Home
|
About IAC
|
Contact
|
A-Z Index
|
Donate
|
Shop
|
SUBSCRIBE
Immunization Action Coalition
IAC Express 2010
Issue number 881: August 9, 2010
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. ACIP makes recommendations for use of CSL's Afluria seasonal influenza vaccine during 2010-11
  2. CDC Health Advisory Network notifies providers about seasonal influenza A (H3N2) virus infections
  3. CDC publishes ACIP influenza recommendations in MMWR Recommendations and Reports
  4. CDC updates information on supply of Hib and hepatitis B vaccines
  5. IAC updates screening questionnaires and standing orders for seasonal influenza vaccination
  6. CDC Health Advisory Network notifies providers about shortened shelf life of sanofi pasteur's H1N1 2009 monovalent influenza vaccine in multi-dose vials
  7. IAC's Video of the Week features an original song about vaccination
  8. IAC updates "Pneumococcus: Questions and Answers"
  9. "CDC Features" educates the public about shingles vaccination
  10. Texas Immunization Summit scheduled for September 30-October 1 in Fort Worth
  11. Hepatitis Foundation International summits to be held in four locations this fall
 
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 881: August 9, 2010
1.  ACIP makes recommendations for use of CSL's Afluria seasonal influenza vaccine during 2010-11

On August 6, CDC issued a media statement titled "ACIP Recommendation for Use of CSL Influenza Vaccine." Portions of the statement are reprinted below. At the end of this IAC Express article, you will find links to the complete statement, as well as to a Q&A on CSL vaccine safety and to a table of influenza vaccines recommended for use in the United States during the 2010-11 influenza season.


Background
On Thursday, August 5, 2010, CDC's Advisory Committee on Immunization Practices (ACIP) met to discuss recommendations for use in the United States of seasonal influenza trivalent inactivated vaccine (TIV) [Afluria] manufactured by CSL Limited during 2010-11. . . .

Recommendation
Based upon the data to date suggesting an increased risk of febrile seizures in children aged 6 months through 4 years following 2010 Fluvax or Fluvax Jr, and a higher frequency of reported fever in children aged 5 years through 8 years following Fluvax compared to previous seasons; and based on a higher frequency of fever in children aged 5 years through 8 years following Afluria in one clinical trial in 2009, ACIP recommends that for the 2010-11 influenza season in the United States:
  • Afluria should not be used in children aged 6 months through 8 years.
     
  • Other age-appropriate, licensed seasonal influenza vaccine formulations should be used for prevention of influenza in children aged 6 months through 8 years.
     
  • If no other age-appropriate, licensed seasonal influenza vaccine is available for a child aged 5 years through 8 years old who has a medical condition that increases their risk for influenza complications, Afluria may be given, and providers should discuss the benefits and risks of influenza vaccination with the parents or caregivers before administering Afluria.

There are two types of seasonal influenza vaccines for children: the trivalent inactivated vaccine (TIV) (the flu shot) and the live attenuated vaccine (nasal spray). . . .

[IAC Express editor's note: Because of formatting difficulties, IAC Express cannot reproduce the table that appeared in the media statement.]


To access the complete media statement about the ACIP recommendations, go to: http://www.cdc.gov/media/pressrel/2010/s100806.htm

To access the Q&A titled "CSL Seasonal Influenza Vaccine Safety in the United States," go to: http://www.cdc.gov/flu/protect/vaccine/qa_cslfluvac.htm

To access a newly posted table titled "Recommended Influenza Vaccines for the U.S. 2010-11 Season," go to: http://www.cdc.gov/flu/protect/vaccine/vaccines.htm

Back to top
   
2 CDC Health Advisory Network notifies providers about seasonal influenza A (H3N2) virus infections

On August 5, CDC issued a Health Advisory titled "Seasonal Influenza A (H3N2) Virus Infections." Excerpts of the advisory are reprinted below.


SUMMARY
Influenza A (H3N2) virus infections have been recently detected in people in a number of states across the U.S., including two small localized outbreaks. Sporadic cases of influenza and localized summer outbreaks from seasonal influenza viruses are detected each summer. Clinicians are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illnesses, including pneumonia, even during the summer months. Treatment decisions should not be made on the basis of a negative rapid influenza diagnostic test result since the test has only moderate sensitivity. False positive results also can occur, particularly at times when overall influenza prevalence is low. For patients for whom laboratory confirmation is desired, or to confirm initial influenza cases in a community in which cases have been tested by rapid influenza diagnostic tests, it is recommended that reverse transcriptase-polymerase chain reaction (RT-PCR), and/or viral culture is utilized. Clinicians should use empirical treatment with influenza antiviral medications for persons hospitalized with suspected influenza, and for suspected influenza infection of any severity in high-risk individuals, regardless of influenza immunization status. Early initiation of treatment provides more optimal clinical responses, although treatment of moderate, severe, or progressive disease begun after 48 hours of symptoms can still provide benefit. . . .

