IAC Express 2009
Issue number 784: March 9, 2009
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Contents of this Issue
Select a title to jump to the article.
  1. IAC's laminated versions of the 2009 child/teen and adult immunization schedules offer significant advantages over paper versions. Place your order today and use them throughout 2009!
  2. IAC's redesigned VIS web section is your source for easily accessible VISs in many languages and formats
  3. Influenza complications have killed 22 U.S. children during the current influenza season. It is vital to continue vaccinating through the spring months
  4. IAC's Video of the Week is a doo-wop ditty promoting influenza vaccination for healthcare workers
  5. NCIRD provides updated information on vaccine supply and shortages
  6. Spring issue of Stanford Medicine features a special report, "Hot Shots: Vaccines under the gun"
  7. Archive of the webcast "Vaccines: Wading through the Confusion" now available from California
  8. What to Expect Foundation video answers parents' pressing questions about immunization
  9. New VIS translation: Interim multi-vaccine VIS now available in Korean
  10. NCIRD's new online tool gives users lots of useful information at the click of a mouse
  11. MMWR publishes article on hepatitis C virus transmission at a New York outpatient hemodialysis unit during 2001-08
  12. Coalition University's second and third semesters planned for March 18-19 and May 13 in Baltimore; related Points Across VI conference to be held May 14
  13. MMWR publishes article on progress Afghanistan and Pakistan made toward polio eradication in 2008
 
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 784: March 9, 2009
1.  IAC's laminated versions of the 2009 child/teen and adult immunization schedules offer significant advantages over paper versions. Place your order today and use them throughout 2009!

IAC's 2009 laminated immunization schedules are a must for every exam room at your practice site. We offer the laminated schedules for two age groups. The child/teen immunization schedule is for people ages 0 through 18 years; the adult schedule is for those older than 18. Though both are adapted from the immunization schedules that were posted on the CDC website in January, the laminated schedules offer these advantages over downloadable paper versions:

  • Coated in thick plastic, the laminated schedules are washable and will hold up to a year's worth of use as teaching tools that give providers, patients, and parents authoritative information about the vaccines recommended for various age groups. You can also use them as a handy reference to consult at a moment's notice.
     
  • For the second year in a row, IAC has added a significant feature to the two laminated schedules. Each includes a guide to contraindications and precautions for the pertinent age group (i.e., the child/teen schedule has a guide to contraindications and precautions for child/teen vaccines, and the adult schedule has a guide for adult vaccines). Healthcare professionals will find these guides extremely valuable in making an on-the-spot determination about vaccinating any patient they see in their practice.

The durable laminated schedules come complete with essential footnotes and are printed in color for easy reading. Each schedule has six pages (i.e., three double-sided pages), and when folded, measures 8.5" x 11".

To learn more about the schedules, to view images of each, or to order online or download an order form, visit www.immunize.org/shop

Prices start at $10 each for 1-4 copies and drop to $6.50 each for 5-19 copies. Discount pricing is available for 20 or more copies. For quotes on customizing or placing orders in excess of 999 schedules, call (651) 647-9009 or email admininfo@immunize.org

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2 IAC's redesigned VIS web section is your source for easily accessible VISs in many languages and formats

Making Vaccine Information Statements (VISs) available in more than 35 languages is a hallmark of IAC's website. The VIS home page is the website's most frequently visited section, receiving thousands of visits each day. IAC recently fine-tuned the look and navigation of the VIS web section, making it simple for visitors to find the most recent issue dates of VISs at a glance and to access up-to-date VISs easily.

Need to check for current VIS dates? IAC maintains a quick-reference chart of dates on the VIS home page. Check the dates on your VISs against the dates on the chart. If your supply of VISs contains any out-of-date ones, you can choose to search for VISs sorted alphabetically, as well as by vaccine name and language. Note: All VISs on IAC's site are in ready-to-print (PDF) format. You will need Adobe Reader to view them.

To view the VIS home page, go to: http://www.immunize.org/vis

To view the "VISs Alphabetical" web page, go to:
http://www.immunize.org/vis/?f=7

To view the "VISs by Vaccine" index page, go to:
http://www.immunize.org/vis/?f=8

To view the "VISs by Language" index page, go to:
http://www.immunize.org/vis/?f=9


Look for the new navigation column on the left side of the VIS home page. It provides quick links to more VIS web subsections, such as "How to Use VISs," "Other VIS Sources," "VISs in Alternative Formats," and "Michigan Versions of VISs." You will also find links to "More IAC Materials."

