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Immunization Action Coalition
IAC Express 2009
Issue number 803: June 8, 2009
Please click here to subscribe to IAC Express as well as other FREE IAC periodicals.
Contents of this Issue
Select a title to jump to the article.
  1. MMWR publishes update on H1N1 influenza in Mexico
  2. New! IAC'S padded screening questionnaires for vaccine contraindications are now two-sided, with English on one side and Spanish on the back--added value at no added cost!
  3. New! IAC offers free ready-to-print cards featuring popular quick-links for navigating IAC's www.immunize.org website
  4. IAC updates two print pieces: "It's Federal Law" and "Pertussis: Questions and Answers"
  5. Vaccine issues make the news
  6. IAC's Video of the Week examines the challenges of global immunization
  7. Order laminated U.S. immunization schedules today!
  8. VIS translation: VIS for pneumococcal polysaccharide vaccine now available in Spanish
  9. WHO recommends global use of rotavirus vaccines
  10. MMWR discontinuing publication of continuing education activities in hard-copy format
  11. Michigan's Adolescent Immunization webcast now archived for online viewing
  12. It's not too late to sign up for the B Informed Patient Conference
 
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 803: June 8, 2009
1.  MMWR publishes update on H1N1 influenza in Mexico

CDC published "Update: Novel Influenza A (H1N1) Virus Infection--Mexico, March-May, 2009" in the June 5 issue of MMWR. The editorial note follows, excluding footnotes.


Editorial Note:
Trends in case counts in Mexico suggest that novel influenza A (H1N1) activity is now decreasing, although localized transmission continues to occur. The epidemic curve of laboratory-confirmed cases remains incomplete because of a backlog of untested specimens. However, data regarding suspected cases also indicate a peak in late April, and delays from case identification to reporting have decreased to a median of <2 days. Taken together, these data suggest that the outbreak likely has moved beyond its peak nationally, although a pattern of heterogeneous transmission and focal outbreak activity remains.

Several features of the outbreak in Mexico are consistent with outbreaks of the same novel influenza virus strain circulating in the United States and other countries. These features include person-to-person transmission during a period that is typically the low season for circulation of influenza viruses and an age distribution of laboratory-confirmed cases that includes severe disease and deaths among children and adults in Mexico aged <60 years. Some deaths have occurred among previously healthy persons, and several patients have experienced an aggressive clinical course with severe pneumonia requiring ventilator support and progression to acute respiratory distress syndrome.

A recently reported serologic study suggested that children and younger adults have no or low levels of serum antibody, respectively, that are cross-reactive for the novel influenza A (H1N1) virus. Approximately one third of U.S. adults aged >60 years who were tested had cross-reactive neutralizing antibodies; however, the extent to which such antibody might be protective remains unknown. The serologic data, along with the age distribution of illness and clinical severity from the outbreak in Mexico, suggest age <60 years as a risk for infection and serious illness from novel A (H1N1) infection.

The current pattern of novel influenza A (H1N1) transmission in the northern hemisphere includes many localized outbreaks, including several among school children. This pattern is consistent with influenza outbreaks occasionally reported outside of the usual influenza season. However an unprecedented number of such off-season outbreaks are occurring currently. These outbreaks also involve extension into the community, as demonstrated by confirmed illness among travelers with no known epidemiologic link to focal outbreaks. Similar patterns of off-season outbreaks have been observed previously with the emergence and sustained transmission of other novel influenza A virus strains among humans.

The recent introduction of novel influenza A (H1N1) into several countries in the southern hemisphere at the beginning of its influenza season and the presumed susceptibility among much of the population to this new virus suggest that this strain might become a dominant circulating virus in the southern hemisphere during the coming months. The government of Mexico continues to coordinate a national response, engage partners, increase surge capacity, and implement mitigation measures to slow the spread of novel influenza A (H1N1). Investigations are ongoing to monitor virus circulation and evaluate mitigation strategies that might help guide prevention and control strategies in Mexico and worldwide.


