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