Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 261            July 18, 2001

CONTENTS OF THIS ISSUE

  1. CDC announces influenza vaccine delays for 2001-02 season and supplementary ACIP recommendations
  2. CDC publishes recommendations on the control and prevention of rubella
  3. CDC publishes report on hepatitis C prevalence among clients of HIV counseling and testing sites
  4. CDC's National Immunization Program releases Influenza Bulletin #4
  5. New Chinese translation of "Screening Questionnaire for Child and Teen Immunization" on IAC's website
  6. New Turkish translation of "Screening Questionnaire for Adult Immunization" on IAC's website
  7. Reminder: CDC's National Immunization Program offers course on vaccine-preventable diseases August 14-15 in Atlanta

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(1)
July 18, 2001
CDC ANNOUNCES INFLUENZA VACCINE DELAYS FOR 2001-02 SEASON AND SUPPLEMENTARY ACIP RECOMMENDATIONS

The Centers for Disease Control and Prevention (CDC) published in the July 13, 2001, issue of Morbidity and Mortality Weekly Report (MMWR), a Notice to Readers titled "Delayed Influenza Vaccine Availability for 2001-02 Season and Supplemental Recommendations of the Advisory Committee on Immunization Practices."

According to the notice, manufacturers expect that nearly 50 million doses of influenza vaccine will be available for delivery by the end of October. This is about 26 million fewer doses than were available in October in 1999. Manufacturers expect to supply another 27 million doses in November and December, however, for a total distribution level higher than last year and comparable with 1999.

Because of the expected delay, the Advisory Committee on Immunization Practices (ACIP) has developed supplemental recommendations for influenza vaccination, in hopes that people at highest risk for severe flu and complications and their health care providers receive the vaccine early. These recommendations are reprinted below:

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VACCINE PROVIDERS

Providers should target vaccine available in September and October to persons at increased risk for influenza complications and to health-care workers. The optimal time for vaccinating high-risk persons is October through November. To avoid missed opportunities, vaccine also should be offered to high-risk persons when they access medical care in September, if vaccine is available. Vaccinating high-risk persons early can be facilitated through reminder and recall systems, in which such patients are identified and encouraged to come into the office for a vaccination-only visit. Additional information that may help providers implement a reminder/recall system is available at http://www.cdc.gov/nip/flu

Beginning in November, providers should offer vaccine to contacts of high-risk persons, healthy persons aged 50-64 years, and any other persons wanting to reduce their risk for influenza.

Providers should continue vaccinating patients, especially those at high risk and in other target groups, in December and should continue as long as there is influenza activity and vaccine is available. To increase vaccination rates, health-care organizations are encouraged to assess their providers' influenza vaccine use and provide feedback on coverage among persons aged > or equal to 65 years and other high-risk patients.

THE PUBLIC 

Persons at high risk for complications from influenza, including those aged > or equal to 65 years and those aged <65 years who have underlying chronic illnesses, should seek vaccination with their provider when vaccine is available. The optimal vaccination period is October through November but may include September if vaccine is available. Unvaccinated high-risk  persons should continue to seek vaccine later in the season.

Persons who are not at high risk for complications from influenza, including household contacts of high-risk persons, are encouraged to seek influenza vaccine in November and later. Persons who are unsure of their risk status should consult their provider to determine whether they should receive vaccine earlier and, if so, whether vaccine will be available. When additional vaccine is available, providers are encouraged to send a reminder to persons deferred from vaccination.

MANUFACTURERS, DISTRIBUTORS, AND VENDORS

Distribution of vaccine to worksites, where campaigns primarily vaccinate healthy workers, should be delayed until November. Delaying distribution of vaccine to worksites makes more early-season vaccine available to providers of high-risk patients. Manufacturers and distributors should identify worksite orders, or those placing orders should indicate they are doing so for worksites, so arrangements can be made for later vaccine shipment. Delivery of vaccine to hospitals and chronic-care facilities serving high-risk patients should not be delayed.

All providers who have placed orders should receive some early season vaccine. This strategy will ensure that virtually all providers will be able to vaccinate some of their high-risk patients early in the season. As an exception, complete orders for chronic-care facilities serving high-risk populations should be provided early so that vaccine can be administered in October or November, the optimal time for vaccination of this highest risk group.

Manufacturers, distributors, and vendors should inform providers of the amount of vaccine they will be receiving and the date of shipment. This will allow providers to notify high-risk patients when vaccine will be available.

