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IAC Express 2007
Issue number 689: October 22, 2007

Contents of this Issue Select a title to jump to the article.
New: CDC publishes Recommended Adult Immunization Schedule for October 2007-September 2008 New: CDC publishes updated recommendations for prevention of hepatitis A virus infection after exposure and before international travel New: FDA approves use of Menactra, a bacterial meningitis vaccine, in children age 2-10 years October 2007 issue of Vaccinate Adults is filled with resources for adult medicine specialists CDC's influenza website puts a mix of resources at the fingertips of health professionals and their patients Mayo Clinic's Dr. Gregory Poland makes a strong case for mandatory influenza vaccination of healthcare personnel New: PKIDS launches national educational campaign--"Silence the Sounds of Pertussis" HPV vaccine VISs now in Arabic, Bengali, Chinese, Haitian Creole, Korean, and Urdu What are your state's immunization laws for healthcare personnel and patients? The CDC website has the answer! For coalitions: IZTA plans two conference calls on website design and strategic Internet use

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 689: October 22, 2007

New: CDC publishes Recommended Adult Immunization Schedule for October 2007-September 2008

CDC published "Recommended Adult Immunization Schedule--United States, October 2007-September 2008" (as an MMWR QuickGuide) in the October 19 MMWR. The article is reprinted below in its entirety, excluding references and two figures.

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 2007, ACIP approved the Adult Immunization Schedule for October 2007-September 2008. Additional information is available as follows:

Schedule (in English and Spanish [IAC Express editor's note: the Spanish-language version will be available in 2008]) at http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm
Adult vaccinations at http://www.cdc.gov/vaccines
ACIP statements for specific vaccines at http://www.cdc.gov/vaccines/pubs/acip-list.htm
Reporting adverse events at http://www.vaers.hhs.gov or by telephone, (800) 822-7967

CHANGES FOR OCTOBER 2007-SEPTEMBER 2008

Age-Based Schedule

The yellow bar for varicella vaccine has been extended through all age groups, indicating that the vaccine is recommended for all adults without evidence of immunity to varicella.
Zoster vaccine has been added, with a yellow bar indicating that the vaccine is recommended for persons aged >=60 years.

Medical/Other Indications Schedule

The title has been changed to "Vaccines that might be indicated for adults based on medical and other indications," indicating that not all of the vaccines are recommended based on medical indications.
The word "contraindicated" has been added to the red bars and removed from the legend.
The "immunocompromising conditions" column heading has been shortened by removing the list of conditions.
The "human immunodeficiency virus (HIV) infection" column has been moved next to the "immunocompromising conditions" column.
The HIV column has been split into CD4+ T lymphocyte counts of <200 cells/microliter and >=200 cells/microliter.
The indication "recipients of clotting factor concentrates" has been removed from the column heading "chronic liver disease" because only one vaccine has this recommendation. The indication remains in the hepatitis A vaccine footnote.
The varicella vaccine yellow bar has been extended to include persons infected with HIV who have CD4+ T lymphocyte counts of >=200 cells/microliter.
The influenza vaccine yellow bar for "healthcare personnel" indicates that healthcare personnel can receive either trivalent inactivated influenza vaccine (TIV) or live, attenuated influenza vaccine (LAIV).
The yellow bar for influenza vaccine has been extended to include persons in the "asplenia" risk group.
The bar for meningococcal vaccine has been revised to indicate that 1 or more doses might be indicated.
Zoster vaccine has been added to the schedule with a yellow bar to indicate that the vaccine is recommended for all indications except pregnancy, immunocompromising conditions, and HIV. A red bar, indicating a contraindication, has been inserted for pregnancy, immunocompromising conditions, and HIV infection with a CD4+ T lymphocyte count of <200 cells/microliter.

