Immunization Action Coalition and the Hepatitis B Coalition

IAC EXPRESS

Previous issues index

Home page

Issue Number 569            December 12, 2005

CONTENTS OF THIS ISSUE

  1. CDC publishes guidelines on antimicrobials recommended for treatment and postexposure prophylaxis of pertussis
  2. NIP issues updated version of the provisional recommendation for vaccinating adolescents with Tdap vaccine
  3. December Immunization Works newsletter focuses on the billions routine childhood immunization saves each year
  4. HHS starts a process to integrate pandemic influenza planning at federal, state, and local levels
  5. CDC report on epidemiology of measles in U.S. in 2004 indicates only 37 reported cases, a new one-year low
  6. New: Current Issues in Immunization Net Conference to focus on new hepatitis A vaccine recommendations
  7. MMWR notifies readers that FDA approved lowering the age limit for Havrix hepatitis A vaccine to 12 months
  8. Errata: MMWR corrects errors in its December 2 article on licensure of measles-mumps-rubella-varicella vaccine
  9. New: Current VISs for injectable and nasal-spray influenza vaccines now available in Russian and Somali
  10. New: Interim VIS for meningococcal vaccine now available in Russian and Somali
  11. Before the holiday rush, take time to register for CDC's 2006 National Immunization Conference
  12. Johns Hopkins/UNICEF report makes the case for investing in immunization communication
  13. CDC updates its Influenza web section

----------------------------------------------------------

Back to Top

---------------------------------------------------------------

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.
---------------------------------------------------------------

(1 of 13)
December 12, 2005
CDC PUBLISHES GUIDELINES ON ANTIMICROBIALS RECOMMENDED FOR TREATMENT AND POSTEXPOSURE PROPHYLAXIS OF PERTUSSIS

CDC published "Recommended Antimicrobial Agents for Treatment and Postexposure Prophylaxis of Pertussis: 2005 CDC Guidelines" in the December 9 issue of MMWR Recommendations and Reports. The article includes information on disease burden, clinical manifestations, differential diagnosis, prevention, treatment, general principles of treatment and postexposure prophylaxis, and specific antimicrobial agents.

The introductory summary to the guidelines is reprinted below.

***********************

The recommendations in this report were developed to broaden the spectrum of antimicrobial agents that are available for treatment and postexposure prophylaxis of pertussis. They include updated information on macrolide agents other than erythromycin (azithromycin and clarithromycin) and their dosing schedule by age group.

***********************

To access a web-text (HTML) version of the guidelines, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5414a1.htm

To access a ready-to-print (PDF) version of them, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5414.pdf
---------------------------------------------------------------

Back to Top

(2 of 13)
December 12, 2005
NIP ISSUES UPDATED VERSION OF THE PROVISIONAL RECOMMENDATION FOR VACCINATING ADOLESCENTS WITH Tdap VACCINE

On December 9, NIP posted to its Provisional ACIP Recommendations web page an updated version of the provisional recommendation for vaccinating adolescents with Tdap vaccine. The updated version includes a new recommendation for use in pregnancy.

To access a ready-to-print (PDF) version of the updated provisional recommendation, go to:
http://www.cdc.gov/nip/vaccine/tdap/tdap_acip_recs.pdf

To access the Provisional ACIP Recommendations web page, go to:
http://www.cdc.gov/nip/recs/provisional_recs/default.htm
---------------------------------------------------------------

Back to Top

(3 of 13)
December 12, 2005
DECEMBER IMMUNIZATION WORKS NEWSLETTER FOCUSES ON THE BILLIONS ROUTINE CHILDHOOD IMMUNIZATION SAVES EACH YEAR

The lead article in the December issue of CDC's Immunization Works newsletter focuses on an NIP study on the economic impact of routine childhood immunizations. Much of the rest of information in the December issue has already appeared in previous issues of IAC Express. Following is the text of the lead article and three articles we have not covered previously.

************************

ROUTINE CHILDHOOD IMMUNIZATIONS SAVE BILLIONS EACH YEAR
A recent study by CDC's National Immunization Program (NIP) evaluated the impact of seven vaccines (DTaP, Td, Hib, polio, MMR, hepatitis B, and varicella) routinely given as part of the childhood immunization schedule and found that vaccines are tremendously cost effective. This is the first time the seven vaccines have been examined together and with a common methodology.

The study found that the use of these seven vaccines will prevent over 14 million cases of disease and over 33,500 deaths over the lifetime of children born this year. When comparing the cost of the diseases they prevent and the cost of administering them, these vaccines save nearly $10 billion per year. These vaccines also prevent the need for patients to spend time seeking care and the need for parents to take time off work to care for sick children. When including these and other prevented costs to society, the annual savings exceed $40 billion.

A child is protected from vaccine-preventable diseases after receiving a series of vaccines over time, not just one shot. Therefore, this economic evaluation is groundbreaking in that previous studies demonstrating the cost savings of childhood vaccination in the United States have only focused on single vaccines. Expanding beyond the single-vaccine cost benefit perspective provides policymakers better information about the economic impact of the immunization program by examining a routine seven-vaccine U.S. childhood immunization schedule.

This analysis will be helpful in understanding the economic effects of the immunization program under current circumstances. Administrators and policymakers may use the results to justify sustained support for programs, make needed modifications, and guide future programs.

The publication--entitled "Economic Evaluation of the 7-Vaccine Routine Childhood Immunization Schedule in the United States, 2001"--appears in the December 2005 edition of the Archives of Pediatrics and Adolescent Medicine. A summary can be found on the Archive website at http://archpedi.ama-assn.org/cgi/content/short/159/12/1136

OTHER IMMUNIZATION NEWS
CDC SEEKS PUBLIC COMMENT: CDC is seeking public comment on the new CDC Health Protection Research Guide, 2006-2015. The comment period, which began on Friday, November 18, 2005, will last for 60 days, concluding on January 15, 2006.

The Research Guide will provide a comprehensive, long-range vision of national and global public health needs that CDC and its partners can address through research. The Research Guide will help identify critical knowledge needed to achieve CDC's new Health Protection Goals, which are designed to maximize the health impact of programs, services, and emergency responses.

The Research Guide can be accessed, and comments can be submitted from a public website:
http://www.rsvpBOOK.com/custom_pages/50942/index.php

Comments from CDC partners, stakeholders, and the public will be considered in producing the final version the Research Guide, expected to be completed in early 2006. For more information, please call Jamila Rashid, PhD, MPH, of CDC's Office of Public Health Research, at (404) 639-4621 or send an email to ResearchGuide@cdc.gov More information about the Office of Public Health Research and the new Research Guide can be found at http://www.cdc.gov/od/ophr

INFLUENZA [VACCINE] SUPPLY UPDATE: As of the end of November, more than 78 million doses of influenza vaccine had been produced and distributed within the United States. However, while some communities and providers appear to have ample supplies of influenza vaccine, others may not have received much influenza vaccine and may have used most, if not all, of their supply. Some communities and providers may not have received any vaccine.

The total amount of vaccine expected to be available in the United States this season is enough to meet past consumer demand, which has usually been around 70-75 million doses. However, in some communities current demand for vaccine might be exceeding what has been seen in previous years (perhaps due to increased media attention on avian influenza, or "bird flu", concerns resulting from last year's vaccine shortage, or increased use among children).

In addition, Chiron Corporation recently announced that it will not be able to produce as much vaccine as it originally anticipated. Consequently, providers and distributors who ordered from Chiron received substantially less vaccine than they had ordered.

The very last doses of influenza vaccine are currently being produced (3.5 million doses from sanofi pasteur and 680,000 doses from Chiron) and will be available late in December or January as part of the CDC influenza vaccine stockpile. Since influenza peaks most often in January and February, vaccination is encouraged through the winter months.

CDC is currently assessing how distribution of influenza vaccine has gone this season with physicians, public health agencies, community vaccinators, pharmacists, occupational health providers, federally qualified health centers, nursing homes, and the public. While influenza vaccine distribution and administration are mostly private sector enterprises, CDC will continue to work with manufacturers and our partners to address challenges of matching influenza vaccine supplies with demand at national, state, community, and provider levels.

To view questions and answers concerning the 2005-06 influenza vaccine supply, please visit
http://www.cdc.gov/flu/about/qa/0506supply.htm

MEETINGS, CONFERENCES, AND RESOURCES
NIP NEEDS PILOT TESTERS: The National Immunization Program (NIP) has an ongoing need for volunteers to pilot test immunization training courses. Volunteers are particularly needed in the following occupations: physicians, pharmacists, health educators, medical assistants, and nurses. To learn more about becoming a pilot tester, please send an email to nippilot@cdc.gov

************************

To access the complete December issue from the NIP website, go to:
http://www.cdc.gov/nip/news/newsltrs/imwrks/2005/200512.htm
---------------------------------------------------------------

Back to Top

(4 of 13)
December 12, 2005
HHS STARTS A PROCESS TO INTEGRATE PANDEMIC INFLUENZA PLANNING AT FEDERAL, STATE, AND LOCAL LEVELS

On December 5, Health and Human Services (HHS) issued a press release announcing the start of pandemic influenza planning among federal, state, and local government agencies. Portions of the press release are reprinted below.

