Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 555            October 3, 2005

CONTENTS OF THIS ISSUE

  1. CDC issues official Health Advisory about Menactra meningococcal vaccine and Guillain Barre Syndrome
  2. New: October 2005 issue of Needle Tips offers many resources for childhood, adolescent, and adult immunization
  3. New: Influenza Vaccine Bulletin #3 available for the 2005-06 influenza season
  4. New: NIP makes its Vaccine Storage and Handling Toolkit available in web-based and CD-ROM formats
  5. Locate influenza clinics with ALA's online Flu Clinic Locator or your 2-1-1 information-and-referral call center
  6. NIAID and MedImmune to collaborate in developing vaccines against potential pandemic influenza viruses
  7. New: ECBT launches a vaccine safety web section
  8. VIS translations: Interim influenza vaccine VISs now available in Haitian Creole, Portuguese, and Turkish
  9. Reminder: Two-day course "Epidemiology & Prevention of VPDs" to be held at two California sites in November
  10. CDC reports on WHO's laboratory surveillance for wild and vaccine-derived polioviruses during 2004-05

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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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October 3, 2005
CDC ISSUES OFFICIAL HEALTH ADVISORY ABOUT MENACTRA MENINGOCOCCAL VACCINE AND GUILLAIN BARRE SYNDROME

On September 30, CDC issued an official Health Advisory for the public and healthcare providers about Menactra meningococcal vaccine and Guillain Barre Syndrome. The Health Advisory is reprinted below in its entirety.

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This is an official CDC Health Advisory
Distributed via Health Alert Network
Friday, September 30, 2005, 19:00 EDT (7:00PM EDT)

FDA AND CDC ISSUE ALERT ON MENACTRA MENINGOCOCCAL VACCINE AND GUILLAIN BARRE SYNDROME

The Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) are alerting consumers and healthcare providers to five reports of Guillain Barre Syndrome (GBS) following administration of Meningococcal Conjugate Vaccine A, C, Y, and W135 (trade name Menactra), manufactured by sanofi pasteur. It is not known yet whether these cases were caused by the vaccine or are coincidental. FDA and CDC are sharing this information with the public now and actively investigating the situation because of its potentially serious nature.

Guillain Barre Syndrome (GBS) is a serious neurological disorder that can occur, often in healthy individuals, either spontaneously or after certain infections. GBS typically causes increasing weakness in the legs and arms that can be severe and require hospitalization.

Meningococcal infection, which Menactra prevents, is a major cause of bacterial meningitis, affecting approximately 1 in 100,000 people annually. The infection can be life threatening:

10-14 percent of cases are fatal and 11-19 percent of survivors may have permanent disability.

According to Jesse Goodman, MD, director of FDA's Center for Biologics Evaluation and Research, at the present time there are no changes in recommendations for vaccination; individuals should continue to follow their doctors' recommendations. FDA and CDC are not able to determine if any or all of the cases were due to vaccination. The current information is very preliminary and the two agencies are continuing to evaluate the situation.

Because of the potentially serious nature of this matter, FDA and CDC are asking any persons with knowledge of any possible cases of GBS occurring after Menactra to report them to the Vaccine Adverse Event Reporting System (VAERS) to help the agencies further evaluate the matter. Individuals can report to VAERS on the web at www.vaers.hhs.gov or by phone at (800) 822-7967.

The five cases of GBS reported following administration of Menactra occurred in individuals living in NY, OH, PA, and NJ. All five patients were 17 or 18 years of age and developed weakness or abnormal sensations in the arms or legs, two-four weeks after vaccination. All individuals are reported to be recovering or to have recovered. More than 2.5 million doses of Menactra vaccine have been distributed to date. The rate of GBS based on the number of cases reported following administration of Menactra is similar to what might have been expected to occur by coincidence, that is, even without vaccination. However, the timing of the events is of concern. Also, vaccine adverse events are not always reported to FDA so there may be additional cases of which we are unaware at this time.

Prelicensure studies conducted by sanofi pasteur of more than 7000 recipients of Menactra showed no GBS cases. CDC conducted a rapid study using available healthcare organization databases and found that no cases of GBS have been reported to date among 110,000 Menactra recipients.

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To access the Health Alert from the archives of the Health Alert Network, go to:
http://www.phppo.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00237
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October 3, 2005
NEW: OCTOBER 2005 ISSUE OF NEEDLE TIPS OFFERS MANY RESOURCES FOR CHILDHOOD, ADOLESCENT, AND ADULT IMMUNIZATION

IAC recently mailed the latest issue of Needle Tips (October 2005) to 130,000 health professionals and others who work in the field of immunization. Packed with immunization resources for health professionals, patients, and parents, the 24-page issue is well worth downloading. All articles and education pieces, except editorials, have been thoroughly reviewed by immunization and hepatitis experts at CDC.


