Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 543            August 8, 2005

CONTENTS OF THIS ISSUE

  1. Do it today: Please thank Tim Russert for moderating the vaccines-and-autism debate on Meet the Press
  2. Must read: Slate.com article sheds light on controversy about thimerosal-containing vaccines and autism
  3. NIP announces temporary shortage of conjugated meningococcal vaccine
  4. CDC outlines priority groups for vaccination with injectable influenza vaccine in the event of a vaccine shortage
  5. Errata: MMWR corrects four errors in ACIP's newly released influenza recommendations
  6. Register today: Update on 2005-06 influenza vaccine communications and supply planned for August 16
  7. Three states enact immunization legislation for a variety of vaccines
  8. Updated: Spanish-language version of IAC's brochure "Immunization . . . Not Just Kids' Stuff"
  9. New: Interim 2005-06 VIS for injectable influenza vaccine now available in audio format

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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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August 8, 2005
DO IT TODAY: PLEASE THANK TIM RUSSERT FOR MODERATING THE VACCINES-AND-AUTISM DEBATE ON MEET THE PRESS

On August 7, Tim Russert of Meet the Press moderated a debate between Institute of Medicine Director Dr. Harvey Fineberg and "Evidence of Harm" author David Kirby. Please take time to thank him and the staff of Meet the Press for their handling of the vaccines-and-autism issue.

To access a complete transcript and an online video of the program, go to: http://www.msnbc.msn.com/id/3032608

To access the Meet the Press Mailbox, go to:
http://www.msnbc.msn.com/id/6872152
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August 8, 2005
MUST READ: SLATE.COM ARTICLE SHEDS LIGHT ON CONTROVERSY ABOUT THIMEROSAL-CONTAINING VACCINES AND AUTISM

On August 2, the online magazine Slate.com posted "Sticking Up for Thimerosal: Read the studies--it's safe." Written by Arthur Allen, the article is a concise chronology of events that have led to the current turmoil over the presence of thimerosal in childhood vaccines. It touches on scientific issues, as well as on the role anti-vaccine activists have played in the public debate on this issue. As such, it is a valuable resource for healthcare providers to recommend to parents concerned about vaccine safety.

Allen, a freelance science and health writer, is writing a history of vaccination.

To access "Sticking Up for Thimerosal," go to:
http://slate.msn.com/id/2123647
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August 8, 2005
NIP ANNOUNCES TEMPORARY SHORTAGE OF CONJUGATED MENINGOCOCCAL VACCINE

NIP website recently announced that conjugated meningococcal vaccine (MCV4) is temporarily in short supply, owing to a high volume of demand. Vaccine is being allocated in the public and private sectors based on estimates of monthly needs and on available supply. The supply-and-demand mismatch is expected to be short term. IAC Express will keep readers informed as the situation changes.

To access further information, go to:
http://www.cdc.gov/nip/news/shortages#Which
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August 8, 2005
CDC OUTLINES PRIORITY GROUPS FOR VACCINATION WITH INJECTABLE INFLUENZA VACCINE IN THE EVENT OF A VACCINE SHORTAGE

CDC published "Tiered Use of Inactivated Influenza Vaccine in the Event of a Vaccine Shortage" in the August 5 issue of MMWR. The article is reprinted below in its entirety with the exception of footnotes and one table, "Priority groups for vaccination with inactivated influenza vaccine and estimated vaccine coverage for 2003."

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The United States has experienced disruptions in the manufacture or distribution of inactivated influenza vaccine during three of the last five influenza seasons. Delays in delivery of influenza vaccine or vaccine shortages remain possible, in part, because of inherent time constraints in manufacturing the vaccine, given the annual updating of influenza vaccine strains and uncertainties regarding vaccine supply (including licensure of new vaccine preparations). Although total vaccine supply for the 2005-06 influenza season is not yet known, the minimum anticipated supply is approximately 58-60 million doses of inactivated vaccine and 3 million doses of live, attenuated vaccine. This estimated supply is similar to that available during the 2004-05 season and would be adequate to satisfy historical demand for influenza vaccine among persons considered by the Advisory Committee on Immunization Practices (ACIP) to be at high risk for serious complications associated with influenza virus infection, healthcare workers, and household contacts of children aged <6 months. These groups were prioritized for influenza vaccination in 2004-05. Additional doses of inactivated influenza vaccine might be available for the U.S. market in 2005-06, but this cannot yet be confirmed. Availability of additional vaccine would allow for expansion of the priority groups and, preferably, vaccination of all persons who desire it.

