Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 538            July 18, 2005

CONTENTS OF THIS ISSUE

  1. New: CDC issues the latest ACIP influenza recommendations in an "MMWR Early Release"
  2. MMWR notifies readers about August 9 webcast on prevention of human papilloma virus infection and cervical cancer
  3. Teleconference on communicating with legislatures about vaccine safety is scheduled for August 9
  4. CDC releases guidance statement on HIPAA and perinatal hepatitis B
  5. Learn about proposed hepatitis B vaccination strategies for U.S. adults
  6. Study reveals that handwashing with soap can save children's lives by reducing the incidence of certain diseases
  7. New: July 15 issue of IAC's Hep Express electronic newsletter now available online
  8. CDC reports on a survey of U.S. syringe exchange programs operating during 2002
  9. CDC reports on the use of a rapid analysis system to assess influenza vaccination coverage among California HMO members

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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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July 18, 2005
NEW: CDC ISSUES THE LATEST ACIP INFLUENZA RECOMMENDATIONS IN AN "MMWR EARLY RELEASE"

On July 13, CDC issued "Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)" as an electronic "MMWR Early Release." A hard copy of the recommendations will be printed in a future issue of MMWR. PLEASE NOTE: An error occurred on page 20 of the recommendations in the section Vaccination Before October. The last sentence should read, "For previously vaccinated children, 1 dose is needed to provide optimal protection against influenza."

Two sections of the recommendations are reprinted below: (1) the Summary and (2) a portion of the introduction titled Primary Changes and Updates in the Recommendations.

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SUMMARY
This report updates the 2004 recommendations by the Advisory Committee on Immunization Practices (ACIP) regarding the use of influenza vaccine and antiviral agents (CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2004;53[No. RR-6]:1-40). The 2005 recommendations include new or updated information regarding (1) vaccination of persons with conditions leading to compromise of the respiratory system; (2) vaccination of health-care workers; (3) clarification of the role of live, attenuated influenza vaccine (LAIV) in vaccine shortage situations; (4) the 2005-06 trivalent vaccine virus strains: A/California/7/2004 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like, and B/Shanghai/361/2002-like antigens (for the A/California/7/2004 [H3N2]-like antigen, manufacturers may use the antigenically equivalent A/New York/55/2004 virus, and for the B/Shanghai/361/2002-like antigen, manufacturers may use the antigenically equivalent B/Jilin/20/2003 virus or B/Jiangsu/10/2003 virus); and (5) the assessment of vaccine supply, timing of influenza vaccination, and prioritization of inactivated vaccine in shortage situations. A link to this report and other information can be accessed at http://www.cdc.gov/flu . . . .

[From the Introduction]
PRIMARY CHANGES AND UPDATES IN THE RECOMMENDATIONS
The 2005 recommendations include five principal changes or updates:

  • ACIP recommends that persons with any condition (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders) that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration be vaccinated against influenza (see Target Groups for Vaccination).
     
  • ACIP emphasizes that all healthcare workers should be vaccinated against influenza annually, and that facilities that employ healthcare workers be strongly encouraged to provide vaccine to workers by using approaches that maximize immunization rates.
     
  • Use of both available vaccines (inactivated and LAIV) is encouraged for eligible persons every influenza season, especially persons in recommended target groups. During periods when inactivated vaccine is in short supply, use of LAIV is especially encouraged when feasible for eligible persons (including healthcare workers) because use of LAIV by these persons might considerably increase availability of inactivated vaccine for persons in groups at high risk.
     
  • The 2005-06 trivalent vaccine virus strains are A/California/7/2004 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like, and B/Shanghai/361/2002-like antigens. For the A/California/7/2004 (H3N2)-like antigen, manufacturers may use the antigenically equivalent A/New York/55/2004 virus, and for the B/Shanghai/361/2002-like antigen, manufacturers may use the antigenically equivalent B/Jilin/20/2003 virus or B/Jiangsu/10/2003 virus (see Influenza Vaccine Composition).
     
