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Immunization Action Coalition
IAC Express 2008
Issue number 770: December 15, 2008
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Contents of this Issue
Select a title to jump to the article.
  1. New: CDC issues provisional recommendations for use of pneumococcal vaccines
  2. FDA approves expanded indication for use of Boostrix Tdap vaccine in people ages 10-64 years
  3. New interim VIS for PCV incorporates changes in recommendations for vaccinating healthy children ages 2-4 years
  4. Audio of NPR's interview with Dr. Paul Offit and Amanda Peet is available online
  5. Reminder: December 18 is the date for CDC's webcast "The Immunization Encounter: Critical Issues"
  6. IAC updates its parent-education piece "MMR vaccine does not cause autism: Examine the evidence!"
  7. IAC's Video of the Week features a polio survivor's story
  8. Important: Be sure to give influenza vaccine throughout the influenza season--through spring 2009
  9. CDC issues update on U.S. influenza activity during September 28-November 29
  10. VIS for injectable influenza vaccine now in Turkish; VIS for yellow fever vaccine now in Chinese, Tagalog, and Vietnamese
  11. Mark your calendar: IZTA's teleconference on fundraising and outreach for coalitions is planned for January 13, 2009
 
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 770: December 15, 2008
1.  New: CDC issues provisional recommendations for use of pneumococcal vaccines

On December 8, CDC posted provisional recommendations for use of pneumococcal vaccines on the ACIP web section. Provisional recommendations are those ACIP has voted on but that are not yet approved by CDC or the Department of Health and Human Services and have not yet been published in MMWR. The provisional recommendations for pneumococcal vaccines are reprinted below.


ACIP PROVISIONAL RECOMMENDATIONS FOR USE OF PNEUMOCOCCAL VACCINES

Date of ACIP vote: October 22, 2008
Date of posting of provisional recommendations: December 8, 2008

On October 22, 2008, the ACIP voted on new and revised recommendations for the use of 23-valent pneumococcal polysaccharide vaccine (PPSV23) for the prevention of invasive pneumococcal disease. The new provisional recommendations are as follows:

RECOMMENDATION FOR USE OF THE 23-VALENT PNEUMOCOCCAL POLYSACCHARIDE VACCINE (PPSV23) AMONG ADULT CIGARETTE SMOKERS:
  • Adults who smoke cigarettes are at substantially increased risk for invasive pneumococcal disease.
  • The ACIP recommends that cigarette smoking should be added to the list of indications for PPSV23 in adults aged 19 through 64 years.
  • Proposed wording of the revised recommendation: "Persons aged 19 through 64 years who smoke cigarettes should receive a single dose of PPSV23 and smoking cessation counseling."

RECOMMENDATION FOR THE USE OF PPSV23 AMONG ADULTS WHO HAVE ASTHMA:

  • Asthma is an independent risk factor for invasive pneumococcal disease.
  • The ACIP recommends that asthma should be included among the chronic pulmonary diseases (such as COPD and emphysema) that are indications for PPSV23 in adults aged 19 through 64 years.
  • Proposed wording of the revised recommendation: "Persons aged 19 through 64 years who have asthma should receive a single dose of PPSV23."

REVISED RECOMMENDATION FOR USE OF PPSV23 AMONG AMERICAN INDIANS AND ALASKA NATIVES

  1. American Indian/Alaska Native children aged 24 through 59 months:
    • "Routine use of PPSV23 after PCV7 is not recommended for Alaska Native or American Indian children aged 24 through 59 months. However, in special situations, public health authorities may recommend the use of PPSV23 after PCV7 for Alaska Native or American Indian Children aged 24 through 59 months who are living in areas in which risk of invasive pneumococcal disease is increased."
       
  2. American Indian/Alaska Native adults:
    • "Routine use of PPSV23 is not recommended for Alaska Native or American Indian persons younger than 65 years old unless they have underlying medical conditions that are PPSV23 indications. However, in special situations, public health authorities may recommend PPSV23 for Alaska Natives and American Indians aged 50 through 64 years who are living in areas in which the risk of invasive pneumococcal disease is increased."

