Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-30 (of 30 Records) |
Query Trace: Pickering S[original query] |
---|
General recommendations on immunization --- recommendations of the Advisory Committee on Immunization Practices (ACIP)
Kroger AT , Sumaya CV , Pickering LK , Atkinson WL . MMWR Recomm Rep 2011 60 (2) 1-64 This report is a revision of the General Recommendations on Immunization and updates the 2006 statement by the Advisory Committee on Immunization Practices (ACIP) (CDC. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2006;55[No. RR-15]). The report also includes revised content from previous ACIP recommendations on the following topics: adult vaccination (CDC. Update on adult immunization recommendations of the immunization practices Advisory Committee [ACIP]. MMWR 1991;40[No. RR-12]); the assessment and feedback strategy to increase vaccination rates (CDC. Recommendations of the Advisory Committee on Immunization Practices: programmatic strategies to increase vaccination rates-assessment and feedback of provider-based vaccination coverage information. MMWR 1996;45:219-20); linkage of vaccination services and those of the Supplemental Nutrition Program for Women, Infants, and Children (WIC program) (CDC. Recommendations of the Advisory Committee on Immunization Practices: programmatic strategies to increase vaccination coverage by age 2 years-linkage of vaccination and WIC services. MMWR 1996;45:217-8); adolescent immunization (CDC. Immunization of adolescents: recommendations of the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American Medical Association. MMWR 1996;45[No. RR-13]); and combination vaccines (CDC. Combination vaccines for childhood immunization: recommendations of the Advisory Committee on Immunization Practices [ACIP], the American Academy of Pediatrics [AAP], and the American Academy of Family Physicians [AAFP]. MMWR 1999;48[No. RR-5]). Notable revisions to the 2006 recommendations include 1) revisions to the tables of contraindications and precautions to vaccination, as well as a separate table of conditions that are commonly misperceived as contraindications and precautions; 2) reordering of the report content, with vaccine risk-benefit screening, managing adverse reactions, reporting of adverse events, and the vaccine injury compensation program presented immediately after the discussion of contraindications and precautions; 3) stricter criteria for selecting an appropriate storage unit for vaccines; 4) additional guidance for maintaining the cold chain in the event of unavoidable temperature deviations; and 5) updated revisions for vaccination of patients who have received a hematopoietic cell transplant. The most recent ACIP recommendations for each specific vaccine should be consulted for comprehensive details. This report, ACIP recommendations for each vaccine, and additional information about vaccinations are available from CDC at http://www.cdc.gov/vaccines. |
Recommended adult immunization schedule: United States, 2009*
Advisory Committee on Immunization Practices , Pickering LK , Mootrey GT . Ann Intern Med 2009 150 (1) 40-4 The Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule (Figure) to ensure that the schedule reflects current recommendations for the licensed vaccines. In October 2008, ACIP approved the Adult Immunization Schedule for 2009. No new vaccines were added to the schedule. However, several indications were added to the pneumococcal polysaccharide vaccine footnote; clarifications were made to the footnotes for human papillomavirus, varicella, and meningococcal vaccines; and schedule information was added to the hepatitis A and hepatitis B vaccine footnotes. |
Passive in-line chlorination for drinking water disinfection: A critical review
Lindmark M , Cherukumilli K , Crider YS , Marcenac P , Lozier M , Voth-Gaeddert L , Lantagne DS , Mihelcic JR , Zhang QM , Just C , Pickering AJ . Environ Sci Technol 2022 56 (13) 9164-9181 The world is not on track to meet Sustainable Development Goal 6.1 to provide universal access to safely managed drinking water by 2030. Removal of priority microbial contaminants by disinfection is one aspect of ensuring water is safely managed. Passive chlorination (also called in-line chlorination) represents one approach to disinfecting drinking water before or at the point of collection (POC), without requiring daily user input or electricity. In contrast to manual household chlorination methods typically implemented at the point of use (POU), passive chlorinators can reduce the user burden for chlorine dosing and enable treatment at scales ranging from communities to small municipalities. In this review, we synthesized evidence from 27 evaluations of passive chlorinators (in 19 articles, 3 NGO reports, and 5 theses) conducted across 16 countries in communities, schools, health care facilities, and refugee camps. Of the 27 passive chlorinators we identified, the majority (22/27) were solid tablet or granular chlorine dosers, and the remaining devices were liquid chlorine dosers. We identified the following research priorities to address existing barriers to scaled deployment of passive chlorinators: (i) strengthening local chlorine supply chains through decentralized liquid chlorine production, (ii) validating context-specific business models and financial sustainability, (iii) leveraging remote monitoring and sensing tools to monitor real-time chlorine levels and potential system failures, and (iv) designing handpump-compatible passive chlorinators to serve the many communities reliant on handpumps as a primary drinking water source. We also propose a set of reporting indicators for future studies to facilitate standardized evaluations of the technical performance and financial sustainability of passive chlorinators. In addition, we discuss the limitations of chlorine-based disinfection and recognize the importance of addressing chemical contamination in drinking water supplies. Passive chlorinators deployed and managed at-scale have the potential to elevate the quality of existing accessible and available water services to meet "safely managed" requirements. |
Measuring environmental exposure to enteric pathogens in low-income settings: Review and recommendations of an interdisciplinary working group