  • CDC and other agencies will assess the vaccine supply throughout the manufacturing period and will make recommendations preceding the 2005-06 influenza season regarding the need for tiered timing of vaccination of different risk groups. In addition, CDC will publish ACIP recommendations regarding inactivated vaccine subprioritization (tiering) on a later date in MMWR. . . .

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To access a web-text (HTML) version of the recommendations, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr54e713a1.htm

To access a ready-to-print (PDF) version, go to:
http://www.cdc.gov/mmwr/pdf/rr/rr54e713.pdf
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July 18, 2005
MMWR NOTIFIES READERS ABOUT AUGUST 9 WEBCAST ON PREVENTION OF HUMAN PAPILLOMA VIRUS INFECTION AND CERVICAL CANCER

CDC published "Notice to Readers: Webcast on Human Papilloma Virus (HPV)" in the July 15 issue of MMWR. The notice is reprinted below in its entirety.

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CDC will present a webcast, "HPV and Cervical Cancer: An Update on Prevention Strategies," on August 9, 2005, 1:00-2:00PM EDT. Genital HPV infection is one of the most common sexually transmitted diseases. New information is available about the natural history of HPV infection, the association of different HPV types with various clinical manifestations, HPV transmission, and methods of HPV prevention. In addition, the Food and Drug Administration recently approved the use of a commercially available HPV DNA test for two purposes: (1) management of patients with abnormal Pap test results and (2) as an adjunct to the Pap test for cervical cancer screening in women aged >=30 years. This new information about HPV might require changes in approaches to cervical cancer screening in primary-care practices and in counseling and educating patients and their sex partners. The webcast will address cervical cancer screening guidelines and strategies for preventing genital HPV infection, including appropriate patient counseling messages.

Information about content, registration, continuing education credit, and accessing the webcast is available at http://www.phppo.cdc.gov/phtn/hpv-05 Information about registration is also available from CDC, telephone (800) 418-7246 or (404) 639-1292.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5427a5.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5427.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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July 18, 2005
TELECONFERENCE ON COMMUNICATING WITH LEGISLATURES ABOUT VACCINE SAFETY IS SCHEDULED FOR AUGUST 9

The National Immunization Coalition TA [technical assistance] Network has scheduled a teleconference on communicating with your legislature about vaccine safety. It will be held at 1PM ET on August 9. The network is a program of the Center for Health Communication, Academy for Educational Development.

The teleconference facilitator is Diane Peterson, associate director for immunization projects, Immunization Action Coalition.

In winter and spring 2005, several members of the Minnesota immunization community collaborated to defeat proposed anti-thimerosal legislation. Using this experience as a model, the teleconference discussion will cover the following: (1) key steps for building effective support/opposition to legislative initiatives; (2) resources helpful in achieving the above objective; and (3) importance of collaborating to support/oppose legislative initiatives.

To register for the teleconference, send an email to IZTA@aed.org and include the following in your message: "Sign me up for the Communicating with Your Legislature call."

For additional information go to:
http://www.izcoalitionsta.org/confcall.cfm
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July 18, 2005
CDC RELEASES GUIDANCE STATEMENT ON HIPAA AND PERINATAL HEPATITIS B

[The following is cross posted from IAC's Hep Express electronic newsletter, 7/15/05.]

The CDC Office of General Counsel has released the second in a series of guidance statements regarding the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule. "HIPAA and Perinatal Hepatitis B Prevention" was developed to answer common questions about the intent and implementation of the rule as it relates to accessing patient records for immunization assessment and surveillance.

To read "HIPAA and Perinatal Hepatitis B" and the first guidance statement, "HIPAA Privacy Rule and Public Health," go to: http://www.immunize.org/birthdose/hepb_hipaa.pdf
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July 18, 2005
LEARN ABOUT PROPOSED HEPATITIS B VACCINATION STRATEGIES FOR U.S. ADULTS

[The following is cross posted from IAC's Hep Express electronic newsletter, 7/15/05.]