Are you interested in providing IAC with any new or updated translations of VISs? Read the letter of instruction at http://www.immunize.org/translating/trans_letter.pdf Then contact admininfo@immunize.org

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

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3 Influenza complications have killed 22 U.S. children during the current influenza season. It is vital to continue vaccinating through the spring months

U.S. Influenza activity is really on the move. In the week of February 22-28, CDC received reports of five more U.S. children killed by complications from influenza; the total of reported pediatric influenza deaths this influenza season now stands at 22. Thirty-one states have reported widespread influenza activity, up from 27 the previous week.

Yearly vaccination is the first and most important step in protecting against influenza and its complications. It is important to continue vaccinating into the spring months. The supply of influenza vaccine is robust; if you run out of vaccine in your work setting, please place another order.

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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4 IAC's Video of the Week is a doo-wop ditty promoting influenza vaccination for healthcare workers

Using song and lyrics to raise awareness of the importance of influenza vaccination for its employees, the Hospital of the University of Pennsylvania created a five-minute video, "Baby, Be Wise--Immunize." It features scores of employees lip-synching to a doo-wop beat.

The video will be available on the home page of IAC's website through March 15. 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. It may take a few moments for the video to begin playing; please be patient!

Remember to bookmark IAC's home page to view a new video every Monday. While you're at our home page, we encourage you to browse around--you're sure to find resources and information that will enhance your practice's immunization delivery.

To view IAC's video collection, go to:
http://www.vaccineinformation.org/video

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5 NCIRD provides updated information on vaccine supply and shortages

On March 2, NCIRD updated its information on the supply status of vaccines recommended in the U.S. childhood and adolescent immunization schedule. The updated information is reprinted below.


PEDIATRIC HEPATITIS B. In February 2009, both Merck and GSK experienced an inability to fill orders for pediatric Hepatitis B vaccine, resulting in backorders. CDC has released doses from its monovalent pediatric Hepatitis B vaccine stockpiles to each manufacturer to support private and public sector vaccine usage through March. Merck expects supplies of pediatric Recombivax HB to be limited during the remainder of 2009 and does not expect to return to a full supply until some time in 2010. GSK expects to be able to meet the U.S. market demand for monovalent Hepatitis B vaccine through the end of May with its pediatric Hepatitis B vaccine (Pediatric Engerix-B), and is working closely with CDC to determine how much additional monovalent Hepatitis B product can be supplied to the U.S. market during the second half of 2009.

ADULT HEPATITIS B: In December 2008, Merck communicated with CDC that it expected to deplete available adult and dialysis formulations of their hepatitis B vaccine, Recombivax HB, in the first quarter of 2009. Once depleted, these formulations will be unavailable for the remainder of 2009. Supply of GSK's Adult hepatitis B vaccine (Adult Engerix-B) and Adult hepatitis A/hepatitis B combination vaccine (Twinrix) is sufficient to meet demand for routine adult usage of this vaccine as well as [for] CDC's ongoing High Risk Adult Hepatitis B Initiative.

HIB: Merck is working to restore market availability of Hib-containing vaccines, PedvaxHIB and Comvax, but the availability of these vaccines may be subject to a further delay, with Merck's current estimate of availability being mid-to-late 2009. In response to the shortage, CDC and AAP recommend deferral of the booster dose at 12-through-15 months of age except in high-risk groups. Sanofi pasteur currently is providing sufficient Hib vaccine (ActHIB and Pentacel) to cover the 3-dose series through mid 2009, and has developed a supply plan to support reinstatement of the booster dose some time in mid 2009, using a combination of their Hib-containing products. CDC will work closely with sanofi pasteur to determine available supply and options for catch up.

MONOVALENT MEASLES, MUMPS, RUBELLA: In December 2008, Merck communicated with CDC that it was not producing or taking orders for the monovalent vaccines ATTENUVAX (measles vaccine), MUMPSVAX (mumps vaccine), and MERUVAX (rubella vaccine). Merck has not yet made a decision about the future availability of these three monovalent vaccines.

VARICELLA AND ZOSTER: There is adequate supply of Varivax (varicella vaccine) to fully implement the recommended 2-dose immunization schedule, including catch-up, for all age groups. ProQuad (MMRV) will not be available in 2009. Zostavax (zoster vaccine) is available for ordering; however, the manufacturer is experiencing shipping delays. Merck anticipates a return to normal shipping times for Zostavax in mid-2009. Merck vaccine supply status, including specific shipping status information for zoster vaccine, is updated weekly and may be found at http://www.merck.com/e-business/reports/MVC_Supply_Status.pdf

PEDIATRIC AND ADULT HEPATITIS A. Merck & Co previously had experienced production delays that resulted in temporarily not accepting orders for Pediatric and Adult hepatitis A vaccines (Pediatric & Adult VAQTA). As of December 1, 2008, Merck's Pediatric/Adolescent formulation of hepatitis A vaccine, VAQTA, is available for ordering. Merck estimates that the Adult formulation of VAQTA may be available in the second quarter 2009. GSK production and supply of their Pediatric and Adult hepatitis A vaccine (Pediatric & Adult Havrix) and their Adult hepatitis A/hepatitis B combination vaccine (Twinrix) are in adequate supply to meet demand.


