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IAC Express 2007 |
| Issue number 691: November 5, 2007 |
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Contents
of this Issue
Select a title to jump to the article. |
- New: ACIP
votes to recommend nasal-spray influenza vaccine for children age 2-5
years
- CDC's
Drs. Atkinson and Kroger correct answer in Needle Tips (October 2007)
about which children should receive two doses of influenza vaccine
- Two AAP
clinical reports will help physicians identify and manage patients with
autism spectrum disorder
- Wall
Street Journal editorial defends childhood vaccination and counters Jenny
McCarthy's claim of vaccination harm
- Updated
data indicate a normal range of intussusception cases among children
vaccinated with rotavirus vaccine
- Get
ready: CDC announces National Influenza Vaccination Week for November
26-December 2 and posts related materials
-
Important: Be sure to administer influenza vaccine throughout the
influenza season--from fall 2007 through spring 2008
- VIS for
nasal-spray influenza vaccine now available in Hmong, Russian, and Somali
- CDC's
Seasonal Flu web section posts new materials
-
Reminder: November 15 is the deadline for submitting abstracts for CDC's
2008 National Immunization Conference
- WHO
website posts document that outlines the organization's work to ensure
immunization quality, safety, and standards
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| Abbreviations |
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AAFP, American Academy of Family Physicians; AAP,
American Academy of Pediatrics; ACIP, Advisory Committee on Immunization
Practices; AMA, American Medical Association; CDC, Centers for Disease
Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization
Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NCIRD,
National Center for Immunization and Respiratory Diseases; NIVS, National
Influenza Vaccine Summit; VIS, Vaccine Information Statement; VPD,
vaccine-preventable disease; WHO, World Health Organization. |
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Issue 691: November 5, 2007 |
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1. |
New: ACIP votes to recommend nasal-spray influenza vaccine for children age
2-5 years
On October 26, CDC issued a press release
announcing that ACIP
voted to recommend the use of FluMist, the live attenuated
influenza vaccine (LAIV; nasal-spray formulation) to include
children age 2-5 years. Previously, the vaccine was recommended
for use in persons age 5-49 years. The press release is
reprinted below in its entirety.
CDC ADVISORY COMMITTEE RECOMMENDS NASAL SPRAY FLU VACCINE FOR
CHILDREN AGES TWO TO FIVE
A panel of immunization experts has voted to expand the
recommendation for the nasal spray influenza vaccine, FluMist
(MedImmune Vaccines, Inc., Gaithersburg, MD), to include
children from 2 to 5 years of age who are healthy and don't have
a history of asthma or wheezing.
The Advisory Committee on Immunization Practices (ACIP), the
committee that advises the Centers for Disease Control and
Prevention (CDC) on vaccine issues, voted on the new
recommendation during its October 24-25, 2007, meeting in
Atlanta.
The vaccine, which contains a weakened form of the live virus
and is sprayed in the nose, had previously been limited to
healthy children 5 years of age and older and healthy adults up
to age 50.
Every year in the United States, 5 percent to 20 percent of the
population develops influenza, more than 200,000 people are
hospitalized, and about 36,000 people die from influenza
complications.
The CDC recommends that all children age 6 months to 59 months
receive a vaccination to protect against influenza. Studies have
shown that children 24 months to 5 years were more likely to see
a healthcare provider for influenza than older children.
"We know that vaccinating children protects them against flu,"
said Dr. Anne Schuchat, director of CDC's National Center for
Immunization and Respiratory Diseases. "This recommendation
gives parents another option when vaccinating their children."
People younger than 2 or older than 49 years of age, or those
with an underlying chronic health condition, such as heart or
lung disease, diabetes or kidney disease should not receive
FluMist. Those individuals should receive a flu shot rather than
the nasal spray.
Previously, there were only two injectable influenza vaccines
licensed in the United States for children under the age of 5.
One vaccine, Fluzone (sanofi pasteur Inc., Swiftwater, PA), is
indicated for those six months of age and older, while another
vaccine, Fluvirin (Novartis Vaccines and Diagnostics Ltd,
Liverpool, England) is available for use in children ages 4 and
older.
Manufacturers project there will be plenty of vaccine this year;
therefore, anyone who wants to reduce their chances of getting
the flu should get vaccinated. However, it is especially
important that certain people get vaccinated each year, because
they are at high risk of having serious flu-related
complications or because they live with or care for high-risk
persons.
CDC recommends that the following people get vaccinated each
year:
People at high risk for complications from the flu, including
- Children aged 6 months until their 5th birthday,
- Pregnant women,
- People 50 years of age and older,
- People of any age with certain chronic medical conditions, and
- People who live in nursing homes and other long-term care
facilities.