Goddard FGB , Ban R , Barr DB , Brown J , Cannon J , Colford JM Jr , Eisenberg JNS , Ercumen A , Petach H , Freeman MC , Levy K , Luby SP , Moe C , Pickering AJ , Sarnat JA , Stewart J , Thomas E , Taniuchi M , Clasen T . Environ Sci Technol 2020 54 (19) 11673-11691 Infections with enteric pathogens impose a heavy disease burden, especially among young children in low-income countries. Recent findings from randomized controlled trials of water, sanitation, and hygiene interventions have raised questions about current methods for assessing environmental exposure to enteric pathogens. Approaches for estimating sources and doses of exposure suffer from a number of shortcomings, including reliance on imperfect indicators of fecal contamination instead of actual pathogens and estimating exposure indirectly from imprecise measurements of pathogens in the environment and human interaction therewith. These shortcomings limit the potential for effective surveillance of exposures, identification of important sources and modes of transmission, and evaluation of the effectiveness of interventions. In this review, we summarize current and emerging approaches used to characterize enteric pathogen hazards in different environmental media as well as human interaction with those media (external measures of exposure), and review methods that measure human infection with enteric pathogens as a proxy for past exposure (internal measures of exposure). We draw from lessons learned in other areas of environmental health to highlight how external and internal measures of exposure can be used to more comprehensively assess exposure. We conclude by recommending strategies for advancing enteric pathogen exposure assessments. |
Associations between enteric pathogen carriage and height-for-age, weight-for-age and weight-for-height in children under 5 years old in urban Dhaka, Bangladesh
Berendes D , Capone D , Knee J , Holcomb D , Sultana S , Pickering AJ , Brown J . Epidemiol Infect 2020 148 e39 Nutritional factors and infectious agents may contribute to paediatric growth deficits in low- and middle-income countries; however, the contribution of enteric pathogens is only beginning to be understood. We analysed the stool from children <5 years old from an open cohort, cluster-randomised controlled trial of a point-of-collection water chlorinator in urban Bangladesh. We compared the presence/absence of 15 enteric pathogens detected via multiplex, molecular methods in the stool with concurrent Z-scores/Z-score cut-offs (-2 standard deviations (s.d.)) for height-for-age (HAZ/stunting), weight-for-age (WAZ/underweight) and weight-for-height (WHZ/wasting), adjusted for sociodemographic and trial-related factors, and measured caregiver-reported diarrhoea. Enteric pathogen prevalence in the stool was high (88% had >/=1 enteric pathogen, most commonly Giardia spp. (40%), Salmonella enterica (33%), enterotoxigenic E. coli (28%) and Shigella spp. (27%)) while reported 7-day diarrhoea prevalence was 6%, suggesting high subclinical infection rates. Many children were stunted (26%) or underweight (24%). Adjusted models suggested Giardia spp. detection was associated with lower HAZ (-0.22 s.d., 95% CI -0.44 to 0.00; prevalence ratio for stunting: 1.39, 95% CI 0.94-2.06) and potentially lower WAZ. No pathogens were associated with reported diarrhoea in adjusted models. Giardia spp. carriage may be associated with growth faltering, but not diarrhoea, in this and similar low-income settings. Stool-based enteric pathogen detection provides a direct indication of previous exposure that may be useful as a broader endpoint of trials of environmental interventions. |
Principles of vaccine licensure, approval, and recommendations for use
Pickering LK , Meissner HC , Orenstein WA , Cohn AC . Mayo Clin Proc 2020 95 (3) 600-608 The licensure and recommendation processes for vaccines are complex. In the United States, vaccines are licensed for the civilian and military populations on the basis of review of Biologics License Applications submitted to the Food and Drug Administration (FDA) by vaccine manufacturers. For FDA-licensed vaccines, the product label includes indications, contraindications, and precautions for each vaccine. Package inserts do not include recommendations for vaccine use from the Advisory Committee on Immunization Practices (ACIP). The ACIP is chartered as a federal advisory committee to provide expert external advice and guidance to the director of the Centers for Disease Control and Prevention on the use of vaccines and related agents for control of vaccine preventable diseases in the civilian and military populations of the United States. As an external advisory committee to the Centers for Disease Control and Prevention, the ACIP has no regulatory authority but the committee does have responsibility for approving vaccines to be covered under the Vaccines for Children program. To implement ACIP vaccine recommendations in the public and private sectors, a collaboration of federal, state, and local governments as well as private organizations dealing with public health, vaccine supply, vaccine administration, vaccine finance, outcomes monitoring, public perception, and public trust and support must work together. Issues including vaccine misinformation, declining community immunity (herd protection), and need for risk communication add stress to this complex and fragile system. This study describes the functions of and interactions between FDA and ACIP. |
Association between malaria infection and early childhood development mediated by anemia in rural Kenya
Milner EM , Kariger P , Pickering AJ , Stewart CP , Byrd K , Lin A , Rao G , Achando B , Dentz HN , Null C , Fernald LCH . Int J Environ Res Public Health 2020 17 (3) Malaria is a leading cause of morbidity and mortality among children under five years of age, with most cases occurring in Sub-Saharan Africa. Children in this age group in Africa are at greatest risk worldwide for developmental deficits. There are research gaps in quantifying the risks of mild malaria cases, understanding the pathways linking malaria infection and poor child development, and evaluating the impact of malaria on the development of children under five years. We analyzed the association between malaria infection and gross motor, communication, and personal social development in 592 children age 24 months in rural, western Kenya as part of the WASH Benefits environmental enteric dysfunction sub-study. Eighteen percent of children had malaria, 20% were at risk for gross motor delay, 21% were at risk for communication delay, and 23% were at risk for personal social delay. Having a positive malaria test was associated with increased risk for gross motor, communication, and personal social delay while adjusting for child characteristics, household demographics, study cluster, and intervention treatment arm. Mediation analyses suggested that anemia was a significant mediator in the pathway between malaria infection and risk for gross motor, communication, and personal social development delays. The proportion of the total effect of malaria on the risk of developmental delay that is mediated by anemia across the subscales was small (ranging from 9% of the effect on gross motor development to 16% of the effect on communication development mediated by anemia). Overall, malaria may be associated with short-term developmental delays during a vulnerable period of early life. Therefore, preventative malaria measures and immediate treatment are imperative for children's optimal development, particularly in light of projections of continued high malaria transmission in Kenya and Africa. |