RECOMMENDATIONS
Healthcare providers are reminded to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illnesses, including pneumonia, even during the summer months. The neuraminidase inhibitors oseltamivir (Tamiflu) and zanamivir (Relenza) are currently recommended for use against circulating influenza viruses. The adamantanes (amantadine and rimantadine) are not recommended because of high levels of resistance to these drugs among recently circulating influenza A (H3) and 2009 H1N1 pandemic viruses.

Clinical judgment is an important factor in treatment decisions for patients presenting with influenza-like illness. Prompt empiric antiviral treatment with influenza antiviral medications is recommended while results of definitive diagnostic tests are pending, or if diagnostic testing is not possible, for patients with clinically suspected influenza illness who have:
  • Illness requiring hospitalization,
     
  • Progressive, severe, or complicated illness, regardless of previous health status, and/or
     
  • Patients at increased risk for severe disease.

Persons at high risk of influenza complications include people aged 65 years and older, young children, pregnant women, people with long-term health conditions like asthma, diabetes, neurologic and neuro-developmental disorders, heart disease, and people with immunosuppressive conditions or medications.

Antiviral treatment, when clinically indicated, should not be delayed pending definitive laboratory confirmation of influenza. Influenza antiviral medications are most effective when initiated within the first 2 days of illness, but these medications may also provide benefits for severely ill patients when initiated even after 2 days. Point of care rapid tests capable of detecting influenza A and B virus infections are available, but healthcare providers and public health personnel should be aware that rapid influenza diagnostic tests have limited sensitivity and false negative results are common. Thus, negative results from rapid influenza diagnostic test should not be used to guide decisions regarding treating patients with influenza antiviral medications. In addition, false positive tests can occur and are more likely when influenza is rare in the community. When laboratory confirmation is desired, testing by RT-PCR and/or viral culture is recommended.

Providers are asked to report unusual increases in febrile respiratory disease outbreaks to their local and state health departments and to confirm positive rapid test results with PCR or culture when community circulation of influenza viruses is low.

FOR MORE INFORMATION
More information on influenza prevention, diagnosis and treatment can be found at http://www.cdc.gov/flu Beginning this influenza season, the Advisory Committee on Immunization Practices (ACIP) recommends influenza vaccination of all persons 6 months of age and older. These updated recommendations can be found at http://www.cdc.gov/mmwr/pdf/rr/rr5908.pdf

To access the complete text of the CDC Health Advisory, go to: http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00316

Back to top
   
3 CDC publishes ACIP influenza recommendations in MMWR Recommendations and Reports

CDC published "Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2010" in the August 6 issue of MMWR. This report was previously published as an MMWR Early Release on July 29, and was previously covered in IAC Express on August 2.

To access the recommendations, go to: http://www.cdc.gov/mmwr/pdf/rr/rr5908.pdf

Back to top
   
4 CDC updates information on supply of Hib and hepatitis B vaccines

On August 3, CDC posted updated information about the availability of Hib and adult hepatitis B vaccines and their combination products. The information is reprinted below.


Hib: Effective July 1, 2009, CDC, in consultation with ACIP, AAFP, and AAP, recommended reinstatement of the booster dose of Hib vaccine for children aged 12 through 15 months who have completed the primary 3-dose series. Based on available supply, providers are now recommended to recall children in need of a booster dose. Currently available Hib vaccine products include monovalent Hib vaccines from GSK (Hiberix, licensed for use as the booster dose only); Merck (PedvaxHIB); and sanofi pasteur (ActHIB). Currently available Hib-containing combination vaccines include sanofi pasteur's Pentacel (DTaP-IPV/Hib) and Merck's Comvax (Hep B-Hib). The combination product from sanofi pasteur (DTaP-Hib, TriHIBit) is currently not available.

Hepatitis B: As of August 2, 2010, Merck's dialysis formulation of their hepatitis B vaccine (Recombivax) is now available. Production and supply of GSK's adult hepatitis B vaccine (Adult Engerix-B) and Adult hepatitis A/hepatitis B combination vaccine (Twinrix) currently are sufficient to meet demand for routine adult usage of this vaccine as well as CDC's ongoing High Risk Adult Hepatitis B Initiative.

For continuing vaccine supply information, go to: http://www.cdc.gov/vaccines/vac-gen/shortages

Back to top
   
5 IAC updates screening questionnaires and standing orders for seasonal influenza vaccination

IAC recently revised the following four handouts for healthcare professionals to use during the 2010-11 influenza season.

