Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 272            September 7, 2001

CONTENTS OF THIS ISSUE

  1. Providers urged to reassess flu vaccine orders, checking for overestimates, in a letter from Walter A. Orenstein, MD, Director, National Immunization Program
  2. CDC'S National Immunization Program releases influenza bulletin #7
  3. Reminder! CDC's Immunization Update 2001 satellite broadcast set for September 20
  4. National Immunization Program issues Q & A for parents and providers in response to recently published article in New England Journal of Medicine (August 30, 2001) titled "The Risk of Seizures After Receipt of Whole-Cell Pertussis or Measles, Mumps, and Rubella Vaccine"
  5. CDC publishes report on polio eradication efforts in the South-East Asia Region
  6. Advance registration deadline approaching for APHA annual meeting, October 21-25, Atlanta
  7. Third World Congress on Vaccines and Immunisation set for June 4-9, 2002, in Opatija, Adriatic Riviera, Croatia

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(1)
August 30, 2001
PROVIDERS URGED TO REASSESS FLU VACCINE ORDERS, CHECKING FOR OVERESTIMATES, IN A LETTER FROM WALTER A. ORENSTEIN, MD, DIRECTOR, NATIONAL IMMUNIZATION PROGRAM

Dr. Orenstein lays out a four-part plan designed to minimize the potential adverse effects of an influenza vaccine delay this year. His letter is reprinted below in its entirety.

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August 30, 2001

Dear Health Care Provider:

I am writing to ask for your help in maximizing influenza vaccine health benefits and minimizing possible disruptions due to influenza vaccine distribution delays.

CDC previously encouraged those of you with high risk patients to order vaccine early, to help manufacturers and distributors gauge demand and  improve the opportunity to immunize high risk individuals as early in the season as possible. We are pleased to learn that many of you followed that advice. Manufacturers have reported that even though current projections of the total vaccine supply expected for this year exceed that of prior years, all anticipated influenza vaccine has been obligated much earlier than has previously been the case. (Some vaccine may still be available from distributors.)

Because orders were placed much earlier this year, we believe that some providers may have over-estimated their anticipated vaccine needs for the upcoming season and ordered more vaccine than needed. Given the limited amount of vaccine that will be available prior to November, along with the fact that vaccination of lower risk individuals should be deferred until November when supplies should increase, we are now asking that you reassess your needs. If you find that your influenza vaccine order over-estimates your needs, or if orders were placed with multiple suppliers, prompt notification of  your actual needs to your vaccine providers (i.e., manufacturers or distributors), will facilitate a broader distribution of vaccine to providers with high risk patients.

Immunization with influenza vaccine is the best means of preventing serious complications from influenza infection. During an average influenza season, approximately 20,000 deaths and approximately 114,000 hospitalizations result from influenza-related complications. Persons at greatest risk from influenza include those 65 years of age [and older], those in nursing homes, and those with certain chronic diseases, particularly of the lungs and heart.

Influenza vaccination typically takes place in October through mid November before there is significant influenza activity. The optimal period for immunization is October through the end of November. Nevertheless, many persons at high risk of influenza-related complications remain unvaccinated after this time period and vaccination in December and later can still be beneficial. During the last 19 years, influenza peaked in December during 4 seasons and January or later in 15 seasons.

During the 2001-2002 influenza season, the three influenza vaccine manufacturers are predicting that the overall number of doses to be produced will be greater than in past years, resulting in about 79 million doses. However, there will be a substantial delay with 47.8 million doses of vaccine projected to be distributed by the end of October (60% of projected season totals). Often, over 99% of vaccine doses are distributed by the end of October. However, current projections indicate the difference this year will be made up with increased production and distribution of more than 31 million doses in November and December.

The following plan, based on four primary principles, is designed to minimize the potential adverse effects of an influenza vaccine delay:

  • TARGET USE OF VACCINE AVAILABLE EARLY IN THE SEASON TO PERSONS AT GREATEST RISK OF COMPLICATIONS FROM INFLUENZA.
       
