IAC Express 2008
Issue number 740: July 7, 2008
 
Contents of this Issue
Select a title to jump to the article.
  1. New: CDC posts the provisional recommendations for use of rotavirus vaccine on the ACIP web section
  2. IAC reviews and revises several of its hepatitis A and B resources and one resource on vaccine storage and handling
  3. New: "Questions Parents Ask about Baby Shots" now in Spanish, Arabic, Chinese, French, Korean, Russian, and Vietnamese
  4. New Jersey and Vermont expand school vaccination requirements; West Virginia allows pharmacists to vaccinate
  5. American Journal of Medicine publishes a supplement on expanding the influenza vaccination season
  6. CDC's QuickStats charts percentage of adults age >=65 years who ever received pneumococcal vaccine by sex, age group, and race/ethnicity
  7. Summer meeting of the Chicago Area Immunization Campaign scheduled for July 23 in Chicago
  8. MMWR issues correction to the ACIP recommendations "Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants"
 
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 740: July 7, 2008
1.  New: CDC posts the provisional recommendations for use of rotavirus vaccine on the ACIP web section

On July 1, CDC posted provisional recommendations for the prevention of rotavirus gastroenteritis among infants and children. They are reprinted below in their entirety.

Note: Provisional recommendations are those ACIP has voted on but that are not yet approved by CDC or the Department of Health and Human Services and have not yet been published in MMWR.


ACIP PROVISIONAL RECOMMENDATIONS FOR THE PREVENTION OF ROTAVIRUS GASTROENTERITIS AMONG INFANTS AND CHILDREN

Date of ACIP vote: June 25, 2008
Date of posting of provisional recommendations: July 1, 2008

A new rotavirus vaccine [Rotarix (GlaxoSmithKline Biologicals)] was licensed on April 3, 2008, for use in the United States. On June 25, 2008, the ACIP voted on new recommendations for the use of rotavirus vaccine for the prevention of rotavirus gastroenteritis among infants and children.

The new provisional recommendations for the use of rotavirus vaccine follow:

Routine Administration
  • For routine vaccination of U.S. infants, two different rotavirus vaccine products are licensed: RotaTeq (Merck & Co) (RV5) and Rotarix (GSK) (RV1). The products differ in composition and schedule of administration. ACIP does not express a preference for RV5 or RV1.
  • RV5 is to be administered orally in a 3-dose series with doses given at ages 2, 4, and 6 months. RV1 is to be administered orally in a 2-dose series with doses given at ages 2 and 4 months. The first dose of rotavirus vaccine should be administered from age 6 weeks through age 14 weeks 6 days (the maximum age for the first dose is 14 weeks 6 days). Vaccination should not be initiated for infants of age 15 weeks 0 days or older. The minimum interval between doses of rotavirus vaccine is 4 weeks. All doses should be administered by age 8 months 0 days.

Interchangeability of Rotavirus Vaccines

  • ACIP recommends that the rotavirus vaccine series be completed with the same product whenever possible. However, vaccination should not be deferred if the product used for previous doses is not available or is unknown. In this situation, the provider should continue or complete the series with the product available.
  • If any dose in the series was RV5 or the product is unknown for any dose in the series, a total of three doses of rotavirus vaccine should be given.

Contraindications

  • Rotavirus vaccine should not be administered to infants who have a history of a severe allergic reaction (e.g., anaphylaxis) after a previous dose of rotavirus vaccine or to a vaccine component. Latex rubber is contained in the RV1 oral applicator, so infants with a severe (anaphylactic) allergy to latex should not receive RV1. The RV5 dosing tube is latex-free.

The 2006 ACIP recommendations for the prevention or rotavirus gastroenteritis among infants and children are available at
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5512a1.htm

The Rotarix package insert is available at
http://www.fda.gov/cber/label/rotarixLB.pdf


To access the RotaTeq package insert, go to:
http://www.merck.com/product/usa/pi_circulars/r/rotateq/rotateq_pi.pdf

To access a ready-to-print (PDF) version of the provisional recommendations, go to:
http://www.cdc.gov/vaccines/recs/provisional/downloads/roto-7-1-08-508.pdf

All provisional ACIP recommendations can be found at
http://www.cdc.gov/vaccines/recs/provisional

A chronological listing of all published ACIP recommendations is available at
http://www.immunize.org/acip

An alphabetical listing of all published ACIP recommendations is available at
http://www.immunize.org/acip/vacpolicy_vax.asp

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2 IAC reviews and revises several of its hepatitis A and B resources and one resource on vaccine storage and handling

IAC recently reviewed and revised several of its hepatitis A and B print resources and one resource on vaccine storage and handling. Links to all follow.

