Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 489            November 1, 2004

CONTENTS OF THIS ISSUE

  1. New: CDC issues a supplement to the VIS for trivalent inactivated influenza vaccine
  2. More than 4.2 million doses of influenza vaccine were shipped last week to providers who serve high-priority groups
  3. New: Register now for CDC's Influenza Update Net Conference, scheduled for November 19
  4. Updated: CDC adds new professional and patient information related to the influenza vaccine shortage to its website
  5. DHHS announces that it has potentially identified more than 5 million additional doses of influenza vaccine
  6. CDC issues an update on U.S. and worldwide influenza activity for May-October 2004
  7. VIS translations: New hepatitis A vaccine VIS now available in eight additional languages
  8. Reminder: November 19 is the deadline for abstracts for CDC's 2005 National Immunization Conference
  9. CDC issues notice about false-positive HBsAg tests
  10. CDC reports on laboratory surveillance for wild and vaccine-derived polioviruses during January 2003-June 2004

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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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November 1, 2004
NEW: CDC ISSUES A SUPPLEMENT TO THE VIS FOR TRIVALENT INACTIVATED INFLUENZA VACCINE

On October 29, CDC issued a supplement to the VIS for trivalent inactivated influenza vaccine (TIV). Titled "Inactivated Influenza Vaccine: 2004-2005 Supplement--Vaccine Shortage," the one-page supplement lists the people who should get influenza vaccine during the current vaccine shortage. The supplement is intended to be used with the VIS for TIV, which is dated 5/24/04. The supplement is currently available in English only.

To access the supplement from the CDC website, go to:
http://www.cdc.gov/nip/publications/VIS/vis-flu-suplmt.pdf

To access the 5/24/04 VIS in English, go to:
http://www.cdc.gov/nip/publications/VIS/vis-flu.pdf

To access the 5/24/04 VIS in additional languages, go to: http://www.immunize.org/vis/index.htm#influenza Click on the language(s) you want.
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November 1, 2004
MORE THAN 4.2 MILLION DOSES OF INFLUENZA VACCINE WERE SHIPPED LAST WEEK TO PROVIDERS WHO SERVE HIGH-PRIORITY GROUPS

On October 29, CDC issued a press release announcing that more than 4.2 million doses of influenza vaccine were shipped during the week of October 25-29. The press release is reprinted below in its entirety.

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For immediate release
October 29, 2004

OVER 4.2 MILLION INFLUENZA VACCINE DOSES SHIPPED THIS WEEK TO HEALTH PROVIDERS SERVING HIGH-PRIORITY GROUPS

Over 4.2 million influenza vaccine doses were shipped this week to health providers serving high-priority groups as part of the plan announced on October 12 by the Centers for Disease Control and Prevention (CDC) and Aventis Pasteur. Since October 11, 2004, more than 9 million doses of flu vaccine have been shipped to the following groups:

  • State public health departments
  • Department of Veterans Administration
  • Long-term care facilities/acute care hospitals
  • Vaccines for Children program
  • Private physicians who care for young children
  • HMOs and private providers serving high-priority groups
  • Department of Defense

"We are and will continue to take all the steps possible to get vaccine out in an equitable way to those who need it most," said CDC Director Dr. Julie Gerberding. "The spirit of cooperation we are seeing by Aventis Pasteur, state and local health officials, clinicians, hospitals, and the public is extraordinary and is what will help deal with this challenging situation."

Dr. Gerberding urged people to continue to be patient and persistent as health officers work to fill vaccine coverage gaps in the coming weeks. The approximately 16.5 million remaining doses of vaccine will be shipped to public and private vaccine providers, at a rate of about 2.5-3 million doses per week, primarily through early December. About 2.6 million doses of the Aventis Pasteur vaccine will be available for shipment in early January 2005.

