CDC/MMWR Watch [to 14 September 2013]
:: National, State, and Local Area Vaccination Coverage Among Children Aged 19–35 Months — United States, 2012
:: Measles — United States, January 1–August 24, 2013
:: Influenza Vaccination Practices of Physicians and Caregivers of Children with Neurologic and Neurodevelopmental Conditions — United States, 2011–12 Influenza Season
:: Notes from the Field: Measles Outbreak Among Members of a Religious Community — Brooklyn, New York, March–June 2013
:: Notes from the Field: Measles Outbreak Associated with a Traveler Returning from India — North Carolina, April–May 2013
CDC Telebriefing: National Immunization Survey, Vaccine for Children Program, and recent measles outbreaks in the U.S.
Thursday, September 12, 2013 Noon ET
Press Briefing Transcript [Audio recording [MP3, 5.51 MB]
“….Twenty years ago, the VFC program was developed to fix a national crisis of missed opportunities. Today we have a strong public private partnership for immunizing children that reflects the success of the VFC program. But today we also have local measles outbreaks representing a very different dynamic. Instead of our system missing opportunities to vaccinate young children, in some communities people have been rejecting opportunities to be vaccinated.
Let me start with our National Immunization Report Card— National Immunization Survey of Toddlers, age 19 to 35 months, or the NIS. According to the 2012 NIS, the vast majority of parents are vaccinating their children against potentially serious diseases…
The 2012 NIS report shows most that children are complete on the recommended vaccinations. The U.S. continues to have high rates of immunization coverage at the national level. Vaccination coverage remains near or above 90 percent for measles, mumps and rubella vaccine or MMR. For the polio series, for hepatitis B series, and for varicella or chicken pox vaccine. The percentage of children who received no vaccinations remains low. Only 0.8 percent or less than one percent of children in this survey had received no vaccines at all. These are really good results, but there is opportunity for improvement. Vaccination coverage varies by state. Both for individual vaccines and for the series measure….
…So, next I want to briefly discuss the national measles situation so far this year. It is a far cry from that crisis that we had 24 years ago. But with measles things can change very quickly. And we need to stay ahead of this virus which means we need to make sure that immunization coverage is high everywhere. This year, the U.S. is experiencing a higher than usual number of measles cases. There are three outbreaks that account for most of this year’s measles cases in New York City, North Carolina, and Texas. From January 1st to August 24th, 159 measles cases have been reported across the United States. That’s the second largest number of measles cases we have had in this country since measles was eliminated in 2000. During this period, 16 states reported measles cases and the age of cases ranged widely from birth to 61 years. Thirty-seven percent of the cases were children under five. And 18 or 11 percent of all cases were in babies under 12 months who are too young to be routinely vaccinated. Seventeen or 11 percent of the cases required hospitalization. Four of the patients had pneumonia. Fortunately none of the measles cases here in the U.S. this year died. Most of this year’s cases were unvaccinated. One hundred and thirty-one or 82 percent. Four had unknown vaccinations status, 16 cases or nine percent. Among the 140 U.S. residents, 117 were unvaccinated.
I want to tell you in particulars about why they were unvaccinated because it’s so different than what we were seeing in back in 1989 to 1991. Seventy-nine percent of the U.S. residents cases that were unvaccinated had philosophical objections to the vaccine. A smaller numbers, 15 cases or 13 percent, were babies under 12 months that cannot directly be vaccinated but rely on those around them being vaccinated. Let me say a few words about the outbreaks. New York City reported 58 cases, making this the largest outbreak reported in the United States since 1996. None of the patients in that outbreak had documentation of measles vaccination. North Carolina reported the second largest outbreaks so far with 23 cases. Cases mainly occurred among people who were unvaccinated due to philosophical objection. And in the current outbreak in Texas, 20—actually 21 cases, more since we’ve made the report in the MMWR, have — been reported. The numbers may continue to change as this outbreak may be ongoing. Seventeen of those cases in Texas were unvaccinated. As these outbreaks are showing, clusters of people with like-minded beliefs leading them to forego vaccines can be susceptible to outbreaks when measles outbreaks are imported from elsewhere. Measles, as we know, is highly contagious and can lead to serious complications and even death. We need very high rates of immunization to protect the most vulnerable –children too young to be vaccinated and those who can’t be vaccinated due to health conditions.
Importation of measles in the U.S. continues to occur and it poses a threat to our country. It poses a particular threat to people who are not vaccinated. All of the measles cases reported in the U.S. in 2013 were associated with importations from other countries. There were 42 actual importations from 18 other countries. You can think of an import associated case as being linked back to a traveler who brought the disease into the U.S. from another country. Half of the imported measles cases we had in the U.S. originated from Europe. Not a place that many people think of when they try to update their vaccine records before travel. Measles is still common in many parts of the world. And, unfortunately, about 160,000 people around the world die from the disease each year. Rapid public health response to measles is critical. Given how very infectious measles is and the fact we still have pockets of unvaccinated people. We have to rapidly investigate and respond to measles cases. But thanks to the high vaccination rates and rapid public health response the outbreak in 2013 has been contained and it is – that is at the cost of tremendous effort on the part of public health workers who respond to these outbreaks when they occur….