During periods of inactivated influenza vaccine shortfall, vaccination is prioritized on the basis of risk for serious influenza-associated complications. CDC and ACIP recommend use of vaccination priority groups only in the event of vaccine supply disruptions. At present, CDC and ACIP do not recommend prioritization of inactivated influenza vaccine for the 2005-06 season. Current recommendations for use of influenza vaccine were published recently. However, to help vaccine providers develop contingency plans for the upcoming influenza season in the event of a shortfall, this report details the priority groups for vaccination [IAC Express editor's note: these details are given in the table, which IAC Express readers can access by clicking on the links given at the end of this article]. Announcement of a need for prioritization will be made promptly upon receipt of information indicating a potential disruption to the vaccine supply, if necessary.

ACIP and CDC determined the priority groups, ranked in three tiers, on the basis of influenza-associated mortality and hospitalization rates. In the event of an influenza vaccine shortfall, persons in tier 1 should be vaccinated preferentially, followed by persons in tier 2, then persons in tier 3. On rare occasions when local vaccine supply is extremely limited, state and local health officials and vaccination providers should prioritize persons in group 1A before all other groups. However, in all other vaccine shortfall situations, persons in groups 1A, 1B, and 1C should be considered equivalent and should be vaccinated simultaneously. Eligible persons in group 1C and tiers 2 and 3 should be encouraged to receive live, attenuated influenza vaccine during periods of inactivated influenza vaccine shortfall.

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To access a web-text (HTML) version of the article, which includes the table "Priority groups for vaccination with inactivated influenza vaccine and estimated vaccine coverage for 2003," go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5430a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5430.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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August 8, 2005
ERRATA: MMWR CORRECTS FOUR ERRORS IN ACIP'S NEWLY RELEASED INFLUENZA RECOMMENDATIONS

CDC published "Errata: Vol. 54, No. RR-8" in the August 5 issue of MMWR. The article is reprinted below in its entirety.

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In the MMWR Recommendations and Reports, "Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)," the following errors occurred:

On page 2, the fourth bullet should read, "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."

On page 6, under the section "Children," the first sentence should read, "Children aged >=6 months can develop protective levels of anti-influenza antibody against specific influenza virus strains after influenza vaccination, although the antibody response among children at high risk for influenza-related complications might be lower than among healthy children."

On page 18, under the section "LAIV Dosage and Administration," the fourth sentence should read, "Alternatively, the vaccine can be thawed in a refrigerator and stored at 2 degrees C to 8 degrees C for up to 60 hours before use."

On page 20, under the section "Vaccination Before October," the last sentence should read, "For previously vaccinated children, 1 dose is needed to provide optimal protection against influenza."

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To access a web-text (HTML) version of the article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5430a6.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5430.pdf
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August 8, 2005
REGISTER TODAY: UPDATE ON 2005-06 INFLUENZA VACCINE COMMUNICATIONS AND SUPPLY PLANNED FOR AUGUST 16

A National Immunization Coalition TA [technical assistance] Network teleconference will update participants on influenza vaccine communications and supply for the 2005-06 influenza season. The teleconference will be held at 1PM ET on August 16. The facilitator is Karena Sapsis, health communications specialist, CDC/NIP.

The teleconference program will provide an update on the influenza vaccine supply situation, an overview of how CDC is going to communicate about influenza vaccine in light of the vaccine shortage experienced last year, and an overview of educational materials CDC has developed for the upcoming  influenza season.

To register, send an email IZTA@aed.org. Include this message in the subject line: "Sign me up for the Influenza Vaccine Communications Update call."

