IAC Express 2006
Issue number 634: December 4, 2006
 
Contents of this Issue
Select a title to jump to the article.
  1. New: CDC issues ACIP's General Recommendations on Immunization
  2. New Hampshire's vaccine program to offer free HPV vaccine to girls ages 11-18 years
  3. Dr. Julie Gerberding issues statement for World AIDS Day and announces the launch of www.aids.gov website
  4. Updated: IAC revises standing orders protocols for administering four vaccines to adults
  5. IAC updates its online Ask the Experts information on varicella and diphtheria, tetanus, and pertussis
  6. IAC makes major revisions to hepatitis B education material for Asian American and Pacific Islander patients
  7. Two freebies: Bulk copies of October 2006 issues of Needle Tips and Vaccinate Adults will go fast—don't miss out!
  8. Influenza Summit newsletter publishes a thank-you to all who participated in National Influenza Vaccination Week
  9. Correction: Influenza Summit corrects a phone number in the November 30 issue of its newsletter
 
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.
  
Issue 634: December 4, 2006
1.  New: CDC issues ACIP's General Recommendations on Immunization

On December 1, CDC published "General Recommendations on Immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP)" in the MMWR Recommendations and Reports. Last issued in 2002, the recommendations now cover the following topics: (1) timing and spacing of immunobiologics, (2) contraindications and precautions, (3) vaccine administration, (4) altered immunocompetence, (5) special situations, (6) vaccination records, (7) reporting adverse events after vaccination, (8) vaccination programs, and (9) vaccine information sources.

The 2006 revision of the General Recommendations features visual elements, such as diagrams, images, tables. Following are some of the more notable additions: (1) an updated table of contraindications and precautions to commonly used vaccines, (2) images displaying the correct administration site for intramuscular and subcutaneous injections for infants and adults, (3) a table outlining the treatment of anaphylaxis, (4) a table comparing the advantages and disadvantages of various types of thermometers used to monitor vaccine storage temperatures, and much more.

The Summary, which outlines significant changes made to the General Recommendations, is reprinted below in its entirety.


Summary

This report is a revision of General Recommendations on Immunization and updates the 2002 statement by the Advisory Committee on Immunization Practices (ACIP) (CDC. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices and the American Academy of Family Physicians. MMWR 2002;51[No. RR-2]). This report is intended to serve as a general reference on vaccines and immunization. The principal changes include (1) expansion of the discussion of vaccination spacing and timing; (2) an increased emphasis on the importance of injection technique/age/body mass in determining appropriate needle length; (3) expansion of the discussion of storage and handling of vaccines, with a table defining the appropriate storage temperature range for inactivated and live vaccines; (4) expansion of the discussion of altered immunocompetence, including new recommendations about use of live-attenuated vaccines with therapeutic monoclonal antibodies; and (5) minor changes to the recommendations about vaccination during pregnancy and vaccination of internationally adopted children, in accordance with new ACIP vaccine-specific recommendations for use of inactivated influenza vaccine and hepatitis B vaccine. The most recent ACIP recommendations for each specific vaccine should be consulted for comprehensive discussion. This report, ACIP recommendations for each vaccine, and other information about vaccination can be accessed at CDC's National Center for Immunization and Respiratory Diseases (proposed; formerly known as the National Immunization Program) website at http://:www.cdc.gov/nip


To access a web-text (HTML) version of the General Recommendations, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5515a1.htm

To access a ready-to-print (PDF) version, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5515.pdf

Note: The PDF version includes a free CDC-sponsored education activity that can be completed online or submitted by U.S. mail for CME, CEU, CNE, CHES, or CPE credit. Simply read the primer, answer the questions at the end, and follow instructions for submitting your answers.

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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2 New Hampshire's vaccine program to offer free HPV vaccine to girls ages 11-18 years

On November 29, the New Hampshire Department of Health & Human Services issued a press release announcing that it will offer free human papillomavirus (HPV) vaccine routinely to girls ages 11-18 years. It is the first state in the U.S. to do so. The press release is reprinted below in its entirety.


DHHS ANNOUNCES NEW HAMPSHIRE WILL OFFER FREE VACCINE TO CHILDREN FOR HPV; MOST COMMON SEXUALLY TRANSMITTED DISEASE NATIONALLY

The Department of Health and Human Services (DHHS) today announced that New Hampshire's Vaccine for Children program will now offer vaccine for several common types of human papillomavirus (HPV). The vaccine, which was recently approved by the Food and Drug Administration, covers four strains of HPV that are responsible for 70 percent of cervical cancers and 90 percent of genital warts. The vaccine, called Gardasil, will be made available, free of charge, to New Hampshire girls aged 11-18.

"The HPV vaccine represents a significant step forward in protecting the health and lives of the women and girls of New Hampshire," said DHHS Commissioner John Stephen. "This represents a small victory in the battle against cancer, and we are thrilled to be able to offer this vaccine. We strongly recommend that all parents consider getting their daughters vaccinated."