People who live with or care for those at high risk for
complications from flu, including
- Household contacts of persons at high risk for complications
from the flu (see above),
- Household contacts and out of home caregivers of children less
than 6 months of age (these children are too young to be
vaccinated), and
- Healthcare workers.
To access the press release, go to:
http://www.cdc.gov/od/oc/media/pressrel/2007/r071026.htm
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2. |
CDC's Drs. Atkinson and Kroger correct answer in Needle Tips (October 2007)
about which children should receive two doses of influenza vaccine
The October 2007 issue of the IAC periodical
Needle Tips
included an Ask the Experts Q&A, written by CDC's Dr. William
Atkinson and Dr. Andrew Kroger, about which children need two
doses of influenza vaccine the first year they receive the
vaccine. IAC has received some questions asking for
clarification of the answer. Here is the corrected Q&A:
Q: Which children need two doses of influenza vaccine this
season?
A: Children age eight years and younger who are receiving
influenza vaccine (TIV or LAIV) for the first time should
receive two vaccine doses given with a minimum interval of four
weeks. If the child fails to get the second dose during that
season, he should be given two doses in the next influenza
vaccination season. If he fails to receive those two doses, he
should only get one dose per year from that point on.
Previously, the Q&A stated the following:
Q. Which children need two doses of influenza vaccine this
season?
Children age six months through eight years who are receiving influenza
vaccine for the first time should receive two vaccine
doses at a four-to-six week interval (depending on the type of
vaccine). A child younger than age nine years who received
influenza vaccine in only one previous season, and received only
one dose, should receive two doses this season. A child who has
received a total of two doses of influenza vaccine, either in
the same or different years, should receive only one dose.
IAC regrets the confusion the initial Q&A may have caused Needle
Tips readers.
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3. |
Two AAP clinical reports will help physicians identify and manage patients
with autism spectrum disorder
The November issue of the AAP publication
Pediatrics includes
two clinical reports on autism. Titled "Identification and
Evaluation of Children with Autism Spectrum Disorders" and
"Management of Children with Autism Spectrum Disorders," the
reports were discussed at a press briefing held October 29 at
AAP's 2007 National Conference and Exhibition. Portions of an
AAP press release about the reports are reprinted below. At the
end of this IAC Express article, links are given to (1) the
complete AAP press release; (2) the two clinical reports
mentioned above; and (3) CDC's autism web section, "Learn the
Signs. Act Early."
[From the AAP press release]
Two new clinical reports from the American Academy of Pediatrics
(AAP) will help pediatricians recognize autism spectrum
disorders (ASDs) earlier and guide families to effective
interventions, which will ultimately improve the lives of
children with ASDs and their families. The first clinical
report, "Identification and Evaluation of Children with Autism
Spectrum Disorders," provides detailed information on signs and
symptoms so pediatricians can recognize and assess ASDs in their
patients. Language delays usually prompt parents to raise
concerns to their child's pediatrician, usually [when the child
is] around 18 months of age. However, there are earlier subtle
signs that if detected could lead to earlier diagnosis. . . .
Educational strategies and associated therapies, which are the
cornerstones of treatment for ASDs, are reviewed in the second
AAP clinical report, "Management of Children with Autism
Spectrum Disorders." Early intervention is crucial for effective
treatment. The report strongly advises intervention as soon as
an ASD diagnosis is seriously considered rather than deferring
until a definitive diagnosis is made. The child should be
actively engaged in intensive intervention at least 25 hours per
week, 12 months per year with a low student-to-teacher ratio
allowing for sufficient one-on-one time. Parents should also be
included. . . .
To access the complete AAP press release, go to:
http://www.aap.org/advocacy/releases/oct07autism.htm
To access the full text of "Identification and Evaluation of
Children with Autism Spectrum Disorders," go to:
http://pediatrics.aappublications.org/cgi/content/full/peds.2007-2361v1
To access the full text of "Management of Children with Autism
Spectrum Disorders," go to:
http://pediatrics.aappublications.org/cgi/content/full/peds.2007-2362v1
To access CDC's "Learn the Signs. Act Early." web section, go
to: http://www.cdc.gov/ncbddd/autism/actearly
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4. |
Wall Street Journal editorial defends childhood vaccination and counters
Jenny McCarthy's claim of vaccination harm
On October 27, the Wall Street Journal published
a guest
editorial, "The New McCarthyism: Vaccines & Autism." It is
written by Dr. Ari Brown, a pediatrician in Austin, TX. Portions
of the editorial are reprinted below.