On October 5, 2004, after Chiron Corporation announced that none of the doses of influenza vaccine it had produced would be available this year, CDC announced priority groups for vaccination for the 2004-2005 influenza season:

  • all children aged 6-23 months,
  • adults aged 65 years and older,
  • persons aged 2-64 years with underlying chronic medical conditions,
  • all women who will be pregnant during influenza season,
  • residents of nursing homes and long-term care facilities,
  • children 6 months-18 years of age on chronic aspirin therapy,
  • health care workers with direct patient care, and
  • out-of-home caregivers and household contacts of children aged <6 months.

Influenza season is unpredictable. In most years, the season peaks between December and March. It is too early to say how severe the 2004-2005 season will be, but to date only sporadic cases have been reported.

Vaccination is the best protection against influenza, but there are alternatives. Antiviral drugs can be used before someone becomes ill to prevent them from getting the flu or taken within 1-2 days of first flu symptoms to reduce the severity of the illness.

The Department of Health and Human Services has purchased a stockpile of antiviral drugs to treat more than 7 million people during the 2004-2005 flu season. Other supplies of the antiviral drugs are available through private health providers. It is estimated that about 40 million people could be treated this flu season with the antiviral drugs available.

Finally, everyone can take practical steps to help prevent spread of flu:

  • avoid close contact with people who are sick,
  • keep your distance from others if you're sick,
  • when possible, stay home from work, school, and errands when you are sick, and don't send your children to daycare or school if they are sick,
  • cover your mouth and nose when coughing or sneezing, and
  • clean your hands often.

For more information about the flu, visit the CDC website: http://www.cdc.gov/flu

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November 1, 2004
NEW: REGISTER NOW FOR CDC'S INFLUENZA UPDATE NET CONFERENCE, SCHEDULED FOR NOVEMBER 19

Scheduled for November 19 from 12PM to 1PM (ET), the next Influenza Update Net Conference will provide clinicians with the most up-to-date information on influenza and will focus on antivirals. This is a limited-registration event; registration closes November 18 at midnight (ET) or when the course is full. Don't be disappointed, register NOW by going to http://www2.cdc.gov/nip/isd/fluconference

More information on the program's content will be available soon. Stay informed by going to http://www.cdc.gov/flu/professionals/training/novnetconf.htm

The program will combine a telephone audio conference with simultaneous online visual content. It will include a Q&A session, accessible by telephone and Internet. Internet access and a separate phone line are needed to participate. Graphics will be available to download as a PowerPoint file after the presentations. For more information, see Instructions and System Requirements at http://www.cdc.gov/nip/ed/ciinc/instructions.htm

If you have questions, send them to Clinician Outreach and Communication Activity at COCA@cdc.gov
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November 1, 2004
UPDATED: CDC ADDS NEW PROFESSIONAL AND PATIENT INFORMATION RELATED TO THE INFLUENZA VACCINE SHORTAGE TO ITS WEBSITE

CDC recently posted several new documents related to the influenza vaccine shortage to its website. Following are links to the new information.

PROFESSIONAL INFORMATION
(1) The two-page "Guidelines and Recommendations: Guidance for Prevention and Control of Influenza in the Peri- and Postpartum Settings" details infection control measures for hospitalized pregnant and recently delivered women and their infants.

To access a ready-to-copy (PDF) version, go to:
http://www.cdc.gov/flu/professionals/infectioncontrol/pdf/peri-post-settings.pdf

To access a web-text (HTML) version, go to:
http://www.cdc.gov/flu/professionals/infectioncontrol/peri-post-settings.htm

(2) Three items have been added to the Q&A section on influenza vaccine administration. To access them, go to: http://www.cdc.gov/flu/about/qa/vaxadmin.htm

(3) One question has been added to the Q&A section on live attenuated influenza vaccine. To access it, go to: http://www.cdc.gov/flu/about/qa/nasalspray.htm