HPV is the most prevalent sexually transmitted disease in the United States. According to the Centers for Disease Control and Prevention (CDC), 6.2 million Americans acquire the disease each year, which, in some women, can lead to cervical cancer. Based on CDC figures, in 2002 more than 12,000 women were diagnosed with cervical cancer and nearly 4,000 died nationally. In New Hampshire, between 2000 and 2002, 53 women were diagnosed with cervical cancer each year, and between 1999-2003, 16 women died from the illness annually, according to the National Cancer Institute. The administration of this vaccine was a recommendation of the Advisory Committee on Immunization Practices (ACIP). ACIP, a part of CDC, is made up of healthcare professionals who make recommendations on the use of vaccines nationally.

"This vaccine is a major scientific breakthrough, we know there is a direct relationship between HPV and cervical cancer and we have the rare opportunity to reduce the incidences of cancer in women," said Mary Ann Cooney, Director of Public Health, "We are very excited to be able to offer this vaccine to our young women. This vaccine has the ability to reduce healthcare costs, cancer death rates, and the devastating impact this disease can have on women and their families."


To access the press release, go to:
http://www.dhhs.state.nh.us/DHHS/PIO/LIBRARY/Press+Release/DPHS-HPV.htm

To access comprehensive information on HPV disease and vaccine, go to: http://www.immunize.org/HPV

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3 Dr. Julie Gerberding issues statement for World AIDS Day and announces the launch of www.aids.gov website

On December 1, on World AIDS Day, CDC issued a press release of a statement made by Julie Gerberding, MD, MPH, CDC's director. It is reprinted below in its entirety.


More than 25 years into the AIDS epidemic, we've made important progress against the disease but serious challenges remain. Advances in treatment continue to extend and improve the lives of people living with HIV and AIDS, yet not everyone has access to quality care. HIV prevention efforts have saved countless lives in the United States and around the world, but many people at risk must still be reached. And though we've achieved extraordinary declines in mother-to-child HIV transmission in the United States to fewer than 240 cases per year, even that number could be significantly reduced.

Over a million people are living with HIV in the United States, with African Americans and gay and bisexual men of all races remaining most severely affected. Far too many Americans with HIV are not diagnosed until years after they were infected, when it may be too late to fully benefit from available treatments. And one-quarter of people with HIV—at least 250,000 Americans—still do not realize they are infected.

If we are to defeat HIV/AIDS, we must ensure that people know whether or not they are infected, so those who are HIV positive can receive life-extending treatment and take steps to protect their partners. To help accomplish this goal, CDC recently issued new recommendations to make HIV screening a routine part of medical care for all patients between the ages of 13 and 64. These recommendations are an essential part of the nation's comprehensive program of HIV prevention and care, and we believe they will help reach many of the quarter-million Americans who are unaware of their infection.

On World AIDS Day, the Department of Health and Human Services launches http://www.aids.gov, the new Internet gateway to federal HIV/AIDS information. It will guide users to information on prevention, testing, treatment, and research programs, and to federal HIV/AIDS policies and resources.

Success against HIV will require many different solutions and a life-long commitment from everyone—from those infected, from those at risk, and from society as a whole. As we pause today to remember those lost to AIDS, let us also honor them with a renewed commitment to completely stopping the spread of HIV in the United States and around the world.


To access the press release, go to:
http://www.cdc.gov/od/oc/media/pressrel/a061201.htm

To access the new HIV screening recommendations, go to:
http://www.aids.gov/testing/guidelines

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4 Updated: IAC revises standing orders protocols for administering four vaccines to adults

IAC recently revised the standing orders protocols for administering the following vaccines to adults: hepatitis B, varicella, pneumococcal polysaccharide (PPV), measles-mumps-rubella (MMR).

The protocol for administering hepatitis B vaccine now includes the information that the vaccine may be administered to anyone who wants to be protected against hepatitis B virus infection. In addition, minor changes were made. To access a ready-to-print (PDF) version of the protocol, go to: http://www.immunize.org/catg.d/p3076.pdf

The protocol for administering varicella vaccine now includes new information regarding who needs the vaccine. In addition, minor changes were made. To access a ready-to-print (PDF) version of the protocol, go to: http://www.immunize.org/catg.d/p3080.pdf

The protocol for administering PPV was revised with minor changes. To access a ready-to-print (PDF) version of the protocol, go to: http://www.immunize.org/catg.d/p3075.pdf

The protocol for administering MMR vaccine was revised with changes to the specifics about mumps. To access a ready-to-print (PDF) version of the protocol, go to: http://www.immunize.org/catg.d/p3079.pdf

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5 IAC updates its online Ask the Experts information on varicella and diphtheria, tetanus, and pertussis

The IAC website recently posted updated Ask the Experts information on the following diseases and vaccines: varicella; and diphtheria, tetanus, and pertussis. IAC extends thanks to William L. Atkinson, MD, MPH, and Andrew T. Kroger, MD, MPH, for reviewing and revising these Ask the Experts web pages so that they reflect the most current information. Both are medical epidemiologists with CDC's National Center for Immunization and Respiratory Diseases.