Dangerous vaccines that harm kids. An epidemic of disabled
children, hurt by an uncaring medical establishment.
Sounds like a B-grade Hollywood thriller. But this is supposedly
a true story as told by actress Jenny McCarthy, author of the
best seller "Louder Than Words: A Mother's Journey in Healing
Autism."
When I heard Ms. McCarthy tell Oprah and Larry King that
vaccines caused her son's autism, I had a flashback . . . I was
the senior pediatric resident on call in the Intensive Care
Unit. . . [A] seven-year-old girl was brought to the emergency
room at Children's Hospital Boston. The girl had come down with
chickenpox a few days earlier . . . That night, she had taken a
turn for the worse. Her fever shot up to 106 and she became
confused and lethargic. . . .
Now she was in "multiple system organ failure"--every square
inch of her body was shutting down all at once. . . .
My attending physician told me to grab dinner. This child would
need me for the rest of the night. I returned to the ICU to find
that my patient had gone into cardiac arrest and died. I
watched, helplessly, as the nurses placed the little girl into a
body bag.
Fast forward five months: The first chickenpox vaccine was
approved. That day, I vowed never to let a child on my watch
suffer from a disease that was preventable by vaccination.
That's a story that doesn't grab headlines or guest shots on
Larry King. Vaccines are one of mankind's greatest scientific
achievements. . . . Yet vaccines are victims of their own
success. Today's parents are unfamiliar with the diseases they
prevent, but these diseases are alive and well in the
U.S. . . . .
Celebrity books come and go, but the anxiety they create lives
on in pediatricians' offices across the country. A small but
growing number of parents are even lying about their religious
beliefs to avoid having their children vaccinated, thanks in
part to the media hysteria created by [Ms. McCarthy's] book.
Parents go through stages of grief when their child is diagnosed
with a disorder like autism. . . . But why hasn't the media
called out Ms. McCarthy on all the medical inaccuracies in her
book? . . . .
[For example:] Ms. McCarthy told Oprah that her son was a normal
toddler until he received his measles, mumps, and rubella
vaccine (at 15 months of age). . . . Yet she contradicts
herself in her book: "My friends' babies all cracked a smile way
before Evan did . . . he was almost five months old." Which is
it? Was he normal until his MMR vaccine or were some of the
signs [of autism] missed before he got that shot?
Ms. McCarthy also contends that mercury in vaccines caused
damage to her son's gut and immune system, leading to autism.
Yet the mercury preservative Ms. McCarthy assails was removed
from the childhood vaccination series in 2001. Her son, Evan,
was born in 2002. . . .
Doctors do need to do a better job of guiding families through
the maze of autism treatments. I also desperately want to know
why autism happens and how to treat it. But let's put our energy
into funding autism research and treatment, not demonizing our
vaccination program. . . .
To access the full text of the editorial from Dr. Brown's
website, go to:
http://baby411.typepad.com/baby_411_blog/2007/10/the-new-mccarth.html
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5. |
Updated data indicate a normal range of intussusception cases among children
vaccinated with rotavirus vaccine
On October 25, the PATH Rotavirus Vaccine Program
issued a news
update announcing that updated data, presented at the October
24-25 ACIP meeting, indicate that RotaTeq rotavirus vaccine does
not pose an elevated risk for intussusception in infants
immunized with the vaccine. Portions of the news update are
reprinted below.
Updated data on the administration of RotaTeq to infants in the
U.S. were presented to the Advisory Committee on Immunization
Practices (ACIP) of the U.S. Centers for Disease Control and
Prevention (CDC) at its meeting today. Consistent with previous
analyses, the rate of intussusception in infants receiving
RotaTeq was not greater than expected by chance alone,
indicating that the vaccine does not pose an elevated risk for
intussusception. Intussusception is the most common cause of
bowel obstruction in infants, and increased risk of
intussusception appeared to be linked to an earlier rotavirus
vaccine withdrawn from the market in the United States in 1999.
Between March 2006 and August 2007, 9.1 million doses of RotaTeq
were distributed in the U.S., and ongoing, routine surveillance
confirmed 160 cases of intussusception--a rate below the
expected background occurrence. Of these 160 cases, 47 were
reported within three weeks of the infant receiving a vaccine
dose. In an unvaccinated population of the same age, the number
of expected cases would be approximately 150. . . .
