Immunization Action Coalition and the Hepatitis B Coalition

IAC EXPRESS

Previous issues index

Home page

Issue Number 444            February 16, 2004

CONTENTS OF THIS ISSUE

  1. CDC, ACIP, and professional associations recommend temporary suspension of the routine use of the fourth dose of PCV7
  2. Attention adult medical specialists: The latest issue of "VACCINATE ADULTS!" is on the Web
  3. Revised: IAC's "Ask the Experts" compilation is updated with information from the January 2004 issue of "NEEDLE TIPS"
  4. Updated: IAC adds to its popular collection of video footage related to vaccine-preventable diseases
  5. CDC reports on outbreaks of avian influenza in Asia and on recommendations for evaluating and reporting suspected cases
  6. CDC reports on recent cases of influenza A (H5N1) in Thailand
  7. Plan ahead: Dates for National Adult Immunization Awareness Week are moved up
  8. Updated VIS translation: The most current meningococcal VIS is now available in Spanish on IAC's website
  9. U.S. military personnel who received smallpox vaccine rarely transferred vaccinia virus to others
  10. CDC publishes update of smallpox vaccine adverse events among U.S. civilians during 2003
  11. April 16 is the early-bird registration deadline for the Seventh Annual Conference on Vaccine Research
  12. Mark your calendar: Vaccination Week in the Americas will be observed April 24-30
  13. CDC reports on WHO's updated Global Polio Eradication Initiative Strategic Plan

----------------------------------------------------------

Back to Top

---------------------------------------------------------------

ABBREVIATIONS: AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NIP, National Immunization Program; VIS, Vaccine Information Statement; WHO, World Health Organization.
---------------------------------------------------------------

(1 of 13)
February 16, 2004
CDC, ACIP, AND PROFESSIONAL ASSOCIATIONS RECOMMEND TEMPORARY SUSPENSION OF THE ROUTINE USE OF THE FOURTH DOSE OF PCV7

CDC published "Notice to Readers: Limited Supply of Pneumococcal Conjugate Vaccine: Suspension of Recommendation for Fourth Dose" in the February 13 issue of MMWR. The article concerns CDC's decision, made in conjunction with ACIP, AAP, and AAFP, to recommend that health care providers temporarily suspend routine use of the fourth dose of the pneumococcal conjugate vaccine (PCV7) in response to a shortage arising from production and supply problems.

In addition, CDC posted on its NIP website a Q&A series and a press release about the shortage and released a statement about it through one of its electronic news services, "Immunization Works!"

The MMWR article is reprinted below in its entirety, excluding references.

**********************

In December 2003, CDC reported that Wyeth Vaccines, the only U.S. supplier of 7-valent pneumococcal conjugate vaccine (PCV7, marketed as Prevnar), was experiencing production constraints that could cause delays in shipments and was implementing an allocation plan to ensure the equitable distribution of available vaccine. In February 2004, Wyeth advised CDC that production constraints had not been resolved and that supplies will remain limited at least through July 2004. Until full production capacity is resumed, local shortages might occur. Effective immediately, CDC recommends that health care providers temporarily suspend routine use of the fourth dose of PCV7 to conserve vaccine and minimize the likelihood of shortages.

PCV7 is a highly effective vaccine. In October 2000, a primary series of three PCV7 injections and one booster was recommended for all children. In 2001, the incidence of invasive pneumococcal disease among children aged <2 years was 69% less than during 1998-1999, before the recommendation. Preliminary data from CDC's Active Bacterial Core Surveillance program indicate that effectiveness, at least for the short term, is not compromised by delaying administration of the fourth dose. A case-control study comparing the effectiveness of a 3-dose series with a 4-dose series found that 3 doses were 90% effective (95% confidence interval [CI] = 74%-96%) against invasive disease caused by serotypes represented in the vaccine, whereas 4 doses were 96% effective (95% CI = 68%-100%); this difference was not statistically significant.

Because precise allocation of PCV7 is difficult, spot shortages are inevitable when supplies are limited. To ensure that every child can be protected against pneumococcal disease despite the limited supply, and on the basis of the short-term effectiveness of the 3-dose primary series of PCV7 at ages 2, 4, and 6 months, CDC, in consultation with the American Academy of Family Physicians, the American Academy of Pediatrics, and the Advisory Committee on Immunization Practices, recommends that all health care providers, regardless of the amount of PCV7 in their inventories, help conserve the national PCV7 supply by temporarily discontinuing administration of the fourth dose of PCV7 for healthy children. Health care providers should continue to administer the fourth dose to children at increased risk for severe disease*. Children whose booster dose is deferred should receive PCV7 on their first visit after supplies are restored. If all health care providers comply with this temporary recommendation, >1 million doses will be conserved by July 2004, making widespread or prolonged disruptions in vaccination services less likely.

This recommendation reflects CDC's assessment of the existing national PCV7 supply and may be changed if the supply changes. Updated information about vaccine supplies is available from CDC at http://www.cdc.gov/nip/news/shortages

* Includes children with sickle cell disease and other hemoglobinopathies, anatomic asplenia, chronic diseases (e.g., chronic cardiac and pulmonary disease and diabetes), cerebrospinal fluid leak, human immunodeficiency virus infection and other immunocompromising conditions, immunosuppressive chemotherapy or long-term systemic corticosteroid use; children who have undergone solid organ transplantation; and children who either have received or will receive cochlear implants. All these children have been identified as being at either "high risk" or "presumed high risk" for severe invasive pneumoccocal disease.

**********************

To access a web-text (HTML) version of the complete MMWR article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5305a6.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5305.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html

To access NIP's Q&A series "PCV7 (Prevnar) Shortages and Suspension of the Recommendation for the Fourth Dose," go to:
http://www.cdc.gov/nip/news/shortages/pcv7-shortage-faqs2-04.htm

To access the CDC press release "Health Groups Recommend Temporary Suspension of Pediatric Pneumococcal Conjugate Vaccine Dose," go to:
http://www.cdc.gov/od/oc/media/pressrel/r040212.htm

To access the statement in CDC's "Immunization Works!" electronic newsletter, go to:
http://www.immunize.org/news.d/newssupp204.htm
---------------------------------------------------------------

Back to Top

(2 of 13)
February 16, 2004
ATTENTION ADULT MEDICAL SPECIALISTS: THE LATEST ISSUE OF "VACCINATE ADULTS!" IS ON THE WEB

The hard copy of the February 2004 issue of "VACCINATE ADULTS!" was recently mailed to nearly 130,000 adult medicine specialists and health departments. You can access the entire issue or selected articles from the IAC website. Immunization and hepatitis experts at CDC have reviewed the articles and education pieces in the issue for accuracy (with the exception of editorials).

The February issue has a number of hepatitis resources: an editorial, "Prevent Viral Hepatitis: Vaccinate!"; an updated patient-education piece, "Every Week Hundreds of Sexually Active People Get Hepatitis B"; and a new professional-education piece, "Standing Orders for Administering Hepatitis B Vaccine to Adolescents and Adults." In addition, the issue has two practical pieces on storing and handling vaccines: "CDC's Guidelines for Maintaining and Managing the Vaccine Cold Chain" and "Temperature Logs (Fahrenheit and Celsius) for Vaccines." This is information you won't find anywhere else; we hope you'll peruse the table of contents (given below) and read articles that interest you online.

HOW TO ACCESS "VACCINATE ADULTS!" ON THE WEB
You can download the entire issue from the Web or view selected articles from the table of contents below.

To view the table of contents with links to individual articles, go to: http://www.immunize.org/va

Please note: The PDF file of the entire February 2004 issue, linked below, is large at 421,245 bytes. Some printers cannot print such a large file. For tips on downloading and printing PDF files, go to: http://www.immunize.org/nslt.d/tips.htm

To download the entire PDF version of the February 2004 issue, go to: http://www.immunize.org/va/va12.pdf

SUMMARIES OF INDIVIDUAL ARTICLES AND FEATURES
Summaries of "VACCINATE ADULTS!" articles and features are below, followed by URLs.

"Ask the Experts"
CDC immunization expert William Atkinson, MD, MPH, and viral hepatitis experts Linda Moyer, RN, and Eric Mast, MD, answer readers' questions.

HTML: http://www.immunize.org/va/va12exprt.htm
PDF: http://www.immunize.org/va/va12exprt.pdf

"Prevent Viral Hepatitis: Vaccinate!"
Citing the distressing statistic that nearly 80,000 persons in the United States become infected with hepatitis B virus (HBV) each year, this editorial urges health professionals to identify and vaccinate adults with behavioral risk factors for HBV infection.

PDF: http://www.immunize.org/va/viralhepatitis.pdf

"Vaccine Highlights"
A digest of recent recommendations and news about vaccines and vaccine resources pertaining to adults.

HTML: http://www.immunize.org/va/va12vac.htm
PDF: http://www.immunize.org/va/va12vac.pdf

"Every Week Hundreds of Sexually Active People Get Hepatitis B"
This recently revised duo-fold patient brochure succinctly describes the facts associated with hepatitis B: what it is, who gets it, how they get it, how to prevent it, and more.

HTML: http://www.immunize.org/catg.d/4112std.htm
PDF: http://www.immunize.org/catg.d/4112std.pdf

"Standing Orders for Administering Hepatitis B Vaccine to Adolescents and Adults"
This one-page sheet outlines the purpose, policy, and procedures for using standing orders for hepatitis B vaccine administration and presents information about contraindications, precautions, and administration techniques.

PDF: http://www.immunize.org/va/orders.pdf

"CDC's Guidelines for Maintaining and Managing the Vaccine Cold Chain"
Reprinted from the MMWR of October 24, 2003, this article presents current information on recommended vaccine storage temperatures, storage requirements, and temperature monitoring.

HTML: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5242a6.htm
PDF: http://www.immunize.org/va/coldchain.pdf

"Temperature Logs (Fahrenheit and Celsius) for Vaccines"
This one-page sheet provides URLs for Fahrenheit and Celsius temperature logs; each log has space for recording a month's worth of temperatures.

One-page sheet with URLs for both temperature logs
PDF: http://www.immunize.org/va/templogs.pdf

Fahrenheit temperature log
PDF: http://www.immunize.org/catg.d/p3039.pdf

Celsius temperature log
PDF: http://www.immuize.org/news.d/celsius.pdf

"Adult Resources and Order Form"
Order materials for patients and clinic staff here.

PDF: http://www.immunize.org/va/catalog.pdf

"Letter from the Executive Director: Your Yearly Contribution Promotes Immunization!"
IAC's Executive Director, Deborah L. Wexler, MD, shows how much good your money does when you contribute to IAC.

HTML: http://www.immunize.org/va/va12back.htm
PDF: http://www.immunize.org/va/va12back.pdf
---------------------------------------------------------------

Back to Top

(3 of 13)
February 16, 2004
REVISED: IAC'S "ASK THE EXPERTS" COMPILATION IS UPDATED WITH INFORMATION FROM THE JANUARY 2004 ISSUE OF "NEEDLE TIPS"

IAC recently updated its "Ask the Experts" web section with Q&As from the January 2004 issue of "NEEDLE TIPS." Included are answers to general vaccine questions, as well as answers to questions about 14 disease-specific vaccines. The web section is based on "Ask the Experts" columns written by experts from CDC's National Immunization Program and Division of Viral Hepatitis.

To access the "Ask the Experts" web section, go to:
http://www.immunize.org/catg.d/p2021.htm
---------------------------------------------------------------

Back to Top

(4 of 13)
February 16, 2004
UPDATED: IAC ADDS TO ITS POPULAR COLLECTION OF VIDEO FOOTAGE RELATED TO VACCINE-PREVENTABLE DISEASES

The video section of IAC's public website now features 63 videos in RealPlayer format. Some of the new resources include the following:

  • From the Vaccine Education Center, Children's Hospital of Philadelphia, two videos, "Vaccines: Separating Fact from Fear" and "Vaccines and Your Baby." Each is available in its entirety or in separate segments; each can be downloaded or viewed online.
     
  • From UNICEF, three 30-second public service announcements about polio eradication.
     
  • From UNICEF, a 3-minute video, "Protect Every Child," discusses the role of immunization in global health.
     
  • From the Measles Initiative, an award-winning documentary, "Disease of the Wind," focuses on measles in Africa. Includes actress Jane Seymour and eight American school children in Kenya. We have eleven representative clips, ranging in length from 1 minute to 3-1/2 minutes. The Measles Initiative is a project of the American Red Cross, UN Foundation, CDC, WHO, UNICEF, and the International Federation of Red Cross and Red Crescent Societies.
     
  • From the Global Alliance for Vaccines and Immunization, multiple broadcast segments and public service announcements about vaccinating the world's children.

To access these and other videos directly, go to:
http://www.vaccineinformation.org/video

You can also access the video web page from IAC's two main websites, www.immunize.org and www.vaccineinformation.org
---------------------------------------------------------------

Back to Top

(5 of 13)
February 16, 2004
CDC REPORTS ON OUTBREAKS OF AVIAN INFLUENZA IN ASIA AND ON RECOMMENDATIONS FOR EVALUATING AND REPORTING SUSPECTED CASES

CDC published "Outbreaks of Avian Influenza A (H5N1) in Asia and Interim Recommendations for Evaluation and Reporting of Suspected Cases--United States, 2004" in the February 13 issue of MMWR. The article's opening paragraph is reprinted below.