VIRAL HEPATITIS A AND B RESOURCES
"Hepatitis A: Questions and Answers--information about the disease and vaccines." Changes were made to information about the use of immune globulin and/or hepatitis A vaccine prior to travel.

To access "Hepatitis A: Questions and Answers--information about the disease and vaccines," go to:
http://www.immunize.org/catg.d/p4204.pdf

Note: This resource is also available in web-text format on IAC's www.vaccineinformation.org website at http://www.vaccineinformation.org/hepa/qandadis.asp

"Hepatitis B Information for Asian Americans and Pacific Islanders" was extensively revised.

To access "Hepatitis B Information for Asian Americans and Pacific Islanders," go to:
http://www.immunize.org/catg.d/p4190.pdf

"Should You Be Vaccinated Against Hepatitis A? A screening questionnaire for adults." This risk-assessment statement was added: "I might have been exposed to the hepatitis A virus in the past two weeks."

To access "Should You Be Vaccinated Against Hepatitis A? A screening questionnaire for adults," go to:
http://www.immunize.org/catg.d/p2190.pdf

"Hospitals & Doctors Sued for Failing to Protect Newborns from Hepatitis B Virus Transmission" was reviewed and found to be still accurate.

To access "Hospitals & Doctors Sued for Failing to Protect Newborns from Hepatitis B Virus Transmission," go to:
http://www.immunize.org/catg.d/p2061.pdf

"Hospitals and Doctors Sued for Failing to Immunize" was reviewed and found to be still accurate.

To access "Hospitals and Doctors Sued for Failing to Immunize," go to: http://www.immunize.org/catg.d/p2060.pdf

VACCINE STORAGE AND HANDLING RESOURCE
"Don't Be Guilty of These Errors in Vaccine Storage and Handling" was reviewed and found to be still accurate.

To access "Don't Be Guilty of These Errors in Vaccine Storage and Handling," go to: http://www.immunize.org/catg.d/p3036.pdf

IAC's Print Materials web section has more than 175 FREE, English-language, ready-to-print resources for healthcare professionals and the public. To access them, go to:
http://www.immunize.org/printmaterials

Note: The web address above will also take you to many IAC print materials in translation.

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3 New: "Questions Parents Ask about Baby Shots" now in Spanish, Arabic, Chinese, French, Korean, Russian, and Vietnamese

The IAC website now has translations of the parent-education brochure "Questions Parents Ask about Baby Shots" in seven languages in addition to English. The languages are Spanish, Arabic, Chinese, French, Korean, Russian, and Vietnamese. Links to all follow.

To access the Spanish version of "Questions Parents Ask about Baby Shots" go to: http://www.immunize.org/catg.d/p4025-01.pdf

To access the Arabic version of "Questions Parents Ask about Baby Shots" go to: http://www.immunize.org/catg.d/p4025-20.pdf

To access the Chinese version of "Questions Parents Ask about Baby Shots" go to: http://www.immunize.org/catg.d/p4025-08.pdf

To access the French version of "Questions Parents Ask about Baby Shots" go to: http://www.immunize.org/catg.d/p4025-10.pdf

To access the Korean version of "Questions Parents Ask about Baby Shots" go to: http://www.immunize.org/catg.d/p4025-09.pdf

To access the Russian version of "Questions Parents Ask about Baby Shots" go to: http://www.immunize.org/catg.d/p4025-07.pdf

To access the Vietnamese version of "Questions Parents Ask about Baby Shots" go to: http://www.immunize.org/catg.d/p4025-05.pdf

To access the English version of "Questions Parents Ask about Baby Shots" go to: http://www.immunize.org/catg.d/p4025.pdf

To access additional FREE, ready-to-print translations from the IAC website, go to:
http://www.immunize.org/printmaterials/translations.asp

IAC's Print Materials web section has more than 175 FREE, ready-to-print resources for healthcare professionals and the public. To access them, go to:
http://www.immunize.org/printmaterials

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4 New Jersey and Vermont expand school vaccination requirements; West Virginia allows pharmacists to vaccinate

New Jersey now requires childcare enrollees to be vaccinated against influenza and pneumococcal disease, and Vermont requires students to be vaccinated against varicella and hepatitis B virus infection. Both states require students to be vaccinated against meningococcal disease and against tetanus, diphtheria, and pertussis. West Virginia permits pharmacists to administer influenza and pneumococcal vaccines to adults. More detailed information follows.

