Immunizations, An Issue of Primary Care Clinics in Office Practice

Marc Altshuler

Description

This issue covers important topics to any primary care physician such as: Immunology for the primary care physician, Routine pediatric immunization, special cases in pediatrics, Routine adult immunization, special cases in adult vaccination, Foreign born individuals, Travel medicine, Immunoglobulins, Pandemic illness/flu , Future vaccine development, clinical trials, immunization and cancer prevention/treatment, Ethics of vaccination refusal, Vaccine administration: Rules and regulations, and Keeping current with vaccine recommendations

Sujets

• Family Practice
• General Practice
• Medical
• Médecine

Informations

• Publié par: Saunders
• Date de parution: 28 octobre 2011
• Nombre de lectures: 0
• EAN13: 9781455709502
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Primary Care Clinics in Office Practice , Vol. 38, No. 4, December 2011
ISSN: 0095-4543
doi: 10.1016/S0095-4543(11)00080-7

Contributors
Primary Care Clinics in Office Practice
Immunizations
GUEST EDITORS: Marc Altshuler, MD
Department of Family and Community Medicine, Thomas Jefferson University, 833 Chestnut Street, Suite 301, Philadelphia, PA 19107, USA
Edward M. Buchanan, MD
Department of Family and Community Medicine, Thomas Jefferson University, 833 Chestnut Street, Suite 301, Philadelphia, PA 19107, USA
CONSULTING EDITOR: Joel J. Heidelbaugh, MD
ISSN  0095-4543
Volume 38 • Number 4 • December 2011

Primary Care Clinics in Office Practice , Vol. 38, No. 4, December 2011
ISSN: 0095-4543
doi: 10.1016/S0095-4543(11)00081-9

Contents
Cover
Contributors
Forthcoming Issues
Immunizations as the Nucleus of Prevention
Preface
How the Immune Response to Vaccines is Created, Maintained and Measured: Addressing Patient Questions About Vaccination
Routine Pediatric Immunization, Special Cases in Pediatrics: Prematurity, Chronic Disease, Congenital Heart Disease: Recent Advancements/Changes in Pediatric Vaccines
Adult Vaccination
Vaccine-Preventable Diseases and Foreign-Born Populations
Immunization in Travel Medicine
Passive Immunization
The Course and Management of the 2009 H1N1 Pandemic Influenza
Cancer Vaccines
Vaccination Refusal: Ethics, Individual Rights, and the Common Good
Office Immunization
Keeping Up-to-Date with Immunization Practices
Q & A: Patient to Physician FAQs: Answers to Common Patient Questions About Vaccinations
Index
Primary Care Clinics in Office Practice , Vol. 38, No. 4, December 2011
ISSN: 0095-4543
doi: 10.1016/S0095-4543(11)00082-0

Forthcoming Issues
Primary Care Clinics in Office Practice , Vol. 38, No. 4, December 2011
ISSN: 0095-4543
doi: 10.1016/j.pop.2011.08.001

Foreword
Immunizations as the Nucleus of Prevention

Joel J. Heidelbaugh, MD
Ypsilanti Health Center, 200 Arnet Street, Suite 200, Ypsilanti, MI 48198, USA
E-mail address: [e-mail]


Joel J. Heidelbaugh, MD, Consulting Editor
Every year, I dread flying to conferences for fear of contracting the latest H?N& influenza strain. I also struggle with memorizing the subtle changes in the immunization schedule recommended by the Advisory Committee on Immunization Practices. Like many clinicians, each time I see a child in my practice, the first part of the medical record I review is the immunization registry with the intent of capturing and correcting any missing vaccinations.
Most of us can’t begin to understand the potential ramifications of a widespread pandemic, because we haven’t lived through one and have only read about outbreaks of deadly communicable diseases in books or heard about them through a distant family member. I contracted chicken pox when I was in kindergarten at age 5 and convalesced at home; then I couldn’t return to school because nearly the entire class was infected and school was canceled! When I was a freshman at Siena College in 1989, we had an outbreak of measles that afflicted 45 students. Regardless of immunization status, every student had to receive an additional MMR booster and present a verified ticket prior to attending classes. The threat of national widespread disease and panic originating in the small hamlet of Loudonville, New York became a real possibility. The preface of this volume outlines pre- and postvaccine data that offer great reassurance that when clinicians follow immunization protocols appropriately, such a risk can be greatly minimized.
Recommending immunizations in my current practice assumes two disparate scenarios: the immediate sell and the immediate decline. Most parents agree without hesitation to administer the recommended immunizations to their children. There are, and always will be, parents who feel that such immunizations are not required, are risky (eg, cause autism), and that the threat of sporadic or widespread epidemics of communicable diseases simply won’t apply to their offspring. Adults are often more dismissive, especially with regard to getting their yearly influenza immunization. The excuses, “my friend got it and he got the flu” and “I’ve never gotten the flu shot, and I’ve never gotten the flu, so I won’t need it,” can be very tough to counter.
Drs Altshuler and Buchanan should be heralded for compiling a unique, practical, and detailed Primary Care: Clinics in Office Practice volume dedicated to teaching us not only the importance of the wide array of immunizations, but the science behind what it takes to prevent an epidemic. It is my hope that clinicians who utilize this volume in their daily practices will be suitably equipped with a fantastic resource to portend immunizations as the true nucleus of disease prevention.
Primary Care Clinics in Office Practice , Vol. 38, No. 4, December 2011
ISSN: 0095-4543
doi: 10.1016/j.pop.2011.08.002

