Real World Health Care Blog

Tag Archives: vaccination

Get Your Flu Shot Now to Stay Healthier Later

So you think you’re too busy to get your flu shot? It’s easy to put off, but taking the time to do it sooner rather than later could prevent you from getting sick while helping to protect those you care about – during the holidays and beyond. That’s why the U.S. Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention (CDC), state and local health departments as well as other health agencies are raising visibility around National Influenza Vaccination Week (NIVW), from Dec. 8-14.

Paul DeMiglio

Paul DeMiglio

With the flu season beginning in the fall and not peaking until January-February, it’s certainly not too late to get your influenza shot. In fact, the CDC’s Advisory Committee on Immunization Practices recommends that everyone 6 months of age or older receive it, including:

  • Children
  • Seniors 65 and older
  • Pregnant women
  • American Indians and Alaska Natives
  • Those with underlying health conditions like asthma
  • Those living with conditions including chronic lung disease, heart disease, HIV/AIDS, cancer and diabetes

Although the effectiveness of flu vaccination varies each year, the CDC reports that recent studies demonstrate the evidence-based public health benefits. The Mayo Clinic agrees, calling flu shots your best defense against the flu, enabling “your body to develop the antibodies necessary to ward off influenza viruses.”

“The single best way to protect against the flu is to get vaccinated each year,” said CDC’s Anne Schuchat, M.D., Director, National Center for Immunization and Respiratory Diseases. “Today, flu vaccines are available in more convenient locations than ever. The few minutes it takes to get a flu vaccine can save you from experiencing several unproductive days due to influenza. The most common side effects are mild and short-lasting, especially when compared to symptoms of influenza infection.  Flu vaccine cannot cause flu illness.”

Despite evidence that the influenza vaccine is an effective tool, some still fear that getting their shot might put them at risk for experiencing severe side effects. No more than one or two cases per million people vaccinated acquire Guillain-Barré syndrome, an outcome much lower than the risk of developing severe complications from influenza. From 1976-2006, in fact, estimates show that far more people died from flu-associated deaths in the U.S. (3,000-49,000) than from negative reactions to the vaccines that protect against influenza.

To build awareness and support of NIVW and encourage people to get their shots, the CDC is making a rich variety of online tools and resources available to a wide spectrum of patients, educators and providers, such as:

Partnering with Reckitt Benckiser, Inc., the makers of LYSOL® Brand Products, the CDC is also spotlighting the Ounce of Prevention Campaign, which seeks to empower consumers and professionals with practical tips and information around effective hand hygiene and cleaning habits to prevent infectious diseases like the flu.

Click here to see if the vaccine is available in your area. To find a nearby location to get the vaccine, check out HHS’s “Flu Vaccine Finder” on Flu.gov, enter your ZIP code and share the widget to let your family members, colleagues and friends know where they can go too. HHS also provides a series of informative YouTube videos that cover prevention strategies, share tips for identifying symptoms and provide recommended treatment practices.

You can also make a powerful statement by taking the pledge to get vaccinated for the 2013-14 season, commit to taking a friend with you and in the process spread the word by clicking here. To get the latest updates on flu vaccination efforts, follow the CDC on Twitter (@CDCFlu and @CDCgov) and “like” them on Facebook.

Now tell us if you’ve gotten your flu shot. Where did you go? How long did it take? What ways could providers and health care stakeholders more effectively remind patients to get vaccinated?

Targeted Therapies Open Door to Improved Outcomes and Lower Costs to Treat HCV

As we were reminded on World Hepatitis Day, early detection is critical to turning the tide of this “silent epidemic” that impacts millions. However, strategies to end the deadly effects of viral hepatitis don’t stop there. Personalized treatment is another essential tool that fuels better outcomes for patients with hepatitis C (HCV) while saving money in the long term for the health care system too. 

Paul DeMiglio

Paul DeMiglio

The importance of finding effective therapies for HCV is underscored by the reality that the disease often goes undetected, with an estimated 80 percent of Americans with HCV unaware of their status. Many HCV-positive people show mild to no symptoms, making it more likely for the illness to progress and become more expensive to treat as a result. 

Although safe and effective vaccines are available for hepatitis A and B, none exist for HCV. To help answer this need, Abbott created the fully automated RealTime HCV Genotype II Test – the first FDA-approved genotyping test in the United States for HCV patients – to facilitate targeted diagnosis and treatment that boosts desired outcomes.

