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Immunization Action Coalition
IAC Express 2007
Issue number 685: September 24, 2007
 
Contents of this Issue
Select a title to jump to the article.
  1. New: FDA approves use of FluMist nasal-spray influenza vaccine in children age 2-5 years
  2. Health experts deplore low influenza vaccination rates and call for vaccination throughout fall and winter months
  3. CDC data show low influenza vaccination rates for older and at-risk adults
  4. CDC data indicate that fewer than one-third of children age 6-23 months received influenza vaccine during 2005-06
  5. CDC data from six sentinel sites point to low influenza vaccination coverage for children age 6-59 months in 2006-07
  6. VISs for shingles, HPV, DTaP, and PCV7 vaccines available in Hmong, Somali, and/or Russian
  7. Nominations due September 27 for Association of Immunization Managers Bull's-Eye Award
  8. Global Hepatitis A Meeting planned for November 30- December 1 in Miami; abstracts due October 1
  9. CDC reports on progress in controlling measles in Kenya during 2002-07
  10. CDC reports on laboratory surveillance for wild and vaccine-derived polioviruses
 
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 685: September 24, 2007
1.  New: FDA approves use of FluMist nasal-spray influenza vaccine in children age 2-5 years

On September 19, FDA issued a press release announcing that it approved the use of FluMist nasal-spray influenza vaccine in children age 2-5 years. The nasal-spray vaccine, also known as live attenuated influenza vaccine (LAIV), is now recommended for use in people age 2-49 years. Previously, it had been recommended for those age 5-49 years. The press release is reprinted below in its entirety.

Also on September 19, CDC's seasonal influenza website posted several online resources for health professionals that have been revised to reflect the expanded age range for LAIV. Links to those resources appear at the end of this IAC Express article.


[FDA press release]
FDA APPROVES NASAL INFLUENZA VACCINE FOR USE IN YOUNGER CHILDREN

The U.S. Food and Drug Administration today approved expanding the population for use of the nasal influenza vaccine FluMist to include children between the ages of 2 and 5.

Approval for the vaccine, which contains a weakened form of the live virus and is sprayed in the nose, was previously limited to healthy children 5 years of age and older and to adults up to age 49.

"The goal of preventing influenza is now more attainable with the availability of FluMist for younger children," said Jesse L. Goodman, MD, director, FDA's Center for Biologics Evaluation and Research. "This approval also offers parents and health professionals a needle-free option for squeamish toddlers, who may be reluctant to get a traditional influenza shot."

The U.S. Centers for Disease Control and Prevention recommends that all children age 6 months to 59 months receive a vaccination to protect against influenza. Studies have shown that children younger than 5 years had rates of influenza-associated hospitalizations similar to those among individuals age 50 through 64 years, emphasizing the need for improved influenza prevention efforts for this younger U.S. population.

However, until today, there have been only two vaccines licensed in the U.S. for children under the age of 5. One influenza vaccine, Fluzone, is indicated for people over 6 months of age, while another vaccine, Fluvirin, is available for use in children age 4 and older.

Approximately 6,400 infants and children age 6 months to 59 months received FluMist in three studies to support the vaccine's safety and effectiveness. Two studies compared FluMist to placebo (no vaccine), both of which demonstrated the vaccine's effectiveness in preventing influenza illness. A third study compared FluMist to an inactivated or "killed" seasonal influenza vaccine shot. The results showed that there were 53 cases of influenza disease among 3,900 children who received FluMist compared to 93 cases among the same number of children who received an inactivated or "killed" seasonal influenza vaccine shot. Children under the age of 2 should not receive FluMist because there was an increased risk of hospitalization and wheezing for this age group during the clinical trials.

Commonly observed adverse events from the vaccine were generally mild and most often included runny nose and/or nasal congestion, as well as a slight fever in children 2 to 6 years of age.

FluMist should not be administered to anyone with asthma or to children under the age of 5 years with recurrent wheezing because of the potential for increased wheezing after receiving the vaccine. People who are allergic to any of FluMist's components, including eggs or egg products, should also not receive the vaccine.

FluMist is manufactured by MedImmune Vaccines, Inc., Gaithersburg, MD. Fluvirin is made by Novartis Vaccines and Diagnostics Ltd, Liverpool, England. Fluzone is manufactured by sanofi pasteur Inc., Swiftwater, PA.


