Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 151            March 28, 2000

CONTENTS OF THIS ISSUE

  1. CDC publishes "Recommendations and Reports" on strategies to increase adult immunization rates
  2. CDC publishes report on rubella outbreaks among Hispanic adults
  3. Most recent polio VIS (1-1-00) now available in 22 languages on IAC's website!
  4. Check out these resources for National Infant Immunization Week, including a new Spanish-language campaign
  5. "Advances in Childhood Disease Prevention" teleconference is offered April 17 until May 18, 2000
  6. Protecting college students from meningococcal disease is the focus of California's satellite broadcast in May
  7. New resource! IAC adds "CDC Resources You Should Know About" web page
  8. New resource! IAC adds "Vaccine Safety" web page

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(1)
March 24, 2000
CDC PUBLISHES "RECOMMENDATIONS AND REPORTS" ON STRATEGIES  TO INCREASE ADULT IMMUNIZATION RATES

Strategies for successful adult immunization efforts are the focus of a new issue of "MMWR Recommendations and Reports" published by the Centers for Disease Control and Prevention (CDC) on March 24, 2000. In this MMWR issue, CDC has combined two important documents. First, CDC presents a report of the National Vaccine Advisory Committee (NVAC) titled "Adult Immunization Programs in Nontraditional Settings: Quality Standards and Guidance for Program Evaluation." Following this report are recommendations of the Advisory Committee on Immunization Practices titled "Use of Standing Orders Programs to Increase Adult Vaccination Rates."

According to the "Conclusion" of the NVAC report, "The efforts that effectively lowered vaccine-preventable disease rates among children now need to be targeted toward developing new and effective immunization programs that will make appropriate vaccines readily accessible to adults."

Both of the documents in this MMWR issue provide information on practical programs for vaccinating adults at every opportunity. The following sections describe their content.

1. ADULT IMMUNIZATION PROGRAMS IN NONTRADITIONAL SETTINGS: QUALITY STANDARDS AND GUIDANCE FOR PROGRAM EVALUATION (A Report of the National Vaccine Advisory Committee)

The "Summary" of this report reads:
"This report provides a summary of the National Vaccine Advisory Committee's (NVAC) workshop on adult immunization programs in nontraditional settings, quality standards for such programs, and guidance for program evaluation. Throughout the United States, an increasing number of adults are receiving vaccine in nontraditional settings (e.g., pharmacies and churches). Immunization programs in nontraditional settings are often more accessible and convenient than a health-care provider's office or a public health clinic, especially for medically underserved adults (e.g., economically disadvantaged, inner city, and minority populations). Medically underserved adults might be at particular risk for undervaccination because they are often without a medical home (i.e., a regular point of contact where their health-care needs are met). Immunization programs in nontraditional settings might enhance the capacity of the health-care system to effectively deliver vaccine to adults by increasing the number and types of sites where adults can receive vaccine. NVAC has recognized that strategies need to be developed to make vaccines available to all adults and that the number of immunization programs in nontraditional settings is increasing. Therefore, the Committee issues the following report, including quality standards and guidance for program evaluation." 

To obtain the text version (HTML format) of this NVAC report, go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4901a1.htm


2. USE OF STANDING ORDERS PROGRAMS TO INCREASE ADULT VACCINATION RATES (Recommendations of the Advisory Committee on Immunization Practices)

The "Introduction" to these recommendations reads:
"Standing orders programs authorize nurses and pharmacists to administer vaccinations according to an institution- or physician-approved protocol without a physician's exam. These programs have documented improved vaccination rates among adults. Standing orders programs can be used in inpatient and outpatient facilities, long-term-care facilities, managed-care organizations, assisted living facilities, correctional facilities, pharmacies, adult workplaces, and home health-care agencies to vaccinate patient, client, resident, and employee populations. The Advisory Committee on Immunization Practices (ACIP) recommends standing orders for influenza and pneumococcal vaccinations. Recently, systematic literature reviews by the Task Force for Community Preventive Services and the Southern California Evidence-Based Practice Center-RAND endorsed these programs for adult populations. 