INFLUENZA VACCINATION
New Jersey: Children attending licensed child care centers and preschools are required to show annual vaccination against influenza, effective September 2008. New Jersey is the first state in the nation to require children in this age group to receive annual influenza vaccination.

PNEUMOCOCCAL VACCINATION
New Jersey: Children attending licensed child care centers and preschools are required to be vaccinated with pneumococcal conjugate vaccine (PCV), effective September 2008.

IAC has compiled a table of information about all states that have pneuomococcal conjugate vaccination mandates for children in day care facilities. To access the information, go to:
http://www.immunize.org/laws/pneuconj.asp

This information is also depicted visually on a map of the United States. To access the map, go to:
http://www.immunize.org/pdfs/pcv7.pdf

VARICELLA (CHICKENPOX) VACCINATION
Vermont: Students entering either kindergarten or grade 7 are required to have received two doses of varicella vaccine (disease history may be substituted for vaccine). A new requirement for post-secondary schools includes two doses of varicella vaccine or evidence of disease. The new requirements are effective August 2008.

With the addition of Vermont, the total number of states now requiring varicella vaccination or proof of disease in day care, elementary, or middle schools has increased to 48. Only Idaho and Wyoming do not have requirements.

IAC has compiled a table of information about all states that have varicella prevention mandates for children in day care facilities and for students in elementary, middle school, and junior high. To access the information, go to:
http://www.immunize.org/laws/varicel.asp

This information is also depicted visually on a map of the United States. To access the map, go to:
http://www.immunize.org/pdfs/varicella.pdf

HEPATITIS B VACCINE
Vermont: Students entering kindergarten and post-secondary schools are required to have received three doses of hepatitis B vaccine; since 1999, children entering grade 7 have been required to be vaccinated against hepatitis B. The requirements for kindergarten and post-secondary school attendance become effective August 2008.

IAC has compiled a table of information about all states that have hepatitis B prevention mandates for children in day care facilities and students in elementary and middle school. To access the information, go to:
http://www.immunize.org/laws/hepb.asp

This information is also depicted visually on a map of the United States. To access the map, go to:
http://www.immunize.org/pdfs/hepb.pdf

IAC has compiled a table of information about all states that have hepatitis B prevention mandates for students in post-secondary schools. To access the information, go to:
http://www.immunize.org/laws/hepbcollege.asp

This information is also depicted visually on a map of the United States. To access the map, go to
http://www.immunize.org/pdfs/hepb_college.pdf

MENINGOCOCCAL VACCINE
New Jersey: Students born after January 1, 1997, and enrolled in grade 6, are required to show documentation of one dose of meningococcal vaccine, effective September 2008.

Vermont: Students who are entering grades 7-12, and who will be living in a residential-based school, are required to have received one dose of meningococcal vaccine. First-year post-secondary students who will be living in dormitories are also required to have received one dose of meningococcal vaccine. The meningococcal requirements become effective August 2008.

Note: Both a table and a map of this information are under development.

TETANUS-DIPHTHERIA-ACELLULAR PERTUSSIS VACCINE
New Jersey: Students born after January 1, 1997, and enrolled in grade 6 are required to show documentation of one dose of Tdap vaccine, effective September 2008.

Vermont: Students entering grade 7 are required to have had a one-time dose of Tdap vaccine, effective August 2008.

Note: Both a table and a map of this information are under development.

PHARMACIST AUTHORIZATION TO VACCINATE
West Virginia: Pharmacists are now authorized to administer influenza and pneumococcal vaccines to adults age 18 and older under a new West Virginia state law.