********************

For immediate release
December 5, 2005

FEDERAL GOVERNMENT BEGINS PANDEMIC PLANNING WITH STATES
"Pandemic planning needs to go beyond public health"

Noting that communities will be on the front lines of any effort to stop or contain a pandemic, HHS Secretary Mike Leavitt today convened senior state and local officials to establish an integrated federal-state influenza-pandemic planning process. Department of Homeland Security Secretary Michael Chertoff helped open the meeting. Officials from every U.S. state, territory, Puerto Rico, and tribal governments participated. The officials were advised to plan broadly. . . .

"By their nature, pandemics happen across the globe--but their effects are excruciatingly local," Secretary Leavitt said. "Pandemic planning needs to go beyond public health. Discussion at the state and local level needs to address how schools, businesses, public agencies, and others participate in pandemic preparedness. . . ."

Secretary Leavitt asked participants to begin preparing for a series of in-state pandemic-planning summits to be held in every state over the next several months. These in-state summits will help the public health and emergency response community in each state inform and involve their political, economic, and community leadership in this process. . . .

A web cast of today's proceedings, the state and local health department checklist, the National Strategy, HHS Pandemic Influenza Plan, and more information can be found online at www.pandemicflu.gov

********************

To access the complete press release, go to:
http://www.hhs.gov/news/press/2005pres/20051205.html
---------------------------------------------------------------

Back to Top

(5 of 13)
December 12, 2005
CDC REPORT ON EPIDEMIOLOGY OF MEASLES IN U.S. IN 2004 INDICATES ONLY 37 REPORTED CASES, A NEW ONE-YEAR LOW

CDC published "Measles--United States, 2004" in the December 9 issue of MMWR. Portions of the article are reprinted below.

***********************

Measles is a highly infectious, acute viral illness that can cause severe pneumonia, diarrhea, encephalitis, and death. During 2004, a total of 37 cases (incidence: [less than] 1 case per million population) was reported to CDC by local and state health departments, the lowest number of measles cases ever reported in 1 year in the United States and a decrease of 16% from the previous low of 44 cases in 2002. This report describes the epidemiology of measles in the United States in 2004, documenting the absence of endemic measles and the continued risk for internationally imported measles cases that can result in indigenous transmission. . . .

Editorial Note
The 37 confirmed cases in 2004 represent a record low number of reported measles cases since measles became a nationally reportable disease in 1912. The epidemiology of measles in 2004 confirms the previous finding that endemic transmission of measles virus has been eliminated in the United States. Thirty-three (89%) cases were import-associated (i.e., imported or import-linked), and 14 imported cases occurred among U.S. residents who contracted measles while traveling abroad. Sixty-four percent of the imported cases among U.S. residents could have been prevented if long-standing ACIP recommendations concerning measles vaccination of foreign travelers had been followed.

Of the 27 persons with imported cases in 2004, 13 (48%) traveled on aircraft while infectious. Measles virus is a highly infectious pathogen, and intercontinental flights create the potential for prolonged exposure. However, on the basis of available data, the risk for in-flight measles transmission among passengers appears to be low. . . .

As long as measles is endemic in most countries worldwide, sustaining measles elimination in the United States will require maintenance of high levels of vaccination coverage (i.e., [greater than] 90%), vigilance in detecting and containing imported cases, and enhanced surveillance to detect and characterize cases and identify sources and viral genotypes.

***********************

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5448a1.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5448.pdf

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

Back to Top

(6 of 13)
December 12, 2005
NEW: CURRENT ISSUES IN IMMUNIZATION NET CONFERENCE TO FOCUS ON NEW HEPATITIS A VACCINE RECOMMENDATIONS

Scheduled for January 19, 2006, from noon to 1PM ET, the net conference Current Issues in Immunization is designed to provide clinicians with up-to-date information on immunization. The program has two primary topics: (1) new hepatitis A vaccine recommendations and (2) overview of vaccine information statements (VISs).

