Issue
Number 571
December 19, 2005
CONTENTS OF THIS ISSUE
- All of us at IAC wish you a wonderful holiday season
- AAP releases policy statement on use of Tdap vaccine in
adolescents
- CDC issues an update of U.S. influenza activity from
October 2 to December 3
- NEJM: Influenza-associated deaths among persons younger
than 18 years were "substantial" during 2003-04 influenza season
- NIP website posts provisional ACIP recommendations for
use of Tdap, hepatitis A, and hepatitis B vaccines
- Updated: IAC revises its parent-education piece "What if
you don't vaccinate your child?"
- Deadline for abstracts for the National Conference on
Immunization Coalitions is January 27, 2006
- Deadline for abstracts for the Conference on Vaccine
Research is February 3, 2006
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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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December 19, 2005
ALL OF US AT IAC WISH YOU A WONDERFUL HOLIDAY SEASON
All of us at IAC wish the readers of IAC Express a safe, happy, and relaxing
holiday season--free from influenza.
This is our last issue for 2005. We'll email you the next issue on January
3, 2006.
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December 19, 2005
AAP RELEASES POLICY STATEMENT ON USE OF Tdap VACCINE IN ADOLESCENTS
On December 12, AAP's Committee on Infectious Diseases released a policy
statement, "Prevention of Pertussis Among Adolescents: Recommendations for
Use of Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis (Tdap)
Vaccine." The abstract to the policy statement is reprinted below in its
entirety.
******************
The purpose of this statement is to provide the rationale and
recommendations for adolescent use of tetanus toxoid, reduced diphtheria
toxoid, and acellular pertussis (Tdap) vaccines. Despite universal
immunization of children with multiple doses of pediatric diphtheria and
tetanus toxoids and acellular pertussis (DTaP) vaccine, pertussis remains
endemic with a steady increase in the number of reported cases. Two peaks in
the incidence of pertussis occur in pediatric patients: infants younger than
6 months of age who are inadequately protected by the current immunization
schedule and adolescents 11 through 18 years of age whose vaccine-induced
immunity has waned. Significant medical and public health resources are
being consumed in postexposure management of adolescent cases, contacts, and
outbreaks with little beneficial effect on individuals or the epidemiology
of disease. Two Tdap products were licensed in 2005 for use in people 10
through 18 years of age (BOOSTRIX) and 11 through 64 years of age (ADACEL).
The American Academy of Pediatrics (AAP) recommends the following:
-
Adolescents 11 to 18 years should receive a single dose of Tdap instead of
tetanus and diphtheria toxoids (Td) vaccine for booster immunization. The
preferred age for Tdap immunization is 11 to 12 years.
-
Adolescents 11 to 18 years of age who have received Td but not Tdap are
encouraged to receive a single dose of Tdap. An interval of at least 5
years between Td and Tdap is suggested to reduce the risk of local and
systemic reactions; however, intervals less than 5 years can be used,
particularly in settings of increased risk of acquiring pertussis, having
complicated disease, or transmitting infection to vulnerable contacts.
Data support acceptable safety with an interval as short as approximately
2 years.
-
Tdap and tetravalent meningococcal conjugate vaccine (MCV4 [Menactra])
should be administered during the same visit if both vaccines are
indicated. If this is not feasible, MCV4 and Tdap can be administered
using either sequence. When not administered simultaneously, the AAP
suggests a minimum interval of 1 month between vaccines.
The rational for this strategy is to provide direct protection of immunized
adolescents. With implementation of vaccine recommendations, indirect
benefit also is likely to extend to unimmunized peers and other age groups.
The strategy of universal Tdap immunization at 11 to 12 years of age is cost
effective.
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To access a ready-to-print (PDF) version of the complete policy statement,
go to:
http://www.aap.org/advocacy/releases/Tdap121205.pdf
To access a press release announcing the policy statement, go to:
http://www.aap.org/advocacy/releases/dec05pertussis.htm
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December 19, 2005
CDC ISSUES AN UPDATE OF U.S. INFLUENZA ACTIVITY FROM OCTOBER 2 TO DECEMBER 3
CDC published "Update: Influenza Activity--United States, October 2-December
3, 2005" in the December 16 issue of MMWR. Portions of the article are
reprinted below.
