Sunday Mass readings: 2 October 2011

Twenty-Seventh Sunday in Ordinary Time 

Reading 1      Is 5:1-7

Let me now sing of my friend,
my friend’s song concerning his vineyard.
My friend had a vineyard
on a fertile hillside;
he spaded it, cleared it of stones,
and planted the choicest vines;
within it he built a watchtower,
and hewed out a wine press.
Then he looked for the crop of grapes,
but what it yielded was wild grapes.Now, inhabitants of Jerusalem and people of Judah,
judge between me and my vineyard:
What more was there to do for my vineyard
that I had not done?
Why, when I looked for the crop of grapes,
did it bring forth wild grapes?
Now, I will let you know
what I mean to do with my vineyard:
take away its hedge, give it to grazing,
break through its wall, let it be trampled!
Yes, I will make it a ruin:
it shall not be pruned or hoed,
but overgrown with thorns and briers;
I will command the clouds
not to send rain upon it.
The vineyard of the LORD of hosts is the house of Israel,
and the people of Judah are his cherished plant;
he looked for judgment, but see, bloodshed!
for justice, but hark, the outcry!

Responsorial Psalm    Ps 80:9, 12, 13-14, 15-16, 19-20

R. (Is 5:7a) The vineyard of the Lord is the house of Israel.
A vine from Egypt you transplanted;
you drove away the nations and planted it.
It put forth its foliage to the Sea,
its shoots as far as the River.
R. The vineyard of the Lord is the house of Israel.
Why have you broken down its walls,
so that every passer-by plucks its fruit,
The boar from the forest lays it waste,
and the beasts of the field feed upon it?
R. The vineyard of the Lord is the house of Israel.
Once again, O LORD of hosts,
look down from heaven, and see;
take care of this vine,
and protect what your right hand has planted
the son of man whom you yourself made strong.
R. The vineyard of the Lord is the house of Israel.
Then we will no more withdraw from you;
give us new life, and we will call upon your name.
O LORD, God of hosts, restore us;
if your face shine upon us, then we shall be saved.
R. The vineyard of the Lord is the house of Israel.

Reading 2       Phil 4:6-9

Brothers and sisters:
Have no anxiety at all, but in everything,
by prayer and petition, with thanksgiving,
make your requests known to God.
Then the peace of God that surpasses all understanding
will guard your hearts and minds in Christ Jesus.Finally, brothers and sisters,
whatever is true, whatever is honorable,
whatever is just, whatever is pure,
whatever is lovely, whatever is gracious,
if there is any excellence
and if there is anything worthy of praise,
think about these things.
Keep on doing what you have learned and received
and heard and seen in me.
Then the God of peace will be with you.

Gospel        Mt 21:33-43

Jesus said to the chief priests and the elders of the people:
“Hear another parable.
There was a landowner who planted a vineyard,
put a hedge around it, dug a wine press in it, and built a tower.
Then he leased it to tenants and went on a journey.
When vintage time drew near,
he sent his servants to the tenants to obtain his produce.
But the tenants seized the servants and one they beat,
another they killed, and a third they stoned.
Again he sent other servants, more numerous than the first ones,
but they treated them in the same way.
Finally, he sent his son to them, thinking,
‘They will respect my son.’
But when the tenants saw the son, they said to one another,
‘This is the heir.
Come, let us kill him and acquire his inheritance.’
They seized him, threw him out of the vineyard, and killed him.
What will the owner of the vineyard do to those tenants when he comes?”
They answered him,
“He will put those wretched men to a wretched death
and lease his vineyard to other tenants
who will give him the produce at the proper times.”
Jesus said to them, “Did you never read in the Scriptures:
The stone that the builders rejected
has become the cornerstone;
by the Lord has this been done,
and it is wonderful in our eyes?
Therefore, I say to you,
the kingdom of God will be taken away from you
and given to a people that will produce its fruit.”

 

Influenza Vaccination 2011-2012: Recommendations

The influenza vaccination recommendation this year is simple

Everyone 6 months of age and older should receive influenza vaccine. The annual “universal” influenza vaccination recommendation was first established in 2010 to expand protection against influenza to more people.

You may receive questions from patients who were vaccinated last season about whether they still need an annual influenza vaccination because the influenza vaccine virus strains included in the 2011-2012 influenza vaccines are the same as those in last year’s vaccines. It’s not common for all 3 vaccine virus strains to be unchanged from one season to the next — this has happened only 8 times since 1969. However, CDC has always recommended that people get vaccinated every year.

Annual influenza vaccination, even when the vaccine strains are unchanged, is important because a person’s immune protection from influenza vaccination declines over time. Immunity acquired from vaccine administered last season will have declined and may not be enough to prevent infection this season. So, annual influenza vaccination is recommended for optimal protection.

Increasingly, there are influenza vaccination options. There are 3 trivalent inactivated vaccines (TIV) as well as live attenuated influenza virus vaccine (LAIV or the nasal spray vaccine).

