Andrew T Kroger, William L Atkinson, Edgar K Marcuse, Larry K Pickering, Advisory Committee on Immunization Practices (ACIP) Centers for Disease Control and Prevention (CDC)
General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP).
MMWR Recomm Rep. 2006 Dec 1;55(RR-15):1-48.
Abstract/Text
This report is a revision of General Recommendations on Immunization and updates the 2002 statement by the Advisory Committee on Immunization Practices (ACIP) (CDC. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices and the American Academy of Family Physicians. MMWR 2002;51[No. RR-2]). This report is intended to serve as a general reference on vaccines and immunization. The principal changes include 1) expansion of the discussion of vaccination spacing and timing; 2) an increased emphasis on the importance of injection technique/age/body mass in determining appropriate needle length; 3) expansion of the discussion of storage and handling of vaccines, with a table defining the appropriate storage temperature range for inactivated and live vaccines; 4) expansion of the discussion of altered immunocompetence, including new recommendations about use of live-attenuated vaccines with therapeutic monoclonal antibodies; and 5) minor changes to the recommendations about vaccination during pregnancy and vaccination of internationally adopted children, in accordance with new ACIP vaccine-specific recommendations for use of inactivated influenza vaccine and hepatitis B vaccine. The most recent ACIP recommendations for each specific vaccine should be consulted for comprehensive discussion. This report, ACIP recommendations for each vaccine, and other information about vaccination can be accessed at CDC's National Center for Immunization and Respiratory Diseases (proposed) (formerly known as the National Immunization Program) website at http//:www.cdc.gov/nip.
Committee on Obstetric Practice
ACOG committee opnion: antenatal corticosteroid therapy for fetal maturation.
Obstet Gynecol. 2002 May;99(5 Pt 1):871-3.
Abstract/Text
The National Institute of Child Health and Human Development and the Office of Medical Applications of Research of the National Institutes of Health convened consensus conference in 1194 and 2000 that recommended giving a single course of corticosteriods to all pregnant women between 24 and 34 weeks of gestation who are at risk of preterm delivery within 7 days. Because of insufficient scientific evidence, the consensus panel also recommended that repeat corticosteroid courses, including so-called "rescue therapy," should not be routinely used but should be reserved for women enrolled in clinical trials. Betamethasone and dexamethasone have been most widely studied and have generally been the preferred corticosteroids for antenatal treatment to accelerate fetal organ maturation. The American College of Obstetricians and Gynecologists' Committee on Obstetric Practice supports the conclusions of the consensus conferences.
O P Heinonen, S Shapiro, R R Monson, S C Hartz, L Rosenberg, D Slone
Immunization during pregnancy against poliomyelitis and influenza in relation to childhood malignancy.
Int J Epidemiol. 1973 Autumn;2(3):229-35.
Abstract/Text
[http:idsc.nih.go.jp/disease/influenza/fluQA/index.htm 国立感染症研究所感染症情報センター：インフルエンザ Q&A（Guideline) ].
[http:www.cdc.gov/mmwr/preview/mmwrhtml/rr5808a1.htm Prevention and Control of Seasonal Influenza with Vaccines.Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2009; 58 (RR8): 1―52 (Guideline)].
K Zaman, Eliza Roy, Shams E Arifeen, Mahbubur Rahman, Rubhana Raqib, Emily Wilson, Saad B Omer, Nigar S Shahid, Robert F Breiman, Robert E Breiman, Mark C Steinhoff
Effectiveness of maternal influenza immunization in mothers and infants.
N Engl J Med. 2008 Oct 9;359(15):1555-64. doi: 10.1056/NEJMoa0708630. Epub 2008 Sep 17.
Abstract/Text
BACKGROUND: Young infants and pregnant women are at increased risk for serious consequences of influenza infection. Inactivated influenza vaccine is recommended for pregnant women but is not licensed for infants younger than 6 months of age. We assessed the clinical effectiveness of inactivated influenza vaccine administered during pregnancy in Bangladesh.