To access the complete news update, go to:
http://www.rotavirusvaccine.org/RotaFlash_ACIP_25Oct07.htm
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6. |
Get ready: CDC announces National Influenza Vaccination Week for November
26-December 2 and posts related materials
Both NCIRD and CDC's Seasonal Flu web section
have recently
posted information related to National Influenza Vaccination
Week (NIVW) 2007, which is planned for November 26-December 2.
FROM NCIRD
NCIRD announced that NIVW aims to highlight the importance of
continuing influenza vaccination and to foster greater use of
the vaccine through the months of November, December, and
beyond. It's also intended to encourage vaccine providers to
enhance vaccine availability by scheduling additional clinics,
extending clinic hours, and enabling mass vaccination at venues
such as retail locations.
November 27 is set aside as Children's Flu Vaccination Day, with
a focus on vaccinating high-risk children.
The NIVW web section has links to the following:
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Resources for health professionals and partners, including a
28-page media toolkit, podcasts, and e-cards
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Listings of national, regional, and state vaccination
activities related to NIVW
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Online form for submitting information about your
organization's planned activities for NIVW
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A graphic element (available in English and Spanish) to post
on your organization's website. The message is "Get
vaccinated. Don't get flu. Don't spread flu."
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Related organizations—Families Fighting Flu and the American
Lung Association's Flu Clinic Locator
To access the NIVW web section, go to
http://www.cdc.gov/flu/nivw07.htm
FROM CDC'S SEASONAL FLU WEB SECTION
The section titled Info for Health Professionals offers links to
the following:
IAC Express will update readers on additional resources when
they are posted on the NCIRD and the Seasonal Flu web sections.
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7. |
Important: Be sure to administer influenza vaccine throughout the influenza
season--from fall 2007 through spring 2008
Influenza vaccination should continue from now
into the early
months of 2008. Visit the following websites often to find the
information you need to keep vaccinating. Both are continually
updated with the latest resources.
The National Influenza Vaccine Summit website at
http://www.preventinfluenza.org
CDC's Seasonal Flu web section at
http://www.cdc.gov/flu
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8. |
VIS
for nasal-spray influenza vaccine now available in Hmong, Russian, and Somali
Dated 10/4/07, the current
version of the VIS for FluMist, the
live attenuated influenza vaccine (LAIV; nasal spray) is now
available on the IAC website in Hmong, Russian, and Somali. IAC
gratefully acknowledges the Minnesota Department of Health for
the translations.
To obtain a ready-to-print (PDF) version of the VIS for LAIV
vaccine in Hmong, go to:
http://www.immunize.org/vis/hmLAIV04.pdf
To obtain the VIS for LAIV in Russian, go to:
http://www.immunize.org/vis/ru_LAIV05.pdf
To obtain the VIS for LAIV in Somali, go to:
http://www.immunize.org/vis/so_LAIV05.pdf
To obtain the VIS for LAIV in English, go to:
http://www.immunize.org/vis/liveflu.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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9. |
CDC's Seasonal Flu web section posts new materials
CDC recently added a new fact
sheet to its Seasonal Flu web
section:
"Fact Sheet: Protecting Against the Flu: Advice for Caregivers
of Children Less Than 6 Months Old" (10/26/07)
To access this resource, go to:
http://www.cdc.gov/flu/whatsnew.htm#new and click on the
pertinent link.
To access a broad range of continually updated information on
seasonal influenza, avian influenza, pandemic influenza, and
swine influenza, go to: http://www.cdc.gov/flu
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10. |
Reminder: November 15 is the deadline for submitting abstracts for CDC's 2008
National Immunization Conference
The deadline for submitting
abstracts for the 2008 National
Immunization Conference is Thursday, November 15.
To access information about submitting an abstract, go to:
http://cdc.confex.com/cdc/nic2008/cfp.cgi
To access the online submission form, go to:
http://cdc.confex.com/cdc/nic2008/input/papers
The conference will be held in Atlanta on March 17-20, 2008. For
complete conference information, go to:
http://www.cdc.gov/vaccines/events/nic
For additional information, contact the conference planning team
by phone at (404) 639-8225 or by email at NIPNIC@cdc.gov
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11. |
WHO website posts document that outlines the organization's work to ensure
immunization quality, safety, and standards
WHO recently announced the
availability of a new publication,
"WHO: Working to Ensure Global Quality, Safety, and Standards in
Immunization." It gives an overview of WHO's work in setting
norms and standards; assuring the quality of vaccines and
immunization equipment; and monitoring, assessing, and
responding to vaccine safety issues of global concern.
To access the document, go to:
http://www.who.int/immunization/newsroom/QSS_BR.pdf
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