Two new web pages offer information related to proposed strategies for adult hepatitis B vaccination in the United States.

First, CDC's Division of Viral Hepatitis (DVH) has posted notes online from an adult hepatitis B vaccination consultation meeting held in May 2005. DVH convened the meeting to discuss the implementation of proposed Advisory Committee on Immunization Practices (ACIP) strategies for adult hepatitis B vaccination.

Continuing low rates of hepatitis B vaccination among adults are attributed mainly to challenges in implementation. To address these challenges and accelerate elimination of HBV transmission in the United States, the ACIP drafted an updated statement on hepatitis B vaccination that includes new strategies for implementation of adult vaccination. This consultation was convened to consider the feasibility of these strategies and to address barriers, challenges, and opportunities. Lessons learned from the experiences of the invited participants and their comments on the proposed strategies will inform the final version of the ACIP statement on adult hepatitis B vaccination, which will be presented for a vote at the October 2005 ACIP meeting.

The meeting summary, highlights, PowerPoint presentations, and participant information can be viewed at http://www.cdc.gov/ncidod/diseases/hepatitis/partners/consultants_mtg_2005.htm

Second, the National Viral Hepatitis Roundtable (NVHR) has started a web page to advocate for a universal, age-based hepatitis B immunization recommendation. NVHR states, "We believe that vaccinating adults is a necessary and important step to eliminating hepatitis B in the United States, and that a recommendation [that] endorses age-based, rather than risk-based immunization, is the most effective way to achieve this goal."

Anyone interested in learning more about this issue is encouraged to visit NVHR's website where letters to ACIP from several organizations and individuals are posted. Go to: http://www.nvhr.org/acip_letters/acip.htm
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July 18, 2005
STUDY REVEALS THAT HANDWASHING WITH SOAP CAN SAVE CHILDREN'S LIVES BY REDUCING THE INCIDENCE OF CERTAIN DISEASES

On July 14, CDC issued a press release summarizing the results of a study published in the Lancet, a British medical journal. Conducted in Pakistan the study indicates that teaching children to wash their hands with soap and water can dramatically decrease the incidence of pneumonia, diarrhea, and impetigo. Portions of the press release are reprinted below.

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NEW STUDY DEMONSTRATES SIMPLE HANDWASHING WITH SOAP CAN SAVE CHILDREN'S LIVES

Handwashing with Soap Halved Incidence of Pneumonia--Leading Cause of Death in Children under Five Globally

Handwashing with soap can reduce the number of pneumonia-related infections in children under the age of five by more than 50 percent, according to a study published in the Lancet. The research, conducted in Pakistan by the Centers for Disease Control and Prevention (CDC) and P&G Beauty, a division of the Procter & Gamble Company (P&G), is the first field study to show that handwashing can help prevent pneumonia, the leading killer of children under age 5 worldwide.

The study in the Lancet's July 16 edition, also showed that handwashing with soap significantly reduced the number of diarrheal infections, the second leading cause of death in children under age 5. In addition, there was a 47 percent reduction in the prevalence of impetigo, a skin infection, in children who bathed daily with soap.

"Handwashing with soap is something that is within the reach of hundreds of millions of at-risk families worldwide," said Dr. Stephen Luby, the study's lead investigator and a medical epidemiologist at CDC. "This research can be used by families worldwide to greatly improve the health and save the lives of their children."

Acute respiratory infections account for an estimated 2 million children's deaths a year. Nearly 75 percent of those who die are less than a year old. Approximately 5 to 10 percent of all children living in developing countries under the age of 5 develop pneumonia each year. When combined, diarrhea and acute respiratory tract infections, both prevalent in low-income communities, kill an estimated 4 million children under age 5 each year.

"Many people, even in well-developed countries like the United States, do not realize that they should wash their hands with soap and water for at least 15 seconds, and that water alone is not as effective," said Tim Long, PhD, a principal scientist with P&G Beauty, which provided the soap used in the study. "Parents should encourage children to wash their hands with soap and water as long as it takes them to sing their ABCs. . . ."

