医師の一分

アクセスカウンタ

zoom RSS 16才への髄膜炎菌性髄膜炎ワクチンの追加接種を推奨/米国医療事情

<<   作成日時 : 2010/11/01 20:20   >>

なるほど(納得、参考になった、ヘー) ブログ気持玉 1 / トラックバック 0 / コメント 0

 連邦政府CDCワクチン委員会Advisory Committee for Immunization Practices (ACIP)は水曜日、16才への髄膜炎菌性髄膜炎ワクチンの追加接種と、11-64才への百日咳・ジフテリア・破傷風ワクチンの追加接種を推奨を表明した。
 2つの髄膜炎菌性髄膜炎ワクチンが期待ほど十分ではなく、効果が10年ではなくわずか5年ほどしか持たないという。11-12才に接種しても最も危険なティーンエイジャーを保護するには不十分だとわかった。16才で追加接種すれば、流行が時々起こる大学生の最初の数年を保護できる。初回接種を3-4年遅らせるか、追加接種をするかを議論してきた。ワクチン1回に約100ドルかかり、疾患は稀であるので高額な費用がかかる。現在の方法で毎年9人の死亡を回避し、初回接種を遅らせると14人の死亡を回避、追加接種で24人の死亡を回避できると試算している。委員会では6対5の僅差で追加接種が決定された。
 これとは別に、カリフォルニアでの百日咳の流行も議論された。1960年以来で最も多い6,257人の患者数となり、10人の乳幼児が死亡した。これを予防するには家族に予防接種することが必要である。11-64才と家族に乳幼児がいる65歳以上に百日咳・ジフテリア・破傷風ワクチンの追加接種を推奨すると決定された。
---------------------
髄膜炎 薬剤耐性菌が急速増加
http://kurie.at.webry.info/201006/article_12.html
Hibワクチン(髄膜炎ワクチン)120万本が回収/米国
http://kurie.at.webry.info/200712/article_24.html
-----------------------------------------------------
Meningitis Booster Urged for Teenagers
By GARDINER HARRIS
Published: October 27, 2010
http://www.nytimes.com/2010/10/28/health/policy/28vaccine.html

ATLANTA ― Federal vaccine advisers recommended on Wednesday that 16-year-olds be given a booster dose of a vaccine against meningococcal meningitis and that people ages 11 to 64 get a booster to protect against whooping cough, diphtheria and tetanus.

The reason for the meningitis recommendation is that two popular vaccines against the disease do not seem to work as well as hoped. Instead of providing 10 years of protection, they may work for only five years or less.

That is not long enough to protect teenagers and young adults through the riskiest years because the vaccine is usually given at 11 or 12 years of age. The hope is that a booster dose at 16 would yield protection through the first few years of college, when outbreaks occur most often.

Members of the Advisory Committee on Immunization Practices debated whether to recommend that the first dose simply be delayed by three or four years or to add a second dose. The vaccine is about $100 a dose, and the disease is rare. So adding a second dose ensures that every death averted would be expensive. Federal officials estimated that while the current strategy prevents 9 deaths each year, delaying the first dose would prevent 14 deaths and adding a second dose would prevent 24.

Since the federal government pays for about half of all vaccines, the additional cost would be partly borne by taxpayers. The committee voted 6 to 5 to support a booster, but for the recommendation to take effect, the Department of Health and Human Services would need to endorse it, which generally happens but not always.

Dr. Janet Englund, a committee member from Seattle Children’s Hospital, said that delaying the vaccine by three or four years would result in fewer teenagers being vaccinated. A smaller share of 16-year-olds are vaccinated compared with preteenagers, she noted. And because teenagers may drop out of high school, she said, “by moving the age up, I very strongly fear we’re going to be missing at-risk youths.”

Dr. James Turner, a liaison representative to the committee from the American College Health Association, said that if the vaccines were truly so ineffective after five years, more meningitis cases would be popping up on college campuses. But he said a recent survey of 207 schools found just 11 cases, and fewer than half of those cases would have been prevented by vaccination because of differences in strains of the disease.

“If there is waning immunity, we’re not seeing any emerging disease yet,” he said. “So I don’t know that there’s a lot of urgency today in deciding on a booster.”

Meningococcal meningitis is a horrifying disease. It strikes so quickly that often only a day passes between the first signs of illness and the death of the child. Lori Buher of Mount Vernon, Wash., told the committee about how her 6-foot-4, 14-year-old son, Carl, was playing football one day and was being airlifted, near death, to Seattle Children’s Hospital the next. His heart stopped three times during the flight.

Carl survived but lost both legs below the knee, as well as three fingers and the use of his knuckles. He underwent 11 skin graft operations. She urged a booster shot, she said, because vaccination at age 11 would have saved Carl from his illness. His illness struck in 2003, before the current vaccines were approved.

“I can’t tell you what it would have meant if we’d been able to vaccinate him at 11,” Ms. Buher said.

Separately, the committee discussed a growing epidemic in California of whooping cough, also known as pertussis. The state so far this year has had 6,257 cases, the most since 1960. Ten infants have died in California this year, and cases have risen nationally as well.

One way to prevent infant deaths is to vaccinate family members. The committee voted to recommend a booster shot of a vaccine against diphtheria, tetanus and pertussis to those between ages 11 and 64, and to those over 65 if they come in close contact with infants. The committee said uncertainty about whether someone had recently received a combined tetanus and diphtheria vaccine should not rule out getting the combined vaccine that also protects against pertussis.


テーマ

関連テーマ 一覧


月別リンク

ブログ気持玉

クリックして気持ちを伝えよう!
ログインしてクリックすれば、自分のブログへのリンクが付きます。
→ログインへ
気持玉数 : 1
なるほど(納得、参考になった、ヘー)

トラックバック(0件)

タイトル (本文) ブログ名/日時

トラックバック用URL help


自分のブログにトラックバック記事作成(会員用) help

タイトル
本 文

コメント(0件)

内 容 ニックネーム/日時

コメントする help

ニックネーム
本 文
16才への髄膜炎菌性髄膜炎ワクチンの追加接種を推奨/米国医療事情 医師の一分/BIGLOBEウェブリブログ
文字サイズ:       閉じる