"This report briefly reviews the evidence regarding the effectiveness of standing orders programs in improving adult vaccination coverage rates and recommends prioritizing these programs for influenza and pneumococcal vaccinations, to have the greatest impact on the burden of vaccine-preventable diseases in the United States. Standing orders programs are also recommended for other vaccines, including hepatitis B vaccine and diphtheria and tetanus toxoid vaccines, when feasible."

To obtain the text version (HTML format) of these ACIP recommendations, go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4901a2.htm

To obtain both the NVAC report and the ACIP recommendations as a combined camera-ready document (PDF format), go to: ftp://ftp.cdc.gov/pub/Publications/mmwr/rr/rr4901.pdf

For information on how to obtain a free electronic subscription to the MMWR, see the instructions that follow article two below.
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(2)
March 24, 2000
CDC PUBLISHES REPORT ON RUBELLA OUTBREAKS AMONG HISPANIC ADULTS

The Centers for Disease Control and Prevention (CDC) published an article titled "Rubella Among Hispanic Adults--Kansas, 1998, and Nebraska, 1999" in the March 24, 2000, issue of the MMWR. This report describes two workplace-associated outbreaks of rubella, and summarizes the characteristics of recent rubella outbreaks in the United States. The "Editorial Note" for this article reads in part: 

"During 1969-1989, the annual number of reported cases of rubella in the United States decreased 99.6% as a result of a successful childhood vaccination program. Indigenous rubella is targeted for elimination in the United States by the end of 2000. However, approximately two thirds of other countries did not routinely vaccinate against rubella before 1997. Rubella remains endemic in many Latin American countries, and large epidemics of rubella occur periodically. For example, during January-June 1998, approximately 25,000 cases of rubella were reported to the Ministry of Health in Mexico....

"Although rubella is near record low levels in the United States, epidemics continue to occur among susceptible foreign-born adults. Workers born outside the United States are a potentially susceptible population in which outbreaks may occur after importation of the virus from areas outside the United States where rubella is endemic. Vaccinating against rubella in workplaces is a strategy to reach this susceptible population and can be a critical step in eliminating indigenous rubella. Public health professionals, other health-care professionals, and industrial health-care services should design appropriate programs to assure high coverage of foreign-born employees with rubella vaccine."

To obtain the complete text version (HTML format) of this MMWR article, go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4911a1.htm

HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
To obtain a free electronic subscription to the "Morbidity and Mortality Weekly Report" (MMWR), visit CDC's MMWR website at: http://www2.cdc.gov/mmwr Select "Free MMWR Subscription" from the menu at the left of the screen.  Once you have submitted the required information, weekly issues of the MMWR and all new ACIP statements (published as MMWR's "Recommendations and Reports") will arrive automatically by e-mail.
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(3)
March 28, 2000
MOST RECENT POLIO VIS (1-1-00) NOW AVAILABLE IN 22 LANGUAGES ON IAC'S WEBSITE!

The most current polio Vaccine Information Statement (VIS) dated 1-1-00 is now available in 22 languages on the website of the Immunization Action Coalition (IAC). Languages in which this polio VIS is now available include Arabic, Armenian, Cambodian, Chinese, Croatian, English, Farsi, French, German, Hmong, Japanese, Korean, Laotian, Portuguese, Romanian, Russian, Samoan, Serbo-Croatian, Somali, Spanish, Tagalog, and Vietnamese.

This current polio VIS reflects the most recent recommendations of the Advisory Committee on Immunization Practices (ACIP), which support an all-inactivated polio vaccine (IPV) schedule for routine childhood polio vaccination in the United States. Effective January 1, 2000, children should receive IPV at ages 2 months, 4 months, 6-18 months, and 4-6 years. Oral polio vaccine (OPV) is no longer recommended except in special situations.

Regarding the use of the VIS, under federal law anyone who receives a dose of polio vaccine must be given a polio VIS prior to the dose being administered.

