850 | Immunize.org

IAC Express 2010
Issue number 850: February 8, 2010

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Contents of this Issue Select a title to jump to the article.
New! February 2010 edition of Needle Tips is now online The Lancet retracts 1998 paper about MMR and autism by Wakefield, et al. CDC's Health Alert Network notifies clinicians about shortened shelf life of certain lots of Sanofi Pasteur H1N1 vaccine in prefilled syringes IAC updates "Guide to Contraindications and Precautions to Commonly Used Vaccines" and "Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults" IAC updates Spanish-language "When Do Children and Teens Need Vaccinations?" "Adult Immunization: Shots to Save Lives" report released IAC's Video of the Week section features video clips for parents produced by ECBT Check out IAC's redesigned VIS web section January issue of CDC's Immunization Works electronic newsletter recently released Free "Shots 2010" software for the new adult, child, teen, and catch-up immunization schedules now available "CDC Features" educates the public about cervical cancer and HPV vaccines Reminder: Early Bird registration for National Immunization Conference ends February 19 New hepatitis training resource from the University of Alabama available online

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 850: February 8, 2010

New! February 2010 edition of Needle Tips is now online

The February 2010 issue of Needle Tips has just been placed online at http://www.immunize.org/nt This issue focuses on the two newly published 2010 U.S. immunization schedules, one for children/teens and one for adults, and on recently released provisional ACIP recommendations.

Here are some of the features included in the issue:

Ask the Experts
Vaccine Highlights
Recommended Immunization Schedules for Children and Teens, U.S., 2010
Recommended Adult Immunization Schedule--United States, 2010
When Do Children and Teens Need Vaccinations?
Are you 11-19 years old? Then you need to be vaccinated against these serious diseases!
Do I need any vaccinations today?

On the Needle Tips web page, you will find a link for displaying and printing the entire 16-page PDF of this issue. There is also a table of contents for viewing and printing individual sections.

To access the Needle Tips web page, go to:
http://www.immunize.org/nt

If you would like to download the entire issue right now, click here: http://www.immunize.org/nslt.d/n43/n43.pdf

The Lancet retracts 1998 paper about MMR and autism by Wakefield, et al.

On February 2, 2010, the editors of The Lancet published a retraction of the February 1998 paper titled, "Retraction--Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children." The paper by Andrew Wakefield, MB, BS, FRCS, and 12 other authors suggested a link between MMR vaccine and autism. The study set off a media firestorm and subsequent drop in MMR vaccination rates, especially in the United Kingdom, despite involving only a dozen children.

The retraction followed the ruling of the U.K.'s General Medical Council that stated Dr. Wakefield's conduct regarding his research was "dishonest" and "irresponsible" and that he had shown a "callous disregard" for the suffering of children involved in his studies.

The text of The Lancet retraction follows in its entirety.

Following the judgment of the UK General Medical Council's Fitness to Practise Panel on Jan 28, 2010, it has become clear that several elements of the 1998 paper by Wakefield et al are incorrect, contrary to the findings of an earlier investigation. In particular, the claims in the original paper that children were "consecutively referred" and that investigations were "approved" by the local ethics committee have been proven to be false. Therefore we fully retract this paper from the published record.

To access the retraction online, go to:
http://www.lancet.com/journals/lancet/article/PIIS0140-6736(10)60175-7/fulltext

To access the "Fitness to Practise Panel Hearing" report from the General Medical Council, go to:
http://www.neurodiversity.com/wakefield_gmc_ruling.pdf

The Lancet retraction has received major coverage in the popular media. Links to two related editorials follow.

Arthur Caplan, PhD, director of the Center for Bioethics at the University of Pennsylvania, contributed a commentary to MSNBC titled "Tiny, flawed vaccine study a case study in biased medicine." To read this powerful editorial, go to:
http://www.msnbc.msn.com/id/35218819/ns/health-health_care

Alison Singer, co-founder and president of the Autism Science Foundation, wrote an opinion piece for CNN describing how the Wakefield study has affected her life as a mother of a child with autism and as an advocate for autistic children. To read this opinion piece, go to:
http://edition.cnn.com/2010/OPINION/02/03/singer.autism.study.vaccines

Historical editorial note: prior to the publication of this full retraction, the following statements had been published.

