:

The Measles & Rubella Initiative supports implementation of the Measles & Rubella Strategic Framework 2021-2030

Around the world, measles cases surged in 2019 reaching the highest level in 23 years, reported the World Health Organization (WHO), and the US Centers for Disease Control and Prevention (CDC).

Global measles fatalities climbed nearly 50 percent since 2016, claiming an estimated 207,500 lives in 2019 alone, reported the WHO on November 12, 2020.

Measles outbreaks occur when people who are not protected from the virus are infected and spread the disease to unvaccinated or under-vaccinated populations. Around 90 percent of people who are not protected will become infected following exposure to the measles virus.

The reason behind this alarming increase is ‘a failure to vaccinate children on time with 2-doses of measles-containing vaccines (MCV1 and MCV2), stated this new WHO report.

“We know how to prevent measles outbreaks and deaths,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, in a related press statement. “These data send a clear message that we are failing to protect children from measles in every region of the world.”

“We must collectively work to support countries and engage communities to reach everyone, everywhere with measles vaccine, and stop this deadly virus.”

To prevent measles outbreaks, measles vaccination coverage rates must reach 95 percent and be maintained at national and sub-national levels.

MCV1 coverage has been stagnant globally for more than a decade at between 84 and 85 percent. And MCV2 coverage has been steadily increasing but is now only at 71 percent.

However, the COVID-19 pandemic has resulted in disruptions in vaccination and crippled efforts to prevent and minimize measles outbreaks.

As of November 2020, more than 94 million people were at risk of missing vaccines due to paused measles campaigns in 26 countries. Many of these countries are experiencing ongoing measles outbreaks.

Of countries with postponed vaccination campaigns, only eight (Brazil, Central African Republic, Democratic Republic of Congo, Ethiopia, Nepal, Nigeria, Philippines, and Somalia) resumed their campaigns after initial delays report the WHO.

As of October 13, 2020, the CDC’s latest data indicates Brazil (4,256) and Nigeria (3,149) have reported the most measles cases during 2020.

And during 2019, most measles outbreaks in the USA were all linked to travel-related cases that reached at-risk populations.

To address these outbreaks, on November 6, 2020, the WHO and UNICEF issued an emergency call to action for measles prevention and response.

Henrietta Fore, UNICEF Executive Director, added: “While health systems are strained by the COVID-19 pandemic, we must not allow our fight against one deadly disease to come at the expense of our fight against another. This means ensuring we have the resources to continue immunization campaigns for all vaccine-preventable diseases, even as we address the growing COVID-19 pandemic.”

In response, global immunization partners are engaging leaders and public health professionals in affected and at-risk countries to ensure that measles vaccines are available and safely delivered and that caregivers understand the life-saving benefit of the vaccine.

“Measles virus easily finds unprotected children, adolescents, and adults because it is so contagious,” said Dr. Robert Linkins, Measles & Rubella Initiative (M&RI) Management Team Chair and Accelerated Disease Control Branch Chief at U.S. CDC.

Since 2000, M&RI has helped deliver over 5.5 billion doses of measles vaccine to children worldwide and saved over 25.5 million lives by increasing vaccination coverage, responding to outbreaks, monitoring, and evaluation, and supporting demand for the vaccine.

A bold strategy released by M&RI, Measles & Rubella Strategic Framework 2021 – 2030, will help to address reversals in global progress toward measles elimination by bolstering strong, national immunization systems that can reach and protect children. This strategic shift by the partnership will focus on strengthening the routine delivery of all vaccines, and quickly and effectively detecting and responding to measles outbreaks.

“Our collective efforts to reach children with vaccines now, ahead of the possible easing of COVID-19 travel restrictions and increased population movement, will save lives.”

The M&RI includes American Red Cross, the United Nations Foundation, the U.S. CDC, UNICEF, and global immunization partners like Gavi, the Vaccine Alliance, the Bill and Melinda Gates Foundation, and others.

PrecisionVaccinations publishes research-based news.