Trivalent inactivated vaccine has been around for decades and is approved for use in people 6 months and older, including people with high-risk medical conditions and pregnant women. It is administered intramuscularly. Different formulations of this vaccine are available from various manufacturers, and the minimum age varies from one formulation to another. Consult the package insert to ensure that a specific vaccine is suitable for your patient’s age. In addition, the 2011-2012 Advisory Committee on Immunization Practices (ACIP) Influenza Vaccine Recommendations should be consulted. For example, ACIP recommends that the TIV Afluria® (Merck & Co., Whitehouse Station, New Jersey) not be given to children aged less than 9 years, although it is approved for children aged 5 years and older.

The high-dose TIV was introduced in 2010 for people 65 years and older. It contains 4 times the amount of antigen as other influenza vaccines to prompt a stronger immune response. The high-dose influenza vaccine is also administered intramuscularly.

The intradermal influenza vaccine was approved in 2011 for use in people aged 18 through 64 years. The intradermal vaccine contains less antigen than either of the other TIV formulations but provides a similar immune response. It is administered with a prefilled syringe into the dermal layer of the skin with a much smaller needle.

Finally, the LAIV is available for healthy, nonpregnant persons aged 2 years through 49 years. There is no preferential recommendation for any of the formulations of TIV or LAIV for healthy, nonpregnant persons aged 2-49 years old, but clinicians should note the recommended age groups and possible contraindications for each.

Whereas 1 dose of influenza vaccine is adequate for most people, young children who were not previously vaccinated against influenza require 2 doses of influenza vaccine for full protection in a given year. For the 2011-2012 season, children aged 6 months through 8 years of age will need 2 influenza vaccine doses spaced 4 weeks apart if they didn’t receive at least 1 dose of influenza vaccine for the 2010-2011 season. Children in this age range who received at least 1 dose of the 2010-2011 influenza vaccine last season will need only 1 dose for the 2011-2012 season.

New for the 2011-2012 season is a more permissive influenza vaccination recommendation for persons with egg allergies. Based on a thorough review of several recent studies, administration of both full doses and split doses of TIV have been tolerated by people with egg allergies without serious reactions. ACIP now recommends that for the 2011-2012 influenza season, people who have experienced only hives from consuming eggs can receive TIV intramuscularly as long as they are treated by a healthcare provider who is familiar with the potential manifestations of egg allergies and can be observed by a healthcare professional for at least 30 minutes after receiving each dose. LAIV should not be used in these patients.

Other measures, such as dividing and administering influenza vaccine using a 2-step approach, are not necessary. People with more severe reactions from ingesting eggs or a previous severe reaction to influenza vaccination should not be given influenza vaccine before having a risk assessment performed. Please use the algorithm provided in the Figure to guide you when considering influenza vaccine for patients who report egg allergy (Figure).

Physicians and others who administer influenza vaccines, such as staff at pharmacies, grocery stores, and clinics, should begin vaccinating as soon as influenza vaccine is available to them and continue throughout the season as long as influenza viruses are still circulating. The influenza season generally occurs from October to May, so influenza vaccination during the winter months can still provide protective benefit for patients who have not yet received the vaccine.

As a final note, CDC offers plenty of free resources, including brochures, posters, and fact sheets, to help educate consumers about influenza and influenza vaccines. Some of these materials can be ordered and shipped directly to your location and others are available online for downloading to an office printer. We also encourage you to use our prepared social media tools, which can be added to your Website. Visit www.cdc.gov/flu, and select the “Free Resources” link to access these materials. Contact fluinbox@cdc.gov if you have questions following this update.

by Tim Uyeki, MD, MPH, MPP
MEDSCAPE

 

Web Resources

CDC. Seasonal influenza. http://www.cdc.gov/flu/. Accessed September 13, 2011.

CDC. Recommendations of the Advisory Committee on Immunization Practices.http://www.cdc.gov/flu/professionals/acip/ Accessed September 13, 2011.

Dr. Tim Uyeki is Deputy Chief for Science in the Epidemiology and Prevention Branch of the Centers for Disease Control and Prevention’s (CDC) Influenza Division. Since 1998 he has worked on the epidemiology, prevention, and control of interpandemic, zoonotic, and pandemic influenza in the United States and worldwide for CDC. Dr. Uyeki serves as a consultant to the World Health Organization (WHO) on clinical and epidemiological issues related to seasonal, zoonotic, and pandemic influenza.

After completing his undergraduate work at Oberlin College, Dr. Uyeki earned master’s degrees in public policy and public health (epidemiology) from the University of California, Berkeley, and his medical degree at Case Western Reserve University School of Medicine. Dr. Uyeki completed residencies in pediatrics at the University of California, San Francisco (UCSF) and in preventive medicine at UCSF-UC Berkeley. He then completed a 2-year Epidemic Intelligence Service applied epidemiology fellowship at CDC.

Board-certified in pediatrics, preventive medicine, and public health, Dr. Uyeki serves as an associate clinical professor in the Department of Pediatrics at the University of California, San Francisco. He is also an adjunct associate professor in the Hubert Department of Global Health at Emory University’s Rollins School of Public Health.