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Immunization Action Coalition
IAC Express 2008
Issue number 738: June 23, 2008
 
Contents of this Issue
Select a title to jump to the article.
  1. FDA approves new combination DTaP-IPV-Hib vaccine for use in infants and young children
  2. IAC website has VIS translations in 36 languages; the most recently added is Karen
  3. International coalition of health agencies announces the "final push" to end polio
  4. CDC issues HAN Advisory announcing a temporary decrease in human rabies vaccine supply
  5. CDC reports only about one-third of persons with asthma received influenza vaccine in 2005-06 influenza season
  6. Revised and updated, "Vaccines" textbook has comprehensive information about all aspects of vaccination
  7. AMA offers physicians practical information on improving immunization among racial and ethnic populations
  8. June 18 issue of IAC's Hep Express electronic newsletter now online
  9. WHO committee makes recommendations on the use of alternative diagnostic samples for measles and rubella surveillance
 
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 738: June 23, 2008
1.  FDA approves new combination DTaP-IPV-Hib vaccine for use in infants and young children

On June 20, the Food and Drug Administration (FDA) approved the use of sanofi pasteur's Pentacel, Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Inactivated Poliovirus and Haemophilus b Conjugate (Tetanus Toxoid Conjugate) Vaccine.

Pentacel vaccine is indicated for active immunization against diphtheria, tetanus, pertussis, poliomyelitis, and invasive disease due to Haemophilus influenzae type b (Hib). Pentacel vaccine is approved for use in infants and children ages 6 weeks through 4 years (prior to fifth birthday). Pentacel vaccine is approved for administration as a four-dose series at 2, 4, 6, and 15-18 months of age.

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

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

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2 IAC website has VIS translations in 36 languages; the most recently added is Karen

With the addition of Karen (spoken in Burma), IAC now offers healthcare professionals VIS translations in 36 languages. IAC gratefully acknowledges the Minnesota Department of Health for the Karen translations. To access them, go to: http://www.immunize.org/vis/vis_karen.asp

CHECK OUT IAC'S REDESIGNED VIS WEB SECTION
The recent redesign of IAC's VIS web section speeds the process of locating VIS-related resources. Following are some of the web section's features:

Visit IAC's VIS redesigned web section at
http://www.immunize.org/vis

The IAC website has many other immunization materials in translation. All are FREE and ready-to-print. To access them, go to: http://www.immunize.org/printmaterials/translations.asp

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3 International coalition of health agencies announces the "final push" to end polio

On June 18, the Center for Infectious Disease Research & Policy (CIDRAP) at the University of Minnesota issued a news article, "Coalition declares 'final push' to end polio." It discusses a plan, jointly developed and announced by WHO, CDC, UNICEF, and Rotary International, to eradicate polio once and for all. Portions of the news article are reprinted below.


The international coalition of health agencies dedicated to ending polio yesterday declared a "final push" toward the long-delayed goal of eradicating the disease. But its members coupled the announcement with a plea for millions of dollars in donations to fill shortfalls, and with an admission that the 20-year-old campaign continues to face stubborn challenges.

Leaders of the organizations that make up the Global Polio Eradication Initiative (GPEI)--the World Health Organization (WHO), the U.S. Centers for Disease Control and Prevention (CDC), UNICEF, and Rotary International--announced the effort and fundraising drive in Los Angeles at Rotary's annual convention. Members of Rotary International have been polio eradication's volunteer shock troops since the campaign was launched in 1988 and have donated about $700 million to the effort.

"The greatest danger we have now is the danger of stopping too soon," Dr. Robert Scott, chair of The Rotary Foundation, said at a press conference. "We have to keep after this virus and finally eradicate it."

Dr. Margaret Chan, the WHO director-general, said she is "committing the entire [WHO] to putting polio as our top operational priority," but declined to offer details of how staff or funds might be shifted to carry that out. She ruled out hiring additional personnel. "We have people who can be mobilized for a short time," she said.

Yesterday's event showcased the launch of a "$100 Million Challenge," an effort to raise matching funds for a 3-year $100 million challenge grant given to Rotary in November 2007 by the Bill and Melinda Gates Foundation. The challenge is aimed at Rotarians, but the organization is also seeking contributions from nonmembers.

"We cannot afford to not eradicate polio," Dr. Julie Gerberding, the director of the CDC, said at the press conference. "It's an economic imperative for us on a global basis. It's also a moral imperative. . . ."


To access the complete CIDRAP news article, go to:
http://www.cidrap.umn.edu/cidrap/content/other/news/jun1808polio.html

To access a press release from Rotary International, click here.

To access the Rotary fund-raising website, go to:
http://www.rotary.org/en/EndPolio/Pages/ridefault.aspx

To visit the CIDRAP website for more information on bioterrorism, biosecurity, influenza, and food safety or to sign up for their free electronic news service on these topics, go to:
http://www.cidrap.umn.edu

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4 CDC issues HAN Advisory announcing a temporary decrease in human rabies vaccine supply

On June 20, CDC issued a Health Alert Network (HAN) Advisory announcing a temporary decrease in the supply of human rabies vaccine. The Advisory is reprinted below in its entirety.


