Vaccine Information

 

Latest recommendations from Centers for Disease Control and Prevention and the World Health Organization for Infection Control in Healthcare Facilities (5/19/06)

DCHHS Answers FAQs about Influenza Pandemic Response

Join Immunize Kids! Dallas Area Partnership

Are Vaccines Safe?

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Latest recommendations from Centers for Disease Control and Prevention
and the World Health Organization for Infection Control in Healthcare Facilities (5/19/06)

Recommendations for Avian Influenza

All patients who present to a healthcare setting with fever and respiratory symptoms should be managed according to recommendations for Respiratory Hygiene and Cough Etiquette and questioned regarding their recent travel history.

Patients with a history of travel within 10 days to a country with avian influenza activity and who are hospitalized with a severe febrile respiratory illness, or who otherwise are under evaluation for avian influenza, should be managed using isolation precautions identical to those recommended for patients with known Severe Acute Respiratory Syndrome (SARS). These include:

Standard Precautions

• Pay careful attention to hand hygiene before and after all patient contact or contact with items potentially contaminated with respiratory secretions.

Contact Precautions

• Use gloves and gown for all patient contact.
• Use dedicated equipment such as stethoscopes, disposable blood pressure cuffs, and disposable thermometers.

Eye protection (i.e., goggles or face shields)

• Wear when within 3 feet of the patient.

Airborne Precautions

• Place the patient in an airborne isolation room (AIR). Such rooms should have monitored negative air pressure in relation to corridor, with 6 to 12 air changes per hour (ACH), and exhaust air directly outside or have recirculated air filtered by a high-efficiency particulate air (HEPA) filter. If an AIR is unavailable, contact the healthcare facility engineer to assist or use portable HEPA filters (see Environmental Infection Control Guidelines) to augment the number of ACH.
• Use a fit-tested respirator, at least as protective as a National Institute of Occupational Safety and Health (NIOSH)-approved N-95 filtering facepiece (i.e., disposable) respirator, when entering the room.

For additional information regarding these and other healthcare isolation precautions, see the Guidelines for Isolation Precautions in Hospitals. These precautions should be continued for 14 days after onset of symptoms or until either an alternative diagnosis is established or diagnostic test results indicate that the patient is not infected with influenza A virus. Patients managed as outpatients or hospitalized patients discharged before 14 days with suspected avian influenza should be isolated in the home setting on the basis of principles outlined for the home isolation of SARS patients (see http://www.cdc.gov/ncidod/sars/guidance/i/pdf/i.pdf).

CDC notes that it is revising its interim guidance for infection control precautions for avian influenza.

http://www.cdc.gov/flu/avian/professional/infect-control.htm

For WHO recommendations as of April 24, 2006, go to http://www.wpro.who.int/NR/rdonlyres/EA6D9DF3-688D-4316-91DF-5553E7B1DBCD/0/InfectionControlAIinhumansWHOInterimGuidelinesfor2.pdf

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Dallas County Health and Human Services Answers FAQs
about Influenza Pandemic Response

February 3, 2006 – Recent discussions and media reports about Avian influenza (bird flu) have increased public interest in and concern about what would happen should a pandemic influenza hit Dallas County. Dallas County Health and Human Services continues to prepare for public health emergencies such as a pandemic flu. “We want the citizens of Dallas County to know that Dallas County Health and Human Services is at the forefront of nationwide public health preparedness efforts,” said Zachary Thompson, DCHHS director. “We continually work to address the health challenges ahead to ensure the health and safety of all residents in the event of any natural or manmade disaster.”

To help educate the public about DCHHS response to an influenza pandemic, the agency has developed this list of FAQs:

1. What is Dallas County Health and Human Services doing to prepare and respond to an influenza pandemic?

DCHHS has developed the capacity to rapidly identify individuals who have the pandemic flu strain. DCHHS also has the capacity to conduct intensive hospital surveillance, document the number of cases occurring each day, and forecast the likely number of cases. Forecasting the effects of a pandemic on Dallas County is a result of several activities. First, the effects of past pandemics are extensively researched. Next, the current disease transmission that occurs during the regular seasonal influenza is studied. This information is compiled using mathematical modeling and computer software programs to give predictions. DCHHS also remains up-to-date as to the global condition and number of human cases occurring elsewhere.

2. What is Dallas County Health and Human Services doing to inform the public about the threat of an influenza pandemic?

DCHHS is actively involved in efforts to prepare and educate municipalities, hospitals, first responders, schools, faith-based organizations, and many nongovernmental agencies and service providers regarding the potential impact of an influenza pandemic. As part of our ongoing efforts to prepare for public health emergencies, DCHHS is hosting a pandemic influenza symposium and table-top exercise, launching public education campaigns, and conducting a series of presentations to organizations including area hospitals, healthcare providers, business community leaders, and government officials.