To access the press release, go to:
http://www.fda.gov/bbs/topics/NEWS/2007/NEW01705.html
  • [Updated online resources]
    Update: Questions & Answers: The Nasal-Spray Flu Vaccine (Live Attenuated Influenza Vaccine [LAIV])
  • Update: Influenza Symptoms
  • Update: Questions & Answers: Seasonal Influenza Vaccine Supply and Vaccination Prioritization Recommendations for the U.S. 2007-08 Influenza Season
  • Update: Questions & Answers: Seasonal Influenza Vaccine Production, Supply, and Distribution in the United States
  • Update: HIV/AIDS and the Flu
  • Update: Questions & Answers: Seasonal Flu Vaccine
  • Update: Key Facts About Seasonal Flu Vaccine

To access the resources listed above, go to: http://www.cdc.gov/flu/whatsnew.htm and click on the pertinent link.

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2 Health experts deplore low influenza vaccination rates and call for vaccination throughout fall and winter months

On September 19, the National Foundation for Infectious Diseases (NFID) held a press conference in collaboration with representatives from the National Influenza Vaccine Summit, CDC, AAP, AMA, and other national organizations. Portions of a press release summarizing the conference are reprinted below.


SERIOUSLY LOW VACCINATION RATES CAUSE EXPERTS TO CALL FOR INCREASED IMMUNIZATION BEFORE INFLUENZA SEASON PEAKS
Paradigm Shift Needed to Ensure Americans Seek Vaccination Now Through the Fall and Winter Months

New data, released today by the Centers for Disease Control and Prevention (CDC), show alarmingly low influenza vaccination rates in both adults and children. CDC joined the National Foundation for Infectious Diseases (NFID) and the nation'sleading health organizations at a national news conference urging increased efforts for Americans to seek immunization against influenza throughout the fall and winter.

"We need to re-think the influenza immunization season and encourage vaccination throughout the fall and winter for anyone wishing to be protected," said Julie L. Gerberding, MD, MPH, director, CDC. "More doses are expected this year than in previous seasons and there is ample time to be immunized."

Dr. Gerberding issued this urgent public health message with leaders from the American Association of Retired Persons (AARP),American Academy of Pediatrics (AAP), American Medical Association (AMA), Centers for Medicare & Medicaid Services (CMS), CDC, and NFID, in partnership with the National Influenza Vaccine Summit, at a news conference this morning at the National Press Club in Washington, DC.

Dr. Gerberding also released new CDC vaccination coverage rates for adults and children, which reinforced the need for ongoing efforts to improve influenza immunization throughout the entire season. During the 2005-2006 season, only one in five children aged 6-23 months were fully vaccinated and little more than one in ten children needing two doses received both doses. Influenza vaccine coverage varied substantially among states, but no state had more than 40 percent of children fully vaccinated.

In addition, this CDC report, released during NFID's news conference, indicates that influenza vaccination coverage in all states during the 2005-2006 influenza season was substantially below the national 60 percent target for persons aged 18-64 years with high-risk conditions, and the 90 percent target for persons aged 65 years and older.

Annual Severe Disease Burden Reinforces Importance of Vaccination

Influenza is responsible for about 36,000 deaths and more than 200,000 hospitalizations in the U.S. each year. In addition, the disease results in more than $87 billion of U.S. economic burden annually (e.g., hospitalization costs, missed days of work, lost lives, etc.). Influenza can be especially severe for those with high-risk conditions (e.g., diabetes, heart disease), and recent studies have also found the illness may trigger up to 92,000 cardiac deaths per year nationwide.

"While we cannot predict influenza virus activity each season, we do know that annual vaccination will help protect individuals against influenza and also reduce spread of the virus to others," said Jeanne M. Santoli, MD, MPH, deputy director of the CDC's Immunization Services Division.

The CDC recommends an annual influenza vaccination for anyone, including school-aged children, who wishes to reduce their risk for contracting the illness or spreading the disease to others. Additionally, vaccination is important for certain populations at increased risk for severe complications, including children from 6 months up to 5 years of age, people with chronic medical conditions (e.g., asthma, diabetes, heart disease, HIV), and pregnant women. Immunization is also recommended for persons 50 years of age and older, healthcare professionals and all others in close contact with high-risk populations, particularly [those] in contact with children younger than 6 months of age who cannot receive influenza vaccine. This includes parents, grandparents, siblings, and babysitters.

"Not only does annual influenza vaccination help protect yourself, it also helps create a 'cocoon of protection' for those around you," said William Schaffner, MD, NFID vice president. "Vaccination is the best way to prevent influenza from infecting yourself and others, including family, friends, schoolchildren, and co-workers, and is the right thing to do for your community this and every influenza season. . . ."

To access a video of the press conference and a copy of the press release, you will need to register by going to http://medianfid.nfidinitiatives.org After registering, scroll down to be taken to the video and to a link to the press release.

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3 CDC data show low influenza vaccination rates for older and at-risk adults

CDC published "State-Specific Vaccination Coverage Among Adults Aged >=18 Years--United States, 2003–04 and 2005–06 Influenza Seasons" in the September 21 issue of MMWR. Portions of an article synopsis made available to the press are reprinted below.