In February 2004, The Lancet's editors issued a statement indicating that they had recently been made aware that the paper's authors had not disclosed a possible conflict of interest and apologized for publishing the paper. To access the editors' statement, go to:
http://image.thelancet.com/extras/statement20Feb2004web.pdf

In March 2004, 10 of the research paper's 13 authors retracted the paper's interpretation that a link exists between MMR vaccine and autism. To access the retraction from the website of Sunday Times reporter Brian Deer, go to:
http://briandeer.com/mmr/lancet-retraction.pdf

CDC's Health Alert Network notifies clinicians about shortened shelf life of certain lots of Sanofi Pasteur H1N1 vaccine in prefilled syringes

On February 2, CDC's Health Alert Network (HAN) issued a HAN Info Service Message titled "Sanofi Pasteur Monovalent 2009 (H1N1) Influenza Vaccine in Pre-Filled Syringes--Shortened Shelf Life of Certain Lots." The summary is reprinted below.

Sanofi Pasteur has notified CDC and FDA that some lots of monovalent 2009 (H1N1) influenza vaccine in prefilled syringes will have a shorter expiration period than indicated on the label. The lots of Sanofi Pasteur monovalent 2009 H1N1 influenza vaccine in prefilled syringes should be used by February 15, 2010, as indicated in the table below regardless of the expiration imprinted on the package. This is to ensure that the vaccine is used while it remains within its potency specification. There are no safety concerns with these lots of 2009 H1N1 vaccine. People who received vaccine from the lots listed below with shortened shelf life do not need to take any action.

To access the complete HAN CDC Health Update, which includes the table of affected lots, go to:
http://www.cdc.gov/H1N1flu/HAN/020210.htm

For Q&As from CDC related to this announcement, go to:
http://www.cdc.gov/h1n1flu/vaccination/qa_expiration.htm

IAC updates "Guide to Contraindications and Precautions to Commonly Used Vaccines" and "Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults"

IAC recently revised the following two print resources for healthcare professionals.

IAC's "Guide to Contraindications and Precautions to Commonly Used Vaccines" is adapted from Table 5 in "Contraindications and Precautions to Commonly Used Vaccines" found in ACIP's General Recommendations on Immunization, and covers all routinely recommended vaccines for children, teens, and adults. IAC added information about antivirals to this piece, and also made other minor edits.

To access the revised ready-to-print (PDF) print piece "Guide to Contraindications and Precautions to Commonly Used Vaccines," go to: http://www.immunize.org/catg.d/p3072a.pdf

IAC's "Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults" is a shortened version of the above, focusing on adult vaccines only. IAC added information about antivirals to this piece, and also made other minor edits.

To access the revised ready-to-print (PDF) print piece "Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults," go to:
http://www.immunize.org/catg.d/p3072.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

IAC updates Spanish-language "When Do Children and Teens Need Vaccinations?"

"When Do Children and Teens Need Vaccinations?" is a handy one-page chart for parents, illustrating all vaccines recommended for children and teens ages 0-18 years. The Spanish translation was recently revised to match the most recent English version, both of which now include information about human papillomavirus (HPV) vaccination in males.

To access the revised ready-to-print (PDF) print piece "When Do Children and Teens Need Vaccinations?" in Spanish, go to:
http://www.immunize.org/catg.d/p4050-01.pdf

To access the revised ready-to-print (PDF) print piece "When Do Children and Teens Need Vaccinations?" in English, go to:
http://www.immunize.org/catg.d/p4050.pdf

To access all IAC print materials, including available translations, go to:
http://www.immunize.org/printmaterials

"Adult Immunization: Shots to Save Lives" report released

On February 4, the Trust for America's Health, the Infectious Diseases Society of America, and the Robert Wood Johnson Foundation released a report titled "Adult Immunization: Shots to Save Lives." Overall, the report found millions of American adults go without recommended vaccinations, leading to an estimated 40,000-50,000 preventable deaths and $10 billion in preventable healthcare costs each year.

The report identified several key reasons why adult vaccination rates remain low:

Limited access: Most adults are outside of institutionalized settings, like the military or colleges, where vaccines can be required;
Limited care and insurance coverage: Primary and preventive care for adults is limited, particularly for the uninsured and underinsured;
Limited financing for immunizations: Many adults have medical insurance that does not pay for vaccines and their administration, so out-of-pocket costs may be prohibitive for many individuals;
Misunderstanding and misinformation: Many adults are misinformed about the safety and effectiveness of vaccines; and
Limited research and development: Vaccine research, development, and production have been limited in the United States for decades.

The report goes on to outline a number of policy recommendations to increase adult vaccination rates.

