Issue Number 481            September 27, 2004

CONTENTS OF THIS ISSUE

  1. CDC reports on influenza-vaccination coverage of U.S. children ages 6-23 months during the 2002-03 influenza season
  2. CDC makes supplemental recommendations about the timing of influenza vaccination for the 2004-05 season
  3. Updated: New edition of "Employee Flu Immunization Campaign Kit" now online
  4. Mark your calendar: October 14 is the date for CDC's next "Current Issues in Immunization" net conference
  5. English/Spanish DVD explains trivalent inactivated influenza vaccine VIS to patients with limited English literacy
  6. New: Trivalent inactivated influenza vaccine VIS now available in Japanese and Italian
  7. New: September issue of IAC's "HEP EXPRESS" electronic newsletter is now online
  8. Newly revised hepatitis A VIS has been translated into Spanish, Chinese, and Tagalog
  9. New: Use IAC's Pediatric and Adult Clinic Supplies Checklist to get your community clinic ready for immunization season
  10. Updated: IAC revises its parent-education brochure "All Kids Need Hepatitis B Shots"
  11. Erratum: MMWR corrects error to its report about suspension of rotavirus vaccine

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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; VPD, vaccine-preventable disease; WHO, World Health Organization.
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September 27, 2004
CDC REPORTS ON INFLUENZA-VACCINATION COVERAGE OF U.S. CHILDREN AGES 6-23 MONTHS DURING THE 2002-03 INFLUENZA SEASON

CDC published "Childhood Influenza-Vaccination Coverage--United States, 2002-03 Influenza Season" in the September 24 issue of MMWR. Portions of the article are reprinted below.

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[From the article text]
Children aged <2 years are at increased risk for influenza-related hospitalizations. Beginning in 2002, the Advisory Committee on Immunization Practices (ACIP) encouraged that, when feasible, all children aged 6-23 months, as well as household contacts and out-of-home caregivers for children aged <2 years, receive influenza vaccinations each influenza season. Beginning with the 2004-05 influenza season, ACIP strengthened the encouragement to a recommendation. Other children recommended to receive influenza vaccine continue to include those aged 6 months-18 years with certain high-risk medical conditions and those aged 6 months-18 years who are household contacts of persons at high risk for influenza complications. This report on childhood influenza-vaccination coverage for the 2002-03 influenza season provides a baseline for the continuing assessment of coverage among children aged 6-23 months. The findings demonstrate that, during the first year of the ACIP encouragement to vaccinate children aged 6-23 months against influenza, vaccination coverage was low, with substantial variability among states and urban areas.

This report is based on data from the 2003 National Immunization Survey (NIS), an ongoing survey that provides estimates of vaccination coverage among noninstitutionalized children aged 19-35 months. Children included in the 2003 NIS were born during January 2000-July 2002. The survey is conducted in all 50 states and 28 selected urban areas. In 2003, entire influenza-vaccination histories were obtained for all children.

Two measures of childhood influenza-vaccination coverage are reported: (1) receipt of one or more influenza vaccinations during September-December 2002 and (2) full vaccination (based on ACIP recommendations for 2 doses of influenza vaccine for previously unvaccinated children aged <9 years and 1 dose for previously vaccinated children aged <9 years). Children were considered fully vaccinated if they had (1) received no doses of influenza vaccine before September 1, 2002, but then received 2 doses from September 1 through either the date of interview or January 31, 2003, or (2) received >=1 dose of influenza vaccine before September 1 and then received >=1 dose during September-December 2002. Because children aged <6 months are not eligible for vaccination and because the encouragement (and now the recommendation) calls for vaccination of children aged 6-23 months, analyses for both measures included only those children who were aged 6-23 months during the entire span of September-December 2002.

In the 2003 NIS, the overall response rate for eligible households was 62.7%, and 13,831 children (unweighted) met the age criteria for this assessment. Of these, 7.4% (+/-0.7) received one or more influenza vaccinations, and 4.4% (+/-0.5) were fully vaccinated. Substantial variability in influenza coverage was observed among states and selected urban areas. Percentages of children receiving one or more influenza vaccinations ranged from 2.2% (+/-2.1) in El Paso County, Texas, to 26.6% (+/-8.0) in Rhode Island. . . .

[From the Editorial Note]
Influenza-vaccination coverage among children aged 6-23 months was low during the first year of the ACIP encouragement. For the 2004-05 influenza season, an ACIP recommendation replaces the encouragement that was in place previously; this change is expected to result in increased vaccination coverage. However, substantial work is needed to fully implement this new recommendation for children aged 6-23 months and household contacts of children aged <2 years and to reduce the number of preventable influenza-related hospitalizations among young children.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a1.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5337.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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September 27, 2004
CDC MAKES SUPPLEMENTAL RECOMMENDATIONS ABOUT THE TIMING OF INFLUENZA VACCINATION FOR THE 2004-05 SEASON

CDC published "Notice to Readers: Supplemental Recommendations About the Timing of Influenza Vaccination, 2004-05 Season" in the September 24 issue of MMWR. The article is reprinted below in its entirety, with the exception of references.

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In early August 2004, discussion with the Food and Drug Administration (FDA) and influenza vaccine manufacturers indicated that production of vaccine for the 2004-05 influenza season was proceeding satisfactorily. However, on August 26, Chiron Corporation announced that, in conducting final internal release procedures for its inactivated influenza vaccine, Fluvirin, the company's quality-assurance systems had identified a small number of lots that did not meet product sterility specifications; these lots will not be distributed. In recent discussions with CDC, the company stated that laboratory testing determined the problem was localized. After the company completes its quality-assurance testing, all remaining lots that have met sterility specifications will be available for distribution. Chiron expects to distribute 46-48 million doses during this influenza season, with 42-44 million doses distributed in October and the remaining doses distributed in early November. Total influenza-vaccine production from all manufacturers who will supply the U.S. market during the 2004-05 influenza season is estimated at 100 million doses, which is approximately 13 million more doses than was produced for the 2003-04 influenza season.

CDC is recommending that influenza vaccination proceed for all recommended persons as soon as vaccine is available, recognizing that availability might be limited in early October. Some delay might occur for customers receiving influenza-vaccine doses purchased from Chiron, which might result in a need to reschedule planned clinics and other vaccination campaigns. The optimal time to vaccinate against influenza is October and November, and the Advisory Committee on Immunization Practices (ACIP) recommends that persons planning substantial organized vaccination campaigns consider scheduling those events after mid-October because availability of vaccine in any one location cannot be ensured consistently in early fall. Aventis Pasteur, Inc., expects to distribute approximately 52 million doses of inactivated influenza vaccine (Fluzone) this season. MedImmune Vaccines, Inc., expects to distribute approximately 1.5 million doses of live attenuated influenza vaccine (FluMist). No delays in the timing of distribution of vaccine from these two manufacturers of influenza vaccine are expected.

The annual preseason assessment of each year's projected vaccine supply was requested by ACIP to help address vaccine shortages first experienced in 2000. The committee recommended that mass vaccination campaigns for the 2000-01 season be delayed until the availability of supply was ensured. ACIP issued similar recommendations for the 2001-02 influenza season and incorporated into its annual influenza recommendations the possible use of prioritized timing of vaccine administration when necessary because of vaccine shortages or delays. No delays occurred in vaccination campaigns during either the 2002-03 or the 2003-04 seasons.

CDC also will purchase 4.5 million doses of inactivated influenza vaccine, which will be held in a stockpile to ensure sufficient supply in the event of increased demand like that experienced last winter. CDC has legislative authority through the Vaccines for Children program to purchase influenza vaccine for a national stockpile program for children aged <=18 years. Additional information about influenza and influenza vaccination is available from CDC at http://www.cdc.gov

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a7.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5337.pdf
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September 27, 2004
UPDATED: NEW EDITION OF "EMPLOYEE FLU IMMUNIZATION CAMPAIGN KIT" NOW ONLINE

The Massachusetts Medical Society recently posted the 2004 "Employee Flu Immunization Campaign Kit" on its website. Developed by the Massachusetts Medical Society, MassPRO, and the Massachusetts Department of Public Health, the updated kit replaces one developed in 2002. It is intended for use with trivalent inactivated influenza vaccine (TIV).