HOW TO READ NEEDLE TIPS ON THE WEB
You can view selected articles from the table of contents below or download the entire issue from the Web.

To view the table of contents with links to individual articles, go to: http://www.immunize.org/nt

The PDF file of the entire issue, linked below, is 1 megabyte. For tips on downloading and printing PDF files, go to: http://www.immunize.org/nslt.d/tips.htm

To download a ready-to-print (PDF) version of the October issue, go to: http://www.immunize.org/nslt.d/n33/n33.pdf

The articles in the October issue fall into five broad areas: (1) general immunization, (2) influenza vaccination, (3) viral hepatitis, (4) childhood and adolescent immunization, and (5) adult immunization.


GENERAL IMMUNIZATION (three resources)
(1) In "Ask the Experts," CDC specialists answer questions about vaccines and their recommended use.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/nslt.d/n33/expert33.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/nslt.d/n33/expert33.htm

(2) "Vaccine Highlights" presents information on four newly licensed vaccines, updated influenza recommendations, and the 2004 vaccination rates for 19-35 month olds.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/nslt.d/n33/vaccin33.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/nslt.d/n33/vaccin33.htm

(3) Newly adapted from the Michigan Department of Community Health, "Healthcare Worker Vaccination Recommendations" offers a succinct overview of seven vaccines all or some healthcare workers should receive.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p2017.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2017.htm


INFLUENZA VACCINATION (four resources)
(1) Developed in response to many requests, "Standing Orders for Administering Influenza Vaccines to Children & Adolescents" presents a model protocol for administering the injectable and nasal-spray influenza vaccines to children and adolescents without a physician's direct order.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p3074a.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p3074a.htm

(2) Updated in August, "Standing Orders for Administering Influenza Vaccines to Adults" now includes information on the new influenza recommendations for injectable and nasal-spray vaccines.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p3074.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p3074.htm

(3) Updated in July, "Screening Questionnaire for Intranasal Influenza Vaccination" lets adult patients indicate if they or their child have contraindications to the live attenuated influenza vaccine (LAIV).

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p4067.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4067.htm

(4) Updated in July, "Screening Questionnaire for Injectable Influenza Vaccination" lets adult patients indicate if they or their child have contraindications to the trivalent inactivated influenza vaccine (TIV).

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p4066.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4066.htm


VIRAL HEPATITIS (two resources)
(1) Updated in September, the professional-education piece "Hepatitis B Facts: Testing and Vaccination" now includes a section on managing chronic hepatitis B infection and information about using results of serologic tests to determine whom to vaccinate.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p2110.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2110.htm

(2) Updated in September, the education piece "Hepatitis A, B, and C: Learn the Differences" offers new hepatitis B treatment information.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p4075abc.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4075abc.htm


CHILDHOOD AND ADOLESCENT IMMUNIZATION (two resources)
(1) "Summary of Recommendations for Childhood and Adolescent Immunization" now includes information on administering the newly licensed meningococcal conjugate vaccine (MCV4).

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/rules1.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/nslt.d/n17/rules1.htm

(2) Updated in September, the parent-education piece "Reliable Sources of Immunization Information: Where to go to Find Answers!" lists online, telephone, print, and video immunization resources.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p4012.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4012.htm


ADULT IMMUNIZATION (two resources)
(1) Updated in September, "Summary of Recommendations for Adult Immunization" now includes the updated influenza recommendations, as well as information on newly licensed vaccines.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p2011b.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2011b.htm

(2) The two-page patient-screening questionnaire "Do I Need Any Vaccinations Today?" makes it easy for patients to check off indicators for eight adult vaccinations.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/4036need.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/4036need.htm
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October 3, 2005
NEW: INFLUENZA VACCINE BULLETIN #3 AVAILABLE FOR THE 2005-06 INFLUENZA SEASON

On September 29, NIP issued Influenza Vaccine Bulletin #3. IAC Express has already covered much of the material presented in the bulletin. Following is material we have not yet covered.

