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Vaccine Developments

The Advisory Committee on Immunization Practice (ACIP) has approved several new vaccines recently:

1. Tdap (Tetanus Toxoid, Reduced Diptheria Toxoid, and Acellular Perussis) was approved for use in adolescents and adults.This primarily represents a significant step to boosting immunity to pertussis for these age groups in which immunity to pertussis significantly wanes after childhood immunization.

2. HPV vaccine (Gardisil) was approved for use in adolescent and young women for prevention of human papilloma virus infection which is the causative agent of most cases of cervical cancer .

3. Zoster vaccine (Zostavax) was approved for prevention of herpes zoster (shingles) in persons 60 years of age or older. This vaccine was shown to be up to 64% effective in preventing shingles in persons aged 60-69 though it was less effective in persons older.

The ACIP has also issued its influenza immunization guidelines for the 2008-2009 flu season.

Methicillin Resistant Staphylococcus aureus - MRSA

A study published in the Journal of the American Medical Association (JAMA Oct 17, 2007) gives new insight into the incidence of invasive Methicillin Resistant Staphylococcus aureus infections in the United States. Epidemiological data were collected through the Emerging Infections Program Network at nine geographic locations across the United States in the period July 2004 to December 2005. In that interval in those locations 8987 cases of invasive MRSA infection were idenitified including 1598 deaths. Extrapolation of these data to the entire U.S. population allowed estimates of 94,360 cases of invasive MRSA and 18,650 deaths in 2005.

These data acquired by active surveillance revealed higher incidence rates of invasive MRSA infections than had been suggested by previous estimates based on hospital discharge diagnosis codes. Eighty-five percent of cases were healthcare associated, the remainder without obvious healthcare association. Incidence rates varied in different geographic areas, and invasive disease occurred more commonly in those aged greater than 65, blacks, and males.

This data were for invasive MRSA infections (as opposed to skin and soft tissue infections) and, as mentioned, included data from nine largely urban centers (representing 5.6% of the total U.S. population). Authors of the study noted that these data may not reflect true national MRSA incidence and that estimates of death were related to crude (all cause) rather than attributable (MRSA) mortality.