Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 622            September 25, 2006

CONTENTS OF THIS ISSUE

  1. Recommendations for HIV testing in healthcare settings published in MMWR Recommendations and Reports
  2. CDC publishes report on inadvertent misadministration of meningococcal conjugate vaccine
  3. CDC releasing August 10 Immunization Update broadcast in podcast format segments
  4. Heads up: November 1 is deadline for abstracts for the 2007 National Immunization Conference
  5. Updated: IAC revises two pieces for healthcare professionals
  6. CDC issues update on U.S. and worldwide influenza activity during May 21–September 9, 2006
  7. CDC reports on measles-control activities in Africa
  8. Earn continuing education credit online by participating in interactive, case-based activities

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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 25, 2006
RECOMMENDATIONS FOR HIV TESTING IN HEALTHCARE SETTINGS PUBLISHED IN MMWR RECOMMENDATIONS AND REPORTS

CDC published "Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings" in the September 22 MMWR Recommendations and Reports. The summary is reprinted below in its entirety, excluding references.

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These recommendations for human immunodeficiency virus (HIV) testing are intended for all healthcare providers in the public and private sectors, including those working in hospital emergency departments, urgent care clinics, inpatient services, substance abuse treatment clinics, public health clinics, community clinics, correctional healthcare facilities, and primary care settings. The recommendations address HIV testing in healthcare settings only. They do not modify existing guidelines concerning HIV counseling, testing, and referral for persons at high risk for HIV who seek or receive HIV testing in nonclinical settings (e.g., community-based organizations, outreach settings, or mobile vans). The objectives of these recommendations are to increase HIV screening of patients, including pregnant women, in healthcare settings; foster earlier detection of HIV infection; identify and counsel persons with unrecognized HIV infection and link them to clinical and prevention services; and further reduce perinatal transmission of HIV in the United States. These revised recommendations update previous recommendations for HIV testing in healthcare settings and for screening of pregnant women.

Major revisions from previously published guidelines are as follows:

For patients in all healthcare settings

  • HIV screening is recommended for patients in all healthcare settings after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
  • Persons at high risk for HIV infection should be screened for HIV at least annually.
  • Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.
  • Prevention counseling should not be required with HIV diagnostic testing or as part of HIV screening programs in healthcare settings.

For pregnant women

  • HIV screening should be included in the routine panel of prenatal screening tests for all pregnant women.
  • HIV screening is recommended after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
  • Separate written consent for HIV testing should not be required; general consent for medical care should be considered sufficient to encompass consent for HIV testing.
  • Repeat screening in the third trimester is recommended in certain jurisdictions with elevated rates of HIV infection among pregnant women.

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To access a web-text (HTML) version of the recommendations, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm

To access a ready-to-print (PDF) version, go to:
http://www.cdc.gov/mmwr/pdf/rr/rr5514.pdf
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September 25, 2006
CDC PUBLISHES REPORT ON INADVERTENT MISADMINISTRATION OF MENINGOCOCCAL CONJUGATE VACCINE

CDC published "Inadvertent Misadministration of Meningococcal Conjugate Vaccine—United States, June–August 2005" in the September 22 issue of MMWR. The opening paragraph is reprinted below.

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During June–August 2005, CDC and the Food and Drug Administration (FDA) were notified of seven clusters of inadvertent subcutaneous (SC) misadministration of the new meningococcal conjugate vaccine (MCV4, Menactra) (Sanofi Pasteur, Inc., Swiftwater, Pennsylvania), which is licensed for intramuscular (IM) administration only. A total of 101 persons in seven states were reported to have received MCV4 by the SC route. Of these, 100 were contacted by their healthcare providers and advised of the administration error. CDC conducted an investigation to determine whether SC administration of MCV4 resulted in a protective immunologic response. This report describes the results of that investigation, which indicated that, despite the misadministration, persons vaccinated by the SC route were sufficiently protected and that revaccination was not necessary.

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The Editorial Note is reprinted below, excluding footnotes.

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The most likely reason for the inadvertent misadministration of MCV4 described in this report was that the older meningococcal vaccine, MPSV4, in use for nearly 30 years, is licensed for SC administration, whereas MCV4 is licensed only for IM administration. This reason was cited by healthcare providers participating in the investigation.

Although the overall serologic response for SC vaccinees was lower than that of IM vaccinees as determined by GMTs [geometric mean titers], nearly all persons vaccinated by the SC route developed rBSA [baby rabbit complement] titers >=8, which was considered protective on the basis of recent population-based studies of meningococcal C conjugate vaccine efficacy in the United Kingdom. Therefore, CDC determined that this particular group of persons vaccinated by the SC route was sufficiently protected and that revaccination was not necessary.

CDC cautions healthcare providers to be aware that the licensed route of vaccine administration can vary among similar vaccines and recommends that providers carefully review and follow the route of administration indicated on the vaccine label and package insert before administering vaccines. This is especially important after introduction of a new vaccine product.

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To access a web-text (HTML) version of the article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5537a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5537.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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September 25, 2006
CDC RELEASING AUGUST 10 IMMUNIZATION UPDATE BROADCAST IN PODCAST FORMAT SEGMENTS

CDC's National Immunization Program is in the process of making the August 10 Immunization Update broadcast available in segments as MP4 (audio and video) and MP3 (audio) files. These segments can be downloaded to a computer or a portable music/video device (such as an iPod) or viewed/listened to directly on the CDC podcast web page.

