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IAC Express 2009
Issue number 790: April 13, 2009

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Contents of this Issue Select a title to jump to the article.
$300 million in Recovery Act funds to be allocated to CDC's Section 317 immunization program Six confirmed measles cases reported in southwest Pennsylvania; additional probable cases await confirmation AAP and partners submit amicus brief in defense of statute that protects U.S. vaccine supply IAC's Video of the Week focuses on shingles disease, treatment, and prevention CDC corrects an answer that appeared in the IAC Express "Ask the Experts" Extra Edition on April 6 Influenza complications have killed 45 U.S. children during the current influenza season. It is vital to continue vaccinating through the spring months NFID releases its Call to Action on adult vaccination and introduces its new adult vaccination website California Department of Public Health launches EZ-IZ, a one-stop shop for immunization training and resources Coming right up: National Infant Immunization Week starts on April 25 and goes through May 2 New: CDC's pocket-size adult and child/teen immunization schedules now available online IAC corrects its March 30 IAC Express article regarding latex gloves WHO issues position paper on human papillomavirus vaccines Reminder: April 25 is the date for World Meningitis Day MMWR notifies readers about ACIP's standardized vaccine abbreviations Guidelines for preventing and treating opportunistic infections in HIV-infected adults and adolescents now published in MMWR Recommendations and Reports

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 790: April 13, 2009

$300 million in Recovery Act funds to be allocated to CDC's Section 317 immunization program

On April 9, the Department of Health and Human Services (HHS) issued a press release titled "Biden Announces $2.3 Billion in Recovery Act Funds to Help Care for Children, Prevent Disease: Child care and vaccination programs to benefit from Recovery Act." Portions of the press release are reprinted below.

Also on April 9, NCIRD posted a page of related information on its website; a link to the page is given at the end of this IAC Express article.

Vice President Joe Biden announced today that the Obama Administration will make $2.3 billion available for crucial health and human services programs that help to provide care for children and prevent disease. States will receive $2 billion in Recovery Act funding to support child care for working families. The administration also plans to make $300 million in vaccines and grants available to ensure more underserved Americans receive the vaccines they need. . . .

In addition to funding for child care programs, an additional $300 million in Recovery Act funding and grants will help to ensure more underserved Americans receive the vaccines they need. The Vice President's announcement came as Americans mark National Public Health Week.

Funded by the American Recovery and Reinvestment Act, the majority of these new resources will be used to purchase vaccines, which will be distributed through the HHS' Centers for Disease Control and Prevention's (CDC) Section 317 immunization program to all 50 states, several large cities, and U.S. territories. Funding will also be used to support national public information campaigns regarding vaccines and support grants to states that demonstrate innovative new ways to ensure more Americans receive the vaccines they need. . . .

To see a list of state by state funding for vaccine programs, visit
http://transparency.cit.nih.gov/RecoveryGrants/grant.cfm?grant=vaccines . . . .

Immunization Grant Program
The Section 317 program provides funding for immunization operations and infrastructure necessary to implement a comprehensive immunization program at the federal, state, and local levels.

Of the $300 million in Recovery Act funds allocated to the Section 317 program, $250 million will help existing Section 317 grantees acquire and make recommended vaccines available by using $200 million of these funds for CDC-purchased vaccines that will be made available to states and territories. The remaining $50 million will be used to provide program operation grants and scientific and technical support to states and territories to deliver the vaccines and strengthen vaccination programs. Vaccines and Recovery Act resources will also be made available to the urban Section 317 programs in Chicago, Houston, New York City, Philadelphia, and San Antonio.

An additional approximately $18 million in grants will be used to provide support to Section 317 grantees that demonstrate innovative approaches to increase the number of Americans who receive the childhood vaccine series, zoster vaccine, and influenza vaccine, and for improving reimbursement practices. A portion of vaccine purchase may be used to support innovative initiatives for expanding access to vaccines in schools and communities. Applications to apply for these grants will be made available on http://www.grants.gov

Nearly $32 million in Recovery Act funds will be used to increase information, communication, and education and strengthen the evidence base for immunization. This will include activities to increase national public awareness and knowledge about the benefits and risks of vaccines and vaccine-preventable diseases. Funds will also help provide tools and education for healthcare providers and to monitor and assess the impact and safety of licensed vaccines routinely recommended for use in the United States to ensure that national vaccine policy is appropriate and effective.

For more information on Section 317 as well as information on vaccine-preventable diseases, go to http://www.cdc.gov/vaccines

To access the entire HHS press release, go to:
http://www.hhs.gov/news/press/2009pres/04/20090409a.html

To access the NCIRD page titled "Recovery Act Funds for Section 317 Program," go to:
http://www.cdc.gov/vaccines/about/recovery-act-funds.htm

Six confirmed measles cases reported in southwest Pennsylvania; additional probable cases await confirmation

On April 9, the Pennsylvania Department of Health issued a press release titled "Health Officials Identify Source of Measles, Additional Places of Possible Exposure: Efforts to contain measles outbreak continue." Portions of the press release are reprinted below.

