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Immunization Action Coalition

IAC Express 2006

Issue number 265: October 16, 2006

Contents of this Issue
(Select a title to jump to the article.)
  1. New: CDC releases October 2006-September 2007 adult immunization schedule
  2. New: Interim VIS for HPV vaccine in Spanish; VISs for injectable and nasal-spray influenza vaccines in Armenian
  3. October issue of CDC's Immunization Works electronic newsletter now available on the NIP website
  4. National Influenza Vaccine Summit posts its August-September newsletter
  5. New: The October 2006 issue of Vaccinate Adults is in the mail and on the Web
  6. AAP publishes three articles on measles-containing vaccine
  7. CDC launches multi-state study to identify risk factors for autism-spectrum disorders, awards $5.9 million
  8. What's your state doing? PandemicFlu website posts comprehensive array of state pandemic planning information
  9. New state requirements: Governors of Kansas, Louisiana, and New York sign immunization legislation
  10. CDC publishes update on vaccine-derived polioviruses worldwide
  11. MMWR issues correction to its October 6 report on 2004-05 childhood influenza vaccination coverage
 
Abbreviations
AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NIP, National Immunization Program; VIS, Vaccine Information Statement; VPD, vaccine-preventable disease; WHO, World Health Organization.
  
Issue 625: October 16, 2006
1.  October 16, 2006
NEW: CDC RELEASES OCTOBER 2006-SEPTEMBER 2007 ADULT IMMUNIZATION SCHEDULE


CDC published "Recommended Adult Immunization Schedule—United States, October 2006-September 2007" as an MMWR QuickGuide in the October 13 issue of MMWR. The article is reprinted below in its entirety, excluding references and two figures.

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The Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule to ensure that the schedule reflects current recommendations for the licensed vaccines. In June 2006, ACIP approved the Adult Immunization Schedule for October 2006-September 2007. This schedule has also been approved by the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists.

CHANGES IN THE SCHEDULE FOR OCTOBER 2006-SEPTEMBER 2007
The 2006-2007 schedule differs from the previous schedule as follows:
  • The broken red line has been deleted on the age-based schedule. Vaccination of persons with specific risk factors is now shown only with purple bars.
     
  • Human papillomavirus (HPV) vaccine has been added to the age-based schedule, with a yellow bar indicating that the vaccine is recommended for women <=26 years.
     
  • Tetanus, diphtheria, and acellular pertussis (Tdap) vaccine has been added to the age-based schedule, with a hatched yellow bar indicating that Tdap is a one-time, 1-dose recommendation for persons <=64 years.
     
  • The purple bar for varicella vaccine has been shortened in anticipation of the recommendation for the use of zoster vaccine in persons aged >=60 years.
     
  • A new column has been added to the medical/other indications schedule to clarify indications for hepatitis A and B vaccines. The indications "chronic liver disease" and "recipients of clotting factor concentrates" have been removed from the previous schedule's third and fifth columns, respectively, and combined into a new column. The column has a yellow bar for hepatitis A and B vaccines, clarifying that these vaccines are recommended for all persons with these medical indications.
     
  • HPV vaccine has been added to the medical/other indications schedule, with a yellow bar to indicate the vaccine is recommended for women aged <=26 years with all indications except pregnancy.
     
  • Tdap was added to the medical/other indications schedule, with a hatched yellow bar to indicate that Tdap is a one-time, 1-dose recommendation for all indications except pregnancy.
     
  • The tetanus and diphtheria footnote (#1) has been reworded to reflect ACIP recommendations for use of Tdap.
     
  • A footnote (#2) has been added to reflect ACIP recommendations for HPV vaccination for all women aged <=26 years.
     
  • The measles, mumps, and rubella (MMR) footnote (#3) has been reworded to reflect ACIP recommendations to administer a second dose of mumps vaccine to adults in certain age groups and with certain risk factors.
     
  • The varicella footnote (#4) has been reworded in accordance with ACIP recommendations for administering a routine second dose for all adults without evidence of immunity. The footnote also has been revised to reflect the new definition of immunity to varicella.
     
  • The influenza footnote (#5) has been revised to reflect recent ACIP recommendations to vaccinate close contacts of children aged 0-59 months rather than 0-23 months.
     
  • The hepatitis B footnote (#9) has been revised to reflect recommendations to vaccinate any adult seeking protection from hepatitis B virus infection and vaccinate adults in specific settings (e.g., sexually transmitted disease clinics).

