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Immunization Action Coalition
IAC Express 2008
Issue number 739: June 30, 2008
 
Contents of this Issue
Select a title to jump to the article.
  1. FDA approves new DTaP-IPV vaccine (Kinrix) for use in children ages 4-6 years
  2. Preliminary data indicate 2007-08 rotavirus season was less severe than usual; new vaccine may have played a part
  3. CDC reports on influenza activity in the United States and worldwide during the 2007-08 influenza season
  4. New: CDLHN offers a two-part webcast on talking with parents and patients about vaccine safety
  5. IAC offers Arabic and French translations of its popular parent-education brochure "All Kids Need Hepatitis B Shots!"
  6. CDC urges Olympic travelers to take protective measures against respiratory ills, dog bites, other health concerns
  7. June issue of CDC's Immunization Works electronic newsletter now available online
  8. New: Hand-hygiene DVD encourages patients to play an active role in preventing hospital infections
 
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 739: June 30, 2008
1.  FDA approves new DTaP-IPV vaccine (Kinrix) for use in children ages 4-6 years

On June 24, FDA approved the use of GlaxoSmithKline's Kinrix diphtheria tetanus toxoids, acellular pertussis adsorbed, and inactivated polio vaccine in children ages 4-6 years.

According to FDA's Product Approval Information, Kinrix vaccine is indicated for active immunization against diphtheria, tetanus, pertussis, and poliomyelitis as the fifth dose in the diphtheria, tetanus, and acellular pertussis (DTaP) vaccine series and the fourth dose in the inactivated poliovirus vaccine (IPV) series in children 4 through 6 years of age whose previous DTaP vaccine doses have been with INFANRIX and/or PEDIARIX for the first three doses and INFANRIX for the fourth dose.

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

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

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2 Preliminary data indicate 2007-08 rotavirus season was less severe than usual; new vaccine may have played a part

CDC published "Delayed Onset and Diminished Magnitude of Rotavirus Activity--United States, November 2007-May 2008" in the June 27 issue of MMWR. Portions of the article are reprinted below.

Note: The same information was published on June 25 as an MMWR Early Release. Also on June 25, CDC issued a press release on the topic titled "Fewer Kids Suffering from Rotavirus This Season: Credit May Go to Newly Introduced Infant Vaccine." Links to both the MMWR Early Release and the press release are given at the end of this IAC Express article.


Rotavirus is the leading cause of severe acute gastroenteritis among infants and young children, accounting for an estimated 527,000 deaths among children aged <5 years worldwide in 2004. In the United States, rotavirus causes few deaths (20-60) each year, but remains a substantial cause of morbidity among children, resulting in approximately 55,000-70,000 hospitalizations, 205,000-272,000 emergency department (ED) visits, and 410,000 physician office visits. In the continental United States, rotavirus activity follows a distinct winter-spring seasonal pattern. In winter months, approximately 50% of hospitalizations and ED visits and 30% of outpatient visits for acute gastroenteritis among U.S. children aged <3 years are caused by rotavirus. To prevent rotavirus disease, in February 2006, a human-bovine rotavirus vaccine, RotaTeq (Merck & Co., Inc., Whitehouse Station, New Jersey), was recommended for routine use among U.S. infants. To summarize rotavirus activity through May 3, during the current 2007-08 season, CDC analyzed data from the National Respiratory and Enteric Virus Surveillance System (NREVSS) and the New Vaccine Surveillance Network (NVSN). The results indicated that, when compared with the 15 previous seasons spanning 1991-2006, rotavirus activity during the current season appeared delayed in onset by 2-4 months and diminished in magnitude by >50%. Additional surveillance and epidemiologic studies are needed to confirm the impact of rotavirus vaccination on the 2007-08 season and to monitor the impact of the vaccine on the incidence and epidemiology of rotavirus during future seasons. . . .


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5725a6.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5725.pdf

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

To access a web-text (HTML) version of the June 25 MMWR Early Release, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e625a1.htm

To access a ready-to-print (PDF) version of the June 25 MMWR Early Release, go to:
http://www.cdc.gov/mmwr/pdf/wk/mm57e625.pdf

To access the CDC press release, go to:
http://www.cdc.gov/media/pressrel/2008/r080625.htm

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3 CDC reports on influenza activity in the United States and worldwide during the 2007-08 influenza season

 CDC published "Influenza Activity--United States and Worldwide, 2007-08 Season" in the June 27 issue of MMWR. Portions of the article are reprinted below.