To obtain camera-ready copies (PDF format) of any or all of the polio VISs, go to the VIS index page (organized by language) on IAC's website at: http://www.immunize.org/vis/

NOTE: To read the ACIP recommendation titled "Revised Recommendations for Routine Poliomyelitis Vaccination," which was published as a "Notice to Readers" in the July 16, 1999, MMWR, go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4827a4.htm
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(4)
March 28, 2000
CHECK OUT THESE RESOURCES FOR NATIONAL INFANT IMMUNIZATION WEEK, INCLUDING A NEW SPANISH-LANGUAGE CAMPAIGN

National Infant Immunization Week (NIIW) is just around the corner! The theme of this year's NIIW, set for April 16-22, 2000, is "You Gave Them Life, Protect It." Fortunately, many resources are available to help you plan your community's participation in this important event. 

A new Spanish-language public service campaign will be unveiled on April 16 at the NIIW national kickoff in Houston, TX. Advance copies of radio and television media kits, which include Spanish-language public service announcements, are available in limited quantities to official media outlets and affiliates. In addition, Spanish-language t-shirts and posters are available in limited quantities to health professionals and community health organizations that work with Latino communities. To request these materials, call HMA Associates at (202) 342-0676.

The English-language public service campaign and NIIW promotion kit, which will remain the same as last year, are currently available from the Centers for Disease Control and Prevention (CDC). NIIW kits can be requested by sending a fax to (404) 639-8555, or by visiting http://www.cdc.gov/nip/publications/niiw/niiw-order.htm

NOTE: You will need to make two changes to the 1999 NIIW promotion kit once you receive it from CDC. First, because rotavirus vaccine is no longer recommended, the materials in the NIIW kit that refer to the administration of  rotavirus vaccine will need to be edited. In addition, last year's kit contains the 1999 childhood immunization schedule. You will need to remove the 1999 schedule and replace it with the 2000 childhood immunization schedule, which is available in camera-ready version (PDF format) at: http://www.cdc.gov/nip/pdf/child-schedule.pdf

Also available at CDC's website are camera-ready copies (PDF format) of "The Community Guide" and "The Implementation Handbook," which contain activities, ideas, and sample documents that can be used during NIIW and throughout the year to promote immunization. Users should be forewarned that the files are both in excess of 40 pages and may be difficult to download. These documents can be found at: http://www.cdc.gov/nip/publications/niiw/index.htm

Many useful print materials are also available from the Immunization Action Coalition's website. The following materials have been revised for the year 2000 and can be downloaded, reproduced, and distributed free of charge:

"Immunization for Babies"
  Text version (HTML format) available at:
   http://www.immunize.org/catg.d/p4010.htm
  Camera-ready version (PDF format) available at:
  http://www.immunize.org/cat.d/p4010imm.pdf

"When Do Children and Teens Need Vaccinations?"
  Text version (HTML format) available at:
  http://www.immunize.org/nslt.d/n17/when1.htm
  Camera-ready version (PDF format) available at:
  http://www.immunize.org/catg.d/when1.pdf
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(5)
March 28, 2000
"ADVANCES IN CHILDHOOD DISEASE PREVENTION" TELECONFERENCE IS OFFERED APRIL 17 UNTIL MAY 18, 2000

"Advances in Childhood Disease Prevention" is a live teleconference (telephone conference) coming soon to your home or office! Offered on 16 different dates and times from April 17-May 18, 2000, this 30-minute teleconference will provide valuable information about what's new in the 2000 Recommended Childhood Immunization Schedule and will cover emerging trends in polio, pertussis, pediatric influenza, meningitis, and pneumococcal disease.

Part of Montefiore Medical Center's CME teleconference series, the teleconference is a live forum presented by Sharon G. Humiston, MD, MPH, a medical epidemiologist at the National Immunization Program, Centers for Disease Control and Prevention (CDC), and Nancy Rosenstein, MD, a meningitis specialist at CDC's National Center for Infectious Diseases. A 15-minute interactive question-and-answer session will follow each teleconference. CME credit is available through Albert Einstein College of Medicine. CEU credit is offered through the New York State Nurses Association Council on Continuing Education.

