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Immunization Action Coalition
IAC Express 2008
Issue number 735: June 9, 2008
 
Contents of this Issue
Select a title to jump to the article.
  1. CDC's recommendations for preventing herpes zoster (shingles) now published as an MMWR Recommendations and Reports
  2. CDC reports on hospital-acquired pertussis among newborns in Texas in 2004
  3. FDA approves use of Tenivac tetanus and diphtheria toxoids in adults age 60 years and older
  4. Two hepatitis B parent-education resources now available in Spanish and six additional languages
  5. Update: IAC revises its "Emergency Response Worksheet"
  6. Correction: June 2 IAC Express had incorrect URL for ordering vaccination resources from the Vaccine Education Center (VEC)
  7. The Vaccine Quarterly provides an evidence-based academic review of timely vaccine-related issues
  8. AMA offers physicians practical information on improving adolescent immunization
  9. Two comprehensive sharps injury prevention resources are available--one on CD-ROM, the other for downloading
  10. New: Interim VIS for MMR vaccine now available in Thai
  11. PowerPoint presentations now available from the National Conference on Immunization and Health Coalitions
  12. Seminar on CMI techniques standardization for vaccine response evaluation is planned for September 15-17 in Annecy, France
 
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 735: June 9, 2008
1.  CDC's recommendations for preventing herpes zoster (shingles) now published as an MMWR Recommendations and Reports

On June 6, CDC published "Prevention of Herpes Zoster: Recommendations of the Advisory Committee on Immunization Practices (ACIP)" as an MMWR Recommendations and Reports. Previously, the recommendations were available only in electronic format as an MMWR Early Release (published May 15). There is no difference in the content of these two documents; the content of the MMWR Recommendations and Reports published on June 6 is identical to the content of the MMWR Early Release published on May 15.

Important note: If you bookmarked these recommendations based on the URL given in the MMWR Early Release, please change your bookmark to reflect the URL below.

To access a ready-to-print (PDF) version of the recommendations, go to: http://www.cdc.gov/mmwr/PDF/rr/rr5705.pdf

Note: The PDF version includes a free CDC-sponsored education activity that can be completed online or submitted by fax or U.S. mail for continuing education credit. Simply read the recommendations, answer the questions at the end, and follow instructions for submitting your answers.

To access a web-text (HTML) version of the recommendations, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5705a1.htm

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

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2 CDC reports on hospital-acquired pertussis among newborns in Texas in 2004

CDC published "Hospital-Acquired Pertussis Among Newborns--Texas, 2004" in the June 6 issue of MMWR. Portions of the article are reprinted below.


On July 10, 2004, staff members at a children's hospital in Texas noted that six infants with pertussis diagnosed by clinical symptoms and confirmed by polymerase chain reaction (PCR) testing had all been born during June 4-16 at the same area general hospital. The infants had symptoms consistent with pertussis, including cough, congestion, cyanosis, emesis, or apnea. Infection-control personnel at the general hospital (general hospital A), children's hospital (children's hospital A), and the county health department investigated and determined that an outbreak of pertussis among 11 newborns at general hospital A had occurred after direct exposure to a healthcare worker (HCW) with pertussis. This report describes the outbreak investigation and highlights the importance of following recommendations to administer tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine to HCWs to prevent transmission of pertussis to patients.

Immediately after identification of the six infants with pertussis at children's hospital A, hospital staff members reviewed newborn nursery charts at general hospital A. One staff member (HCW A) was identified as having directly cared for all six infants during their stay in the newborn nursery. Review of work logs for all shifts identified four additional hospital workers who had been present while the six infants were in the newborn nursery.

From early to mid-June until July 17, while working in the newborn nursery at general hospital A, HCW A had exhibited symptoms of pertussis, including cough, posttussive emesis, and dyspnea. Her spouse reportedly had similar symptoms after he returned from a trip to California, 2-3 weeks before HCW A began exhibiting her symptoms. HCW A, aged 24 years, had been fully vaccinated for pertussis during early childhood. HCW A and a nursery coworker with cough symptoms were tested for pertussis by PCR; only HCW A tested positive. On July 17, HCW A was furloughed from general hospital A for 5 days and treated with erythromycin. Her husband also was prescribed erythromycin. . . .

The review of laboratory records and charts at children's hospital A revealed that 29 infants aged <4 months met the case definition for pertussis during June-August. Of these 29 infants, 11 (including the six previously known patients) had been born at general hospital A and directly exposed to HCW A in the newborn nursery. All 11 had been treated at children's hospital A with erythromycin and recovered; none developed hypertrophic pyloric stenosis, which has been reported as a complication of treatment of infants with erythromycin. Five of the infants required admission to the pediatric intensive-care unit (PICU), and four were treated in the general pediatric medical unit; one infant was treated in the emergency department, and one was treated as an outpatient. Median age of the 11 infants born at general hospital A was 31 days at the time of pertussis diagnosis, compared with a median age of 61 days for the other 18 infants with diagnosed pertussis, who were born at 12 other general hospitals during June-August. . . .

