Issue
Number 621
September 18, 2006
CONTENTS OF THIS ISSUE
- New: CDC releases interim VIS for shingles (herpes
zoster) vaccine
- Survey of 2005 vaccination rates of U.S. children ages
19-35 months shows similar rates across racial and ethnic lines
- CDC reports on state and local health departments'
response to U.S. varicella outbreaks during 2003-04
- 2006 National Adult Immunization Week scheduled for
September 24-30; promotional materials available
- IAC updates its two summaries of immunization
recommendations and other materials for healthcare professionals
- National Influenza Vaccine Summit web section posts
materials on influenza vaccination of healthcare professionals
- Massachusetts Medical Society website posts the 2006
Employee Flu Immunization Campaign Kit
- Promote healthcare worker vaccination with CDC's updated
posters and flyers
- Don't delay: Add your influenza clinic to the American
Lung Association's popular Flu Clinic Locator website
- Article in FDA Consumer magazine explains the basics of
influenza vaccine selection and recommendations
- CDC's Influenza web section posts an assortment of
influenza information sheets for healthcare professionals
- September issue of CDC's Immunization Works electronic
newsletter focuses on influenza vaccine
- Women in Government recommends HPV vaccination for
girls entering middle school
- MMWR issues corrections to the STD treatment guidelines
it published on August 4
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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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September 18, 2006
NEW: CDC RELEASES INTERIM VIS FOR SHINGLES (HERPES ZOSTER) VACCINE
On September 11, CDC released an interim VIS for shingles (herpes zoster)
vaccine. ACIP has not yet voted on recommendations for zoster vaccine. The
interim VIS is based primarily on information from the manufacturer's
package insert. The final VIS will be produced after the ACIP
recommendations have been published in MMWR. The final VIS could differ from
the interim version.
To obtain a ready-to-print (PDF) version of the interim VIS from the CDC
website, go to:
http://www.cdc.gov/nip/publications/VIS/vis-shingles.pdf
To obtain it from the IAC website, go to:
http://www.immunize.org/vis/shingles.pdf
For information about the use of VISs, and for VISs in more than 30
languages, visit IAC's VIS web section at
http://www.immunize.org/vis
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September 18, 2006
SURVEY OF 2005 VACCINATION RATES OF U.S. CHILDREN AGES 19-35 MONTHS SHOWS
SIMILAR RATES ACROSS RACIAL AND ETHNIC LINES
CDC published "National, State, and Urban Area Vaccination Coverage Among
Children Aged 19-35 Months—United States, 2005" in the September 15 issue of
MMWR. A link to tables describing data collected during the 2005 National
Immunization Survey (NIS) appears at the end of this IAC Express article, as
do links to a CDC press release relating to the 2005 survey and to the full
transcript of a CDC press briefing on the topic.
Portions of the MMWR article are reprinted below.
***********************
The National Immunization Survey (NIS) provides vaccination coverage
estimates among children aged 19-35 months for each of the 50 states and
selected urban areas. Findings from the 2005 NIS include nationwide
increases in coverage with >=3 and >=4 doses of pneumococcal conjugate
vaccine (PCV) and continued high levels of coverage for the other
recommended vaccines and vaccine series. In addition, no racial/ethnic
disparities in coverage estimates were observed in the 4:3:1:3:3:1 vaccine
series, the recommended series for children aged 19-35 months that includes
DTP/DT/DTaP; poliovirus vaccine; measles, mumps, and rubella vaccine (MMR);
Haemophilus influenzae type b vaccine; hepatitis B vaccine; and varicella
vaccine. An important accomplishment indicated by the 2005 NIS data is the
achievement of >50% coverage for the full series of PCV (>=4 doses) and >80%
coverage for >=3 doses within 5 years after being added to the
U.S.-recommended childhood immunization schedule in 2000. This occurred
despite shortages of this vaccine during 2001-2004, which might have
affected accessibility to PCV. . . .
National vaccination coverage estimates increased from 2004 to 2005 for PCV,
from 73.2% to 82.8% for >=3 doses and from 43.4% to 53.7% for >=4 doses.
Coverage for >=1 dose of MMR vaccine decreased from 93.0% to 91.5%. Coverage
estimates for all other vaccines and vaccine series in 2005 were not
significantly different (by t test) from 2004 estimates.