During the 2007-08 influenza season, influenza activity peaked in mid-February in the United States and was associated with greater mortality and higher rates of hospitalization of children aged 0-4 years, compared with each of the previous three seasons. In the United States, influenza A (H1N1) was the predominant strain early in the season; influenza A (H3N2) viruses increased in circulation in January and predominated overall. While influenza A (H1N1), A (H3N2), and B viruses cocirculated worldwide, influenza A (H1N1) viruses were most commonly reported in Canada, Europe, and Africa, and influenza B viruses were predominant in most Asian countries. This report summarizes influenza activity in the United States and worldwide during the 2007-08 influenza season (September 30, 2007-May 17, 2008).

Overview of Influenza Activity in the United States
The national percentage of respiratory specimens that tested positive for influenza peaked in early to mid-February, and the proportion of outpatient visits to sentinel providers for influenza-like illness (ILI) and to BioSense Department of Veteran's Affairs (VA) and Department of Defense (DoD) outpatient clinics for acute respiratory illness (ARI) peaked in mid-February. . . .

Pneumonia- and Influenza-Related Mortality
During the 2007-08 influenza season, the percentage of deaths attributed to pneumonia and influenza (P&I) exceeded the epidemic threshold for 19 consecutive weeks in the 122 Cities Mortality Reporting System during the weeks ending January 12-May 17, 2008 (weeks 2-20). The percentage of P&I deaths peaked at 9.1% during the week ending March 15, 2008 (week 11). During the previous three influenza seasons, the peak percentage of P&I deaths has ranged from 7.7% to 8.9% and the total number of weeks the P&I ratio exceeded the epidemic threshold has ranged from one to 11. . . .

Influenza-Related Pediatric Mortality
As of June 19, 2008, 83 deaths associated with influenza infections that occurred among children aged <18 years during the 2007-08 influenza season were reported to CDC. These deaths were reported from 33 states (Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Tennessee, Texas, Utah, Vermont, Washington, and Wisconsin). All patients had laboratory-confirmed influenza virus infection. Among the 83 cases, the mean and median age was 6.4 years and 5.0 years, respectively; nine children were aged <6 months, 15 were aged 6-23 months, 11 were aged 2-4 years, and 48 were aged 5-17 years. Of the 79 cases for which the influenza virus type was known, 51 were influenza A viruses, 27 were influenza B viruses, and one had co-infection with influenza A and B viruses. Of the 63 cases aged >=6 months for whom vaccination status was known, 58 (92%) had not been vaccinated against influenza according to the 2007 Advisory Committee on Immunization Practices (ACIP) recommendations. These data are provisional and subject to change as more information becomes available. . . .

In February 2008, ACIP voted to expand influenza vaccination recommendations to include all children aged 5-18 years, beginning with the 2008-09 influenza season, if feasible, but no later than the 2009-10 influenza season. The influenza vaccine supply is projected to be abundant for the upcoming influenza season in the United States with ample doses available for implementation of the new pediatric influenza vaccination recommendation. Continued efforts, however, are needed to improve influenza vaccination coverage among children aged 6 months through 4 years, an age group at high risk for influenza-related complications and hospitalization, and close contacts of all children aged <5 years. Vaccination of household contacts of children aged <6 months is particularly important because children aged <6 months are the pediatric group at highest risk for influenza complications, but no vaccine is available for this age group. High rates of laboratory confirmed influenza-associated hospitalization reported from the two population-based surveillance systems for children aged 0-4 years, and the low vaccination rate among influenza-associated pediatric deaths reported to CDC, highlight the increased risk for influenza-related complications and hospitalizations in young children, and the need to improve vaccine coverage in this age group.

Healthcare providers should offer vaccination, whether individually or through mass campaigns, soon after 2008-09 vaccine is available. All children aged 6 months through 8 years who previously have not received influenza vaccine should have their first dose administered as soon as vaccine is available to allow time for a second dose before or shortly after the onset of influenza activity in their community. Influenza activity in the United States rarely peaks before November, and activity has peaked in January or later in 20 (80%) of the previous 25 influenza seasons. Thus, vaccine administered in December or later is likely to be beneficial during most influenza seasons. Additional information regarding influenza viruses, influenza surveillance, avian influenza, and influenza vaccination recommendations is available at http://www.cdc.gov/flu


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5725a5.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5725.pdf

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4 New: CDLHN offers a two-part webcast on talking with parents and patients about vaccine safety

 California Distance Learning Health Network (CDLHN) recently announced the availability of a two-part webcast, "Talking About Vaccine Safety with Parents and Patients." The webcasts can be viewed on demand, at any time.

Part 1 covers why vaccine safety has been in the public spotlight, where parents are likely to hear about vaccine safety, and how media and the Internet influence public perceptions. It presents effective communication strategies when talking about immunization.

Part 2 includes a discussion of the major controversies surrounding vaccine safety and the delivery of vaccines and talking points to help health educators or clinical staff address specific concerns. Key resources and web links are provided for further information.

