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Immunization Action Coalition
IAC Express 2007
Issue number 650: March 12, 2007
 
Contents of this Issue
Select a title to jump to the article.
  1. New: CDC issues ACIP recommendations for the use of quadrivalent human papillomavirus vaccine
  2. New VIS translation: Spanish-language version of the interim VIS for varicella vaccine now online
  3. Reminder: Be sure to continue administering influenza vaccine during the early months of 2007
  4. CDC's report on aging includes a call to action to increase adult immunization in racial/ethnic minority populations
  5. New formats: 2007 Immunization Schedule for Children and Adolescents now available in pocket and brochure sizes
  6. Fewer than one in three asthmatic children received inactivated influenza vaccine in the 2004-05 influenza season
  7. CDC website posts presentation slides from the February 2007 ACIP meeting
  8. CDC's Adult Immunization Quiz now advises on the need for shingles vaccination
  9. New: March 7 issue of IAC's Hep Express electronic newsletter now online
  10. Pre-travel health advice is the topic for CDC's April 12 Current Issues in Immunization Net Conference
  11. March 13 teleconference to focus on pandemic influenza and the role of immunization coalitions
 
Abbreviations
AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; AMA, American Medical Association; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NCIRD, National Center for Immunization and Respiratory Diseases; NIVS, National Influenza Vaccine Summit; VIS, Vaccine Information Statement; VPD, vaccine-preventable disease; WHO, World Health Organization.
  
Issue 650: March 12, 2007
1.  New: CDC issues ACIP recommendations for the use of quadrivalent human papillomavirus vaccine

On March 12, CDC published an MMWR Early Release, "Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices." CDC issues the web-based Early Release only for the immediate release of important public health information. The recommendations will be published in a future issue of Morbidity and Mortality Weekly Report. The recommendation's summary is reprinted below.


These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a quadrivalent human papillomavirus (HPV) vaccine licensed by the U.S. Food and Drug Administration on June 8, 2006. This report summarizes the epidemiology of HPV and associated diseases, describes the licensed HPV vaccine, and provides recommendations for its use for vaccination among females aged 9-26 years in the United States.

Genital HPV is the most common sexually transmitted infection in the United States; an estimated 6.2 million persons are newly infected every year. Although the majority of infections cause no clinical symptoms and are self-limited, persistent infection with oncogenic types can cause cervical cancer in women. HPV infection also is the cause of genital warts and is associated with other anogenital cancers. Cervical cancer rates have decreased in the United States because of widespread use of Papanicolaou testing, which can detect precancerous lesions of the cervix before they develop into cancer; nevertheless, during 2007, an estimated 11,100 new cases will be diagnosed and approximately 3,700 women will die from cervical cancer. In certain countries where cervical cancer screening is not routine, cervical cancer is a common cancer in women.

The licensed HPV vaccine is composed of the HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein in yeast using recombinant DNA technology produces noninfectious virus-like particles (VLP) that resemble HPV virions. The quadrivalent HPV vaccine is a mixture of four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18 combined with an aluminum adjuvant. Clinical trials indicate that the vaccine has high efficacy in preventing persistent HPV infection, cervical cancer precursor lesions, vaginal and vulvar cancer precursor lesions, and genital warts caused by HPV types 6, 11, 16, or 18 among females who have not already been infected with the respective HPV type. No evidence exists of protection against disease caused by HPV types with which females are infected at the time of vaccination. However, females infected with one or more vaccine HPV types before vaccination would be protected against disease caused by the other vaccine HPV types.

The vaccine is administered by intramuscular injection, and the recommended schedule is a 3-dose series with the second and third doses administered 2 and 6 months after the first dose. The recommended age for vaccination of females is 11-12 years. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 13-26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended. . . .


To access a web-text (HTML) version of the Early Release, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr56e312a1.htm

To access a ready-to-print (PDF) version of it, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr56e312.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 New VIS translation: Spanish-language version of the interim VIS for varicella vaccine now online

Dated 1/10/07, the most recent version of the interim VIS for varicella vaccine is now available on the IAC website in Spanish. IAC gratefully acknowledges the California Department of Health Services for the translation.

To obtain a ready-to-copy (PDF) version of the interim VIS for varicella vaccine in Spanish, go to:
http://www.immunize.org/vis/spvaric.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/varic07.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 Reminder: Be sure to continue administering influenza vaccine during the early months of 2007

Remember, influenza vaccination should continue through the early months of 2007. Visit the following websites often to find the information you need to keep vaccinating. Both are continually updated with the latest resources.

The National Influenza Vaccine Summit website at http://www.preventinfluenza.org

CDC's Influenza web section at http://www.cdc.gov/flu

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4 CDC's report on aging includes a call to action to increase adult immunization in racial/ethnic minority populations

CDC recently released "The State of Aging and Health in America 2007." The report presents the most current national data available on 15 key health indicators for older adults related to health status, health behaviors, preventive care and screening, and injuries. The "State-by-State Report Card" included in the report provides similar information for each of the 50 states and the District of Columbia, and enables states to see where they are on each indicator, as well as in relation to other states.