Footnotes

Text for vaccine contraindications in pregnancy has been removed from the footnotes of human papillomavirus (HPV) (#2); measles, mumps, rubella (MMR) (#3); and varicella (#4) to be consistent with the intent of the footnotes to summarize the indications for vaccine use. Pregnancy contraindications are indicated with a red bar.
The HPV footnote (#2) has been revised to clarify evidence of prior infection, clarify that HPV vaccine is not specifically indicated based on medical conditions, and indicate that efficacy and immunogenicity might be lower in persons with certain medical conditions.
The varicella footnote (#4) has been revised to clarify that birth before 1980 for immunocompromised persons is not evidence of immunity and to add a requirement for evidence of immunity.
The pneumococcal polysaccharide vaccine (PPV) footnote (#6) has been revised by adding chronic alcoholism and cerebrospinal fluid leaks and deleting the immunocompromising conditions.
The hepatitis B footnote (#9) has been revised by removing persons who receive clotting factor concentrates as a risk group and by clarifying the special formulations dose.
The meningococcal vaccine footnote (#10) has been revised to clarify that persons who remain at increased risk for infection might be indicated for revaccination.
A footnote (#11) has been added to reflect ACIP recommendations for herpes zoster vaccination for persons aged >=60 years.
A footnote (#13) has been added to provide a reference for vaccines in persons with immunocompromising conditions.

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5641a7.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5641.pdf

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

New: CDC publishes updated recommendations for prevention of hepatitis A virus infection after exposure and before international travel

CDC published "Update: Prevention of Hepatitis A After Exposure to Hepatitis A Virus and in International Travelers. Updated Recommendations of the Advisory Committee on Immunization Practices" in the October 19 issue of MMWR. Portions of the article are reprinted below.

In addition, on October 18, the CDC website posted a Q&A about the revised recommendations, and the New England Journal of Medicine (NEJM; issue dated 10/25/07) published a related article, "Hepatitis A Vaccine versus Immune Globulin for Postexposure Prophylaxis," and an editorial, "Another Success for Hepatitis A Vaccine." Links to the CDC Q&A and the NEJM article and editorial are given at the end of this IAC Express article.

For decades, immune globulin (IG) has been recommended for prophylaxis after exposure to HAV. IG also has been recommended in addition to hepatitis A vaccine for preexposure prophylaxis for travelers to countries with high or intermediate hepatitis A endemicity who are scheduled to depart <4 weeks after receiving the initial vaccine dose. This report details updated recommendations, made by ACIP in June 2007, for prevention of hepatitis A after exposure to HAV and in departing international travelers and incorporates existing ACIP recommendations for prevention of hepatitis A. . . .

I. PREVENTION OF HEPATITIS A AFTER EXPOSURE TO HAV . . . .

Advantages of hepatitis A vaccine
The ability to use hepatitis A vaccine for postexposure prophylaxis provides numerous public health advantages, including the induction of active immunity and longer protection, greater ease of administration, higher acceptability and availability, and a cost per dose that is similar to IG. Also, the greater availability and ease of administration of hepatitis A vaccine might increase the number of persons at risk for infection who receive postexposure prophylaxis. . . .

Recommendations for postexposure prophylaxis with IG or hepatitis A vaccine
Persons who recently have been exposed to HAV and who previously have not received hepatitis A vaccine should be administered a single dose of single-antigen vaccine or IG (0.02 mL/kg) as soon as possible. Information about the relative efficacy of vaccine compared with IG postexposure is limited, and no data are available for persons aged >40 years or those with underlying medical conditions. Therefore, decisions to use vaccine or IG should take into account patient characteristics associated with more severe manifestations of hepatitis A, including older age and chronic liver disease.

For healthy persons aged 12 months-40 years, single-antigen hepatitis A vaccine at the age-appropriate dose is preferred to IG because of vaccine advantages that include long-term protection and ease of administration. For persons aged >40 years, IG is preferred because of the absence of information regarding vaccine performance and the more severe manifestations of hepatitis A in this age group; vaccine can be used if IG cannot be obtained. The magnitude of the risk for HAV transmission from the exposure should be considered in decisions to use IG or vaccine. IG should be used for children aged <12 months, immunocompromised persons, persons who have had chronic liver disease diagnosed, and persons for whom vaccine is contraindicated.

Persons administered IG for whom hepatitis A vaccine also is recommended for other reasons should receive a dose of vaccine simultaneously with IG. For persons who receive vaccine, the second dose should be administered according to the licensed schedule to complete the series. The efficacy of IG or vaccine when administered >2 weeks after exposure has not been established.

Close personal contact. Hepatitis A vaccine or IG should be administered to all previously unvaccinated household and sexual contacts of persons with serologically confirmed hepatitis A. In addition, persons who have shared illicit drugs with a person who has serologically confirmed hepatitis A should receive hepatitis A vaccine, or IG and hepatitis A vaccine simultaneously. Consideration also should be given to providing IG or hepatitis A vaccine to persons with other types of ongoing, close personal contact (e.g., regular babysitting) with a person with hepatitis A.