The Biosafety Level 4 Zoonotic Laboratory Network (BSL4ZNet): Report of a workshop on live animal handling
Pickering BS , Spengler JR , Shadabi E , Dalziel AE , Lautner EA , Silva P . Antiviral Res 2019 172 104640 The Biosafety Level 4 Zoonotic Laboratory Network (BSL4ZNet) was established in 2016, to provide a means of communication and support for the global high-containment laboratory community. Its working groups focus on international response, institutional cooperation and knowledge sharing, scientific excellence and training. In the latter role, BSL4ZNet sponsored its first international workshop in February, 2018, held at the USDA National Centers for Animal Health, Ames, Iowa, USA, focused on necropsy procedures in high-containment laboratories. A second workshop, in November, 2018, was held at the National Microbiology Laboratories (CFIA/PHAC) in Winnipeg, Canada, and focused on decontamination. A third workshop, held at the Australian Animal Health Laboratory in Geelong, Australia, in February, 2019, was devoted to handling methods and ethical concerns for live animals in high-containment laboratories. The third workshop brought together 12 laboratorians from seven partner organizations in Australia, Canada, Germany, the United Kingdom and the United States. It included both discussion-based and hands-on training sessions on animal welfare, animal models, site-specific infrastructure constraints, health monitoring and humane endpoints, sampling procedures, and carcass disposal. This report summarizes the inception, development, and structure of the BSL4ZNet, and highlights the aims and results of the Geelong workshop. |
Understanding FDA-approved labeling and CDC recommendations for use of vaccines
Meissner HC , Farizo K , Pratt D , Pickering LK , Cohn AC . Pediatrics 2018 142 (3) Adherence to recommendations for the use of licensed vaccines ensures maximum individual and societal benefits from the national immunization program. The US Food and Drug Administration (FDA) licenses a vaccine once it determines that data submitted by the manufacturer reveal that the vaccine is safe and effective for its intended use. For each US-licensed vaccine, the FDA-approved prescribing information contains detailed information for health care providers to ensure safe and effective use. Centers for Disease Control and Prevention recommendations for the use of a licensed vaccine often are based on additional considerations, such as disease epidemiology, public acceptance, vaccine supply, and cost. Our objective in this article is to explain the reasons for the differences between FDA-approved prescribing information and Centers for Disease Control and Prevention recommendations for vaccine use. |
Serology reflects a decline in the prevalence of trachoma in two regions of The Gambia
Migchelsen SJ , Sepulveda N , Martin DL , Cooley G , Gwyn S , Pickering H , Joof H , Makalo P , Bailey R , Burr SE , Mabey DCW , Solomon AW , Roberts CH . Sci Rep 2017 7 (1) 15040 Trachoma is caused by Chlamydia trachomatis (Ct). It is targeted for global elimination as a public health problem. In 2014, a population-based cross-sectional study was performed in two previously trachoma-endemic areas of The Gambia. Participants of all ages from Lower River Region (LRR) (N = 1028) and Upper River Region (URR) (N = 840) underwent examination for trachoma and had blood collected for detection of antibodies against the Ct antigen Pgp3, by ELISA. Overall, 30 (1.6%) individuals had active trachoma; the prevalence in children aged 1-9 years was 3.4% (25/742) with no statistically significant difference in prevalence between the regions. There was a significant difference in overall seroprevalence by region: 26.2% in LRR and 17.1% in URR (p < 0.0001). In children 1-9 years old, seroprevalence was 4.4% in LRR and 3.9% in URR. Reversible catalytic models using information on age-specific seroprevalence demonstrated a decrease in the transmission of Ct infection in both regions, possibly reflecting the impact of improved access to water, health and sanitation as well as mass drug administration campaigns. Serological testing for antibodies to Ct antigens is potentially useful for trachoma programmes, but consideration should be given to the co-endemicity of sexually transmitted Ct infections. |
2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea
Shane AL , Mody RK , Crump JA , Tarr PI , Steiner TS , Kotloff K , Langley JM , Wanke C , Warren CA , Cheng AC , Cantey J , Pickering LK . Clin Infect Dis 2017 65 (12) e45-e80 These guidelines are intended for use by healthcare professionals who care for children and adults with suspected or confirmed infectious diarrhea. They are not intended to replace physician judgement regarding specific patients or clinical or public health situations. This document does not provide detailed recommendations on infection prevention and control aspects related to infectious diarrhea. |
Prevalence of signs of trachoma, ocular Chlamydia trachomatis infection and antibodies to Pgp3 in residents of Kiritimati Island, Kiribati