TEMPORARY DECREASE IN HUMAN RABIES VACCINE SUPPLIES

The Centers for Disease Control and Prevention (CDC) has been notified that Novartis Vaccines, maker of RabAvert (Rabies Vaccine), will temporarily cease to provide their rabies vaccine for both pre- and post-exposure prophylaxis uses to healthcare providers. This includes physicians, nurse practitioners, hospitals, clinics, etc. A second company, sanofi pasteur, produces IMOVAX Rabies (Rabies Vaccine), and will continue to supply vaccine to healthcare providers for post-exposure prophylaxis (PEP). In certain circumstances, such as an allergic reaction to one company's vaccine product, the other company's vaccine product can be obtained to complete a vaccination series after consultation with state health departments and CDC, on a case-by-case basis. Overall, both manufacturers have limited supplies of rabies vaccine, necessitating the need for judicious use of these products by health care providers. (It is expected that additional RabAvert will be available on the market in July 2008. When that occurs, it is expected that the demand for pre-exposure vaccinations can be fully met with RabAvert.)

Due to temporarily limited supplies, distribution of vaccine for pre-exposure prophylaxis (PreP) will be approved by state and federal public health authorities. Priority will be given for those individuals at greatest rabies exposure risk (e.g., rabies laboratory workers, animal control officers, veterinary staff, wildlife workers) and in consideration of available rabies vaccine supplies. In lower risk rabies exposure categories (e.g., travelers, veterinary students, etc.), human rabies PreP should be delayed until vaccine supply levels are restored.

Priority use of rabies vaccine will be for post-exposure prophylaxis (PEP) following ACIP human rabies prevention recommendations (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5703a1.htm). IMOVAX rabies vaccine is available for PEP and providers should carefully review the ACIP recommendations and guidelines from their states to ensure that PEP is needed. They are also strongly encouraged to consult with local/state public health departments.

Public health authorities and healthcare providers are encouraged to educate the public concerning the need to take appropriate precautions to avoid rabies exposure and actions to take if an exposure occurs. Appropriate precautions include vaccination of pets, as well as livestock having close human contact, avoiding stray and wild animals, and safely capturing or detaining biting animals or obtaining owner contact information for follow up. Such practices will decrease the need for rabies PEP and thus allow for the responsible management of currently limited vaccine supplies.

CDC is working closely with both vaccine companies and state and federal public health authorities to ensure that healthcare providers receive up-to-date information on supply fluxes. Discussions among federal, state, and local public health personnel are ongoing to review additional strategies to manage the current supply of rabies vaccines. State and local health departments are working to ensure that healthcare providers are informed and have available consultation regarding best practices for the use of rabies vaccine.

Information about rabies, its prevention, and updates on the rabies vaccine situation can be obtained on the CDC rabies website http://www.cdc.gov/rabies or by calling (800) 232-4636 ([800] CDC-INFO). The rabies web site will be updated as new information becomes available.

To access the HAN Advisory, go to:
http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00276

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5.  CDC reports only about one-third of persons with asthma received influenza vaccine in 2005-06 influenza season

CDC published "Influenza Vaccination Coverage Among Persons with Asthma--United States, 2005-06 Influenza Season" in the June 20 issue of MMWR. Portions of the article are reprinted below.


During 2006, approximately 6.8 million (9.3%) U.S. children and 16.1 million (7.3%) U.S. adults were reported to have asthma. Since 1964, the Advisory Committee on Immunization Practices (ACIP) has recommended influenza vaccination of all persons with asthma because of the higher risk for medical complications from influenza for those persons. Influenza vaccination coverage of persons with asthma varies by age group and remains below Healthy People 2010 targets of 60% coverage of persons aged 18-64 years with high-risk conditions and 90% of all persons aged >=65 years. Influenza vaccination rates of children and older adults with asthma have not been well studied. Using 2006 National Health Interview Survey (NHIS) data, this report provides the first examination of influenza vaccination rates and related factors across a national sample of persons with asthma aged >=2 years. The results indicated that 36.2% received influenza vaccination during the 2005-06 influenza season. Vaccination rates remained below target levels among all subgroups examined, including those reporting the greatest number of healthcare visits in the past 12 months. The results of this study indicate that influenza vaccination coverage of all persons with asthma can be improved by increasing access to health care and using opportunities for vaccination during healthcare visits. . . .

Editorial Note: This report presents the first estimates of influenza vaccination coverage in the United States among the civilian, noninstitutionalized population of persons with asthma and reinforces the need to increase vaccination throughout this at-risk population. Healthcare visits provide an opportunity for vaccination, but even among persons with the highest number of visits, nearly half remained unvaccinated in the 2005-06 influenza season. Even so, access to health care is an important factor associated with receiving influenza vaccination. Persons with asthma who had health insurance had a greater rate of influenza vaccination than did those who lacked insurance. Likewise, the vaccination rate for persons with asthma who had a usual place for health care was significantly greater than the rate for those who did not have a regular place for health care. After the vaccine shortage of the 2004-05 influenza season, vaccination coverage of persons with asthma in 2005-06 failed to improve among households with the lowest incomes, among persons without health insurance, and among persons without a regular place for medical care, emphasizing the need for interventions that include the medically underserved.

