US to reconsider vaccine guidelines amid vaccine shortage

Image copyright Getty Images Image caption Pediatricians find that many childhood vaccines are only ‘50% protective’

Pediatricians across America have issued a rare call for a change in vaccination guidelines amid fears that the immunisation rate for some youngsters is too low.

Vaccinations for more than 800 children are currently at risk because they lack full immunisation.

Experts say “timely” vaccinations should be prioritised to stop a deadly childhood disease from resurfacing.

The American Academy of Pediatrics calls for more research into the ability of the flu vaccine to protect against illnesses such as meningitis and polio.

Vaccination challenges

There are three main vaccines given to all children. They are all given in three doses and the children are given the second and final dose when they are between five and 16 years old.

First, the five-year-old receive two doses of the flu vaccine. In 2017 and 2018 the vaccine itself did not work, so another dose was administered last year.

The 2018 third dose of the flu vaccine did work, and the strain of the virus was actually not as aggressive as they were anticipating.

Image copyright Getty Images Image caption The hospitalisation of a 20-month-old boy was the first such warning

By 2018-19, the so-called vaccine refusal index (VRI) – a measure of the number of children and teenagers who refuse vaccination – was around half of what it had been in 2016-17.

However, this plateau is only in 2018, when the vaccine went ineffective for a brief period.

Immunisations are also dependent on the immunological systems of infants and toddlers. If this system is not strong enough, it can result in the child becoming vulnerable to illnesses such as meningitis and spinal meningitis.

The 20-month-old boy who was hospitalised in 2018 was the first such “serious” example of concern being highlighted to the public.

Dr James Bland, president of the Academy of Pediatrics, said the VRI should be treated as “a serious public health issue”.

He stressed: “Timely vaccination of children is more important than ever before, given the growing number of rare cases of vaccine refusal.”

He pointed out that around half of children in the US do not have the full immunisation regimens as they were not fully vaccinated as children themselves.

“Ideally the vaccines should be administered during the pregnant period, when a baby is not fully vaccinated,” he added.

He also called for a thorough understanding of how to prevent diseases such as meningitis – a disease that resulted in about 1,200 deaths annually in the US in 1990.

Image copyright Getty Images Image caption The CDC said the number of cases of meningitis and other diseases such as pneumonia had dropped by a quarter

Advocacy group SafeMinds’ Executive Director Nicole Patrotis said the calls for the vaccine refusal index to be examined closely are hugely encouraging and welcomed them.

“If we don’t address the limitations of vaccines, we will continue to see outbreaks across our country in which healthy young children are diagnosed with life-threatening complications,” she said.

The United States Centres for Disease Control and Prevention (CDC) said the number of cases of meningitis and other diseases had dropped by a quarter from 1,200 to 8,800 between 1990 and 2016.

Image copyright Getty Images Image caption The new AVN call comes after a series of dramatic US outbreaks of the preventable meningitis C

US authors of the new study said the low level of adherence to the current vaccination schedule was a “common concern for public health and pediatricians”.

While they recommended that every child should be vaccinated, the authors said more attention should be paid to situations in which the vaccine is already “not enough”.

“The data also suggest that the pregnant period represents a high-risk period for both vaccine refusal and vaccine failure,” said Jennifer Papworth, an associate professor at Oregon Health and Science University in the US.

“But we need to be concerned about the rest of the year as well, because there are often many competing needs for pediatric attention, and doctor’s offices are less likely to be fully staffed or well equipped during these times.”

The authors of the study concluded that “it is imperative that the shortage of vaccine becomes an active public health issue and that policymakers take the steps necessary to take vaccine refusal seriously”.

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