The Adult Immunization Schedule is available in English and Spanish at http://www.cdc.gov/nip/recs/adult-schedule.htm [IAC Express editor's note: the Spanish-language version will be available in January 2007]. General information about adult vaccinations, including recommendations concerning vaccination of person with HIV and other immunosuppressive conditions, is available from state and local health departments and at http://www.cdc.gov/nip Vaccine information statements are available at http://www.cdc.gov/nip/publications/vis ACIP statements for each recommended vaccine and provisional vaccine recommendations can be viewed, downloaded, and printed at http://www.cdc.gov/nip/publications/acip-list.htm Instructions for reporting adverse events to the Vaccine Adverse Event Reporting System are available at http://www.vaers.hhs.gov or by telephone, (800) 822-7967.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5540a10.htm

To access a ready-to-print (PDF) version of this MMWR issue, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5540.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to: http://www.cdc.gov/mmwr/mmwrsubscribe.html

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2.  October 16, 2006
NEW: INTERIM VIS FOR HPV VACCINE IN SPANISH; VISs FOR INJECTABLE AND NASAL-SPRAY INFLUENZA VACCINES IN ARMENIAN


The current interim VIS for human papillomavirus (HPV) vaccine (dated 9/5/06) is now available in Spanish. Dated 6/30/06, the current VISs for trivalent inactivated influenza vaccine (TIV) and live attenuated intranasal influenza vaccine (LAIV) are available in Armenian. IAC gratefully acknowledges the California Department of Health Services for the translations.

INTERIM HPV VACCINE VIS (dated 9/5/06)
To obtain a ready-to-print (PDF) version of the VIS for HPV vaccine in Spanish, go to:
http://www.immunize.org/vis/sp_hpv.pdf

To obtain it in English, go to: http://www.immunize.org/vis/vis-hpv-gardasil.pdf

INFLUENZA VACCINE VISs (dated 6/30/06)
To obtain a ready-to-print (PDF) version of the VIS for TIV in Armenian, go to: http://www.immunize.org/vis/ar_flu06.pdf

To obtain it in English, go to: http://www.immunize.org/vis/2flu.pdf

To obtain a ready-to-print (PDF) version of the VIS for LAIV in Armenian, go to: http://www.immunize.org/vis/arLAIV06.pdf

To obtain it in English, go to: http://www.immunize.org/vis/liveflu.pdf

For information about the use of VISs, and for VISs in more than 30 languages, visit IAC's VIS web section at http://www.immunize.org/vis

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3.  October 16, 2006
OCTOBER ISSUE OF CDC'S IMMUNIZATION WORKS ELECTRONIC NEWSLETTER NOW AVAILABLE ON THE NIP WEBSITE


The October issue of Immunization Works, a monthly email newsletter published by CDC, is available on NIP's website. The newsletter offers members of the immunization community non-proprietary information about current topics. CDC encourages its wide dissemination.

Some of the information in the October issue has already appeared in previous issues of IAC Express. Following is the text of three articles we have not covered.

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FDA APPROVES ADDITIONAL INFLUENZA VACCINE
The U.S. Food and Drug Administration (FDA) approved FluLaval, an influenza vaccine to immunize people 18 years of age and older against the disease caused by strains of influenza virus judged likely to cause seasonal flu in the Northern Hemisphere in 2006-2007.

With this additional vaccine, CDC projects a total of about 115 million doses of influenza vaccine for the 2006–2007 season, but these projections could change as manufacturing continues. Furthermore, 75 million doses are projected for distribution by October 31st.

FluLaval was approved using FDA's accelerated approval pathway, which allows the agency to approve products for serious or life-threatening diseases based on early evidence of a product's effectiveness, reducing the time it takes for needed medical products to become available to the public. In this case, the manufacturer demonstrated that the vaccine induced levels of antibodies in the blood likely to be effective in preventing seasonal influenza. As part of the accelerated approval process, the manufacturer will conduct further studies to verify that the vaccine will decrease seasonal influenza disease after vaccination. FluLaval is the second seasonal influenza vaccine approved using the accelerated approval process; GlaxoSmithKline's Fluarix received approval in 2005. To view the complete FDA press release on FluLaval, please visit http://www.fda.gov/bbs/topics/NEWS/2006/NEW01478.html