Preface

Marc Altshuler, MD Edward M. Buchanan, MD
Department of Family and Community Medicine, Thomas Jefferson University, 833 Chestnut Street, Suite 301, Philadelphia, PA 19107, USA
E-mail address: [e-mail]
E-mail address: [e-mail]


Marc Altshuler, MD, Guest Editor

Edward M. Buchanan, MD, Guest Editor
Vaccine science has been a critical field in the control of numerous diseases with infectious and noninfectious etiologies. Through widespread vaccination programs, smallpox has been eradicated globally, while polio has been eliminated from the Western hemisphere and is poised for global elimination as well. One by one, a number of devastating diseases, that in the past were leading causes of worldwide mortality, have been so successfully controlled that most present-day individuals, laypersons, and clinicians alike have no experience with them ( Table 1 ).
Table 1 Present day impact of vaccines compared to the prevaccine era 1, 2 Disease Prevaccine US Data 2009 Smallpox 29,005 0 Diphtheria 21,053 0 Pertussis 200,752 16,858 Tetanus 580 18 Polio 16,316 1 Measles 530,217 71 Mumps 162,344 1,991 Varicella 4,085,120 20,480 Hepatitis B 66,232 3,405 Invasive HIB 20,000 3,022
This success, however, has brought new challenges to the primary care provider. Clinicians must constantly remain updated on the increasing number of available vaccines and their indications. Likewise, they must be alert to the vaccination needs of their patients, who may present to the office with a very different agenda altogether. In many cases, they may be faced with the reluctance or hostility of patients toward vaccines based on fears magnified by the media and Internet.
Unfortunately, even with the universally accepted recognition of the benefits of vaccine administration, many individuals in the United States remain undervaccinated. Statewide initiatives and school-based requirements have increased the numbers of vaccinated children in this country, but the numbers of adults who lack the appropriate vaccinations is astounding. The primary care provider plays an essential role in educating these individuals and bridging the gaps between the undervaccinated and the immunized population.
In this edition of Primary Care: Clinics in Office Practice , we aim to educate primary care clinicians to the variety of challenges posed by vaccine science through its implementation in primacy care practice. We begin with an article reviewing the immune response and how vaccines induce immunity. Several articles will then review routine pediatric and adult vaccination, including special populations such as pregnant women, premature babies, and the immunocompromised individual. Proper vaccine administration is also addressed. The next several articles discuss more unique situations of vaccination, including the use of vaccine in foreign-born individuals, travel medicine, pandemic illness, and the importance of immunoglobulins. As mentioned earlier, there still exist may widely held beliefs and concerns that often lead to vaccine refusal; one article addresses the ethics of vaccine refusal. The last few articles bring important closure, as we carefully examine the role of clinical trials and the future of vaccine development. We end with two important articles on keeping up to date with current US vaccine guidelines and a Question and Answer section for the primary care provider.
As editors, we wish to thank many individuals who have contributed to this issue. First, we would like to express our highest level of gratitude to the many authors who helped create this important component to the Primary Care Clinics series. We recognize their busy lives and appreciate the time and dedication they put into writing their individual articles. Next, we would like to thank our mentor, Chair, and past editor of Primary Care Clinics , Dr Richard Wender, who met with us throughout the process, providing us with continued guidance and leadership. And finally, our most sincere thanks to our editors, Yonah Korngold and Joel Heidelbaugh, for their ongoing support and assistance, in addition to the staff at Elsevier, who patiently work with us to create what we hope to be another successful series for Primary Care Clinics.

References

   1. S.W. Roush, T.V. Murphy. The Vaccine-Preventable Disease Table Working Group. Historical comparisons of morbidity and mortality for vaccine-preventable diseases in the U.S. JAMA . 2007;298(18):2155-2156.
   2.