Currently, eight segments are available. Go to http://www2a.cdc.gov/podcasts and look under the following dates for the segments. To download either an MP3 or MP4 file to your computer, right-click on the "download" link for the file, then use the "save as" command to save the file.

September 8, 2006
"Vaccines: Guidelines for Healthcare Providers—Influenza Part 1"
"Vaccines: Guidelines for Healthcare Providers—Influenza Part 2"
"Vaccines: Guidelines for Healthcare Providers—Influenza Part 3"
"Vaccines: Guidelines for Healthcare Providers—Herpes Zoster (Shingles)"

September 15, 2006
"Vaccines: Guidelines for Healthcare Providers—HPV"
"Vaccines: Guidelines for Healthcare Providers—Varicella"

September 22, 2006
"Vaccines: Guidelines for Healthcare Providers—Rotavirus"
"Vaccines: Guidelines for Healthcare Providers—VIS"

Each segment is also available as a transcript in ready-to-print (PDF) format.

Keep checking http://www2a.cdc.gov/podcasts for newly released segments. Important note: continuing education credit is not available for viewing/listening to these segments.
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September 25, 2006
HEADS UP: NOVEMBER 1 IS DEADLINE FOR ABSTRACTS FOR THE 2007 NATIONAL IMMUNIZATION CONFERENCE

November 1 is the deadline for submitting abstracts for CDC's 2007 National Immunization Conference, which will be held in Kansas City, MO, on March 5-8, 2007. Abstracts must be submitted online. To access submission guidelines, go to: http://www.cdc.gov/nip/nic/#abstract

The deadline for early-bird registration ($200) is January 12. The deadline for regular registration ($225) is February 16. Late and on-site registration will be $250.

For general information on the 41st National Immunization Conference, including conference goals, objectives, and registration, go to: http://www.cdc.gov/nip/nic

Those without Internet access can contact the conference planning team at (404) 639-8225 or nipnic@cdc.gov
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September 25, 2006
UPDATED: IAC REVISES TWO PIECES FOR HEALTHCARE PROFESSIONALS

IAC recently revised two pieces for healthcare professionals.

"First do no harm: Protect patients by making sure all staff receive yearly influenza vaccine!" encourages healthcare employers to protect patients by increasing staff influenza vaccination rates. The revised piece is based on the CDC publication, "Influenza Vaccination of Health-Care Personnel," published February 2006. "First do no harm" also includes information on the Joint Commission of Accreditation of Healthcare Organization's infection control standard requiring accredited organizations to offer influenza vaccination to staff, volunteers, and independent practitioners who have close patient contact.

The updated piece also features a list of practical resources, including links to standing order protocols, screening questionnaires, and declination of influenza vaccination forms.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p2014.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2014.htm

IAC's "Vaccine Administration Record for Adults" was revised to include space to record HPV and zoster vaccines.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p2023b.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2023b.htm
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September 25, 2006
CDC ISSUES UPDATE ON U.S. AND WORLDWIDE INFLUENZA ACTIVITY DURING MAY 21–SEPTEMBER 9, 2006

CDC published "Update: Influenza Activity—United States and Worldwide, May 21–September 9, 2006" in the September 22 issue of MMWR. The opening paragraph is reprinted below.

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During May 21–September 9, 2006, influenza A(H3), influenza A(H1), and influenza B viruses cocirculated worldwide and were identified sporadically in North America. This report summarizes influenza activity in the United States and worldwide since the last MMWR update.

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To access a web-text (HTML) version of the article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5537a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5537.pdf
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September 25, 2006
CDC REPORTS ON MEASLES-CONTROL ACTIVITIES IN AFRICA

CDC published "Effects of Measles-Control Activities—African Region, 1999–2005" in the September 22 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

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This study demonstrates that the strategies used in the accelerated measles control program in the WHO African Region, when implemented effectively, can result in a sharp drop in measles cases. Reported measles cases in 32 African countries were reduced by 93 percent—from nearly 203,000 in 1999 to just over 14,000 in 2005—as a result of large-scale vaccination campaigns, improvements in routine immunization services, case management, and surveillance activities. The remaining children in Africa not yet vaccinated against measles will be targeted for vaccination campaigns by the end of 2006. Successful control of measles in these countries is important to reducing child mortality and reaching global goals of measles mortality reduction. Measles is the leading vaccine-preventable cause of death worldwide, causing nearly half a million deaths annually.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5537a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5537.pdf
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September 25, 2006
EARN CONTINUING EDUCATION CREDIT ONLINE BY PARTICIPATING IN INTERACTIVE, CASE-BASED ACTIVITIES

The University of Pennsylvania School of Medicine and SCIOS Continuing Education are jointly sponsoring a series of interactive, online case-based learning opportunities designed to improve childhood immunization rates. Titled "Medical Detectives," the series has been designed for family practice physicians, pediatricians, nurse practitioners, physician assistants, and other healthcare professionals interested in learning about overcoming barriers to optimal pediatric vaccine use.

The activities have been approved for credit for physicians; the program is pending approval by the National Association of Pediatric Nurse Practitioners. Faculty includes Jay M. Lieberman, MD; Sharon G. Humiston, MD, MPH, FAAP; and S. Michael Marcy, MD.

For more information, or to register, go to:
http://www.pedsvaccinescme.com

 

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 September 25, 2006