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INFLUENZA VACCINE SUPPLY AND PRODUCTION

PROJECTION OF THE 2005-06 INFLUENZA VACCINE SUPPLY:
None of the manufacturers have changed projections since publication of Bulletin #2. Total production is estimated to range between 71 and 97 million doses. The lower estimate includes inactivated vaccine produced by manufacturers sanofi pasteur, Inc. and GlaxoSmithKline and live attenuated vaccine produced by the manufacturer MedImmune. All 3 of these companies have had lots released for distribution by the U.S. Food and Drug Administration (FDA). Approximately 10 million doses from sanofi pasteur, Inc. are late-production doses. The upper estimate includes inactivated vaccine projected to be available from Chiron. However, no lots of Chiron vaccine have been released by FDA to date.

INFLUENZA VACCINE PACKAGE INSERTS:
For details about influenza vaccines being produced by the four manufacturers licensed in the United States, consult their package inserts at the following links:

FDA LISTS INFLUENZA VACCINE LOT RELEASES:
To see an up-to-date list of influenza vaccine lot releases by company go to www.fda.gov/cber/flu/flulot091405.htm

INFLUENZA VACCINE DISTRIBUTION AND ADMINISTRATION

ORDERING INFLUENZA VACCINE:

  • Providers may need to explore several potential sources to find influenza vaccine. The Health Industry Distributors Association (HIDA) offers a listing of many of the distributors that are carrying influenza vaccine this year at http://www.hida.org/document.asp?document_id=10082

COST OF INFLUENZA VACCINE:
The following table provides catalog prices of each of the influenza vaccines licensed for use in the United States this season. The amounts a purchaser pays may differ depending upon such variables as the quantities purchased, contractual arrangements, and source of purchase.

Influenza Vaccine Catalog Prices, by Manufacturer, 2005-06**
Company/Presentation Price/dose
MedImmune
   Returnable single-dose sprayer (<=20 doses) $25.25
   Non-returnable single-dose sprayer (<50 doses) $20.70
   Non-returnable single-dose sprayer (>=50 doses) $19.70
sanofi pasteur, Inc.
   Multi-dose vial (ages >=6 months) $10.70
   Single-dose vial, 0.5mL (ages 3+ years) Unavailable
   Single-dose syringe, 0.5mL (ages 3+ years) $14.00
   Single-dose syringe, 0.25mL (ages 6-35 months) $13.00
GlaxoSmithKline
   Single-dose syringe, 0.5mL (ages >=18 years) $11.00
Chiron
   Multi-dose vial (ages >=4 years) $11.00
   Single-dose syringe (ages >=4 years) $13.65

**All prices were provided by the individual influenza vaccine manufacturers. All prices include $.75 excise tax.

INFLUENZA VACCINE ADDED TO THE NATIONAL VACCINE INJURY COMPENSATION PROGRAM:
See more information on this recent development, including the Federal Register notice and a Question and Answer compilation at http://www.hrsa.gov/osp/vicp To cover the costs of inclusion in the program, a $.75 excise tax is levied on each dose of influenza vaccine sold.

INFLUENZA VACCINE COMMUNICATIONS AND RESOURCES

MEDICARE INFORMATION:
For a variety of helpful information materials about Medicare topics such as billing and payment rates, and a substantial amount of related educational resources, check the following links:

(1) http://www.cms.hhs.gov/preventiveservices/2.asp
(2) http://www.cms.hhs.gov/medlearn/refimmu.asp#edu

INFLUENZA VACCINE BULLETINS:
Refer to previous bulletins at http://www.cdc.gov/flu/professionals/flubulletin.htm Individual requests for subscriptions to the bulletin should be emailed to listserv@listserv.cdc.gov Type "subscribe flu-serve" in the body of the email.

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To access a ready-to-print (PDF) version of Influenza Vaccine Bulletin #3 in its entirety, go to:
http://www.cdc.gov/flu/professionals/bulletin/pdf/2005-06/bulletin3_092905.pdf

To access a web-text (HTML) version of it, go to:
http://www.cdc.gov/flu/professionals/bulletin/2005-06/bulletin3_092905.htm
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October 3, 2005
NEW: NIP MAKES ITS VACCINE STORAGE AND HANDLING TOOLKIT AVAILABLE IN WEB-BASED AND CD-ROM FORMATS

NIP recently announced that its professional-education resource Vaccine Storage and Handling Toolkit is now available online and on CD. The toolkit features 11 chapters of information, numerous online resources, and two videos, How to Protect Your Vaccine Supply (updated in June 2005) and 10 Top Vaccine Storage and Handling Errors.