Child care centers. Hepatitis A vaccine or IG should be administered to all previously unvaccinated staff members and attendees of child care centers or homes if (1) one or more cases of hepatitis A are recognized in children or employees or (2) cases are recognized in two or more households of center attendees. In centers that do not provide care to children who wear diapers, hepatitis A vaccine or IG need be administered only to classroom contacts of the index patient. When an outbreak occurs (i.e., hepatitis A cases in three or more families), hepatitis A vaccine or IG also should be considered for members of households that have children (center attendees) in diapers.

Common-source exposure. If a food handler receives a diagnosis of hepatitis A, vaccine or IG should be administered to other food handlers at the same establishment. Because common-source transmission to patrons is unlikely, hepatitis A vaccine or IG administration to patrons typically is not indicated but may be considered if (1) during the time when the food handler was likely to be infectious, the food handler both directly handled uncooked or cooked foods and had diarrhea or poor hygienic practices and (2) patrons can be identified and treated <=2 weeks after the exposure. In settings in which repeated exposures to HAV might have occurred (e.g., institutional cafeterias), stronger consideration of hepatitis A vaccine or IG use could be warranted. In the event of a common-source outbreak, postexposure prophylaxis should not be provided to exposed persons after cases have begun to occur because the 2-week period after exposure during which IG or hepatitis A vaccine is known to be effective will have been exceeded.

Schools, hospitals, and work settings. Hepatitis A postexposure prophylaxis is not routinely indicated when a single case occurs in an elementary or secondary school or an office or other work setting, and the source of infection is outside the school or work setting. Similarly, when a person who has hepatitis A is admitted to a hospital, staff members should not routinely be administered hepatitis A postexposure prophylaxis; instead, careful hygienic practices should be emphasized. Hepatitis A vaccine or IG should be administered to persons who have close contact with index patients if an epidemiologic investigation indicates HAV transmission has occurred among students in a school or among patients or between patients and staff members in a hospital.

II. PREVENTION OF HEPATITIS A BEFORE INTERNATIONAL TRAVEL . . . .

The following recommendation updates recommendations for prevention of hepatitis A among travelers departing in <4 weeks to areas where prophylaxis is recommended and consolidates other recommendations for prevention of hepatitis A among international travelers. These recommendations replace previous ACIP recommendations for preexposure protection against hepatitis A for travelers.

Recommendations for preexposure protection against hepatitis A for travelers
All susceptible persons traveling to or working in countries that have high or intermediate hepatitis A endemicity are at increased risk for HAV infection and should be vaccinated or receive IG before departure. Hepatitis A vaccination at the age-appropriate dose is preferred to IG. Data are not available regarding the risk for hepatitis A for persons traveling to certain areas of the Caribbean, although prophylaxis should be considered if travel to areas with questionable sanitation is anticipated. Travelers to Australia, Canada, western Europe, Japan, or New Zealand (i.e., countries in which endemicity is low) are at no greater risk for infection than [are] persons living or traveling in the United States.

The first dose of hepatitis A vaccine should be administered as soon as travel is considered. Based on limited data indicating equivalent postexposure efficacy of IG and vaccine among healthy persons aged <=40 years, 1 dose of single-antigen hepatitis A vaccine administered at any time before departure can provide adequate protection for most healthy persons. However, no data are available for other populations or other hepatitis A vaccine formulations (e.g., Twinrix). For optimal protection, older adults, immunocompromised persons, and persons with chronic liver disease, or other chronic medical conditions planning to depart to an area in <=2 weeks should receive the initial dose of vaccine and also simultaneously can be administered IG (0.02 mL/kg) at a separate anatomic injection site. Completion of the vaccine series according to the licensed schedule is necessary for long-term protection.

Travelers who elect not to receive vaccine, are aged <12 months, or are allergic to a vaccine component should receive a single dose of IG (0.02 mL/kg), which provides effective protection against hepatitis A for up to 3 months. Such travelers whose travel period is expected to be >2 months should be administered IG at 0.06 mL/kg; administration must be repeated if the travel period is >5 months. The full statement containing licensed vaccination schedule and recommended dose of IG and vaccine has been published previously.

