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IAC Express 2006 |
| Issue number 626: October 23, 2006 |
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Contents
of this Issue
(Select a title to
jump to the article.) |
- CDC influenza web section
posts letter to healthcare providers about influenza vaccine supply for
2006-07 season
- JAMA article links
increased pertussis incidence to nonmedical exemptions to school
immunization requirements
- Congratulations! Walt
Orenstein, MD, elected to the Institute of Medicine
- Gene is linked to autism
spectrum disorders in families with more than one affected child
- New: NIP posts web page of
shingles (herpes zoster) vaccine information for healthcare providers and
public
- CDC issues update on GBS
among U.S. recipients of Menactra meningococcal conjugate vaccine during
2005-06
- New: Fact sheet available
for health professionals and the public on GBS and meningococcal conjugate
vaccine
- CDC reports on 2004 survey
of STD-prevention counseling practices and HPV opinions of clinicians with
teen patients
- More than half of U.S.
states report >=95 percent vaccination coverage of children entering
school in 2005-06
- CDC reports on U.S.
varicella surveillance practices in 2004
- CDC's influenza web
section begins posting the "Weekly Report: Influenza Summary Update" for
the 2006-07 season
- Guidance on use of
surgical masks and respirators in healthcare settings posted on Pandemic
Influenza website
- Conference on preparing
for influenza pandemic is planned for November 13-15 in Washington, DC
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| Abbreviations |
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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. |
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| Issue 626: October 23, 2006 |
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1. |
October 23, 2006
CDC INFLUENZA WEB SECTION POSTS LETTER TO HEALTHCARE PROVIDERS ABOUT
INFLUENZA VACCINE SUPPLY FOR 2006-07 SEASON
On October 17, CDC's Influenza web section posted a letter informing
healthcare providers about the supply of influenza vaccine for the 2006-07
season. The letter was written by Jeanne M. Santoli, MD, MPH, deputy
director, Immunization Services Division, National Center for Immunization
and Respiratory Diseases. Portions of it are reprinted below.
On October 18, Dr. Santoli conducted a press briefing on the influenza
vaccine supply. A link to the transcript appears at the end of this IAC
Express article.
******************************
From Dr. Santoli's letter:
Because the U.S. influenza vaccine manufacturers are currently producing
vaccine at or near full capacity, it isn't possible for all of the doses to
be produced and distributed before the vaccination season begins. . . .
Especially during the first weeks of October, it is likely that different
providers will have received different amounts of vaccine. Depending upon the
manufacturer or distributor that a provider ordered vaccine from, it is
likely that some providers will get vaccine ahead of others. In contrast to
last year, we anticipate that these discrepancies will be more limited in
both time and scope because all of the manufacturers continue to report good
progress in vaccine production/lot release activities.
In planning influenza vaccination activities, CDC encourages providers to
take this phased nature of influenza vaccine production and distribution into
account. All providers should have some vaccine in September and October to
allow them to begin vaccinating their patients. Thus, vaccination should
begin NOW with available vaccine rather than waiting until more vaccine
arrives because the optimal time to get vaccinated is in October and
November. Additional vaccine will be arriving throughout the vaccination
season, and we expect that there will be more vaccine available than ever
before.
Phased vaccine production and distribution also means that many providers
will not see their entire vaccine order until the end of November. For this
reason, CDC urges providers to make significant effort to offer influenza
immunization in December, January, and beyond, consistent with the most
recent Advisory Committee on Immunization Practices (ACIP) recommendations
for use of influenza vaccine. Vaccinating beyond November is important and
beneficial because the peak of influenza disease typically occurs in February
or later, and many high-risk persons and their household contacts who are
recommended for vaccination are not vaccinated by the end of November. In
addition, even when disease is present in a community, individuals may still
benefit from vaccination.
******************************
To access Dr. Santoli's complete letter, go to:
http://www.cdc.gov/flu/whatsnew.htm and click on the pertinent link.