(4) The National Center for Infectious Diseases' web section on Personal protective Equipment (PPE) in Health Care Settings offers a 12-minute video on the topic, as well as a slide set and posters. To access the web section, go to: http://www.cdc.gov/ncidod/hip/ppe/default.htm

PATIENT INFORMATION
(5) The National Center for Infectious Diseases web section has added a poster for health care settings: "Important Notice to All Patients: Please tell staff immediately if you have flu symptoms." To access a ready-to-print (PDF) version, go to: http://www.cdc.gov/ncidod/hip/INFECT/RespiratoryPoster.pdf

(6) Patient information sheets and posters have recently been posted in the following languages: Chinese, Vietnamese, Tagalog, and Russian. To access them, go to: http://www.cdc.gov/flu/languages.htm Click on the language(s) you want.
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November 1, 2004
DHHS ANNOUNCES THAT IT HAS POTENTIALLY IDENTIFIED MORE THAN 5 MILLION ADDITIONAL DOSES OF INFLUENZA VACCINE

On October 28, the Department of Health and Human Services (DHHS) issued a press release announcing that it has potentially identified more than 5 million additional doses of influenza vaccine for the 2004-05 influenza season. The press release also reports that DHHS is redirecting some influenza vaccine initially earmarked for the military and federal employees to high-risk populations nationwide and that a major vaccine manufacturer is tripling its production of pneumococcal vaccine. Portions of the press release are reprinted below.

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October 28, 2004
For immediate release

HHS IDENTIFIES MORE INFLUENZA VACCINE: Department Takes Steps To Acquire Foreign Vaccine, Redirect Government Doses

HHS Secretary Tommy G. Thompson announced today significant progress toward expanding the nation's supply of vaccines for flu season . . .

"We're continuing to build our arsenal of vaccines and medicines to confront the coming flu season," Secretary Thompson said. "We are encouraged about the potential for some 5 million doses of vaccine from foreign manufacturers and we're sending our inspectors to those facilities. . . ."

Secretary Thompson said FDA inspectors would be traveling to two foreign manufacturing facilities--GlaxoSmithKline's facility in Germany and IDBiomedical's facility in Canada--to inspect their manufacturing plants and products. The inspection teams will confirm the availability of the 5 million doses, assure that the vaccine can be used safely, and then make arrangements to acquire them. . . .

Additionally, the department has recouped about 300,000 doses of influenza vaccine that had been purchased by the federal government for federal employees and the military this flu season. . . .

Secretary Thompson also announced that Merck & Co. is tripling its production of pneumococcal vaccine used to prevent one of the major complications of the flu, pneumonia. . . .

[Pneumococcal vaccine] is not a substitute for the influenza vaccine, but can help shield people against flu complications . . . . Many people who fall into the priority groups for the influenza vaccine should also get the pneumonia vaccine, including seniors. . . .

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To read the complete press release, go to:
http://www.hhs.gov/news/press/2004pres/20041028a.html
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November 1, 2004
CDC ISSUES AN UPDATE ON U.S. AND WORLDWIDE INFLUENZA ACTIVITY FOR MAY-OCTOBER 2004

CDC published "Update: Influenza Activity--United States and Worldwide, May-October 2004" in the October 29 issue of MMWR. Portions of the article and Editorial Note are reprinted below.

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[From the article]
During May-October 2004, influenza A (H3N2) viruses circulated worldwide and were associated with mild-to-moderate levels of disease activity. Influenza A (H1N1) and B viruses were reported less frequently. In North America, isolates of influenza A (H3N2), A (H1N1), and B were identified sporadically. This report summarizes influenza activity in the United States and worldwide during May-October 2004. Influenza activity in North America typically peaks during December-March.

United States

Until recently, in the United States, national influenza surveillance was conducted by four systems that operated during October-May. . . .

For the 2004-05 influenza season, CDC has added two new surveillance systems: one that tracks naturally reported pediatric deaths associated with laboratory-confirmed influenza infections and another that tracks hospitalizations associated with laboratory-confirmed influenza infections in children aged <18 years. . . .

