Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 616            August 21, 2006

CONTENTS OF THIS ISSUE

  1. New: CDC posts the provisional recommendations for use of HPV vaccine on the ACIP web section
  2. New: August 2006 issue of Vaccinate Women is on the IAC website
  3. August issue of CDC's Pandemic Influenza Update now available on IAC's website
  4. JAMA publishes study showing Hib vaccination of infants in Kenya significantly reduces invasive Hib disease rates
  5. Pharmacy-Based Immunization Summit planned for September 1314 in Arlington, VA
  6. 2006 Asian American Pacific Islander Health Summit scheduled for September 1416 in San Jose, CA

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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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August 21, 2006
NEW: CDC POSTS THE PROVISIONAL RECOMMENDATIONS FOR USE OF HPV VACCINE ON THE ACIP WEB SECTION

On August 14, CDC posted provisional recommendations for use of HPV vaccine on the ACIP web section. The provisional recommendations are reprinted below in their entirety.

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ACIP PROVISIONAL RECOMMENDATIONS FOR THE USE OF QUADRIVALENT HPV VACCINE

Date of ACIP vote: June 29, 2006

Date of posting of provisional recommendations: August 14, 2006

Tentative date of publication of recommendations in CDC Morbidity and Mortality Weekly Report: November 2006

Provisional recommendations for use of quadrivalent HPV vaccine:

  • Routine vaccination with three doses of quadrivalent HPV vaccine is recommended for females 1112 years of age. The vaccination series can be started in females as young as 9 years of age.
     
  • Catch-up vaccination is recommended for females 1326 years of age who have not been vaccinated previously or who have not completed the full vaccine series. Ideally, vaccine should be administered before potential exposure to HPV through sexual contact.
     
  • Each dose of quadrivalent HPV vaccine is 0.5 mL, administered intramuscularly.
     
  • Quadrivalent HPV vaccine is administered in a three-dose schedule. The second and third doses should be administered 2 and 6 months after the first dose.
     
  • Quadrivalent HPV vaccine can be administered at the same visit when other age-appropriate vaccines are provided, such as Tdap, Td, and MCV4.
     
  • At present, cervical cancer screening recommendations have not changed for females who receive quadrivalent HPV vaccine.

Special situations:

  • Quadrivalent HPV vaccine can be given to females who have an equivocal or abnormal Pap test, a positive Hybrid Capture II high-risk test, or genital warts.

Vaccine recipients should be advised that data from clinical trials do not indicate the vaccine will have any therapeutic effect on existing Pap test abnormalities, HPV infection, or genital warts. Vaccination of these females would provide protection against infection with vaccine HPV types not already acquired.

  • Lactating women can receive quadrivalent HPV vaccine.
     
  • Females who are immunocompromised either from disease or medication can receive quadrivalent HPV vaccine. However, the immune response to vaccination and vaccine effectiveness might be less than in females who are immunocompetent.

Pregnancy:

  • Quadrivalent HPV vaccine is not recommended for use in pregnancy.
    The vaccine has not been associated causally with adverse outcomes of pregnancy or adverse events to the developing fetus. However, data on vaccination during pregnancy are limited. Any exposure to vaccine during pregnancy should be reported to the vaccine pregnancy registry (800) 986-8999.
     
  • Contraindications to use of vaccine:
    Quadrivalent HPV vaccine is contraindicated for people with a
    history of immediate hypersensitivity to yeast or to any
    vaccine component.

Precautions:

  • Quadrivalent HPV vaccine can be administered to females with minor acute illnesses (e.g., diarrhea or mild upper respiratory tract infections, with or without fever). Vaccination of people with moderate or severe acute illnesses should be deferred until after the illness improves.

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To access a ready-to-print (PDF) version of the provisional recommendations, go to:
http://www.cdc.gov/nip/recs/provisional_recs/hpv.pdf

All provisional ACIP recommendations can be found at http://www.cdc.gov/nip/recs/provisional_recs

All published ACIP recommendations can be accessed at http://www.cdc.gov/nip/ACIP
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August 21, 2006
NEW: AUGUST 2006 ISSUE OF VACCINATE WOMEN IS ON THE IAC WEBSITE

The August 2006 issue of Vaccinate Women is now available on the IAC website. Hard copies were recently mailed to all members of the American College of Obstetricians and Gynecologists (ACOG). This publication was supported by a cooperative grant by the Division of Viral Hepatitis at the Centers for Disease Control and Prevention. It was distributed free of charge by ACOG.

The new issue is filled with reliable, practical information intended to assist obstetricians/gynecologists in providing immunization services in their healthcare settings.

HOW TO READ VACCINATE WOMEN 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/vw

Please note: The PDF file of the entire issue, linked below, is 759,034 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 entire issue, go to:
http://www.immunize.org/vw/vw0806.pdf

TO ACCESS INDIVIDUAL ARTICLES
Following are descriptions of and direct links to each of the main Vaccinate Women articles:

"Ask the Experts"
CDC immunization experts William L. Atkinson, MD, MPH, and Andrew T. Kroger, MD, MPH, answer general immunization questions. Hepatitis specialist Eric E. Mast, MD, MPH, answers hepatitis questions.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/vw/expert6.pdf

Revised in April, the one-page "Guidelines for Standing Orders in Labor & Delivery and Nursery Units to Prevent Hepatitis B Virus Transmission to Newborns," now reflects ACIP's recommendations for preventing hepatitis B virus infections in infants, which were updated in December 2005. The piece includes detailed information for infants born to HBsAg-negative mothers, infants born to HBsAg-positive mothers, and infants born to mothers with unknown HBsAg status.