To access the transcript of Dr. Santoli's press briefing, go to:
http://www.cdc.gov/od/oc/media/transcripts/t061018.htm
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2. |
October 23, 2006
JAMA ARTICLE LINKS INCREASED PERTUSSIS INCIDENCE TO NONMEDICAL EXEMPTIONS TO
SCHOOL IMMUNIZATION REQUIREMENTS
On October 11, the Journal of the American Medical Association (JAMA)
published the article "Nonmedical Exemptions to School Immunization
Requirements: Secular Trends and Associations of State Policies with
Pertussis Incidence." The abstract is reprinted below.
*************************
Context: School immunization requirements have played a major role in
controlling vaccine-preventable diseases in the United States. Most states
offer nonmedical exemptions to school requirements (religious or personal
belief). Exemptors are at increased risk of acquiring and transmitting
disease. The role of exemption policies may be especially important for
pertussis, which is endemic in the United States.
Objective: To determine if (1) the rates of nonmedical exemptions differ and
have been increasing in states that offer only religious vs. personal belief
exemptions; (2) the rates of nonmedical exemptions differ and have been
increasing in states that have easy vs. medium and easy vs. difficult
processes for obtaining exemptions; and (3) pertussis incidence is associated
with policies of granting personal belief exemptions, ease of obtaining
exemptions, and acceptance of parental signature as sufficient proof of
compliance with school immunization requirements.
Design, Setting, and Participants: We analyzed 1991 through 2004 state-level
rates of nonmedical exemptions at school entry, and 1986 through 2004
pertussis-incidence data for individuals aged 18 years or younger.
Main Outcome Measures: State-level exemption rates and pertussis incidence.
Results: From 2001 through 2004, states that permitted personal belief
exemptions had higher nonmedical exemption rates than states that offered
only religious exemptions, and states that easily granted exemptions had
higher nonmedical exemption rates in 2002 through 2003 compared with states
with medium and difficult exemption processes. The mean exemption rate
increased an average of 6% per year, from 0.99% in 1991 to 2.54% in 2004,
among states that offered personal belief exemptions. In states that easily
granted exemptions, the rate increased 5% per year, from 1.26% in 1991 to
2.51% in 2004. No statistically significant change was seen in states that
offered only religious exemptions or that had medium and difficult exemption
processes. In multivariate analyses adjusting for demographics, easier
granting of exemptions (incidence rate ratio = 1.53; 95% confidence interval,
1.10-2.14), and availability of personal belief exemptions (incidence rate
ratio = 1.48; 95% confidence interval, 1.03-2.13) were associated with
increased pertussis incidence.
Conclusions: Permitting personal belief exemptions and easily granting
exemptions are associated with higher and increasing nonmedical U.S.
exemption rates. State policies granting personal belief exemptions and
states that easily grant exemptions are associated with increased pertussis
incidence. States should examine their exemption policies to ensure control
of pertussis and other vaccine-preventable diseases.
*************************
To access the abstract, go to:
http://jama.ama-assn.org/cgi/content/abstract/296/14/1757
The full text is available to JAMA subscribers.
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3. |
October 23, 2006
CONGRATULATIONS! WALT ORENSTEIN, MD, ELECTED TO THE INSTITUTE OF MEDICINE
On October 9, the Institute of Medicine (IOM) issued a press release
announcing that it has elected 65 new members. Among the 65 is Walter A.
Orenstein, MD. Dr. Orenstein is currently professor of medicine and director,
Program for Vaccine Policy and Development, Department of Medicine, Emory
University, Atlanta. Previously, he served for many years as director of
CDC's National Immunization Program. He is also co-editor of the fourth
edition of the textbook "Vaccines" and serves on IAC's Advisory Board.
To read the IOM press release, go to:
http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=10092006
On October 11, Emory University issued a press release; to read it, go to:
http://www.whsc.emory.edu/press_releases.cfm
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4. |
October 23, 2006
GENE IS LINKED TO AUTISM SPECTRUM DISORDERS IN FAMILIES WITH MORE THAN ONE
AFFECTED CHILD
On October 17, the National Institute of Mental Health (NIMH) issued a press
release titled Gene Linked to Autism in Families with More Than One Affected
Child. Portions of it are reprinted below.
