Issue
Number 324 July 15, 2002
CONTENTS OF THIS ISSUE
- CDC says increased
DTaP, MMR vaccine supplies permit return to
routine schedules
- National
Immunization Program creates new "flu shot
flyers" to give to patients in 2002-2003
- World Health
Organization and UNICEF co-sponsor strategic
plan to reduce measles mortality worldwide
- National Influenza
Summit 2002 presentations and recommendations
are now online
- Register now for CDC
course in Minneapolis on August 28-29!
- New training module
from Children's Vaccine Program: "Immunizing
Children against Hepatitis B"
- World Vaccine
Congress 2002 will convene in Lyon, France, on
September 30-October 2
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July 15, 2002
CDC SAYS INCREASED DTaP, MMR VACCINE SUPPLIES PERMIT
RETURN TO ROUTINE SCHEDULES
On July 12, 2002, the Centers for Disease Control and
Prevention (CDC) published "Notice to Readers:
Resumption of Routine Schedule for
Diphtheria and Tetanus Toxoids and Acellular
Pertussis Vaccine and for Measles, Mumps, and
Rubella Vaccine" in Morbidity and Mortality Weekly Report
(MMWR). This suspends the use of
interim recommendations by the Advisory Committee
on Immunization Practices (ACIP)
developed in response to recent vaccine shortages.
Following is the entire Notice to Readers (excluding
footnotes):
*******************************
Please note: The text of this report [HTML] has been
corrected and does not correspond to the official
electronic PDF version [the version "of record"]. An
erratum to the official version will be published in a
subsequent issue. [In the PDF version, the word
"insufficient" in the second paragraph of the DTaP
section has not yet been changed to
"sufficient."]
Supplies of diphtheria and tetanus toxoids and acellular
pertussis (DTaP) vaccine and measles, mumps,
and rubella (MMR) vaccine in the United
States have become sufficient to permit the
resumption of the routine schedule for DTaP
and MMR use as recommended by the Advisory Committee on
Immunization Practices (ACIP). However,
health-care providers should be advised that, for
the next 2 months, supply
might not be adequate for the initiation of
ambitious recall or special initiative programs. With
increases in national inventory, more
comprehensive recall programs can be established.
Child care and school attendance provisions
requiring children to receive a DTaP booster and a
second dose of MMR vaccine at age 4-6 years
can be reinstituted.
DTaP Vaccine
Three DTaP vaccines are distributed currently in the
United States: Tripedia[R] (Aventis Pasteur,
Swiftwater, Pennsylvania), Infanrix[TM] (GlaxoSmithKline,
Philadelphia, Pennsylvania), and
DAPTACEL[TM] (Aventis Pasteur, Toronto, Ontario).
The Food and Drug Administration (FDA)
approved DAPTACEL[TM] for use in the United
States on May 14, 2002.
During the DTaP vaccine shortage beginning in 2000, ACIP
recommended that health-care providers
vaccinate infants with the initial 3 DTaP doses,
if they did not have sufficient supply of DTaP to
vaccinate all children in their practice.
ACIP also recommended deferral of the fourth and
fifth DTaP doses if supplies were still
inadequate. Supplies are now adequate to resume the full
5-dose schedule for DTaP vaccine.
MMR Vaccine
A temporary shortage of MMR vaccine in the United States
resulted from a voluntary interruption of
manufacturing operations of Merck & Co.,
Inc., the only manufacturer of this vaccine in the
United States. During the vaccine
shortage, ACIP recommended deferral of the second dose of
MMR vaccine at age 4-6 years if
health-care providers were unable to obtain
sufficient amounts of vaccine. The first dose at
age 12-15 months was not to be delayed because of
the severity of measles in young children.
Supplies are now adequate to resume the second
dose of MMR vaccine.
Vaccine Supply
Health-care providers should review the vaccination status
of their patients and administer DTaP and
MMR vaccines, as appropriate. For at least the
next 2 months, providers should order DTaP and MMR
vaccine in amounts sufficient for a 30-day
or less supply to ensure that current supplies can
meet requests. Recall or special initiative
programs can be instituted when DTaP and MMR vaccine
supply improves further but should be
deferred during this transition period. However,
if children who need these
vaccines seek medical care for other reasons, they should
be administered vaccine provided no
contraindications exist. Furthermore, vaccine
should be offered to children who need vaccination
and whose parents requested
vaccination. CDC will continue to monitor DTaP and MMR
vaccine supply and, if necessary,
allocate vaccine. Updates regarding vaccine supply
and shortages can be found at
http://www.cdc.gov/nip/.
