MMWR News Synopsis for August 21, 2014

Vaccine-Associated Paralytic Poliomyelitis and BCG-osis in an Immigrant Child with Severe Combined Immune Deficiency Syndrome — Texas, 2013

Anil T. Mangla, MS., PhD., MPH., FRIPH
Assistant Director of Health
San Antonio Metropolitan Health District
Tel: (210) 207-8805

Recent arrival of foreign-born children in the United States should trigger awareness of differing vaccine schedules in other countries and the potential for morbidity and mortality of vaccine-associated diseases. The identification of immune-deficiency-associated polio in an immigrant child underscores the need for U.S. pediatricians to understand that vaccine schedules vary in different parts of the globe. Knowing the immunization history of foreign-born children presenting with unusual illnesses helps to ensure inclusion of vaccine-related diseases in the differential diagnosis. This helps ensure that appropriate specimens are collected and appropriate diagnostic tests are ordered. By being vigilant, vaccine-associated diseases can be diagnosed early, the spread of disease can be prevented by immunization of contacts and exposed individuals in the community, and appropriate treatment can be given in a timely manner to reduce morbidity and mortality.

Racial Disparities in Access to Maternity Care Practices That Support Breastfeeding — United States, 2011

CDC Media Relations
404-639-3286

All maternity care facilities should apply recommended policies and practices that support mothers and babies in starting and continuing breastfeeding. Breastfeeding has many health benefits for mothers and babies. Hospital practices during childbirth have a major impact on whether a mother is able to start and continue breastfeeding. In 2011, hospitals in neighborhoods with a higher percentage of blacks were less likely to follow recommended practices for mother and baby carethan hospitals in neighborhoods with a lower percentage of blacks. The reasons for this disparity are unclear. However, this observation could provide insight into the reasons for the persistent gap in breastfeeding rates between black and white babies in the United States. All hospitals can support mothers’ breastfeeding decisions by applying policies and practices proven to be supportive of breastfeeding.

Update on Recommendations for Use of Herpes Zoster Vaccine

CDC Media Relations
404-639-3286

After review, the Advisory Committee on Immunization Practices (ACIP) recommendations remain unchanged: herpes zoster vaccine is routinely recommended only for adults aged ≥60 years. The ACIP maintains its current recommendation that herpes zoster (shingles) vaccine be routinely recommended for adults aged 60 years and older. The vaccine is approved for use in people aged 50 years and older. Considering that the burden of herpes zoster and its complications increases with age and that the duration of vaccine protection in persons aged 60 years of age and older is uncertain, the ACIP maintained its current recommendation. Clinicians considering herpes zoster vaccination for certain persons aged 50 through 59 years, despite the absence of an ACIP recommendation, should discuss the risks and benefits of vaccination.

Closure of Varicella-Zoster Virus–Containing Vaccines Pregnancy Registry — United States, 2013

CDC Media Relations
404-639-3286

During 17 years of experience with the Merck/CDC pregnancy registry for varicella-zoster virus-containing vaccines, no cases of congenital varicella syndrome and no increased prevalence of other birth defects have been observed among offspring of women who inadvertently received these vaccines immediately before or during pregnancy. However, a small risk for congenital varicella syndrome cannot be ruled out. Pregnant women should not get the Varivax, ProQuad, or Zostavax vaccines. Vaccines that contain live attenuated varicella-zoster virus, (Varivax, ProQuad, and Zostavax [Merck & Co., Inc.]) are contraindicated during pregnancy. Merck and CDC established a registry in 1995 to monitor the pregnancy outcomes of women inadvertently vaccinated with vaccines containing live attenuated varicella-zoster virus immediately before or during pregnancy.  Through March 2012, no cases of congenital varicella syndrome and no increased prevalence of other birth defects have been detected among registrants. Although a small risk for congenital varicella syndrome cannot be ruled out, the number of exposures being registered each year is now too low to improve on the current estimate of the risk. Consequently, new patient enrollment was discontinued as of October 2013. Varivax, ProQuad, and Zostavax remain contraindicated during pregnancy. To report new cases of exposure during pregnancy or other adverse events, health-care providers may contact Merck at 1-877-888-4231. CDC and FDA will continue to monitor adverse events after vaccination with varicella-zoster virus-containing vaccines through the Vaccine Adverse Event Reporting System.

Notes from the Field:

• Atypical Pneumonia in Three Members of an Extended Family — South Carolina and North Carolina, July−August 2013

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES