Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 250            June 6, 2001

CONTENTS OF THIS ISSUE

  1. CDC's National Immunization Program issues influenza vaccine bulletin
  2. CDC publishes MMWR issue on HIV/AIDS
  3. CDC seeks proposals for primary care physician immunization survey

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(1)
June 6, 2001
CDC'S NATIONAL IMMUNIZATION PROGRAM ISSUES INFLUENZA VACCINE BULLETIN

On May 29, 2001, the National Immunization Program of the Centers for Disease Control and Prevention (CDC) issued the first in a series of influenza vaccine bulletins designed to update health professionals on the production, distribution, and administration of influenza vaccine for the 2001-2002 influenza season. The bulletin is reprinted below in its entirety.

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INFLUENZA VACCINE BULLETIN #1 MAY 29, 2001

The National Immunization Program (NIP) of the Centers for Disease Control and Prevention (CDC) is publishing and distributing a periodic bulletin to update partners about recent developments related to the production, distribution and administration of influenza vaccine for the 2001-2002 influenza season. All recipients of this bulletin are encouraged to distribute each issue widely to colleagues, members and constituents.


INFLUENZA VACCINE SUPPLY/PRODUCTION

Influenza vaccine manufacturers periodically update their influenza vaccine production projections.

At different points in the production process, influenza vaccine manufacturers project how much influenza vaccine they are going to produce. Completion of various steps in the manufacturing process provides data that allow the projections to be refined over time. Although still relatively early in the process, all three companies recently provided updated projections which suggest that this year's production may at least approximate last year's. Nevertheless, officials at FDA caution that the projections assume that no difficulties are encountered during the remainder of production. They stress that the final yields cannot be known until production is completed.


INFLUENZA VACCINE DISTRIBUTION

Annual contingency planning for the possibility of an influenza vaccine production delay or shortfall is essential.

Each year, as new influenza viruses emerge, influenza vaccine manufacturers must produce a new vaccine containing one or more viruses that differ from the previous year's formulation. Because of the challenges these emergent viruses pose to the vaccine manufacturers and the FDA, and the many other uncertainties inherent in influenza vaccine production, definitive information about annual influenza vaccine production usually will not be available until late summer or early fall. Thus, CDC recommends that all organizations and institutions involved in distributing and administering influenza vaccine annually develop contingency plans. These plans should address problems that would result should a shortfall in vaccine production or a delay in vaccine distribution occur. CDC has asked State health departments to develop plans that include, among other elements, communication with partners and voluntary reallocation of vaccine where needed. The plans will ensure that in the event of a shortfall, vaccine could be targeted to high-risk patients and if distribution of vaccine is delayed, all providers could at least begin their vaccination efforts in their high-risk patients.

A delay in vaccine distribution may impact different providers differently. Providers with high-risk patients should order vaccine now.

Because influenza vaccine is newly produced for each influenza season, numerous factors may affect each manufacturer's vaccine production and distribution. If some manufacturers are delayed in getting their vaccine to their customers, uneven distribution of the vaccine will result with providers who ordered from one manufacturer possibly receiving vaccine later than providers who ordered from another. Further, providers who order late may receive vaccine late. Providers who order from third party distributors will be dependent upon which manufacturer is supplying that distributor.

If a vaccine shortfall or delay in distribution occurs, mass vaccination clinics should follow the recommendations of the Advisory Committee on Immunization Practices (ACIP) and CDC's "Best Practices."

An important change in the ACIP recommendations is to extend the optimal time for vaccinating high-risk individuals from mid-November to the end of November, but realize that immunization attempts should continue into January if necessary. For a copy of the entire ACIP influenza recommendations, please refer to the Resources section at the bottom of this bulletin. A copy of CDC's "Best Practices" is also attached.


INFLUENZA VACCINE COMMUNICATIONS

As the season progresses and more information is obtained regarding influenza vaccine issues, CDC will provide that information at its website at http://www.cdc.gov/nip/issues/flu


RESOURCES

ACIP influenza recommendations:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5004a1.htm


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BEST PRACTICES FOR MASS INFLUENZA VACCINATION CAMPAIGNS: ENSURING THAT PERSONS AT HIGH RISK AND THEIR HOUSEHOLD CONTACTS ARE VACCINATED


GENERAL STRATEGIES

  • Develop liaisons with community groups representing the elderly and those with chronic diseases (e.g., offer incentives for groups to attend clinics, ask for volunteers to help promote and run clinics).
      
