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IAC Express 2008 |
| Issue number 758: October 13, 2008 |
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Contents
of this Issue
Select a title to jump to the article. |
- CDC
publishes information on adolescent vaccination rates
-
Association for Professionals in Infection Control and Epidemiology
releases position paper on influenza immunization of healthcare personnel
- Journal
of Child Neurology publishes letters about failure to disclose possible
conflict of interest related to Poling case article
- CDC
publishes updated recommendation for isolation of persons with mumps
- CDC
answers additional questions about use of zoster vaccine
- IAC
revises Spanish-language influenza screening questionnaires
- Current
VISs for injectable and nasal-spray influenza vaccines now available in
Karen
- September
issue of The Vaccine Quarterly features article on advocating for vaccines
-
Association for Prevention Teaching and Research offers updated training
module on influenza
- Franklin
Institute sponsoring public forum on HPV vaccine issues on October 30
- Summary
of WHO global immunization work from 2006-07 available online
- CDC's
"Baby Steps" campaign offers information on early recognition of
developmental disabilities
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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 758: October 13, 2008 |
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1. |
CDC publishes information on adolescent vaccination rates
CDC published "Vaccination Coverage Among
Adolescents Aged 13–17
Years--United States, 2007" in the October 10 issue of MMWR. A
portion of the summary made available to the press is reprinted
below.
CDC conducts the National Immunization Survey–Teen (NIS–Teen) to
determine vaccination coverage estimates in a national sample of
adolescents aged 13–17 years. Three new vaccines have been
recommended for adolescents since 2005: meningococcal conjugate
vaccine (MCV4), tetanus, diphtheria, acellular pertussis vaccine
(Tdap), and human papillomavirus vaccine (HPV4). Adolescents
should also receive childhood vaccinations that were missed.
Between 2006 and 2007, there were substantial increases in
receipt of new adolescent vaccinations including Tdap (from 10.8
percent to 30.4 percent) and MCV4 (from 11.7 percent to 32.4
percent), and increases in coverage of childhood vaccinations
including measles, mumps, and rubella (MMR), hepatitis B, and
varicella vaccines (among those without prior disease history).
For HPV4 coverage, which is reported for the first time, 25.1
percent of adolescent females had initiated the vaccine series
(>1 dose). To improve vaccination coverage among adolescents,
providers should take advantage of every healthcare visit as an
opportunity to evaluate vaccination status and administer
vaccines when needed.
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5740a2.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5740.pdf
To access a transcript from the related October 9 press
briefing, go to:
http://www.cdc.gov/media/transcripts/2008/t081009.htm
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. |
Association for Professionals in Infection Control and
Epidemiology releases position paper on influenza
immunization of healthcare personnel
On October 9, the Association for Professionals
in Infection
Control and Epidemiology (APIC) released a position paper titled
"Influenza Immunization of Healthcare Personnel." The first four
paragraphs are reprinted below, excluding references.
Influenza is a serious disease that is associated with high
rates of morbidity and mortality. In the United States, an
estimated 5 percent to 15 percent of the population is affected
by the virus each year. Influenza infections result in
approximately 226,000 hospital admissions and 36,000 deaths
annually. A recent study using a probability model from 2003
data estimated that annual influenza epidemics account for
610,660 life–years lost, 3.1 million days of hospitalization,
and 31.4 million outpatient visits.
The most efficient method of preventing these outbreaks and the
associated morbidity and mortality is through pre-exposure
vaccination. Healthcare personnel (HCP) are at high risk for
acquiring influenza infection due to their exposure to ill
patients as well as their exposure in the community. Because
those persons who are at greatest risk of developing
complications of influenza are exposed to healthcare personnel
in a variety of inpatient and outpatient settings, an important
strategy to decrease exposure to these high-risk individuals is
to immunize healthcare workers.
Although annual influenza vaccination for HCP has been
recommended by the Centers for Disease Control and Prevention
(CDC) since 1981, national survey data from 2005-2006,
demonstrated a vaccination coverage level of 42 percent among
these workers. Despite long-standing recommendations by
APIC, CDC, and other national healthcare organizations, the
response to voluntary vaccination has not risen significantly
over the past decade. Even among those healthcare organizations
having aggressive targeted campaigns, 30-50 percent of HCP
remain unvaccinated.