In 2005, Tdap vaccine was licensed by the Food and Drug Administration for use in adolescents and adults. In December 2006, the Advisory Committee on Immunization Practices (ACIP) recommended use of Tdap vaccine for HCWs with direct patient contact and for adults who have or might have close contact with infants aged <12 months. This recommendation was based on the documented risk for transmission of pertussis in healthcare facilities. Despite the costs involved for healthcare facilities, one study suggests the return on investment from vaccinating HCWs with Tdap vaccine is twice the cost of the vaccine.

Widespread implementation of Tdap vaccination of adolescents and adults as recommended by ACIP can reduce the risk for pertussis in the community and the incidence of pertussis transmission in healthcare facilities. This outbreak also highlights the importance of rapid recognition of pertussis transmission in healthcare settings and rapid response from hospital and public health practitioners to identify the source and prevent more extensive spread of disease, particularly among vulnerable newborns and infants.


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5722a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5722.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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3 FDA approves use of Tenivac tetanus and diphtheria toxoids in adults age 60 years and older

On June 5, the Food and Drug Administration (FDA) approved the use of sanofi pasteur's Tenivac tetanus and diphtheria toxoids adsorbed for adults age 60 years and older. In the original licensure, the age indication was for persons ages 7-59 years.

To view the supplemental license approval information on the FDA website, go to:
http://www.fda.gov/cber/approvltr/tenivac060608L.htm

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

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4 Two hepatitis B parent-education resources now available in Spanish and six additional languages

IAC now offers two of its popular hepatitis B parent-education print resources in languages in addition to English. "Hepatitis B Shots Are Recommended for All New Babies" is available in Spanish, Arabic, Chinese, French, Korean, Russian, and Vietnamese. "All Kids Need Hepatitis B Shots" is available in Spanish, Chinese, Hmong, Korean, Russian, Tagalog, and Vietnamese. IAC gratefully acknowledges the California Department of Public Health, Immunization Branch, for the translations of "All Kids Needs Hepatitis B Shots." Links to all translations of both print resources follow.


"HEPATITIS B SHOTS ARE RECOMMENDED FOR ALL NEW BABIES"
For a Spanish version of "Hepatitis B Shots Are Recommended for All New Babies," go to:
http://www.immunize.org/catg.d/p4110-01.pdf

For an Arabic version of "Hepatitis B Shots Are Recommended for All New Babies," go to:
http://www.immunize.org/catg.d/p4110-20.pdf

For a Chinese version of "Hepatitis B Shots Are Recommended for All New Babies," go to:
http://www.immunize.org/catg.d/p4110-08.pdf

For a French version of "Hepatitis B Shots Are Recommended for All New Babies," go to:
http://www.immunize.org/catg.d/p4110-10.pdf

For a Korean version of "Hepatitis B Shots Are Recommended for All New Babies," go to:
http://www.immunize.org/catg.d/p4110-09.pdf

For a Russian version of "Hepatitis B Shots Are Recommended for All New Babies," go to:
http://www.immunize.org/catg.d/p4110-07.pdf

For a Vietnamese version of "Hepatitis B Shots Are Recommended for All New Babies," go to:
http://www.immunize.org/catg.d/p4110-05.pdf

For an English version of "Hepatitis B Shots Are Recommended for All New Babies," go to: http://www.immunize.org/catg.d/p4110.pdf


"ALL KIDS NEED HEPATITIS B SHOTS"
For a Spanish version of "All Kids Need Hepatitis B Shots," go to:
http://www.immunize.org/catg.d/p4055-01.pdf

For a Chinese version of "All Kids Need Hepatitis B Shots," go to:
http://www.immunize.org/catg.d/p4055-08.pdf

For a Hmong version of "All Kids Need Hepatitis B Shots," go to:
http://www.immunize.org/catg.d/p4055-02.pdf

For a Korean version of "All Kids Need Hepatitis B Shots," go to:
http://www.immunize.org/catg.d/p4055-09.pdf

For a Russian version of "All Kids Need Hepatitis B Shots," go to:
http://www.immunize.org/catg.d/p4055-07.pdf

For a Tagalog version of "All Kids Need Hepatitis B Shots," go to:
http://www.immunize.org/catg.d/p4055-06.pdf

For a Vietnamese version of "All Kids Need Hepatitis B Shots," go to: http://www.immunize.org/catg.d/p4055-05.pdf

For an English version of "All Kids Need Hepatitis B Shots," go
to: http://www.immunize.org/catg.d/p4055.pdf

To access more than 175 FREE print resources for healthcare professionals and the public from IAC's Print Materials web section, go to: http://www.immunize.org/printmaterials

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5 Update: IAC revises its "Emergency Response Worksheet"

IAC recently updated "Emergency Response Worksheet," a print resource that outlines the steps healthcare professionals should take if a power failure or other event results in vaccine storage outside of the recommended temperature range. Updates were made to the telephone numbers of vaccine manufacturers.