***********************
[From the article text]
During October 2-December 3, 2005, low-level influenza activity was reported
in the United States. This report summarizes U.S. influenza activity since
the beginning of the 2005-06 influenza surveillance season and updates the
previous summary. . . .
Influenza-Related Pediatric Mortality
During the current influenza surveillance season, California reported two
influenza-related pediatric deaths. One occurred during the 2004-05
influenza surveillance season, and one occurred during the 2005-06 season,
the only influenza- related pediatric death reported during the current
surveillance season. . . .
[From the Editorial Note]
During October 2-December 3, the United States experienced a low level of
influenza activity. During the week ending December 3, state and territorial
epidemiologists reported only one state (Nebraska) with local influenza
activity and 29 states, New York City, and Puerto Rico with sporadic
activity; 20 states and the District of Columbia reported no activity. In
addition, P&I [pneumonia and influenza] mortality and patient visits for ILI
[influenza-like illness] have remained below national baseline levels.
Vaccination is the best way to prevent influenza. Although influenza
vaccinations begin in October, vaccination in December and beyond is still
beneficial; influenza activity usually does not peak in the United States
until December-March. The degree of antigenic match between the current
vaccine strains and strains that will circulate this season will be
determined as more strains become available for analysis.
Influenza surveillance reports for the United States are posted online
weekly during October-May and are available at
http://www.cdc.gov/flu/weekly/fluactivity.htm Additional information
about influenza viruses, influenza surveillance, and the influenza vaccine
is available at http://www.cdc.gov/flu
Sporadic cases of avian influenza A (H5N1) in humans continue to be reported
in Asia; in November, for the first time during the current outbreak
(December 26, 2003, through December 9, 2005), China reported
laboratory-confirmed cases. The majority of cases appear to have been
acquired from direct contact with infected poultry. No evidence of sustained
human-to-human transmission of H5N1 has been detected, although rare cases
of human-to-human transmission likely have occurred.
Recently, influenza A (H5N1) was reported for the first time in avian
species in Europe, although the likely Asian origin of the outbreaks has
been confirmed by virus sequencing analysis and virus isolation. This
westward spread of disease might be attributed to transport of virus by wild
migratory birds from Asia; further research is needed to better understand
the role of migratory birds in the current H5N1 epizootic.
CDC continues to recommend enhanced surveillance for suspected H5N1 cases
among travelers with unexplained severe respiratory illness returning from
H5N1-affected countries as a defense against further spread of the disease
from H5N1-affected countries. Additional information regarding avian
influenza is available at
http://www.cdc.gov/flu/avian/index.htm
***********************
To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5449a2.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5449.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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December 19, 2005
NEJM: INFLUENZA-ASSOCIATED DEATHS AMONG PERSONS YOUNGER THAN 18 YEARS WERE
"SUBSTANTIAL" DURING 2003-04 INFLUENZA SEASON
In its December 15 issue, the New England Journal of Medicine (NEJM)
published "Influenza-Associated Deaths among Children in the United
States, 2003-2004." The abstract is reprinted below
in its entirety.
*******************
Background. Although influenza is common among children, pediatric
mortality related to laboratory-confirmed influenza has not been assessed
nationally.
Methods. During the 2003–2004 influenza season, we requested that state
health departments report any death associated with laboratory-confirmed
influenza in a U.S. resident younger than 18 years of age. Case reports,
medical records, and autopsy reports were reviewed, and available
influenza-virus isolates were analyzed at the Centers for Disease Control
and Prevention.
Results. One hundred fifty-three influenza-associated deaths among
children were reported by 40 state health departments. The median age of
the children was three years, and 96 of them (63 percent) were younger
than five years old. Forty-seven of the children (31 percent) died outside
a hospital setting, and 45 (29 percent) died within three days after the
onset of illness. Bacterial coinfections were identified in 24 of the 102
children tested (24 percent). Thirty-three percent of the children had an
underlying condition recognized to increase the risk of influenza-related
complications, and 20 percent had other chronic conditions; 47 percent had
previously been healthy. Chronic neurologic or neuromuscular conditions
were present in one third. The mortality rate was highest among children
younger than six months of age (0.88 per 100,000 children; 95 percent
confidence interval, 0.52 to 1.39 per 100,000).