This treatment-defining genotyping test empowers physicians to better pinpoint specific strains of HCV, determine which treatment option is best for the patient, and make more informed recommendations about when it should be administered. Available to individuals with chronic HCV, the test is not meant to act as a means to screen the blood prior to diagnosis.

So how does finding the right HCV treatment save money?

Targeted therapies like these are important for diseases like HCV because they reduce the “trial and error” of having to use additional treatments when the initial ones don’t work, saving money and time for patients and providers. Early detection, combined with follow-up care, can prevent patients from developing later stages of hepatitis that can mean more serious long-term conditions that are harder and more expensive to treat.

Treating HCV patients with end-stage liver disease, for example, is 2.5 times higher than treating those with early stage liver disease. Advanced HCV can also escalate to chronic hepatitis infection, a side effect of this being cirrhosis (scarring of the liver and poor liver function) and liver cancer. Treatment for these two conditions (which can include a liver transplant) can cost more than $30,000. Liver cancer treatment can be more than $62,000 for the first year, while the first-year cost of a liver transplant can be more than $267,000.

As more and more patients find themselves unable to afford treatments, HCV is becoming an increasingly larger financial burden on the health care system.

The annual costs of treating HCV in the United States could be up to $9 billion, and over the course of a lifetime the collective cost associated with treatments for chronic HCV is estimated to total $360 billion.

“As we see patients with more advanced liver disease, we see significantly more costs to the system,” says Dr. Stuart Gordon, author of the Henry Ford Study. “The key, therefore, is to treat and cure the infection early to prevent the consequences of more advanced disease and the associated economic burden.”  

Targeted therapies show great promise to improve outcomes while saving time and money by linking patients to the specific treatments they need at earlier points of diagnosis. But what can health systems do to make innovations like the HCV Genotype II Test accessible to more patients and increase the cost-savings benefit on a larger scale?

World Hepatitis Day Spotlights Importance of Early Detection to Improve Prevention and Treatment Strategies

This Sunday, July 28, is World Hepatitis Day, an observance that reminds us that hepatitis (inflammation of the liver) remains largely unknown as a major health threat. Approximately half a billion people worldwide and 4.4 million people in the U.S. live with chronic viral hepatitis, with one million deaths resulting from the disease each year.

Linda Barlow

Linda Barlow

The goal of World Hepatitis Day is to move from awareness to action to address the “silent epidemic” of viral hepatitis – so named because most people don’t experience symptoms when they first become infected, often not until they develop chronic liver disease many years later.

Stakeholders in government and private industry are stepping up to answer the call, supporting early detection and medical intervention as key starting points to effectively address the epidemic.

Earlier this month, Quest Diagnostics announced a partnership with the CDC to improve public health analysis of hepatitis C screening, diagnosis and treatment for the 3.2 million Americans living with it. Under the collaboration, anonymous patient data will be evaluated to identify and track epidemiological trends in hepatitis C virus infection, testing and treatment and determine how those trends differ based on gender, age, geography and clinical management.

“Our collaboration with the CDC underscores the importance of using diagnostic information to derive useful insights enabling effective prevention, detection and management programs for diseases with significant impact on public health,” Jay Wohlgemuth, M.D., senior vice president, science and innovation, Quest Diagnostics, said in a statement.

Early detection was also the focus of a 2012 National Institutes of Health (NIH) study published in Proceedings of the National Academy of Sciences. In the study, researchers concluded that elevated blood levels of a specific enzyme and a specific protein early on in the course of hepatitis C infection were much more likely to develop into advanced fibrosis or cirrhosis. The study found:

  • The long-term course of chronic hepatitis C is determined early in infection.
  • Rapidly progressive disease correlated with persistent and significant elevations of alanine aminotransferase (ALT), an enzyme released when the liver is damaged or diseased.
  • Rapidly progressive disease correlated with persistent and significant elevations of the protein MCP-1 (CCL-2), a chemokine that is critical to the induction of progressive fibrogenesis and ultimately cirrhosis.

Armed with this information, clinicians are expected to make a fairly accurate assessment of which patients are likely to develop advanced disease rapidly. Instead of waiting for a new class of drugs to be approved, these patients are likely to be pressed to start treatment right away – with the goal of treating the virus before it causes cirrhosis of the liver.