  • Share information about vaccine availability with other clinics/facilities providing flu vaccine in your community. Inform clients about other locations where vaccine is available.
      
  • Schedule and publicize special "senior clinics" when only  elderly or other high-risk patients will be accepted.
      
  • Schedule flu vaccine delivery during daytime hours when the elderly, and other high-risk patients, have less need to compete with younger, healthy clients for a place in line at the vaccination location.
      
  • Workplace sites can offer vaccination to elderly and chronically ill employees and relatives of persons in the workplace.
      
  • Promote the campaign by publishing "public service" announcements in local media stressing a commitment to first serve the high-risk population and asking healthy people to cooperate by waiting for availability of vaccine. Include up-to-date information about expected availability of more vaccine and about flu activity (or lack thereof) in the community.
      
  • Share vaccine with other providers (e.g., hospitals, nursing homes, physicians) who see high-risk patients.

 

AT THE VACCINATION LOCATION . . .

  • Establish criteria for identifying high-risk individuals and those living with them, and ensure that they receive top priority.
      
  • Develop a brief questionnaire or checklist to enable prospective vaccinees to determine their risk status, and encourage those not at high risk to return in December or later.
      
  • Post notices (or personnel) asking healthy people to defer their flu shots so high-risk people can be protected with available vaccine. Give people the opportunity to defer before they have started to wait in line.
      
  • Establish "express lanes" for elderly and high-risk patients to reduce the amount of time they have to stand in line to receive the vaccine.
      
  • Offer incentives for non-high-risk patients who accept a "rain check" to return at a later date for their shots.
       
  • Keep customers informed. Post notices informing clients of hours of flu vaccine clinics and of the need to vaccinate high-risk patients first. Assure them (if appropriate) that additional shipments of vaccine are expected. Post information about other locations where vaccine is available.

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To obtain a camera-ready copy (PDF format) of "Best Practices for Mass Influenza Vaccination Campaigns," go to: http://www.immunize.org/cdc/cdcflu2.pdf
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(2)
June 6, 2001
CDC PUBLISHES MMWR ISSUE ON HIV/AIDS

The June 1, 2001, issue of "Morbidity and Mortality Weekly Report" (MMWR), published by CDC, is devoted to "new reports on the epidemiologic features and impact of HIV/AIDS on communities in the United States and in other countries." The issue includes the following stories:

First Report of AIDS:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5021a1.htm

HIV and AIDS--United States, 1981-2000:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5021a2.htm

The Global HIV and AIDS Epidemic, 2001:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5021a3.htm

HIV Incidence among Young Men Who Have Sex with Men--Seven U.S. Cities, 1994-2000:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5021a4.htm

Notice to Readers: The 20th Year of AIDS: A Time to Re-Energize Prevention:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5021a5.htm

A compilation of notable MMWR reports on HIV and AIDS is available at
http://www.cdc.gov/mmwr/hiv_aids20.html

AIDS video commentary and report summaries are available on the CDC website. Video clips include interviews with participants in CDC's first AIDS investigations and reports. Go to:
http://www.cdc.gov/mmwr/hiv_video.html

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://www.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)
June 6, 2001
CDC SEEKS PROPOSALS FOR PRIMARY CARE PHYSICIAN IMMUNIZATION SURVEY

CDC is seeking proposals to obtain longitudinal and nationally representative data on the attitudes and practices of pediatricians, family physicians, and their patients regarding vaccination.

Data will be used to characterize rates and types of concerns regarding safety of childhood vaccinations and measure provider and parent confidence in the safety of vaccines; identify parents' questions and concerns about alleged side effects; and assess patient education methods and materials used in childhood immunizations.

The project involves developing a collection instrument, collecting and analyzing data, and preparing various reports. Period of performance is 48 months.

More information, including the request for proposals (RFP), is available online at: http://www.eps.gov/spg/HHS/CDCP/PGOA/2001-N-00086/listing.html

For further information, contact Wanda Allison at CDC by telephone at (770) 488-2645 or by email at WAllison@cdc.gov

 

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 June 6, 2001