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Almost 41 countries have delayed measles campaigns due to the COVID-19 pandemic

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WHO: Worldwide Measles Deaths Climb 50% from 2016 to 2019 Claiming Over 207,500 Lives in 2019

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Measles and Polio Vaccination Programs Need Support

Don Hackett — Fri, 06 Nov 2020 15:21:34 +0000

Reviewer:

UNICEF and WHO call for emergency action to avert major measles and polio epidemics

The World Health Organization (WHO) issued an urgent call to action to avert major measles and polio epidemics around the globe.

The WHO stated on November 5, 2020, ‘COVID-19 continues to disrupt immunization services, leaving millions of vulnerable children at heightened risk of preventable childhood diseases.’

The WHO and UNICEF estimate that $655 million ($400 million for polio and $255 million for measles) in funding is needed to address dangerous immunity gaps in non-Gavi eligible countries and target age groups.

“COVID-19 has had a devastating effect on health services and in particular immunization services, worldwide,” commented Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, in a press statement.

“But unlike with COVID, we have the tools and knowledge to stop diseases such as polio and measles. What we need are the resources and commitments to put these tools and knowledge into action. If we do that, children’s lives will be saved.”

In recent years, there has been a global resurgence of measles with ongoing outbreaks in all parts of the world. During 2019, measles climbed to the highest number of new infections in more than two decades.

In the USA, a nationwide measles outbreak started in New York City from international travelers who were under-immunized for the measles virus.

The M-M-R-II vaccine remains a highly recommended vaccine in the USA.

Separately, poliovirus transmission is accelerating in various African and Middleast countries during 2020. In response, the WHO extended its Polio Alert.

‘Failure to eradicate polio now would lead to the global resurgence of the disease, resulting in as many as 200,000 new cases annually, within 10 years,’ added the WHO press statement.

The U.S. CDC recommends that before traveling to these countries, adults who completed their routine polio vaccine series as children should receive a single, lifetime adult booster dose of an inactivated poliovirus vaccine (IPV) booster dose, which has been the only polio vaccine offered in the USA since 2000.

Because of the generous financial support from Gavi, the Vaccine Alliance, and previous access to funding for outbreak response, preventive catch-up vaccinations for children who were missed due to COVID-19 disruptions in Gavi-eligible countries are underway.

‘However, significant financing gaps remain in middle-income countries that are not Gavi-eligible. This new call for emergency action will go to support those middle-income countries that are not eligible for support from Gavi,’ concluded the WHO’s comments.

To know more about UNICEF’s work on immunization, visit UNICEF.

PrecisionVaccinations publishes research-based vaccine news.

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WHO’s urgent call to action to increase vaccinations for measles and poliovirus

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Africa’s Island States Collaborate to Purchase Vaccines and Medicines

Don Hackett — Wed, 30 Sep 2020 16:53:48 +0000

Reviewer:

WHO: African island states launch joint medicines procurement initiative

The ministers of health from (7) African island states have signed an agreement to jointly procure drugs and vaccines in a bid to improve quality and access to medicines and other health products, announced the World Health Organization’s Africa Region.

The cost of drugs and medical supplies is one of the major challenges Africa’s Small Island States face due to the modest size of the populations.

Joint procurement is the ultimate model of intercountry collaboration aimed at improving procurement efficiency, says the WHO.

The ministers from Cabo Verde, Comoros, Guinea-Bissau, Madagascar, Mauritius, Sao Tome & Principe and Seychelles that form the Small Island Developing States signed the Pooled Procurement agreement on September 29, 2020, to take advantage of economies of scale and collective bargaining.

These nations comprise an archipelago containing 115 islands.

The WHO’s Director-General, Dr. Tedros Adhanom Gebreyesus, and the Regional Director for Africa, Dr. Matshidiso Moeti, joined the ministers in the virtual signing ceremony.

Dr. Moeti noted that ‘the efforts made so far in establishing the joint procurement program had already increased the attractiveness of the pharmaceutical market of the Small Island Developing States.’

“By creating a larger stream of demand, we can look forward to better access to quality and competitively-priced medicines. The high cost of medicines is one of the major barriers many countries in our region face in providing affordable health care of good standard. Pooling our resources is one way of overcoming this challenge,” added Dr. Moeti.

As the African region faces the double burden of communicable and noncommunicable diseases, it is essential that countries have systems in place for the timely procurement of supplies at a reasonable cost and in sufficient quantities to address treatment needs and efficiently complement important investments in health promotion, says the WHO.