As a profession, we must do a better job of immunizing HCP every
year to ensure patient safety and protect those individuals at
high risk of developing complications of influenza. Therefore,
APIC recommends that hospitals, long-term care, and other
facilities that employ healthcare personnel, implement a
comprehensive strategy which incorporates all of the
recommendations for influenza vaccination of HCP of the
Healthcare Infection Control Practices Advisory Committee
(HICPAC) and the Advisory Committee on Immunization Practices
(ACIP). As part of a comprehensive strategy, we recommend that
influenza vaccine be required annually for all healthcare
personnel with direct patient care. Organizations should adopt a
system in which an informed declination is obtained from
employees that decline for other than medical reasons. This
information should be utilized by the facility to develop
improvement strategies for the following vaccine season.
To access the APIC position paper in full, click
here.
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3. |
Journal of Child Neurology publishes letters about failure to
disclose possible conflict of interest related to Poling case
article
The September 2008 issue of the Journal of Child
Neurology (JCN)
contains three letters that may be of interest to readers who
have been receiving inquiries about the case of Hannah Poling, a
girl with neurological abnormalities including some autistic
features, whose National Vaccine Injury Compensation Program
(VICP) case was evaluated as compensable by the Department of
Health and Human Services. Many have been confused by claims
made in the media that this case proves vaccines can cause
autism.
The three letters relate to the failure of Jon Poling, MD, PhD,
the father of Hannah Poling, to disclose the fact that the
family was engaged in litigation over Hannah's disabilities when
he co-authored a report on her case which was published in JCN.
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In the first letter, Dr. Poling apologizes for failing to
disclose to JCN that the subject of the case report was his
daughter, but seemingly argues that because he did not submit
the JCN report to the court, and was not heavily involved in
pursuing his daughter's case, the conflict of interest was
immaterial.
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In the second letter, the co-authors of the JCN case report
denied knowing that the Polings were VICP litigants at the time
the paper was submitted and expressed their regret that there
had been no disclosure of Dr. Poling's relationship to the
subject of the report and his status as a VICP petitioner.
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In the third letter, JCN's editor-in-chief, Roger A. Brumback,
MD, noted that the authors of the case report, including Poling,
had explicitly stated they had no conflicts of interest when
submitting their paper to JCN. He described failure to disclose
a conflict of interest as an "appallingly troubling issue"
because it threatens the integrity of the scientific literature.
Dr. Brumback also expressed concern that media linkage of the
JCN report with the Poling case might imply that JCN endorsed
the government's decision in the Poling case.
While the exposure of Dr. Poling's conflict of interest doesn't
shed additional light on Hannah Poling's health issues, it is a
reminder that this case sits at the uncomfortable intersection
of science and law, and that much of what has been portrayed as
scientific fact is actually based on lay interpretations of
legal conclusions.
The letters to the editor cited above can be found in the
September 2008 issue of the Journal of Child Neurology. To view
them electronically, one must be a subscriber to the journal or
pay a fee for temporary access:
http://jcn.sagepub.com/content/vol23/issue9
The abstract for the original report, "Developmental Regression
and Mitochondrial Dysfunction in a Child With Autism," can be
accessed at http://jcn.sagepub.com/cgi/content/abstract/21/2/170
The full article is available to subscribers or by paying a fee.
You can also check with your medical library to access this
journal in print format.
The editor of IAC Express would like to thank Neurodiversity.com
for bringing these letters to IAC’s attention. Interested readers
can access the Neurodiversity.com report at
http://neurodiversity.com/weblog/article/176
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4. |
CDC publishes updated recommendation for isolation of persons
with mumps
CDC published "Updated Recommendations for
Isolation of Persons
with Mumps" in the October 10 issue of MMWR. A portion of the
summary made available to the press is reprinted below.
National recommendations concerning the isolation for person
with mumps for 9 days conflicted with other guidance that the
infectious period of mumps extended through the 4th day after
parotitis and resulted in confusion during the 2006 mumps
resurgence in the U.S. with respect to the appropriate length of
case isolation. To address this issue, researchers at the CDC
and American Academy of Pediatrics (AAP) reviewed scientific
evidence underlying the 9-day isolation recommendation including
published articles on mumps transmission; viral isolation,
detection, and load; and mumps in healthcare settings and, as a
result, in 2007, revised the recommended isolation period for
community and healthcare workers in ambulatory settings to 5
days. In February 2008, the Healthcare Infection Control
Practices Advisory Committee approved a similar recommendation
in in-patient settings. The evidence reviewed suggested that
isolation of mumps virus is highest before or around the time of
onset of parotitis, with the rate of mumps virus isolation and
viral load declining rapidly during the 3 to 5 days following
onset of parotitis. The risk of mumps transmission is considered
to be low after 5 days; most transmission likely occurs before
symptom onset or within the subsequent 5 days.
