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IAC Express 2008 |
| Issue number 752: September 8, 2008 |
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Contents
of this Issue
Select a title to jump to the article. |
- New
interim rotavirus VIS: contains information about the Rotarix vaccine
schedule
- CDC
reports on 2007 NIS data on vaccination coverage among U.S. children ages
19-35 months
- National
Adult Immunization Awareness Week is September 21-27; NFID posts extensive
resources on its website
- Study
results published in the Public Library of Science firmly show no
connection between MMR vaccine and autism
- The
Vaccine Education Center offers an updated version of its influenza
resource
- This
one-page ready-to-copy flyer will make conference attendees aware of
hundreds of reliable immunization resources--all FREE from IAC!
- 2008-09
influenza vaccine update posted on CDC's seasonal flu web section
- South
Carolina Immunization Conference to be held November 7 in Columbia
- MMWR
publishes report on worldwide laboratory surveillance for wild and
vaccine-derived polioviruses
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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 752: September 8, 2008 |
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1. |
New interim rotavirus VIS: contains information about the Rotarix vaccine
schedule
On August 28, CDC issued a
revised version of the interim VIS
for rotavirus vaccine; it replaces the interim VIS dated
4/12/06. The interim VIS dated 8/28/08 includes information
about the Rotarix (GSK) vaccine schedule. Providers may use up
stocks of the 4/12/06 interim VIS for patients receiving RotaTeq
(Merck) vaccine; patients receiving Rotarix should receive the
8/28/08 interim VIS.
To access the 8/28/08 interim VIS for rotavirus vaccine from the
IAC website, go to: http://www.immunize.org/vis/rota_06.pdf
For information about the use of VISs, and for VISs in more than
35 languages, visit IAC's VIS web section at
http://www.immunize.org/vis
For general information about VISs from CDC's website go to:
http://www.cdc.gov/vaccines/pubs/vis
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2. |
CDC reports on 2007 NIS data on vaccination coverage among U.S. children ages
19-35 months
CDC published "National, State, and Local Area
Vaccination
Coverage Among Children Aged 19-35 Months--United States, 2007"
in the September 5 issue of MMWR. Portions of it are reprinted
below. On September 4, the CDC (1) posted on its website the
2007 National Immunization Survey (NIS) data in graph and table
formats, (2) held a press conference on the NIS data, and (3)
issued a related press release. Links to the NIS data, the press
conference transcript, and the press release appear at the end
of this IAC Express article under the heading Related Resources.
The National Immunization Survey (NIS) provides vaccination
coverage estimates among children aged 19-35 months for each of
the 50 states and selected urban areas. This report describes
the results of the 2007 NIS, which provided coverage estimates
among children born during January 2004-July 2006. Healthy
People 2010 established vaccination coverage targets of 90% for
each of the vaccines included in the combined 4:3:1:3:3:1
vaccine series and a target of 80% for the combined series.
Findings from the 2007 NIS indicated that >=90% coverage was
achieved for most of the routinely recommended vaccines. The
majority of parents were vaccinating their children, with less
than 1% of children receiving no vaccines by age 19-35 months.
The coverage level for the 4:3:1:3:3:1 series remained steady at
77.4%, compared with 76.9% in 2006. Among states and local
areas, substantial variability continued, with estimated
vaccination coverage ranging from 63.1% to 91.3%. Coverage
remained high across all racial/ethnic groups and was not
significantly different among racial/ethnic groups after
adjusting for poverty status. However, for some vaccines,
coverage remained lower among children living below the poverty
level compared with children living at or above the poverty
level. Maintaining high vaccination coverage and continued
attention to reducing current poverty disparities is needed to
limit the spread [of vaccine]-preventable diseases and ensure
that children are protected. . . .
In 2007, national coverage with the 4:3:1:3:3:1 series was
77.4%; this coverage has been stable since 2004. Coverage with
the combined 4:3:1:3:3:1:4 vaccine series (i.e., the 4:3:1:3:3:1
series plus >=4 doses of 7-valent pneumococcal conjugate vaccine
[PCV7]) is being reported for the first time and was 66.5%.
National coverage was >=90% for each of the vaccines included in
the 4:3:1:3:3:1 series except for >=4 doses of DTaP (84.5%);
coverage with >=3 doses of DTaP was 95.5%. Coverage with >=1
dose of varicella vaccine (VAR) reached 90% for the first time.