The report includes bold "Calls to Action" and a "Spotlight" on reducing injuries associated with falls. These features highlight model intervention programs and thoughtful recommendations for policymakers, healthcare providers, and older adults themselves to ensure not just longer, but healthier lives. Also included are emerging public health opportunities such as promoting cognitive health and addressing end-of-life decision-making issues.

Among the items included in the report's National Report Card on Healthy Aging are data on the percentage of adults age 65 and older who received an influenza vaccination within the past year or who ever received a pneumococcal vaccination. The data show that 68 percent report receiving an influenza vaccination within the year, and 65 percent report ever receiving a pneumococcal vaccination. The goal for both interventions is 90 percent, according to the Healthy People 2010 initiative.

The report's "Call to Action for Increasing Adult Immunization in Racial/Ethnic Minorities" is reprinted below in its entirety.


National Healthy People 2010 objectives call for 90% of non-institutionalized persons aged 65 years or older to be vaccinated against influenza and pneumonia . . . Although all population groups currently fall short of this target, African-Americans and Hispanics have significantly lower influenza and pneumococcal immunization rates compared with the rest of the population.

No single factor can be identified that can account for the significant racial/ethnic disparities in vaccination of older persons. Recent research provides evidence for multiple factors that may contribute to this problem, including lower education levels, lower likelihood of vaccination in non-medical settings among African-Americans, less awareness about current vaccine recommendations, and possibly more missed opportunities for vaccination by providers. Although the differences caused by any of these individual factors may be slight, in combination these could lead to the larger disparities observed in vaccination rates among racial/ethnic groups. Focus group research suggests that the desire to protect family members, particularly grandchildren, may be an important motivator for these groups.

The READII [Racial and Ethnic Adult Disparities in Immunization Initiative] project has been a significant effort to address these disparities through multi-year demonstration projects. Conducted in five areas [Monroe County, NY; Milwaukee, WI; San Antonio, TX; Chicago, IL; and 18 counties in the Mississippi Delta Region and Hinds County, MS] from August 2002 through December 2004, these projects aimed to improve influenza and pneumococcal vaccination levels among elderly non-Hispanic blacks and/or Hispanics. Each site identified community partners, and, together, identified a plan for increasing vaccination rates in their target population[s] based on evidence-based interventions recommended in the Guide to Community Preventive Services. Examples of specific activities conducted included working with pharmacists to offer vaccinations, collaborating with the faith-based community, conducting assessment and feedback activities in physician offices, and implementing a tracking/recall/outreach system in clinics serving the target population.

Systematic offering of vaccine to all patients, as was conducted in Monroe County, NY, was shown to reduce disparities in participating practices. Another key outcome was the development of new partnerships that facilitated reaching the target populations, and have continued after the end of the demonstration period.

More information on this program may be found at http://www.cdc.gov/nip/specint/readii


To access the entire 46-page report, go to:
http://www.cdc.gov/aging/pdf/saha_2007.pdf

To access the report's Executive Summary, go to:
http://www.cdc.gov/aging/pdf/saha_exec_summary_2007.pdf

To access CDC's Healthy Aging web section, go to:
http://www.cdc.gov/aging/saha.htm

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5 New formats: 2007 Immunization Schedule for Children and Adolescents now available in pocket and brochure sizes

The CDC website recently posted printable versions of the 2007 Recommended Immunization Schedule for Children and Adolescents Aged 0-18 Years in two additional formats: pocket size (6" x 4.5") and brochure size (11" x 17").

To access them, go to: http://www.cdc.gov/nip/recs/child-schedule.htm

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6 Fewer than one in three asthmatic children received inactivated influenza vaccine in the 2004-05 influenza season

CDC published "Influenza Vaccination Coverage Among Children with Asthma—United States, 2004-05 Influenza Season" in the March 9 issue of MMWR. The opening paragraph of the article is reprinted below.


In 2005, approximately 8.9% (6.5 million) of U.S. children aged <18 years were reported to have current asthma. Children with asthma are at high risk for complications from influenza, and influenza vaccination has been determined to safely and effectively reduce rates of influenza in these children. Since its establishment in 1964, the Advisory Committee on Immunization Practices (ACIP) has recommended that all children with asthma aged >=6 months receive vaccination with inactivated influenza vaccine during each influenza season; however, national influenza vaccination coverage rates specifically for children with asthma have not been determined. Previous studies have assessed influenza vaccination rates in children with asthma at the local level using health maintenance organization and clinician group-practice information, with estimates ranging from 10% to 43% for various influenza seasons. Another study used Behavioral Risk Factor Surveillance System (BRFSS) data to estimate influenza vaccination coverage in children aged 2-17 years with one or more conditions putting them at high risk for complications from influenza (including asthma, although asthma was not assessed separately); in that study, the national rate was estimated at 34.8% for the 2004-05 influenza season (based on a sample size of 685, which included all states and the District of Columbia [DC]). To estimate national influenza vaccination coverage rates among children aged 2-17 years with current asthma, CDC analyzed data from the 2005 National Health Interview Survey (NHIS). This report describes the results of that analysis and provides the first national estimates of influenza vaccination coverage among children with asthma. The findings indicated that although children with current asthma were more likely to receive influenza vaccination than children without current asthma, the vaccination coverage rate among children with asthma was low, at 29.0% (95% confidence interval [CI] = 24.5-33.9). These findings underscore the need to increase influenza vaccination coverage in children with asthma aged 2-17 years by identifying and overcoming barriers to vaccination. . . .