CDC encourages anyone who wants to be protected against influenza to seek vaccination, especially those at increased risk for influenza-related complications as well as those who live with or care for people at high risk—including healthcare providers, children between 6 months and up to 5 years old, and people with chronic diseases such as diabetes, asthma, and heart disease, as well as people 50 years old and older. For the 2006-07 season, CDC projects that vaccine supplies will be adequate for children ages 6-23 months. There is also likely to be sufficient influenza vaccine for 4-year-olds. Vaccine doses licensed for 3-year-olds, however, are limited in supply, and CDC anticipates that there will be insufficient vaccine for this age group. More information about influenza and influenza vaccine can be found at http://www.cdc.gov/flu and CDC's Flu Gallery can be found at http://www.cdc.gov/flu/gallery

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MEETINGS, CONFERENCES & RESOURCES

IMMUNIZATION PROVIDER AWARDS ANNOUNCED: CDC awarded five cooperative agreements to immunization provider organizations. Approximately $140,000 will be awarded to each of five organizations: American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), American College of Physicians (ACP), American Pharmacists Association (APhA), and Interamerican College of Physicians and Surgeons. The new funding will support a range of new and continuing projects that inform and educate immunization providers about immunization issues, and promote the improvement of immunization coverage. Funding for this cooperative agreement  is expected to be available for three years, concluding in September 2009. Information about future CDC funding opportunities can be found on http://www.grants.gov

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JOIN IZTA: Local or state immunization coalition members are encouraged to join the Immunization Coalitions National Technical Assistance Network (IZTA). This CDC-funded project provides free technical assistance and resources to immunization coalitions across the country, including monthly presentations on hot immunization topics (via conference call); free individual technical assistance; access to information about coalition building, social marketing, evaluation, and other topics; opportunities to share ideas and experiences with other coalitions across the country; and bi-weekly updates on IZTA events and immunization news. IZTA is managed by the Academy for Educational Development (AED). To sign up, please visit http://www.izcoalitionsta.org

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To access the complete October issue from the NIP website, go to: http://www.cdc.gov/nip/news/newsltrs/imwrks/2006/200610.htm

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4.  October 16, 2006
NATIONAL INFLUENZA VACCINE SUMMIT POSTS ITS AUGUST-SEPTEMBER
NEWSLETTER


The National Influenza Vaccine Summit has posted its August-September 2006 newsletter online at http://www.ama-assn.org/ama1/pub/upload/mm/36/summitnewsletter3_06.pdf

The National Influenza Vaccine Summit website is sponsored by CDC and the American Medical Association. In addition to its newsletter, the site includes presentations from meetings and information about influenza vaccine manufacturing, supply, and distribution.

To visit the National Influenza Vaccine Summit website, go to: http://www.ama-assn.org/ama/pub/category/13732.html

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5.  October 16, 2006
NEW: THE OCTOBER 2006 ISSUE OF VACCINATE ADULTS IS IN THE MAIL AND ON THE WEB


IAC recently mailed the latest issue of Vaccinate Adults (October 2006) to 145,000 adult medicine specialists and others who work in the field of immunization. Packed with immunization resources for health professionals and patients, the 16-page issue is well worth downloading. All articles and education pieces, except editorials, have been thoroughly reviewed by immunization and hepatitis experts at CDC.

HOW TO READ VACCINATE ADULTS ON THE WEB
You can view selected articles from the table of contents below or download the entire issue from the Web.

To view the table of contents with links to individual articles, go to: http://www.immunize.org/va

The PDF file of the entire issue, linked below, is 1.11 megabytes. For tips on downloading and printing PDF files, go to: http://www.immunize.org/nslt.d/tips.htm

To download a ready-to-print (PDF) version of the October issue, go to: http://www.immunize.org/va/va18.pdf

Below are descriptions of articles published in the October issue, followed by links:


GENERAL IMMUNIZATION INFORMATION (three resources)
(1) In "Ask the experts," immunization and hepatitis experts from CDC answer questions about vaccines and their recommended use.

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/va/va18exprt.pdf

To access a web-text (HTML) version, go to: http://www.immunize.org/va/va18exprt.htm

(2) "Vaccine highlights" presents information on recently published ACIP recommendations and newly licensed vaccines.

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/va/va18info.pdf

(3) "If you administer vaccines, you need these materials" offers four resources: three patient screening questionnaires and one guideline for administering intramuscular and subcutaneous injections to persons across the life span. All can be downloaded.