***********************

During December 2003-February 2004, outbreaks of highly pathogenic avian influenza A (H5N1) among poultry were reported in Cambodia, China, Indonesia, Japan, Laos, South Korea, Thailand, and Vietnam. As of February 9, 2004, a total of 23 cases of laboratory-confirmed influenza A (H5N1) virus infections in humans, resulting in 18 deaths, had been reported in Thailand and Vietnam. In addition, approximately 100 suspected cases in humans are under investigation by national health authorities in Thailand and Vietnam. CDC, the World Health Organization (WHO), and national health authorities in Asian countries are working to assess and monitor the situation, provide epidemiologic and laboratory support, and assist with control efforts. This report summarizes information about the human infections and avian outbreaks in Asia and provides recommendations to guide influenza A (H5N1) surveillance, diagnosis, and testing in the United States.

***********************

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5305a1.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5305.pdf
---------------------------------------------------------------

Back to Top

(6 of 13)
February 16, 2004
CDC REPORTS ON RECENT CASES OF INFLUENZA A (H5N1) IN THAILAND

CDC published "Cases of Influenza A (H5N1)--Thailand, 2004" in the February 13 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

***********************

Human disease caused by the current strain of avian influenza is rapidly progressive, severe, and fatal in most cases.

This article describes the clinical features of the five confirmed human cases of avian influenza in the ongoing outbreak in Thailand. It provides the first clear picture of the unusually severe and rapidly progressive pneumonia, with failure of other organ systems, and death in all five patients. Set in the context of an avian outbreak involving at least eight countries that is not yet under control, the severity of disease in these young boys provides a reminder that avian influenza, even without a reassortant event that might result in a strain capable of efficient human-to-human transmission, is a serious public health threat.

***********************

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5305a2.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5305.pdf
---------------------------------------------------------------

Back to Top

(7 of 13)
February 16, 2004
PLAN AHEAD: DATES FOR NATIONAL ADULT IMMUNIZATION AWARENESS WEEK ARE MOVED UP

On January 22, the National Foundation for Infectious Diseases (NFID) and National Coalition for Adult Immunization (NCAI) announced they have changed the date for National Adult Immunization Awareness Week (NAIAW). Previously observed in October, NAIAW will now be celebrated each year at the end of September. The dates for 2004 are September 26 to October 2.

NAIAW's new dates allow immunizers and the general public to better prepare for the start of influenza vaccination season, which typically begins October 1. Immunizers can plan immunization events at the start of October, rather than in mid-October, when NAIAW previously occurred. The end of September also provides time for the general public, particularly those considered at high-risk, to schedule earlier appointments for their influenza, pneumococcal, tetanus-diphtheria, or other needed adult vaccinations.

To learn more about NAIAW, visit the NFID/NCAI website at www.nfid.org/ncai
---------------------------------------------------------------

Back to Top

(8 of 13)
February 16, 2004
UPDATED VIS TRANSLATION: THE MOST CURRENT MENINGOCOCCAL VIS IS NOW AVAILABLE IN SPANISH ON IAC'S WEBSITE

Dated 7/28/03, the most current meningococcal VIS is now available in Spanish on IAC's website. IAC gratefully acknowledges the California Department of Health Services for the translation.

To obtain a ready-to-copy (PDF) version of the meningococcal VIS in Spanish, go to: http://www.immunize.org/vis/sp_men03.pdf

To obtain a ready-to-copy (PDF) version of it in English, go to:
http://www.immunize.org/vis/menin03.pdf

For information about the use of VISs, and for VISs in a total of 30 languages, visit IAC's VIS web section at http://www.immunize.org/vis
--------------------------------------------------------------

Back to Top

(9 of 13)
February 16, 2004
U.S. MILITARY PERSONNEL WHO RECEIVED SMALLPOX VACCINE RARELY TRANSFERRED VACCINIA VIRUS TO OTHERS

CDC published "Secondary and Tertiary Transfer of Vaccinia Virus Among U.S. Military Personnel--United States and Worldwide, 2002-2004" in the February 13 issue of MMWR. The article includes two case studies. Part of a summary made available to the press is reprinted below.