********************
A version of a gene has been linked to autism in families that have more than
one child with the disorder. Inheriting two copies of this version more than
doubled a child's risk of developing an autism spectrum disorder, scientists
supported by the National Institutes of Health's (NIH) National Institute of
Mental Health (NIMH) National Institute on Child Health and Human Development
(NICHD) have discovered. In a large sample totaling 1,231 cases, they traced
the connection to a tiny variation in the part of the gene that turns it on
and off. People with autism spectrum disorders were more likely than others
to have inherited this version, which cuts gene expression by half, likely
impairing development of parts of the brain implicated in the disorder,
report Drs. Daniel Campbell, Pat Levitt, Vanderbilt Kennedy Center at
Vanderbilt University, and colleagues, online during the week of October 16,
2006 in the Proceedings of the National Academy of Sciences.
"This common gene variant likely predisposes for autism in combination with
other genes and environmental factors," said Levitt. "It exerts the strongest
effect detected thus far among autism candidate genes."
Autism is one of the most heritable mental disorders. If one identical twin
has it, so will the other in nearly 9 out of 10 cases. If one sibling has the
disorder, the other siblings run a 35-fold greater-than-normal risk of having
it. Still, scientists have so far had only mixed success in identifying the
genes involved.
While most previous studies had focused on genes expressed in the brain,
Levitt's team saw a clue in the fact that some people with autism also have
gastrointestinal, immunological, or neurological symptoms in addition to
behavioral impairments. They focused on a gene that affects such peripheral
functions, as well as the development of the cortex and cerebellum, brain
areas disturbed in autism. Moreover, it is located in a suspect area of
chromosome 7 that has been previously linked to autism spectrum disorders. .
. .
********************
To access the complete press release, go to:
http://www.nimh.nih.gov/press/autismmetgene.cfm
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5. |
October 23, 2006
NEW: NIP POSTS WEB PAGE OF SHINGLES (HERPES ZOSTER) VACCINE INFORMATION FOR
HEALTHCARE PROVIDERS AND PUBLIC
On October 16, NIP posted a new web page for healthcare providers and the
public on shingles (herpes zoster) vaccine. It contains links to information
on the status of the vaccine, basic Q&As on the disease and vaccine, the
vaccine information statement and package insert, and press releases. To
access the web section, go to:
http://www.cdc.gov/nip/vaccine/zoster
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6. |
October 23, 2006
CDC ISSUES UPDATE ON GBS AMONG U.S. RECIPIENTS OF MENACTRA MENINGOCOCCAL
CONJUGATE VACCINE DURING 2005-06
CDC published "Update: Guillain-Barre Syndrome Among Recipients of Menactra
Meningococcal Conjugate Vaccine—United States, June 2005-September 2006" in
the October 20 issue of MMWR. Portions of the article are reprinted below.
***********************
In October 2005, reports indicating a possible association between
Guillain-Barre Syndrome (GBS) and receipt of meningococcal conjugate vaccine
(MCV4) (Menactra, sanofi pasteur, Inc., Swiftwater, Pennsylvania) were made
to the Vaccine Adverse Event Reporting System (VAERS). GBS is a serious
neurologic disorder involving inflammatory demyelination of the peripheral
nerves. During March 2005-February 2006, eight confirmed cases had occurred
within 6 weeks (i.e., the time window of elevated risk noted for GBS after
administration of other vaccines) after MCV4 vaccination. This report
summarizes nine additional GBS cases reported to VAERS during March-September
2006. This report also provides a preliminary analysis of data from VAERS and
the Vaccine Safety Datalink (VSD) since MCV4 became available in the United
States in March 2005 and includes all 17 cases of GBS reported since June
2005. Although these data suggest a small increased risk for GBS after MCV4
vaccination, the inherent limitations of VAERS and the uncertainty regarding
background incidence rates for GBS require that these findings be viewed with
caution. Because of the risk for meningococcal disease and the associated
morbidity and mortality, CDC continues to recommend routine vaccination with
MCV4 for adolescents, college freshmen living in dormitories, and other
populations at increased risk. . . .