IAC has compiled a table of information about all states that authorize pharmacists to vaccinate. To access the information, go to:
http://www.immunize.org/laws/pharm.asp

This information is also depicted visually on a map of the United States. To access the map, go to
http://www.immunize.org/pdfs/pharm.pdf

IAC Express depends on readers to help us stay informed and ensure our website contains the most current and accurate information available. Please let us know when any changes occur in your state by emailing us at admin@immunize.org

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5 American Journal of Medicine publishes a supplement on expanding the influenza vaccination season

The American Journal of Medicine (AJM) has devoted one of its July Supplements to "Expanding the Influenza Vaccination Season: A New Paradigm for Increasing Immunization Rates." The supplement is free and can be downloaded. AJM is a publication of the Association of Professors of Medicine.

Following is a list of the supplement's chapter titles and authors:

  • Introduction: Expanding the Influenza Season, by William Schaffner
  • Increasing Influenza Vaccination Rates: The Need to Vaccinate Throughout the Entire Influenza Season, by Gregory A. Poland and David R. Johnson
  • Practice-Proven Interventions to Increase Vaccination Rates and Broaden the Immunization Season, by Patricia K. Stinchfield
  • Lessons Learned: Role of Influenza Vaccine Production, Distribution, Supply, and Demand--What It Means for the Provider, by Walter A. Orenstein and William Schaffner
  • Barriers to Adult Immunization, by David R. Johnson, Kristin L. Nichol, and Kim Lipczynski

To access the supplement, which can be downloaded by chapter, go to:
http://www.amjmed.com/issues/contents?issue_key=S0002-9343(08)X0012-9

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6 CDC's QuickStats charts percentage of adults age >=65 years who ever received pneumococcal vaccine by sex, age group, and race/ethnicity

As part of its QuickStats series, CDC published "Percentage of Adults Aged >=65 Years Who Ever Received a Pneumococcal Vaccination, by Sex, Age Group, and Race/Ethnicity--National Health Interview Survey, United States, 2007" in the July 4 issue of MMWR. Presented in graph format, QuickStats provides updates on key indicators and important trends in public health. They are based on survey data from the National Center for Health Statistics. The text of the QuickStats that appeared in the July 4 MMWR is reprinted below in its entirety, excluding references.


In 2007, approximately 58% of adults aged >=65 years had ever received a pneumococcal vaccination. In this population, statistically significant differences by sex, age group, and race/ethnicity were observed. Women were more likely than men to have ever received a pneumococcal vaccination. Adults aged >=75 years were more likely to have ever received a pneumococcal vaccination compared with adults aged 65-74 years. Non-Hispanic white adults aged >=65 years were more likely than Hispanic and non-Hispanic black adults in that age group to have received the vaccination.

SOURCE: Heyman KM, Schiller JS, Barnes P. Early release of selected estimates based on data from the 2007 National Health Interview Survey. U.S. Department of Health and Human Services, CDC, National Center for Health Statistics; 2008. Available at http://www.cdc.gov/nchs/about/major/nhis/released200806.htm


To access a web-text (HTML) version of the complete QuickStats, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5726a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5726.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP recommendations), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html

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7 Summer meeting of the Chicago Area Immunization Campaign scheduled for July 23 in Chicago

The Chicago Area Immunization Campaign will hold its summer meeting on July 23 in Chicago at St. Mary & Elizabeth Medical Center. The special guest speaker is Gary S. Marshall, MD, professor of pediatrics; chief, Division of Pediatric Infectious Diseases, University of Louisville School of Medicine, Louisville, KY.

To access a registration form, go to:
http://www.ilmaternal.org/CAIC/Misc/summer08generalmtg.pdf

For additional information, contact Melissa Ponce at (312) 491-8161.

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8 MMWR issues correction to the ACIP recommendations "Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants"

CDC published "Erratum: Vol. 57, No. RR-4" in the July 4 issue of MMWR. The erratum concerns "Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants: Recommendations of the Advisory Committee on Immunization Practices (ACIP)," which was published on May 30 as an MMWR Recommendations and Reports. The erratum is reprinted below in its entirety.


In the MMWR Recommendations and Reports (Vol. 57, No. RR-4), "Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants: Recommendations of the Advisory Committee on Immunization Practices (ACIP)," an error occurred on page 4 in Table 1. For the vaccine ADACEL, the fimbriae component of the formulation was omitted; it should be 5 [micrograms], followed by the [three paragraph marks] footnote symbol.


To access a web-text (HTML) version of the erratum, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5726a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5726.pdf

To access a ready-to-print (PDF) version of the May 30 ACIP recommendations "Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants," go to: http://www.cdc.gov/mmwr/PDF/rr/rr5704.pdf

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