Cama A , Muller A , Taoaba R , Butcher RMR , Itibita I , Migchelsen SJ , Kiauea T , Pickering H , Willis R , Roberts CH , Bakhtiari A , Le Mesurier RT , Alexander NDE , Martin DL , Tekeraoi R , Solomon AW . PLoS Negl Trop Dis 2017 11 (9) e0005863 OBJECTIVE: In some Pacific Island countries, such as Solomon Islands and Fiji, active trachoma is common, but ocular Chlamydia trachomatis (Ct) infection and trachomatous trichiasis (TT) are rare. On Tarawa, the most populous Kiribati island, both the active trachoma sign "trachomatous inflammation-follicular" (TF) and TT are present at prevalences warranting intervention. We sought to estimate prevalences of TF, TT, ocular Ct infection, and anti-Ct antibodies on Kiritimati Island, Kiribati, to assess local relationships between these parameters, and to help determine the need for interventions against trachoma on Kiribati islands other than Tarawa. METHODS: As part of the Global Trachoma Mapping Project (GTMP), on Kiritimati, we examined 406 children aged 1-9 years for active trachoma. We collected conjunctival swabs (for droplet digital PCR against Ct plasmid targets) from 1-9-year-olds with active trachoma, and a systematic selection of 1-9-year-olds without active trachoma. We collected dried blood spots (for anti-Pgp3 ELISA) from all 1-9-year-old children. We also examined 416 adults aged ≥15 years for TT. Prevalence of TF and TT was adjusted for age (TF) or age and gender (TT) in five-year age bands. RESULTS: The age-adjusted prevalence of TF in 1-9-year-olds was 28% (95% confidence interval [CI]: 24-35). The age- and gender-adjusted prevalence of TT in those aged ≥15 years was 0.2% (95% CI: 0.1-0.3%). Twenty-six (13.5%) of 193 swabs from children without active trachoma, and 58 (49.2%) of 118 swabs from children with active trachoma were positive for Ct DNA. Two hundred and ten (53%) of 397 children had anti-Pgp3 antibodies. Both infection (p<0.0001) and seropositivity (p<0.0001) were strongly associated with active trachoma. In 1-9-year-olds, the prevalence of anti-Pgp3 antibodies rose steeply with age. CONCLUSION: Trachoma presents a public health problem on Kiritimati, where the high prevalence of ocular Ct infection and rapid increase in seropositivity with age suggest intense Ct transmission amongst young children. Interventions are required here to prevent future blindness. |
Policy making for vaccine use as a driver of vaccine innovation and development in the developed world
Seib K , Pollard AJ , de Wals P , Andrews RM , Zhou F , Hatchett RJ , Pickering LK , Orenstein WA . Vaccine 2017 35 (10) 1380-1389 In the past 200years, vaccines have had unmistakable impacts on public health including declines in morbidity and mortality, most markedly in economically-developed countries. Highly engineered vaccines including vaccines for conditions other than infectious diseases are expected to dominate future vaccine development. We examine immunization vaccine policy as a driver of vaccine innovation and development. The pathways to recommendation for use of licensed vaccines in the US, UK, Canada and Australia have been similar, including: expert review of disease epidemiology, disease burden and severity; vaccine immunogenicity, efficacy and safety; programmatic feasibility; public demand; and increasingly cost-effectiveness. Other attributes particularly important in development of future vaccines are likely to include: duration of immunity for improved vaccines such as pertussis; a greater emphasis on optimizing community protection rather than direct protection only; programmatic implementation, feasibility, improvements (as in the case of development of a universal influenza vaccine); public concerns/confidence/fears related to outbreak pathogens like Ebola and Zika virus; and major societal burden for combating hard to treat diseases like HIV and antimicrobial resistant pathogens. Driving innovation and production of future vaccines faces enormous economic hurdles as available approaches, technologies and regulatory pathways become more complex. As such, cost-mitigating strategies and focused, aligned efforts (by governments, private organizations, and private-public partnerships) will likely be needed to continue to spur major advances in vaccine technologies and development. |
Lessons learned from making and implementing vaccine recommendations in the U.S
Walton LR , Orenstein WA , Pickering LK . Am J Prev Med 2015 49 S406-11 After publication of certain vaccine recommendations made by the Advisory Committee on Immunization Practices, several unexpected events have occurred during implementation of these recommendations. These have included changes in recommendations following adverse events involved with a particular vaccine and the conferral of community protection as an offshoot of vaccination of a specific population. Vaccine shortages and hesitancy have also been proven impediments to full implementation, and vaccine recommendations have not gone unaffected by either public perception of a vaccine or by cost considerations. |
The history of the United States Advisory Committee on Immunization Practices (ACIP)
Walton LR , Orenstein WA , Pickering LK . Vaccine 2014 33 (3) 405-14 The United States Advisory Committee on Immunization Practices (ACIP) is a federal advisory committee that develops written recommendations for use of vaccines licensed by the Food and Drug Administration (FDA) for the U.S. civilian population. Vaccine development and disease outbreaks contributed to the need for a systematized, science-based, formal mechanism for establishing national immunization policy in this country. Formed in 1964, the ACIP was charged with this role. The committee has undergone significant changes in structure and operational activities during its 50-year history. The ACIP works closely with many liaison organizations to develop its immunization recommendations, which are harmonized among key professional medical societies. ACIP vaccine recommendations form two immunization schedules, which are updated annually: (1) the childhood and adolescent immunization schedule and (2) the adult immunization schedule. Today, once ACIP recommendations are adopted by the Director of the Centers for Disease Control and Prevention and the Secretary of the Department of Health and Human Services, these recommendations are published in Morbidity and Mortality Weekly Report (MMWR), become official policy, and are incorporated into the appropriate immunization schedule. |
Microbiological evaluation of the efficacy of soapy water to clean hands: a randomized, non-inferiority field trial