REVISED RECOMMENDATION FOR REVACCINATION WITH PPSV23 IN HIGH RISK CHILDREN AGED =<10 YEARS

  • Immunocompromised persons or persons with sickle cell disease or functional or anatomic asplenia are at highest risk for serious pneumococcal infection and may have a rapid decline in pneumococcal antibody levels after PPSV23.
  • The ACIP recommends a single revaccination interval for these persons in all age groups.
  • Proposed wording for the revised recommendation: "A second dose of PPSV23 is recommended 5 years after the first dose of PPSV23 for persons aged >=2 years who are immunocompromised, have sickle cell disease, or functional or anatomic asplenia."

Additional recommendations for use of PPSV23 and PCV7 can be found in the following documents:

The 1997 ACIP recommendations for prevention of pneumococcal disease. Available at: http://www.cdc.gov/mmwr/PDF/rr/rr4608.pdf

The [2000] ACIP recommendations for preventing pneumococcal disease among infants and young children. Available at:
http://www.cdc.gov/mmwr/PDF/rr/rr4909.pdf


To access CDC's pneumococcal provisional recommendations, go to:
http://www.cdc.gov/vaccines/recs/provisional/downloads/pneumo-Oct-2008-508.pdf

All provisional ACIP recommendations can be found at
http://www.cdc.gov/vaccines/recs/provisional

All published ACIP recommendations can be accessed at
http://www.cdc.gov/vaccines/pubs/ACIP-list.htm

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2 FDA approves expanded indication for use of Boostrix Tdap vaccine in people ages 10-64 years

On December 4, FDA approved GlaxoSmithKline's (GSK) request to supplement the biologics license application for the tetanus-diphtheria-acellular pertussis (Tdap) vaccine Boostrix. The vaccine is now approved for use as a one-time booster for people ages 10-64 years. Previously, it was approved for use in people ages 10-18 years.

To access the December 4 approval letter, go to:
http://www.fda.gov/cber/approvltr/tdapboostrix120408L.htm

Note: The package insert posted on the FDA website is dated December 2005. To view an updated package insert (dated December 2008) posted on the GSK website, go to:
http://us.gsk.com/products/assets/us_boostrix.pdf

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3 New interim VIS for PCV incorporates changes in recommendations for vaccinating healthy children ages 2-4 years

On December 9, CDC issued an interim VIS for pneumococcal conjugate vaccine (PCV); it replaces the VIS for PCV dated 9/30/02. The new interim VIS incorporates changes made in the recommendations for vaccinating healthy children ages 2-4 years with the vaccine. Miscellaneous minor changes were also made. CDC advises providers to use the new interim VIS immediately when vaccinating children ages 2-4 years, but existing stocks may continue to be used temporarily.

To access the 12/9/08 interim VIS for PCV, go to:
http://www.immunize.org/vis/pnPCV7.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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4 Audio of NPR's interview with Dr. Paul Offit and Amanda Peet is available online

Every Child by Two (ECBT) provided a brief overview of a National Public Radio (NPR) interview with Dr. Paul Offit and Amanda Peet that aired on December 11 on NPR's morning news program Morning Edition. Dr. Offit is the chief of Infectious Diseases and the director of the Vaccine Education Center at the Children's Hospital of Philadelphia, as well as the Maurice R. Hilleman Professor of Vaccinology and professor of pediatrics at the University of Pennsylvania School of Medicine. Film and television actress Amanda Peet is ECBT's Vaccinate Your Baby campaign spokesperson.

ECBT's overview is reprinted below.


Today on Morning Edition, science correspondent Jon Hamilton reported on the vaccine-autism "debate" and set the record straight. Mr. Hamilton interviewed both Vaccinate Your Baby volunteer spokeswoman Amanda Peet and Dr. Paul Offit to counter the recent onslaught of celebrity claims that immunizations and the neurodevelopmental disorder are linked.

Both Ms. Peet and Dr. Offit pointed out the importance of immunizing children, and the frightening consequences of exempting--especially for the 500,000 vulnerable Americans who cannot be vaccinated due to autoimmune disorders.

You can listen to the 5-minute segment on NPR's web site by clicking here.

