Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 558            October 17, 2005

CONTENTS OF THIS ISSUE

  1. FDA releases three lots of Chiron's Fluvirin vaccine for use during 2005-06 influenza season
  2. NEW: CDC issues Adult Immunization Schedule for October 2005-September 2006
  3. MMWR includes CDC's report on Guillain-Barre Syndrome among recent recipients of Menactra vaccine
  4. MMWR notifies readers about FDA's approval of VAQTA hepatitis A vaccine for children age 1 year and older
  5. New: The October 2005 issue of Vaccinate Adults is in the mail and on the Web
  6. Typo trouble: NIP corrects a typo on the interim VIS for Tdap vaccine
  7. Erratum: IAC Express corrects its October 10 article on Alaska's meningococcal mandate
  8. Update: IAC makes minor changes to four of its vaccine administration pieces
  9. Rate of pertussis hospitalizations for infants younger than 6 months increased by 20% from 1994-1998 to 1999-2003
  10. New: November 4 is the deadline for abstracts for the 2006 National Immunization Conference
  11. CDC's Influenza web section begins posting the "Weekly Report: Influenza Summary Update" for the 2005-06 season
  12. CDC's Influenza web section posts information on laboratory diagnosis of respiratory illness

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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 17, 2005
FDA RELEASES THREE LOTS OF CHIRON'S FLUVIRIN VACCINE FOR USE DURING 2005-06 INFLUENZA SEASON

The website of the FDA recently posted information that as of October 12 FDA had released three lots of Chiron Corp.'s Fluvirin trivalent inactivated influenza vaccine (TIV). To access the information, go to: http://www.fda.gov/cber/flu/flulot101205.htm
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October 17, 2005
NEW: CDC ISSUES ADULT IMMUNIZATION SCHEDULE FOR OCTOBER 2005-SEPTEMBER 2006

CDC published "Recommended Adult Immunization Schedule--United States, October 2005-September 2006" as an MMWR QuickGuide in the October 14 issue of MMWR. The article is reprinted below in its entirety, excluding references and two figures.

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Changes in the Schedule for October 2005-September 2006

The 2005-2006 schedule differs from the previous schedule as follows:

  • Vaccines listed on the age-based schedule (Figure 1) are displayed so that vaccines recommended for routine use can be differentiated from those recommended for adults with certain risk indicators (similar to the childhood immunization schedule). This is illustrated both by the color scheme and by the broken line.
     
  • The yellow bars ("For all persons in this group") and the green bars ("For persons lacking documentation of vaccination or evidence of disease") from the previous schedule have been merged into one yellow bar, which now reads, "For all persons in this category who meet the age requirements and who lack evidence of immunity (e.g., lack documentation of vaccination or have no evidence of prior infection)."
     
  • The purple bar has been changed from "For persons at risk (e.g., with medical/exposure indications)" to "Recommended if some other risk factor is present (e.g., on the basis of medical, occupational, lifestyle, or other indications)." The purple bar was added to the 50-64 years and >=65 years age-group columns for measles, mumps, rubella (MMR) vaccine.
     
  • The column, "Diabetes, heart disease, chronic pulmonary disease, or chronic liver disease including chronic alcoholism" has been transposed with the column, "Congenital immunodeficiency, leukemia, lymphoma, generalized malignancy, therapy with alkylating agents, antimetabolites, cerebrospinal fluid leaks, radiation, or large amounts of corticosteroids" on the medical/other indications schedule (Figure 2) so that contraindications for MMR and varicella vaccines are now side-by-side.
     
  • The row for varicella vaccine has been moved up on both figures (i.e., to immediately after MMR vaccine) because the vaccine is now universally recommended for certain age groups.
     
  • Meningococcal vaccine has been added to the medical/other indications schedule (Figure 2). The footnote has been revised to incorporate the recently published ACIP recommendations for this vaccine.
     
  • The tetanus and diphtheria footnote (#1) has been reworded.
     
  • The varicella footnote (#3) has been reworded in accordance with ACIP recommendations adopted in June 2005.
     
  • The influenza footnote (#4) has been revised to add the newest high-risk condition: neuromuscular conditions that compromise respiratory function.
     
  • A 10th footnote has been added regarding Haemophilus influenzae type b vaccination for populations at high risk (i.e., persons with asplenia, leukemia, and human immunodeficiency virus [HIV] infection).

