Volume 32 • Number 1 • January 2011
Changes in MCV4 use include
booster dose for adolescents
by Michael T. Brady, M.D., FAAP
The Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention has recommended two
modifications for use of quadrivalent meningococcal vaccines
(MCV4, Menactra and Men-veo) that will affect the 2011
The AAP Committee on Infectious Diseases has
approved these recommendations.
MCV4 elicits antibodies protective against Neisseria
meningitidis serogroups A, C, Y and W-135.
For children who are at high risk for meningococcal
disease due to immunocompromise (complement deficiency, asplenia, HIV infection), a two-dose primary
series (at least two months
apart) is now recommended.
Children at high risk for meningococcal disease due
to immunocompromise who have received only one
Look to the February AAP News for
the 2011 immunization schedules.
See MCV4, page 13
Menu of options Food allergies affect an estimated 4%-5% of children and teens. New guidelines will help pediatricians diagnose and manage this prevalent health problem.
The Academy has endorsed evidence-based guidelines that address reactions to the seven most common food
allergens in the United States. Access the guidelines from the National Institute of Allergy and Infectious Diseases
and summaries for clinicians and patients at www.niaid.nih.gov/topics/foodAllergy/clinical/Pages/default.aspx.
See story on page 7.
Congress votes to
from Red Flags Rule
from the AAP Department of Practice
Physicians would not be required to comply with the
Federal Trade Commission’s “Red Flags” Rule under legislation approved by Congress. At press time, the bill was
awaiting President Obama’s signature.
The Red Flags Rule defines what a creditor and financial
institution must do to implement an identity theft prevention
program. The Academy and other medical specialty organizations have advocated over the past four years to exclude
physicians from the Red Flags Rule, saying it would increase
their administrative burden and would affect the patient-physician relationship.
Since 2009, Congress has extended the deadline for Red
Flags Rule compliance in an effort to consider the scope of
entities that would be covered. The bill passed by the U.S.
Senate and House of Representatives in early December
excludes physicians from the definition of creditors.
For more information on the Red Flags Rule, visit
www.ftc.gov/opa/2010/05/redflags.shtm or contact Trisha
Calabrese at 800-433-9016, ext. 7124, or tcalabrese@
aap.org, or Julie Ake at 800-433-9016, ext. 7662, or
Improving care, reducing costs
Why some experts have
high hopes for accountable
by Jessica Pupillo • Correspondent
Colleen Kraft, M.D., FAAP, a pediatrician at Carilion
Clinic in Roanoke, Va., is seeing the impact of accountable
care organizations (ACOs) firsthand.
Carilion Clinic is one of three sites participating in an
ACO pilot project sponsored by the Dartmouth Institute
and the Brookings Institution’s Engelberg Center for Health
ACOs, a heralded model for improving health care delivery,
are encouraged under the federal Affordable Care Act and
are driven largely by Medicare reform. The Centers for
Medicare & Medicaid Services (CMS) defines them as organizations of health care providers that agree to be accountable
for the quality, cost and overall care of beneficiaries. In return,
ACOs receive incentive payments based on quality and efficiency in managing costs.
For Dr. Kraft, that means she is paid a base salary and has
opportunities to earn bonuses for meeting care benchmarks
and performance measurements, and for productivity. Invest-