To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5821a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5821.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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2 New! IAC'S padded screening questionnaires for vaccine contraindications are now two-sided, with English on one side and Spanish on the back--added value at no added cost!

In response to demand, IAC has recently added a Spanish-language translation of the questions on its padded Screening Questionnaire for Child and Teen Immunization and Screening Questionnaire for Adult Immunization. The Spanish page, which is printed on the back of the English page, has been added to this product at no additional cost.

These questionnaires provide a quick, easy, and thorough way for you and your patients to determine if they have contraindications and precautions to vaccination. Patients (now including Spanish-speaking patients!) fill out the questionnaire with yes-or-no answers while waiting to be seen, allowing you to review their responses quickly and be confident you're not missing any contraindications or precautions.

The questionnaires come in convenient tear-off pads of 100 sheets. The price per pad is economical (discounts for 2 pads or more), so you'll be able to keep pads at the receptionist's desk, the nurse's station, and in every exam room. Each pad comes with four English-language reference sheets (printed on heavy-weight paper) for health professionals.

Prices start at $16 each for one pad and drop to $12 each for two pads, $11 each for three pads, and $10 each for four pads. For quotes on larger quantities or customizing, call (651) 647-9009 or email admininfo@immunize.org

To learn more about the padded screening questionnaires, or to order online or download an order form, visit

Screening Questionnaire for Child and Teen Immunization
http://www.immunize.org/shop/pad_sqchild.asp

Screening Questionnaire for Adult Immunization
http://www.immunize.org/shop/pad_sqadult.asp

IAC's offers other products for sale, including educational videos and personal immunization record cards, at http://www.immunize.org/shop

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3 New! IAC offers free ready-to-print cards featuring popular quick-links for navigating IAC's www.immunize.org website

IAC has recently developed a postcard-sized card that lists quick-links to the most commonly used sections of IAC's website for healthcare professionals, www.immunize.org, as well as general IAC contact information.

We encourage you to print cards for your personal reference, as well as for distribution to all those involved with immunization, including staff members and training and conference participants.

To access the new printable quick-link cards, go to:
http://www.immunize.org/news.d/u6024.pdf

Measuring 5-1/2" x 4-1/4", the cards can be printed on an inkjet printer using Avery cardstock products #8387 (50 sheets; 200 cards) or #3263 (15 sheets; 60 cards). White with a matte finish, these Avery cardstock products are perforated and produce 4 cards per sheet.

The following quick links are included on one side of the postcard.

To access all 82 IAC website quick links, go to: http://www.immunize.org/quicklinks

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4 IAC updates two print pieces: "It's Federal Law" and "Pertussis: Questions and Answers"

IAC updated the healthcare provider resource, "It's federal law! You must give your patients current Vaccine Information Statements (VISs)," to incorporate newly released VIS dates.

To access the revised "It's federal law! You must give your patients current Vaccine Information Statements (VISs)," go to: http://www.immunize.org/catg.d/p2027.pdf

IAC also updated the piece for the general public, "Pertussis: Questions and Answers," to include new statistics and licensure information.

To access the revised "Pertussis: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4212.pdf

To view an HTML version of these pertussis Q&As, go to the following:

(1) Pertussis disease:
http://www.vaccineinformation.org/pertuss/qandadis.asp

(2) Pertussis vaccine:
http://www.vaccineinformation.org/pertuss/qandavax.asp

To access Q&As about other diseases and vaccines in PDF format, go to:
http://www.immunize.org/printmaterials/questions.asp

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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5 Vaccine issues make the news

Articles related to vaccine safety and effectiveness were recently published in various sources.

