In the first five years that PCV7 was used, the incidence of invasive pneumococcal disease in children fell by 94%. Post-licensure evaluation of vaccine performance is necessary to ensure that vaccines have the intended public health impact. Public health evaluates our national vaccine programs and policies. Public health continued to monitor the supply of PCV7 and, in 2004, when the supply stabilized, public health terminated the interim recommendations so that the vaccine could be used according to the 2000 recommendation. 4 Public health experts and systems at the state and local levels provided strategies for implementing the vaccination guidelines, such as using immunization registries to identify those children who need to be vaccinated and issuing reminders to parents to get them vaccinated. CDC issued interim vaccination recommendations to withhold vaccine from healthy children aged 2 years and older, and to defer some doses for healthy children who were younger than 2 years of age. 3 Because some children are at higher risk of disease and/or its complications than others, public health was called upon to help conserve vaccine and direct it to protect those children at highest risk. Following the 2000 recommendation, the supply of PCV7 vaccine did not keep up with demand. Vaccine supply interruptions are managed by public health to ensure that those most at risk can be protected first. State and local public health experts worked with the health-care providers in their communities to make sure they had the tools they need to help their patients make informed decisions, from how to hold a child during a vaccination to responding to questions about the need for, and the safety of, the vaccine. Using science-based strategies, public health provided parents with information about the risks of pneumococcal disease and the benefits of the new vaccine. Parents consider many factors when deciding to vaccinate their children. Public health helps inform people about the vaccines they need and the risks and benefits of receiving vaccines. After a careful review of the evidence, including data about the burden of disease caused by pneumococcus, the effectiveness and safety of the vaccine, and the feasibility of incorporating it into the immunization program, the Advisory Committee on Immunization Practices (ACIP) made a recommendation for the routine use of PCV7 among children, 2 and the Centers for Disease Control and Prevention (CDC) incorporated it into the immunization schedule, which gives doctors specific recommendations for the use of vaccines across the life span. look to public health for guidance in the use of vaccines. Before PCV7 was introduced, these seven strains caused more than 80% of severe pneumococcal infections among children. There are more than 90 strains of pneumococcal bacteria, and PCV7 provided protection against seven of them. In 2000, a pediatric heptavalent PCV (PCV7) was licensed for use in the U.S. 1 Young children and older adults are especially vulnerable, and many children who develop pneumococcal meningitis have long-term complications such as deafness or seizures. In the absence of a pediatric vaccine, pneumococcus was a significant public health concern, causing approximately 63,000 cases of invasive pneumococcal disease and 6,100 deaths in the U.S. Streptococcus pneumoniae (pneumococcus) is a major cause of invasive disease, including meningitis, pneumonia, and bacteremia. The success of the pneumococcal conjugate vaccine (PCV) in preventing suffering, disability, and death is one example that illustrates the essential role of our nation's public health systems and workforce in protecting us from vaccine-preventable diseases (VPDs). Along every step of the way, public health-at the national, state, and local levels-plays a fundamental role. But vaccination in the United States is much more complex and only made possible through a robust public-private partnership that begins with the development of the vaccine and continues long after it is used routinely. Food and Drug Administration (FDA) licenses it, health-care providers give it to their patients, and we see disease disappear. It seems simple: a pharmaceutical company develops a new vaccine, the U.S. Vaccines are one of our most successful tools for protecting the public's health.
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