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Immunization Action Coalition
IAC Express 2009
Issue number 817: August 17, 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. New: Updated interim VISs for 2009-10 seasonal influenza vaccines are available--in English only, for now
  2. MMWR Dispatch reports on oseltamivir-resistant H1N1 virus infection in two immunosuppressed patients
  3. IAC's Video of the Week presents stories from families affected by seasonal influenza
  4. The "Flu Clinic Locator" gives the public a way to find a clinic and providers a way to promote their clinics
  5. "CDC Features" includes information for parents on how the government monitors vaccine safety
  6. CDC's "Take 3" plan urges public to take three action steps to protect against seasonal and H1N1 influenza
  7. CDC's H1N1 influenza web section updated with prevention guidance for workplaces, planning information for healthcare professionals, and more
  8. Order IAC's laminated U.S. immunization schedules today!
  9. HHS reports on the insurance industry's practice of denying coverage to or discriminating against Americans with pre-existing health conditions
  10. Philadelphia Immunization Coalition's online education modules cover a huge spectrum of immunization topics
  11. PKIDS sponsors a handwashing video and poster contest; deadline for submissions is September 15
  12. GAVI announces a $165 million grant will be used to introduce 5-in-1 vaccine in India; 18 million children to be vaccinated over the next five years
  13. August 14 MMWR includes a short summary of the 2008 Reports of Nationally Notifiable Infectious Diseases
  14. Forum on the domestic response to hepatitis B and C planned for Washington, DC, on September 10-11
 
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 817: August 17, 2009
1.  New: Updated interim VISs for 2009-10 seasonal influenza vaccines are available--in English only, for now

On August 11, CDC issued updated versions of the English-language interim VIS for trivalent inactivated seasonal influenza vaccine (TIV; injectable) and the English-language VIS for the live intranasal seasonal influenza vaccine (LAIV; nasal spray). The updated VISs are intended for use during the 2009-10 seasonal influenza vaccination season. They replace both 2008-09 seasonal influenza vaccine VISs, which were dated 7/24/08.

IMPORTANT NOTE FROM CDC: The version of both the TIV and LAIV seasonal influenza VISs that CDC originally posted contained an error. Section 3 of each VIS stated that the vaccine is indicated for household contacts and caregivers of children under 5 and people 65 and older. The latter age should read "people 50 and older." This error was fixed on August 14, and downloadable versions of both VISs are correct on CDC's site and IAC's site. If you downloaded the 8/11/09 seasonal influenza VISs before August 14, discard them and use the corrected VISs.

Both of the 8/11/09 seasonal influenza vaccine VISs include a box of information that tells readers that, "These 'seasonal' influenza vaccines are formulated to prevent annual flu. They do not protect against pandemic H1N1 influenza." CDC plans to issue a VIS for H1N1 influenza vaccine when a vaccine exists and information about contraindications, adverse events, and other matters becomes available. IAC Express will inform readers when the VIS for H1N1 influenza vaccine is issued.

IMPORTANT NOTE FROM IAC: CDC issued the two 8/11/09 seasonal influenza vaccine VISs in English only. When translations become available and are posted, IAC Express will notify readers ASAP.

To access the 8/11/09 interim VIS for seasonal injectable TIV, go to:
http://www.immunize.org/vis/2flu.pdf

To access the 8/11/09 VIS for nasal-spray LAIV, go to:
http://www.immunize.org/vis/liveflu.pdf

For information about the use of VISs, and for VISs in more than 35 languages, visit IAC's VIS web section at
http://www.immunize.org/vis

For general information about VISs from CDC's website go to:
http://www.cdc.gov/vaccines/pubs/vis

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2 MMWR Dispatch reports on oseltamivir-resistant H1N1 virus infection in two immunosuppressed patients

CDC published "Oseltamivir-Resistant Novel Influenza A (H1N1) Virus Infection in Two Immunosuppressed Patients--Seattle, Washington, 2009" in an August 14 MMWR Dispatch. The first paragraph is reprinted below.