Because hepatitis does not result in symptoms until serious liver damage occurs, getting tested is also crucial. In fact, the CDC recommends that everyone born from 1945-65 get a one-time test for hepatitis C because they are five times more likely than American adults in other age categories to be infected and face an increased risk of dying from hepatitis C-related illnesses.

The first FDA-approved hepatitis C genotype test is now available in the U.S. From Abbott, the fully automated Realtime HCV Genotype II test determines the specific type or strain of the HVC virus present in the blood of an HCV-infected individual.

To locate organizations where you can access services including Hepatitis testing, vaccines and treatment, click here. You can also take this 5-minute Hepatitis Risk Assessment to obtain a personalized report from the CDC.

Early awareness and prevention-based practices are crucial to avoiding hepatitis. But what else can be done to ensure access to and availability of reliable and cost-effective screening and diagnostics, in addition to safe and simple treatment regimens for people with the disease?

We hope this post serves as a resource for journalists covering or interested in writing stories about World Hepatitis Day and related issues. Also stay tuned for our follow-up post next week that will address the cost-savings implications of vaccination and early treatment of hepatitis.

HPV Vaccine Reduces Infection Rates in Teen Girls

Since the human papillomavirus (HPV) vaccine was introduced in 2006, vaccine-type HPV prevalence has decreased by 56 percent among females 14-19 years old, according to a new study published in The Journal of Infectious Diseases.

Linda Barlow

Linda Barlow

HPV is the most common sexually transmitted virus in the United States. Although the vast majority of HPV infections do not cause serious harm, some will persist and can lead to cervical cancer. Each year in the U.S., about 19,000 cancers caused by HPV occur in women.

“Unfortunately, only one-third of girls aged 13-17 have been fully vaccinated with HPV vaccine,” says CDC Director Tom Frieden, M.D., M.P.H. “Our low vaccination rates represent 50,000 preventable tragedies, which means 50,000 girls alive today will develop cervical cancer over their lifetime. This would be prevented if we reach 80 percent vaccination rates. For every year we delay in doing so, another 4,400 girls will develop cervical cancer in their lifetimes.”

Study author Markowitz notes that the decline in vaccine type prevalence could be due to factors such as “Herd” Immunity (also called “community immunity”), which occurs when most members of a community are protected against a contagious disease because a critical portion of the population has been immunized and the opportunities for an outbreak are reduced. “Herd” Immunity has been shown to control a variety of contagious diseases, including measles, mumps, rotavirus (MMR), influenza and pneumococcal disease.

Public health experts recommend routine HPV vaccination at ages 11-12 for both boys and girls. A series of three shots is recommended over six months. HPV vaccination is also recommended for older teens and young adults who were not vaccinated when younger.

The HPV vaccine is not without its critics, and health care providers are not consistently giving strong recommendations for the vaccine, particularly for younger teens, according to the CDC.

“One of the most common criticisms from parents – that their teen is not sexually active yet – misses the point,” suggests Frieden, who says that vaccines should be administered well before people are exposed to an infection.

Frieden also points out that, with the Vaccines for Children Program and the Affordable Care Act, vaccination is easy and cost should not be a barrier because many insurers are required to cover the vaccine at no cost to either female or male patients.

The power of an effective and widespread vaccination program should not be ignored. Smallpox, for example – a serious and sometimes fatal infectious disease – has no specific treatment and is only prevented by a vaccine. Although outbreaks of the disease have occurred from time to time over thousands of years, it is now eradicated worldwide because of a successful and comprehensive vaccination campaign.

A similar initiative is underway to eradicate polio worldwide. The development of effective vaccines to prevent paralytic polio was one of the major medical breakthroughs of the 20th century. Supported by the Bill & Melinda Gates Foundation, the Global Polio Eradication Initiative (GPEI) has helped to reduce the incidence of polio by more than 99 percent.

As with smallpox, if enough people in a community are immunized, the virus will be deprived of susceptible hosts and will die out. But high levels of vaccination coverage must be maintained to stop transmission and prevent outbreaks.

Will HPV go the way of smallpox and polio thanks to “Herd” Immunity? Do you agree with the CDC that it’s time to ramp up efforts to protect the next generation with the HPV vaccine? Or do you share the critics’ concerns?