HEALTH DEPARTMENTS AND OTHER ORGANIZATIONS

Organizers of mass vaccination campaigns not in workplaces (e.g., at health departments, clinics, senior centers, and retail stores) should plan campaigns for late October or November or when they are assured of vaccine supply and make special efforts to vaccinate elderly persons and those at high risk for influenza complications. Information that may be used in a campaign setting is available at http://www.cdc.gov/nip/flu

Influenza vaccine service providers should develop contingency plans for possible delays in vaccine distribution. In a delay or shortage, communications among partner organizations and potential redirection of vaccine to high-risk persons in the community will be important. State and local health departments can provide guidance that is appropriate for their population and systems of care.

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To read the complete text of this article online, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5027a3.htm

To read the complete issue of this MMWR in camera-ready (PDF) format, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5027.pdf

To learn how to obtain a free subscription to the MMWR, see the information following story three below.
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(2)
July 18, 2001
CDC PUBLISHES RECOMMENDATIONS ON THE CONTROL AND PREVENTION OF RUBELLA

CDC published "Control and Prevention of Rubella: Evaluation and Management of Suspected Outbreaks, Rubella in Pregnant Women, and Surveillance for Congenital Rubella Syndrome" in the July 13, 2001, issue of "MMWR Recommendations and Reports" (vol. 50, no. RR-12).

The summary of this report is reprinted below:

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SUMMARY
Outbreaks of rubella continue to occur in the United States despite widespread use of the measles-mumps-rubella (MMR) vaccine. Throughout the mid- to late-1990s, rubella outbreaks were characterized by increased numbers of cases among adults born in countries that do not have or have only recently instituted a national rubella vaccination program. To address this change in disease epidemiology, CDC's National Immunization Program (NIP) developed the following recommendations in conjunction with public health officials in the field. Public health officials should implement appropriate responses to reports of suspected rubella to determine if an outbreak exists, evaluate its scope, and implement appropriate control measures. Health-care providers should be aware of the need for rubella prevention and control among women of childbearing age and of the appropriate follow-up for pregnant women exposed to rubella. Comprehensive surveillance for congenital rubella syndrome should begin during a rubella outbreak.

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To obtain the complete statement, go to the following links:

Camera-ready (PDF) format:
http://www.cdc.gov/mmwr//PDF/rr/rr5012.pdf

Text (HTML) format:
http://www.cdc.gov/mmwr//preview/mmwrhtml/rr5012a1.htm

The PDF version of this report includes a free CDC-sponsored continuing education activity that can be completed online or submitted via U.S. mail for CME, CEU, or CNE credit. Simply read the MMWR report, answer the questions at the end, and follow the instructions for submitting your answers.

To learn how to obtain a free subscription to the MMWR, see the information following story three below.
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(3)
July 18, 2001
CDC PUBLISHES REPORT ON HEPATITIS C PREVALENCE AMONG CLIENTS OF HIV COUNSELING AND TESTING SITES

CDC published a report titled "Prevalence of Hepatitis C Virus Infection Among Clients of HIV Counseling and Testing Sites--Connecticut, 1999" in the July 13, 2001, issue of MMWR.

This report found that HIV counseling and testing sites can be important settings for identifying people with risk factors for hepatitis C virus (HCV) infection. More people seeking services in the programs studied in Connecticut had HCV infection than HIV.

According to the report's Editorial Note, "This study documents the potential for integrating services to prevent major bloodborne and sexually transmitted virus infections into existing public HIV CTS [counseling and testing sites]. Risk factors for transmission of these viruses are shared by populations seeking public health services in such sites. Offering HCV counseling and testing as part of existing programs may attract new clients primarily interested in hepatitis screening but who also are at risk for and might accept prevention services for HIV. In addition, HIV CTS can provide hepatitis B vaccination to persons at increased risk for HBV infection. Because of the well-established infrastructure for HIV counseling and testing in public health programs, expanding these services to include prevention of HCV and HBV infection should be feasible. Health-care providers in HIV CTS should be trained to screen actively for risk factors for HIV, HBV, and HCV and to offer prevention education, counseling, and hepatitis B vaccine to clients with risk factors. In substance abuse treatment settings, data from Connecticut indicate that counseling and testing for HIV and HCV should be provided to all clients."