The Adult Immunization Schedule is available in English at http://www.cdc.gov/nip/recs/adult-schedule.htm [IAC Express editor's note: The Spanish-language version will be available at a later date.] General information about adult immunization, including recommendations concerning vaccination of persons with HIV and other immunosuppressive conditions, is available from state and local health departments and from the National Immunization Program at http://www.cdc.gov/nip Vaccine information statements are available at http://www.cdc.gov/nip/publications/vis ACIP statements for each recommended vaccine can be viewed, downloaded, and printed from the National Immunization Program website at http://www.cdc.gov/nip/publications/acip-list.htm Instructions for reporting adverse events to the Vaccine Adverse Event Reporting System are available at http://www.vaers.hhs.gov or by telephone, (800) 822-7967.

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To access a web-text (HTML) version of the Adult Immunization Schedule, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5440-Immunizationa1.htm

To access a ready-to-print (PDF) version of it, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5440-Immunization.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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October 17, 2005
MMWR INCLUDES CDC'S REPORT ON GUILLAIN-BARRE SYNDROME AMONG RECENT RECIPIENTS OF MENACTRA VACCINE

CDC published "Guillain-Barre Syndrome Among Recipients of Menactra Meningococcal Conjugate Vaccine--United States, June-July 2005" in the October 14 MMWR. Previously, the article was available only in electronic format as an "MMWR Dispatch."

To access a web-text (HTML) version of the MMWR article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5440a6.htm

To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5440.pdf
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October 17, 2005
MMWR NOTIFIES READERS ABOUT FDA'S APPROVAL OF VAQTA HEPATITIS A VACCINE FOR CHILDREN AGE 1 YEAR AND OLDER

CDC published "Notice to Readers: FDA Approval of VAQTA (Hepatitis A Vaccine, Inactivated) for Children Aged [1 Year and Older]" in the October 14 issue of MMWR. The article is reprinted below in its entirety, with the exception of references.

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On August 11, 2005, the Food and Drug Administration (FDA) approved an application of a pediatric/adolescent formulation of VAQTA (hepatitis A vaccine, inactivated) (Merck & Co., Whitehouse Station, New Jersey) for use among persons aged 12 months-18 years. Previously, the pediatric/adolescent formulation of VAQTA was approved for use in persons aged 2-18 years. The approved labeling change applies only to VAQTA and not to other licensed hepatitis A vaccines.

The formulation, dosage, and schedule for VAQTA have not changed. Each 0.5 mL dose of the pediatric/adolescent formulation of VAQTA contains approximately 25 units of formalin-inactivated hepatitis A virus antigen, adsorbed onto aluminum hydroxyphosphate sulfate, in 0.9% sodium chloride. The formulation does not contain a preservative.

VAQTA is now indicated for active immunization of persons aged 12 months [and older] to protect against disease caused by hepatitis A virus. The primary vaccination schedule is unchanged and consists of 2 doses, administered on a 0, 6-18 month schedule. The Advisory Committee on Immunization Practices (ACIP) has issued recommendations for hepatitis A vaccination.

Results from the study to lower the age indication for VAQTA indicated that 100% of 343 initially seronegative children aged 12-23 months who received 2 doses of VAQTA had seroconverted to antibody levels previously indicated to be protective. The study also indicated that VAQTA may be administered concomitantly with M-M-R II (measles, mumps, and rubella virus vaccine live). Insufficient data are available to evaluate the concomitant use of VAQTA with other routinely recommended childhood vaccines. According to the general recommendations of ACIP, inactivated vaccines generally do not interfere with the immune response to other inactivated or live vaccines.

In combined clinical trials reported as part of the labeling change application, 706 healthy children aged 12-23 months received 1 [or more] doses of VAQTA alone or in combination with other routinely recommended pediatric vaccines. The most commonly reported complaints after 1 or both doses of VAQTA were similar to those reported among older children. VAQTA is contraindicated in persons with known hypersensitivity to any component of the vaccine.