Amin N , Pickering AJ , Ram PK , Unicomb L , Najnin N , Homaira N , Ashraf S , Abedin J , Islam MS , Luby SP . Am J Trop Med Hyg 2014 91 (2) 415-23 We conducted a randomized, non-inferiority field trial in urban Dhaka, Bangladesh among mothers to compare microbial efficacy of soapy water (30 g powdered detergent in 1.5 L water) with bar soap and water alone. Fieldworkers collected hand rinse samples before and after the following washing regimens: scrubbing with soapy water for 15 and 30 seconds; scrubbing with bar soap for 15 and 30 seconds; and scrubbing with water alone for 15 seconds. Soapy water and bar soap removed thermotolerant coliforms similarly after washing for 15 seconds (mean log10 reduction = 0.7 colony-forming units [CFU], P < 0.001 for soapy water; mean log10 reduction = 0.6 CFU, P = 0.001 for bar soap). Increasing scrubbing time to 30 seconds did not improve removal (P > 0.05). Scrubbing hands with water alone also reduced thermotolerant coliforms (mean log10 reduction = 0.3 CFU, P = 0.046) but was less efficacious than scrubbing hands with soapy water. Soapy water is an inexpensive and microbiologically effective cleansing agent to improve handwashing among households with vulnerable children. |
History and evolution of the Advisory Committee on Immunization Practices - United States, 1964-2014
Smith JC , Hinman AR , Pickering LK . MMWR Morb Mortal Wkly Rep 2014 63 (42) 955-8 The Advisory Committee on Immunization Practices (ACIP) is chartered as a federal advisory committee to provide expert external advice to CDC and the Secretary of the U.S. Department of Health and Human Services (DHHS) on the use of vaccines in the civilian population of the United States. This report summarizes the evolution of ACIP over the 50 years since its establishment in 1964 by the Surgeon General of the U.S. Public Health Service (USPHS). |
Elevated Staphylococcus ceftriaxone MICs are an Etest artifact
Limbago BM , Pierce VM , Lonsway DR , Ferraro MJ . Clin Infect Dis 2014 60 (1) 162-3 The recent publication by Pickering et al [1] described a collection of methicillin-susceptible Staphylococcus aureus (MSSA) that displayed elevated ceftriaxone minimum inhibitory concentrations (MICs) when tested by Etest (bioMerieux, Durham, North Carolina) gradient diffusion and would have been called “Resistant” to ceftriaxone based on previous Clinical and Laboratory Standards Institute (CLSI) interpretive guidance. The authors reported that approximately 60% of MSSA tested at their institution would have been misclassified based on the current CLSI guidance, which recommends testing staphylococci only against penicillin and oxacillin or cefoxitin in order to infer susceptibility or resistance to other β-lactam agents. This article was available electronically ahead of print for several months. Although it was subsequently retracted as “an honest error in interpretation,” we believe a fuller explanation of the findings could improve understanding among Clinical Infectious Diseases readership. | We investigated the accuracy of the initial report by performing reference broth microdilution (BMD), disk diffusion, and Etest [both low (0.002–32 µg/mL) and high (0.016–256 µg/mL) range ceftriaxone Etest products] antimicrobial susceptibility testing on 8 pulsed field gel electrophoresis (PFGE)-matched pairs of MSSA from the Pickering study [1] reported to have mismatched ceftriaxone susceptibility. All 16 isolates were confirmed as oxacillin, cefoxitin, and ceftriaxone susceptible [2, 3] with BMD and disk methods. Ceftriaxone MICs obtained by both Etest products were typically higher than those obtained with BMD but were still in the susceptible range for 100% of isolates using the high concentration ceftriaxone Etest, and for 93.8% of isolates using the low concentration ceftriaxone Etest (1 isolate tested as intermediate). In addition, 30 consecutive, unique MSSA isolated from blood cultures during 2 months at a single hospital were tested against ceftriaxone byBMD, disk diffusion, and Etest using a single 0.5 McFarland inoculum. All isolates tested ceftriaxone susceptible by disk diffusion and BMD; 13 (43%) isolates tested nonsusceptible with Etest (Table 1). We also note that the Etest ceftriaxone package inserts do not list staphylococci as an organism group for which testing has been cleared [4, 5]. |
Military healthcare providers reporting of adverse events following immunizations to the vaccine adverse event reporting system
Li R , McNeil MM , Pickering S , Pemberton MR , Duran LL , Collins LC , Nelson MR , Engler RJ . Mil Med 2014 179 (4) 435-41 OBJECTIVES: We studied military health care provider (HCP) practices regarding reporting of adverse events following immunization (AEFI). METHODS: A convenience sample of HCP was surveyed to assess familiarity with Vaccine Adverse Event Reporting System (VAERS), AEFI they were likely to report, methods used and preferred for reporting, and perceived barriers to reporting. We analyzed factors associated with HCP reporting AEFI to VAERS. RESULTS: A total of 547 surveys were distributed with 487 completed and returned for an 89% response rate. The percentage of HCP aware of VAERS (54%) varied by occupation. 47% of respondents identified knowledge of at least one AEFI with only 34% of these indicating that they had ever reported to VAERS. More serious events were more likely to be reported. Factors associated with HCP reporting AEFIs in bivariate analysis included HCP familiarity with filing a paper VAERS report, HCP familiarity with filing an electronic VAERS report, HCP familiarity with VAERS, and time spent on immunization tasks. In a multivariable analysis, only HCP familiarity with filing a paper VAERS report was statistically significant (Odds ratio = 115.3; p < 0.001). CONCLUSIONS: Specific educational interventions targeted to military HCP likely to see AEFIs but not currently filing VAERS reports may improve vaccine safety reporting practices. |
Video surveillance captures student hand hygiene behavior, reactivity to observation, and peer influence in Kenyan primary schools