The Pennsylvania Department of Health and the Allegheny County Health Department, in coordination with UPMC's [University of Pennsylvania Medical Center's] Children's Hospital of Pittsburgh, today reported the source of the recent measles outbreak was a traveler from India who arrived in the U.S. on March 7, 2009.

The number of confirmed measles cases in southwestern Pennsylvania now totals six, with additional probable cases awaiting confirmation.

State and county investigators and staff from numerous healthcare facilities have contacted thousands of people who might have been exposed to measles to assess each person's risk. While most of those exposed have been found to be immune to the disease, some non-immune persons have been asked to stay home until they are cleared of risk.

As previously reported, initial exposures occurred at Children's Hospital. . . . .

To access the entire press release, go to:
http://www.dsf.health.state.pa.us/health/cwp/view.asp?Q=252927&A=190

AAP and partners submit amicus brief in defense of statute that protects U.S. vaccine supply

On April 9, the American Academy of Pediatrics (AAP) issued a press release titled "American Academy of Pediatrics and Other Health Organizations Submit Amicus Brief in Response to Georgia Vaccine Case." The press release is reprinted below in its entirety.

The American Academy of Pediatrics (AAP), which represents 60,000 pediatricians, along with several other health organizations, filed an amici curiae (friends of the court) brief with the U.S. Supreme Court asking that it overturn a recent decision by the Georgia Supreme Court that would allow cases alleging injury from childhood vaccines to be decided by state juries, threatening the no-fault system enacted by Congress in the mid-1980s.

Congress enacted the National Childhood Vaccine Injury Compensation Act of 1986 to protect the small number of children injured by vaccines and to safeguard the nation's vaccine supply. Leading up to passage of the legislation, vaccine-related lawsuits against vaccine manufacturers had spiked, and the rising litigation threatened to halt necessary production of life-saving vaccines. The recent ruling in American Home Products Corp. v. Ferrari would reverse the intentions set forth in the Act.

"If this decision is allowed to stand, it could lead to the very same crisis that Congress sought to prevent in passing the original legislation. There is a genuine threat to our nation's public health if manufacturers abandon or consider abandoning the production of vaccines. This decision would set our country back decades, and have deadly consequences for our children," says Stephan E. Lawton, JD, FAAP, co-author of the amicus brief.

"The public health benefits of childhood vaccines cannot be overstated. Multiple life-threatening and debilitating infectious diseases have been eliminated or nearly eliminated because of vaccines. The enormous benefits of vaccination vastly outweigh the small risk of injury," says David T. Tayloe, Jr., MD, FAAP, AAP president.

In filing the brief, the AAP strongly stands by the current no-fault system, and urges the U.S. Supreme Court to overturn the ruling by the Georgia Supreme Court.

Co-author of the brief was Hogan & Hartson, LLP, a Washington, DC, law firm. Other organizations that joined the AAP in the brief include: American Academy of Family Physicians, AAP Section on Infectious Diseases, American College of Osteopathic Pediatricians, American Medical Association, American Public Health Association, Every Child By Two, Immunization Action Coalition, Infectious Disease Society of America, Pediatric Infectious Disease Society, and the Vaccine Education Center at The Children's Hospital of Philadelphia.

To access the press release, go to:
http://www.aap.org/advocacy/releases/apr09amicusbrief.htm

IAC's Video of the Week focuses on shingles disease, treatment, and prevention

IAC encourages IAC Express readers to watch "What Can Be Done about Shingles," a three-minute video provided by the National Institutes of Health. It discusses shingles disease, treatment, and prevention and features a patient's account of his extremely painful experience with shingles at age 70. A link to the transcript is available by clicking a button located under the video screen. Note: To view the video, you may need to install Adobe Flash Player.

The video will be available on the home page of IAC's website through April 19. 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

CDC corrects an answer that appeared in the IAC Express "Ask the Experts" Extra Edition on April 6

IAC was informed by careful readers that an incorrect answer was given in the IAC Express "Ask the Experts" Extra Edition that was published on April 6. The question concerned the two rotavirus vaccines licensed for use in the United States. The error was in stating that the maximum age for an infant to receive the first dose of either rotavirus vaccine is 15 weeks 0 days. In fact the maximum age for receiving the first dose of either vaccine is 14 weeks 6 days. Here is the corrected Q&A:

Q: How do the two rotavirus vaccines differ?