Editorial Note:
Neisseria meningitidis is a major cause of bacterial meningitis and sepsis in
the United States. The case-fatality ratio for meningococcal disease is
10%-14%. Meningococcal disease also causes substantial morbidity; 11%-19% of
survivors have sequelae (e.g., neurologic disability, limb loss, or hearing
loss). Although rates of disease are highest among children aged <2 years,
62% of meningococcal disease cases in the United States occur among persons
aged >11 years. During 1991-2002, the rate for persons aged 11-19 years was
1.2 per 100,000 per year and was higher than the rate for the general
population. The Advisory Committee on Immunization Practices (ACIP) has
recommended MCV4 vaccination for the prevention of invasive meningococcal
disease.
In October 2005 and April 2006, CDC and the Food and Drug Administration
alerted healthcare providers about a possible association between GBS and
MCV4. Since introduction of MCV4, a total of 15 cases of GBS have been
reported in persons aged 11-19 years with onset within 6 weeks of MCV4
vaccination. The ratio calculated by using HCUP [Heathcare Cost and
Utilization Project] data, but not VSD data, to define the background
incidence rate, suggests a statistically significant increased risk for GBS
after vaccination with MCV4.
The completeness of GBS reporting to VAERS, a passive surveillance system, is
unknown. If underreporting to VAERS of GBS after MCV4 vaccination has
occurred, the risk would be higher than estimated in this report. In
addition, VSD has a limited ability to detect rare health events such as GBS;
therefore, not finding any cases after vaccination in this population aged
11-19 years should not offer substantial reassurance regarding the safety of
MCV4. Finally, the timing of onset of neurologic symptoms within 1-5 weeks of
vaccination among reported cases continues to be of concern.
Using the HCUP background incidence rate and assuming the ratio of 1.78
accurately represents the true magnitude of increased risk after MCV4
vaccination, the number of excess cases of GBS for every 1 million doses
distributed to persons aged 11-19 years is approximately 1.25 (CI [confidence
interval] = 0.058-5.99). However, substantial uncertainty exists regarding
the risk estimate, using either the HCUP or VSD background incidence rate.
Furthermore, no surge in the frequency of GBS reports to VAERS was noted
after either the October 2005 or April 2006 CDC reports, as might be expected
if underreporting had occurred (e.g., after alerts for intussusception
associated with RotaShield vaccine).
GBS is a rare illness, regardless of etiology; expected incidence rates for
GBS are not precisely known, and the available data cannot determine with
certainty whether MCV4 increases the risk for GBS. Ongoing evaluation of GBS
after MCV4 vaccination is being performed using VSD data. A larger study will
be necessary to provide a more definitive assessment, but any such study
likely will take several years to accumulate cases and attain sufficient
statistical power.
In May 2005, CDC recommended routine vaccination with MCV4 of adolescents,
college freshmen living in dormitories, and others at high risk for
meningococcal disease. However, CDC recommends that persons with a history of
GBS not receive MCV4, although persons with a history of GBS at especially
high risk for meningococcal disease (i.e., microbiologists routinely exposed
to isolates of Neisseria meningitidis) might consider vaccination. Given the
data in this report, ACIP will review the current recommendations for MCV4. A
Vaccine Information Statement and fact sheet providing information on the
vaccine and reported GBS cases is available at
http://www.cdc.gov/nip/publications/vis/default.htm An updated fact sheet
for healthcare workers on GBS and Menactra is available at
http://www.cdc.gov/nip/vacsafe/concerns/gbs/menactra.htm Because of the
ongoing risk for meningococcal disease and the limitations of the data
indicating a small risk for GBS after MCV4 vaccination, the additional cases
reported here do not affect or change current CDC recommendations.
CDC encourages all persons to report cases of GBS or any other clinically
significant adverse events associated with MCV4 or any other vaccination to
VAERS. Reports may be submitted securely online at
http://www.vaers.hhs.gov or by fax at
(877) 721-0366. Reporting forms and additional information are available at
telephone, (800) 822-7967.