Pickering AJ , Blum AG , Breiman RF , Ram PK , Davis J . PLoS One 2014 9 (3) e92571 BACKGROUND: In-person structured observation is considered the best approach for measuring hand hygiene behavior, yet is expensive, time consuming, and may alter behavior. Video surveillance could be a useful tool for objectively monitoring hand hygiene behavior if validated against current methods. METHODS: Student hand cleaning behavior was monitored with video surveillance and in-person structured observation, both simultaneously and separately, at four primary schools in urban Kenya over a study period of 8 weeks. FINDINGS: Video surveillance and in-person observation captured similar rates of hand cleaning (absolute difference <5%, p = 0.74). Video surveillance documented higher hand cleaning rates (71%) when at least one other person was present at the hand cleaning station, compared to when a student was alone (48%; rate ratio = 1.14 [95% CI 1.01-1.28]). Students increased hand cleaning rates during simultaneous video and in-person monitoring as compared to single-method monitoring, suggesting reactivity to each method of monitoring. This trend was documented at schools receiving a handwashing with soap intervention, but not at schools receiving a sanitizer intervention. CONCLUSION: Video surveillance of hand hygiene behavior yields results comparable to in-person observation among schools in a resource-constrained setting. Video surveillance also has certain advantages over in-person observation, including rapid data processing and the capability to capture new behavioral insights. Peer influence can significantly improve student hand cleaning behavior and, when possible, should be exploited in the design and implementation of school hand hygiene programs. |
The Red Book through the ages
Pickering LK , Peter G , Shulman ST . Pediatrics 2013 132 (5) 898-906 The first edition of the Red Book was published in 1938. Since then, there have been numerous advances in the fields of infectious diseases and public health that have decreased morbidity and mortality of infants, children, and adolescents. Over the years, emerging pathogens and disease complexes have been described, sophisticated diagnostic techniques developed, advances in antimicrobial therapy have occurred, and immunizations have been implemented to prevent previously deadly diseases. Of the 18 diseases or organisms in the 1938 edition, 13 are now vaccine-preventable. Since inception of the Red Book, the aims of the editors have been to keep pace with these innovations and to continue to inform the medical community. These goals have made the Red Book a fundamental resource for pediatricians and other health care professionals in terms of guiding diagnosis, therapy, and prevention of infectious diseases. The list of 18 diseases or organisms originally described in the 1938 Red Book has expanded to include over 160 diseases or organisms in the 2012 edition. The pace of biomedical discovery, as well as the amount of information available and the number of methods for its delivery, will continue to accelerate in the future. Integration of information into future editions of the Red Book will ensure that practitioners continue to rely on the Red Book in its various electronic formats for clinical guidance and support. |
COPD causation and workplace exposures: an assessment of agreement among expert clinical raters
Fishwick D , Darby A , Hnizdo E , Barber C , Sumner J , Barraclough R , Bolton C , Burge S , Calverley P , Hopkinson N , Hoyle J , Lawson R , Niven R , Pickering T , Prowse K , Reid P , Warburton C , Blanc PD . COPD 2013 10 (2) 172-9 BACKGROUND: Although occupational exposure is a known risk factor for Chronic Obstructive Pulmonary Disease (COPD), it is difficult to identify specific occupational contributors to COPD at the individual level to guide COPD prevention or for compensation. The aim of this study was to gain an understanding of how different expert clinicians attribute likely causation in COPD. METHODS: Ten COPD experts and nine occupational lung disease experts assigned occupational contribution ratings to fifteen hypothetical cases of COPD with varying combinations of occupational and smoking exposures. Participants rated the cause of COPD as the percentage contribution to the overall attribution of disease for smoking, occupational exposures and other causes. RESULTS: Increasing pack-years of tobacco smoking was associated with significantly decreased proportional occupational causation ratings. Increasing weighted occupational exposure was associated with increased occupational causation ratings by 0.28% per unit change. Expert background also contributed significantly to the proportion of occupational causation rated, with COPD experts rating on average a 9.4% greater proportion of occupational causation per case. CONCLUSION: Our findings support the notion that respiratory physicians are able to assign attribution to different sources of causation in COPD, taking into account both smoking and occupational histories. The recommendations on whether to continue to work in the same job also differ, the COPD experts being more likely to recommend change of work rather than change of work practice. |
Who is unlikely to report adverse events after vaccinations to the vaccine adverse event reporting system (VAERS)?
McNeil MM , Li R , Pickering S , Real TM , Smith PJ , Pemberton MR . Vaccine 2013 31 (24) 2673-9 BACKGROUND: Healthcare provider (HCP) reporting to the vaccine adverse event reporting system (VAERS) is important to assuring the safety of U.S. licensed vaccines. HCP awareness of and practices regarding reporting of adverse events following immunization (AEFI) is understudied. METHODS: A large, nationally representative sample of U.S. office-based HCP across three occupational groups (physicians, mid-level providers [physician assistants, advanced practice nurses] and nurses) and three primary care practice areas (pediatrics, family medicine, internal medicine) were surveyed utilizing standardized methodology. We assessed HCP familiarity with VAERS, the situations under which they were likely to report an AEFI, and the methods they used and preferred for reporting. We used logistic regression to determine factors associated with HCP not reporting AEFI to VAERS. RESULTS: Our survey response rate was 54.9%. The percentage of HCP aware of VAERS (71%) varied by occupation and primary care practice area. About 40% of HCP had identified at least one AEFI with only 18% of these indicating that they had ever reported to VAERS. More serious events were more likely to be reported. Factors associated with HCP not reporting AEFI included: HCP not familiar versus very familiar with filing a paper VAERS report (OR=12.84; p<0.0001), primary care practice area of internal medicine versus pediatrics (OR=4.22; p=0.0005), and HCP not familiar versus very familiar with when it was required to file a VAERS report (OR=5.52; p=0.0013). CONCLUSIONS: Specific educational interventions targeted to HCP likely to see AEFI but not currently reporting may improve vaccine safety reporting practices. |
Epidemiology and diagnosis of health care-associated infections in the NICU