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5641a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5641.pdf

CDC Q&A: To access the CDC's Q&A on the revised recommendations, go to:
http://www.cdc.gov/ncidod/diseases/hepatitis/a/faqa_PEP.htm

NEJM ARTICLE: To access the full text of the article, go to:
http://content.nejm.org/cgi/content/full/NEJMoa070546

NEJM EDITORIAL: To access the full text of the editorial, go to:
http://content.nejm.org/cgi/content/full/NEJMe078189

New: FDA approves use of Menactra, a bacterial meningitis vaccine, in children age 2-10 years

On October 18, FDA issued a press release announcing that it approved the use of Menactra bacterial meningitis vaccine (sanofi pasteur) to include children age 2-10 years. Previously, the vaccine was licensed for use in persons age 11-55 years. The press release is reprinted below in its entirety. Links to the package insert and approval letter appear at the end of this IAC Express article.

FDA EXPANDS AGE RANGE FOR USE OF BACTERIAL MENINGITIS VACCINE

The U.S. Food and Drug Administration today expanded the approved age range for Menactra, a bacterial meningitis vaccine, to include children ages 2 to 10 years.

Meningitis is a serious inflammation of the lining that surrounds the spinal cord and brain. It can result in death or permanent injury to the brain and nervous system. In the United States, about 2,600 people become ill from bacterial meningitis annually. About 10 percent die from the infection and another 15 percent or so suffer brain damage or limb amputation.

Menactra was first approved by FDA in January 2005 for people ages 11 to 55 years. Previously, Menomune was the only meningococcal vaccine available in the United States for use in children ages 2 years and older. Both products are manufactured by sanofi pasteur Inc. of Swiftwater, PA Both vaccines offer protection against four groups of Neisseria meningitidis, the bacterium that can cause meningitis.

"Approving Menactra for younger children offers another option for healthcare providers and parents. Now there are two vaccines available for children between 2 and 10 years of age who may be at increased risk of meningitis," said Jesse L. Goodman, MD, MPH, director of FDA's Center for Biologics Evaluation and Research.

The Centers for Disease Control and Prevention's (CDC) Advisory Committee on Immunization Practices (ACIP) currently recommends meningococcal vaccination for children ages 2 to 10 years who are at increased risk of developing meningococcal disease, such as those who have had their spleen removed or whose spleen is not functioning; those with a medical condition called terminal complement component deficiency, which makes it difficult to fight infection; and those who expect to travel to areas outside of the United States where the disease is common. Vaccination also is used to control outbreaks of bacterial meningitis.

Menactra's effectiveness was measured in clinical trials that included people ages 2 to 55 years. The vaccine was shown to produce an immune response one month after vaccination. The safety of Menactra was evaluated in eight clinical studies that included a total of 10,057 participants who received Menactra and 5,266 participants who received Menomune. The most common adverse events reported in the studies were pain at the injection site and irritability. Diarrhea, drowsiness, and lack of appetite also were common.

While not observed in these clinical trials, Guillain-Barre syndrome (GBS), a neurological disorder that causes muscle weakness, was noted as a possible but unproven risk in some adolescents following immunization with Menactra, occurring in an estimated 1 in 1 million vaccine recipients. As a precaution, people who have previously been diagnosed with GBS should not receive Menactra.

FDA and CDC will continue to monitor the safety of Menactra through their jointly administered Vaccine Adverse Event Reporting System.

To access the press release, go to:
http://www.fda.gov/bbs/topics/NEWS/2007/NEW01729.html

To access the package insert, go to:
http://www.fda.gov/cber/label/menactraLB.pdf

To access the approval letter, go to:
http://www.fda.gov/cber/approvltr/menactra101807L.htm

October 2007 issue of Vaccinate Adults is filled with resources for adult medicine specialists

IAC recently mailed the latest issue of Vaccinate Adults (October 2007) to 160,000 adult medicine specialists and others who work in the field of immunization. Packed with immunization resources for health professionals and patients, the 12-page issue is well worth downloading. All articles and education pieces have been reviewed by immunization and hepatitis experts at CDC.

You can view selected articles from the table of contents below or download the entire issue from the Web.