THE TOOLKIT ONLINE. To access the toolkit on the Web, go to:
http://www2a.cdc.gov/nip/isd/shtoolkit/splash.html

The toolkit requires Windows Media 9 Player, Macromedia Flash 7 Player, and Acrobat Reader 6, all of which can be installed at no charge. For installation information, go to:
http://www2a.cdc.gov/nip/isd/shtoolkit/helpinstall.html

THE TOOLKIT ON CD-ROM. To order a CD from NIP's online catalog, go to: https://www2.cdc.gov/nchstp_od/PIWeb/niporderform.asp In the section on publications for healthcare providers, look for item #99-8263. Orders are limited to one CD-ROM; however, you can order a master CD for mass duplication.

PLEASE NOTE: NIP is no longer distributing the videotape How to Protect Your Vaccine Supply as a discrete product, separate from the toolkit. To order it separately, contact IAC at admin@immunize.org (email), https://www.immunize.org/vachandling (online order form), (651) 647-9131 (fax), or (651) 647-9009 (phone).
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October 3, 2005
LOCATE INFLUENZA CLINICS WITH ALA'S ONLINE FLU CLINIC LOCATOR OR YOUR 2-1-1 INFORMATION-AND-REFERRAL CALL CENTER

[The following two articles are cross posted with thanks from the bi-monthly newsletter of Every Child By Two, September 2005.]

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FLU CLINIC LOCATOR FROM THE AMERICAN LUNG ASSOCIATION

For the [third] year in a row, the American Lung Association (ALA) will provide its Flu Clinic Locator online at http://www.flucliniclocator.org

By typing in their 5-digit zip code, site visitors can receive a list of clinics in their surrounding area offering the vaccine. An estimated 23,000 clinics will be posted on the site this year.

For more information about the ALA's Flu Clinic Locator, visit http://lungusa2.org/embargo/flucliniclocator05

For more information about the American Lung Association, visit their website at http://www.lungusa.org

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2-1-1: A NEW FLU VACCINATION FINDER CALL SERVICE

2-1-1 is an easy-to-remember telephone number that connects callers to information about critical health and human services available in their community. By dialing 2-1-1, information and referral (I&R) service questions can be addressed. For example, 2-1-1 can be a shelter locator after a natural disaster or an influenza vaccination clinic finder. Connecticut, Hawaii, Idaho, Iowa, Minnesota, North Dakota, New Jersey, Texas, Utah, Vermont, and West Virginia have statewide 2-1-1 phone service. When this system is connected nationwide it will allow "one number for one nation."

Statewide flu leadership groups may talk to their local 2-1-1 call center director or their local Community Information & Referral center director about how to get 2-1-1 reports that showcase the call volume related to this issue.

Please share this announcement with doctors' offices and flu vaccination clinic coordinators in your area. Anyone with flu vaccine can register details with a local 2-1-1 call center. 2-1-1 will then add that detail to their database and take many calls from the community. . . .

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To access a ready-to-print (PDF) version of the September 2005 newsletter, go to: http://www.ecbt.org/0905TextOnly.pdf

To access a web-text (HTML) version of it, go to:
http://www.ecbt.org/new0905.html
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October 3, 2005
NIAID AND MEDIMMUNE TO COLLABORATE IN DEVELOPING VACCINES AGAINST POTENTIAL PANDEMIC INFLUENZA VIRUSES

On September 28, the Department of Health and Human Services (DHHS) issued a press release outlining details of a planned collaboration between the National Institute of Allergy and Infectious Diseases (NIAID) to develop multiple vaccines against potential pandemic influenza viruses. Portions of the press release are reprinted below.

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For immediate release
Wednesday, Sept. 28, 2005

NIAID AND MEDIMMUNE JOIN FORCES TO DEVELOP POTENTIAL PANDEMIC INFLUENZA VACCINES

HHS Secretary Mike Leavitt today announced that the National Institute of Allergy and Infectious Diseases (NIAID) and MedImmune Inc. have signed a cooperative research and development agreement for the development of vaccines against avian influenza viruses that have the potential to cause pandemics. Under the agreement, NIAID, part of the National Institutes of Health, and MedImmune of Gaithersburg, MD, will produce and test multiple vaccines against potential pandemic flu strains, including the H5N1 avian influenza virus.

"The threat of pandemic flu is an urgent health challenge," Secretary Leavitt said. "This agreement will help speed the process of developing vaccines we will need to fight an outbreak if the avian flu starts to spread rapidly through the human population."

Kanta Subbarao, MD, MPH, and Brian Murphy, MD, of NIAID's Laboratory of Infectious Diseases will lead NIAID's part in this collaboration. The agreement specifies that the scientists will add selected genes from avian flu viruses with pandemic potential into a weakened human flu virus to create several attenuated, live virus vaccine candidates.