Polin RA , Denson S , Brady MT , Papile LA , Baley JE , Carlo WA , Cummings JJ , Kumar P , Tan RC , Watterberg KL , Barfield WD , Jefferies AL , Macones GA , Mainous RO , Raju TNK , Wang KS , Couto J , Byington CL , Davies HD , Edwards KM , Glode MP , Jackson MA , Keyserling HL , Maldonado YA , Murray DL , Orenstein WA , Schutze GE , Willoughby RE , Zaoutis TE , Fischer MA , Gellin B , Gorman RL , Lee L , Pratt RD , Read JS , Robinson J , Safadi MAP , Seward J , Starke JR , Simon G , Tan TQ , Baker CJ , Bernstein HH , Kimberlin DW , Long SS , Meissner HC , Pickering LK , Rubin LG , Frantz J . Pediatrics 2012 129 (4) e1104-e1109 Health care-associated infections in the NICU are a major clinical problem resulting in increased morbidity and mortality, prolonged length of hospital stays, and increased medical costs. Neonates are at high risk for health care-associated infections because of impaired host defense mechanisms, limited amounts of protective endogenous flora on skin and mucosal surfaces at time of birth, reduced barrier function of neonatal skin, the use of invasive procedures and devices, and frequent exposure to broad-spectrum antibiotics. This statement will review the epidemiology and diagnosis of health care-associated infections in newborn infants. (Copyright 2012 by the American Academy of Pediatrics.) |
How to communicate with vaccine-hesitant parents
Healy CM , Pickering LK . Pediatrics 2011 127 Suppl 1 S127-33 Development of safe and effective vaccines is one the greatest medical triumphs. However, despite high immunization rates in the United States, 85% of health care providers (HCPs) will have a parent refuse a vaccine for his or her child each year. HCPs have the greatest influence on a parent's decision to vaccinate his or her child. To effectively communicate with vaccine-hesitant parents, HCPs must first understand the concerns of parents regarding immunization and understand influences that can lead to misinformation about the safety and effectiveness of vaccines. HCPs should establish an open, nonconfrontational dialogue with vaccine-hesitant parents at an early stage and provide unambiguous, easily comprehensible answers about known vaccine adverse events and provide accurate information about vaccination. Personal stories and visual images of patients and parents affected by vaccine-preventable diseases and reports of disease outbreaks serve as useful reminders of the need to maintain high immunization rates. Ongoing dialogue including provider recommendations may successfully reassure vaccine-hesitant parents that immunization is the best and safest option for their child. |
Recommended adult immunization schedule: United States, 2011
Advisory Committee on Immunization Practices , Pickering LK , Friedman C . Ann Intern Med 2011 154 (3) 168-73 The Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule (Figure) to ensure that the schedule reflects current recommendations for the licensed vaccines. In October 2010, ACIP approved the Adult Immunization Schedule for 2011, which includes several changes. The notation for seasonal influenza vaccine in the figure and footnotes was changed to reflect the expanded recommendation for annual influenza vaccination for everyone 6 months of age or older, which was approved by ACIP in February 2010. In October 2010, ACIP issued a permissive recommendation for use of the tetanus, diphtheria, pertussis (Tdap) vaccine in adults aged 65 years or older; approved the recommendation that Tdap can be administered regardless of how much time has elapsed since the last tetanus and diphtheria (Td)–containing vaccine; and approved a recommendation for a 2-dose series of meningococcal vaccine in adults with certain high-risk medical conditions. The vaccines listed in the Figure have been reordered to keep all universally recommended vaccines together (for example, influenza, Td/Tdap, varicella, human papillomavirus [HPV], and zoster). |
Policy statement--Recommended childhood and adolescent immunization schedules--United States, 2010
Bocchini JA Jr , Bradley JS , Brady MT , Bernstein HH , Byington CL , Fisher MC , Glode MP , Jackson MA , Keyserling HL , Kimberlin DW , Orenstein WA , Schutze GE , Willoughby RE Jr , Bell BP , Bortolussi R , Clover RD , Fischer MA , Gorman RL , Lee L , Pratt RD , Read JS , Gellin BG , Starke JR , Swanson J , Meissner HC , Rubin LG , Pickering LK , Baker CJ , Long SS , Frantz J , Committee on Infectious Diseases . Pediatrics 2010 125 (1) 195-6 The 2010 recommended childhood and adolescent immunization schedules have been approved by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, and the American Academy of Family Physicians. There are 3 schedules: one for children 0 through 6 years of age, one for people 7 through 18 years of age, and a catch-up immunization schedule for children and adolescents who start late or fall behind. These schedules reflect current recommendations for the use of vaccines licensed by the US Food and Drug Administration and include the following changes from last year: | Reference to the recommendations of the Advisory Committee on Immunization Practices for use of influenza A (H1N1) 2009 monovalent vaccine1 is included in a footnote. | Revaccination with meningococcal conjugate vaccine (MCV4) is recommended for children who remain at increased risk for meningococcal disease. A dose of MCV4 should be administered after 3 years in children who received the initial MCV4 dose at ages 2 through 6 years and after 5 years if the first dose was given at age 7 years or older. Additional doses of MCV4 are then given every 5 years.2 | Recommendations on use of combination vaccines have been updated (the use of a combination vaccine generally is preferred over separate injections of its equivalent component vaccines). The final dose in the inactivated poliovirus vaccine series should be administered on or after the 4th birthday and at least 6 months following the previous dose. If 4 doses are administered before age 4 years, an additional (fifth) dose should be administered at age 4 through 6 years.3 | Recommendations for use of the recently licensed bivalent human papillomavirus vaccine in females and the quadrivalent human papillomavirus vaccine in males are included. | Most of the footnotes for the individual vaccines have been revised to provide additional information and to clarify recommendations provided in the schedules. |
The role of immunoprophylaxis in the reduction of disease attributable to respiratory syncytial virus