A: The rotavirus vaccination series consists of either two 1-mL doses of Rotarix (GSK) given at ages 2 and 4 months or three 2-mL doses of RotaTeq (Merck) given at ages 2, 4, and 6 months. CDC has revised its recommendations to make the schedule less confusing: the maximum age for the first dose of both vaccines is 14 weeks 6 days and the series should be completed on or before the time the infant turns 8 months 0 days. CDC's recommendations for rotavirus vaccine are available at http://www.cdc.gov/mmwr/PDF/rr/rr5802.pdf

IAC regrets the error the initial Q&A may have caused readers of the "Ask the Experts" Extra Edition.

Influenza complications have killed 45 U.S. children during the current influenza season. It is vital to continue vaccinating through the spring months

CDC reports that influenza viruses are still causing illness in the U.S. In the week of March 29-April 4, CDC received reports of two more U.S. children killed by complications from influenza; the total of reported pediatric influenza deaths this influenza season now stands at 45.

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.

Many resources regarding influenza disease and vaccination are available to healthcare professionals and the public. Following is a list of some of them.

To access the National Influenza Vaccine Summit website, go to:
http://www.preventinfluenza.org

To access CDC's Seasonal Flu web section, go to:
http://www.cdc.gov/flu

To access IAC's print piece titled "Don't take chances with your family's health--make sure you all get vaccinated against influenza every year!" go to:
http://www.immunize.org/catg.d/p4069.pdf

To access a CDC web page of information for the public titled "Taking Care of Yourself: What to Do if You Get Sick with Flu," go to: http://www.cdc.gov/flu/takingcare.htm

NFID releases its Call to Action on adult vaccination and introduces its new adult vaccination website

The National Foundation for Infectious Diseases (NFID) recently released a Call to Action titled "Saving Lives: Integrating Vaccines for Adults into Routine Care." The document presents data showing that most adults are not vaccinated against vaccine-preventable diseases, and the consequences are that 50,000 U.S. adults die from VPDs annually, hundreds of thousands are hospitalized, and millions get sick and miss work.

In addition to publishing the Call to Action, NFID launched a comprehensive website on the importance of adult vaccination. Intended to help educate the public, healthcare providers, and the media, the website includes information on 13 adult diseases and the vaccines recommended to protect against them, as well as many useful related resources.

To access the Call to Action, go to:
http://www.adultvaccination.com/doc/Adult_Immunization_Report.pdf

To access the website, go to: http://www.adultvaccination.com

California Department of Public Health launches EZ-IZ, a one-stop shop for immunization training and resources

Recently launched by the California Department of Public Health, the EZ-IZ website currently features interactive training on preparing and administering vaccines. Medical assistants in VFC provider practices in California are the primary audience for the EZ-IZ curriculum. However, the site will be useful to anyone involved in immunization delivery who needs initial training or a refresher.

More lessons will be developed during the next year to help VFC providers develop their staffs' immunization skills and knowledge. Two new lessons, storing vaccines and monitoring temperatures, are currently in development and are scheduled to be posted at the end of June.

In addition to the curriculum, the site offers abundant online resources that can be accessed by any provider, anywhere, at anytime. Visitors are welcome to view and print the resources as needed.

You are encouraged to take a few minutes to browse the site and discover its features. To visit, go to: http://www.eziz.org

Coming right up: National Infant Immunization Week starts on April 25 and goes through May 2

National Infant Immunization Week (NIIW) will take place from April 25-May 2. CDC offers health departments, immunization coalitions, and community groups a variety of resources including tools for planning and publicizing events. To find them, go to: http://www.cdc.gov/vaccines/events/niiw

If you have already planned an event, CDC wants to know about it. To add your event to the 2009 Activities and Events page, go to:
http://www.cdc.gov/vaccines/events/niiw/2009/activity-form.htm

To find out what others have planned for NIIW 2009, go to:
http://www.cdc.gov/vaccines/events/niiw/2009/09activities.htm

In addition, the Immunization Coalitions Technical Assistance Network (IZTA) has announced that it can provide FREE technical assistance to immunization coalitions that need guidance in planning, implementing, or evaluating their NIIW activities. For information, contact Melissa Van Orman at mvanorman@aed.org

IZTA is a program of the Center for Health Communication, Academy for Educational Development.

10.

New: CDC's pocket-size adult and child/teen immunization schedules now available online

On April 6, CDC made several versions of its pocket-size (6" x 4.5") adult and child/teen immunization schedules available online. Included are a color version, a black and white version, a commercial press color version, and a screen-reader version.

To access all versions of the pocket-size adult and child/teen schedules, go to:
http://www.cdc.gov/vaccines/recs/schedules/pocketsize.htm

11.

