Primary care
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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.
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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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This highlights the key recommendations for immunization in the setting of chronic disease, children and adults with special needs, and health care providers. Immunization is an effective strategy to reduce the burden of suffering and cost of care from chronic disease. ⋯ Clinicians need to develop systems to evaluate patients' risk factors and tailor immunization recommendations to their individual needs. Patients with intellectual disabilities, neurologic and neurodevelopmental disorders, and autism are at higher risk for vaccine-preventable illness and face significant health disparities.