During May 23-October 2, the weekly percentage of patient visits to sentinel providers for ILI [influenza-like illness] ranged from 0.4% to 0.8%. WHO and NREVSS [National Respiratory and Enteric Virus Surveillance System] collaborating laboratories tested 11,916 respiratory specimens; 54 (0.5%) were positive for influenza. Of the positive results, 29 (54%) were influenza B viruses, 14 (26%) were influenza A (H3N2) viruses, and 11 (20%) were influenza A viruses that were not subtyped. Both influenza A and B viruses were reported during late May-September 2004.

During October 3-16, influenza activity occurred at low levels in the United States. Since October 3, WHO and NREVSS collaborating laboratories in the United States have tested 1,414 respiratory specimens; eight (0.6%) were positive. Of these, six were influenza A viruses, and two were influenza B viruses. The proportion of patient visits to sentinel providers for ILI and the proportion of deaths attributed to pneumonia and influenza were below baseline levels. During the week ending October 16, nine states and New York City reported sporadic influenza activity, and 40 states and the District of Columbia reported no influenza activity. . . .

[From the Editorial Note]
During May-October 2004, influenza A (H3N2) viruses were the most frequently reported virus subtype worldwide; however, influenza A (H1N1) and influenza B viruses also circulated. At this time, neither the influenza virus subtype that will predominate in the United States nor the severity and timing of the 2004-05 season can be predicted.

The ongoing widespread epizootic of highly pathogenic H5N1 [avian influenza A] viruses in Asia remains a major concern. Since December 2003, nine Asian countries have reported H5N1 poultry outbreaks, with human cases reported from two of these countries. No evidence of sustained person-to-person transmission has been identified to date, although a probable instance of limited person-to-person transmission in a family cluster was identified recently in Thailand. CDC continues to recommend enhanced surveillance for suspected H5N1 cases among travelers with severe unexplained respiratory illness returning from H5N1-affected countries. Additional information about avian influenza is available at http://www.phppo.cdc.gov/han/archivesys/viewmsgv.asp?alertnum=00209

Influenza surveillance reports for the United States are published weekly during October-May and are available through CDC's voice (telephone, [888] 232-3228) and fax (telephone, [888] 232-3299, document number 361100) information systems and at http://www.cdc.gov/flu/weekly/fluactivity.htm Additional information about influenza viruses, influenza surveillance, and the influenza vaccine is available at http://www.cdc.gov/flu

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5342a5.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5342.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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November 1, 2004
VIS TRANSLATIONS: NEW HEPATITIS A VACCINE VIS NOW AVAILABLE IN EIGHT ADDITIONAL LANGUAGES

Dated 8/4/04, the current version of the VIS for hepatitis A vaccine is now available on the IAC website in eight additional languages: Arabic, Armenian, Cambodian, Farsi, Haitian Creole, Hmong, Korean, and Vietnamese. IAC gratefully acknowledges the Massachusetts Department of Public Health for the Haitian Creole translation and the California Department of Health Services for the remaining translations.

PLEASE NOTE: When hepatitis A vaccine is added to the Vaccine Injury Compensation Program's injury table, presumably later in 2004, another hepatitis A vaccine VIS will be issued. To avoid large printing expenses, print off only as many of the 8/4/04 VISs as you anticipate needing for the next several months.