"Our agreement with MedImmune coordinates public and private resources and brings a deeper pool of talent to bear on the urgent need for vaccines to combat the threat of an influenza pandemic," said NIAID director Anthony S. Fauci, MD. "It is an example of the many productive public-private partnerships upon which we depend in our quest to develop vaccines, drugs, and diagnostics for myriad infectious disease threats. . . ."

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To access the complete press release, go to:
http://www.hhs.gov/news/press/2005pres/20050928.html
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October 3, 2005
NEW: ECBT LAUNCHES A VACCINE SAFETY WEB SECTION

[The following is cross posted with thanks from the bi-monthly newsletter of Every Child By Two, September 2005.]

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ECBT UNVEILS NEW VACCINE SAFETY SECTION ON ITS WEBSITE

Every Child By Two [ECBT] is pleased to unveil a new section to our website focused solely on vaccine safety. This section provides our audience a complete list of scientific studies, information about the IOM [Institute of Medicine] studies on vaccine safety, summaries of media coverage, and a list of credible organizations and recommended vaccine safety resources. We hope that this information will help to inform parents and others interested in the safety of vaccines. To visit this section of the ECBT website, please go to http://64.14.120.34/ecbt/vaccinesafety.htm or go to the ECBT website main page at http://www.ecbt.org and click on the vaccine safety link.

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To access a ready-to-print (PDF) version of the September 2005 newsletter, go to: http://www.ecbt.org/0905TextOnly.pdf

To access a web-text (HTML) version of it, go to:
http://www.ecbt.org/new0905.html
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October 3, 2005
VIS TRANSLATIONS: INTERIM INFLUENZA VACCINE VISs NOW AVAILABLE IN HAITIAN CREOLE, PORTUGUESE, AND TURKISH

The interim VISs for the trivalent inactivated influenza vaccine (TIV) and the live attenuated intranasal influenza vaccine (LAIV) are now available on the IAC website in Haitian Creole and Portuguese. In addition, the VIS for TIV is also available in Turkish. IAC gratefully acknowledges the Massachusetts Department of Public Health for the Haitian Creole and Portuguese translations and Mustafa Kozanoglu, MD, and Murat Serbest, MD, for the Turkish translation.

INTERIM VISs FOR TIV (dated 7/18/05)
To obtain a ready-to-copy (PDF) version of the interim VIS for TIV in Haitian Creole, go to:
http://www.immunize.org/vis/ha_flu05.pdf

To obtain it in Portuguese, go to:
http://www.immunize.org/vis/pr_flu05.pdf

To obtain it in Turkish, go to:
http://www.immunize.org/vis/tu_flu05.pdf

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

INTERIM VISs FOR LAIV (dated 7/18/05)
To obtain a ready-to-copy (PDF) version of the interim VIS for LAIV in Haitian Creole, go to:
http://www.immunize.org/vis/haliveflu05.pdf

To obtain it in Portuguese, go to:
http://www.immunize.org/vis/prliveflu05.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/liveflu.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
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October 3, 2005
REMINDER: TWO-DAY COURSE "EPIDEMIOLOGY & PREVENTION OF VPDs" TO BE HELD AT TWO CALIFORNIA SITES IN NOVEMBER

NIP's popular two-day course "Epidemiology and Prevention of Vaccine-Preventable Diseases" is scheduled for two California sites in November. The course will be given November 14-15 in Sacramento and November 17-18 in Torrance.

For information or to register, contact Myan Nguyen by phone at (510) 620-3737 or by email at mnguyen2@dhs.ca.gov
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October 3, 2005
CDC REPORTS ON WHO'S LABORATORY SURVEILLANCE FOR WILD AND VACCINE-DERIVED POLIOVIRUSES DURING 2004-05

CDC published "Laboratory Surveillance for Wild and Vaccine-Derived Polioviruses, January 2004-June 2005" in the September 30 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

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Results of virologic testing of stool specimens taken from patients with acute flaccid paralysis provide the most important evidence to monitor the progress of the polio eradication initiative. This report describes the findings of surveillance for wild polioviruses and vaccine-derived polioviruses (VDPVs) by the WHO Global Polio Laboratory Network from January 2004 to June 2005. The network tested 134,855 samples in this period, a 37 percent increase from the preceding 18 months. The network operates at a very high level of routine proficiency, and has documented the presence of wild poliovirus in 22 countries (14 wild type 1 only; 8 with types 1 and 3; none with type 2). Genetic sequence data from several network laboratories documented the spread of wild type 1 poliovirus from Nigeria as far east as Indonesia. The Global Polio Laboratory Network has been key to monitoring progress towards achieving polio eradication.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5438a5.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5438.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html

 

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 October 4, 2005