During the 2005-06 influenza season, the oldest age groups (50-64 years and >=65 years) had the highest vaccination coverage. Influenza vaccination is recommended for both age groups, regardless of asthma status, because the influenza-related death rate increases sharply among older adults. In February 2006, ACIP recommended that all children aged 24-59 months be vaccinated against influenza, regardless of risk status. Examination of the 2007 NHIS data could determine whether the expanded recommendation affected coverage among the subset of children with asthma, who already had been recommended for vaccination under previous guidelines. Because ACIP voted in February 2008 to recommend influenza vaccination for all children, data soon will be available to also study the effects on coverage for older children. . . .

The findings in this report emphasize the need for measures to uniformly increase influenza vaccination rates among persons with asthma. Interventions that target patients, healthcare access, and healthcare providers have demonstrated benefits in similar settings and should be implemented to improve influenza vaccination coverage. Such interventions include automated reminders, standing orders, multicomponent educational programs, reduction of travel distances or out-of-pocket vaccine costs, and provider performance feedback. Persons with inadequate access to health care and those treated at multiple facilities would be less likely to miss opportunities for vaccination if they consistently sought care at a single medical facility. That continuity of care could reduce the diffusion of responsibility that occurs when patients are treated at multiple healthcare facilities. Providing vaccination through at least January and February of the influenza season can further reduce missed opportunities for effective vaccination of persons in this group at high risk.


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5724a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5724.pdf

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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6.  Revised and updated, "Vaccines" textbook has comprehensive information about all aspects of vaccination

Publisher Elsevier recently reminded us that the fifth edition of the highly esteemed textbook "Vaccines" is available for order. Excerpts from the publisher's website are reprinted below.


Completely revised and updated, this respected reference offers comprehensive and current coverage of every aspect of vaccination--from development to use in reducing disease. It provides authoritative information on vaccine production, available preparations, efficacy, and safety; recommendations for vaccine use, with rationales; data on the impact of vaccination programs on morbidity and mortality; and more. And now, as an Expert Consult title, Vaccines includes a companion website offering this unparalleled guidance where and when you need it most!

Author Information:
Stanley A. Plotkin, MD, emeritus professor of pediatrics, University of Pennsylvania; Walter A. Orenstein, MD, professor of medicine and pediatrics, Emory University and former director of CDC's National Immunization Program; and Paul A. Offit, MD, chief, Division of Infectious Diseases, Children's Hospital of Philadelphia and Maurice R. Hilleman Professor of Vaccinology, the University of Pennsylvania School of Medicine, Philadelphia.

Priced at $325, "Vaccines" contains 1,748 pages and 600 illustrations. For additional information, including access to the table of contents and online ordering, go to:
http://www.us.elsevierhealth.com/product.jsp?isbn=9781416036111

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7.  AMA offers physicians practical information on improving immunization among racial and ethnic populations

The website of the American Medical Association (AMA) recently added a self-study course on immunizing racial and ethnic populations. The course is part of AMA's Roadmaps for Clinical Practice series.

Titled "Improving Immunization: Addressing Racial and Ethnic Populations" the course includes four booklets: (1) Overview, (2) Childhood and Adolescent Immunizations, (3) Adult Immunizations, and (4) Resources for Physicians and Patients.

The course provides background information, practical recommendations, and solutions to commonly encountered questions that physicians face from diverse patient populations; case presentations for improving healthcare delivery; and resources.

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 Immunization: Addressing Racial and Ethnic Populations," go to:
http://www.ama-assn.org/ama/pub/category/9958.html

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8.  June 18 issue of IAC's Hep Express electronic newsletter now online

The June 18 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 June 18 Hep Express; titles of articles we have not yet covered follow.

  • ECRI Institute provides resources related to medical device reuse issues
  • AASLD [American Association for the Study of Liver Diseases] 2008 Liver Meeting to be held in San Francisco, October 31-November 4
  • California Central Valley Viral Hepatitis Summit scheduled for August 8 in Atwater
  • Minnesota Viral Hepatitis Symposium to take place on July 30 in Bloomington

To access the June 18 issue, go to:
http://www.hepprograms.org/hepexpress/issue72.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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9.  WHO committee makes recommendations on the use of alternative diagnostic samples for measles and rubella surveillance

CDC published "Recommendations from an Ad Hoc Meeting of the WHO Measles and Rubella Laboratory Network (LabNet) on Use of Alternative Diagnostic Samples for Measles and Rubella Surveillance" in the June 20 issue of MMWR.

To access a web-text (HTML) version of the article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5724a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5724.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.