NCIRD updates vaccine supply information as needed to provide public information on vaccine shortages and/or delays.

To access vaccine supply and shortage information, go to:
http://www.cdc.gov/vaccines/vac-gen/shortages/default.htm

To receive email notification of updated information, click on the URL above; then click on the link near the top of the page titled Get Email Updates (it's next to an image of a mailbox).

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6 Spring issue of Stanford Medicine features a special report, "Hot Shots: Vaccines under the gun"

The journal Stanford Medicine has devoted the lion share of its spring 2009 issue to a special report on vaccines and immunization. Titled "Hot Shots: Vaccines under the gun," the report comprises articles that examine vaccines and vaccination from many angles. The table of contents follows:

  • A letter from former First Lady Rosalynn Carter, president and co-founder of Every Child By Two
  • The demonization of immunization: Shots get the once over
  • What is a vaccine? Immunization demystified
  • Asking how: Vaccine side effects probed
  • When science gets hijacked: NBC News chief medical editor tells why she broke her silence
  • Insourced to India: A vaccine for a scourge of the developing world
  • Peet's passion: The medical education of Amanda Peet
  • Field yields: Can genetically-engineered plants provide vaccines?
  • Shoot it, don't smoke it: An injectable tobacco-grown vaccine
  • Golden needles: Vaccines for seniors
  • Grow up: What to do when immunity wanes

In addition, the Departments section of the spring issue includes another vaccine-related article, "Backstory--A vaccine against vampires: The genetics of TB hold the key."

To access Stanford Medicine's spring issue, go to:
http://stanmed.stanford.edu/2009spring

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7 Archive of the webcast "Vaccines: Wading through the Confusion" now available from California

Originally held on February 19, the webcast "Vaccines: Wading through the Confusion" is now available on the website of the California Department of Public Health. The 1.5-hour video features a panel of medical, scientific, public health, and communication professionals discussing parents' questions and fears about vaccines. It also includes parents whose lives have been touched by vaccine-preventable diseases or by autism.

To access the video, go to: http://www.brochure2blog.org/publichealthcafe Note: The video begins with about five minutes of recorded music; the panel discussion follows.

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8 What to Expect Foundation video answers parents' pressing questions about immunization

The website of the What to Expect Foundation recently added a 14-minute video to its web section on childhood immunization. The video features Heidi Murkoff, the author of the popular What to Expect When You're Expecting prenatal and parenting books, and Dr. Jay M. Lieberman, pediatrician and professor of pediatrics, University of California School of Medicine, Irvine.

The video, which can be viewed in short segments, answers questions about the number, safety, and timing of childhood vaccinations. To access the video, go to:
http://www.whattoexpect.com/child-vaccinations

An array of downloadable immunization information is also available from the link above, including the "What to Expect Guide to Immunizations," available in English and Spanish.

The What to Expect Foundation is the nonprofit arm of the What to Expect When You're Expecting book series.

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9 New VIS translation: Interim multi-vaccine VIS now available in Korean

Dated 9/18/08, the most current version of the interim multi-vaccine VIS is available for the first time in Korean. IAC gratefully acknowledges the Minnesota Department of Health for the translation.

To access the Korean version of the interim multi-vaccine VIS, go to: http://www.immunize.org/vis/ko_multi.pdf

To access the English version of the interim multi-vaccine VIS, go to: http://www.immunize.org/vis/vis_multi1.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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10.  NCIRD's new online tool gives users lots of useful information at the click of a mouse

NCIRD recently added a new online tool to its website--a sortable table of basic information about vaccines licensed for use in the U.S. It allows users to access information by vaccine name, abbreviation, trade name, and manufacturer. As an example, a user who was interested in finding out about Kinrix would click on the "trade name" column heading to get a listing of vaccines sorted alphabetically by trade name. From there, the user would learn that Kinrix is a DTaP-IPV inactivated combination vaccine manufactured by GlaxoSmithKline and licensed for intramuscular administration to children ages 4-6 years as the fifth dose of DTaP and the fourth dose of IPV. Pretty slick!