METHODS: In this randomized study, we assigned 340 mothers to receive either inactivated influenza vaccine (influenza-vaccine group) or the 23-valent pneumococcal polysaccharide vaccine (control group). Mothers were interviewed weekly to assess illnesses until 24 weeks after birth. Subjects with febrile respiratory illness were assessed clinically, and ill infants were tested for influenza antigens. We estimated the incidence of illness, incidence rate ratios, and vaccine effectiveness.
RESULTS: Mothers and infants were observed from August 2004 through December 2005. Among infants of mothers who received influenza vaccine, there were fewer cases of laboratory-confirmed influenza than among infants in the control group (6 cases and 16 cases, respectively), with a vaccine effectiveness of 63% (95% confidence interval [CI], 5 to 85). Respiratory illness with fever occurred in 110 infants in the influenza-vaccine group and 153 infants in the control group, with a vaccine effectiveness of 29% (95% CI, 7 to 46). Among the mothers, there was a reduction in the rate of respiratory illness with fever of 36% (95% CI, 4 to 57).
CONCLUSIONS: Inactivated influenza vaccine reduced proven influenza illness by 63% in infants up to 6 months of age and averted approximately a third of all febrile respiratory illnesses in mothers and young infants. Maternal influenza immunization is a strategy with substantial benefits for both mothers and infants. (ClinicalTrials.gov number, NCT00142389.)
Massachusetts Medical Society
Cristofer S Price, William W Thompson, Barbara Goodson, Eric S Weintraub, Lisa A Croen, Virginia L Hinrichsen, Michael Marcy, Anne Robertson, Eileen Eriksen, Edwin Lewis, Pilar Bernal, David Shay, Robert L Davis, Frank DeStefano
Prenatal and infant exposure to thimerosal from vaccines and immunoglobulins and risk of autism.
Pediatrics. 2010 Oct;126(4):656-64. doi: 10.1542/peds.2010-0309. Epub 2010 Sep 13.
Abstract/Text
OBJECTIVE: Exposure to thimerosal, a mercury-containing preservative that is used in vaccines and immunoglobulin preparations, has been hypothesized to be associated with increased risk of autism spectrum disorder (ASD). This study was designed to examine relationships between prenatal and infant ethylmercury exposure from thimerosal-containing vaccines and/or immunoglobulin preparations and ASD and 2 ASD subcategories: autistic disorder (AD) and ASD with regression.
METHODS: A case-control study was conducted in 3 managed care organizations (MCOs) of 256 children with ASD and 752 controls matched by birth year, gender, and MCO. ASD diagnoses were validated through standardized in-person evaluations. Exposure to thimerosal in vaccines and immunoglobulin preparations was determined from electronic immunization registries, medical charts, and parent interviews. Information on potential confounding factors was obtained from the interviews and medical charts. We used conditional logistic regression to assess associations between ASD, AD, and ASD with regression and exposure to ethylmercury during prenatal, birth-to-1 month, birth-to-7-month, and birth-to-20-month periods.
RESULTS: There were no findings of increased risk for any of the 3 ASD outcomes. The adjusted odds ratios (95% confidence intervals) for ASD associated with a 2-SD increase in ethylmercury exposure were 1.12 (0.83-1.51) for prenatal exposure, 0.88 (0.62-1.26) for exposure from birth to 1 month, 0.60 (0.36-0.99) for exposure from birth to 7 months, and 0.60 (0.32-0.97) for exposure from birth to 20 months.
CONCLUSIONS: In our study of MCO members, prenatal and early-life exposure to ethylmercury from thimerosal-containing vaccines and immunoglobulin preparations was not related to increased risk of ASDs.