Additional information is available from the manufacturer's package insert and at telephone (800) 672-6372.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5440a7.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5440.pdf
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October 17, 2005
NEW: THE OCTOBER 2005 ISSUE OF VACCINATE ADULTS IS IN THE MAIL AND ON THE WEB

IAC recently mailed the latest issue of Vaccinate Adults (October 2005) to 130,000 adult medicine specialists and others who work in the field of immunization. Packed with immunization resources for health professionals and patients, the 12-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 VACCINATE ADULTS 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/va

The PDF file of the entire issue, linked below, is 563,483 bytes. 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/va/va16.pdf

Below are descriptions of articles published in the October issue, followed by links:


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/va/va16exprt.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/va/va16exprt.htm

(2) "Vaccine Highlights" presents information on four newly licensed vaccines and updated influenza recommendations.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/va/va16vacc.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/va/va16vacc.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


ADULT IMMUNIZATION (one resource)
(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


VIRAL HEPATITIS (one resource)
(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


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
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October 17, 2005
TYPO TROUBLE: NIP CORRECTS A TYPO ON THE INTERIM VIS FOR Tdap VACCINE

NIP recently corrected a typo in the interim VIS for tetanus-diphtheria-pertussis (Tdap) vaccine. In the first section (Why get vaccinated?), the last sentence in the paragraph titled PERTUSSIS now reads, "Up to 2 in 100 adolescents with pertussis are hospitalized or have complications." Previously, the sentence had read, "Up to 2 in 10 adolescents with pertussis are hospitalized or have complications."

To access a ready-to-print (PDF) version of the corrected interim VIS (dated 9/22/05) from the NIP website, go to: http://www.cdc.gov/nip/publications/VIS/vis-tdap.pdf

To access a ready-to-print (PDF) version of it from the IAC website, go to: http://www.immunize.org/vis/tdap.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 17, 2005
ERRATUM: IAC EXPRESS CORRECTS ITS OCTOBER 10 ARTICLE ON ALASKA'S MENINGOCOCCAL MANDATE

The title of article #6 in IAC Express #557 (dated October 10) was misleading. The title, which read "New: Alaska mandates meningococcal vaccine for college students; three more states let pharmacists vaccinate," implied that Alaska has mandated meningococcal VACCINATION for college students.

In fact, as the body of the article stated, Alaska has mandated EDUCATION about meningococcal disease and vaccine for incoming college students who intend to reside in campus housing. IAC has corrected the title to read "New: Alaska mandates education about meningococcal disease and vaccine for college students; three more states let pharmacists vaccinate." To access the corrected article, go to: http://www.immunize.org/genr.d/issue557.htm#n6

IAC regrets the misleading title and any confusion it may have caused IAC Express readers.
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October 17, 2005
UPDATE: IAC MAKES MINOR CHANGES TO FOUR OF ITS VACCINE ADMINISTRATION PIECES

IAC recently revised four of its vaccine administration pieces to include information about recently licensed vaccines. The pieces are (1) "How to administer intramuscular (IM) injections and how to administer subcutaneous (SC) injections"; (2) "How to administer IM and SC injections to adults"; (3) "Vaccine administration record for children and teens"; and (4) "Vaccine administration record for adults." Information about the revisions follows:

(1) The two-page "How to administer intramuscular (IM) injections and how to administer subcutaneous (SC) injections" now includes information on administering these two vaccines: diphtheria-tetanus with pertussis (Tdap) and meningococcal conjugate (MCV4).

To access a ready-to-print (PDF) version of the revised piece, go to: http://www.immunize.org/catg.d/p2020.pdf

(2) The one-page "How to administer IM and SC injections to adults" now includes information on administering these two vaccines: diphtheria-tetanus with pertussis (Tdap) and meningococcal conjugate (MCV4).

To access a ready-to-print (PDF) version of the revised piece, go to: http://www.immunize.org/catg.d/p2020A.pdf

(3) The four-page "Vaccine administration record for children and teens" now includes information on administering these four vaccines: diphtheria-tetanus with pertussis (Tdap); measles-mumps-rubella with varicella (MMRV); meningococcal conjugate (MCV4); and live attenuated influenza (LAIV).

To access a ready-to-print (PDF) version of the revised piece, go to: http://www.immunize.org/catg.d/p2022b.pdf

To access a web-text (HTML) version of it, go to:
http://www.immunize.org/catg.d/p2022b.htm

(4) The two-page "Vaccine administration record for adults" now includes information on administering these three vaccines: diphtheria-tetanus with pertussis (Tdap); meningococcal conjugate (MCV4); and live attenuated influenza (LAIV).