The conference requires pre-registration, as space is limited. Registration will close when the course is full or on January 17, 2006 (midnight ET). To register for the conference, go to: http://www2.cdc.gov/nip/isd/ciinc

The program will combine a telephone audio conference and simultaneous online visual content. Participants can join the Q&A session by telephone or Internet. For instructions and system requirements, go to: http://www.cdc.gov/nip/ed/ciinc/instructions.htm

For additional information, go to: nipinfo@cdc.gov
---------------------------------------------------------------

Back to Top

(7 of 13)
December 12, 2005
MMWR NOTIFIES READERS THAT FDA APPROVED LOWERING THE AGE LIMIT FOR HAVRIX HEPATITIS A VACCINE TO 12 MONTHS

CDC published "Notice to Readers: FDA Approval of Havrix (Hepatitis A Vaccine, Inactivated) for Persons Aged 1-18 Years" in the December 9 issue of MMWR. The notice is reprinted below in its entirety, with the exception of footnotes.

***********************

On October 17, 2005, the Food and Drug Administration approved an application to allow use of the pediatric/adolescent formulation of Havrix (hepatitis A vaccine, inactivated) (GlaxoSmithKline Biologicals, Rixensart, Belgium) for persons aged 1-18 years. Previously, pediatric use of Havrix was approved for use in persons aged 2-18 years.

Vaccine Description
The formulation, dosage, and schedule for Havrix were not changed. Each 0.5-mL dose of pediatric/adolescent Havrix contains 720 enzyme-linked immunosorbent assay units of formalin-inactivated hepatitis A viral antigen adsorbed onto aluminum hydroxide. The formulation contains 0.5% 2-phenoxyethanol as a preservative.

The pediatric/adolescent formulation of Havrix is indicated for vaccination of persons aged 1-18 years against disease caused by hepatitis A virus. Recommendations for hepatitis A vaccination have been published previously and are periodically updated. The primary vaccination schedule is unchanged and consists of 2 doses, administered on a 0, 6-12-month schedule.

In a study presented as part of the labeling change application, 99% of 218 children aged 11-13 months and 100% of 200 children aged 15-18 months who received 2 doses of Havrix developed a vaccine response. The approval included concomitant use of Havrix with Haemophilus influenzae type b conjugate vaccine (PRP-T Hib). Data regarding concomitant use with other routinely recommended childhood vaccines are limited. According to general recommendations of the Advisory Committee on Immunization Practices, inactivated vaccines usually do not interfere with the immune response to other inactivated or live vaccines.

Among the 723 healthy children who received 1 or more dose of Havrix, the most common adverse events were similar among children aged 11-18 months and children aged 23-25 months. Havrix is contraindicated in persons with known hypersensitivity to any component of the vaccine. Additional information is available from the manufacturer's package insert and GlaxoSmithKline Biologicals at telephone (888) 825-5249.

***********************

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5448a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5448.pdf
---------------------------------------------------------------

Back to Top

(8 of 13)
December 12, 2005
ERRATA: MMWR CORRECTS ERRORS IN ITS DECEMBER 2 ARTICLE ON LICENSURE OF MEASLES-MUMPS-RUBELLA-VARICELLA VACCINE

CDC published "Errata: Vol. 54, No. 47" in the December 9 issue of MMWR. The article is reprinted below in its entirety.

***********************

In the Notice to Readers, "Licensure of a Combined Live Attenuated Measles, Mumps, Rubella, and Varicella Vaccine," multiple errors occurred.

On page 1212, in the last sentence of the first paragraph, the sentence should read: The titer of Oka/Merck varicella-zoster virus is higher in MMRV vaccine than in single antigen varicella vaccine, VARIVAX (Merck), a minimum of 3.99 log 10 plaque-forming units (pfu) versus 1,350 pfu (approximately 3.13 log 10), respectively.

On page 1213, under "Indications and Usage," No. 1, the last sentence should read: MMRV vaccine can reduce the number of injections when administered to children aged 12 months-12 years for whom (1) the first doses of MMR and varicella vaccines are indicated and (2) the second dose of MMR and either the first or second dose (e.g., during a varicella outbreak) of varicella vaccine are indicated. MMRV vaccine is administered subcutaneously as a single 0.5-mL dose.