***********************
To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5541a2.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5541.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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7. |
October 23, 2006
NEW: FACT SHEET AVAILABLE FOR HEALTH PROFESSIONALS AND THE PUBLIC ON GBS AND
MENINGOCOCCAL CONJUGATE VACCINE
On October 19, CDC's website posted a fact sheet for health professionals and
the public titled Frequently Asked Questions about Guillain-Barre Syndrome [GBS]
and Menactra Meningococcal Conjugate Vaccine. To access it, go to:
http://www.cdc.gov/od/science/iso/faq.htm
Additional information about the vaccine and Guillain-Barre syndrome is
available at
http://www.cdc.gov/od/science/iso/gbsfactsheet.htm
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8. |
October 23, 2006
CDC REPORTS ON 2004 SURVEY OF STD-PREVENTION COUNSELING PRACTICES AND HPV
OPINIONS OF CLINICIANS WITH TEEN PATIENTS
CDC published "STD-Prevention Counseling Practices and Human Papillomavirus
Opinions Among Clinicians with Adolescent Patients—United States, 2004" in
the October 20 issue of MMWR. Portions of the article are reprinted below.
***********************
In 2000, an estimated 18.9 million new cases of sexually transmitted diseases
(STDs) occurred in the United States. Although young persons aged 15-24 years
represented only 25% of the sexually active population, approximately 48% of
STD cases in 2000 occurred in this age group. The most common sexually
transmitted infection in persons aged <=24 years was attributed to human
papillomavirus (HPV). Although the natural immunity of most young persons can
clear HPV infections with no clinical consequences, certain infections
persist and result in warts, precancerous changes, and invasive cancers of
the anogenital region in both males and females. In 2000, an estimated 4.6
million new HPV infections occurred among persons aged 15-24 years, resulting
in expected direct medical lifetime costs of $2.9 billion. In June 2006, the
Food and Drug Administration licensed the first HPV vaccine for females aged
9-26 years for the prevention of cervical cancer (U.S. 2000 incidence rate:
9.4 cases per 100,000), precancerous genital lesions, and genital warts
associated with HPV types included in the vaccine (HPV 6, 11, 16, and 18).
Protection has been demonstrated for genital infections associated with HPV
types included in the vaccine; therapeutic efficacy for persons already
infected has not been demonstrated. To assess (1) STD risk assessment,
counseling, and education practices of U.S. healthcare providers during
routine adolescent checkups and (2) provider opinions regarding methods to
prevent HPV acquisition, CDC and Battelle Centers for Public Health Research
and Evaluation surveyed clinicians who provided adolescent primary care. The
results of this survey indicated that most of the clinicians assessed STD
risk in their adolescent patients, addressed STD prevention, and recommended
various STD-prevention methods; however, clinician opinions varied regarding
the effectiveness of methods for preventing HPV infection and whether their
patients would adopt these methods for the long term. Clinicians periodically
should assess STD risk in their adolescent patients and provide STD
counseling and education to reduce the incidence of STDs in this age group at
high risk.
The analyses described in this report resulted from a broader assessment of
the knowledge, attitudes, and practices among U.S. linicians regarding HPV
infections and general STD practice. In May 2004, CDC mailed surveys to 5,386
clinicians in seven specialties who commonly provide STD diagnosis,
treatment, and prevention services. Nationally representative samples were
drawn from databases that included members and nonmembers of the American
Medical Association, American Association of Physicians' Assistants, American
College of Nurse Midwives, and American Association of Nurse Practitioners. .
. .
Editorial Note:
As recommended by national STD treatment guidelines, 81% of the clinicians
surveyed in this study reported taking advantage of the routine checkup to
assess STD risk in their adolescent patients. In addition, 93% of those with >=75% of their patients aged <18 years reported educating patients they
believed were sexually active about prevention of STDs, and 69% reported
specifically addressing HPV infection. Clinician counseling of adolescents
regarding STD prevention has been determined to reduce the incidence of STDs.
Current national recommendations encourage clinicians to periodically assess
adolescents for STD risk and provide STD counseling.
Although abstinence is the surest method to reduce the risk for acquiring HPV
infection and other sexually transmitted infections, monogamy, minimizing the
number of sex partners, and condom use also can reduce the risk. Large
proportions (78%-95%) of clinicians believed that consistent condom use,
abstinence, monogamy, and limiting number of sex partners were highly
effective methods to prevent acquisition of HPV infection or HPV-related
conditions. However, only 6%-23% believed that the majority of their patients
would adopt these methods for the long term.
In this study, clinicians were more likely to rate abstinence, monogamy, and
limiting number of sex partners as highly effective compared with condom use;
however, they rated condoms as the method their patients most likely would
use long term. . . .
