1. Update on the Nation’s Immunization
National Immunization Conference
Kansas City, Missouri—March 5, 2007
Update on the Nation’s Immunization
Anne Schuchat, MD
Rear Admiral, US Public Health Service Director, National Center for Immunization and Respiratory Diseases
Centers for Disease Control and Prevention Atlanta, GA

3. Today 11,000 babies will be born in US
17 diseases are now vaccine-preventable
3 new vaccines in last year alone
Rotavirus
Human Papilloma Virus
Shingles

4. In Dreams Begin Responsibilities
Delmore Schwartz

6. Eliminating Racial Disparity in Immunization Coverage 4:3:1:3:3:1 Vaccination Coverage Month Olds, United States
National Immunization Survey, MMWR Sept 14, 2006

7. Increasing Vaccine-Specific Coverage Rates Among Preschool-Aged Children
2010 Target
DTP(3+)†
Hep B (3+)
PCV 7 (3+)
MMR(1+)
Polio (3+)
Hib (3+)
Varicella (1+)
2005
† DTP(3+) is not a Healthy People 2010 objective. DTP(4) is used to assess Healthy People 2010 objectives.
Note: Children in the USIS and NHIS were months of age. Children in the NIS were months of age.
Source: USIS ( ), NHIS ( ) CDC, NCHS, and NIS (1994-December 2003), CDC, NIP and NCHS; No data from due to cancellation of USIS because of budget reductions.

8. VMBIP Goes Live!

9. Monitoring Vaccine Safety
October 14, 2005
April 7, 2006
October 20, 2006

10. Parotitis initially may be unilateral, with swelling of the other gland 2-3 days later. The swelling usually peaks and resolves within about 7-10 days. Although this looks alarming, long term sequelae of mumps parotitis are rare.
However, serious complications of mumps can occur without evidence of parotitis.
OUTBREAK !

11. Mumps Cases by Week of Onset, United States, Jan 1– Sept 9, 2006 (n=5594)
National Notifiable Diseases Surveillance System (data provisional)

12. Human H5N1 Avian Influenza Cases and Deaths since 2003
Source: World Health Organization
Cumulative: as of 2/27/2007

13. Influenza Vaccine Production and Distribution, US, 1980-2005
Year
Doses Produced (millions)
Doses Distributed (millions)
1980
15.7
12.4
1985
23.1
20.1
1990
32.3
28.3
1995
71.5
54.9
1999
77.2
76.8
2000
77.9
70.4
2001
87.7
77.7
2002
95.0
83.0
2003
86.9
83.1
2004
61.0
56.5
2005
86.0
81.2
Produced Distributed % % % % % % % % % % %
sanofi: 50 m
Chiron: 40 m
GSK: 7-9 m
MedImmune: 3 m m
IDB: m

14. Influenza Vaccine Production and Distribution, US, 1980-2005
Year
Doses Produced (millions)
Doses Distributed (millions)
1980
15.7
12.4
1985
23.1
20.1
1990
32.3
28.3
1995
71.5
54.9
1999
77.2
76.8
2000
77.9
70.4
2001
87.7
77.7
2002
95.0
83.0
2003
86.9
83.1
2004
61.0
56.5
2005
86.0
81.2
2006/7 Vaccine Season: 102 million doses
Largest Number Ever Distributed
Produced Distributed % % % % % % % % % % %
sanofi: 50 m
Chiron: 40 m
GSK: 7-9 m
MedImmune: 3 m m
IDB: m

15. Cumulative Monthly Distribution of Influenza Vaccine, 2000 – 2006/7 (01/12/2007)
102.5 83
81.2
Doses (Millions)
This graph, produced by Greg Wallace at CDC, shows the timing of influenza vaccine distribution by month for 2000, 2002, 2004, and The white dotted oval will help you to focus on the month of October, a time when vaccination activities are solidly underway and when delays in vaccine arrival begin to become increasingly problematic.
The light blue line represents 2000, a season in which there was a delay that resulted in only about 30% of doses being delivered by the end of October. In contrast, the orange line represents 2002, a season in which nearly 100% of doses were distributed by the end of October.
The most recent season, shown in yellow, falls somewhat between 2000 and 2002 in terms of vaccine availability during October.

16. National Influenza Vaccination Week
November 27 – December 3, 2006

17. Do you know where your children are?
ITS 10 O’CLOCK
Do you know where your children are?

18. Increased Participation in Immunization Information Systems
Percent

20. 4:3:1:3:3 Coverage by Insurance Status
19-24 mo old children, NIS
PJ Smith et al, Pediatrics, 2006; 117:

21. Estimated Vaccination Coverage with 3+ PCV
Estimated Vaccination Coverage with 3+ PCV*, by Coverage Level and State National Coverage = 83% 84 85 81 87 82 73 90 89 83 79 70 80 86 78 66 88 75 77 76 54
VT 89 NJ CT MA NH RI DC DE MD 87 95 94 91 82 83 77 85
 90%
80-89%
70-79%
 69%
* 3+ doses Pneumoccocal Conjugate vaccine
Source: National Immunization Survey 2005

23. Federal Contract Prices for Vaccines Recommended Universally for Children and Adolescent Girls 1985, 1995, 2006
$1182
$155
$45
Federal contract price shown for 1985 and 1995 are averages that account for price changes within that year.

25. State HPV Vaccine Legislation, 2007

26. For Girls Only…
HPV vaccine is first routine vaccine in US recommended only in girls or women
Targets HPV types linked to 70% of cervical cancer

28. Kyaw M et al, New Engl J Med 2006;354:14.
Decreased Invasive Pneumococcal Disease Caused by Both Penicillin Nonsusceptible and Susceptible Strains, Children <2 years,
Pen S
Vaccine Introduced
Pen NS
Kyaw M et al, New Engl J Med 2006;354:14.

29. Decreased Incidence of IPD Caused by
Penicillin Nonsusceptible Pneumococci in
Persons 2 yrs or older, 1996 to 2004
Kyaw M, et al. New Engl J Med 2006;354:14.

30. Poliovirus Spread, 2003-2006 25 countries, 71 events
Number of importations from India viral origin: 13 (18%)
Number of importations from Nigeria viral origin: 58 (82%)
Wild virus type 1
Wild virus type 3
Wild virus type 1 & 3
Endemic countries
Case or outbreak following importation (last 6 months)
Case or outbreak following importation ( months)
Data in HQ as of January2007

31. Sleepless in Seattle

33. mmunization I I
nformation I
nspiration

34. Thank you! THEN NOW Smallpox 48,164 Diphtheria 175,885 Measles 503,282
Diphtheria
175,885
Measles
503,282 66
Mumps
152,209
314
Pertussis
147,271
25,616
Polio (paralytic)
16,316 1
Rubella
47,745 11
Congenital Rubella
Syndrome
823
Tetanus
1,314 27
Hepatitis A
117,333
19,183
Hepatitis B (acute)
66,232
15,352
H. influenzae
20,000
226
Pneumococcus (inv.)
All ages
63,067
40,325
< 5 y/o
16,069
4,400
Varicella
4,085,120
817,024
Thank you!