To access the webcasts, click here.

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5 IAC offers Arabic and French translations of its popular parent-education brochure "All Kids Need Hepatitis B Shots!"

 IAC now offers the "All Kids Need Hepatitis B Shots!" brochure in Arabic and French.

To access the Arabic version of "All Kids Need Hepatitis B Shots!" go to: http://www.immunize.org/catg.d/p4055-20.pdf

To access the French version of "All Kids Need Hepatitis B Shots!" go to: http://www.immunize.org/catg.d/p4055-10.pdf

To access the English version of "All Kids Need Hepatitis B Shots!" go to: http://www.immunize.org/catg.d/p4055.pdf

In addition to Arabic, French, and English, "All Kids Need Hepatitis B Shots!" is available in Spanish and six other languages. To access these additional translations, go to the alphabetical listing of print resources at
http://www.immunize.org/printmaterials/alpha.asp

To access additional FREE, ready-to-print translations from the IAC website, go to:
http://www.immunize.org/printmaterials/translations.asp

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

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6 CDC urges Olympic travelers to take protective measures against respiratory ills, dog bites, other health concerns

 CDC is urging travelers to the 2008 summer Olympics, which will take place August 8-24 in Beijing, to take preventive measures before traveling and to take precautions during travel. On June 26, CDC issued a press release on the topic: "Respiratory Illness, Dog Bites Among Top Concerns for Travelers to China: Study Provides Insight to Help Olympic Travelers Prepare for Trip." Portions of the press release are reprinted below.


Beijing–bound Olympic travelers should worry less about exotic diseases, and instead focus on preventing more mundane health problems like respiratory illness and dog bites. A new study by experts at the Centers for Disease Control and Prevention and the GeoSentinel Surveillance Network found that, during the past 10 years, dog bites were actually one of the more common health problems travelers face when visiting China. Other common ailments were respiratory infections, skin problems, injuries, and diarrhea. . . .

Travel health experts at CDC say that travelers can help reduce their risk of becoming ill or injured by taking the following precautions:
  • Visit a travel medicine clinic four to six weeks prior to leaving to get travel advice.
  • Ensure all vaccinations are up-to-date.
  • Wash hands or use hand sanitizers frequently to help prevent the spread of respiratory and diarrheal illness.
  • Avoid all animals while in China. If bitten, wash all bite wounds promptly and seek reliable medical care immediately.
  • Wear comfortable walking shoes and pay special attention when crossing the street and boarding public transportation to minimize injury risk.
  • Eat only fully cooked food that is served hot or fruits and vegetables you can wash and peel yourself to decrease the risk of diarrhea.

For more CDC recommendations for Olympic travelers, athletes and health-care providers, please visit http://wwwn.cdc.gov/travel/contentOlympics2008.aspx For general recommendations for travel to China, see http://wwwn.cdc.gov/travel/destinationChina.aspx

To access the complete press release, go to:
http://www.cdc.gov/media/pressrel/2008/r080626.htm

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7 June issue of CDC's Immunization Works electronic newsletter now available online

The June issue of Immunization Works, a monthly email newsletter published by CDC, is available on the website of the National Center for Immunization and Respiratory Diseases (NCIRD). The newsletter offers the immunization community information about current topics. The information is in the public domain and can be reproduced and circulated widely.

Some of the information in the June issue has already appeared in previous issues of IAC Express. Following are titles of articles IAC Express has already covered:

  • Fewer kids suffering from rotavirus this season
  • FDA approves Pentacel (DTaP, Polio, Hib)
  • Just released: Epidemiology and Prevention of Vaccine-Preventable Diseases 2008
  • Pink Book, new printing

Following is the text of some articles we have not covered.


OTHER NEWS & SUMMARIES

RAPID CYCLE ANALYSIS (RCA): In 2005, the Vaccine Safety Datalink (VSD) Project (http://www.cdc.gov/vaccinesafety/vsd) team launched an active surveillance system called Rapid Cycle Analysis (RCA). Its goal is to monitor adverse events following vaccination in near real time, so the public can be informed quickly of possible risks. RCA data come from participating managed care organizations that include more than 8.8 million people annually, representing nearly 3% of the United States population. The RCA data contain no personal identifiers. The VSD Project team uses RCA to monitor newly licensed vaccines and new vaccine recommendations. For more information, please visit Rapid Cycle Analysis (http://www.cdc.gov/vaccinesafety/vsd/rca.htm).