    This will facilitate vaccination of persons most in need of protection from influenza in the unlikely event of an early influenza disease epidemic.
       
  • DISTRIBUTE A PORTION OF VACCINE EARLY TO ALL PROVIDERS.
       
    All providers are likely to serve some high-risk patients and having some early vaccine will enable them to vaccinate at least some of those individuals.
       
  • DEFER VACCINATION OF LOW RISK PERSONS UNTIL NOVEMBER WHEN VACCINE SUPPLIES SHOULD INCREASE.
       
    Such a step encompasses deferral of vaccine distribution to work site clinics until November since those clinics largely vaccinate persons at low-risk for influenza complications. It also includes asking persons at low-risk of influenza-related complications to delay seeking vaccination until November.
       
  • EXTEND THE RECOMMENDED OPTIMAL TIME FOR VACCINATION FROM OCTOBER THROUGH THE END OF NOVEMBER AND ENCOURAGE CONTINUED VACCINATION THROUGH DECEMBER AND LATER, AS LONG AS VACCINE IS AVAILABLE.
        
    This will facilitate effective utilization of vaccine that becomes available later in the season and will help increase vaccination levels in high-risk and targeted populations.
       
    Achieving influenza vaccination goals will require the combined actions of vaccine providers; the public; manufacturers, distributors, and vendors; and health departments and other organizations providing vaccine. The participation of all groups who are involved in the spectrum of influenza immunization activities is essential to the success of the plan.
       
    For updated information about influenza availability as the season progresses, we urge you to check our website at http://www.cdc.gov/nip/flu/. We appreciate your efforts to ensure individuals at high risk of complications from influenza are appropriately  targeted for immunization and thank you for your consideration in this important public health matter.

Walter A. Orenstein, MD
Assistant Surgeon General
Director
National Immunization Program
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(2)
August 31, 2001
CDC'S NATIONAL IMMUNIZATION PROGRAM RELEASES INFLUENZA VACCINE BULLETIN #7

On August 31, 2001, the National Immunization Program (NIP) issued the seventh 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.

To obtain a camera-ready version (PDF file) of bulletin #7, go to: http://www.immunize.org/news.d/flubull7.pdf

For previous influenza vaccine bulletins, visit: http://www.cdc.gov/nip/flu/News.htm#bulletin

The latest information regarding influenza vaccine issues is available on CDC's website: http://www.cdc.gov/nip/flu/
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(3)
September 7, 2001
REMINDER! CDC'S IMMUNIZATION UPDATE 2001 SATELLITE BROADCAST SET FOR SEPTEMBER 20

The Centers for Disease Control and Prevention (CDC) has scheduled Immunization Update 2001, an interactive satellite videoconference, for September 20, 2001. The broadcast will air twice, from 9 to 11:30 a.m. and again from 12 to 2:30 p.m., Eastern Time.

The program will offer the latest immunization recommendations and will also feature a question-and-answer session via toll-free telephone with medical epidemiologists William Atkinson, MD, MPH, and Raymond Strikas, MD, and nurse educator Donna Weaver, MN, RN, all from CDC's National Immunization Program. Anticipated topics include pneumococcal conjugate vaccine, influenza vaccine, the national shortage of tetanus and diphtheria toxoids, meningococcal vaccine, hepatitis B vaccine for adolescents, global polio eradication, and recent vaccine safety issues.

The target audience includes health professionals such as physicians, nurses, physician assistants, nurse practitioners, pharmacists, medical students, and others who provide vaccination and vaccine information. Continuing education credit will be offered.

For more information on registration and the technical specifications for the broadcast, go to CDC's website at: http://www.cdc.gov/phtn/imm2001/ or contact your state or county immunization program. A list of state immunization program satellite broadcast distance learning coordinators is available on the website of CDC's National Immunization Program at: http://www.cdc.gov/nip/ed/coordinators.htm For questions about registration, call (800) 418-7246 (800-41-TRAIN).

