Primary care
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The details of vaccine development, licensing, and monitoring have never been more important and relevant to the health care conversation in the United States. The potential exists for a preventive medicine such as a vaccine to cause harm, and physicians and patients need to understand the real balance of risks and benefits of immunization. Vaccines given in the United States undergo rigorous testing before licensure as well as extensive postlicensure safety monitoring.
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A vaccine-positive practice culture encourages immunization against vaccine-preventable diseases by supporting policies and practices that reduce barriers and improve efficacy for vaccine delivery. Key components of a vaccine-positive practice include a well-trained, knowledgeable, collaborative health care practice team; access to immunizations in the practice; and a vaccine practice champion. Leveraging these encourages a provaccine environment and fosters productive dialogue, even among vaccine-hesitant patients/parents.
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Outbreaks of vaccine-preventable diseases are becoming more common in the United States. Outbreaks of some diseases, such as measles, can be attributed to decreasing vaccination rates. ⋯ Clinicians also need to work with public health officials to identify, treat, and limit the spread of these infections. This article describes the populations most at risk from illnesses associated with sporadic outbreaks, with information on diagnosis, treatment, and ways to limit the spread of infection.
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In an era when the success of the US vaccination policies to date is threatened by vaccine hesitancy, it is important for clinicians to have a working understanding of how vaccines are developed and recommended for use in the United States and how federal and state governments are coordinated to ensure a safe and effective vaccine supply. This article discusses the federal agencies involved in vaccine development and recommendation, other organizations involved in vaccine policy, and the role of vaccine-related public health law in promoting universal vaccination.
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Human papillomavirus (HPV) is a significant cause of global morbidity and mortality. A nonavalent HPV vaccine is widely available and recommended for routine use at 11 to 12 years old. Older teens and adults though age 45 years also could be offered vaccination. ⋯ Some parents/teens may hesitate to be vaccinated. The strongest predictor to receiving the vaccine remains a trusted health care professional making a strong recommendation to receive the vaccine. New HPV vaccines are in the pipeline, including therapeutic vaccines to treat HPV-related cancers.