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Immunization Action Coalition
IAC Express 2007
Issue number 671: June 25, 2007
 
Contents of this Issue
Select a title to jump to the article.
  1. ACIP's varicella recommendations now published in MMWR Recommendations and Reports
  2. IDSA issues policy blueprint to strengthen adult and adolescent immunization
  3. IAC introduces new pieces that answer patients' questions about chickenpox, diphtheria, and HPV
  4. HHS Policy Information Center releases five influenza vaccine issue briefs
 
Abbreviations
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.
  
Issue 671: June 25, 2007
1.  ACIP's varicella recommendations now published in MMWR Recommendations and Reports

CDC published "Prevention of Varicella: Recommendations of the Advisory Committee on Immunization Practices (ACIP)" in the June 22 MMWR Recommendations and Reports. These recommendations were available online previous to this publication, but were considered provisional until now. The summary follows.

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


Two live, attenuated varicella zoster virus-containing vaccines are available in the United States for prevention of varicella: 1) a single-antigen varicella vaccine (VARIVAX, Merck & Co., Inc., Whitehouse Station, New Jersey), which was licensed in the United States in 1995 for use among healthy children aged >=12 months, adolescents, and adults; and 2) a combination measles, mumps, rubella, and varicella vaccine (ProQuad, Merck & Co., Inc., Whitehouse Station, New Jersey), which was licensed in the United States in 2005 for use among healthy children aged 12 months-12 years. Initial Advisory Committee on Immunization Practices (ACIP) recommendations for prevention of varicella issued in 1995 (CDC. Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 1996;45[No. RR-11]) included routine vaccination of children aged 12-18 months, catch-up vaccination of susceptible children aged 19 months-12 years, and vaccination of susceptible persons who have close contact with persons at high risk for serious complications (e.g., healthcare personnel and family contacts of immunocompromised persons). One dose of vaccine was recommended for children aged 12 months-12 years and 2 doses, 4-8 weeks apart, for persons aged >=13 years. In 1999, ACIP updated the recommendations (CDC. Prevention of varicella: updated recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 1999;48[No. RR-6]) to include establishing child care and school entry requirements, use of the vaccine following exposure and for outbreak control, use of the vaccine for certain children infected with human immunodeficiency virus, and vaccination of adolescents and adults at high risk for exposure or transmission.

In June 2005 and June 2006, ACIP adopted new recommendations regarding the use of live, attenuated varicella vaccines for prevention of varicella. This report revises, updates, and replaces the 1996 and 1999 ACIP statements for prevention of varicella. The new recommendations include 1) implementation of a routine 2-dose varicella vaccination program for children, with the first dose administered at age 12-15 months and the second dose at age 4-6 years; 2) a second dose catch-up varicella vaccination for children, adolescents, and adults who previously had received 1 dose; 3) routine vaccination of all healthy persons aged >=13 years without evidence of immunity; 4) prenatal assessment and postpartum vaccination; 5) expanding the use of the varicella vaccine for HIV-infected children with age-specific CD4+T lymphocyte percentages of 15%-24% and adolescents and adults with CD4+T lymphocyte counts >=200 cells/microliter; and 6) establishing middle school, high school, and college entry vaccination requirements. ACIP also approved criteria for evidence of immunity to varicella.


To access a web-text (HTML) version of the recommendations, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5604a1.htm

To access a ready-to-print (PDF) version of it, go to:
http://www.cdc.gov/mmwr/pdf/rr/rr5604.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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2 IDSA issues policy blueprint to strengthen adult and adolescent immunization

The Infectious Diseases Society of America (IDSA) has released a new "blueprint for action" to prevent thousands of deaths and illnesses by strengthening adult and adolescent immunization.

Unacceptably low rates of immunization coverage exist among many adults and adolescents in the United States. Coverage for adult vaccines ranges from 26% to 65%, depending on the vaccine and specific target group. IDSA has developed a set of policy principles and recommendations to strengthen adult and adolescent immunization coverage. Published in Clinical Infectious Diseases (June 15, 2007), the blueprint addresses raising provider and public awareness regarding the availability of vaccines; improving public financing for vaccines; improving health insurance coverage; and improving quality, monitoring, and research. A companion commentary offers an analysis of strategies to improve adult immunization from the vantage point of factors that have led to the success of the pediatric immunization experience.

All parts of the blueprint and additional information on adult and adolescent immunization can be accessed from http://www.idsociety.org/adultimmunization

Individual components of the blueprint include:

"Actions to Strengthen Adult and Adolescent Immunization Coverage in the United States: Policy Principles of the Infectious Diseases Society of America"
http://www.journals.uchicago.edu/CID/journal/issues/v44n12/51160/51160.html

"Executive Summary--Actions to Strengthen Adult and Adolescent Immunization Coverage in the United States: Policy Principles of the Infectious Diseases Society of America"
http://www.journals.uchicago.edu/CID/journal/issues/v44n12/51161/51161.html

"Adult Immunization: What Can We Learn from the Childhood Immunization Program?"
http://www.journals.uchicago.edu/CID/journal/issues/v44n12/51162/51162.html

IDSA is an organization of physicians, scientists, and other healthcare professionals dedicated to promoting health through excellence in infectious diseases research, education, prevention, and patient care.

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3 IAC introduces new pieces that answer patients' questions about chickenpox, diphtheria, and HPV

IAC recently developed ready-to-print versions of some of the CDC-reviewed Q&A material located on IAC's Vaccine Information website (www.vaccineinformation.org). The website is intended for the public, health professionals, and the media.

The newly formatted Q&As present information on the following diseases and vaccines: chickenpox (varicella), diphtheria, and HPV (human papillomavirus). In the next several weeks, IAC Express will announce the availability of more ready-to-print Q&As on additional vaccine-preventable diseases and vaccines.

Organized in an easy-to-follow Q&A format, these pieces can be printed and handed out to patients to help educate them about the seriousness of VPDs and the importance of vaccination. Links to the new ready-to-print Q&As follow:

To access "Chickenpox (Varicella): Questions and Answers," go to: http://www.immunize.org/catg.d/p4202.pdf

To access "Diphtheria: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4203.pdf

To access "HPV: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4207.pdf

In the June 4, 11, and 18 issues of IAC Express, we announced newly formatted Q&As on 11 other diseases and vaccines. Following are the direct links to them:

To access "Tetanus: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4220.pdf

To access "Rubella: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4218.pdf

To access "Polio: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4215.pdf

To access "Meningococcal: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4210.pdf

To access "Rotavirus: Questions and Answers, go to:
http://www.immunize.org/catg.d/p4217.pdf

To access "Mumps: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4211.pdf

To access "Pertussis: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4212.pdf

To access "PPV: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4213.pdf

To access "Hepatitis A: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4204.pdf

To access "Hepatitis B: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4205.pdf

To access "Measles: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4209.pdf

To access IAC's online disease/vaccine Q&A material for patients and parents, go to: http://www.vaccineinformation.org and click on the pertinent link(s).

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4 HHS Policy Information Center releases five influenza vaccine issue briefs

The Department of Health and Human Services Policy Information Center has released a series of Influenza Vaccine Issue Briefs, dated October 2005. This project was an attempt to clarify the dynamics of influenza vaccine supply and demand. The five briefs are titled Overview: Summary and Assessment; Manufacturing; Who Buys It, Who Sells It; Demand: Chicken and Egg; and Economics.

To access any or all of these five briefs, go to:
http://aspe.hhs.gov/pic/fullreports/06/8476.htm

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