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/va/adminvacs.pdf

VIRAL HEPATITIS INFORMATION (one resource)
(1) Updated in August, "Hepatitis B and the healthcare worker" is a comprehensive, three-page Q&A about indications for healthcare worker hepatitis B vaccination, postvaccination serologic testing, and prophylaxis after occupational exposure to hepatitis B virus infection.

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/catg.d/2109hcw.pdf

To access a web-text (HTML) version, go to: http://www.immunize.org/catg.d/2109hcw.htm


ADULT IMMUNIZATION RESOURCES (one resource)
(1) The three-page chart "Summary of Recommendations for Adult Immunization" was updated in September with new information on using Td/Tdap vaccines during pregnancy and on new definitions of evidence of immunity to varicella.

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/catg.d/p2011b.pdf

To access a web-text (HTML) version, go to: http://www.immunize.org/catg.d/p2011b.htm


INFLUENZA IMMUNIZATION RESOURCES (two resources)
(1) Completely revised in September, "First do no harm: Protect patients by making sure all staff receive yearly influenza vaccine!" briefly reviews the sweeping changes found in the new ACIP recommendations for influenza vaccination of healthcare personnel and the new standard of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/catg.d/p2014.pdf

To access a web-text (HTML) version, go to: http://www.immunize.org/catg.d/p2014.htm

(2) "Influenza vaccination standing orders and screening questionnaires" presents five resources: one sheet of information outlining which persons need influenza vaccine; one standing orders protocol for administering influenza vaccine to adults; two patient-screening questionnaires, one for injectable influenza vaccine and one for intranasal vaccine; and one Declination of Vaccination form for healthcare employees who decline influenza vaccination. All can be downloaded.

To access a ready-to-print (PDF) version, go to: http://www.immunize.org/va/so_screens.pdf

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6.  October 16, 2006
AAP PUBLISHES THREE ARTICLES ON MEASLES-CONTAINING VACCINE


In the October 2006 issue of the journal Pediatrics, the American Academy of Pediatrics published three articles concerning measles-containing vaccines. Article titles and links to article abstracts or extracts follow; the full text of articles is available to Pediatrics subscribers.

To access the abstract for "Evaluation of potentially common adverse events associated with the first and second doses of measles-mumps-rubella vaccine," go to: http://pediatrics.aappublications.org/cgi/content/abstract/118/4/1422

To access the abstract for "No evidence of persisting measles virus in peripheral blood mononuclear cells from children with autism spectrum disorder," go to: http://pediatrics.aappublications.org/cgi/content/abstract/118/4/1664

To access the extract for "Has the measles-mumps-rubella vaccine been fully exonerated?" go to: http://pediatrics.aappublications.org/cgi/content/extract/118/4/1744

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7.  October 16, 2006
CDC LAUNCHES A MULTI-STATE STUDY TO IDENTIFY RISK FACTORS FOR AUTISM-SPECTRUM DISORDERS, AWARDS $5.9 MILLION


On October 6, CDC issued a press release announcing it is launching a study at five sites to identify risk factors for autism-spectrum disorders. Portions of the press release follow.

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The Centers for Disease Control and Prevention (CDC) is initiating a multi-state collaborative study to help identify factors that may put children at risk for autism spectrum disorders (ASDs) and other developmental disabilities. Approximately 2,700 children, ages 2 to 5, and their parents will be part of this study.

CDC has awarded a total of $5.9 million to five sites—Kaiser Foundation Research Institute in California, Colorado Department of Public Health and Environment, Johns Hopkins University in Maryland, University of North Carolina at Chapel Hill, and the University of Pennsylvania. These sites make up the Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) Network. CDC will also be participating in the study, and will include children and their parents from the metropolitan Atlanta area.

"We hope this national study will help us learn more about the characteristics of children with ASDs, factors associated with developmental delays, and how genes and the environment may affect child development," said Dr. Jose F. Cordero, assistant surgeon general and director of CDC's National Center on Birth Defects and Developmental Disabilities. . . .

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To access the complete press release, go to: http://www.cdc.gov/od/oc/media/pressrel/r061006.htm

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8.  October 16, 2006
WHAT'S YOUR STATE DOING? PANDEMICFLU WEBSITE POSTS COMPREHENSIVE ARRAY OF STATE PANDEMIC PLANNING INFORMATION


The federal government's PandemicFlu website (http://www.pandemicflu.gov) recently added a new feature to its homepage. Titled Where You Live, it is a multi-colored map of the United States. Under the map is this explanation: "Selecting this map will take you to a page with links to state pandemic planning information, state pandemic Web site information, and local state contacts."