Scientific data link HPV infection to cervical cancer. Screening tests for
HPV infection and the new vaccine to prevent infections from HPV genotypes
that cause most cases of cervical HPV infection are now available, in
addition to traditional Pap tests for precancerous and cancerous cervical
lesions. The Advisory Committee on Immunization Practices issued provisional
recommendations that this vaccine be routinely administered to girls aged
11-12 years and used for catch-up immunization in females aged 13-26 years.
Clinicians should be prepared to discuss with their adolescent patients
prevention of HPV infection and other viral and bacterial STDs.
To support clinician risk assessment and prevention counseling for HPV
infection, CDC and others have updated online training and support materials.
A web cast, HPV and Cervical Cancer: An Update on Prevention Strategies, is
available at
http://www.phppo.cdc.gov/phtn/hpv-05; a net conference, Human
Papillomavirus (HPV), Cervical Cancer, and HPV Vaccine and Recommendations,
is available at
http://www.cdc.gov/nip/ed/ciinc/hpv.htm Materials regarding HPV infection
also have been updated for patients and the general public to increase
awareness of these topics and various prevention strategies. An overview of
HPV infection and information regarding STDs is available at
http://www.cdc.gov/std/hpv, and
information regarding HPV vaccine is available at
http://www.cdc.gov/nip/vaccine/hpv
***********************
To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5541a1.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5541.pdf
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9. |
October 23, 2006
MORE THAN HALF OF U.S. STATES REPORT >=95 PERCENT VACCINATION COVERAGE OF
CHILDREN ENTERING SCHOOL IN 2005-06
CDC published "Vaccination Coverage Among Children Entering School—United
States, 2005-06 School Year" in the October 20 issue of MMWR. Portions of the
article are reprinted below.
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One of the national health objectives for 2010 is to achieve and sustain >=95% vaccination coverage among children in kindergarten through first grade
for the following vaccines: hepatitis B vaccine; diphtheria and tetanus
toxoids and pertussis vaccine, diphtheria and tetanus toxoids and acellular
pertussis vaccine, or diphtheria and tetanus toxoids vaccine (DTP/DTaP/DT);
poliovirus (polio) vaccine; measles, mumps, and rubella vaccines; and
varicella vaccine. To determine vaccination coverage among children entering
kindergarten, data were analyzed from reports submitted to CDC by states and
the District of Columbia (DC) for the 2005-06 school year. This report
summarizes the results of that analysis, which indicated that coverage for
each vaccine was reported to have exceeded 95% in more than half of the
states. . . .
Editorial Note:
More than half of reporting states indicate that they have already reached
the Healthy People 2010 goal of >=95% coverage for each of the vaccines
recommended by the Advisory Committee on Immunization Practices (ACIP); the
remaining states are making progress toward this goal. However, required
vaccines and methods for surveying kindergarten-aged children vary
substantially from state to state; the majority of states rely on
self-reports by schools, rather than audits by health departments, to
determine coverage, which might lead to underestimations or overestimations.
CDC provided a new online reporting system, which has been available since
the 2002-03 school year, to help states and U.S.-affiliated jurisdictions
collect and report data on vaccination coverage among children entering
school. Anecdotal reports from states indicate that this system, which
automates data-management and calculation tasks, has made reporting coverage
easier. CDC also has promoted greater standardization of reporting, for
example, by encouraging all states to report coverage based on ACIP
recommendations rather than on state requirements. These improvements in
survey methods and assessment procedures will help ensure that health
jurisdictions are accurately reporting progress toward the >=95% coverage
goal.
State laws requiring proof of vaccination at school entry have been
considered a safety net for the U.S. vaccination program because they are
intended to ensure that no child is missed. This safety net relies on school
nurses, teachers, health department staff, and others to identify children
who are not up to date with their vaccinations. Findings of high nationwide
coverage in recent years underscore the success of school entry requirements
in boosting vaccination coverage, which increased substantially when entry
requirements were established. Childhood vaccination coverage also is
measured nationally among children aged 19-35 months. Higher percentages of
children are up to date when entering kindergarten than at younger ages,
suggesting that school entry laws are an important factor in maintaining high
vaccination coverage and ensuring completion of the vaccine doses recommended
at ages 4-6 years.