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5 Reminder: December 18 is the date for CDC's webcast "The Immunization Encounter: Critical Issues"

CDC will present a webcast, "The Immunization Encounter: Critical Issues," on December 18 from 12 noon-2PM EST. The program will address issues related to the routine encounter at an immunization clinic. Topics include patient and parent communication and education, vaccine storage and handling, preparing for medical emergencies, screening for contraindications and precautions to vaccination, vaccine administration, records and documentation, the Vaccine Adverse Event Reporting System, and the Vaccine Injury Compensation Program. Continuing education credits will be offered.

Additional information about the program is available at http://www2a.cdc.gov/phtn/imm-encounter2008 No registration is necessary to access the webcast via an Internet connection. The link to the webcast is available at http://www2a.cdc.gov/phtn/webcast/imm-encounter2008 The webcast will be accessible through an Internet connection until January 20, 2009, and will become available as a self-study DVD and Internet-based program in January 2009.

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6 IAC updates its parent-education piece "MMR vaccine does not cause autism: Examine the evidence!"

IAC recently updated "MMR vaccine does not cause autism: Examine the evidence!" Two additional references have been added to the list of articles demonstrating there is no connection between MMR vaccine and autism.

To access the updated piece, go to:
http://www.immunize.org/catg.d/p4026.pdf

IAC's Print Materials web section offers healthcare professionals and the public approximately 250 FREE English-language materials (many also available in translation), which we encourage website users to print out, copy, and distribute widely. To access all of IAC's free print materials, go to:
http://www.immunize.org/printmaterials

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7 IAC's Video of the Week features a polio survivor's story

IAC encourages IAC Express readers to watch a two-minute video about the experiences recounted in the book "Twin Voices: A memoir of polio, the forgotten killer." Written by Janice Flood Nichols, the book chronicles a 1953 polio outbreak that claimed the life of Ms. Nichols' twin brother and left her with paralytic polio. Ms. Nichols is currently the interim executive director of Voices for Vaccines, an immunization advocacy organization.

Titled "A Memoir of Polio," the video will be available on the home page of IAC's website through December 21. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week, which you'll find toward the top of the page.

Remember to bookmark the URL above to view a new video every Monday. While you're at our homepage, we encourage you to browse around--you're sure to find resources and information that will enhance your practice of immunization delivery.

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8 Important: Be sure to give influenza vaccine throughout the influenza season--through spring 2009

Influenza vaccine for the 2008-09 influenza season is widely available, and the supply is robust. If you run out of vaccine in your work setting, please place another order. Influenza vaccination efforts should continue through the holiday season and into the spring months of 2009.

For abundant information about influenza vaccination, visit the following two websites often. They are continually updated with the latest resources:

The National Influenza Vaccine Summit website at
http://www.preventinfluenza.org

CDC's Seasonal Flu web section at http://www.cdc.gov/flu

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9 CDC issues update on U.S. influenza activity during September 28-November 29

CDC published "Update: Influenza Activity--United States, September 28-November 29, 2008" in the December 12 issue of MMWR. Portions of the article are reprinted below.


During September 28-November 29, 2008, influenza activity remained low in the United States. Of the few influenza viruses characterized thus far this season, most are antigenically related to the strains included in the 2008-09 influenza vaccine. Oseltamivir-resistant influenza A (H1N1) viruses have been detected, but currently available data are insufficient to predict their prevalence for the 2008-09 season. This report summarizes U.S. influenza activity since the last update and reviews new influenza vaccine recommendations for the current season. . . .

Antigenic Characterization
WHO collaborating laboratories in the United States are requested to submit a subset of their influenza-positive respiratory specimens to CDC for further antigenic characterization. CDC has antigenically characterized 30 influenza viruses collected by U.S. laboratories during the 2008-09 season, including 20 influenza A (H1N1), three influenza A (H3N2), and seven influenza B viruses. Twenty-seven of the 30 viruses were antigenically related to the components included in the 2008-09 influenza vaccine (A/Brisbane/59/2007-like (H1N1), A/Brisbane/10/2007-like (H3N2), and B/Florida/04/2006-like). The other three influenza B viruses belong to the B/Victoria/02/87 lineage. . . .

Pneumonia- and Influenza-Related Mortality
For the week ending November 29, 2008, pneumonia and influenza (P&I) was reported as an underlying or contributing cause of death for 6.7% of all deaths reported to the 122 Cities Mortality Reporting System. This is below the epidemic threshold of 7.1% for that period. Since September 28, 2008, the weekly percentage of deaths attributed to P&I ranged from 6.0%-6.7%, remaining below the epidemic threshold. . . .