VAR coverage among American Indian/Alaska Native (AI/AN)
children increased significantly, from 85.4% in 2006 to 94.9% in
2007. National vaccination coverage estimates for PCV7 continued
to increase, from 86.9% in 2006 to 90.0% in 2007 for >=3 doses
and from 68.4% to 75.3% for >=4 doses. Among AI/AN children,
coverage with the fourth dose of PCV7 increased significantly,
from 62.7% to 80.4%.
Substantial differences were observed in vaccination coverage
among states and local areas. Estimated coverage for the
4:3:1:3:3:1 series ranged from 91.3% in Maryland to 63.1% in
Nevada. Among the 14 local areas included in the 2007 NIS,
coverage with the 4:3:1:3:3:1 series ranged from 82.2% in
Philadelphia, Pennsylvania, to 69.6% in San Bernardino,
California.
Vaccination coverage levels were higher among AI/ANs compared
with whites for measles, mumps, and rubella (MMR) vaccine,
hepatitis B (HepB) vaccine, and VAR. Coverage with the fourth
dose of DTaP and the fourth dose of PCV7 among black children
was not significantly lower than white children after
controlling for poverty status. Vaccination coverage with the
fourth dose of DTaP and the fourth dose of PCV7 was lower among
children living below the poverty level compared with children
living at or above the poverty level, but this difference
declined from 6.1% in 2006 to 4.8% in 2007 for >=4 doses of DTaP
and from 9.4% in 2006 to 3.5% in 2007 for >=4 doses of PCV7.
Vaccination coverage levels were similar across all
racial/ethnic groups for the 4:3:1:3:3:1 series. Coverage
differed for this series among children living at or above the
poverty level compared with children living below the poverty
level, but this difference declined from 4.9% in 2006 to 3.2% in
2007. Coverage between white and black children with the
4:3:1:3:3:1:4 series was not significantly different after
controlling for poverty status.
Editorial Note:
NIS is the only population-based, provider-verified survey to
provide national, state, and local area estimates of vaccination
coverage among children aged 19-35 months. The results of the
2007 survey indicate that vaccination coverage for vaccines
recommended routinely by ACIP since 2000 and before reached
record high levels. Improvements in vaccination coverage for VAR
meant that national coverage estimates for all individual
vaccines in the 4:3:1:3:3:1 series were >=90%, except coverage
with >=4 doses of DTaP. Coverage with >=4 doses of PCV7 also was
<90%. However, 3-dose coverage for both DTaP and PCV7 remained
high. Coverage with >=4 doses of PCV7 increased significantly to
75.3% in 2007, a substantial increase since PCV7 was first
recommended in 2000. However, coverage with >=4 doses of DTaP
has not changed during the past 5 years. Increasing coverage for
the fourth dose of DTaP and the fourth dose of PCV7 would
improve national coverage for the 4:3:1:3:3:1 series and the
4:3:1:3:3:1:4 series, which will be used to monitor the Healthy
People 2010 immunization objectives beginning with 2009 NIS
data. The vaccine shortage that ended in September 2004 might
have reduced coverage with the fourth dose of PCV7 among
children in the 2007 NIS cohort (i.e., those born during January
2004-July 2006). Use of effective interventions, such as parent
and provider reminder/recall, reducing out-of-pocket costs,
increasing access to vaccination, and multicomponent
interventions that include education might further improve
overall coverage in areas where coverage is low. In addition,
closing the coverage gap between areas with the highest and
lowest coverage remains a priority. To achieve this, further
collaborative efforts among CDC, state immunization
coordinators, immunization programs, and other entities are
essential.
Vaccination coverage among AI/AN children for VAR, MMR vaccine,
and the fourth dose of PCV7 increased significantly in 2007
compared with 2006; in 2007, coverage levels among AI/AN
children were higher for two of these vaccines (VAR and MMR
vaccine) compared with white children. Improved exchange of data
between the Indian Health Service information system and state
immunization information systems and implementation of evidence-based strategies such as reminder/recall at Indian Health
Service and tribal facilities, might have contributed to these
increases in vaccination coverage (A. Groom, CDC, personal
communication, August 2008). However, further monitoring is
needed to determine whether these levels will be sustained.
As in 2006, the results of the 2007 NIS indicate that
differences in poverty status accounted for the observed
differences in coverage between white and black children for the
fourth dose of DTaP and fourth dose of PCV7. In 2007, these
differences in coverage between children living at or above the
poverty level compared with children living below the poverty
level were reduced by one percentage point for DTaP and by
nearly six percentage points for PCV7. Continued efforts are
needed to improve vaccination coverage among children of all
racial and ethnic groups living below the poverty level.