REPORTS SHOW GARDASIL VACCINE IS SAFE (DATA UPDATED THROUGH APRIL 30, 2008): On June 8, 2006, the FDA licensed Gardasil, the first vaccine developed to prevent cervical cancer caused by certain kinds of human papillomavirus (HPV). Since then, more than 12 million doses of Gardasil vaccine have been distributed. The Vaccine Adverse Event Reporting System (VAERS) is a national program of CDC and the Food and Drug Administration (FDA) that monitors the safety of vaccines after they are licensed. VAERS receives reports of adverse events that occur after people receive vaccines. VAERS reports after Gardasil vaccination in the U.S. between June 8, 2006 and April 30, 2008 can be found on the CDC Immunization Safety Office web site. For more information, please visit Gardasil Vaccine Reports (http://www.cdc.gov/vaccinesafety/vaers/gardasil.htm).


ROTATEQ VACCINE SAFETY STUDY FINDS NO ASSOCIATION WITH INTUSSUSCEPTION: CDC and the Food and Drug Administration (FDA) conduct routine safety monitoring for new vaccines. In 2006, CDC implemented a post-licensure vaccine safety study of the RotaTeq vaccine. On June 2, 2008, PEDIATRICS published CDC's Immunization Safety Office work on Postlicensure Monitoring of Intussusception After RotaTeq Vaccination in the United States, February 1, 2006, to September 25, 2007. This study, conducted by CDC's Vaccine Safety Office, analyzed the data from reports of intussusception after RotaTeq vaccination using data from CDC's Vaccine Adverse Event Reporting System (VAERS) and Vaccine Safety Datalink (VSD) Project. The study found no association between RotaTeq and intussusceptions. For more information on the study, please visit RotaTeq Vaccine Safety Study (http://www.cdc.gov/vaccinesafety/vaers/rotateq.htm).


STATE GRANTEES TESTED IN EMERGENCY RESPONSE: CDC recently concluded an eight-week pilot test to assess the capability of CDC and the 62 Public Health Emergency Preparedness grantees to collect and transmit vaccine doses data administered through the Countermeasure and Response Administration (CRA) System (http://www.cdc.gov/phin/activities/applications-services/cra). For this exercise, data from seasonal influenza vaccine clinics were used as a proxy for pandemic influenza vaccine. . . .Fifty-five percent (34/62) of project areas met the criteria to be considered fully successful. . . .


MEETINGS, CONFERENCES & RESOURCES

PERINATAL HEPATITIS B PREVENTION TRAINING SERIES: A four-part netconference training series entitled "Essentials of Perinatal Hepatitis B Prevention: A Training Series for Coordinators and Case Managers 2008" (http://www2.cdc.gov/vaccines/ed/hepbtraining) was designed for perinatal hepatitis B prevention coordinators and case workers in state and local health departments. The archived versions of these sessions are now available and provide guidance to successfully manage, implement, and evaluate a prenatal hepatitis B prevention program. The content is drawn from CDC-developed guidelines and resources, such as ACIP immunization strategy to eliminate hepatitis B virus infection in the United States, the perinatal hepatitis B prevention program manual, and the immunization program operations manual. Continuing Education (CE) credits are available.

Issues of Immunization Works are posted on CDC's Vaccines & Immunizations website a few days after publication. To access the June issue, go to: http://www.cdc.gov/vaccines/news/newsltrs/imwrks Click on the link titled "Jun" under the banner titled "2008 Newsletters Available Online."

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8 New: Hand-hygiene DVD encourages patients to play an active role in preventing hospital infections

On June 24, the Association for Professionals in Infection Control and Epidemiology (APIC) issued a press release, "Patient Safety DVD Encourages Consumers to Play Active Role in Preventing Hospital Infections." Portions of it are reprinted below.


The life-saving benefits of hand hygiene are the subject of a new patient safety DVD developed by the Association for Professionals in Infection Control and Epidemiology (APIC), the Centers for Disease Control and Prevention (CDC), and Safe Care Campaign.

The DVD, which will be shown to patients on admission into the hospital, is modeled after the video airline passengers are required to view prior to take-off on a flight. The goal of the campaign is to teach patients before admission to the hospital what they can do to help prevent the spread of infection and to encourage them to ask or remind their healthcare workers to practice hand hygiene. . . .

This DVD is available in both English and Spanish with accompanying posters and brochures and can be downloaded from the CDC website at
http://www.cdc.gov/handhygiene/Patient_Admission_Video.html


The CDC Hand Hygiene web section offers several additional resources, including CDC's hand hygiene guidelines, "Hand Hygiene Saves Lives," an interactive training course, and a fact sheet. To access these resources, go to http://www.cdc.gov/handhygiene and click on the pertinent link.

To access the complete APIC press release, click here and click on the link titled "6/24/08 Patient Safety DVD Press Release."

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Immunization Action Coalition  •  Saint Paul, MN
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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.