News in brief - May 16, 2005

Plans laid for next year's flu vaccine - Vaccine-averse parents most common reason for not vaccinating children - AMA calls for end to NCAA alcohol ads - Nonalcoholic fatty liver disease increasing

Plans laid for next year's flu vaccine

Government committees have selected the strains to be included in next year's flu vaccine and recommended strategies for allocating the supply, according to several statements issued last month.

The Centers for Disease Control and Prevention is recommending that physicians place two pre-booking orders, according to the April 1 Morbidity and Mortality Weekly Report. The first order should request supplies to provide vaccine only for those in priority groups, and this request would be filled if supplies are limited. The second order would be for these doses plus shots for those who are not regarded as high priority but still want them. This one would be filled if supplies are ample. Also, health care workers who are not caring for severely immunocompromised patients are being encouraged to use the live, attenuated influenza vaccine.

Officials monitoring the situation believe that at least 61 million doses of injectible and nasal vaccine will be available from sanofi pasteur and MedImmune, although more doses could be available from Chiron or other companies currently seeking Food and Drug Administration approval.

The Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee also recommended in mid-April that next season's vaccine include antigens that provide protection against A/New Caledonia/20/99 (H1N1)-like, A/California/7/2004 (H3N2)-like and B/Shanghai/361/2002-like viruses.

Vaccine-averse parents most common reason for not vaccinating children

Concern that vaccines might cause harm was the most common reason given by parents who choose not to have their children vaccinated for preventable diseases, according to an article in the May issue of Archives of Pediatrics & Adolescent Medicine.

The number of parents of school-age children claiming nonmedical exemptions from vaccination requirements has been increasing for the last decade in a number of states. Children with exemptions tend to be geographically clustered, thus contributing to the possibility of disease outbreaks in those areas.

Responses to surveys sent by researchers at the Johns Hopkins Bloomberg School of Public Health in Baltimore to the parents of 277 children with exemptions revealed that 69% said a reason for seeking an exemption was concern that the vaccines cause harm. Those parents were also significantly more likely to report low perceived vaccine safety and effectiveness and a low level of trust in the government.

The parents also were likely to report lack of confidence in medical, public health and government sources for vaccine information and to be more likely to report confidence in alternative medicine professionals.

Most children with exemptions had received some vaccine, with vaccination for varicella the one most often missed.

AMA calls for end to NCAA alcohol ads

The AMA called on the National Collegiate Athletic Assn. to eliminate alcohol advertising at events associated with the NCAA.

"The prevalence of alcohol advertising in college sports sends a damaging message about the core values of the NCAA and higher education," said AMA President-elect J. Edward Hill, MD. "Allowing aggressive alcohol advertising during its events only encourages underage consumption of alcohol."

The AMA appeal came as NCAA Division 1 officials met in Indianapolis April 28 to review current policy allowing beer advertising during radio and television broadcasts of collegiate sporting events.

A national survey conducted by the AMA in April in partnership with the Robert Wood Johnson Foundation found that the majority of the 2,271 adults polled agreed that the NCAA should reverse its policy and not allow beer companies to advertise during college sporting events.

"As a physician, I know all too well the dangers posed to underage youth by early alcohol use, and college campuses include many underage drinkers who are attracted by the messages in alcohol ads," Dr. Hill said.

Nonalcoholic fatty liver disease increasing

Alcohol remains the most common cause of abnormal liver function, but obesity is increasingly linked to this condition, according to a study of residents of a town in Southern Italy published in this month's Hepatology.

Obesity has long been a leading cause of this problem in the United States, and researchers say this study is evidence that the rest of the world is catching up.

Researchers screened over 1,500 randomly selected residents for abnormal liver values, hepatitis B and C and alcohol consumption. About 12% had liver function tests that were not quite right. Of these, 46% were caused by excessive alcohol consumption. About 20% were caused by infection with hepatitis B and C, and 24% were caused by excess weight.