vaccination

Mandatory Flu Vaccine for all Healthcare Professionals, and More

Mandatory Flu Vaccination for HCPs

The American Academy of Pediatrics has reaffirmed its call for mandatory influenza vaccination for all healthcare personnel (HCP) in a new policy statement.

“Many individuals at high risk of influenza and its associated complications are in frequent, close contact with HCP because of their need to seek medical services. Therefore, immunization of HCP is a crucial step in efforts to protect those at risk of health care-associated influenza,” they wrote.
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The statement notes that mandatory immunization of HCPs has also been recommended by other organizations including the CDC, American Academy of Family Physicians, the American Hospital Association, and the Infectious Disease Society of America.

To ensure the success of the program, they recommend:

  • Making the vaccination free to all HCPs
  • Using a universal form defining accepted medical exemptions to vaccination
  • Creating a clear institutional policy for the management of exempted employees
  • Offering convenient vaccine education and administration, preferably in-house.

“HCP fail to lead by example if they recommend universal influenza immunization to their patients, but do not require it of themselves. To prevent and control influenza, the health and safety of patients must be the top priority,” they concluded.

Shingles Vaccine

The shingles vaccine is not cost-effective for adults in their 50s and should not be recommended to patients in this age group, according to a recent study.

While the shingles vaccine is licensed for patients over 50 years old, the Advisory Committee on Immunization Practices doesn’t recommend the vaccine until age 60.

In order to evaluate the cost-effectiveness of the shingles vaccine in patients 50-59 years old, researchers conducted a meta-analysis of several US-based studies, finding that for every 1000 individuals who received the vaccine at 50 years, 25 cases of shingles were prevented. This produced an incremental cost-effectiveness ratio of $323,000 per quality-adjusted life-year, which was 3 times the amount considered “reasonable”.

“Herpes zoster vaccine for persons aged 50 years does not seem to represent good value according to generally accepted standards. Our findings support the decision of the Advisory Committee on Immunization Practices not to recommend the vaccine for adults in this age group,” they concluded.

Updated Pneumococcal Vaccine Recommendations

The CDC’s Advisory Committee on Immunization Practices has recommended changing the interval between administration of the 13-valent pneumococcal conjugate vaccine (PCV13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23) from 6-12 months to ≥1 year in immunocompetent adults 65-years-old and over.

The new recommendations are based on findings suggested that longer times between administration of vaccines may increase immune responses.

“For immunocompetent adults aged ≥65 years who have not previously received pneumococcal vaccine, ACIP makes the following recommendation for intervals between PCV13 followed by PPSV23: A dose of PPSV23 should be given ≥1 year following a dose of PCV13. The 2 vaccines should not be co-administered. If a dose of PPSV23 is inadvertently given earlier than the recommended interval, the dose need not be repeated.”

—Michael Potts

References:

  1. AAP. AAP: Mandatory flu immunization of health care workers ethical, necessary [press release]. September 7, 2015.  http://aapnews.aappublications.org/content/early/2015/09/07/aapnews.20150907-2.
  2. Le P, Rothberg MB. Cost-effectiveness of herpes zoster vaccine for persons aged 50 years. Ann Intern Med. September 8, 2015 [epub ahead of print]. doi:10.7326/M15-0093.
  3. CDC. Intervals between PCV13 and PPSV23 vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). [press release]. September 4, 2015. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6434a4.htm?s_cid=mm6434a4_w.