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To obtain the complete text of the Notice online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5127a5.htm
To obtain a camera-ready (PDF format) copy of this issue
of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5127.pdf
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 email.
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July 15, 2002
NATIONAL IMMUNIZATION PROGRAM CREATES NEW "FLU SHOT
FLYERS" TO GIVE TO PATIENTS IN 2002-2003
On July 3, 2002, CDC's National Immunization Program (NIP)
published Influenza Vaccine Bulletin #3. In
this bulletin, NIP estimates that influenza
vaccine production for 2002-2003 will reach 92 to 97 million
doses. The bulletin also summarizes CDC's
recent erratum regarding influenza vaccine timing
(see the erratum at
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5125a4.htm) and
provides the latest vaccine ordering
information.
Of special note is the bulletin's announcement of new
educational flyers about flu shots for patients now
available on CDC's website. With all the changed
recommendations for 2002-2003, these flyers will help
vaccinators explain the recommendations to patients. Two
of the three planned flyers are now ready for
downloading.
"When Should You Get Your Flu Shot?" shows in simple chart
form who should receive vaccine in October
and who can wait until November, visually
reminding people that if they missed it in those
two months it's "not too late" in
December or later.
"Is It a Flu Shot Fact or a Myth?" lists eight statements
about the flu and the flu shot and sets the record
straight.
To obtain a camera-ready (PDF format) copy of "When Should
You Get Your Flu Shot?" go to:
http://www.cdc.gov/nip/Flu/Pubs_03/flyr_time.pdf
To obtain a camera-ready (PDF format) copy of "Is It a Flu
Shot Fact or a Myth?" go to:
http://www.cdc.gov/nip/flu/pubs_03/flyr-myths.pdf
To read Influenza Vaccine Bulletin #3, go to:
http://www.cdc.gov/nip/Flu/Bulletins_2002-03/bulletin_3.htm
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July 15, 2002
WORLD HEALTH ORGANIZATION AND UNICEF CO-SPONSOR STRATEGIC
PLAN TO REDUCE MEASLES MORTALITY WORLDWIDE
On July 5, 2002, "WHO-UNICEF Joint Statement on Strategies
to Reduce Measles Mortality Worldwide" was
published in the World Health Organization (WHO)
news journal "Weekly Epidemiological Record"
(vol. 77., no. 27). The statement outlines
a Global Measles Strategic Plan with the main goal
of halving the current number of measles deaths by
the year 2005.
The statement reads in part as follows (excluding one
figure reference):
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There were an estimated 30 million to 40 million cases of
measles in 2000, causing some 777,000
deaths. Measles thus accounts for nearly half of
the 1.7 million annual deaths due to childhood
vaccine-preventable diseases. . . .
Failure to deliver at least one dose of measles vaccine to
all infants remains the primary reason for high
measles morbidity and mortality. Many of
the deaths can be prevented by more efficient use
of existing immunization
services and by ensuring the availability of resources for
implementing all recommended strategies in
each country. . . .
Of all health interventions, measles immunization carries
the highest health return for the money spent,
saving more lives per unit cost. The
vaccine, which has been available for more than 30
years, costs US$0.26 per dose, which
includes safe injection equipment. . . .
[The four strategies to reduce measles mortality are:]
(1) Provide the first dose of measles vaccine
to successive groups of children at the age of 9
months or shortly after [IAC editorial note: the
current recommendation for the United States is to
give the first dose at 12-15 months
of age];
(2) Guarantee a "second opportunity" for measles
vaccination either through campaigns or routine
immunization. The second opportunity is needed both to
increase the chance that every child receives
at least one dose of measles vaccine and to
increase the proportion of the population that is
fully immunized. When the first
dose is given at 9 months, not all children will develop a
protective response. The second dose, given
later, will increase the protective response and
the likelihood of immunity. . . ;
(3) Establish an effective system to monitor coverage and
conduct measles surveillance. . . ;
(4) Improve management of every measles case. . . .