To register or to obtain a schedule of teleconference dates and times, call (888) 375-9573 between 9:00 am and 5:30 pm Eastern Time.

For a detailed list of additional upcoming immunization and hepatitis conferences, visit the Immunization Action Coalition's "Calendar of Events" at: http://www.immunize.org/calendar/
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(6)
March 28, 2000
PROTECTING COLLEGE STUDENTS FROM MENINGOCOCCAL DISEASE IS THE FOCUS OF CALIFORNIA'S SATELLITE BROADCAST IN MAY

"Armed with Information: Protecting College Students from Meningococcal Disease" is a live, interactive satellite broadcast for health professionals who want to know more about meningococcal disease prevention and management strategies aimed at the high-risk, college-aged population. Produced by the California Distance Learning Health Network, this program is set for May 18, 2000, from 9:00 am to 10:30 am Pacific Time.

This course will address the history and changing epidemiology of meningococcal disease in the United States as well as specific risk factors for the disease, and will emphasize the importance of providing information about and access to vaccination for college-bound students and their parents. A question-and-answer session, in which participants can interact with infectious disease experts via toll-free telephone lines, will be included in this broadcast. Course instructors include William Schaffner, MD, professor and chair, Department of Preventive Medicine, Vanderbilt School of Medicine; and Georges Peter, MD, director, Division of Pediatric Infectious Diseases, Rhode Island Hospital, professor of Pediatrics, Brown University School of Medicine.

CME and CEU credit will be available for participation in this program. For more information on registration or locations where you can view this broadcast, contact the California Distance Learning Health Network at (619) 594-3348 or by e-mail at cdlhn@mail.sdsu.edu

For a detailed list of additional upcoming immunization and hepatitis conferences, visit the Immunization Action Coalition's "Calendar of Events" at: http://www.immunize.org/calendar/
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(7)
March 28, 2000
NEW RESOURCE! IAC ADDS "CDC RESOURCES YOU SHOULD KNOW ABOUT" WEB PAGE

If you want quick and easy access to information from the Centers for Disease Control and Prevention (CDC) website, check out the new "CDC Resources You Should Know About" page on the website of the Immunization Action Coalition (IAC). Here you will find links to valuable information that IAC references daily when people call us looking for resources.

The page contains links to numerous CDC documents and publications, including recommendations of the Advisory Committee on Immunization Practices (ACIP), Vaccine Information Statements (VISs), current adult and childhood immunization schedules, and other publications on immunization issues. Links are also included for various immunization-related CDC programs and informational websites, including the National Immunization Program (NIP), the Vaccines for Children program, the NIP Vaccine Safety web page, the NIP Immunization Registry Clearinghouse, the National Center or Infectious Diseases' Hepatitis Branch, and the Travelers' Health web page. Other government immunization resource websites are indexed as well, including the National Vaccine Injury Compensation Program and Vaccine Adverse Event Reporting System.

To visit IAC's "CDC Resources You Should Know About," go to: http://www.immunize.org/news.d/cdc-resr.htm
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(8)
March 28, 2000
NEW RESOURCE! IAC ADDS "VACCINE SAFETY" WEB PAGE

If you have questions or concerns about vaccine safety, be sure to visit the new "Vaccine Safety" page on the website of the Immunization Action Coalition (IAC). This page includes links to more than two dozen publications and websites that provide recent and reliable information about this important issue. Links are provided to general resources on vaccine safety, as well as to information on specific topics of concern such as hepatitis B vaccine, autism, thimerosal, fetal tissue research, and anthrax vaccine.

To visit IAC's "Vaccine Safety" web page, go to: http://www.immunize.org/genr.d/vaxsafe.htm

 

Immunization Action Coalition1573 Selby AvenueSt. Paul MN 55104
E-mail: admin@immunize.org Web: http://www.immunize.org/
Tel: (651) 647-9009Fax: (651) 647-9131

This page was updated on March 28, 2000