To access the table, go to:
http://www.cdc.gov/vaccines/about/terms/USVaccines.html

NOTE: The abbreviations given in the table are the standardized vaccine abbreviations agreed upon by various groups and individuals within CDC and beyond. They are intended to provide a uniform approach to vaccine references used in ACIP immunization recommendations, MMWR articles, NCIRD's Pink Book, AAP's Red Book, and other publications. For more information, go to: http://www.cdc.gov/vaccines/recs/acip/vac-abbrev.htm

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11.  MMWR publishes article on hepatitis C virus transmission at a New York outpatient hemodialysis unit during 2001-08

CDC published "Hepatitis C Virus Transmission at an Outpatient Hemodialysis Unit--New York, 2001-2008" in the March 6 issue of MMWR. A summary made available to the press is reprinted below in its entirety.


Hepatitis C virus and other infections can spread in healthcare settings when proper infection control procedures are not followed. All patients treated in hemodialysis units should be screened for hepatitis C virus (HCV) infection. CDC recommends routine screening in hemodialysis settings to quickly identify and halt potential transmission. It is critical that all healthcare providers understand and follow correct infection control practices to ensure the safety of their patients and prevent transmission of viral hepatitis in healthcare facilities. Preventing these outbreaks is the responsibility of every healthcare worker and represents basic patient safety. Provider education and infection control training is critical. Hemodialysis patients should ask their provider if they have been tested for hepatitis C virus. Patients needing healthcare should continue to seek access to it and should not stop receiving care due to perceived risk. Patients should discuss any concerns with their provider. Due to basic breaches in infection control, several viral hepatitis outbreaks have occurred in recent years in healthcare settings. This investigation documents four cases of patient-to-patient transmission of HCV infection and identified five additional patients who might have acquired HCV infection while receiving treatment at a common outpatient hemodialysis center. Multiple potential mechanisms of HCV transmission were identified, including contaminated healthcare worker hands and treatment surfaces. This outbreak highlights the need for hemodialysis units to adhere to CDC recommendations for infection control and comprehensive HCV surveillance, including routine anti-HCV screening and prompt reporting of HCV infections to the local health department.


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5808a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5808.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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12.  Coalition University's second and third semesters planned for March 18-19 and May 13 in Baltimore; related Points Across VI conference to be held May 14

The second and third semesters of the Coalition University's three-part training series will be held in Baltimore on March 18-19 and May 13, respectively. Intended for health promotion professionals, the related Points Across VI conference is scheduled for May 14, also in Baltimore. Information on the Coalition University's second and third semesters and Points Across VI follow.

COALITION UNIVERSITY'S SECOND AND THIRD SEMESTERS
The Coalition University series is designed to provide the multi-disciplinary skill set necessary for creating, maintaining, and participating in successful coalitions.

The second semester will focus on conflict management, fundraising, strategic planning (part I), board development, and cultural competency. The third semester will cover volunteer management, media relations, strategic planning (part II), advocacy, and program evaluation.

To download the Coalition University class schedule and registration information in ready-to-print (PDF) format, go to: http://www.edcp.org/pdf/Coalition_University_Reg.pdf Note: Limited space is still available for the second semester.

POINTS ACROSS VI
This year's Points Across conference is titled Back to the Basics. It will present information on professional development and self-care for health promotion professionals. To download information about the conference, including registration information, go to:
http://www.edcp.org/pdf/2009_Points_Across_VI_Brochure.pdf

For additional information on either the Coalition University or Points Across VI, email info@immunizemaryland.org or call (410) 902-4677.

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13.  MMWR publishes article on progress Afghanistan and Pakistan made toward polio eradication in 2008

CDC published "Progress Toward Poliomyelitis Eradication--Afghanistan and Pakistan, 2008" in the March 6 issue of MMWR. A summary made available to the press is reprinted below in its entirety.


In addition to continued support from the international polio eradication partnership, interruption of wild poliovirus (WPV) transmission in Afghanistan and Pakistan will require overcoming one of the most important remaining challenges in polio eradication globally: the barriers to access and vaccination of children in large, remote, and security-compromised areas. Efforts to engage political and tribal leaders will need to be enhanced to secure access and safe passage of vaccination teams to these areas. In the interim, critical improvements are needed in the quality of immunization campaigns and delivery of routine immunization in both countries. During 2008, Afghanistan and Pakistan continued to conduct coordinated immunization campaigns against WPV. In total, 149 WPV cases (31 in Afghanistan and 118 in Pakistan) were confirmed in 2008, compared with 49 cases (17 in Afghanistan and 32 in Pakistan) in 2007. Security problems in areas along the common border limited access by vaccination teams to large numbers of children in the two countries. In Pakistan, continued managerial and operational problems impeded full implementation of immunization campaigns and adversely affected vaccination coverage. Further progress toward interruption of WPV transmission in Afghanistan and Pakistan will require continued measures to overcome access problems in conflict-affected areas of both countries and improvements in the quality of immunization activities and delivery of routine immunization services in Pakistan.


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5808a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5808.pdf

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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