(1) Titled "Crazy Talk," the cover story in the June 8 issue of Newsweek is a hard-hitting article about Oprah Winfrey's coverage of health issues. The story includes discussion of Winfrey's promotion of inaccurate information about vaccines and autism. To read this article online, go to: http://www.newsweek.com/id/200025

(2) The May 2009 issue of PLoS Biology includes an article by Liza Gross, senior science writer/editor, titled "A Broken Trust: Lessons from the Vaccine-Autism Wars." This article can be accessed at
http://www.plosbiology.org/article/info%3Adoi%2F10.1371%2Fjournal.pbio.1000114

(3) The June 2009 issue of Discover magazine includes an excellent article titled "Vaccination Nation." The description in the table of contents reads, "Ignoring a wealth of data, a vocal minority still insists vaccines cause autism. But the anti-vaccine movement is a far more serious threat to public health." This article can be read online at
http://discovermagazine.com/2009/jun/06-why-does-vaccine-autism-controversy-live-on

(4) City Pages, a Minneapolis, MN, alternative newspaper, published an article titled "Rare Hib disease increases in Minnesota: Is the anti-vaccine movement to blame?" on June 2. The article details the experiences of several families affected by Hib disease. To access this article online, go to:
http://www.citypages.com/2009-06-03/news/rare-hib-disease-increases-in-Minnesota/

(5) Paul Offit, MD, Vaccine Education Center of the Children's Hospital of Philadelphia, was profiled in an article in the June issue of Philadelphia Magazine. To read about the clash between Dr. Offit and some segments of the anti-vaccine movement, go to:
http://www.phillymag.com/articles/will_this_doctor_hurt_your_baby/page1

(6) Trust for Health, a project of the Robert Wood Johnson Foundation and the Center for Biosecurity of UPMC [University of Pittsburgh Medical Center], published a report titled "Pandemic Flu Preparedness: Lessons from the Frontlines" in June. The report looks at the current H1N1 influenza outbreak as a real-world test of the world's ability to respond to a major infectious disease outbreak.  To read this report, go to:
http://healthyamericans.org/assets/files/pandemic-flu-lesson.pdf

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6 IAC's Video of the Week examines the challenges of global immunization

IAC encourages IAC Express readers to watch a 22-minute video titled "Vaccine Hunters: An Injection of Hope." Vaccine Hunters is a four-part BBC World documentary series (originally aired in February 2007) that examines the science of modern vaccines, what it takes to deliver them to some of the poorest people in the world, and the challenges and opportunities that lie ahead.

The video will be available on the home page of IAC's website through June 14. 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!

If you wish to watch the other three segments of the Vaccine Hunters series, you can access them from the same introductory page (look for links on the right side).

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.

Videos previously featured as IAC's Video of the Week are archived by month on IAC's website. To view any of them, go to: http://www.immunize.org/votw/may09.asp

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7 Order laminated U.S. immunization schedules today!

IAC has two laminated immunization schedules for 2009--one for children/teens ages 0 through 18 years and one for adults. Based on CDC's 2009 immunization schedules, the laminated schedules offer two significant advantages over paper schedules:

(1) They are covered with a tough, washable coating that lets them stand up to a year's worth of use as at-your-fingertips guides to immunization and as teaching tools you can use to give patients and parents authoritative immunization information.

(2) Each schedule includes a guide to vaccine contraindications and precautions, an additional feature that will help you to make an on-the-spot determination about vaccinating any patient of any age.

IAC's 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".

For specific information about the child/teen schedule, to view images of it, or to order online or download an order form, visit http://www.immunize.org/shop/schedule_child.asp

For specific information about the adult schedule, to view images of it, or to order online or download an order form, visit http://www.immunize.org/shop/schedule_adult.asp

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

To learn about other essential immunization resources available for purchase from IAC, such as personal immunization record cards, padded screening questionnaires, and educational videos, go to: http://www.immunize.org/shop

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8 VIS translation: VIS for pneumococcal polysaccharide vaccine now available in Spanish

The current version (dated 4/16/09) of the VIS for pneumococcal polysaccharide vaccine (PPSV) is now available on the IAC website in Spanish. IAC gratefully acknowledges Iowa Health Des Moines, Des Moines, IA, for the translation.