(1) IAC made minor edits to "Screening Questionnaire for Inactivated Injectable Influenza Vaccination." Go to: http://www.immunize.org/catg.d/p4066.pdf

(2) IAC added one question to "Screening Questionnaire for Live Attenuated Intranasal Influenza Vaccination" and made other minor edits. Go to: http://www.immunize.org/catg.d/p4067.pdf

(3) IAC updated "Standing Orders for Administering Seasonal Influenza Vaccine to Adults" to take into account the ACIP recommendation to vaccinate all people age 6 months and older. Go to: http://www.immunize.org/catg.d/p3074.pdf

(4) IAC updated "Standing Orders for Administering Seasonal Influenza Vaccines to Children & Adolescents" to take into account the ACIP recommendation to vaccinate all people age 6 months and older. Go to: http://www.immunize.org/catg.d/p3074a.pdf

Standing orders for all other routinely administered vaccines are available at http://www.immunize.org/standing-orders

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

Back to top
   
6 CDC Health Advisory Network notifies providers about shortened shelf life of sanofi pasteur's H1N1 2009 monovalent influenza vaccine in multi-dose vials

On August 6, CDC issued a Health Advisory titled "Sanofi pasteur Influenza A (H1N1) 2009 Monovalent Vaccine in Multi-Dose Vials--Shortened Shelf Life." Excerpts from the advisory are reprinted below.


SUMMARY
Sanofi pasteur has notified CDC and FDA that their influenza A (H1N1) 2009 monovalent vaccine manufactured in 2009 in multi-dose vials will have a shorter expiration period than indicated on the label, and they will provide more specific notification of which lots will be affected and the new expiration date in the very near future. 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 were immunized with sanofi pasteur influenza A (H1N1) 2009 monovalent vaccine from multi-dose vials do not need to take any action.

2009 H1N1 viruses, along with influenza A H3N2 viruses and influenza B viruses are circulating internationally. While it cannot be known in advance which influenza viruses will predominate in any given year, the 2009 H1N1 virus, along with influenza A H3N2 viruses and influenza B viruses may circulate in the United States during its upcoming influenza season. The 2010-2011 influenza vaccine will protect against an influenza A H3N2 virus, an influenza B virus, and the 2009 H1N1 virus. Initial shipping of the 2010-2011 influenza vaccine has begun.

BACKGROUND
. . . Sanofi pasteur influenza A (H1N1) 2009 monovalent vaccine in multi-dose vials is the only remaining presentation of monovalent 2009 H1N1 influenza vaccine whose expiration date has not yet passed.

Sanofi pasteur will send a notification to providers who received this product regarding the specific lot numbers and the new expiration date.

FOR MORE INFORMATION
For Questions and Answers on Using Monovalent 2009 Influenza A (H1N1) Vaccine Prior to the Availability of Trivalent 2010-11 Seasonal Influenza Vaccine, go to: http://www.cdc.gov/flu/about/qa/infohealthcare.htm

Questions about the Federal H1N1 Influenza Vaccine Central Recovery Program should be directed to state immunization programs or the HHS Supply Service center (1-800-642-0263, 7:00 am to 7:00 pm EST).

For other inquiries, please contact sanofi pasteur Customer Services:

1-800-VACCINE (1-800-822-2463) or visit: http://www.vaccineshoppe.com

To access the complete text of the CDC Health Advisory online, go to: http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00317

Back to top
   
7 IAC's Video of the Week features an original song about vaccination

IAC encourages IAC Express readers to watch a 3.5-minute video titled "The Vaccine Song," created by Brain Warm-Ups Entertainment (http://brainwarmups.com). This original musical number teaches viewers about the importance of vaccination and counters anti-vaccine arguments, all in an entertaining manner.

The video will be available on the home page of IAC's website through August 15. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week. After this date, the video will continue to be available at http://thevaccinesong.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

Back to top
   
8 IAC updates "Pneumococcus: Questions and Answers"

IAC recently revised "Pneumococcus: Questions and Answers," a resource for both healthcare professionals and their patients. The piece was updated to take into account the licensure of PCV13 vaccine.Go to: http://www.immunize.org/catg.d/p4213.pdf

To access a table with links to IAC's Q&A handouts for each vaccine, go to: http://www.immunize.org/handouts/vaccine-questions.asp

Back to top
   
9 "CDC Features" educates the public about shingles vaccination

The "CDC Features" web section includes new information for the public about preventing shingles with vaccination.

To access "Protect Yourself against Shingles: Get Vaccinated," go to: http://www.cdc.gov/Features/Shingles

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

Back to top
   
10.  Texas Immunization Summit scheduled for September 30-October 1 in Fort Worth

The 2010 Texas Immunization Summit is scheduled for September 30-October 1, in Fort Worth. The summit will bring together stakeholders from all over the state, including physicians, nurses, and public health officials.

For more information, go to: http://www.immunizeusa.org

Back to top
   
11.  Hepatitis Foundation International summits to be held in four locations this fall

Hepatitis Foundation International will host four viral hepatitis summits this fall, beginning September 10 in Atlanta. Subsequent programs will be held in New Orleans, Indianapolis, and Richmond. For more information, go to: http://www.hepfi.org/summit%20page/index-summit.htm

Back to top
   
Immunization Action Coalition  •  2550 University Avenue West  •  Suite 415 North  •  Saint Paul, Minnesota  •  55114
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.