To access the revised "Emergency Response Worksheet," go to:
http://www.immunize.org/catg.d/p3051.pdf

To access more than 175 FREE print resources for healthcare professionals and the public from IAC's Print Materials web section, go to: http://www.immunize.org/printmaterials

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6 Correction: June 2 IAC Express had incorrect URL for ordering vaccination resources from the Vaccine Education Center (VEC)

The June 2 issue of IAC Express included an article titled "Free: VEC offers sample quantities of new adult and teen vaccination resources at no charge." The article gave readers the incorrect link to the healthcare professionals' ordering page. IAC Express regrets the error and any inconvenience it may have caused the Vaccine Education Center and our readers.

The correct URL is
https://www.chop.edu/vaccine/vec/vecprof_order.cfm

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7 The Vaccine Quarterly provides an evidence-based academic review of timely vaccine-related issues

Begun in March 2007, The Vaccine Quarterly (TVQ) provides an authoritative, academic, evidence-based review of timely vaccine-related issues of interest to practitioners. Published by Lippincott and approved by the Lippincott CME Institute, it is a continuing education (CE) publication that awards CE credits to physicians. TVQ became available on the Internet in December 2007.

The editor is Gary S. Marshall, MD, professor of pediatrics; chief, Division of Pediatric Infectious Diseases, University of Louisville School of Medicine, Louisville, KY.

Each issue includes the following:
(1) Literature reviews: Members of the editorial board review eight articles published in the primary scientific literature in the previous 3-6 months. TVQ publishes a summary of each article and a comment section that includes a critique of the science and a discussion of the implications.

(2) Editor's section: This highlights up-to-the-minute vaccine news, including licensures, ACIP recommendations, outbreaks, and other notable immunization happenings.

(3) Invited guest article: Each issue contains one informative, concise review/opinion piece on a hot topic written by an invited guest.

To access The Vaccine Quarterly, go to:
http://www.vaccinequarterly.com

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8 AMA offers physicians practical information on improving adolescent immunization

The website of the American Medical Association (AMA) recently added a self-study course on adolescent immunization to its Roadmaps for Clinical Practice series. Titled "Improving Adolescent Immunizations: A primer for physicians," the course includes a monograph, continuing medical education questionnaire, and pocket booklet.

The course material examines the new recommendations for adolescent immunizations. Key concepts include adolescent "catch up" immunizations and special adolescent populations. The course provides information on the National Vaccine Injury Compensation Program and the Vaccine Adverse Event Reporting System. At the practice level, it reviews the following topics: payment, maximizing rates of immunization, and ways to enhance relationships with adolescents and their parents.

A collaboration between AMA and the Department of Health and Human Services, the Roadmaps for Clinical Practice series is intended to assist physicians in integrating disease prevention and health promotion into routine clinical care.

To access "Improving Adolescent Immunizations," go to:
http://www.ama-assn.org/ama/pub/category/18393.html

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9 Two comprehensive sharps injury prevention resources are available--one on CD-ROM, the other for downloading

The CD-ROM "Sharps Injury Prevention" is available from the Public Health Foundation's Learning Resource Center. It contains a 168-page workbook for designing, implementing, and evaluating a sharps injury prevention program; customizable slide presentations that provide an overview of sharps injury prevention practices; and a brochure that urges healthcare workers to be prepared, be aware, and dispose with care. Alternatively, the workbook can be downloaded directly from the CDC website.

To order the CD-ROM from the Public Health Foundation for $14.50, go to:
http://bookstore.phf.org/product_info.php?cPath=69_58&products_id=618

To download the workbook at no cost from the CDC website, go to: http://www.cdc.gov/sharpssafety and click on the pertinent links in the left column.

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10.  New: Interim VIS for MMR vaccine now available in Thai

Dated 3/13/08, the interim VIS for measles-mumps-rubella (MMR) vaccine is now available in Thai. IAC gratefully acknowledges Asian Pacific Health Care Venture of Los Angeles for the translation.

For a Thai version of the interim VIS for MMR vaccine, go to:
http://www.immunize.org/vis/th_mmr03.pdf

For an English version of the interim VIS for MMR vaccine, go to:
http://www.immunize.org/vis/mmr03.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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11.  PowerPoint presentations now available from the National Conference on Immunization and Health Coalitions

PowerPoint presentations made at the National Conference on Immunization and Health Coalitions can now be downloaded. The conference was held in San Francisco on May 21-23.

To access the presentations, go to:
http://www.sfimmunize.org/page4.html

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12.  Seminar on CMI techniques standardization for vaccine response evaluation is planned for September 15-17 in Annecy, France

A seminar on cell-mediated immunity (CMI) techniques standardization for vaccine response evaluation will be held September 15-17 at Les Pensieres Conference Center, Annecy, France.

For information on the seminar program and registration, go to: http://www.fondation-merieux.org/?-Conferences,176- Scroll down to the listing titled "15-17 September 2008."

For additional information, email Catherine Dutel at catherine.dutel@fondation-merieux.org

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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.