Click anywhere on the map to be taken to a larger map. Click on a state on the larger map to be taken to a page of links pertinent to the state and its pandemic planning information.

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9.  October 16, 2006
NEW STATE REQUIREMENTS: GOVERNORS OF KANSAS, LOUISIANA, AND NEW YORK SIGN IMMUNIZATION LEGISLATION


The governors of Kansas and Louisiana recently signed legislation requiring college and university students to show proof of vaccination against meningococcal disease. The governor of New York signed a bill that expands requirements for protecting children attending daycare facilities against pneumococcal disease. Details follow.

MENINGOCOCCAL VACCINATION
Kansas. The governor signed a bill on April 14 that requires all incoming college and university students who will be residing in student housing to show proof of vaccination against meningococcal disease. The law allows for waivers for students who refuse to be vaccinated. The requirement will become effective July 1, 2007.

Louisiana. The governor signed a bill on June 8 that requires all students taking courses on campus in public or nonpublic colleges and universities to show proof of vaccination against meningococcal disease. Waivers are permitted for students who choose not to be vaccinated. The law also requires the educational institution to provide detailed information on the vaccine and meningococcal disease to all students. The requirements became effective for the fall 2006 school year.

Immunization Action Coalition has compiled information about all states that have meningococcal prevention mandates for college and university students. To access the information, go to: http://www.immunize.org/laws/menin.htm

This information is also depicted visually on a map of the United States. To access the map, go to: http://www.immunize.org/laws/meninmap.pdf

PNEUMOCOCCAL VACCINATION
New York. The governor signed a bill into law on July 26 that expands the immunization requirements for children attending childcare facilities, effective immediately. The newest requirements are for age-appropriate vaccination against pneumococcal disease and will apply to children born on or after January 1, 2008.

Immunization Action Coalition has compiled information about all states that have pneumococcal prevention mandates for children attending daycare. To access the information, go to: http://www.immunize.org/laws/pneuconj.htm

This information is also depicted visually on a map of the United States. To access the map, go to: http://www.immunize.org/laws/pneuconjmap.pdf

IAC depends on readers to help us stay informed and ensure our website contains the most current and accurate information available. Please let us know when any changes occur in your state by emailing us at admin@immunize.org

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10.  October 16, 2006
CDC PUBLISHES UPDATE ON VACCINE-DERIVED POLIOVIRUSES WORLDWIDE


CDC published "Update on Vaccine-Derived Poliovirus" in the October 13 issue of MMWR. Portions of a summary made available to the press are reprinted below.

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The oral poliovirus vaccine (OPV) is the primary tool used to eradicate polio worldwide. Two primary categories of vaccine-derived polioviruses (VDPVs) resembling wild polioviruses have been identified. Both of these VDPVs are rare. Since 1961 only 30 of these VDPVs have been recognized and only eight outbreaks have been identified in the past. Most iVDPV [immunodeficiency-associated VDPV] infections cease spontaneously, and all cVDPV [circulating VDPV] outbreaks have been rapidly controlled by OPV campaigns. Sensitive laboratory methods have also been developed to support global surveillance for VDPVs. The potential for VDPV emergence will continue as long as OPV is used. Therefore, continued development and implementation of a comprehensive strategy to minimize the risks of VDPV emergence through high polio vaccine coverage remains a high priority.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5540a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5540.pdf

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11.  October 16, 2006
MMWR ISSUES CORRECTION TO ITS OCTOBER 6 REPORT ON 2004-05 CHILDHOOD INFLUENZA VACCINATION COVERAGE


CDC published "Erratum: Vol. 55, No. 39" in the October 13 issue of MMWR. The correction is reprinted in its entirety, excluding references.

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In the MMWR report, "Childhood Influenza Vaccination Coverage—United States, 2004-05 Influenza Season," on page 1061, an error occurred in the fifth sentence of the first paragraph. The sentence should read, "Others recommended to receive influenza vaccination include children aged 5-18 years who have certain high-risk medical conditions, are on chronic aspirin therapy, or who are household contacts of persons at high risk for influenza complications."

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5540a8.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5540.pdf

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This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 5U38IP000290) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.