To access a ready-to-print (PDF) version of the revised piece, go to: http://www.immunize.org/catg.d/p2023b.pdf

To access a web-text (HTML) version of it, go to:
http://www.immunize.org/catg.d/p2023b.htm
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October 17, 2005
RATE OF PERTUSSIS HOSPITALIZATIONS FOR INFANTS YOUNGER THAN 6 MONTHS INCREASED BY 20% FROM 1994-1998 TO 1999-2003

CDC published "QuickStats: Rate of Hospitalizations for Pertussis Among Infants Aged [Younger Than] 6 Months--United States, 1994-1998 to 1999-2003" in the October 14 issue of MMWR. The article is reprinted below in its entirety, with the exception of the figure.

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More than 90% of hospitalizations for pertussis among children aged [younger than] 2 years occurred in infants aged [younger than] 6 months, a group too young either to receive vaccination or to have developed adequate protection from vaccination. The pertussis hospitalization rate for infants aged [younger than] 6 months increased by 20% from 1994-1998 to 1999-2003.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5440a10.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5440.pdf
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October 17, 2005
NEW: NOVEMBER 4 IS THE DEADLINE FOR ABSTRACTS FOR THE 2006 NATIONAL IMMUNIZATION CONFERENCE

If you have an idea for a workshop or poster presentation for the 2006 National Immunization Conference, you have only a few weeks to submit your abstract. The deadline is November 4. To submit an abstract online, go to: http://cdc.confex.com/cdc/nic2006/index.epl

Planned for Atlanta on March 6-9, 2006, the conference will offer opportunities to learn about the following topics: childhood, adolescent, and adult immunization; vaccine safety, health communications, community, partnerships, policy, and legislation; vaccine-preventable diseases, new vaccines, and vaccine development; cultural diversity and health education; assessment, surveillance, and barriers to immunization; immunization registries; and global immunization. To access the preliminary agenda, go to: http://cdc.confex.com/cdc/nic2006/techprogram/meeting_nic2006.htm

The deadline for early-bird registration ($175) is January 13, 2006. To register online, go to:
http://conferences.taskforce.org/2006NIC/2006NIC.htm

For questions or assistance with registration, contact Beverly Fowler by email at bfowler@taskforce.org or by phone at (404) 592-1425.

For comprehensive conference information, go to:
http://www.cdc.gov/nip/nic

For additional information, contact the Conference Planning Team by email at nipnic@cdc.gov
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October 17, 2005
CDC'S INFLUENZA WEB SECTION BEGINS POSTING THE "WEEKLY REPORT: INFLUENZA SUMMARY UPDATE" FOR THE 2005-06 SEASON

CDC collects surveillance data year-round and reports on U.S. influenza activity each week from October through May in its "Weekly Report: Influenza Summary Update." For the 2005-06 influenza season, each Weekly Report will include these components: a synopsis, laboratory surveillance, pneumonia and influenza (P&I) mortality surveillance, influenza-associated pediatric mortality, influenza-associated pediatric hospitalizations, influenza-like illness (ILI) surveillance, and influenza activity as assessed by state and territorial epidemiologists.

To access Weekly Reports for the 2005-06 influenza season, as well as reports from previous seasons, go to: http://www.cdc.gov/flu/weekly/fluactivity.htm This link will also give you access to a U.S. map showing current influenza activity and to websites that contain international influenza surveillance data.
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October 17, 2005
CDC'S INFLUENZA WEB SECTION POSTS INFORMATION ON LABORATORY DIAGNOSIS OF RESPIRATORY ILLNESS

On October 12, CDC updated the Lab Diagnosis web page of its Influenza web section. The web page has current information on (1) the role of laboratory diagnosis in treating patients with respiratory illness, (2) laboratory diagnostic procedures for influenza, and (3) an influenza diagnostic table, which lists information on a variety of tests, including viral culture, polymerase chain reaction, and rapid diagnostic tests.

To access the Lab Diagnosis web page, go to:
http://www.cdc.gov/flu/professionals/labdiagnosis.htm

CDC's Influenza web section offers an array of information and materials for health professionals and the public. Visit it often at http://www.cdc.gov/flu

For ongoing information about new and updated additions to the Influenza web section, go to:
http://www.cdc.gov/flu/whatsnew.htm

 

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 17, 2005