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5609a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5609.pdf

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7 CDC website posts presentation slides from the February 2007 ACIP meeting

The CDC website recently posted the PowerPoint slides presented at the February 21-22 ACIP meeting. Slides are available on the following topics:

  • Hepatitis A postexposure prophylaxis
  • Rotavirus vaccines
  • Thimerosal
  • Vaccine supply
  • Influenza
  • DTaP/IPV/Hib combination vaccine
  • Immunization safety
  • Human papillomavirus vaccine (HPV)

To access the slides, go to: http://www.cdc.gov/nip/ACIP/slides/mtg-slides-feb07.htm

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8 CDC's Adult Immunization Quiz now advises on the need for shingles vaccination

CDC's Adult Immunization Quiz has been updated with information about shingles vaccination. Using the following statement, it advises adults age 60 and older to be vaccinated with the zoster vaccine: "Your age indicates that you need a single dose of this vaccine to protect against shingles. You should receive this vaccine even if you have already had shingles." It also offers links to information about the disease and vaccine.

To access the updated quiz, go to: http://www2.cdc.gov/nip/adultImmSched

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9 New: March 7 issue of IAC's Hep Express electronic newsletter now online

The March 7 issue of Hep Express, an electronic newsletter published by IAC, is now available online. It is intended for health professionals, program planners, and advocates involved in prevention, screening, and treatment of viral hepatitis.

IAC Express has already covered some of the information presented in the November 7 Hep Express; titles of articles we have not yet covered follow.

  • NASTAD [National Alliance of State & Territorial AIDS Directors] issues Action Alert to ask Congress for more federal funding
  • CDC's hepatitis C coordinator portal offers useful resources
  • Latino Organization for Liver Awareness sponsoring New York City Hepatitis C Walk
  • Journal articles you may have missed

To access the March 7 issue, go to:
http://www.hepprograms.org/hepexpress/issue53.asp

To sign up for a free subscription to Hep Express, go to:
http://www.immunize.org/subscribe

To access previous issues of Hep Express, go to:
http://www.hepprograms.org/hepexpress

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10.  Pre-travel health advice is the topic for CDC's April 12 Current Issues in Immunization Net Conference

Scheduled for April 12, from noon to 1PM ET, the net conference Current Issues in Immunization is designed to provide clinicians with up-to-date information on immunization.

In the April conference, the CDC Traveler's Health Team will present an overview of issues related to international travel health and safety. The discussion will highlight current information about international travel including its status, epidemiology, risks, safety, vaccines, health counseling, and available resources. The team will present content followed by a question and answer session for providers.

Two additional sessions focusing on specific travel topics (e.g., travel vaccines, malaria) are being planned for late summer. Because content of the next two net conferences will build on material presented in April, it is recommended that you participate in the April conference.

The conference requires pre-registration, as space is limited. Registration will close when the course is full or on April 11 (midnight ET). To register for the conference, go to: http://www2.cdc.gov/nip/isd/ciinc

The program will combine a telephone audio conference with simultaneous online visual content. It will allow for a question-and-answer segment both by telephone and Internet. Internet access and a separate phone line are needed to participate.

For instructions and system requirements, go to:
http://www.cdc.gov/nip/ed/ciinc/instructions.htm

For additional information, go to: nipinfo@cdc.gov

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11.  March 13 teleconference to focus on pandemic influenza and the role of immunization coalitions

The National Immunization Coalition TA [technical assistance] Network has scheduled a teleconference that will focus on the current status of the federal government's pandemic influenza plan and how immunization coalitions can get involved. The network is a program of the Center for Health Communication, Academy for Educational Development.

The hour-long teleconference will be held at 2:00PM, ET, March 13. The presenters are Raymond Strikas, MD, coordinator, Seasonal and Pandemic Influenza, Department of Health and Human Services (HHS); and Stephanie Marshall, director, Pandemic Communications, HHS. To register, send an email to izta@aed.org Include this message: "Sign me up for the pandemic influenza call."

For additional information, or to access earlier programs, go to: http://www.izcoalitionsta.org/confcall.cfm

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Immunization Action Coalition  •  Saint Paul, MN
tel 651-647-9009  •  fax 651-647-9131
 
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.