To download a ready-to-print (PDF) version of the entire issue, go to:
http://www.immunize.org/va/va20.pdf

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

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

The October issue includes several notable articles, all of which can be downloaded:

Ask the Experts
"Give These People Influenza Vaccine," plus a healthcare worker influenza vaccination piece, adult influenza vaccination standing orders, and adult influenza screening questionnaires
"Questions Frequently Asked About Hepatitis B," plus four additional viral hepatitis educational print materials for patients and staff
Summary of Recommendations for Adult Immunization

CDC's influenza website puts a mix of resources at the fingertips of health professionals and their patients

Since its September 17 launch date, CDC's seasonal influenza website (http://www.cdc.gov/flu) has been continually updated with resources of value to health professionals and patients. Following is information about the website's special features and recent additions.

VODCAST
Released in September, the vodcast "2007-2008 Influenza Vaccine Production and Distribution" explains the process of producing and distributing influenza vaccine for the influenza season. Intended for healthcare professionals, the vodcast features CDC's Dr. William Atkinson and Dr. Larry Pickering; the run time is approximately 11 minutes.

To access the vodcast, go to: http://www2a.cdc.gov/podcasts/player.asp?f=6678 You can also access a transcript by clicking the pertinent link.

FLU GALLERY GRID
The materials in the Flu Gallery are intended for health professionals (in private practice, public clinics, and pharmacies) to use to promote influenza vaccine to their patients. All materials can be downloaded and printed. This year, the materials are organized on a grid that shows the available languages (English and/or Spanish), sizes (letter, tabloid, and/or poster); and colors (color and/or black and white) for each material offered in the Flu Gallery.

To access the grid, go to:
http://www.cdc.gov/flu/professionals/flugallery

SEASONAL FLU WIRELESS ALERTS
Website users can now get the latest Seasonal Flu Activity Report or News & Highlights information sent directly to their cell phone or mobile device. After a user has signed up for the service, CDC will automatically send a wireless alert to the user when the contents of selected web pages are updated.

For more information and to subscribe, go to:
http://www.cdc.gov/flu/updates.htm

WHAT'S NEW AND WHAT'S BEEN UPDATED
The What's New web section (http://www.cdc.gov/flu/whatsnew.htm) offers a listing of CDC's new print resources pertaining to influenza, organized chronologically by the most recent posting date.

These are the new resources posted on or since September 17:

2007-08 Influenza Vaccine Dosage Chart (10/16/07)
Thimerosal in Seasonal Influenza Vaccine (10/12/07)
Vaccine Supply for the U.S. 2007-08 Influenza Season (10/12/07)
Influenza: Self-Reported Vaccination Coverage Trends 1989-2006 (10/1/07)
Pneumococcal: Self-Reported Pneumococcal Vaccination Coverage Trends 1989-2006 (10/1/07)
Selecting the Viruses in the Influenza (Flu) Vaccine (9/18/07)
2007-08 Flu Gallery--Free Flu Materials (9/17/07)

To access these materials, go to: http://www.cdc.gov/flu/whatsnew.htm#new and click on the pertinent link.

In addition, CDC posts updated influenza print materials; here are the updates posted on or since September 17:

Preventing the Spread of Influenza (the Flu) in Child Care Settings (10/2/07)
Questions & Answers: The Nasal-Spray Flu Vaccine (Live Attenuated Influenza Vaccine [LAIV]) (9/19/07)
Influenza Symptoms (9/19/07)
Questions & Answers: Seasonal Influenza Vaccine Supply and Vaccination Prioritization Recommendations for the U.S. 2007-08 Influenza Season (9/19/07)
Questions & Answers: Seasonal Influenza Vaccine Production, Supply, and Distribution in the United States (9/19/07)
HIV/AIDS and the Flu (9/19/07)
Questions & Answers: Seasonal Flu Vaccine (9/19/07)
Update: Key Facts About Seasonal Flu Vaccine (9/19/07)
Order Select Pre-printed Flu Materials (9/17/07)
Patient & Provider Education (9/17/07)

To access these materials, go to: http://www.cdc.gov/flu/whatsnew.htm#updated and click on the pertinent link.

INFLUENZA MATERIALS AVAILABLE IN OTHER LANGUAGES
Some CDC influenza materials are available in Spanish, Tagalog, Vietnamese, and/or Chinese. To access materials in languages other than English, go to: http://www.cdc.gov/flu/languages.htm and click on the language of your choice.

