Kristine%20Sheedy,%20PhD - PowerPoint PPT Presentation

Title: Kristine%20Sheedy,%20PhD


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The Importance of Effective Vaccine Communication

• Kristine Sheedy, PhD
• Associate Director for Communication Science
• National Center for Immunization and Respiratory
  Diseases

VICNetwork 2011 Virtual Immunization
Symposium May 25, 2011

• National Center for Immunization Respiratory
  Diseases

• Office of the Director

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Comparison of 20th Century Annual Morbidity and
Current Morbidity Vaccine-Preventable Diseases
Disease 20th Century Annual Morbidity 2009 Reported Cases Percent Decrease
Smallpox 29,005 0 100
Diphtheria 21,053 0 100
Measles 530,217 61 gt 99
Mumps 162,344 982 99
Pertussis 200,752 13,506 93
Polio (paralytic) 16,316 0 100
Rubella 47,745 4 gt 99
Congenital Rubella Syndrome 152 1 99
Tetanus 580 14 98
Haemophilus influenzae 20,000 243 99
Source JAMA. 2007298(18)2155-2163
Source CDC. MMWR January 8, 201058(51,52)1458
-1468. (provisional, 2009 week 52 NNDSS data)
25 type b and 218 unknown (lt 5 years of age)
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Vaccines Routinely Recommended for Children and
Adolescents
1985
1995
2006
Measles Rubella Mumps Diphtheria Tetanus Pertussis
Polio Hib (infant) HepB Varicella
Measles Rubella Mumps Diphtheria Tetanus Pertussis
Polio Hib (infant) Hepatitis B Varicella Pneumoc
occal disease Influenza Meningococcal
disease Hepatitis A Rotavirus HPV
Measles Rubella Mumps Diphtheria Tetanus Pertussis
Polio
7
10
16
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Increasing Vaccine-Specific Coverage Rates Among
Preschool-Aged Children
2010 Target
DTP / DTaP(3)
Hep B (3)
PCV 7 (4)
MMR(1)
Polio (3)
Rotavirus (3)
Hib (3)
Varicella (1)
0.6 of toddlers had received no vaccines at all
Source USIS (1967-1985), NHIS (1991-1993) CDC,
NCHS, and NIS (1994-2009), CDC, NIP and NCHS
No data from 1986-1990 due to cancellation of
USIS because of budget reductions.
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Estimated Return on Investmentof Childhood
Vaccines, United States, 2011

• For each birth cohort vaccinated against 13
  diseases in accordance with the childhood
  schedule for DTaP, Hib, IPV, MMR, hep B,
  Varicella, Hepatitis A, Pneumo-7, and Rotavirus
  vaccines
• 42,000 lives are saved
• 20M cases of disease are prevented
• 13.6 billion dollars in direct costs are saved
• 68.9 billion dollars in direct plus indirect
  (societal) costs are saved
• For each dollar invested in these vaccinations,
  10.20 is saved

• Preliminary results of updated analysis from Zhou
  et al, Arch of Ped and Adolesc Med 2005

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Confidence in Vaccine Safety
Percent of parents of at least one child 6 years
of age or younger who reported that they were
confident or very confident in the safety of
routine childhood vaccines
Percent
Year
Source PN HealthStyles and ConsumerStyles
Surveys
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The Good News

• Protect children from 16 VPDs
• Record low rates for most VPDs
• Record high toddler immunization rates
• Less than 1 zero dose children
• Several newer vaccines in routine use
• Narrowing racial and economic disparities
• Generally a high level of confidence in vaccine
  safety

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Less Disease and More Vaccines More Attention
to Vaccine Risks

• Low disease awareness increased focus on
  vaccine risks
• Low tolerance for vaccine risks
• Full and complicated immunization schedule

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Highly Concerned Parents seem to Cluster
Geographically
Smith, P, Chu, S, Barker L. Children who have
received no vaccines Who are they and where do
they live? Pediatrics, 2004 114187-195.

• Although lt 1 of all children have received no
  vaccines, these children cluster geographically
  and increase the risk of transmitting
  vaccine-preventable diseases to others in their
  communities
• Zero-dose children tend to have higher SES and
  are frequently source cases in VPD outbreaks

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Measles 2008

• Highest number of reported cases/year since 1996
• No increase in imported cases
• Increase in spread within the U.S.
• 7 outbreaks
• Parent vaccine refusal common

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Measles ImportationsUnited States, 2011

• 98 measles cases reported to date in 2011
• Importations into gt 20 states from 12-15
  countries
• gt 10 from France
• 8 outbreaks (3-21 cases)

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Slide Courtesy of Kathleen Winter, Source
California Department of Public Health
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Multiple Factors Can Lead to Vaccine-Preventable
Disease Increases

• Failure to vaccinate (e.g., due to access,
  supply, acceptance)
• Accumulation of unvaccinated susceptible persons
  permits infectious agent to spread (e.g., measles
  outbreaks in 2008)
• Waning immunity following childhood vaccination
• Pertussis rise in CA 2010
• Less than optimal vaccine effectiveness and high
  force of infection
• Mumps (Midwest universities 2006, NE religious
  schools 2010)
• Change in circulating strains
• Pneumococcal infectious caused by nonvaccine
  types

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Which concerns, if any, do you have about
childhood vaccines?
Many Parents Have Questions and Concerns
  2010 Weighted
It is painful for children to receive so many shots during one doctors visit. 38
My child getting too many vaccines in one doctors visit. 36
Children get too many vaccines in the first two years of life. 34
Vaccines causing fevers in my child. 32
Vaccines may cause learning disabilities (such as autism). 30
Preliminary results from PN HealthStyles and
ConsumerStyles Surveys
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What are the three most important sources of
information that have helped you make decisions
about your youngest childs vaccinations?

• Childs healthcare provider, such as a doctor
  or nurse (85)
• Family (46)
• American Academy of Pediatrics (28)
• CDC (26)
• Internet (24)

Preliminary results Health Styles 2010, parents
of children lt6
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2009 Focus Groups Vaccine Schedule and Timing

• Mothers were generally knowledgeable about the
  timing of vaccines
• Many reacted negatively to receiving multiple
  injections during one visit
• Most were vaccinating according to the
  recommended schedule, but several across
  race/education/location segments reported
  (generally short-term) spreading vaccinations
• Variety of reasons for spreading concerns about
  childrens ability to handle multiple vaccines
  concerns about ability to pinpoint source of
  adverse events some concerns about pain

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2009 Focus Groups VPD Knowledge and Beliefs

• After reading brief descriptions of the 14 VPDs,
  many mothers said they were surprised to find out
  how many could be fatal, including some they
  previously did not consider serious
• Many mothers shared personal stories that
  impacted their view of particular VPDs
• Some knew a baby who had whooping cough
  (heightened their perception of severity)
• Most talked about their own experience with flu
  or chickenpox (lessened their perception of
  severity)

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www.cdc.gov/vaccines/conversations
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Websites

• Provider Resources for Vaccine Conversations with
  Parents
• www.cdc.gov/vaccines/conversations
• Give Feedback on Provider Resources
• www.cdc.gov/vaccines/tellus
• Health Care Professional Home Page
• www.cdc.gov/vaccines/hcp
• Get the Picture Childhood Video
• www.youtube.com/user/CDCStreamingHealth

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Thank youksheedy_at_cdc.gov