The findings in this report are subject to at least two limitations. First,
the substantial variation in assessment methods limits the comparability of
these data and suggests, in some cases, that data quality could be improved
(e.g., by using methods other than self-report, standardizing measurement of
vaccination coverage, monitoring data for validity and reliability, and using
appropriate sampling methods). Second, children attending private schools or
home schools were not surveyed by all states. The difference in vaccination
rates between children schooled at home and children in public or private
school environments is unknown.
Additional information about assessing and reporting vaccination coverage
among children entering school is available at
http://www.cdc.gov/nip/coverage/schoolsurv/overview.htm The schedule of
recommended vaccinations for children is available at
http://www.cdc.gov/nip/recs/child-schedule-4pg-landscp.pdf
***********************
To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5541a3.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5541.pdf
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October 23, 2006
CDC REPORTS ON U.S. VARICELLA SURVEILLANCE PRACTICES IN 2004
CDC published "Varicella Surveillance Practices—United States, 2004" in the
October 20 issue of MMWR. Portions of a summary made available to the press
are reprinted below.
***********************
In 2004, to assess the progress in varicella surveillance in the United
States, CDC surveyed immunization program managers in selected public health
jurisdictions. This report describes the results of that survey, which
indicated that substantial progress has been made toward the implementation
of case-based surveillance as recommended by CSTE [Council of State and
Territorial Epidemiologists] in 2002. As of 2004, however, 28 jurisdictions
still had not implemented case-based surveillance. To monitor the effect of
the vaccination program on the changing epidemiology of varicella disease,
every state should conduct case-based surveillance for varicella. This is
particularly important in light of the 2006 recommendation by the Advisory
Committee on Immunization Practices for a routine second dose of varicella
vaccine for children aged 4-6 years because enhanced surveillance is needed
to further monitor varicella epidemiology.
***********************
To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5541a4.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5541.pdf
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11. |
October 23, 2006
CDC'S INFLUENZA WEB SECTION BEGINS POSTING THE "WEEKLY REPORT: INFLUENZA
SUMMARY UPDATE" FOR THE 2006-07 SEASON
CDC collects surveillance data year-round and reports on U.S. influenza
activity each week from October through May in its "Weekly Report: Influenza
Summary Update." For the 2006-07 influenza season, each Weekly Report will
include these components: background, synopsis, laboratory surveillance,
pneumonia and influenza (P&I) mortality surveillance, influenza-associated
pediatric mortality, influenza-associated pediatric hospitalizations,
influenza-like illness (ILI) surveillance, and influenza activity as assessed
by state and territorial epidemiologists.
To access Weekly Reports for the 2006-07 influenza season, as well as reports
from previous seasons, go to:
http://www.cdc.gov/flu/weekly/fluactivity.htm This link will also give
you access to a U.S. map showing current influenza activity and to websites
that contain international influenza surveillance data.
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12. |
October 23, 2006
GUIDANCE ON USE OF SURGICAL MASKS AND RESPIRATORS IN HEALTHCARE SETTINGS
POSTED ON PANDEMIC INFLUENZA WEBSITE
The federal government's PandemicFlu website recently posted the document
"Interim Guidance on Planning for the Use of Surgical Masks and Respirators
in Health Care Settings During an Influenza Pandemic." To access it, go to:
http://www.pandemicflu.gov/plan/maskguidancehc.html
To access a broad range of continually updated information on seasonal
influenza, avian influenza, and pandemic influenza, go to:
http://www.cdc.gov/flu
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October 23, 2006
CONFERENCE ON PREPARING FOR AN INFLUENZA PANDEMIC IS PLANNED FOR NOVEMBER
13-15 IN WASHINGTON, DC
A three-day conference, End-to-End Preparedness for Pandemic Influenza:
Opportunities for Public-Private Collaboration, will be held November 13-15
in Washington, DC. Its goal is to bring together senior government officials
and top industry executives to develop a partnership for preparing the public
health response to an influenza pandemic. CDC and FDA are participants.
For additional information, including the conference brochure and a link for
online registration, go to:
http://www.infocastinc.com/pand06.html
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