Novel influenza A (H1N1) virus infection continues to cause illness and death among persons worldwide. Immunosuppressed patients with influenza virus infection can shed virus for prolonged periods, increasing the chances for development of drug resistance. On August 6, 2009, CDC detected evidence of resistance to the antiviral medication oseltamivir in two severely immunosuppressed patients with novel influenza A (H1N1) virus infection in Seattle, Washington. The two patients were treated in two different hospitals, and their cases were not epidemiologically linked. Both were being treated with oseltamivir for novel influenza A (H1N1) virus infection and had prolonged viral shedding. In both patients, the virus was documented as initially susceptible to oseltamivir, and resistance developed subsequently during treatment with the drug. Testing of viral RNA from both patients by pyrosequencing detected a mutation that results in a histidine-to-tyrosine substitution at position 275 (H275Y) in the neuraminidase, known to be associated with oseltamivir resistance. The results were confirmed by pyrosequencing, sequencing of the neuraminidase gene, and neuraminidase inhibition testing of virus isolates on August 11. One patient's symptoms resolved after treatment with oseltamivir, and the other patient was receiving treatment with zanamivir and ribavirin as of August 13. An investigation of health-care personnel (HCP) contacts and other close contacts revealed no evidence of virus transmission. This report summarizes the case histories and resulting investigations and highlights the importance of (1) close monitoring for antiviral drug resistance among immunosuppressed patients receiving treatment for novel influenza A (H1N1) virus infection and (2) the implications for infection control.


To access the full dispatch in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0814a1.htm

To access a ready-to-print (PDF) version of this issue of
MMWR, go to: http://www.cdc.gov/mmwr/pdf/wk/mm58d0814.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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3 IAC's Video of the Week presents stories from families affected by seasonal influenza

IAC encourages IAC Express readers to watch a one-minute video narrated by parents who have lost a child to seasonal influenza or have a child who has experienced severe medical complications from seasonal influenza. Titled "Why Flu Vaccination Matters: Personal Stories from Families Affected by Flu," the video was produced by CDC and Families Fighting Flu. To safeguard children from seasonal influenza, CDC recommends seasonal influenza vaccination every year for children ages 6 months through 18 years.

The video will be available on the home page of IAC's website through August 23. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week. It may take a few moments for the video to begin playing; please be patient!

To access CDC information about seasonal influenza, go to:
http://www.flu.gov/seasonalflu

To access information about Families Fighting Flu, go to:
http://www.familiesfightingflu.org

Remember to bookmark IAC's home page to view a new video every Monday. To view an IAC Video of the Week from the past, go to the video archive at http://www.immunize.org/votw/jul09.asp

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4 The "Flu Clinic Locator" gives the public a way to find a clinic and providers a way to promote their clinics

A project of the American Lung Association, the "Flu Clinic Locator" serves two purposes: It gives individuals a way to find an influenza clinic near their home or workplace, and it gives healthcare providers a way to promote their clinics to people in their community. In either case, the first step is to go to http://www.flucliniclocator.org

To find a clinic: Individuals enter their home or workplace zip code and other information into the tinted box titled "Flu Clinic Locator," which is situated on the right side of the page. The individual is then taken to a chart that gives the location of nearby influenza clinics, their dates and times, their distance from the zip code entered, and their location on an online map.

To promote a clinic: Providers interested in having their clinics listed will find detailed information by clicking on the box titled "All About the Flu Clinic Locator." It is in the vertical bar to the left of the page. Providers will be taken to a page of information and instructions.

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5 "CDC Features" includes information for parents on how the government monitors vaccine safety

The "CDC Features" web section includes information for parents about vaccine safety. "Childhood Vaccines: Vaccine Safety" explains pre- and post-licensure testing of vaccines, discusses the Vaccine Adverse Event Reporting System and the Vaccine Safety Datalink Project, and answers common questions parents have about vaccine safety.

To access "Childhood Vaccines: Vaccine Safety," go to:
http://www.cdc.gov/Features/ChildhoodVaccines

To access an alphabetical index of all "CDC Features," go to:
http://www.cdc.gov/az

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6 CDC's "Take 3" plan urges public to take three action steps to protect against seasonal and H1N1 influenza

CDC recently posted a web page and a brochure with this title: "CDC Says 'Take 3' Steps to Fight the Flu: These actions will protect against the new H1N1 too!" Here are the three steps:

1. Take time to get vaccinated (urges yearly vaccination and lists the people for whom vaccination is recommended)

2. Take everyday preventive actions (includes information on cough etiquette, handwashing, and staying away from others when sick)

3. Take flu antiviral drugs if your doctor recommends them (explains what antivirals are and how to get and use them)

To access the Take 3 web page, go to:
http://www.cdc.gov/flu/protect/preventing.htm

To access the Take 3 brochure, go to:
http://www.cdc.gov/flu/professionals/flugallery/2009-10/pdf/h1n1_take3.pdf

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7 CDC's H1N1 influenza web section updated with prevention guidance for workplaces, planning information for healthcare professionals, and more

CDC recently posted new or updated information to various sub-sections of its H1N1 Flu web section. Following are the titles and URLs of documents that have been posted since the August 10 issue of IAC Express:

CDC Novel H1N1 Vaccination Planning Q&A [Information for healthcare professionals on planning and preparing for H1N1 vaccination]
http://www.cdc.gov/h1n1flu/vaccination/statelocal/qa.htm

Update: General Business and Workplace Guidance for the Prevention of Novel Influenza A (H1N1) Flu in Workers
http://www.cdc.gov/h1n1flu/guidance/workplace.htm

Novel H1N1 Flu: CDC Response
http://www.cdc.gov/h1n1flu/cdcresponse.htm

Doses Administered Reporting [describes the doses-administered monitoring requirements for CDC's Countermeasure and Response Administration (CRA) system]
http://www.cdc.gov/H1N1flu/vaccination/statelocal/pdf/H1N1_DosesAdministered.pdf

FOR MORE INFORMATION
The home page of CDC's H1N1 Flu web section can be accessed from http://www.cdc.gov/h1n1flu

IAC has gathered information related to H1N1 influenza into a single web section at http://www.immunize.org/h1n1

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8 Order IAC's 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 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, a feature that will help you to make on-the-spot determinations about vaccinating patients 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".

An image of each schedule is available, as is specific information about each, and a downloadable order form and online ordering information.

To access an image of the child/teen schedule and related information, go to:
http://www.immunize.org/shop/schedule_child.asp

To access an image of the adult schedule and related information, go to:
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

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9 HHS reports on the insurance industry's practice of denying coverage to or discriminating against Americans with pre-existing health conditions

On August 11, the Department of Health and Human Services (HHS) issued a press release titled "New Report Examines Insurance Company Practice of Denying Coverage To or Discriminating Against Americans Who Have Pre-Existing Medical Conditions." A portion of the press release is reprinted below.


In a new report, "Coverage Denied: How the Current Health Insurance System Leaves Millions Behind," the U.S. Department of Health and Human Services examines the insurance company practice of denying coverage to or discriminating against Americans who have pre-existing medical conditions. A recent national survey found that 12.6 million non-elderly adults--36 percent of those who tried to buy insurance on the private market--were discriminated against in the past three years because an insurance company deemed them ineligible for coverage because of a pre-existing condition, charged them a higher premium, or refused to cover their condition. Another survey found 1 in 10 people with cancer said they could not get health coverage, and 6 percent said they lost their coverage because of their diagnosis. . . .


To access the complete press release, go to:
http://www.hhs.gov/news/press/2009pres/08/20090811a.html

To access the complete HHS report, go to:
http://www.healthreform.gov/reports/denied_coverage

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10.  Philadelphia Immunization Coalition's online education modules cover a huge spectrum of immunization topics

If you are looking to educate yourself about many aspects of immunization, you're in luck. The Philadelphia Immunization Coalition recently posted eight comprehensive education modules that anyone can use to gain access to a wealth of information and resources. Each module offers users a brief PowerPoint overview of a specific topic; thorough written information on the topic, complete with abundant clickable links to related resources; a self-testing option; and test results.

Here are the topics:

  • Immunization and global health
  • Ethical aspects of immunization
  • Social and economic aspects of immunization
  • Technical aspects of immunization
  • Immunization schedules and recommendations
  • Vaccine-preventable diseases and vaccines
  • Missed opportunities and registries
  • Healthcare workers and immunizations

To access the modules, go to:
http://www.phillyimmunize.org/modulestart.html

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11.  PKIDS sponsors a handwashing video and poster contest; deadline for submissions is September 15

PKIDS is sponsoring a video and poster contest to mark Global Handwashing Day, which takes place on October 15. The goal of the contest is to remind people that handwashing is an important method of disease prevention. The deadline for submissions is September 15.

The contest is open to people age 14 and older. A $200 gift certificate and a $500 gift certificate will go to the winners of the poster contest and video contest respectively. For contest rules, go to:
http://www.pkids.org/contest.php

For information on Global Handwashing Day, go to:
http://www.globalhandwashingday.org

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12.  GAVI announces a $165 million grant will be used to introduce 5-in-1 vaccine in India; 18 million children to be vaccinated over the next five years

On August 11, the GAVI Alliance issued a press release announcing its decision to make a $165 million grant available to introduce a pentavalent vaccine in India. The vaccine, which protects against diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae type b (Hib), will be used to immunize more than 18 million children over the next five years. The introduction of the Hib vaccine in India is particularly significant. Globally, Hib kills more than 370,000 children each year, and nearly 20 percent of these deaths occur in India.

The GAVI Alliance is an organization that aligns public and private resources in a global effort to increase immunization.

To access the press release, go to:
http://www.gavialliance.org/media_centre/press_releases/2009_08_11_india_pentavalent.php

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13.  August 14 MMWR includes a short summary of the 2008 Reports of Nationally Notifiable Infectious Diseases

CDC published "Notice to Readers: Final 2008 Reports of Nationally Notifiable Infectious Diseases" in the August 14 issue of MMWR. The first paragraph of the notice is reprinted below.


The tables listed on pages 859-869 summarize finalized data for 2008, as of June 30, 2009, from the National Notifiable Diseases Surveillance System (NNDSS). These data will be published in more detail in the Summary of Notifiable Diseases--United States, 2008. During 2008, no cases of anthrax; diphtheria; nonneuroinvasive eastern equine encephalitis virus disease; poliomyelitis, paralytic; poliovirus infection, nonparalytic; Powassan virus disease, nonneuroinvasive; rubella, congenital syndrome; severe acute respiratory syndrome-associated coronavirus disease; smallpox, vancomycin-resistant Staphylococcus aureus infection; neuroinvasive and nonneuroinvasive western equine encephalitis virus disease; and yellow fever were reported in the United States; therefore, these diseases do not appear in these early release tables. Policies for reporting NNDSS data to CDC can vary by disease or reporting jurisdiction, depending on case status classification (i.e., confirmed, probable, or suspected). . . .


To access the full notice in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5831a5.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5831.pdf

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14.  Forum on the domestic response to hepatitis B and C planned for Washington, DC, on September 10-11

A forum, "Dawn of a New Era: Transforming Our Domestic Response to Hepatitis B & C," will be held on September 10-11 in Washington, DC. Its goal is to develop a coordinated national response to chronic viral hepatitis through improved prevention, detection, and patient care.

For comprehensive information, including the meeting agenda, faculty, and online registration, go to:
http://www.regonline.com/builder/site/Default.aspx?eventid=723938

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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.