As in previous years, estimated vaccination coverage levels varied
substantially among states. Estimated coverage with the 4:3:1:3:3:1 vaccine
series ranged from 90.7% (95% confidence interval [CI] = +/-3.8) in
Massachusetts to 62.9% (CI = +/-8.1) in Vermont. Coverage also varied
substantially among the 27 urban areas. The highest estimated coverage among
the urban areas for the 4:3:1:3:3:1 series was 84.5% (CI = +/-6.0) for
Jefferson County, Alabama, and the lowest was 58.8% (CI = +/-7.9) for Clark
County, Nevada. . . .
Editorial Note:
The findings in this report indicate that among U.S. children aged 19-35
months, coverage with the recommended vaccines in 2005 remained at or near
all-time—high levels, with substantial increases in PCV coverage. The 2005
NIS survey cohort included children born during February 2002-July 2004; all
of these children might have been affected by the shortages of PCV during
February-September 2004, when recommendations to defer the 4th dose or the
3rd and 4th doses were in effect. Despite these shortages, coverage with the
full series (>=4 doses) exceeded 50% and coverage with >=3 doses of PCV
exceeded 80% in this survey cohort. Surveillance data from 1998-2003 have
indicated substantial reductions in the incidence of vaccine-type and
overall invasive pneumococcal disease in children and adults, attributable
to routine use of PCV in young children. . . .
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5536a2.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5536.pdf
To access NIS 2005 data tables from the CDC website, go to:
http://www.cdc.gov/nip/coverage/NIS/05/toc-05.htm
To access a CDC press release titled "Racial disparities in childhood
immunization coverage rates closing," go to:
http://www.cdc.gov/od/oc/media/pressrel/r060914.htm
To access the full transcript of the CDC press briefing, go to:
http://www.cdc.gov/od/oc/media/transcripts/t060914.htm
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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September 18, 2006
CDC REPORTS ON STATE AND LOCAL HEALTH DEPARTMENTS' RESPONSE TO U.S.
VARICELLA OUTBREAKS DURING 2003-04
CDC published "Public Health Response to Varicella Outbreaks—United States,
2003-2004" in the September 15 issue of MMWR. Portions of a summary made
available to the press are reprinted below, as are two paragraphs from the
article's Editorial Note.
***********************
FROM THE PRESS SUMMARY
Although varicella disease has decreased as vaccination coverage has
increased, varicella outbreaks are continuing to occur and are being
reported and responded to by state and local health departments. . . .
A national survey was conducted to obtain an estimate of the extent of
varicella outbreaks that occurred in 2003-2004 and to learn more about
public health response to these outbreaks. The survey highlighted that a
large number of varicella outbreaks continue to occur; most health
jurisdictions reported that they were notified about at least one varicella
outbreak in 2003 and 2004. Many health jurisdictions respond to varicella
outbreaks that they are notified about and have a definition for varicella
outbreaks, although their response and definition varies by jurisdiction.
Almost half of health jurisdictions have varicella outbreak management
guidelines. CDC will continue to work with state and local health
jurisdictions to develop and publish a standard varicella outbreak
definition and national outbreak management guidelines and will continue to
provide assistance to health departments on managing outbreaks as these
guidelines are being developed. The recent recommendation by the Advisory
Committee on Immunization Practices for a routine 2-dose varicella
vaccination should help to improve varicella disease control, including
prevention of varicella outbreaks, alleviating the challenges and costs for
health departments to respond to these outbreaks.
FROM THE EDITORIAL NOTE
In June 2005, the Advisory Committee on Immunization Practices (ACIP)
provisionally recommended a second dose of varicella vaccine in outbreak
settings for persons who have had only 1 dose of varicella vaccine and no
disease history (provided that an appropriate interval has elapsed since the
first dose). On the basis of a 10-year follow-up prelicensure study of the
vaccine, a 2-dose vaccination regimen has been determined more effective
than a 1-dose regimen.
In a 2006 position statement, the Council of State and Territorial
Epidemiologists (CSTE) supported a routine 2-dose varicella vaccination
policy to improve varicella control and outbreak prevention. In June 2006,
ACIP approved a routine 2-dose varicella vaccination policy for children
(first dose at 12-15 months, second dose at 4-6 years) and catch-up
vaccinations for children, adolescents, and adults who had previously
received only 1 dose. Establishing a routine 2-dose vaccination regimen
might make the 2-dose outbreak response for susceptible populations more
feasible to implement. . . .
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5536a3.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5536.pdf
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September 18, 2006
2006 NATIONAL ADULT IMMUNIZATION WEEK SCHEDULED FOR SEPTEMBER 24-30;
PROMOTIONAL MATERIALS AVAILABLE
The NIP website recently posted information about the 2006 National Adult
Immunization Awareness Week (NAIAW), which is scheduled for September 24-30.
This year marks the 19th consecutive observance of NAIAW; it is a great
opportunity for individuals and organizations to promote the importance of
adult and adolescent immunization.
In addition, NIP posted a link to the printable version of the NAIAW 2006
Campaign Kit, which was created by the National Foundation for Infectious
Diseases (NFID). To access the kit from the NFID website, go to:
http://www.nfid.org/pdf/publications/naiaw06.pdf
NOTE: The kit is a very large file. For help on downloading and printing
large PDF files, go to:
http://www.immunize.org/nslt.d/tips.htm
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September 18, 2006
IAC UPDATES ITS TWO SUMMARIES OF IMMUNIZATION RECOMMENDATIONS AND OTHER
MATERIALS FOR HEALTHCARE PROFESSIONALS
IAC recently updated its two summaries of immunization recommendations, as
well as three information sheets for healthcare professionals. Following are
explanations of the revisions and links to the updated documents.
(1) Summary of Recommendations for Childhood and Adolescent Immunization
(three pages, updated September 2006): Information was added about the new
vaccines for human papillomavirus (HPV) and rotavirus. In addition, the
sections on the following vaccines were extensively revised: hepatitis B,
Td/Tdap, varicella, MMR, influenza, pneumococcal polysaccharide (PPV), and
hepatitis A.
To access a ready-to-print version of the childhood/adolescent summary, go
to:
http://www.immunize.org/catg.d/rules1.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/nslt.d/n17/rules1.htm
(2) Summary of Recommendations for Adult Immunization (three pages, updated
September 2006): Information on using Td/Tdap vaccines during pregnancy was
revised, as was information about the evidence of immunity to varicella.
To access a ready-to-print version of the adult summary, 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
(3) How to Administer Intramuscular (IM) and Subcutaneous (SC) Injections
(two pages, updated September 2006): Information on the site for
administering IM injections to children ages 12 months to 10 years was
changed.
To access a ready-to-print version of this piece, go to:
http://www.immunize.org/catg.d/p2020.pdf
(4) Screening Questionnaire for Child and Teen Immunization (two pages;
updated September 2006): Minor revisions were made.
To access a ready-to-print version of this piece, go to:
http://www.immunize.org/catg.d/p4060scr.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4060scr.htm
(5) Screening Questionnaire for Adult Immunization (two pages; updated
September 2006): Minor revisions were made.
To access a ready-to-print version of this piece, 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
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September 18, 2006
NATIONAL INFLUENZA VACCINE SUMMIT WEB SECTION POSTS MATERIALS ON INFLUENZA
VACCINATION OF HEALTHCARE PROFESSIONALS
The National Influenza Vaccine Summit recently posted an array of resources
on its Health Care Worker Influenza Immunization Home Page. To access the
home page, go to:
www.ama-assn.org/go/HCWfluimmunization
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September 18, 2006
MASSACHUSETTS MEDICAL SOCIETY WEBSITE POSTS THE 2006 EMPLOYEE FLU
IMMUNIZATION CAMPAIGN KIT
The website of the Massachusetts Medical Society (MMS) recently posted the
Employee Flu Immunization Campaign Kit for 2006. Produced by MMS, Masspro,
and the Massachusetts Department of Public Health, the kit is available
online by clicking
here.
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September 18, 2006
PROMOTE HEALTHCARE WORKER VACCINATION WITH CDC'S UPDATED POSTERS
AND FLYERS
[The following is cross posted from CDC's Immunization Works electronic
newsletter, September 2006.]
PROMOTE HCW VACCINATION: CDC has recently updated posters and flyers for
healthcare worker (HCW) vaccinations, "Healthcare Workers! Are your
vaccinations up-to-date?" The updated materials reflect the Advisory
Committee on Immunization Practices' (ACIP's) new pertussis vaccine
recommendations. They can be downloaded and printed in black and white or
commercial-quality color from
www.cdc.gov/nip/publications/#healthcare (scroll down to Healthcare
Worker Immunizations).
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September 18, 2006
DON'T DELAY: ADD YOUR INFLUENZA CLINIC TO THE AMERICAN LUNG ASSOCIATION'S
POPULAR FLU CLINIC LOCATOR WEBSITE
The American Lung Association recently updated the Professional Resources
section of its popular Flu Clinic Locator website with information for
providers interested in adding their clinics to the website and promoting
them.
For information on how the website works and how to participate, go to:
http://www.flucliniclocator.org
Click on Professional Resources in the left column, and you will be taken to
the Professional Resources web section. Once there, click on All About the
Flu Clinic Locator and then on pertinent links listed under the heading
Helpful, Related Resources.