To access the varicella Ask the Experts, go to:
http://www.immunize.org/catg.d/p2021n.htm

To access the diphtheria, tetanus, and pertussis Ask the Experts, go to:
http://www.immunize.org/catg.d/p2021d.htm

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6 IAC makes major revisions to hepatitis B education material for Asian American and Pacific Islander patients.

IAC recently made major revisions to its three-page patient-education piece "Hepatitis B Information for Asian Americans and Pacific Islanders." To access a ready-to-copy (PDF) version of the revised piece, go to: http://www.immunize.org/catg.d/4190apia.pdf

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7 Two freebies: Bulk copies of October 2006 issues of Needle Tips and Vaccinate Adults will go fast—don't miss out!

IAC is giving away bulk copies of the latest (October 2006) issues of Needle Tips and Vaccinate Adults. Those interested may order up to 50 copies of each publication. Both publications are written for health professionals. THEY ARE NOT FOR DISTRIBUTION TO THE PUBLIC.

NEEDLE TIPS. If you have an immunization conference or an educational program coming up for physicians, residents, or nurses who specialize in pediatrics or family practice, this 24-page publication is an excellent item to distribute. The October 2006 issue includes IAC's Summary of Recommendations for Childhood and Adolescent Immunization; IAC's Summary of Recommendations for Adult Immunization; a comprehensive three-page Q&A about indications for healthcare worker hepatitis B vaccination, postvaccination serologic testing, and postexposure prophylaxis; a review of the sweeping changes found in the ACIP recommendations for influenza vaccination of healthcare personnel and the new standard of the Joint Commission on Accreditation of Healthcare Organizations (JCACO); four resources for administering vaccines across the lifespan; and influenza vaccination standing orders and screening questionnaires.

VACCINATE ADULTS. If you have an immunization conference or an educational program coming up for adult medical specialists, this 12-page publication is an excellent item to distribute. The October 2006 issue offers the resources mentioned above with one notable exception: it does not have IAC's Summary of Recommendations for Childhood and Adolescent Immunization.

HOW TO ORDER. Because supplies of the October 2006 issues of both publications are limited, it's best to make your request right away. Free copies go quickly. Sorry, we can mail orders only to addresses within the United States.

TO REQUEST COPIES OF NEEDLE TIPS, fill out the online form on IAC's website: http://www.immunize.org/freeoffernt

TO REQUEST COPIES OF VACCINATE ADULTS, fill out the online form on IAC's website: http://www.immunize.org/freeofferva

You will be asked to supply the following information:

  • The number of copies of each publication that you want (maximum is 50 copies of each)
  • A description of how you plan to use the copies
  • Your name and complete contact information, including mailing address, telephone number, and email address

For further information, email admin@immunize.org

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8 Influenza Summit newsletter publishes a thank-you to all who participated in National Influenza Vaccination Week

On December 1, the National Influenza Vaccine Summit published a special issue of its newsletter thanking those who participated in National Influenza Vaccination Week. The special issue is reprinted below in its entirety.


Today, on December 1, 2006, it is with great admiration and thanks that we conclude the first annual National Influenza Vaccination Week.

With less than one month between the conception of a national effort to extend vaccination activities and the event itself, an amazing amount of energy, creativity, commitment, and hard work have been accomplished by countless individuals and organizations, including state and local public health officials, private healthcare providers across a wide variety of clinical settings, professional societies, community immunization providers, influenza vaccine manufacturers and distributors, and numerous federal agencies and departments. We have made an important first step in the important work of addressing the misconception that it is "okay" to stop vaccinating after Thanksgiving or that people vaccinated in November or December or beyond won't benefit from vaccination.

We look forward to continuing this tradition next year with the second annual National Influenza Vaccination Week. With lessons learned from this year, it is our hope that next year's effort will have an even greater impact and that we will be able to work even more closely with the same thoughtful and dedicated group of partners in planning and implementing next year's activities.


To access the special issue, go to:
http://www.preventinfluenza.org/summit_news_4g.doc

Remember influenza vaccination should continue through the month of December and beyond! Visit http://www.preventinfluenza.org often to find the information you need to keep vaccinating!

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9 Correction: Influenza Summit corrects a phone number in the November 30 issue of its newsletter

On December 4, the National Influenza Vaccine Summit (NIVS) issued a correction to the article titled "Washoe County District Health Department (Nevada) 'Cocooning' Program," which appeared in the November 30 issue of the NIVS newsletter. Here is the text of the corrected information: "For additional information, please contact Judy Davis, Public Information Officer, at (775) 843-3946."

To access the corrected newsletter, go to:
http://www.preventinfluenza.org/summit_news_4f.doc

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Editorial Information

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    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
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    Courtnay Londo, MA
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    Marian Deegan, JD
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