On page 1214, in Reference 8, the Internet address should read: http://www.cdc.gov/nip/vaccine/varicella/varicella_acip_recs.pdf

***********************

To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5448a8.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5448.pdf
---------------------------------------------------------------

Back to Top

(9 of 13)
December 12, 2005
NEW: CURRENT VISs FOR INJECTABLE AND NASAL-SPRAY INFLUENZA VACCINES NOW AVAILABLE IN RUSSIAN AND SOMALI

The current versions of the VISs for trivalent inactivated influenza vaccine(TIV; injectable) and live attenuated influenza vaccine (LAIV; nasal spray) are now available on the IAC website in Russian and Somali. IAC gratefully acknowledges the Minnesota Department of Health for the translations.

VIS for TIV vaccine (dated 10/20/05)
To obtain a ready-to-print (PDF) version of the VIS for TIV vaccine in Russian, go to:
http://www.immunize.org/vis/ru_flu05.pdf

To obtain it in Somali, go to:
http://www.immunize.org/vis/so_flu05.pdf

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


VIS for LAIV vaccine (dated 10/20/05)
To obtain a ready-to-print (PDF) version of the VIS for LAIV vaccine in Russian, go to:
http://www.immunize.org/vis/ru_LAIV05.pdf

To obtain it in Somali, go to:
http://www.immunize.org/vis/so_LAIV05.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
---------------------------------------------------------------

Back to Top

(10 of 13)
December 12, 2005
NEW: INTERIM VIS FOR MENINGOCOCCAL VACCINE NOW AVAILABLE IN RUSSIAN AND SOMALI

The interim VIS for meningococcal vaccine (dated 10/7/05) is now available on the IAC website in Russian and Somali. IAC gratefully acknowledges the Minnesota Department of Health for the translations.

To obtain a ready-to-print (PDF) version of interim VIS for meningococcal vaccine in Russian, go to:
http://www.immunize.org/vis/ru_men05.pdf

To obtain it in Somali, go to:
http://www.immunize.org/vis/so_men05.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/menin05.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
---------------------------------------------------------------

Back to Top

(11 of 13)
December 12, 2005
BEFORE THE HOLIDAY RUSH, TAKE TIME TO REGISTER FOR CDC'S 2006 NATIONAL IMMUNIZATION CONFERENCE

Take time NOW--before you start juggling work with a long string of winter holiday celebrations--to register for CDC's 2006 National Immunization Conference. Scheduled for March 6-9, 2006, in Atlanta, the conference will give you a chance to get recharged and revitalized by getting together with old friends and colleagues, meeting people you know only through phone conversations and email messages, touring the conference exhibit space, and getting fresh ideas from poster sessions, workshops, and plenary meetings. You don't want to miss it!

The deadline for early-bird registration ($175) is January 13, but why wait? Register today, and you'll have something to look forward to throughout winter. To register online, go to: http://conferences.taskforce.org/2006NIC/2006NIC.htm

To plan some fun in Atlanta, visit the official tourism website at http://www.atlanta.net

For general conference information, including conference goals and objectives, go to: http://www.cdc.gov/nip/nic

Here's some information not yet available on the conference website: The six topic tracks for this year's conference are (1) adult and adolescent immunization, (2) epidemiology and vaccine safety, (3) health and risk communication, (4) immunization information systems, (5) programmatic issues, and (6) policy and legislation.

For additional information, contact the conference planning team at (404) 639-8225 or nipnic@cdc.gov
---------------------------------------------------------------

Back to Top

(12 of 13)
December 12, 2005
JOHNS HOPKINS/UNICEF REPORT MAKES THE CASE FOR INVESTING IN IMMUNIZATION COMMUNICATION

In June, the Health Communication Partnership (based at Johns Hopkins Bloomberg School of Public Health) and UNICEF published a report titled "Why Invest in Communication for Immunization? Evidence and Lesson Learned." In 28 pages, the report outlines key immunization challenges that can be addressed by communication, presents recommendations for addressing immunization challenges, and lists lessons learned from successful communication interventions.

To access a ready-to-print (PDF) version of the report, go to:
http://www.hcpartnership.org/Publications/CommunicationforImmunization.pdf
---------------------------------------------------------------

Back to Top

(13 of 13)
December 12, 2005
CDC UPDATES ITS INFLUENZA WEB SECTION

CDC recently updated a page of its Influenza web section:
"Recent avian influenza outbreaks in Asia and Europe"(12/6/05).

To access this resource, go to:
http://www.cdc.gov/flu/whatsnew.htm#updated and click on the pertinent link.

To access a broad range of continually updated influenza information, go to: http://www.cdc.gov/flu

 

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 December 12, 2005