The 2007 NIS results confirm that the majority of parents are
vaccinating their children, with less than 1% of children
receiving no vaccines by age 19-35 months. Although vaccination
coverage in this age group remains high, recent outbreaks of
measles have occurred in certain communities. Several factors
might explain this apparent paradox. Despite record high
coverage with MMR vaccine, nearly 8% of children aged 19-35
months surveyed for the 2007 NIS remained unvaccinated. Measles
is highly contagious, and clustering of unimmunized children
within geographic areas can increase risk for measles and other
vaccine-preventable disease transmission. Clusters of
unimmunized children might not be detected by NIS methods and
might not be visible in national and state rates. Furthermore,
any changes in vaccination behaviors among parents of children
born after July 2006 would not have been detected by the 2007
survey. Increased attention to parental concerns about vaccine
safety has become apparent in recent years. The 2008 NIS is
collecting information on parental concerns about vaccine safety
to better assess parental attitudes and beliefs about vaccines.
In addition, CDC and its partners are developing new educational
materials that can assist parents in making fully informed
decisions about immunizing their children. . . .
Achieving and maintaining high vaccination coverage levels is
important to further reduce the burden of vaccine-preventable
diseases and prevent a resurgence of measles and other diseases
that have been eliminated in the United States. Although
vaccination coverage estimates were at record highs and above
the Healthy People 2010 target for most of the routinely
recommended vaccines in 2007, ongoing efforts through
partnerships among national, state, local, private, and public
entities are needed to sustain these levels and ensure that
vaccination programs in the United States remain strong.
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5735a1.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5735.pdf
To receive a FREE electronic subscription to MMWR (which
includes new ACIP recommendations), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
RELATED RESOURCES
To access the 2007 NIS data, go to:
http://www.cdc.gov/vaccines/stats-surv/nis/nis-2007-released.htm
To access a transcript of the press conference, go to:
http://www.cdc.gov/media/transcripts/2008/t080905.htm
To access the press release, titled "Most US. Parents are
Vaccinating According to New CDC Survey: Vaccination Coverage
Rates for Children Remain High," go to:
http://www.cdc.gov/media/pressrel/2008/r080904.htm
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3. |
National Adult Immunization Awareness Week is September 21-27; NFID posts
extensive resources on its website
The National Foundation for Infectious Diseases (NFID)
issued a
press release announcing that September 21-27 is National Adult
Immunization Awareness Week (NAIAW). Also, the NFID website
posted a campaign kit comprising extensive resources on adult
and adolescent immunization. The press release, which includes a
link to the campaign kit, is reprinted below in its entirety.
National Adult Immunization Awareness Week (NAIAW) will be held
September 21–27, 2008. The National Foundation for Infectious
Diseases (NFID) coordinates this annual observance to coordinate
awareness-raising activities that focus on adult and adolescent
immunization. This year marks the 21st consecutive observance.
NAIAW serves as a great opportunity for individuals and
organizations to promote the importance of adult and adolescent
immunization. "Immunization: Supporting a Healthier Life
Throughout the LifeSpan" is the theme for NAIAW 2008 campaign.
NFID will hold its annual influenza and pneumococcal disease
news conference on Wednesday, September 24, 2008. This event has
become a major national public awareness forum for influenza and
pneumococcal disease.
NFID has developed a campaign kit, a compilation of materials
and resources that will assist in promoting adult and adolescent
immunization on many levels, during NAIAW and the rest of the
year. A PDF of the kit may be downloaded from
http://www.nfid.org/pdf/publications/naiaw08.pdf NFID encourages
organizations to download the campaign kit, to duplicate the
materials included in the kit, and to modify the information to
fit unique needs.
NFID's website can be accessed at http://www.nfid.org
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4. |
Study results published in the Public Library of Science firmly show no
connection between MMR vaccine and autism
Amidst concerns over increasing measles cases in
unvaccinated
individuals, a new study firmly concludes no connection between
measles, mumps, rubella (MMR) vaccine and autism.
In the recent case control study, the presence of measles virus
RNA was no more likely in children with autism and
gastrointestinal (GI) disturbances than in children with only GI
disturbances. Furthermore, GI symptom and autism onset were
unrelated to MMR vaccine timing.
In 1998, a report of the presence of measles virus RNA in
intestinal tissue from children with autism spectrum disorders
and GI disturbances (Wakefield et al.) resulted in public
concern over the safety of MMR vaccine. Although epidemiological
investigations found no associations between MMR vaccine and
autism, this is the first study to test for the presence of
viral RNA in GI tissues of children with autism and GI
disturbances, and examine the temporal relationship of MMR, GI
disturbances, and autism.