To obtain the VIS for PPSV vaccine in Spanish, go to:
http://www.immunize.org/vis/sppne97.pdf

To obtain the VIS for PPSV vaccine in English, go to:
http://www.immunize.org/vis/pneum3.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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9 WHO recommends global use of rotavirus vaccines

The World Health Organization (WHO) Strategic Advisory Group of Experts announced its recommendation for global use of rotavirus vaccines in the June 5 issue of the WHO Weekly Epidemiological Record (WER). This critical endorsement will help ensure that all the world's children have access to vaccines that protect against the leading cause of diarrheal hospitalizations and deaths.

The universal recommendation is based on new data from clinical trials to evaluate the vaccines' efficacy in Africa. The GAVI Alliance, vaccine manufacturers, and the public health community made an unprecedented commitment to definitively assess how the newest rotavirus vaccines perform in developing-world conditions. A clinical trial conducted by PATH, WHO, GlaxoSmithKine Biologicals, and research sites in high-mortality, low-socioeconomic settings of South Africa and Malawi found that rotavirus vaccine significantly reduced severe diarrhea episodes due to rotavirus.

To access the article in WER, go to:
http://www.who.int/wer/2009/wer8423.pdf

To read a press release about this recommendation, go to:
http://www.path.org/news/pr090605-who-rotavirus.php

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10.  MMWR discontinuing publication of continuing education activities in hard-copy format

CDC published " Notice to Readers: Discontinuation of Paper Copies of MMWR Continuing Education Activities" in the June 5 issue of MMWR. The notice follows in its entirety.


Effective July 6, 2009, MMWR will discontinue publishing continuing education (CE) activities in hard-copy format. MMWR will continue to offer CE electronically on the MMWR CE website at http://www.cdc.gov/mmwr/cme/conted.html MMWR offers CE credits for the following: Continuing Medical Education (CME), Continuing Medical Education for Nonphysicians (CME-NP), Continuing Education Unit (CEU), Continuing Nursing Education (CNE), Certified Health Education Specialist (CHES), Continuing Pharmacy Education (CPE), and Continuing Veterinary Education (CVE). No fees are charged for participating in the CE activities. Questions and comments should be submitted to the MMWR CE mailbox at mmwrce@cdc.gov


To access a web-text (HTML) version of this article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5821a5.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5821.pdf

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11.  Michigan's Adolescent Immunization webcast now archived for online viewing

On June 2, 2009, the Michigan Department of Community Health (MDCH) Division of Immunization hosted a program titled Adolescent Immunization Webcast. One of the goals of this webcast was to provide an update on adolescent immunizations. Other objectives focused on outreach to diverse settings that serve adolescents, communication tools and tips for providers, and a discussion of strategies and barriers to vaccinating adolescents.

This program has now been archived online for viewing by interested individuals or organizations. Running time is 2 hours, 8 minutes.

To access the webcast, go to:
http://learning.mihealth.org/mediasite/adolescentwebcast

For related resources and handouts, go to:
http://learning.mihealth.org/mediasite/adolescentwebcast_resources

Instructions on viewing a webcast can be found at:
http://adolescent.mihealth.org/WebcastInstructions.pdf.

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12.  It's not too late to sign up for the B Informed Patient Conference

There's still time to sign up for the 9th Annual B Informed Patient Conference. The conference will be held June 26-27 at the Delaware Valley College campus in Doylestown, PA, in collaboration with the Hepatitis B Information & Support List and the HBV Adoption Support List. The conference is free, including meals.

Both days will include roundtable discussion, educational seminars, breakout sessions, and opportunities to learn to live more successfully with chronic HBV infection. This conference continues to be the only one of its kind, giving patients and families the unique opportunity to connect with one another in a supportive environment.

For more information on the program and registration, go to:
http://www.hepb.org/patients/patient_conference2009.htm

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Immunization Action Coalition  •  Saint Paul, MN
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.