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To access the complete press release, go to:
http://www.cdc.gov/od/oc/media/pressrel/r050714a.htm
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July 18, 2005
NEW: JULY 15 ISSUE OF IAC'S HEP EXPRESS ELECTRONIC NEWSLETTER NOW AVAILABLE ONLINE

The July 15 issue of Hep Express, an electronic newsletter published by IAC, is now available online. It is intended for health and social service professionals involved in the prevention and treatment of viral hepatitis. IAC Express has already covered some of the information presented in the July 15 Hep Express; titles of articles we have not yet covered follow.

  • National Alliance of State and Territorial AIDS Directors launches listserv related to viral hepatitis
  • Hillsborough County, Florida, shares perinatal hepatitis B prevention resources
  • Conference on methamphetamine, HIV, and hepatitis scheduled for August 19-20
  • IAC adds five programs to its hepatitis prevention programs website
  • VHPB updates its website with new meeting report

To access the July 15 issue, go to:
http://www.hepprograms.org/hepexpress/issue32.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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July 18, 2005
CDC REPORTS ON A SURVEY OF U.S. SYRINGE EXCHANGE PROGRAMS OPERATING DURING 2002

CDC published "Update: Syringe Exchange Programs--United States, 2002" in the July 15 issue of MMWR. Syringe exchange programs can help prevent transmission of bloodborne pathogens such as HIV and hepatitis B virus. A summary made available to the press is reprinted below in its entirety.

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A national survey conducted by New York's Beth Israel Medical Center finds that the total number of syringe exchange programs (SEPs) known by the North American Syringe Exchange Network to be operating in the United States decreased nearly 4 percent between 2000 and 2002. The total number of syringes exchanged by the programs participating in the survey, however, increased more than 10 percent, from 22.6 million to 24.9 million. The survey summarizes activities of 126 SEPs operating in 102 cities. In addition to providing new sterile syringes in exchange for used, often potentially infectious ones, nearly all of the SEPs offer other important public health services, including HIV prevention education (90%), education on safer injection practices (88%), substance-abuse treatment referrals (77%), and voluntary HIV counseling and testing (72%). As a result of such efforts, SEPS can provide a pathway to prevention, treatment, and care for individuals at risk for HIV. In addition, SEPs provide for the safe disposal of millions of potentially infectious syringes that might otherwise end up in the community.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5427a1.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5427.pdf
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July 18, 2005
CDC REPORTS ON THE USE OF A RAPID ANALYSIS SYSTEM TO ASSESS INFLUENZA VACCINATION COVERAGE AMONG CALIFORNIA HMO MEMBERS

CDC published "Rapid Assessment of Influenza Vaccination Coverage Among HMO Members--Northern California Influenza Seasons, 2001-02 Through 2004-05" in the July 15 issue of MMWR. The article's opening paragraph is reprinted below.

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The Vaccine Safety Datalink (VSD) is a collaborative project involving CDC and eight health maintenance organizations (HMOs) in the United States. Computerized data on vaccination, medical outcomes, and patient demographics are collected and linked under a standard protocol at multiple HMOs. Beginning with the 2003-04 influenza season, the VSD team and one of the HMOs, Kaiser Permanente Northern California (KPNC), established an automated system for rapid detection of potentially adverse events after vaccinations among its members. During the 2004-05 influenza season, in response to the influenza vaccine shortfall and resulting prioritization of vaccine distribution, this rapid analysis system also was used to assess influenza vaccination coverage weekly among KPNC members. The results indicated that KPNC followed Advisory Committee on Immunization Practices (ACIP) prioritization guidelines by targeting influenza vaccination to children aged 6-23 months and adults aged >=65 years. For the 2005-06 influenza season, the rapid analysis system should be expanded to include data from additional HMOs and more detailed information on vaccinees (e.g., high risk for influenza complications) to better characterize influenza vaccination coverage during the 2005-06 influenza season on a weekly basis. . . .

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5427a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5427.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 July 18, 2005