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To read the entire text of "WHO-UNICEF Joint Statement on
Strategies to Reduce Measles Mortality
Worldwide," see the July 5 issue of "Weekly
Epidemiological Record" at:
http://www.who.int/wer/pdf/2002/wer7727.pdf
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July 15, 2002
NATIONAL INFLUENZA SUMMIT 2002 PRESENTATIONS AND
RECOMMENDATIONS ARE NOW ONLINE
Co-sponsored by the American Medical Association (AMA) and
the Centers for Disease Control and
Prevention (CDC), the National Influenza Summit
2002 was held in Atlanta, Georgia, May 22-23, with
more than 65 invited participants who are
involved in vaccine production, delivery, and
administration. Working groups discussed
communications, payment for vaccine and its
administration, vaccine distribution, mass
vaccination, and occupational health and business.
The AMA has now posted much of the Summit discussion and
conclusions on its website in both PDF
format and Microsoft Word files. The Summit
agenda, list of participants, presentations, and
final recommendations all
can be accessed from the Summit page.
To read the National Influenza Summit 2002 introductory
text and link to specific documents, go to:
http://www.ama-assn.org/ama/pub/article/1826-6268.html
To read only the Summary of Recommendations, go to:
http://www.ama-assn.org/ama/upload/mm/36/summit_summary_pdf.pdf
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July 15, 2002
REGISTER NOW FOR CDC COURSE IN MINNEAPOLIS ON AUGUST 28-29!
A live, two-day course on vaccine-preventable diseases
(VPDs) will be held in Minneapolis on August
28 and 29 at the downtown Minneapolis Marriott Hotel.
"Epidemiology and Prevention of Vaccine-
Preventable Diseases" will cover the latest
information for providers on schedules,
contraindications, standard immunization
practices, and vaccine management and safety.
The course is based on the book by the same name, also
known as "The Pink Book." Attending this
course is a great way to learn about what's new in
"The Pink Book"--and in the world of VPDs--in a
short period of time. With so many changes
in vaccine supply and recommendations, now is a
good time to get staff updated.
Featured speakers at "Epidemiology and Prevention of
Vaccine-Preventable Diseases" are CDC
experts William L. Atkinson, M.D., M.P.H.; Donna
L. Weaver, M.N., R.N.; Judy V. Schmidt, Ed.D.,
R.N.C.; and IAC Executive Director Deborah
L. Wexler, M.D.
The registration fee for the course is $69. The
Immunization Action Coalition is offering a free set of
VPD slides to the 101st registrant. This VPD slide set
consists of 30 slides to present with an English or
Spanish script.
To print a course brochure, go to:
http://www.immunize.org/vpdcourse/vpd.pdf
To register for the course online, go to:
https://www.immunize.org/vpdcourse/
If you have questions, contact Judy Schmidt at
Jschmidt1@cdc.gov or Patti Storti
at pat@immunize.org
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July 15, 2002
NEW TRAINING MODULE FROM CHILDREN'S VACCINE PROGRAM:
"IMMUNIZING CHILDREN AGAINST HEPATITIS B"
The Children's Vaccine Program at Path (CVP) has developed
a 46-page international training module for
doctors, nurses, and other immunization providers
titled "Immunizing Children against Hepatitis B."
This training module can be downloaded from
the CVP website and printed free of charge.
The user-friendly module comes with a thorough
introduction, including information on training
preparation and objectives, and clear instructions for
adapting content for use in different countries or
regions. The estimated time needed to present the material
in the module "can vary from approximately
2 hours to one full day," according to the
introduction, depending on how much time for
discussion is allowed and how much time is
devoted to student practice giving injections, doing role-plays, and
filling out forms.
Attachments to the module include the very helpful "Has
This Vaccine Been Frozen? Doing the `Shake
Test'" with pictures of sediment-laden vaccine in
a vial to show how hepatitis vaccine should NOT
look.
To print "Immunizing Children against Hepatitis B," go to:
http://www.childrensvaccine.org/files/HBV_training_module_CVP.pdf
For other training materials and clinical information from
CVP, go to:
http://www.childrensvaccine.org/html/ip_clinical.htm
For more information, email
info@childrensvaccine.org
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July 15, 2002
WORLD VACCINE CONGRESS 2002 WILL CONVENE IN LYON, FRANCE,
ON SEPTEMBER 30-OCTOBER 2
The fourth annual World Vaccine Congress will be held at
the Palais de Congres de Lyon in Lyon,
France, on September 30 through October 2, 2002.
The theme of the Congress is "Bringing Vaccines to
Life--from Conception to Delivery."
For more information on the World Vaccine Congress 2002,
call +44 (0) 20-7242-2324, fax +44 (0) 20-7242-2320, or
visit http://www.pharma-rd.net
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