To read the complete text of this report online, including two tables showing HCV prevalence by injection drug user status and selected characteristics, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5027a2.htm

HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR: 
To obtain a free electronic subscription to 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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(4)
July 18, 2001
CDC'S NATIONAL IMMUNIZATION PROGRAM RELEASES INFLUENZA VACCINE BULLETIN #4

On July 12, 2001, the National Immunization Program issued the fourth 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 #4
July 12, 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 AND PRODUCTION

Vaccine manufacturers have provided CDC with updated projections and now expect that 77.1 million doses of influenza will be distributed this season. Some delays in distribution are still anticipated.

  • Projected distribution of influenza vaccine for 2001, based on aggregate manufacturers' estimates as of July 10, is 77.1 million doses, which is greater than in 2000 and comparable with 1999. By the end of October, 49.8 million doses will be available for delivery and 27.3 million doses are projected to be  available in November and December. Delays this year are not expected to be as great as those experienced last season. Nevertheless, officials at FDA and CDC stress that these are early projections from manufacturers and could change as the season progresses.

INFLUENZA VACCINE DISTRIBUTION AND ADMINISTRATION

Supplemental influenza recommendations of the Advisory Committee on Immunization Practices will be published in CDC's Morbidity and Mortality Weekly Report (MMWR) dated July 13, 2001.

  • On the basis of current projections, the Advisory Committee on Immunization Practices (ACIP), is making supplemental recommendations to promote the administration of influenza vaccine that is available early to persons at greatest risk of complications from influenza disease (see Influenza Bulletin #2 for summary). When published, these recommendations can be found at CDC's influenza vaccine website at http://www.cdc.gov/nip/flu

INFLUENZA VACCINE COMMUNICATIONS

The latest information regarding influenza vaccine issues is available on CDC's newly designed website: http://www.cdc.gov/nip/flu

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(5)
July 18, 2001
NEW CHINESE TRANSLATION OF "SCREENING QUESTIONNAIRE FOR CHILD AND TEEN IMMUNIZATION" ON IAC'S WEBSITE

The current version of IAC's "Screening Questionnaire for Child and Teen Immunization" is now available in Chinese. This questionnaire for parents or guardians to fill out is a screening tool for contraindications and precautions to vaccine administration. It includes a companion piece in English explaining why each question is asked.

To obtain a copy of this new Chinese translation, go to: http://www.immunize.org/catg.d/p4060-08.pdf

To obtain a copy of the screening questionnaire in English, go to: http://www.immunize.org/catg.d/p4060scr.htm

IAC appreciates the contributions of the State of New York, which generously provided this new translation.
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(6)
July 18, 2001
NEW TURKISH TRANSLATION OF "SCREENING QUESTIONNAIRE FOR ADULT IMMUNIZATION" ON IAC'S WEBSITE

The "Screening Questionnaire for Adult Immunization" is now available in Turkish translation. This one-page questionnaire for patients provides a screening tool for contraindications and precautions to vaccine administration. It includes a companion piece in English explaining why each question is asked.

To obtain a copy of this screening questionnaire in Turkish, go to: http://www.immunize.org/catg.d/p4065tu.pdf

To obtain it in English, go to: http://www.immunize.org/catg.d/p4065scr.htm

IAC appreciates the contributions of Dr. Mustafa Kozanoglu, pediatrician, and Dr. Murat Serbest, pediatric hematologist, both in a private pediatric practice in Adana, Turkey, who generously provided this new translation.
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(7)
July 18, 2001
REMINDER: CDC'S NATIONAL IMMUNIZATION PROGRAM OFFERS COURSE ON VACCINE-PREVENTABLE DISEASES AUGUST 14-15 IN ATLANTA

Don't miss the August 3 deadline! Register now for "Epidemiology and Prevention of Vaccine-Preventable Diseases," a two-day course presented by CDC's National Immunization Program (NIP) and scheduled for August 14-15 at the Marriott North Central in Atlanta.

Attendees are expected to bring their own textbook, "Epidemiology and Prevention of Vaccine-Preventable Diseases" (sixth edition). Also known as The Pink Book, the text can be ordered for $25 from Public Health Foundation by calling (877) 252-1200 or visiting its online bookstore at http://bookstore.phf.org/prod154.htm It can also be downloaded free from CDC's website at: http://www.cdc.gov/nip/publications/pink/

The cost for the course is $38. Hotel information and course registration forms are available online at: http://www.cdc.gov/nip/ed/epivacaug2001.htm

For a detailed list of additional upcoming immunization and hepatitis conferences and events, visit IAC's "Calendar of Events" at: http://www.immunize.org/calendar/

 

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 July 18, 2001