For additional information, email
flucliniclocator@lungusa.org
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September 18, 2006
ARTICLE IN FDA CONSUMER MAGAZINE EXPLAINS THE BASICS OF INFLUENZA VACCINE
SELECTION AND RECOMMENDATIONS
The website of the U.S. Food and Drug Administration recently posted an
article that appeared in the July-August 2006 issue of the magazine FDA
Consumer. The article, "Getting Ready for Another Flu Season," presents
basic information about the disease and the yearly processes of selecting
vaccine strains and updating the ACIP influenza recommendations. It
concludes with an overview of the recommendations for the 2006-07 influenza
season.
To access the article, go to:
http://www.fda.gov/fdac/features/2006/406_flu.html
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September 18, 2006
CDC'S INFLUENZA WEB SECTION POSTS AN ASSORTMENT OF INFLUENZA INFORMATION
SHEETS FOR HEALTHCARE PROFESSIONALS
On September 8, CDC added four new information sheets to its Influenza web
section and updated 14 more. The new and updated information sheets are
based on information contained in the ACIP influenza recommendations for
2006-07.
NEW
-
"Recommendations for Using Inactivated and Live, Attenuated Influenza
Vaccine"
-
"Influenza Vaccine Supply and Timing of Annual Influenza Vaccination"
-
"Efficacy and Effectiveness of Live, Attenuated Influenza Vaccine (LAIV)"
-
"Vaccination of Close Contacts of Persons at High Risk for Complications
of Influenza"
To access these materials, go to:
http://www.cdc.gov/flu/whatsnew.htm and click on the pertinent links.
UPDATED
To access any of the 14 newly undated information sheets, go to
http://www.cdc.gov/flu/whatsnew.htm#updated and click on the pertinent
links.
To access a broad range of continually updated information on seasonal
influenza, avian influenza, and pandemic influenza, go to:
http://www.cdc.gov/flu
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September 18, 2006
SEPTEMBER ISSUE OF CDC'S IMMUNIZATION WORKS ELECTRONIC NEWSLETTER FOCUSES
ON INFLUENZA VACCINE
The September issue of Immunization Works, a monthly email newsletter
published by CDC, is available on NIP's website. The newsletter offers
members of the immunization community non-proprietary information about
current topics. CDC encourages its wide dissemination.
The lead article, "100 Million Doses of Influenza Vaccine Expected This
Year," is reprinted below in its entirety. Other articles in the September
issue have previously been covered in IAC Express. Following is the text
of articles we have not covered.
************************
100 MILLION DOSES OF INFLUENZA VACCINE EXPECTED THIS YEAR
The Centers for Disease Control and Prevention (CDC) announced this week
that influenza vaccine manufacturers are expecting to produce and
distribute more than 100 million doses of influenza vaccines in the United
States between now and early January 2007. Manufacturers have already
begun to ship this season's influenza vaccine, with almost all of the
vaccine expected to be shipped and distributed in October and November.
The influenza manufacturers and major distributors are implementing
policies designed to provide some influenza vaccine by the end of October
to all providers who ordered it.
The more than 100 million doses is at least 17 million more doses of
influenza vaccine than has ever been distributed in the past and about 19
million more doses than were distributed last year. According to the
information from manufacturers, about 75 million doses will be distributed
by the end of October.
CDC encourages anyone who wants to be protected against influenza to seek
vaccination, especially those at increased risk for influenza-related
complications as well as those who live with or care for people at high
risk—including healthcare providers, children between 6 months and up to 5
years of age, and people with chronic diseases such as diabetes, asthma,
and heart disease, as well as people 50 years old and older.
While the best time for vaccination is October and November before the
influenza season typically begins, vaccination can still provide
protection in December and later because during most years influenza does
not peak until February or later. Since influenza is unpredictable, and
different types and strains of influenza circulate throughout the flu
season, the CDC's Advisory Committee on Immunization Practices (ACIP)
recommends that influenza vaccine be offered throughout the influenza
season—even after influenza has appeared or begun appearing in a
community.
To assist in the promotion of the flu vaccine, CDC's Flu Gallery contains
educational materials for use during the influenza immunization season.
These materials reflect CDC's vaccination recommendations and highlight
the benefits of influenza vaccination. The Gallery contains print
materials such as flyers, posters, and brochures, in color and black and
white, English and Spanish. Many of the materials can be reproduced on an
office printer. You can also have the materials printed by a professional
(offset) printer.