Price CS, Thompson WW, Goodson B, Weintraub ES, Croen LA, Hinrichsen VL, Marcy M, Robertson A, Eriksen E, Lewis E, Bernal P, Shay D, Davis RL, DeStefano F. Prenatal and Infant Exposure to Thimerosal From Vaccines and Immunoglobulins and Risk of Autism. Pediatrics [Internet]. 2010 Oct 1 [cited 2018 Dec 25];126(4):656–664. Available from: http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2010-0309
K M Neuzil, G W Reed, E F Mitchel, L Simonsen, M R Griffin
Impact of influenza on acute cardiopulmonary hospitalizations in pregnant women.
Am J Epidemiol. 1998 Dec 1;148(11):1094-102.
Abstract/Text
This study sought to quantify influenza-related serious morbidity in pregnant women, as measured by hospitalizations for or death from selected acute cardiopulmonary conditions during predefined influenza seasons. The study population included women aged 15-44 years who were enrolled in the Tennessee Medicaid program for at least 180 days between 1974 and 1993. In a nested case-control study, 4,369 women with a first study event during influenza season were compared with 21,845 population controls. The odds ratios associated with study events increased from 1.44 (95% confidence interval (CI) 0.97-2.15) for women at 14-20 weeks' gestation to 4.67 (95% CI 3.42-6.39) for those at 37-42 weeks in comparison with postpartum women. A retrospective cohort analysis, which controlled for risk factors identified in the case-control study, identified 22,824 study events during 1,393,166 women-years of follow-up. Women in their third trimester without other identified risk factors for influenza morbidity had an event rate of 21.7 per 10,000 women-months during influenza season. Approximately half of this morbidity, 10.5 (95% CI 6.7-14.3) events per 10,000 women-months, was attributable to influenza. Influenza-attributable risks in comparable nonpregnant and postpartum women were 1.91 (95% CI 1.51-2.31) and 1.16 (95% CI -0.09 to 2.42) per 10,000 women-months, respectively. The data suggest that, out of every 10,000 women in their third trimester without other identified risk factors who experience an average influenza season of 2.5 months, 25 will be hospitalized with influenza-related morbidity.
日本肝臓学会肝炎診療ガイドライン作成委員会編：B型肝炎治療ガイドライン第4版.2022 https://www.jsh.or.jp/lib/files/medical/guidelines/jsh_guidlines/B_v4.pdf.
National Institutes of Health Consensus Development Conference statement Management of Hepatitis C: 2002 June 10-12, 2002.
HIV Clin Trials. 2003 Jan-Feb;4(1):55-75. doi: 10.1310/hct.2003.4.1.008.
Abstract/Text
Prevention of varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Centers for Disease Control and Prevention.
MMWR Recomm Rep. 1996 Jul 12;45(RR-11):1-36.
Abstract/Text
These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of live, attenuated varicella virus vaccine--VARIVAX--manufactured by Merck and Company, Inc. and licensed in March 1995 for use in healthy persons > or = 12 months of age. In addition to presenting information regarding vaccine, this statement updates previous recommendations concerning the use of varicella zoster immune globulin (VZIG) as prophylaxis against varicella (MMWR 1984; 33:84-90, 95-100).
D Nathwani, A Maclean, S Conway, D Carrington
Varicella infections in pregnancy and the newborn. A review prepared for the UK Advisory Group on Chickenpox on behalf of the British Society for the Study of Infection.
J Infect. 1998 Jan;36 Suppl 1:59-71.
Abstract/Text
D E McCarter-Spaulding
Varicella infection in pregnancy.
J Obstet Gynecol Neonatal Nurs. 2001 Nov-Dec;30(6):667-73.
Abstract/Text
Varicella (chickenpox) is a common childhood illness. Most adults are immune to the virus because of previous exposure. Pregnant women who contract varicella risk complications such as pneumonia. Varicella may be transmitted from mother to fetus and could cause congenital varicella syndrome or perinatal infection. Susceptibility to varicella should be determined before pregnancy. Varicella zoster immune globulin may be considered for the mother or newborn if exposure occurs. Acyclovir may decrease the risk of maternal complications from infection.