Mayo Clinic's Dr. Gregory Poland makes a strong case for mandatory influenza vaccination of healthcare personnel

Sponsored by the Minnesota Department of Health (MDH), Minnesota's October 11-12 "Got Your Shots?" immunization conference included a strong and spirited presentation by Gregory Poland, MD, director, Vaccine Research Group, Mayo Clinic. In his talk, Dr. Poland laid out seven reasons healthcare personnel should be vaccinated against influenza:

1. Influenza infection is a serious illness causing significant morbidity and mortality, adversely affecting the public health on an annual basis.

2. Influenza-infected healthcare personnel can transmit this deadly virus to vulnerable patients.

3. Influenza vaccination of healthcare personnel saves money for employees and employers and prevents workplace disruption.

4. Influenza vaccination of healthcare personnel is already recommended by CDC and is the standard of care.

5. Immunization requirements are effective and work in increasing vaccination rates.

6. Healthcare personnel and healthcare systems have an ethical and moral duty to protect vulnerable patients from transmissible diseases.

7. The healthcare system will either lead or be lambasted.

For more information, including the research Dr. Poland drew on, access the two-page document "Seven Truths About Influenza Vaccination of Healthcare Workers," from the MDH website at http://www.health.state.mn.us/divs/idepc/diseases/flu/hcp/seventruths.pdf

New: PKIDS launches national educational campaign--"Silence the Sounds of Pertussis"

On October 16, Parents of Kids with Infectious Diseases (PKIDs) launched its "Silence the Sounds of Pertussis" education campaign and announced that actress and new mom Keri Russell is featured in public service announcements (PSAs) that will begin airing in October.

The campaign also features a dedicated web section at which users can hear an infant coughing with pertussis. The web section offers the public a broad overview of the disease and the vaccine that prevents it.

To access the web section, go to: http://www.pkids.org/pertussis

To view the PSAs, go to: http://www.pkids.org/mr_psas.php

To access information for the public, go to:
http://www.pkids.org/pertussis/about-pertussis.php

HPV vaccine VISs now in Arabic, Bengali, Chinese, Haitian Creole, Korean, and Urdu

The current version (dated 2/2/07) of the VISs for human papillomavirus (HPV) vaccine is now available on the IAC website in Arabic, Bengali, Chinese, Haitian Creole, Korean, and Urdu. IAC gratefully acknowledges the New York City Department of Education and the New York City Department of Health and Mental Hygiene for the translations.

To obtain a ready-to-print (PDF) version of the VIS for HPV vaccine in Arabic, go to:
http://www.immunize.org/vis/ab_hpv.pdf

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

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

To obtain it in Haitian Creole, go to:
http://www.immunize.org/vis/ha_hpv.pdf

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

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

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

What are your state's immunization laws for healthcare personnel and patients? The CDC website has the answer!

CDC's website offers you an easy way to find information about immunization laws for healthcare personnel and patients. The material is presented on a state-by-state basis, organized by immunization (e.g., all vaccines, hepatitis B, influenza); employee type (e.g., ambulatory care facility employees; hospital employees); and patient type (e.g., individual provider patients, hospital patients). The abridged text of the law is given, as well as information on any exemptions.

To access the State Immunization Laws for Healthcare Workers and Patients web section, go to:
http://www2a.cdc.gov/nip/StateVaccApp/statevaccsApp/default.asp

10.

For coalitions: IZTA plans two conference calls on website design and strategic Internet use

A program of the Center for Health Communication, Academy for Educational Development (AED), the Immunization Coalitions Technical Assistance Network (IZTA) will host two conference calls in November. One is intended to help coalitions design or improve their website; the other, to give information on using the Internet to get messages out to parents, care givers, and health professionals. Details follow.

(1) Titled "Website 101," the November 13 conference call will focus on developing user-friendly websites and improving existing sites. The facilitator is Shea Van Horn, marketing and communication specialist, AED Center for Health Communication.

The call is scheduled for 1 PM ET. To register, send an email to izta@aed.org Include this message in the subject line: "Sign me up for the Website 101 call."

(2) Titled "Websites, blogs, and webinars: Internet strategies that work," the November 27 call will focus on informing participants about emerging technologies and how to use them. The facilitator is Amelia Burke, e-marketing and public relations specialist, AED Center for Health Communication.

The call is scheduled for 1 PM ET. To register, send an email to izta@aed.org Include this message in the subject line: "Sign me up for the Internet strategies call."

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

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