Plans to set up the joint procurement initiative began in 2017 in Seychelles during a meeting of health ministers from Small Island Developing States who expressed commitment to implement the program, particularly for medicines for non-communicable diseases.

The countries of Guinea-Bissau and Madagascar joined later.

“We must admit that it has been a long and tedious effort, and I commend the contributions of past and present Ministers and their teams for the dedication in creating an enabling environment for this mechanism to be launched,” concluded Dr. Moeti.

Vax-Before-Travel publishes research-based travel medicine ad vaccine news.

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African Small Island Developing States agree to collectively purchase vaccines and medicines

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Low Vaccination Rates Fueled NYC’s Last Measles Outbreak

Don Hackett — Fri, 29 May 2020 17:18:46 +0000

Reviewer:

Transmission dynamics of and insights from the 2018–2019 measles outbreak in New York City: A modeling study

An analysis of the 2018-2019 measles outbreak in New York City (NYC), the largest such outbreak in the United States in nearly 30 years, identifies factors that made the outbreak so severe.

Furthermore, this new analysis published on May 27, 2020, highlights the prospective health risks to NYC’s children, as overall vaccination rates have diminished during the COVID-19 disease outbreak.

As of May 15, 2020, the Vaccine Tracking System indicates a notable decrease in orders for measles-containing vaccines.

This decline began the week after the COVID-19 national emergency was declared on March 13, 2020.

Using a model inference system, these researchers reconstructed in detail the transmission dynamics of the measles outbreak in an Orthodox Jewish community in NYC from October 2018 to July 2019.

Using model simulation and the posterior estimates from the model inference system, we are also able to estimate the impact of vaccination campaigns implemented during the outbreak, including numbers of infections and hospitalizations averted.

This analysis estimated that around a quarter of young children aged 1 to 4 in the affected community were susceptible at the onset of the outbreak, likely due to delayed vaccination.

Specifically, 94 percent (101 of 108) of the early measles infections in children were those who were unvaccinated.

In contrast, the vaccination rate remained high in older children 5 to 17 years, with an estimated 94 percent immune to measles.

This difference may be due to better compliance with vaccination regulations, such as at school entry.

Nevertheless, this observation highlights the importance of vaccination compliance with both of the Measles-Mumps-Rubella (MMR) vaccine doses, especially given the long lag-time between the doses.

In addition, recommending the 2nd MMR vaccine dose earlier than the currently scheduled age 4 to 6 years could allow parents to fully vaccinate their children sooner and reduce the number of susceptible children overall.

This study also reveals the intricate interplay of population dynamics and measles transmission.

While the high susceptibility in children under 4 was likely responsible for the early spread of measles, the estimates suggest that the second and more severe part of the outbreak in 2019 was likely due to increased infectious contact (lack of social distancing) among this age group.

In addition, the intensified measles outbreak affected not only children with delayed vaccination but also a large number of infants under 1, who were too young to receive their 1st dose of MMR vaccine in the United States.

At least 100 infants under 1 were infected with measles during the 10-month outbreak period, despite extensive infection and transmission control efforts, including vaccinating infants 6 months or older and postexposure prophylaxis with immune globulin given to those under 6 months.

This was largely a result of the high susceptibility, and low natural immunities, in infants.

In addition, the simulations suggest that, without the vaccination campaigns, the number of infections in infants could have been over 10 times higher than observed.

These findings demonstrate the rippling effects of vaccine hesitancy beyond the risk posted to age-eligible children with delayed vaccination.

In summary, these researchers said ‘Our model simulations, consistent with many previous studies, demonstrate the significant public health impact of vaccination in controlling measles outbreaks.’

‘Without the implemented vaccination campaigns, the severity of the measles outbreak, including the number of infections, hospitalizations, and severe infections needing intensive care, could have been over 10x worse than observed.’

The study was funded by a grant from the National Institute of Allergy and Infectious Diseases (AI145883). No conflicts of interest were disclosed.

Measles vaccination news published by PrecisionVaccinations.

Sub Title:

Pediatric under vaccinations can lead to disease outbreaks in 2021

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Low Vaccination Rates and 'Measles Parties' Fueled 2019 Measles Outbreak in NYC

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