IAC corrects its March 30 IAC Express article regarding latex gloves

The March 30 issue of IAC Express included an article titled "Corrections: IAC fixes errors on its two checklists of vaccine supplies that are essential to have available at immunization clinics" (http://www.immunize.org/express/issue787.asp#n3). Unfortunately, this article included a misleading explanation about the change we made in terminology when we replaced the term "latex gloves" with "medical gloves."

In the article, we said: "Under the subhead titled Vaccine Supplies, we referred to 'latex' gloves. Latex gloves are no longer recommended, and we have changed the term to 'medical' gloves."

Some readers interpreted this to mean that people who administer vaccines could no longer use gloves made of latex and had to use gloves made of another material. This is not the case. We changed the term from "latex gloves" to "medical gloves" because some people are allergic to latex, and we didn't want to give the impression that only latex gloves could be worn when administering vaccines.

IAC regrets the misleading explanation and the confusion it caused some IAC Express readers.

Here are links to the corrected checklists:

"Suggested supplies checklist for pediatric and adult
immunization clinic": http://www.immunize.org/catg.d/p3046.pdf

"Suggested supplies checklist for adult immunization clinic":
http://www.immunize.org/catg.d/p3047.pdf

Please note that according to the General Recommendations on Immunization (http://www.cdc.gov/mmwr/PDF/rr/rr5515.pdf), gloves are not required when administering vaccinations, unless the person administering vaccinations is likely to come into contact with potentially infectious body fluids or has open lesions on their hands.

12.

WHO issues position paper on human papillomavirus vaccines

The April 10 issue of the WHO periodical "Weekly Epidemiological Record" includes a WHO position paper on human papillomavirus vaccines. To access it in English and French, go to: http://www.who.int/wer/2009/wer8415.pdf It will shortly be translated into Arabic, Chinese, Russian, and Spanish.

To access supporting material, go to:
http://www.who.int/immunization/documents/positionpapers/en/index.html#hpv

A collection of WHO position papers on vaccines is available in alphabetical order at
http://www.who.int/immunization/documents/positionpapers

They are available in chronological order on the IAC website at http://www.immunize.org/who

13.

Reminder: April 25 is the date for World Meningitis Day

The Confederation of Meningitis Organizations (CoMO) urges healthcare professionals, meningitis advocates, and others to join hands on April 25 to make World Meningitis Day a day of action to raise awareness about meningitis and septicemia.

To find out more about World Meningitis Day, go to:
http://www.comoonline.org/wmd.html

To join in a virtual community against meningitis, go to:
http://www.comoonline.org/JoiningHands.aspx

Formed in 2004 to bring together meningitis organizations from across the world, CoMO now has members in 19 countries across Europe, North and South America, Australia, the Philippines, and Africa.

To access the CoMO website, go to: http://www.comoonline.org

14.

MMWR notifies readers about ACIP's standardized vaccine abbreviations

CDC published "Notice to Readers: Abbreviations for Vaccines in Immunization Schedules: Advisory Committee on Immunization Practices" in the April 10 issue of MMWR. The notice is reprinted below in its entirety, excluding references.

Each year, the Advisory Committee on Immunization Practices (ACIP) publishes immunization schedules that summarize recommendations for currently licensed vaccines for children aged 18 years and younger, and for adults. In February 2009, ACIP approved a listing of standardized vaccine abbreviations for use in these immunization schedules.

The table of standardized vaccine abbreviations was developed by staff members at CDC; ACIP members and workgroups; editors of Epidemiology and Prevention of Vaccine-Preventable Diseases; and others. These abbreviations are intended to provide a uniform approach to vaccine references used in ACIP recommendations. The standardized vaccine abbreviations are available at http://www.cdc.gov/vaccines/recs/acip/vac-abbrev.htm

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5813a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5813.pdf

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

15.

Guidelines for preventing and treating opportunistic infections in HIV-infected adults and adolescents now published in MMWR Recommendations and Reports

On April 10, MMWR published "Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents: Recommendations from CDC, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America" in MMWR Recommendations and Reports. Previously, the guidelines were available only in electronic format as an MMWR Early Release (published March 24). There is no difference in the content of these two documents.

Important note: If you bookmarked these recommendations based on the URLs given in the MMWR Early Release, please change your bookmark to reflect the URLs below.

To access a ready-to-print (PDF) version of the recommendations, which includes the Appendix, go to:
http://www.cdc.gov/mmwr/pdf/rr/rr5804.pdf

Note: The PDF version includes a free CDC-sponsored education activity that can be completed for continuing education credit. Simply read the recommendations, answer the questions at the end, and follow instructions for submitting your answers.

If you prefer the HTML version, you must access both links below to get the full content:

To access a web-text (HTML) version of the body of the document, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5804a1.htm

To access a web-text (HTML) version of Appendix: Recommendations to Help Patients Avoid Exposure to or Infection from Opportunistic Pathogens, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5804a2.htm

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