For additional information go to:
http://www.izcoalitionsta.org/confcall.cfm
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August 8, 2005
THREE STATES ENACT IMMUNIZATION LEGISLATION FOR A VARIETY OF VACCINES

Arizona, Texas, and Washington recently enacted legislation requiring immunization against various diseases. Arizona and Washington now require varicella vaccination, and Texas requires pneumococcal conjugate and hepatitis A vaccination.

VARICELLA VACCINATION
Arizona: On June 7, the Arizona Department of Health Services enacted a rule requiring varicella vaccination (or proof of disease) for children attending child-care facilities, kindergarten, and first and seventh grades. The rule becomes effective at the beginning of the 2005-06 school year. Two additional grades will be added each year until grades K-12 are covered.

Washington: On July 13, the Washington State Board of Health voted to add varicella vaccination to the state's immunization requirements for children younger than 13 years. The new requirement will be phased in beginning July 1, 2006. It calls for vaccination for children ages 19 months and older attending child-care facilities and either vaccination or verification of disease history for students enrolling in kindergarten and grade six.

The Immunization Action Coalition has compiled information about all states that have varicella prevention mandates for day care, elementary, and middle school entry. To access the information, go to:
http://www.immunize.org/laws/varicel.htm

This information is also depicted visually on a map of the United States. To access the map, go to:
http://www.immunize.org/laws/varimap.pdf

PNEUMOCOCCAL CONJUGATE AND HEPATITIS A VACCINATION
Texas: On June 17, the governor signed a bill into law to expand immunization requirements for children attending child-care facilities, effective September 1, 2005. Age-appropriate vaccination against invasive pneumococcal disease and hepatitis A are now required. The law allows children who have not completed the full series of vaccinations needed to be protected against these diseases to be provisionally enrolled in child care as long as they have begun the vaccination series.

The Immunization Action Coalition has compiled information about state hepatitis A vaccination recommendations and policies. To access the information, go to:
http://www.immunize.org/laws/hepa.htm

This information is also depicted visually on a map of the United States. To access the map, go to:
http://www.immunize.org/laws/hepamap.pdf

We depend on our readers to help us stay informed and ensure our website contains the most current and accurate information available. Please let us know when any changes occur in your state by emailing us at admin@immunize.org
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August 8, 2005
UPDATED: SPANISH-LANGUAGE VERSION OF IAC'S BROCHURE "IMMUNIZATION . . . NOT JUST KIDS' STUFF"

IAC recently posted an updated Spanish-language version of its patient-education brochure "Immunization. . .Not Just Kids' Stuff." We are grateful to the New York State Department of Health Services for the translation.

In addition, IAC made a slight change to the English-language version of the brochure to update the phone number of the CDC-INFO Contact Center.

To access a ready-to-print (PDF) version of the Spanish-language brochure, go to: http://www.immunize.org/catg.d/p4035-01.pdf

To access a web-text (HTML) version of it, go to:
http://www.immunize.org/catg.d/p4035-01.htm

To access a ready-to-print (PDF) version of the English-language brochure, go to: http://www.immunize.org/catg.d/p4035.pdf

To access a web-text (HTML) version of it, go to:
http://www.immunize.org/nslt.d/n17/p4035.htm
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August 8, 2005
NEW: INTERIM 2005-06 VIS FOR INJECTABLE INFLUENZA VACCINE NOW AVAILABLE IN AUDIO FORMAT

The interim 2005-06 VIS for injectable trivalent inactivated influenza vaccine (dated 7/18/05) is now available on IAC's website in audio format. The audio VIS is intended for use with low-literacy, English-speaking patients. IAC is grateful to Healthy Roads Media for providing the audio version. Healthy Roads Media offers health information in a variety of formats and languages. For information, go to:
http://www.healthyroadsmedia.org

To access the audio version of the VIS, go to: http://www.immunize.org/vis/#influenza In the Inactivated  Influenza Vaccine section, click on the link titled "English 7/18/05 (audio VIS*)."

To access a ready-to-print (PDF) hard-copy version of the VIS, go to: http://www.immunize.org/vis/2flu.pdf

For information about the use of VISs, and for VISs in a total of 33 languages, visit IAC's VIS web section at http://www.immunize.org/vis

 

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 August 8, 2005