To access a ready-to-print (PDF) two-page version, go to:
http://www.immunize.org/catg.d/p2130per.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2130.htm

The "Summary of Recommendations for Adult Immunization" condenses hundreds of pages of recommendations into a handy three-page chart. It was revised in July to add information about the new vaccines to protect against human papillomavirus (HPV) and herpes zoster (shingles) and to update information about influenza 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

The one-page piece "How to Administer IM and SC Injections to Adults" was revised in July to add information about administering the new vaccines to protect against human papillomavirus (HPV) and herpes zoster (shingles).

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

Revised in July, the two-page checklist "Screening Questionnaire for Adult Immunization" now has updated information on the following vaccines: MMR, varicella, nasal-spray influenza (LAIV), and pertussis-containing vaccine for adults (Tdap).

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p4065scr.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4065scr.htm

The two-page checklist "Do I Need Any Vaccinations Today?" was revised in July to add information about the new vaccines to protect against human papillomavirus (HPV) and herpes zoster (shingles) and to update information about the following vaccines: pneumococcal, Tdap, and MMR.

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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August 21, 2006
AUGUST ISSUE OF CDC'S PANDEMIC INFLUENZA UPDATE NOW AVAILABLE ON IAC'S WEBSITE

CDC recently issued the August issue of the email newsletter Pandemic Influenza Update. To access it, go to: http://www.immunize.org/pandemic/panflu806.pdf

To access a range of pandemic influenza resources on the IAC website, go to http://www.immunize.org/pandemic
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August 21, 2006
JAMA PUBLISHES STUDY SHOWING HIB VACCINATION OF INFANTS IN KENYA SIGNIFICANTLY REDUCES INVASIVE HIB DISEASE RATES

On August 9 the Journal of the American Medical Association (JAMA) published an article about research indicating that routine vaccination of infants in Kenya against Haemophilus influenzae type b (Hib) reduced invasive Hib disease rates by 88 percent. The article is titled "Effectiveness of Haemophilus influenzae type b conjugate vaccine introduction into routine childhood immunization in Kenya." The abstract is reprinted below.

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Context: Haemophilus influenzae type b (Hib) conjugate vaccine is not perceived as a public health priority in Africa because data on Hib disease burden and vaccine effectiveness are scarce. Hib immunization was introduced in Kenyan infants in 2001.

Objective: To define invasive Hib disease incidence and Hib vaccine program effectiveness in Kenya.

Design, Setting, and Patients: Culture-based surveillance for invasive Hib disease at Kilifi District Hospital from 2000 through 2005 was linked to demographic surveillance of 38,000 children younger than 5 years in Kilifi District, Kenya. Human immunodeficiency virus (HIV) infection and Hib vaccination status were determined for children with Hib disease admitted 20022005.

Interventions: Introduction of conjugate Hib vaccine within the routine childhood immunization program at ages 6, 10, and 14 weeks beginning November 2001.

Main Outcome Measures: Incidence of culture-proven Hib invasive disease before and after vaccine introduction and vaccine program effectiveness.

Results: Prior to vaccine introduction, the median age of children with Hib was 8 months; case fatality was 23%. Among children younger than 5 years, the annual incidence of invasive Hib disease 1 year before and 1 and 3 years after vaccine introduction was 66, 47, and 7.6 per 100,000, respectively. For children younger than 2 years, incidence was 119, 82, and 16 per 100,000, respectively. In 20042005, vaccine effectiveness was 88% (95% confidence interval, 73%-96%) among children younger than 5 years and 87% (95% confidence interval, 66%96%) among children younger than 2 years. Of 53 children with Hib admitted during 20022005, 29 (55%) were age-ineligible to have received vaccine, 12 (23%) had not been vaccinated despite being eligible, and 12 (23%) had received 2 or more doses of vaccine (2 were HIV positive).

Conclusions: In Kenya, introduction of Hib vaccine into the routine childhood immunization program reduced Hib disease incidence among children younger than 5 years to 12% of its baseline level. This impact was not observed until the third year after vaccine introduction.

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To access the abstract, go to:
http://jama.ama-assn.org/cgi/content/abstract/296/6/671
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August 21, 2006
PHARMACY-BASED IMMUNIZATION SUMMIT PLANNED FOR SEPTEMBER 1314 IN ARLINGTON, VA

The third annual Pharmacy-Based Immunization Summit will be held in Arlington, VA, September 1314. Sponsors include the Academy of Managed Care Pharmacy, American Pharmacists Association, and National Association of Chain Drug Stores Foundation.

For complete information and online registration, go to:
http://www.nacdsfoundation.org/wmspage.cfm?parm1=1067
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August 21, 2006
2006 ASIAN AMERICAN PACIFIC ISLANDER HEALTH SUMMIT SCHEDULED FOR SEPTEMBER 1416 IN SAN JOSE, CA

The 2006 Asian American Pacific Islander Health Summit will be held in San Jose, CA, on September 1416. It is sponsored by the Asian & Pacific Islander American Health Forum and the Association of Asian Pacific Community Health Organizations.

Workshops are planned to discuss hepatitis B within the AAPI community. For comprehensive information, including the program agenda and registration options, go to:
http://www.apiahf.org/events/summit2006/AAPIsummit2006.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 August 21, 2006