The 32-page kit is designed to help hospital and nursing home occupational health specialists, employee health specialists, and infection control specialists protect staff and patients from influenza through immunization of health care employees. It includes step-by-step instructions, information, worksheets, promotional materials, and tips to assist in planning and conducting a successful health care employee influenza immunization campaign.

To find out more about the kit and to download each campaign step separately, go to:
http://www.massmed.org/pages/flu_kit.asp
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September 27, 2004
MARK YOUR CALENDAR: OCTOBER 14 IS THE DATE FOR CDC'S NEXT "CURRENT ISSUES IN IMMUNIZATION" NET CONFERENCE

Scheduled for October 14, from noon to 1PM ET, the net conference "Current Issues in Immunization" is designed to provide clinicians with up-to-date information on immunization. The program has two primary topics: (1) adult immunization issues, including adult influenza immunization and influenza vaccine supply, and (2) vaccine information statements: history and use.

The conference requires pre-registration, as space is limited. Registration will close when the course is full or on October 11 (midnight ET). To register for the conference, go to: http://www2.cdc.gov/nip/isd/ciinc/default.asp
 
The program will combine a telephone audio conference and simultaneous online visual content. Participants can join the Q&A session by telephone or Internet. For instructions and system requirements, go to: http://www.cdc.gov/nip/ed/ciinc/instructions.htm

For additional information, call (404) 639-8225 or go to:
http://www.cdc.gov/nip/ed/ciinc/default.htm
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September 27, 2004
ENGLISH/SPANISH DVD EXPLAINS TRIVALENT INACTIVATED INFLUENZA VACCINE VIS TO PATIENTS WITH LIMITED ENGLISH LITERACY

If you will be conducting influenza vaccination clinics for Spanish speakers or low-literacy English speakers this fall, you might want to purchase Healthway Software's new DVD version of the VIS for trivalent inactivated influenza vaccine (TIV). Based on the current (5/24/04) VIS for TIV, the DVD explains the information covered in the VIS in English and Spanish and uses audio and graphics to clarify the material. It comes with a print copy of the VIS.

The DVD's total runtime is about 25 minutes; the price is $18. For additional information about the DVD and to order it online, go to: http://www.healthwaysoftware.com/engspfludvid.htm
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September 27, 2004
NEW: TRIVALENT INACTIVATED INFLUENZA VACCINE VIS NOW AVAILABLE IN JAPANESE AND ITALIAN

Dated 5/24/04, the current version of the VIS for trivalent inactivated influenza vaccine (TIV) is now available on the IAC website in Japanese and Italian. IAC gratefully acknowledges the California Department of Health Services for the Japanese translation and Anastasia Caruso and Maria Rita Arico, U.S. Naval Hospital, Sigonella, Italy, for the Italian translation.

To obtain a ready-to-copy (PDF) version of the VIS for TIV in Japanese, go to: http://www.immunize.org/vis/jp_flu04.pdf

To obtain it in Italian, go to:
http://www.immunize.org/vis/it_flu04.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/2flu.pdf

For information about the use of VISs, and for VISs in a total of 32 languages, visit IAC's VIS web section at http://www.immunize.org/vis
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September 27, 2004
NEW: SEPTEMBER ISSUE OF IAC'S "HEP EXPRESS" ELECTRONIC NEWSLETTER IS NOW ONLINE

The September 16 issue of "HEP EXPRESS," an electronic newsletter published by IAC, is now available online. "HEP EXPRESS" is intended for health and social service professionals involved in the prevention and treatment of viral hepatitis. The September 16 issue includes articles on the following:

  • The addition of a presentation by Dr. Harold Margolis to the Hepatitis B Foundation's online Expert Speakers Forum
     
  • CDC's Q&A web page about HIV and hepatitis C coinfection
     
  • Upcoming annual meetings of the American Association for the Study of Liver Disease and the National Coalition of STD Directors
     