***********************

Spread of the virus in smallpox vaccine was a rare event in the Defense Department's Smallpox Vaccination Program. Using detailed education and good infection-control procedures, only 30 cases of contact transfer occurred after 560,000 smallpox vaccinations. Most of the 30 were spouses or adult intimate contacts. No cases arose in the workplace or in hospitals. Continued efforts are needed so smallpox vaccinees keep their vaccination site covered, wash their hands, and use good hygiene, especially at home. The rate of contact transfer was similar to the rate seen in the 1960s, even though far fewer people today are immune to this virus. The virus in smallpox vaccine is called vaccinia virus and cannot cause smallpox itself.

***********************

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5305a3.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5305.pdf
---------------------------------------------------------------

Back to Top

(10 of 13)
February 16, 2004
CDC PUBLISHES UPDATE OF SMALLPOX VACCINE ADVERSE EVENTS AMONG U.S. CIVILIANS DURING 2003

CDC published "Update: Adverse Events Following Civilian Smallpox Vaccination--United States, 2003" in the February 13 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

***********************

CDC, the Food and Drug Administration, and state health departments are continuing to monitor for vaccine-associated adverse events among civilian vaccinees.

This report provides updated information on smallpox vaccine-associated adverse events (possible side effects) among civilians vaccinated since the beginning of the program and among contacts of vaccinees, received by CDC as of December 31, 2003.

***********************

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5305a4.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5305.pdf
---------------------------------------------------------------

Back to Top

(11 of 13)
February 16, 2004
APRIL 16 IS THE EARLY-BIRD REGISTRATION DEADLINE FOR THE SEVENTH ANNUAL CONFERENCE ON VACCINE RESEARCH

The Seventh Annual Conference on Vaccine Research is scheduled for May 24-26 in Arlington, VA. The National Foundation for Infectious Diseases (NFID) is the conference sponsor, along with several national and international organizations. NFID members who register by April 16 can save $68; non-members can save $75.

The conference will feature international experts leading seminars and panel discussions on topical areas of basic immunology, product development, clinical testing, regulation, and other aspects of vaccine research. The intended audience includes researchers, scientists, epidemiologists, microbiologists, immunologists, molecular biologists, public health officials, physicians, veterinarians, and vaccine manufacturers.

For a comprehensive overview of the conference, including information on registration, abstract submission, and a preliminary program, go to: http://www.nfid.org/conferences/vaccine04

For additional information, contact Sharon Cooper-Kerr or Sheena Majette by phone at (301) 656-0003, ext. 19; by fax at (301) 907-0878; or by email at vaccine@nfid.org
---------------------------------------------------------------

Back to Top

(12 of 13)
February 16, 2004
MARK YOUR CALENDAR: VACCINATION WEEK IN THE AMERICAS WILL BE OBSERVED APRIL 24-30

On February 9, the Pan American Health Organization (PAHO) issued a press release announcing that Vaccination Week in the Americas is set for April 24-30. Countries from Canada to the tip of South America and throughout the Caribbean plan to take part. The majority of countries plan to vaccinate children less than five years of age, along with women of childbearing age and senior citizens. The event is supported by UNICEF, the Red Cross, CDC, USAID (United States Agency for International Development), and other organizations.

To access the press release, go to:
http://www.paho.org/English/DD/PIN/pr040209.htm

For more information, contact Daniel Epstein at PAHO by phone at (202) 974-3459 or by email at epsteind@paho.org or Curtis Allen at CDC by phone at (404) 639-8487.
---------------------------------------------------------------

Back to Top

(13 of 13)
February 16, 2004
CDC REPORTS ON WHO'S UPDATED GLOBAL POLIO ERADICATION INITIATIVE STRATEGIC PLAN

CDC published "Brief Report: Global Polio Eradication Initiative Strategic Plan, 2004" in the February 13 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

***********************

The remaining few countries still endemic for polio will require the highest levels of commitment from national governments and international partners to ensure that the final poliovirus reservoirs are eliminated. Although remarkable progress has been made since 1988 toward achieving the goal of global polio eradication, challenges remain. This updated Strategic Plan details the actions necessary to realize the goal of global polio eradication.

An updated Global Polio Eradication Strategic Plan (2004-2008) was released on 15 January 2004 by the World Health Organization. The plan outlines the activities required to interrupt poliovirus transmission globally (2004-05), to achieve global certification of polio eradication (2006-08), and to prepare for cessation of childhood immunization with oral poliovirus vaccine (OPV) (2009 and beyond). Eliminating all remaining poliovirus reservoirs is now crucial, because the discontinuation of mass immunization campaigns in most polio-free countries has left these areas vulnerable to importations of wild poliovirus from the remaining endemic countries.

***********************

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5305a5.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5305.pdf

 

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 February 16, 2004