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The USA Today reports that a half-dose of flu vaccine has proven to be nearly as effective as the full dose “especially in women and those younger than 50.” Why is this important? During vaccine shortages, half doses of vaccines can be used to conserve resources.
Most people believe that vaccines are for kids. The CDC and public health departments have done a good job of keeping vaccination rates high for children. With the advent of new vaccines for adults, the key now is to increase vaccination rates for these older groups.
The Wall Street Journal (“Get your shots“) details a few of the vaccines that adults should receive.
| Vaccine | Cost | Age and dosage |
| Tetanus/diphtheria/whooping cough | $65 | 19-64 years old, one dose. |
| Tetanus booster | $45 | All adults over 19, every 10 years. |
| Measles/Mumps/rubella | $50-$65 | 19 to 49, one or two doses if not previously vaccinated or infected. |
| Shingles | $220 | Over 60, one dose. |
| Pneumonia | $45 | 19-64, one or two doses when risk of disease is present. One dose after age 65 |
| Influenza | $20-$30 | 19-49, one dose/yr for high risk group. Over 50, one dose/yr |
Not included in the list is the HPV vaccine against cervical cancer.
Another point of interest is that it is increasingly difficult for physicians to supply vaccines to patients. With so many vaccines, the logistics of ordering all these perishable vaccines is very difficult. Further, as vaccines costs have increased, physicians will have to invest more and more capital into vaccine inventory.
For this reason, alternative providers such as pharmacies may a solution. With a vast experience in storage of drugs and supply chain management, pharmacies can easily absorbed the increased adult vaccine demand.
In the Wall Street Journal article, we have the following story:
The doctor didn’t have the shingles vaccine in stock, and recommended they try a walk-in clinic at a nearby drugstore, where the nurse practitioner provided a two-page handout on the vaccine and answered some of their questions. Though the price was about $219 each, all but $40 was covered by their drug benefit plan.
The next time you get a shot, it may be at your local CVS or Walgreens and not at the doctor’s office.
Tags: Pharmacies, vaccines
Vaccines work well because of an adjuvant. The adjuvant boosts immunity but physicians did not know how it worked until now. The Economist reports (“A shot in the dark not more“) that Stephanie Eisenbarth, Richard Flavell an co-authors have discovered that the adjuvant “works by stimulating bits of the immune system called NOD-like receptors.”
Why is this discovery important?
“The value of that is shown by another piece of news. This week GlaxoSmithKline, a big British drug company, won the European Union’s approval for a ‘pre-pandemic’ vaccine that promises protection against multiple strains of bird flu. This vaccine depends, according to Emmanuel Hanon, who helped develop it, on an oil-in-water-emulsion adjuvant so good that only a twentieth of the normal amount of antigen is needed. So how does this amazing adjuvant work? Dr Hanon admits that his team does not actually know.“
ABC News reports that immunization rates are falling. Who’s fault is this?
“Traditionally, the government has measured immunization noncompliance by tallying up only missed doses of a vaccine. In this new research, the CDC recalculated immunization compliance to include vaccine lapses in addition to missed doses. Based on these new criteria, the CDC found that immunization compliance was actually 9 percentage points lower than previous estimates, dropping the compliance rate from 81 percent to 72 percent.”
When we measure compliance as missed vaccines, given that the child goes to the doctor, then we would believe that most of the fault of decreasing immunization rates is the doctors fault. On the other hand, if we measure immunization rates as whether the child is “up to date” with their vaccines, then it could also be the fault of the parents who may not be bringing their child in for necessary check-ups.
Further, with an increasing number of vaccines required, it may be difficult for physicians to give all these vaccines. Kids will only tolerate so many shots at a doctors visit before they start crying uncontrollably. Elizabeth Luman of the National Center for Immunization and Respiratory Diseases says “It’s a complicated schedule … and there are also a lot of vaccines and figuring out when to time them can be a bit complicated.”
Vaccine shortages may also be to blame. Dr. David Freedman, professor of medicine and epidemiology at the University of Alabama at Birmingham, says that “In many cases when there is a shortage, physicians can’t get any, stop giving it and are not rapidly informed when it is available again. In some cases shortages or nonavailability can last a year or more.”
Some doctors propose that an immunization registry, one that would store all an individuals immunization records, could be a solution. This way, doctors and patients would be able to know which vaccines they have received and which ones they need to get.
Tags: vaccines
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