  • Information about recently published journal articles

To access the September 16 issue, go to:
http://www.hepprograms.org/hepexpress/issue21.asp

To sign up for a free subscription to "HEP EXPRESS," go to:
http://www.hepprograms.org/hepexpress/signup.asp

To access previous issues of "HEP EXPRESS," go to:
http://www.hepprograms.org/hepexpress/index.asp
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September 27, 2004
NEWLY REVISED HEPATITIS A VIS HAS BEEN TRANSLATED INTO SPANISH, CHINESE, AND TAGALOG

Dated 8/4/04, the current version of the VIS for hepatitis A vaccine is now available on the IAC website in Spanish, Chinese, and Tagalog. IAC gratefully acknowledges the California Department of Health Services for the translations.

To obtain a ready-to-copy (PDF) version of the VIS for hepatitis A vaccine in Spanish, go to:
http://www.immunize.org/vis/sp_hpa04.pdf

To obtain it in Chinese, go to:
http://www.immunize.org/vis/ch_hpa04.pdf

To obtain it in Tagalog, go to:
http://www.immunize.org/vis/ta_hpa04.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/v-hepa.pdf

For information about the use of VISs, and for VISs in a total of 32 languages, visit IAC's VIS web section at http://www.immunize.org/vis
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September 27, 2004
NEW: USE IAC'S PEDIATRIC AND ADULT CLINIC SUPPLIES CHECKLIST TO GET YOUR COMMUNITY CLINIC READY FOR IMMUNIZATION SEASON

In September, IAC developed a one-page checklist that will save health professionals time when gathering supplies for pediatric and adult immunization clinics. "Suggested Supplies Checklist for Pediatric and Adult Immunization Clinic" organizes clinic supplies into six broad categories: vaccines, vaccine administration supplies, VISs, emergency supplies, clinic charts, and miscellaneous office supplies. A detailed list is given for each category to ensure that clinic staff have all necessary supplies before the clinic is underway.

To obtain a ready-to-copy (PDF) version of the checklist, go to:
http://www.immunize.org/catg.d/p3046chk.pdf

To obtain a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p3046chk.htm

SUPPLIES CHECKLIST FOR ADULT IMMUNIZATION CLINIC
If your community outreach clinic immunizes only adults, you may find IAC's one-page "Suggested Supplies Checklist for Adult Immunization Clinic" more pertinent.

To obtain a ready-to-copy (PDF) version of the adult checklist, go to: http://www.immunize.org/catg.d/p3047.pdf
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September 27, 2004
UPDATED: IAC REVISES ITS PARENT-EDUCATION BROCHURE "ALL KIDS NEED HEPATITIS B SHOTS"

In August, IAC made minor revisions to it two-page parent-education brochure "All kids need hepatitis B shots."

To obtain a ready-to-copy (PDF) version of it, go to:
http://www.immunize.org/catg.d/4055kidb.pdf

The brochure is available in the following languages: Spanish, Armenian, Cambodian, Chinese, Farsi, Hmong, Japanese, Korean, Laotian, Portuguese, Romanian, Russian, Samoan, Somali, Tagalog, Turkish, and Vietnamese.

To access ready-to-copy (PDF) versions of the brochure in these languages, go to: http://www.immunize.org/catg.d/free.htm Scroll down to "All kids need hepatitis B shots" (product P4055) and click on the language(s) you want.
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September 27, 2004
ERRATUM: MMWR CORRECTS ERROR TO ITS REPORT ABOUT SUSPENSION OF ROTAVIRUS VACCINE

CDC published "Erratum: Vol. 53, No. 34" in the September 24 issue of MMWR. The erratum is reprinted below in its entirety.

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In the report "Suspension of Rotavirus Vaccine After Reports of Intussusception--United States, 1999," first paragraph, second sentence, the date for when rhesus-human rotavirus reassortant-tetravalent vaccine was licensed was incorrect. The date should be August 31, 1998.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a8.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5337.pdf

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IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
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  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
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