For questions about the program content of this broadcast, contact Craig Wilkins at (404) 639-8799 or e-mail ckw4@cdc.gov

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/
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(4)
August 30, 2001
NATIONAL IMMUNIZATION PROGRAM ISSUES Q & A FOR PARENTS AND PROVIDERS IN RESPONSE TO RECENTLY PUBLISHED ARTICLE IN NEW ENGLAND JOURNAL OF MEDICINE (AUGUST 30,2001) TITLED "THE RISK OF SEIZURES AFTER RECEIPT OF WHOLE-CELL PERTUSSIS OR MEASLES, MUMPS, AND RUBELLA VACCINE"

William E. Barlow, PhD, and colleagues at the Centers for Disease Control and Prevention Vaccine Safety Datalink Working Group examined the risk of seizures after the receipt of diphtheria, tetanus, and whole-cell pertussis (DTP) and measles, mumps, and rubella (MMR) vaccinations. NIP experts provide the following summary of the study:

"Parents concerned about the link between childhood vaccinations and seizures need not worry, according to the results of this study. The study found that children who suffered rare fever-related seizures after getting DTP (diphtheria, tetanus, and whole-cell pertussis) and MMR (measles, mumps, and rubella) vaccinations did not have an increased risk for subsequent seizures or neurodevelopmental (e.g., learning) disabilities. The study did confirm what was already known--that DTP and MMR vaccinations can temporarily increase the risk for fever-related, or what are called "febrile" seizures, in some children. Since the period covered by this study, the use of acellular pertussis (DTaP) vaccine has replaced DTP vaccine in the United States. DTaP has been associated with fewer side effects than DTP, including febrile seizures."

This summary and the prepared questions-and-answers are available on the NIP website.

To obtain a copy of this summary, go to:
http://www.cdc.gov/nip/issues/mmr-dtp/mmr-dtp.htm

To obtain a copy of NIP's Q & A, go to:
http://www.cdc.gov/nip/issues/mmr-dtp/mmr-dtp-faqs.htm

To read or download a copy of the article abstract (N Engl J Med 2001;345[9]:656-661), go to: http://content.nejm.org/cgi/content/short/345/9/656
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(5)
August 31, 2001
CDC PUBLISHES REPORT ON POLIO ERADICATION EFFORTS IN THE SOUTH-EAST ASIA REGION

The South-East Asia Region of the World Health Organization (WHO) is on the verge of eradicating wild polioviruses, according to a report published in the August 31, 2001, issue of Morbidity and Mortality Weekly Report (MMWR). This report summarizes polio eradication activities during January 2000 to June 2001 in the South-East Asia Region, where wild poliovirus transmission has declined rapidly and is occurring primarily in northern India.

To obtain the full text of this article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5034a3.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5034.pdf

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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(6)
September 7, 2001
ADVANCE REGISTRATION DEADLINE APPROACHING FOR APHA ANNUAL MEETING, OCTOBER 21-25, ATLANTA

Pre-registration ends September 14, 2001, for the American Public Health Association (APHA) annual meeting on October 21-25 in Atlanta.

Featured speakers include Dr. Gro Harlem Brundland, Director-General of the World Health Organization; Rosalyn Carter, former First Lady; and Dr. Louis Sullivan, former Secretary of Health and Human Services.

For registration materials or further information, call (514) 228-3009, e-mail APHA@laser-registration.com or visit the APHA website at http://www.apha.org/meetings/

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/
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(7)
September 7, 2001
THIRD WORLD CONGRESS ON VACCINES AND IMMUNISATION SET FOR JUNE 4-9, 2002, IN OPATIJA, ADRIATIC RIVIERA, CROATIA

The Third World Congress on Vaccines and Immunisation is being organized by the Infections Control World Organization under the auspices of the Ministry of Health, Republic of Croatia.

The deadline for closing registration and hotel reservation is February 20, 2002. For registration materials or further information, e-mail Prof. Dr. Edouard Kurstak at kurstak@sympatico.ca, or visit the Congress at http://www3.sympatico.ca/kurstak/icwo/

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 December 28, 2001