Meissner HC , Bocchini JA Jr , Brady MT , Hall CB , Kimberlin DW , Pickering LK . Pediatrics 2009 124 (6) 1676-9 Respiratory syncytial virus (RSV) is an RNA virus that infects human respiratory epithelial cells and causes annual outbreaks of respiratory tract disease among infants and young children, as well as recurrent infections throughout life. Annual outbreaks of RSV disease are attributable to first-time infection in susceptible infants, reinfection in children and adults with waning or incomplete immunity, and infection by viral genotypes with sufficient antigenic variation to avoid innate and acquired immunity. In industrialized countries, few infectious diseases have a greater effect on the health of young children than does lower respiratory tract disease caused by RSV. By 2 years of age, almost all children will experience an RSV infection, and ∼50% will be infected twice.1 Results from the New Vaccine Surveillance Network (a prospective, population-based surveillance program sponsored by the Centers for Disease Control and Prevention [CDC]) define the burden of RSV disease in children younger than 5 years of age.2 An estimated 2 million children require medical care because of RSV infection, and ∼57500 children younger than 5 years are hospitalized annually. The major burden of RSV disease occurs among previously healthy infants and children whose susceptibility to severe RSV illness cannot be predicted by risk factors. | Protection against RSV infection is mediated by serum antibody, secretory antibody, cytotoxic T lymphocytes, and innate immune responses. A vaccine offers the greatest promise for control of RSV disease, but vaccine development has been slowed by concerns about safety (enhancement of naturally occurring disease), the limited ability of infants to mount an immune response to RSV glycoprotein antigens, and the presence of maternal neutralizing antibody, which may attenuate an active immune response. Passive immunization with either a hyperimmune globulin or a monoclonal antibody preparation has been demonstrated in randomized, placebo-controlled trials to reduce the risk of hospitalization caused by RSV.3–7 The annual rate of hospitalization attributable to RSV infection among young infants in selected high-risk groups who do not receive immunoprophylaxis is ∼10% to 15%, which is ∼5 times higher than the hospitalization rate among infants who are not at high risk.3–7 Results from 2 randomized, placebo-controlled trials that involved 2789 infants and children with prematurity, chronic lung disease, or congenital heart disease who received palivizumab prophylaxis demonstrated a reduction in RSV hospitalization rates of between 39% and 78% in different groups.6,7 |
Recommended adult immunization schedule: United States, 2010
Advisory Committee on Immunization Practices , Baker CJ , Pickering LK , Chilton L , Cieslak P , Ehresmann KR , Englund J , Friedman C , Judson FN , Keitel WA , Lett SM , Plain J , Marcy MS , Meissner CH , Neuzil K , Sawyer MH , Sumaya CV , Temte J . Ann Intern Med 2010 152 (1) 36-9 The Advisory Committee on Immunization Practices (ACIP) annually reviews the Recommended Adult Immunization Schedule (Figure) to ensure that the schedule reflects current recommendations for the licensed vaccines. In October 2009, ACIP approved the Adult Immunization Schedule for 2010, which includes several changes. A bivalent human papillomavirus vaccine (HPV2) was licensed for use in females in October 2009. The ACIP recommends vaccination of females with either HPV2 or the quadrivalent human papillomavirus vaccine (HPV4). HPV4 was licensed for use in males, and the ACIP used a permissive recommendation for use of this vaccine in males. Introductory sentences were added to the footnotes for measles, mumps, rubella, influenza, pneumococcal, hepatitis A, hepatitis B, and meningococcal vaccines. Clarifications were made to the footnotes for measles, mumps, rubella, influenza, hepatitis A, meningococcal, and Haemophilus influenzae type B (Hib) vaccines, and schedule information was added to the hepatitis B vaccine footnote. |
Immunization programs for infants, children, adolescents, and adults: clinical practice guidelines by the Infectious Diseases Society of America
Pickering LK , Baker CJ , Freed GL , Gall SA , Grogg SE , Poland GA , Rodewald LE , Schaffner W , Stinchfield P , Tan L , Zimmerman RK , Orenstein WA . Clin Infect Dis 2009 49 (6) 817-40 Evidence-based guidelines for immunization of infants, children, adolescents, and adults have been prepared by an Expert Panel of the Infectious Diseases Society of America (IDSA). These updated guidelines replace the previous immunization guidelines published in 2002. These guidelines are prepared for health care professionals who care for either immunocompetent or immunocompromised people of all ages. Since 2002, the capacity to prevent more infectious diseases has increased markedly for several reasons: new vaccines have been licensed (human papillomavirus vaccine; live, attenuated influenza vaccine; meningococcal conjugate vaccine; rotavirus vaccine; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis [Tdap] vaccine; and zoster vaccine), new combination vaccines have become available (measles, mumps, rubella and varicella vaccine; tetanus, diphtheria, and pertussis and inactivated polio vaccine; and tetanus, diphtheria, and pertussis and inactivated polio/Haemophilus influenzae type b vaccine), hepatitis A vaccines are now recommended universally for young children, influenza vaccines are recommended annually for all children aged 6 months through 18 years and for adults aged 50 years, and a second dose of varicella vaccine has been added to the routine childhood and adolescent immunization schedule. Many of these changes have resulted in expansion of the adolescent and adult immunization schedules. In addition, increased emphasis has been placed on removing barriers to immunization, eliminating racial/ethnic disparities, addressing vaccine safety issues, financing recommended vaccines, and immunizing specific groups, including health care providers, immunocompromised people, pregnant women, international travelers, and internationally adopted children. This document includes 46 standards that, if followed, should lead to optimal disease prevention through vaccination in multiple population groups while maintaining high levels of safety. |
- Page last reviewed:Feb 1, 2024
- Page last updated:May 13, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure