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Immunization Action Coalition
IAC Express 2009
Issue number 825: September 28, 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. September 2009 issue of Vaccinate Adults now online
  2. CDC publishes recommendation for revaccinating people at prolonged increased risk for meningococcal disease
  3. Trial of 2009 H1N1 vaccine indicates robust early response in children ages 10-17; weaker response in those
    younger
  4. CDC provides Q&A for clinicians about 2009 H1N1 vaccine; updates recommendations for use of antiviral medications
  5. IDSA releases clinical practice guidelines for immunizing infants, children, adolescents, and adults
  6. CDC's "Epidemiology and Prevention of Vaccine-Preventable Diseases" course now available on DVD and CD
  7. IAC's Video of the Week features a CDC expert's advice about meningococcal meningitis
  8. HHS announces the winner of its 2009 H1N1 influenza PSA contest; seven finalists also named
  9. Keep vaccinating against seasonal influenza!
  10. "CDC Features" educate the public about the Hib booster dose, influenza, adult vaccination, and rabies
  11. IAC's "Screening Questionnaire for Injectable Influenza Vaccination" now in Spanish
  12. VISs for seasonal influenza vaccine available in Portuguese and Thai
  13. WHO announces composition of seasonal influenza vaccines for the 2010 southern hemisphere influenza season
  14. Order IAC's laminated U.S. immunization schedules today!
  15. MMWR article reports on performance of rapid influenza diagnostic tests in two H1N1 influenza outbreaks
  16. National Meningitis Association's "Tripod and Friends" teaches families about meningococcal disease
  17. MMWR publishes report on progress made toward controlling measles in Africa during 2001-08
 
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 825: September 28, 2009
1.  September 2009 issue of Vaccinate Adults now online The September 2009 issue of Vaccinate Adults is now available for viewing, downloading, and printing online at http://www.immunize.org/va

Vaccinate Adults is IAC's semiannual periodical for healthcare professionals who provide services to adults. The latest issue is packed with practical, easy-to-read, CDC-reviewed educational material.

Here are a few of the topics included in this issue of Vaccinate Adults:

  • Ask the Experts: answers from CDC immunization experts
     

  • More than a dozen influenza educational materials, some for patients, some for staff
     

  • Pneumococcal Polysaccharide Vaccine: CDC answers your questions
     

  • Summary of Recommendations for Adult Immunization
     

  • All healthcare personnel need seasonal and H1N1 influenza vaccination, by Deborah L. Wexler, MD, IAC's executive director

This is the second issue of Vaccinate Adults that is online-only. Copies are no longer being sent by U.S. mail. You can produce a hard copy of the September issue by printing out the 12-page PDF available at http://www.immunize.org/va/va24.pdf

To view the table of contents with links to individual articles, go to: http://www.immunize.org/va

Earlier in September, we published Needle Tips, our semiannual periodical that covers childhood, adolescent, and adult immunization. To access the September 2009 issue of Needle Tips, go to http://www.immunize.org/nt

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2 CDC publishes recommendation for revaccinating people at prolonged increased risk for meningococcal disease CDC published "Updated Recommendation from the Advisory Committee on Immunization Practices (ACIP) for Revaccination of Persons at Prolonged Increased Risk for Meningococcal Disease" in the September 25 issue of MMWR. The recommendation is reprinted below in its entirety, excluding references.


The Advisory Committee on Immunization Practices (ACIP) recommends quadrivalent meningococcal conjugate vaccine, (MCV4) (Menactra, sanofi pasteur, Swiftwater, Pennsylvania) for all persons aged 11-18 years and for persons aged 2-55 years at increased risk for meningococcal disease. MCV4 is licensed as a single dose. Because of the high risk for meningococcal disease among certain groups and limited data on duration of protection, at its June 2009 meeting ACIP recommended that persons previously vaccinated with either MCV4 or MPSV4 (Menomune, sanofi pasteur) who are at prolonged increased risk for meningococcal disease should be revaccinated with MCV4. Persons who previously were vaccinated at age >=7 years and are at prolonged increased risk should be revaccinated 5 years after their previous meningococcal vaccine, and persons who previously were vaccinated at ages 2-6 years and are at prolonged increased risk should be revaccinated 3 years after their previous meningococcal vaccine. Persons at prolonged increased risk for meningococcal disease include (1) persons with increased susceptibility such as persistent complement component deficiencies (e.g., C3, properdin, Factor D, and late complement component deficiencies), (2) persons with anatomic or functional asplenia, and (3) persons who have prolonged exposure (e.g., microbiologists routinely working with Neisseria meningitidis, or travelers to or residents of countries where meningococcal disease is hyperendemic or epidemic). This report provides the rationale for the new  recommendation and updates and replaces previous recommendations for revaccination with MCV4.

ACIP's Meningococcal Vaccine Work Group reviewed data on the risk for meningococcal disease, antibody titer decline, and the safety and immunogenicity of revaccination with MCV4 at 3 years and 5 years after the first dose of MCV4 or MPSV4. Persons with prolonged increased risk for meningococcal disease have increased susceptibility to the disease or ongoing increased risk for exposure to N. meningitidis, higher levels of serum bactericidal antibody (SBA) against N. meningitidis can provide these groups increased protection against disease. SBA is a measure of the ability of sera to kill a strain of N. meningitidis in the presence of complement. In clinical trials, a baby rabbit SBA titer of 1:128 was used as a conservative correlate of protection. Small subsets of subjects from the MCV4 prelicensure clinical trial were revaccinated 3 years (n = 76) and 5 years (n = 134) after receiving MCV4. Of 71 persons aged 11-18 years at primary vaccination who had been vaccinated with MCV4 3 years previously, 75% and 86% had SBA titers greater than 1:128 for serogroups C and Y, respectively, before revaccination. Of 108 persons aged 2-10 years at primary vaccination who had been vaccinated with MCV4 5 years previously, 55% and 94% had SBA titers greater than 1:128 for serogroups C and Y, respectively, before revaccination. All persons revaccinated with MCV4 in these studies achieved SBA titers greater than 1:128 for serogroups C and Y. Approximately 50%-70% of persons in both the previously vaccinated (n = 210) and vaccine naive groups (n = 323) reported mild to moderate local and systemic adverse events after revaccination (or initial vaccination) with MCV4. However, no serious adverse events were reported in either group (sanofi pasteur, unpublished data, 2009).

On the basis of these data, expert opinion of the workgroup members, and feedback from partner organizations, the workgroup proposed that persons at prolonged increased risk for meningococcal disease be revaccinated with MCV4. ACIP approved this proposal at its June 24, 2009, meeting. Persons who previously were vaccinated at age >=7 years and are at prolonged increased risk should be revaccinated 5 years after their previous meningococcal vaccine. Persons who previously were vaccinated at ages 2-6 years and are at  prolonged increased risk should be revaccinated 3 years after their previous meningococcal vaccine. Persons who remain in one of these increased risk groups indefinitely should continue to be revaccinated at 5-year intervals.

Although the duration of protection from MCV4 is unknown, most entering college students will have received MCV4 within the preceding 4 years. Because of the limited period of increased risk, ACIP currently does not recommend that college freshmen living in dormitories who were previously vaccinated with MCV4 be revaccinated. However, college freshmen living in dormitories who were vaccinated with MPSV4 >=5 years previously are recommended to be vaccinated with MCV4. Information regarding MCV4 and other recommendations for persons aged 2-55 years, including a routine recommendation for vaccination with MCV4 in persons aged 11-18 years, has been published previously.


To access the recommendation in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5837a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5837.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 Trial of 2009 H1N1 vaccine indicates robust early response in children ages 10-17; weaker response in those younger On September 21, the National Institutes of Health issued a press release, "Early Results: In Children, 2009 H1N1 Influenza Vaccine Works Like Seasonal Flu Vaccine." Portions of the press release are reprinted below.


Early results from a trial testing a 2009 H1N1 influenza vaccine in children look promising, according to the trial sponsor, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. Preliminary analysis of blood samples from a small group of trial participants shows that a single 15-microgram dose of a non-adjuvanted 2009 H1N1 influenza vaccine--the same dose that is in the seasonal flu vaccine--generates an immune response that is expected to be protective against 2009 H1N1 influenza virus in the majority of 10- to 17-year-olds eight to 10 days following vaccination. These results are similar to those recently reported in clinical trials of healthy adults. Younger children generally had a less robust early response to the vaccine.

"This is very encouraging news," says NIAID Director Anthony S. Fauci, MD. "As we had hoped, responses to the 2009 H1N1 influenza vaccine are very similar to what we see with routinely used seasonal influenza vaccines made in the same way. It seems likely that the H1N1 flu vaccine will require just one 15-microgram dose for children 10 to 17 years of age. The 2009 H1N1 influenza virus is causing widespread infections among children, so these are welcome results."

The ongoing NIAID-sponsored trial began in mid-August at five sites nationwide. The trial is assessing the safety and immune responses to one and two doses of either 15 micrograms or 30 micrograms of vaccine. Data from the trial is being compared for three age groups: children 6 months to 35 months old; 3 to 9 years old; and 10 to 17 years old.

The preliminary results are based on blood samples taken eight to 10 days after the first vaccination. Immune responses were strongest among the oldest children, those 10 to 17 years old. In this group of 25 children, a strong immune response was seen in 76 percent who received one 15-microgram dose of vaccine. The immune responses in children nine years old and younger were not as strong. Among 25 volunteers aged 3 to 9 years old, a strong immune response was seen in 36 percent of those given 15 micrograms of vaccine. In the youngest group, 20 children between 6 months to 35 months old, a single 15-microgram dose of vaccine produced a strong immune response in 25 percent of recipients. . . .

The vaccine being tested in this trial is manufactured by sanofi pasteur in Swiftwater, PA, in the same manner as its licensed seasonal vaccine, which is used every year in millions of children, and is the same formulation recently licensed by the FDA to protect against 2009 H1N1 influenza. Like inactivated seasonal influenza vaccines, the vaccine contains a purified part of a killed virus and cannot cause  flu. . . .

To access the complete press release, go to:
http://www.nih.gov/news/health/sep2009/niaid-21.htm

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4 CDC provides Q&A for clinicians about 2009 H1N1 vaccine; updates recommendations for use of antiviral medications On September 21, CDC posted a Q&A advising clinicians about practical aspects of ordering and using 2009 H1N1 influenza vaccine. On September 22, CDC posted updated recommendations for the use of antivirals in treating and preventing influenza; it also posted a related Q&A. Links to all the documents appear below.

H1N1 Clinicians Questions and Answers
http://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm

Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season
http://www.cdc.gov/H1N1flu/recommendations.htm

Questions & Answers: Antiviral Drugs, 2009-2010 Flu Season
http://www.cdc.gov/h1n1flu/antiviral.htm

CDC's H1N1 Flu web section contains hundreds of documents for healthcare professionals and the public. To access the web section's home page, go to: http://www.cdc.gov/h1n1flu

To make it easier for you to keep up to date with developments, IAC has gathered important information related to H1N1 influenza into a single web section. To access this resource, go to:
http://www.immunize.org/h1n1

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5 IDSA releases clinical practice guidelines for immunizing infants, children, adolescents, and adults The Infectious Diseases Society of America (IDSA) recently released a document titled "Immunization Programs for Infants, Children, Adolescents, and Adults: Clinical Practice Guidelines by the Infectious Diseases Society of America." The document, which updates the previous guidelines published in 2002, sets forth 46 standards organized into four broad categories:

(1) Vaccine recommendations for infants, children, adolescents, and adults

(2) Immunization standards, overcoming barriers to immunization, vaccine safety, misconceptions, finances, access, and strategies to improve coverage

(3) Complementary (nontraditional) immunization settings

(4) Immunization of specific groups

Published in the September 15 issue of Clinical Infectious Diseases, the guidelines are available at
http://www.journals.uchicago.edu/doi/full/10.1086/605430

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6 CDC's "Epidemiology and Prevention of Vaccine-Preventable Diseases" course now available on DVD and CD The professional-education course "Epidemiology and Prevention of Vaccine-Preventable Diseases" is now available on DVD or CD. The course is also available in web-on-demand format. Continuing-education credit expires on March 31, 2010.

Note: In previous years, the course was delivered by satellite broadcast. In 2007, it was decided that going forward, it would be available only on DVD/CD and by Internet.

To order one copy of the DVD or CD using the new NCIRD ordering system, go to: http://wwwn.cdc.gov/pubs/NCIRD.aspx Scroll down to item #99-9952.

For comprehensive information on the course and supporting resources, go to: http://www.cdc.gov/vaccines/ed/epivac

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7 IAC's Video of the Week features a CDC expert's advice about meningococcal meningitis IAC encourages IAC Express readers to watch a 5-minute video produced by CDC-TV. It includes a CDC expert's advice to parents in the fictional community of Springfield as they learn that a school-age child has been hospitalized with meningococcal meningitis. A script is available.

The video will be available on the home page of IAC's website through October 4. 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!

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

To view other videos produced by CDC-TV, go to:
http://www.cdc.gov/CDCtv

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8 HHS announces the winner of its 2009 H1N1 influenza PSA contest; seven finalists also named On September 22, the Department of Health and Human Services (HHS) issued a press release announcing the winner and finalists of the HHS 2009 H1N1 public service announcement (PSA) contest. Portions of the press release are reprinted below.


Department of Health and Human Services (HHS) Secretary Sebelius and Department of Education (ED) Secretary Arne Duncan today announced that Dr. John Clarke of Baldwin, NY, is the winner of the 2009 H1N1 PSA Contest. More than 50,000 votes were cast by Americans across the country on YouTube. Dr. Clarke will receive a $2,500 cash prize, and his ad will be broadcast on national television. The announcement was made at a What To Do About the Flu town hall meeting held by Obama administration officials with college students and faculty at George Mason University today. . . .

In July, the Department of Health and Human Services teamed up with the Department of Homeland Security and the Department of Education to launch a national public service advertising campaign designed to encourage American children and families to practice healthy habits and to take steps to prevent the spread of the 2009 H1N1 flu virus.

Over 240 videos were submitted by the August deadline, after which a panel of experts narrowed the field to 10 finalists. Over the last two weeks, Americans weighed in to vote for their favorite PSA on YouTube. In the winning video, Dr. Clarke performed an original rap on how to prevent the spread of the flu. Dr. Clarke is the medical director for the Long Island Railroad, and his PSA was videotaped at Columbia University's campus in Manhattan.

The 2009 H1N1 PSA Contest finalists include
  • Jason Phillips (San Francisco, CA)
  • Gary Ashwal (Los Angeles, CA)
  • Christopher Landy (Ardmore, PA)
  • Andrew Starver (La Mirada, CA)
  • Joan Porter (Oak Park, MI)
  • Luke Eddy (West Point, UT)
  • Christopher Cymbalak (Leland, NC) . . . .

To access the entire press release, go to:
http://www.hhs.gov/news/press/2009pres/09/20090922a.html

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9 Keep vaccinating against seasonal influenza! If you're wondering if you should continue to vaccinate against seasonal influenza once H1N1 influenza vaccine becomes available, the answer is YES! The 2009 H1N1 influenza vaccine will not protect people against seasonal influenza, and seasonal influenza vaccine will not protect against H1N1 influenza.

Unfortunately, some healthcare facilities are having difficulty finding available vaccine to purchase. Be assured that though seasonal influenza vaccine may be in temporary short supply right now, production is expected to catch up to demand soon.

To assist providers in finding seasonal influenza vaccine available for purchase, the National Influenza Vaccine Summit supports IVATS (Influenza Vaccine Availability Tracking System). IVATS provides information about vaccine manufacturers and distributors with vaccine available for purchase. To access this information in Excel spreadsheet format, go to:
http://www.preventinfluenza.org/ivats/ivats_09_10.xls

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 IAC's Seasonal Influenza web section, go to:
http://www.immunize.org/influenza

To access IAC's H1N1 Influenza web section, go to:
http://www.immunize.org/h1n1

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


To access CDC's Novel H1N1 Flu web section, go to:
http://www.cdc.gov/h1n1flu

To access IAC's print pieces related to influenza, including screening questionnaires, patient education pieces, and sample standing orders, go to:
http://www.immunize.org/printmaterials/dis_inf.asp

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10.  "CDC Features" educate the public about the Hib booster dose, influenza, adult vaccination, and rabies The "CDC Features" web section now includes information for the public on four immunization topics: Hib disease (in English and Spanish); influenza vaccination; adult immunization; and rabies prevention.

(1) "Is Your Child Protected against Hib Disease?" informs parents that Hib vaccine is no longer in short supply and encourages them to get their child vaccinated if the child missed the booster dose.

To access the English version of "Is Your Child Protected against Hib Disease?" go to:
http://www.cdc.gov/Features/HibDisease

To access the Spanish version of "Is Your Child Protected against Hib Disease?" go to:
http://www.cdc.gov/spanish/especialesCDC/Hib

(2) "It's Flu Season: Learn How to Protect Yourself and Your Loved Ones" outlines the people for whom seasonal influenza vaccine is recommended and discusses the need for both seasonal and H1N1 influenza vaccination.

To access "It's Flu Season: Learn How to Protect Yourself and Your Loved Ones," go to:
http://www.cdc.gov/Features/flu

(3) "Adults Need Immunizations, Too" briefly describes the vaccines adults need and encourages adults to set an example for their families by getting vaccinated.

To access "Adults Need Immunizations, Too," go to:
http://www.cdc.gov/Features/AdultImmunizations

(4) "The Burden of Rabies" informs people that rabies is serious and prevalent, and outlines steps to take in response to being bitten by an animal and in protecting pets against disease.

To access "The Burden of Rabies," go to:
http://www.cdc.gov/Features/dsrabies

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

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11.  IAC's "Screening Questionnaire for Injectable Influenza Vaccination" now in Spanish IAC's recently revised "Screening Questionnaire for Injectable Influenza Vaccination," is now available in Spanish. In the revision, all references to "TIV" (trivalent influenza vaccine) were changed to "inactivated injectable influenza vaccine." This piece can now be used to screen for both seasonal and H1N1 vaccination.

To access the Spanish version of the revised "Screening Questionnaire for Injectable Influenza Vaccination," go to:
http://www.immunize.org/catg.d/p4066-01.pdf

To access the English version of the revised "Screening Questionnaire for Injectable Influenza Vaccination," go to:
http://www.immunize.org/catg.d/p4066.pdf

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

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12.  VISs for seasonal influenza vaccine available in Portuguese and Thai Dated 8/11/09, the VIS for seasonal trivalent influenza vaccine (TIV; injectable) is now available in Portuguese and Thai. Also dated 8/11/09, the VIS for seasonal live attenuated influenza vaccine (LAIV; nasal spray) is available in Portuguese; a Thai version is not yet available. IAC gratefully acknowledges the Massachusetts Department of Public Health for the Portuguese translations and Asian Pacific HealthCare Venture for the Thai translation.

VIS FOR INJECTABLE SEASONAL INFLUENZA VACCINE
To access the Portuguese version of the VIS for injectable seasonal influenza vaccine, go to:
http://www.immunize.org/vis/pr_flu06.pdf

To access the Thai version of the VIS for injectable seasonal influenza vaccine, go to:
http://www.immunize.org/vis/th_flu06.pdf

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

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

VIS FOR NASAL-SPRAY SEASONAL INFLUENZA VACCINE
To access the Portuguese version of the VIS for nasal-spray seasonal influenza vaccine, go to:
http://www.immunize.org/vis/prliveflu06.pdf

To access the English version of the VIS for nasal-spray seasonal influenza vaccine, go to:
http://www.immunize.org/vis/liveflu.pdf

NOTE: The VIS for nasal-spray seasonal influenza vaccine comes in additional languages, including Spanish. To access them, go to: http://www.immunize.org/vis/vis_flu_live.asp Click on the link to the pertinent language.

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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13.  WHO announces composition of seasonal influenza vaccines for the 2010 southern hemisphere influenza season The website of the World Health Organization (WHO) recently posted the following information about the composition of the seasonal influenza vaccines that will be used in the southern hemisphere in 2010.


It is recommended that vaccines for use in the 2010 influenza season (southern hemisphere winter) contain the following:
  • an A/California/7/2009 (H1N1)-like virus;
  • an A/Perth/16/2009 (H3N2)-like virus;
  • an B/Brisbane/60/2008-like virus.

For more information
Recommended composition of influenza virus vaccines for use in the 2010 influenza season--full report
(http://www.who.int/csr/disease/influenza/200909_Recommendation.pdf)

Frequently asked questions
(http://www.who.int/csr/disease/influenza/200909_RecommendationFAQ.pdf)

To access the announcement, go to:
http://www.who.int/csr/disease/influenza/recommendations2010south/en

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14.  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 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".

Click on the following links to go to an image, description, and ordering information for each schedule.