Conclusions. A substantial number of influenza-associated deaths occurred
among U.S. children during the 2003–2004 influenza season. High priority
should be given to improvements in influenza-vaccine coverage and
improvements in the diagnosis and treatment of influenza to reduce
childhood mortality from influenza.
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To access the abstract, go to:
http://content.nejm.org/cgi/content/abstract/353/24/2559
The full text of the article is available to NEJM subscribers and at
medical libraries.
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December 19, 2005
NIP WEBSITE POSTS PROVISIONAL ACIP RECOMMENDATIONS FOR USE OF Tdap,
HEPATITIS A, AND HEPATITIS B VACCINES
NIP recently posted links to provisional ACIP recommendations for the use of
Tdap, hepatitis A, and hepatitis B vaccines to its web page of Provisional
ACIP Recommendations. Provisional recommendations are those that ACIP has
voted on but that CDC and the Department of Health and Human Services have
not yet approved and that MMWR has not yet published. Links to newly posted
provisional recommendations follow:
To access the web page of provisional recommendations, go to:
http://www.cdc.gov/nip/recs/provisional_recs
To access a complete list of ACIP recommendations already published in MMWR,
go to:
http://www.cdc.gov/nip/publications/acip-list.htm
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December 19, 2005
UPDATED: IAC REVISES ITS PARENT-EDUCATION PIECE "WHAT IF YOU DON'T VACCINATE
YOUR CHILD?"
IAC recently revised its two-page parent-education piece "What if you don't
vaccinate your child?" Statistics on pertussis, diphtheria, and influenza
were brought up to date, and information about the CDC-INFO Contact Center
was added.
To access a ready-to-print (PDF) version of the revised piece, go to:
http://www.immunize.org/catg.d/p4017.pdf
To access a web-text version of it, go to:
http://www.immunize.org/catg.d/p4017.htm
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December 19, 2005
DEADLINE FOR ABSTRACTS FOR THE NATIONAL CONFERENCE ON IMMUNIZATION
COALITIONS IS JANUARY 27, 2006
The National Conference on Immunization Coalitions will be held in
Denver August 9-11, 2006. It will provide training on creating, leading,
and sustaining effective state and local coalitions and partnerships
that address childhood, adolescent, and adult immunization.
Online abstracts are being accepted through January 27, 2006. For
information on submitting an abstract, click
here. Click on the Call for Abstracts link at the top of the page.
For more information on abstract content, contact Sarah Nasca by email
at NascaSR@evms.edu or by phone at
(757) 668-6488.
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December 19, 2005
DEADLINE FOR ABSTRACTS FOR THE CONFERENCE ON VACCINE RESEARCH IS
FEBRUARY 3, 2006
CDC published "Notice to Readers: Ninth Annual Conference on Vaccine
Research, May 8-10, 2006" in the December 16 issue of MMWR. It is
reprinted below in its entirety.
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CDC and 10 other national and international agencies and organizations
will collaborate with the National Foundation for Infectious Diseases in
sponsoring the Ninth Annual Conference on Vaccine Research (including
basic science, product development, and clinical and field studies), to
be held May 8-10, 2006, at the Marriott Inner Harbor Hotel, Baltimore,
Maryland. The conference is devoted exclusively to the research and
development of vaccines and related technologies for the prevention and
treatment of disease and will bring together human and veterinary
vaccinology researchers.
Thirty-four speakers will address topics that include tuberculosis
vaccines, vaccines in the elderly and adolescents, herd immunity,
vaccine constructs based on novel immunologic strategies, veterinary
vaccines, adverse reactions, and differing immune responses in
developing countries. Oral and poster presentations will be selected
through peer review of submitted abstracts.
Deadline for submission of abstracts is February 3, 2006.
Information about the preliminary program, abstract submission,
registration, hotel accommodation, and exhibition space is available at
http://www.nfid.org/conferences/vaccine06, and by e-mail (vaccine@nfid.org),
fax [(301) 907-0878], telephone [(301) 656-0003, ext. 19], and mail (NFID,
Suite 750, 4733 Bethesda Avenue, Bethesda, MD 20814).
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To access a web-text (HTML) version of the notice, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5449a4.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5449.pdf
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