Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 571            December 19, 2005

CONTENTS OF THIS ISSUE

  1. All of us at IAC wish you a wonderful holiday season
  2. AAP releases policy statement on use of Tdap vaccine in adolescents
  3. CDC issues an update of U.S. influenza activity from October 2 to December 3
  4. NEJM: Influenza-associated deaths among persons younger than 18 years were "substantial" during 2003-04 influenza season
  5. NIP website posts provisional ACIP recommendations for use of Tdap, hepatitis A, and hepatitis B vaccines
  6. Updated: IAC revises its parent-education piece "What if you don't vaccinate your child?"
  7. Deadline for abstracts for the National Conference on Immunization Coalitions is January 27, 2006
  8. 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.

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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:

  1. 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.
     
  2. 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.
     
  3. 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.

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[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

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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.

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Background. Although influenza is common among children, pediatric mortality related to laboratory-confirmed influenza has not been assessed nationally.

Methods. During the 20032004 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 20032004 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 

 

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 22, 2005