To access the study published as "Lack of Association between
Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study" online in the Public Library of Science, go to:
http://dx.plos.org/10.1371/journal.pone.0003140
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5. |
The Vaccine Education Center offers an updated version of its influenza
resource
The Vaccine Education Center at the Children's
Hospital of
Philadelphia recently updated its two-page education sheet,
"Influenza: What you should know." Intended for patients,
parents, and providers, the sheet answers the most frequently
asked questions about influenza disease and vaccines. English-
and Spanish-language versions are available.
Health professionals can order two 50-sheet pads in each
language at no charge. Additional pads are available for $3,
plus shipping.
To access a ready-to-copy (PDF) version of the sheet in English, click
here.
To access a ready-to-copy (PDF) version of the sheet in Spanish, click
here.
Order by email at vaccines@email.chop.edu or by phone at (215)
590-9990.
For additional ordering information, go to:
http://www.chop.edu/consumer/jsp/division/generic.jsp?id=75982
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6. |
This one-page ready-to-copy flyer will make conference attendees aware of
hundreds of reliable immunization resources--all FREE from IAC!
We want to make IAC Express readers aware of a
one-page ready-to-copy flyer that they can distribute at conferences to make
conference attendees aware of links to hundreds of reliable
immunization resources. Titled "Handy Resources: Practical
information about immunization and vaccine-preventable
diseases," the handout includes links to the following FREE
materials:
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IAC's subscription page,
http://www.immunize.org/subscribe,
where one can subscribe to IAC's three print periodicals--Needle
Tips, Vaccinate Adults, and Vaccinate Women--as well as to IAC's
weekly email news service, IAC Express
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IAC's main website,
http://www.immunize.org, which has
hundreds of ready-to-copy immunization and viral hepatitis print
materials for patients and staff
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IAC's website for the public, healthcare professionals, and
the media, http://www.vaccineinformation.org, which contains
disease and vaccine information, including photos and videos
To download the ready-to-copy flyer, go to:
http://www.immunize.org/catg.d/u6005.pdf
IAC's Print Materials web section has more than 175 FREE, ready-to-print English-language materials for healthcare professionals
and the public--as well as many in translation. To access all of IAC's print materials, go to:
http://www.immunize.org/printmaterials
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7. |
2008-09 influenza vaccine update posted on CDC's seasonal flu web section
On August 28, CDC posted "Questions & Answers:
2008-09 Influenza
Vaccine Updates" on its Seasonal Flu website. To access it, go
to: http://www.cdc.gov/flu/flu_vaccine_updates.htm
To access a broad range of continually updated information on
seasonal influenza, avian influenza, pandemic influenza, swine
influenza, and canine influenza, go to: http://www.cdc.gov/flu
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8. |
South Carolina Immunization Conference to be held November 7 in Columbia
Scheduled for November 7 in Columbia, the 2008
South Carolina
Immunization Conference is open to all interested healthcare
providers, including those from other states. The conference
will focus on the latest information on vaccines.
For information, call the Immunization Division of the South
Carolina Department of Health and Environmental Control at (803)
898-0460.
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9. |
MMWR
publishes report on worldwide laboratory surveillance for wild and
vaccine-derived polioviruses
CDC published "Laboratory Surveillance for Wild
and Vaccine-Derived Polioviruses--Worldwide, January 2007-June 2008 " in the
September 5 issue of MMWR. A portion of a summary made available
to the press is reprinted below.
The Global Polio Laboratory Network (GPLN), comprising 145
laboratories in 100 countries, provides comprehensive virologic
support to the WHO Global Polio Eradication Initiative. Despite
a steadily increasing workload (>230,000 stool specimens from
patients with acute flaccid paralysis were analyzed over the
past 18 months), proficiency remains high, and 99 percent of
GPLN laboratories are fully accredited by WHO. By incorporating
new technologies (e.g., PCR), reporting times have been cut in
half. All wild poliovirus (WPV) isolates from every polio case
are sequenced, and global and local pathways of WPV transmission
are resolved at high resolution. GPLN also screens for and
characterizes genetically divergent vaccine-derived polioviruses
(VDPVs) capable of causing outbreaks in areas of low polio
vaccine coverage and prolonged infections in persons with
primary immunodeficiencies.
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5735a2.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5735.pdf
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