To read a related press release from the Trust for America's Health, go to:
http://healthyamericans.org/report/73/adult-immunization-2010

The complete report is available at
http://healthyamericans.org/assets/files/TFAH2010AdultImmnzBrief13.pdf

IAC's Video of the Week section features video clips for parents produced by ECBT

IAC encourages IAC Express readers to watch a selection of videos produced by Every Child by Two (ECBT). ECBT recently launched a new web page titled "Video FAQs," which features short video clips (30-second to 2-minute) of experts briefly answering parents' most frequently asked questions about vaccination.

The link to the page of video clips will be available on the home page of IAC's website through February 14. 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

Check out IAC's redesigned VIS web section

IAC's VIS web section's main page has been redesigned to offer users an at-a-glance understanding of what is available to them. To enter it, click on this link: http://www.immunize.org/vis

The first thing you'll see is the organizing heart of the page, a large box with Vaccine Index, Language Index, and Alphabetical Index running horizontally across it.

The Vaccine Index lists all 26 VIS used in the U.S. when vaccinating patients. Click on the name of a VIS, and you'll be taken to a link to the English-language version of the VIS and all its translations.

Click on Language Index, and you'll be taken to a list of the 48 languages that IAC makes VISs available in (not every VIS is available in all 48 languages).

Click on Alphabetical Index to be taken to an alphabetical list of VISs. If you click on the name and most recent issue date of the VIS, you'll be taken directly to the English-language version of the VIS. You also have the option of viewing the translated versions of the VIS.

Another useful feature of the VIS home page is the chart titled Current VIS Dates. Use it to make sure all your VISs are up to date.

Be sure to bookmark http://www.immunize.org/vis for easy reference in the future!

January issue of CDC's Immunization Works electronic newsletter recently released

CDC recently released the January issue of its monthly newsletter Immunization Works. The newsletter offers the immunization community information about current topics. The information is in the public domain and can be reproduced and circulated widely.

Some of the information in the January issue has already appeared in previous issues of IAC Express. Following is the text of the articles we have not covered.

FRONT PAGE NEWS: "NIVW Promoted Awareness, Provided Vaccination Opportunities Nationwide" [first paragraph follows]

Established in 2006, National Influenza Vaccination Week (NIVW), is a national observance highlighting the importance of continuing influenza vaccination after the holiday season and into the new year. NIVW kicked off on Sunday, January 10, with an official proclamation from President Barack Obama. The week seized an important window of opportunity to prevent influenza by getting more people vaccinated and encouraging others to do the same. . . .

MORE NEWS & SUMMARIES: "Study Documents Decline in Diarrhea-Related Deaths among Mexican Children Following Introduction of Rotavirus Vaccine"

An article in the January 28, 2010, issue of the New England Journal of Medicine, entitled "Effect of Rotavirus Vaccination on Death from Childhood Diarrhea in Mexico," noted that deaths due to diarrhea among children significantly declined following the introduction of rotavirus vaccine in Mexico.

In 2006, Mexico became one of the first countries to introduce rotavirus vaccine into its national immunization program. Study authors, Vesta Richardson, Joselito Hernandez-Pichardo, Manjari Quintanar-Solares, Marcelino Esparza-Aguilar, Brian Johnson, Cesar Misael Gomez-Altamirano, Umesh Parashar, and Manish Patel, compared childhood diarrhea-related mortality before and after introduction of rotavirus vaccine in Mexico. Their results showed that among infants 11 months and younger (the targeted population for rotavirus vaccination), the number of deaths due to diarrhea declined by 42%. Three key findings support a causal role of vaccination in the reduction of diarrhea-related deaths:

The largest reduction in diarrhea-related deaths was among the vaccinated age-group (infants 11 months and younger).
The most prominent reduction occurred during the typical rotavirus season in Mexico (December through May).
The reduction was sustained through the two rotavirus seasons (2008 and 2009) after vaccine introduction.

In addition, the study showed that among children 12-24 months of age, diarrhea-related deaths declined by 29%. Only 10%-15% of these children were eligible for rotavirus immunization; thus, the reduction demonstrates that vaccination of part of the population could possibly reduce rotavirus transmission overall.

Improved sanitation, promotion of breastfeeding and oral rehydration, and vitamin A supplementation have helped reduce the overall number of childhood diarrhea-related deaths in Mexico, but deaths during the rotavirus season remained prevalent. This persistent burden revealed the importance of immunization as the primary tool for preventing rotavirus.