3. What are some public health recommendations that would be made during an outbreak?

Vaccines or antiviral medications may be in limited quantities or not available if a pandemic occurs in the near future. Therefore, public health control measures are likely to remain the fundamental cornerstone in the attempts to control disease spread. Such measures may include:

Limiting person-to-person transmission by:

• Isolating the ill
• Closing schools and day cares
• Closing all businesses, except for essential infrastructure staffed by minimum personnel required
• Closing public transportation
• Canceling public gatherings such as theaters, sporting events, movies, concerts, church services, museums, and conventions
• Issuing voluntary shelter-at-home orders for the entire population, similar to snow days

Avoiding exposure when in public places:

• Limitation of all close personal contact
• Frequent hand washing
• Regular use of a mask

4. What impact would an influenza pandemic have on Dallas County?

We cannot predict with certainty what impact a pandemic may have or even whether one will occur. However, DCHHS has analyzed past pandemics in order to forecast what could happen in Dallas County if another pandemic were to occur. Should a pandemic similar to the one in 1918 happen, public health and other systems would be severely affected. The impact of illness may restrict travel, which could significantly reduce the delivery of goods and services. Second, the number of sick individuals may over-run hospital capacities, requiring alternative methods of care. Third, significant reductions in the workforce could be expected due to illness and isolation recommendations; thus, every business, large and small, should have a business continuity plan in place.

5. What can the public do to prepare for an influenza pandemic or other public health emergency?

First, DCHHS encourages everyone to follow good health habits to help prevent the spread of seasonal influenza and other diseases and to teach these habits to children:

• Avoid close contact with people who are sick.
• Stay home or avoid close contact with others when you are sick.
• Cover your mouth and nose when coughing or sneezing.
• Wash your hands with soap and water or alcohol-based hand sanitizer often, especially after using the restroom and before eating.
• Avoid touching your eyes, nose, or mouth.

Secondly, DCHHS urges everyone to develop a preparedness plan for their homes and workplace. In some emergencies, such as pandemic influenza, the public may be asked to shelter at home. To shelter at home, each household needs to stock six basic supplies: water, food, first-aid supplies, clothing, bedding, tools, emergency supplies, and special items. DCHHS recommends that you have a two-week supply of each item for every person in your home. Suggested guidelines for the items you will need to prepare your home for an emergency event are available on the DCHHS website at www.dallascounty.org.

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Join Immunize Kids! Dallas Area Partnership

To help in the fight to increase the Dallas immunization rate, join DCMS and numerous other healthcare community service organizations in Immunize Kids! Dallas Area Partnership. The coalition has actively promoted childhood immunizations for more than a decade. Since its inception, childhood immunization rates in Dallas County have risen from 34% to 68.9%.

The coalition reaches thousands of children every year through projects and events. It educates parents, the community at large, and medical professionals about the importance of immunizations through outreach events, flyers, brochure distribution, and seminars for professionals.

Each April, the coalition develops a comprehensive plan to promote National Infant Immunization Week. In September, parents and their fully immunized children will be rewarded at a Birthday Party for 2-Year-Olds.

For more information about Immunize Kids! Dallas Area Partnership, contact Janet Stoufflet at metro (817)417-4164 or jstoufflet@comcast.net.

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Are Vaccines Safe?

Whether we realize it or not, we're all gamblers. There are risks in even the most routine activities:

• We take a bath, even though every year in the United States about 350 people are killed in bath-related accidents.
• We eat breakfast, even though every year about 200 people are killed when food lodges in their windpipe.
• We walk outside on a rainy day, even though every year about 100 people are struck and killed by lightning.

We do these things because we think that the odds are heavily in our favor. We are willing to take small risks to enjoy large benefits. If we wanted, we could avoid many of these risks by simply staying in our home, living in a protective bubble, eating carefully prepared soft foods, and having armed guards at our door. However, with the possible exception of Howard Hughes, few people are willing to do this.

But of course there are other risks that are easier to lessen. Every day we are at risk of catching viral or bacterial infections. For many types of infections, the risks are actually quite high. For example, it is estimated that children less than 6 years old will have an average of six to eight infections every year. This is where vaccines come in. Vaccines are examples of taking small risks (side effects from the vaccine) to enjoy large benefits (avoidance of permanent disabilities or death caused by infection).

The question for vaccines is, "Do the benefits outweigh the risks?"

The answer to the question "Are vaccines safe?" depends on how you define the word safe. If you define safe as completely free of any possible negative side effects, then the answer is no. But nothing is completely safe (not even money).

The better question is "Do the benefits of vaccines (avoiding infections) outweigh their risks (side effects)?" To answer this question you need three pieces of information:

1. What are the chances of catching a particular infection?
2. What are the risks of side effects from a particular vaccine?
3. How effective is the vaccine in preventing disease?

Excerpt from "Vaccines: What Every Parent Should Know" by Paul A. Offit, MD & Louis M. Bell, MD, 1999 (reprinted with permission of Paul A Offit, Chief of Infectious Diseases at The Children's Hospital of Philadelphia.)

For further information contact: Paul A. Offit, MD 215-590-2020

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