More information about influenza and influenza vaccine can be found at
http://www.cdc.gov/flu and the Flu
Gallery can be found at
http://www.cdc.gov/flu/gallery
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OTHER NEWS AND SUMMARIES
INFLUENZA VACCINE DISTRIBUTION DATA IS BEING MADE AVAILABLE TO STATE AND
LOCAL PUBLIC HEALTH OFFICIALS: To aid the visibility of influenza vaccine
distribution, the CDC is making available jurisdiction-specific summary
reports of influenza vaccine distribution data to state and local public
health officials. The CDC is working closely with the licensed
manufacturers of influenza vaccine and seven major influenza vaccine
distributors to provide distribution information on a weekly basis
throughout the influenza season, beginning this month. Distribution data
elements will include the zip code of end recipient, product type, number
of doses, and provider type. A limited amount of jurisdiction-specific
order information ("pre-booking" data) will be available as well.
************************
MEETINGS, CONFERENCES, AND RESOURCES
NEXT ACIP MEETING: The Advisory Committee on Immunization Practices (ACIP)
will hold its next meeting on October, 25-26, 2006, at the CDC in Atlanta,
Georgia. The draft agenda will be available in early October on ACIP's
meetings page. Participants can also register for the October meeting at
ACIP's website. This meeting is open to the general public, but advanced
registration is required.
MMWR NEEDS PILOT TESTERS: CDC's MMWR (Morbidity and Mortality Weekly
Report) has a need for volunteers to pilot test upcoming articles that are
to be published in this journal. MMWR will soon publish articles on the
new General Recommendations and on Tdap vaccination for adults. If you are
interested in pilot testing these articles, contact Barbara Stallworth at
BStallworth@cdc.gov Volunteers
are particularly needed in the following occupations: physicians,
pharmacists, health educators, medical assistants, and nurses. For those
who are already on NIP's pilot testing list: Please note that this is a
separate pool of volunteers. You can volunteer to be included in both
groups if you wish.
************************
To access the complete September issue from the NIP website, go to:
http://www.cdc.gov/nip/news/newsltrs/imwrks/2006/200609.htm
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September 18, 2006
WOMEN IN GOVERNMENT RECOMMENDS HPV VACCINATION FOR GIRLS ENTERING MIDDLE
SCHOOL
On September 12, Women In Government, a bi-partisan organization of women
state legislators, issued a press release recommending that girls entering
middle school receive human papillomavirus (HPV) vaccine. Portions of the
press release are reprinted below.
*************************
WOMEN IN GOVERNMENT ISSUES STATE POLICY RECOMMENDATIONS FOR CERVICAL
CANCER VACCINE
Recommendations Support Middle School Entry Requirements
Following the recent Food and Drug Administration (FDA) approval of a
vaccine targeting cervical cancer, Women in Government, a national,
bi-partisan, non-profit organization representing women state legislators,
today recommended that all girls entering middle school be vaccinated
against the human papillomavirus (HPV), the cause of cervical cancer. The
recommendation is part of the group's new policy recommendations for the
HPV vaccine's implementation in the states. The group also supports
parental exemptions to the HPV vaccine, based on existing state
immunization exemptions. . . .
The new HPV vaccine policy recommendations are part of Women in
Government's "Challenge to Eliminate Cervical Cancer Campaign," which
mobilizes state legislators to help eradicate cervical cancer through
education and policy initiatives. Since 2004, 45 states have introduced
legislation or resolutions tackling this issue. . . .
*************************
To access the complete press release, click
here.
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September 18, 2006
MMWR ISSUES CORRECTIONS TO THE STD TREATMENT GUIDELINES IT PUBLISHED ON
AUGUST 4
CDC published a brief article, "Errata: Vol. 55, No. RR-ll," in the
September 15 issue of MMWR. It concerns errors that appeared in "Sexually
Transmitted Diseases Treatment Guidelines, 2006," published August 4 in
MMWR Recommendations and Reports. The September 15 article is reprinted
below in its entirety.
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In the MMWR Recommendations and Reports, "Sexually Transmitted Diseases
Treatment Guidelines, 2006," the following errors occurred:
On page 42, in the section "Chlamydial Infections Among Children" under
"Diagnostic Considerations," the second recommended regimen should read:
Recommended Regimen for Children Who Weigh >=45 kg but Who Are Aged <8
Years.
On page 48, in the section "Gonococcal Infections Among Children" under
"Diagnostic Considerations," the first recommended regimen should read:
Recommended Regimens for Children Who Weigh >45 kg.
On page 59, under "Recommended Regimen A," the daily dosage for Ofloxacin
was incorrect. It should read: Ofloxacin 400 mg orally twice daily for 14
days*.
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5536a7.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5536.pdf
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