Influenza epidemics occur seasonally and result in substantial morbidity and mortality among adults in the United States. Among adults, annual influenza vaccination is recommended for anyone who wants it for their own protection as well as for prevention of transmission to others, but especially for all persons aged
>=50 years and persons 18-49 years of age with high-risk conditions. To evaluate state-specific recent progress toward the Healthy People 2010 (HP2010) objectives, we compared data from the 2004 and 2006 Behavioral Risk Factor Surveillance System surveys, which reflected vaccine received for the 2003-2004 and 2005-2006 influenza seasons. In the 2005-06 season, influenza vaccination coverage levels among persons aged 18-49 years with high-risk conditions, persons aged 50-64 years, and persons aged >=65 years were 30.5%, 36.6%, and 69.3%, respectively. Influenza vaccination coverage for the 2005–06 season remained substantially below HP2010 targets in all states and was four to nine median percentage points lower than coverage during the 2003–04 season. Thus, vaccination rates in the 2005–06 season had not returned to levels observed before the vaccine shortage of 2004–05. Comprehensive measures are more widely needed to improve influenza vaccination coverage among adult populations in the United States.


To access a web-text (HTML) version of the complete MMWR article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5637a1.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5637.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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4 CDC data indicate that fewer than one-third of children age 6-23 months received influenza vaccine during 2005-06

CDC published "Influenza Vaccination Coverage Among Children Aged 6–23 Months--United States, September–December, 2005–06 Influenza Season" in the September 21 issue of MMWR. Portions of an article synopsis made available to the press are reprinted below.


Children aged <2 years are at increased risk for influenza-related hospitalizations, and those aged <5 years have more influenza-related healthcare visits than older children. In 2004, the ACIP recommended annual influenza vaccination of children aged 6–23 months, with 2 doses at least 4 weeks apart for those receiving influenza vaccination for the first time. To assess influenza vaccination coverage among children aged 6–23 months during the 2005–06 influenza season, data from the 2006 National Immunization Survey (NIS) were analyzed. The findings indicate that 32% of children in this age group received at least 1 dose of influenza vaccine and 21% were fully vaccinated according to ACIP recommendations, with substantial variability among states. The results underscore the need to continue to monitor childhood influenza vaccination coverage among young children and develop systems to more efficiently provide influenza vaccination services.


To access a web-text (HTML) version of the complete MMWR article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5637a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5637.pdf

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5 CDC data from six sentinel sites point to low influenza vaccination coverage for children age 6-59 months in 2006-07

CDC published "Influenza Vaccination Coverage Among Children Aged 6–59 Months--Six Immunization Information System Sentinel Sites, United States, 2006–07 Influenza Season" in the September 21 issue of MMWR. An article synopsis made available to the press is reprinted below in its entirety.


Public health officials should consider Immunization Information Systems (IIS) an important way to rapidly assess influenza vaccination coverage during or shortly following an influenza season. This information can help to increase influenza vaccination coverage by alerting officials to areas with low vaccine coverage during the season and help shape the public health message for the next season.

This is the first assessment of influenza vaccination coverage among children 6-59 months of age during the 2006-07 influenza season. Findings from 6 IIS, indicate that at all 6 sites, <30% of children aged 6–23 months and <20% of children aged 24–59 months were fully vaccinated. IIS can help public health officials monitor vaccination coverage among children by tracking local data throughout the influenza season. Such tracking can alert local and state public health agencies to gaps in coverage during the influenza season in time to recommend vaccination for those children who are not fully vaccinated against influenza.


To access a web-text (HTML) version of the complete MMWR article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5637a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5637.pdf

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6 VISs for shingles, HPV, DTaP, and PCV7 vaccines available in Hmong, Somali, and/or Russian

The VISs for shingles vaccine and human papillomavirus (HPV) vaccine are now available on the IAC website in Hmong, Russian, and Somali. The VIS for diphtheria-tetanus-acellular pertussis (DTaP) vaccine is available in Hmong and Somali, and the VIS for pneumococcal conjugate vaccine (PCV7) is available in Hmong and Russian. IAC gratefully acknowledges the Minnesota Department of Health for the translations.