Influenza-Related Pediatric Mortality
No influenza-related pediatric deaths have been reported for the 2008-09 season. . . .

On average, influenza is estimated to cause approximately 226,000 hospitalizations and 36,000 deaths per year in the United States. Annual vaccination remains the best method for preventing influenza and its potentially severe complications. The Advisory Committee on Immunization Practices (ACIP) recently expanded its recommendations for influenza vaccination to include all children aged 6 months-18 years. In addition, influenza vaccine should be administered to other persons at high risk for influenza-related complications, close contacts of those at high risk (including healthcare workers), and anyone else who wants to decrease their risk for influenza. . . .

Vaccination remains the cornerstone of influenza prevention efforts. Influenza vaccination can prevent influenza infections from strains that are sensitive or resistant to antiviral medications; the influenza A (H1N1) viruses found to be oseltamivir resistant are antigenically similar to the components included in the 2008-09 vaccine. . . .

CDC continues to conduct surveillance to provide up-to-date recommendations regarding prevention and treatment of influenza. Influenza surveillance reports for the United States are posted online weekly during October-May and are available at http://www.cdc.gov/flu/weekly/fluactivity.htm Additional information regarding influenza viruses, influenza surveillance, influenza vaccine, and avian influenza 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/mm5749a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5749.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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10.  VIS for injectable influenza vaccine now in Turkish; VIS for yellow fever vaccine now in Chinese, Tagalog, and Vietnamese

Dated 7/24/08, the current VIS for trivalent inactivated influenza vaccine (TIV; injectable) is now available in Turkish. Dated 11/9/04, the current VIS for yellow fever vaccine is now available in Chinese, Tagalog, and Vietnamese. IAC gratefully acknowledges Mustafa Kozanoglu, MD, and Murat Serbest, MD, for the influenza VIS translation, and the California Department of Public Health, Immunization Branch for the yellow fever vaccine translations.


VIS FOR TIV
To access the Turkish version of the VIS for TIV, go to:
http://www.immunize.org/vis/tu_flu06.pdf

To access the English version of the VIS for TIV, go to:
http://www.immunize.org/vis/2flu.pdf

NOTE: The VIS for TIV comes in additional languages, including Spanish. To access them, go to: http://www.immunize.org/vis/vis_flu_inactive.asp Click on the link to the pertinent language.


VIS FOR YELLOW FEVER VACCINE
To access the Chinese version of the VIS for yellow fever vaccine, go to: http://www.immunize.org/vis/ch_yf.pdf

To access the Tagalog version of the VIS for yellow fever vaccine, go to: http://www.immunize.org/vis/ta_yf.pdf

To access the Vietnamese version of the VIS for yellow fever vaccine, go to: http://www.immunize.org/vis/vn_yf.pdf

To access the English version of the VIS for yellow fever vaccine, go to: http://www.immunize.org/vis/yfever04.pdf

NOTE: The VIS for yellow fever vaccine also comes in Spanish. To access it, go to: http://www.immunize.org/vis/sp_yf04.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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11.  Mark your calendar: IZTA's teleconference on fundraising and outreach for coalitions is planned for January 13, 2009

The Immunization Coalitions Technical Assistance Network (IZTA) conference call on January 13, 2009, will discuss ideas for coalitions that are looking to make the most of their limited resources for fundraising, promotion, and partnership development. IZTA is a program of the Center for Health Communication, Academy for Educational Development (AED).

The presenter is AED's Erik Wang. His professional career includes developing creative public/private partnerships and cause-related marketing campaigns for Best Buy, Magic Johnson Foundation, National Basketball Association, and General Mills.

For this call, IZTA is encouraging coalitions that have a specific fundraising or partnership challenge to email a description of their situation to IZTA. The call will include brainstorming ideas about a few of the submitted situations. Send your email to izta@aed.org

To register for the conference call, send an email to izta@aed.org Include this message in the subject line: "Sign me up for the fundraising and outreach call."

To access earlier programs, go to:
http://www.izta.org/confcall.cfm

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tel 651-647-9009  •  fax 651-647-9131
 
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.