Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 550            September 6, 2005

CONTENTS OF THIS ISSUE

  1. CDC website posts interim immunization recommendations for persons displaced by Hurricane Katrina
  2. CDC website posts interim immunization recommendations for emergency responders assisting with Hurricane Katrina
  3. DHHS establishes web page and toll-free number to identify health professionals to assist in Hurricane Katrina relief

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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 6, 2005
CDC WEBSITE POSTS INTERIM IMMUNIZATION RECOMMENDATIONS FOR PERSONS DISPLACED BY HURRICANE KATRINA

On September 6, the CDC website posted interim immunization recommendations for persons displaced by Hurricane Katrina. The interim recommendations are reprinted below in their entirety.

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INTERIM IMMUNIZATION RECOMMENDATIONS FOR INDIVIDUALS DISPLACED BY HURRICANE KATRINA

The purpose of these recommendations is two-fold:

1. To ensure that children, adolescents, and adults are protected against vaccine-preventable diseases in accordance with current recommendations. Immunization records are unlikely to be available for a large number of displaced children and adults. It is important that immunizations are kept current if possible.

2. To reduce the likelihood of outbreaks of vaccine-preventable diseases in large crowded group settings. Although the possibility of an outbreak is low in a vaccinated U.S. population, it is possible that outbreaks of varicella, rubella, mumps, or measles could occur. Although measles and rubella are no longer endemic to the United States, introductions do occur, and crowded conditions would facilitate their spread. Hepatitis A incidence is low in the affected areas, but postexposure prophylaxis in these settings would be logistically difficult and so vaccination is recommended. In addition, the influenza season will begin soon and influenza can spread easily under crowded conditions.

I. RECOMMENDED IMMUNIZATIONS

If immunization records are available:

Children and adults should be vaccinated according to the recommended child, adolescent, and adult immunization schedules.

If immunization records are not available:

Children aged 10 years and younger should be treated as if they were up-to-date with recommended immunizations and given any doses that are recommended for their current age. This includes the following vaccines:

  • Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP)
  • Inactivated poliovirus vaccine (IPV)
  • Haemophilus influenzae type b vaccine (Hib)
  • Hepatitis B vaccine (HepB)
  • Pneumococcal conjugate vaccine (PCV)
  • Measles-mumps-rubella vaccine (MMR)
  • Varicella vaccine unless reliable history of chickenpox
  • Influenza vaccine if in Tier 1.* This includes all children from 6-23 months and children up to age 10 with a high-risk condition (MMWR 2005;54:749-750). See: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5434a4.htm
  • Hepatitis A is not routinely recommended in all states; state immunization practice should be followed.

Children and adolescents (aged 11-18 years) should receive the following recommended immunizations:

  • Adult formulation tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap)
  • Meningococcal conjugate vaccine [MCV (ages 11-12 and 15 years only)]
  • Influenza vaccine if in Tier 1* (MMWR 2005;54:749-750). See:
    http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5434a4.htm

Adults (aged older than 18 years) should receive the following recommended immunizations:

School requirements
States affected by Hurricane Katrina had immunization requirements for school and daycare and it is likely that children enrolled prior to the disaster would be vaccinated appropriately. There is no recommendation to begin repeating vaccinations for children displaced by the disaster.

II. CROWDED GROUP SETTINGS

In addition to the vaccines given routinely as part of the child and adolescent schedules, the following vaccines should be given to displaced person living in crowded group settings:

Influenza:

  • Everyone 6 months of age [and older] should receive influenza vaccine. Children 8 years old or younger should receive 2 doses, at least one month apart.

Varicella:

  • Everyone [older than] 12 months of age should receive one dose of this vaccine unless they have a history of chickenpox.

MMR:

  • Everyone [older than] 12 months of age and born after 1957 should receive one dose of this vaccine.

Hepatitis A:

  • Everyone 2 years of age [and older] should receive one dose of hepatitis A vaccine unless they have a clear history of hepatitis A.

Immunocompromised individuals, such as HIV-infected persons, pregnant women, and those on systemic steroids, should not receive the live viral vaccines, varicella and MMR. Screening should be performed by self-report.