To obtain a ready-to-copy (PDF) version of the VIS for hepatitis A vaccine in ARABIC, go to:
http://www.immunize.org/vis/ab_hpa04.pdf

To obtain it in ARMENIAN, go to:
http://www.immunize.org/vis/ar_hpa04.pdf

To obtain it in CAMBODIAN, go to:
http://www.immunize.org/vis/ca_hpa04.pdf

To obtain it in FARSI, go to:
http://www.immunize.org/vis/fa_hpa04.pdf

To obtain it in HAITIAN CREOLE, go to:
http://www.immunize.org/vis/ha_hpa04.pdf

To obtain it in HMONG, go to:
http://www.immunize.org/vis/hm_hpa04.pdf

To obtain it in KOREAN, go to:
http://www.immunize.org/vis/ko_hpa04.pdf

To obtain it in VIETNAMESE, go to:
http://www.immunize.org/vis/vn_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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November 1, 2004
REMINDER: NOVEMBER 19 IS THE DEADLINE FOR ABSTRACTS FOR CDC'S 2005 NATIONAL IMMUNIZATION CONFERENCE

November 19 is the deadline for submitting abstracts for CDC's 2005 National Immunization Conference, which will be held in Washington, DC, on March 21-24, 2005. The deadline for early-bird registration ($150) is January 28. The deadline for regular registration ($175) is March 4.

Abstracts must be submitted online. To access submission guidelines, go to: http://www.cdc.gov/nip/nic/#abstract

For general conference information, including conference goals, objectives, and registration, go to: http://www.cdc.gov/nip/nic

For additional information, contact the conference planning team at (404) 639-8225 or nipnic@cdc.gov
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November 1, 2004
CDC ISSUES NOTICE ABOUT FALSE-POSITIVE HBsAg TESTS

CDC recently posted the following notice on the Viral Hepatitis section of the National Center for Infectious Diseases' (NCID) website.

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FALSE-POSITIVE HBsAg TESTS NOTED

BD and Abbott Diagnostics have initiated an investigation concerning the increased rate of initial and/or repeat reactive results for the AUSZYME Monoclonal test when using BD Vacutainer SST Plus tubes. As described in the AUSZYME package insert, reactive specimens should be repeated in duplicate. If either of the repeats is positive, the sample should then be tested with a licensed neutralizing confirmatory test, such as the HBsAg Confirmatory Assay. Only those specimens in which the HBsAg can be neutralized by the confirmatory test procedure may be designated as positive for HBsAg. All highly sensitive immunoassay systems have a potential for nonspecific reactions. The specificity of a repeatedly reactive specimen can be confirmed by neutralization tests.

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To access the notice, go to: http://www.cdc.gov/ncidod/diseases/hepatitis/new.htm#top Click on the link titled "False positive HBsAg tests noted."

For additional technical or product-related information, read the BD technical bulletin at http://www.bd.com/vacutainer/pdfs/techbulletins/Abbott_Diagnostics_17september2004.pdf

If you have identified a cluster of infants born to false-positive HBsAg mothers, who because of the false-positive results, have been monitored as if they were born to HBsAg-positive mothers, please call Susan A. Wang, MD, MPH, at NCID at (404) 371-5953.
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November 1, 2004
CDC REPORTS ON LABORATORY SURVEILLANCE FOR WILD AND VACCINE DERIVED POLIOVIRUSES DURING JANUARY 2003-JUNE 2004

CDC published "Laboratory Surveillance for Wild and Vaccine-Derived Polioviruses, January 2003-June 2004" in the October 29 issue of MMWR. Portions of a summary made available to the press are reprinted below.

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In 1988, the World Health Organization (WHO) established a global laboratory network to ensure that specimens from acute flaccid paralysis cases undergo appropriate processing and testing to detect the presence of poliovirus. The network currently includes 123 national laboratories, 15 regional reference laboratories, and 7 global specialized laboratories. Between January 2003 and June 2004, the network tested 104,946 specimens. The network analyzes the genetic data from all wild poliovirus isolates to determine their relatedness and infer common sources and chains of transmission. Six wild poliovirus genotypes were detected between January 2003 and June 2004. The network has also played a role in detecting the circulation of vaccine-derived poliovirus, which has the potential to cause outbreaks of poliomyelitis. The network is playing a key role in the global eradication of polio.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5342a4.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5342.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 November 2, 2004