MORE NEWS & SUMMARIES: "National Action Plan Open for Review"

Following its 2006 "National Leadership Summit on Eliminating Racial and Ethnic Disparities in Health," HHS launched the "National Partnership for Action to End Health Disparities (NPA)." The main objectives of the NPA include drawing national attention to longstanding, pervasive racial and ethnic health disparities, and fostering community involvement and broad-based partnerships to improve coordination and utilization of research and outcome evaluation to shape strategies and actions to address health disparities.

To develop the plan, HHS conducted a series of "Regional Conversations" throughout the 10 HHS regions involving individual, public health, and community leaders, to identify strategies and actions needed to address health disparities effectively on a regional basis.

CDC and its partners have been asked to review the National Partnership for Action to End Health Disparities Action Plan (http://minorityhealth.hhs.gov/npa), which will be posted for public comment until February 12, 2010.

MEETINGS, CONFERENCES & RESOURCES: "New Website Launched for Employers" [first paragraph follows]

The National Business Group on Health, a nonprofit organization devoted to representing large employers' perspective on national health issues and assisting its members with healthcare problems, has introduced Moving Science into Coverage: An Employer's Guide to Preventive Service (http://www.businessgrouphealth.org/preventive/background.cfm), a website designed to help employers select, define, and implement evidence-based clinical preventive services. Based on A Purchaser's Guide to Clinical Preventive Services, this website provides employers with up-to-date information and resources on high-impact, effective, and value-driven services to prevent chronic conditions.

MEETINGS, CONFERENCES & RESOURCES: "National Infant Immunization Week"

An early reminder: National Infant Immunization Week (NIIW) will be April 24-May 1, 2010. Check the NIIW website for more details as they become available (http://www.cdc.gov/vaccines/events/NIIW).

RESPIRATORY NEWS AND RESOURCES: "Save the Date"

April 24, 2010, is World Meningitis Day, which seeks to raise awareness about meningitis and the importance of being vaccinated. World Meningitis Day is organized by The Confederation of Meningitis Organizations (CoMO), which was formed in 2004 and whose members include organizations and individuals in 19 countries across Europe, North and South America, Australia, the Philippines, and Africa. In addition to encouraging participation in local events, CoMO invites all to log on to their CoMO's Meningitis website (http://www.comoonline.org) during April and join hands against meningitis in a global virtual community. You can also join the cause on Facebook.

To view the January 2010 issue of Immunization Works, go to:
http://www.cdc.gov/vaccines/news/newsltrs/imwrks/2010/201001.htm

10.

Free "Shots 2010" software for the new adult, child, teen, and catch-up immunization schedules now available

The "Shots 2010" quick-reference guides to the adult, child, teen, and catch-up immunization schedules are now available for Palm-OS handhelds and Pocket-PCs handhelds. Both are available on the website of the Group on Immunization Education of the Society of Teachers of Family Medicine.

To access "Shots 2010" for Palm-OS handhelds and Pocket-PCs handhelds, as well as "Shots 2010 Online," go to:
http://www.immunizationed.org/anypage.aspx?pgid=2

11.

"CDC Features" educates the public about cervical cancer and HPV vaccines

The "CDC Features" web section now includes information for the public on cervical cancer that has been updated to include both human papillomavirus (HPV) vaccines, Gardasil (Merck) and Cervarix (GSK).

To access "Cervical Cancer: The Preventable Gynecologic Cancer" go to: http://www.cdc.gov/Features/CervicalCancer

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

12.

Reminder: Early Bird registration for National Immunization Conference ends February 19

The 2010 National Immunization Conference will be held in Atlanta on April 19-22. Register by February 19, and save $25 off the regular registration price of $250.

For complete information on the conference, including the conference goals and objectives, agenda, and online registration, go to: http://www.cdc.gov/vaccines/events/nic

For more information, contact the conference planning team by phone at (404) 639-8225 or by email at nipnic@cdc.gov

13.

New hepatitis training resource from the University of Alabama available online

The National Training Center for Integrated Hepatitis HIV/STD Prevention Services at the University of Alabama at Birmingham has recently launched a new training website, http://www.knowhepatitis.org

Two training opportunities are currently available: a webinar featuring CDC's Division of Viral Hepatitis director John Ward, MD, discussing the recently released Institute of Medicine report about hepatitis; and a video overview of viral hepatitis for the front-line worker presented by Laura Bachman, MD, MPH. To access either of these presentations, go to: http://www.knowhepatitis.org/training/center

The mission of the National Training Center is to decrease the burden of hepatitis in at-risk populations by advocating for and facilitating the integration of hepatitis/HIV/STD prevention and services into community based organizations (CBOs) and clinics through the provision of innovative and evidence-based education and training targeted to front-line workers employed in these organizations.

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