Documentation
It is critical that all vaccines administered be properly documented. Immunization records should be provided in accordance with the practice of the state in which the vaccine is administered. Immunization cards should be provided to individuals at the time of vaccination.

Standard immunization practices should be followed for delivery of all vaccines, including provision of Vaccine Information Statements.

Diarrheal diseases
Vaccination against typhoid and cholera are not recommended. Both diseases are extremely rare in the Gulf States, and there is no vaccine against cholera licensed for use in the United States.

Rabies vaccine should only be used for postexposure prophylaxis (e.g., after an animal bite or bat exposure) according to CDC guidelines.

Tier 1 recommendations include the following priority groups:

  • Persons ages 65 years [and older] with comorbid conditions
  • Residents of long-term care facilities
  • Persons aged 2-64 years with comorbid conditions
  • Persons 65 years [and older] without comorbid conditions
  • Children aged 6-23 months
  • Pregnant women
  • Healthcare personnel who provide direct patient care
  • Household contacts and out-of-home caregivers of children aged [less than] 6 months

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To access a ready-to-print (PDF) version of the interim recommendations, go to:
http://www.bt.cdc.gov/disasters/hurricanes/katrina/pdf/vaccrecdisplaced.pdf

To access a web-text (HTML) version, go to:
http://www.bt.cdc.gov/disasters/hurricanes/katrina/vaccrecdisplaced.asp
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September 6, 2005
CDC WEBSITE POSTS INTERIM IMMUNIZATION RECOMMENDATIONS FOR EMERGENCY RESPONDERS ASSISTING WITH HURRICANE KATRINA

On September 1, the CDC website posted interim immunization recommendations for emergency responders involved in relief efforts for Hurricane Katrina. The recommendations are reprinted below in their entirety.

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INTERIM IMMUNIZATION RECOMMENDATIONS FOR EMERGENCY RESPONDERS: HURRICANE KATRINA

Required immunizations:

1. Tetanus and diphtheria toxoid (receipt of primary series, and Td booster within 10 years)

2. Hepatitis B vaccine series for persons who will be performing direct patient care or [are] otherwise expected to have contact with bodily fluids

There is no indication for the following vaccines given the anticipated conditions in the region:

  • Hepatitis A vaccine (low probability of exposure, even under these conditions, in U.S.). No transmission from contaminated water has been identified in the U.S. since the 1980s. Hepatitis A outbreaks have not occurred following other hurricanes or floods in other parts of the country, including the devastating hurricanes in Florida last year, and the Midwestern floods of the late 1990s. The Gulf Region has had few hepatitis A cases in recent years, with less than 10 in the past 3 months reported from the New Orleans area. Thus, even though the water and sewage systems are damaged or out of operation in many areas along the Gulf Coast, the risk of a hepatitis A epidemic is extremely low. Vaccine will take at least one to two weeks to provide substantial immunity.
     
  • Typhoid vaccine (low probability of exposure, even under these conditions, in U.S. ).
     
  • Cholera vaccine (low probability of exposure, even under these conditions, in U.S., plus no licensed cholera vaccine available in the U.S.).
     
  • Meningococcal vaccine (no expectation of increased risk of meningococcal disease among emergency responders).
     
  • Rabies vaccine series (the full series is required for protection). Persons who are exposed to potentially rabid animals should be evaluated and receive standard post-exposure prophylaxis, as clinically appropriate.

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To access a ready-to-print (PDF) version of the interim recommendations, go to:
http://www.bt.cdc.gov/disasters/hurricanes/pdf/katrina-responder-immun.pdf

To access a web-text (HTML) version of them, go to:
http://www.bt.cdc.gov/disasters/hurricanes/responderimmun.asp
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(3 of 3)
September 6, 2005
DHHS ESTABLISHES WEB PAGE AND TOLL-FREE NUMBER TO IDENTIFY HEALTH PROFESSIONALS TO ASSIST IN HURRICANE KATRINA RELIEF

On September 3, the Department of Health and Human Services (DHHS) established a web page and a toll-free number to help identify healthcare professionals and relief personnel to assist in Hurricane Katrina relief efforts.

To access the web page, go to: https://volunteer.ccrf.hhs.gov

To contact the toll-free number, call (866) 528-6334.  

 

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 September 6, 2005