SHINGLES VACCINE VIS (current version dated 9/11/06)
To access a ready-to-print (PDF) version of the shingles vaccine VIS in Hmong, go to:
http://www.immunize.org/vis/hm_shingles.pdf

To access it in Russian, go to:
http://www.immunize.org/vis/ru_shingles.pdf

To access it in Somali, go to:
http://www.immunize.org/vis/so_shingles.pdf

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

HPV VACCINE VIS (current version dated 2/2/07)
To access a ready-to-print (PDF) version of the HPV vaccine VIS in Hmong, go to: http://www.immunize.org/vis/hm_hpv.pdf

To access it in Russian, go to:
http://www.immunize.org/vis/ru_hpv.pdf

To access it in Somali, go to:
http://www.immunize.org/vis/so_hpv.pdf

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

DTaP VACCINE VIS (current version dated 5/17/07)
To access a ready-to-print (PDF) version of the DTaP vaccine VIS in Hmong, go to: http://www.immunize.org/vis/hmdtap01.pdf

To access it in Somali, go to:
http://www.immunize.org/vis/sodtap01.pdf

To access it in English, go to:
http://www.immunize.org/vis/dtap01.pdf

PCV7 VACCINE VIS (current version dated 9/30/02)
To access a ready-to-print (PDF) version of the PCV7 vaccine VIS in Hmong, go to: http://www.immunize.org/vis/hmpnPCV7.pdf

To access it in Russian, go to:
http://www.immunize.org/vis/rupnPCV7.pdf

To access it in English, go to:
http://www.immunize.org/vis/pnPCV7.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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7 Nominations due September 27 for Association of Immunization Managers Bull's-Eye Award

The Association of Immunization Managers (AIM) Bull's-Eye Award for Innovation and Excellence in Immunization is presented to a local, tribal, territorial, or state government immunization program to recognize excellence and/or innovation demonstrated through an outstanding project or initiative. Three Bull's-Eye Awards will be presented at the Immunization Program Managers meeting on November 6, and award winners will be given an opportunity to showcase their project through presentations at the meeting.

Background materials and nomination forms can be found on the AIM website, http://www.immunizationmanagers.org All submissions must be emailed to aimbullseye@hotmail.com by September 27, using the format detailed on the 2007 AIM Bull's-Eye Award Nomination Form. The recipients will receive a plaque at the Immunization Program Managers meeting and a cash award of $100.

For more information, contact Claire Hannan, AIM executive director, at channan@astho.org or (301) 424-6080.

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8 Global Hepatitis A Meeting planned for November 30-December 1 in Miami; abstracts due October 1

A Global Hepatitis A Meeting will be held in Miami on November 30-December 1. The meeting is sponsored by the University of Antwerp (Belgium), CDC, and Pan American Health Organization, and is endorsed by the American Association for the Study of Liver Diseases. For comprehensive meeting information, including a link to the meeting agenda, go to: http://www.havmeeting.info

Abstracts are due October 1. To access information on abstract submission, go to: http://www.havmeeting.info/index.php?S=abst

To access information on registration, and to register online, go to: http://www.havmeeting.info/index.php?S=regi

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9 CDC reports on progress in controlling measles in Kenya during 2002-07

CDC published "Progress in Measles Control--Kenya, 2002–2007" in the September 21 issue of MMWR. An article synopsis made available to the press is reprinted below in its entirety.


This article shows that supplementary measles vaccination campaigns can help increase coverage of other life-saving interventions to high levels, [but] delaying a campaign may allow a large measles outbreak to occur.

Kenya cut measles cases by over 99% from 2002–2004 as the result of a well-done large-scale vaccination campaign, and improved routine vaccination services, disease surveillance, and measles case management. In 2005, Kenya delayed a scheduled follow-up campaign to 2006 to include distribution of another life-saving measure, long-lasting insecticide-treated bed nets that can prevent malaria. The delay allowed >90% of children at risk for malaria to receive a treated bed net, but during that time a measles outbreak occurred affecting approximately 2,500 people and leading to at least 24 deaths. Despite the documented advantages of integrating measles supplemental immunization activities (SIAs) with other life-saving interventions, in some countries, consideration should be given to the risks of delaying measles SIAs in order to gain the benefits of the other interventions.


To access a web-text (HTML) version of the complete MMWR article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5637a5.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5637.pdf

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10.  CDC reports on laboratory surveillance for wild and vaccine-derived polioviruses

CDC published "Laboratory Surveillance for Wild and Vaccine-Derived Polioviruses" in the September 21 issue of MMWR. An article synopsis made available to the press is reprinted below in its entirety.


The Global Polio Laboratory Network (GPLN) provides critical, detailed laboratory data in support of the WHO Global Polio Eradication Initiative (PEI).

The data are used to identify endemic reservoir areas so that immunization activities can be most effectively targeted and vaccine strategies optimized. The laboratory data also inform plans for eventual Oral Polio Vaccine cessation. The GPLN continues to maintain high performance standards despite challenges of ever increasing workloads, particularly in polio-endemic regions. The GPLN continues to be responsive to the changing needs of the PEI, for example by implementing a new diagnostic algorithm for cutting the time for poliovirus identification in half and developing more sensitive methods for detecting genetically divergent vaccine-derived polioviruses.


To access a web-text (HTML) version of the complete MMWR article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5637a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5637.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.