Child/teen schedule
http://www.immunize.org/shop/schedule_child.asp

Adult schedule
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 mailto:admininfo@immunize.org

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15.  MMWR article reports on performance of rapid influenza diagnostic tests in two H1N1 influenza outbreaks CDC published "Performance of Rapid Influenza Diagnostic Tests During Two School Outbreaks of 2009 Pandemic Influenza A (H1N1) Virus Infection--Connecticut 2009" in the September 25 issue of MMWR. The first paragraph of the article is reprinted below.


During May 2009, a few weeks after 2009 pandemic influenza A (H1N1) infection was first detected in the United States, outbreaks among students from two schools were detected in Greenwich, Connecticut. Staff members from Greenwich Hospital and the Connecticut Department of Public Health collected data on symptoms for 63 patients and submitted nasopharyngeal washings for testing using a rapid influenza diagnostic test (RIDT) for influenza A and B and real-time reverse transcription-polymerase chain reaction (rRT-PCR) assay, thereby affording an opportunity to assess the field performance of the RIDT. A total of 49 patients had infections with pandemic influenza A (H1N1) confirmed by rRT-PCR. This report summarizes the findings from this performance assessment, which indicated that, compared with rRT-PCR, the sensitivity of the RIDT for detecting infection in patients with 2009 pandemic influenza A (H1N1) was 47%, and the specificity was 86%. Sensitivity and specificity did not vary substantially by the presence or absence of CDC-defined influenza-like illness (ILI) or by time from symptom onset to specimen acquisition. In this group of patients, although positive RIDT results performed well in predicting confirmed infection with pandemic H1N1 virus (positive predictive value: 92%), negative tests did not accurately predict the absence of infection (negative predictive value: 32%). These results affirm recent CDC recommendations against using negative RIDT results for management of patients with possible 2009 pandemic influenza A (H1N1) infection. . . .


To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5837a1.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5837.pdf

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16.  National Meningitis Association's "Tripod and Friends" teaches families about meningococcal disease The National Meningitis Association (NMA) recently developed a set of tools that provide information about meningococcal disease and prevention in a kid-friendly way. The materials include an animated video, user's guide, and coloring book featuring Tripod and his animal friends.

The materials are meant to make both children and parents aware of meningococcal disease symptoms and to help them understand ways to prevent the disease. Although they can be used at any time, the materials may be especially useful after a case of meningococcal disease is reported in an area.

The Tripod and Friends video and materials, as well as additional resources for educators, public health departments, school nurses, healthcare providers, and parents, can be downloaded from the NMA website at http://www.nmaus.org/programs/tripod

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17.  MMWR publishes report on progress made toward controlling measles in Africa during 2001-08 CDC published "Progress Toward Measles Control--African Region, 2001-2008" in the September 25 issue of MMWR. The first paragraph of the article is reprinted below.


In 2001, the countries of the World Health Organization (WHO) African Region (AFR) became part of a global initiative with a goal of reducing the number of measles deaths by 50% by 2005, compared with 1999. Recommended strategies for measles mortality reduction included (1) increasing routine coverage for the first dose of measles-containing vaccine (MCV1) for all children, (2) providing a second opportunity for measles vaccination through supplemental immunization activities (SIAs), (3) improving measles case management, and (4) establishing case-based surveillance with laboratory confirmation of all suspected measles cases. Before introduction of MCV throughout AFR, approximately 1 million measles cases had been reported each year in the early 1980s. After strengthening measles-control activities, annual reported cases declined to an estimated 300,000-580,000 during the 1990s. This report summarizes the progress made during 2001-2008 toward improving measles control in AFR. During 2001-2008 estimated MCV1 coverage increased from 57% to 73%, SIAs vaccinated approximately 398 million children, and reported measles cases decreased by 93%, from 492,116 in 2001 to 32,278 in 2008. By 2005, global measles deaths had decreased by 60%, and the AFR goal had been achieved; AFR adopted a new goal to reduce deaths by 90%, compared with 2000, and that goal was achieved in 2006. However, inaccuracies in reported vaccination coverage exist, surveillance is suboptimal, and measles outbreaks continue to occur in AFR countries. Further progress in measles control will require full implementation of recommended strategies, including validation of vaccination coverage. . . .


To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5837a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5837.pdf

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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.