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5740a3.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5740.pdf
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5. |
CDC answers additional questions about use of zoster vaccine
On October 9, CDC added 7 new Q&As to its online
Herpes Zoster
Vaccine Q&A (Shingles) page.
To access this updated resource, go to:
http://www.cdc.gov/vaccines/vpd-vac/shingles/vac-faqs.htm
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6. |
IAC revises Spanish-language influenza screening
questionnaires
IAC made small changes to the Spanish-language
versions of its
screening questionnaires for injectable and intranasal influenza
vaccines.
The Spanish version of "Screening Questionnaire for Injectable
Influenza Vaccination" had a website link updated.
To obtain a ready-to-copy (PDF) version of the revised piece, go
to: http://www.immunize.org/catg.d/p4066-01.pdf
To access the same "Screening Questionnaire for Injectable
Influenza Vaccination" in English, go to:
http://www.immunize.org/catg.d/p4066.pdf
The Spanish version of "Screening Questionnaire for Intranasal
Influenza Vaccination" had question #6 (regarding wheezing)
revised.
To obtain a ready-to-copy (PDF) version of the revised piece, go
to: http://www.immunize.org/catg.d/p4067-01.pdf
To access the same "Screening Questionnaire for Intranasal
Influenza Vaccination" in English, go to:
http://www.immunize.org/catg.d/p4067.pdf
IAC's Print Materials web section offers healthcare
professionals and the public more than 175 FREE, English-language materials (many available also in translation), which
we encourage website users to print out, copy, and distribute
widely. To access all of IAC's free print materials, go to:
http://www.immunize.org/printmaterials
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7. |
Current VISs for injectable and nasal-spray influenza
vaccines now available in Karen
Dated 7/24/08, the current VISs for trivalent
inactivated
influenza vaccine (TIV; injectable) and live attenuated
influenza vaccine (LAIV; nasal spray) are now available in
Karen. IAC gratefully acknowledges the Minnesota Department of
Health for the translations.
TIV vaccine VIS
To access the Karen version of the TIV vaccine VIS, go to:
http://www.immunize.org/vis/ka_flu.pdf
To access the English version of the TIV vaccine VIS, go to:
http://www.immunize.org/vis/2flu.pdf
NOTE: The VIS for TIV vaccine comes in additional languages,
including Spanish. To access them, go to:
http://www.immunize.org/vis/vis_flu_inactive.asp Click on the
link to the pertinent language.
LAIV vaccine VIS
To access the Karen version of the LAIV vaccine VIS, go to:
http://www.immunize.org/vis/ka_LAIV.pdf
To access the English version of the LAIV vaccine VIS, go to:
http://www.immunize.org/vis/liveflu.pdf
NOTE: The VIS for LAIV vaccine comes in additional languages,
including Spanish. To access them, go to:
http://www.immunize.org/vis/vis_flu_live.asp Click on the link
to the pertinent language.
For information about the use of VISs, and for VISs in more than
35 languages, visit IAC's VIS web section at
http://www.immunize.org/vis
For general information about VISs from CDC's website go to:
http://www.cdc.gov/vaccines/pubs/vis
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8. |
September issue of The Vaccine Quarterly features article on
advocating for vaccines
The September issue of The Vaccine Quarterly
features an article
by Diane Peterson titled "Advocating for Safe and Effective
Vaccines." The article identifies resources for physicians to
use in staying informed about current vaccine issues and to
become stronger advocates for safe and effective vaccines.
To view the September issue in ready-to-print (PDF format), click
here.
Each issue of The Vaccine Quarterly can be accessed online at no
charge and includes literature reviews of articles relevant to
clinical practice and an opportunity to earn CME credit. To
access the index page, go to: http://www.vaccinequarterly.com
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9. |
Association for Prevention Teaching and Research offers
updated training module on influenza
The Association for Prevention Teaching and
Research recently
updated its TIME (Teaching Immunization for Medical Education)
module on influenza.
The module consists of six case-based scenarios that are
designed to foster learner knowledge about influenza disease,
the indications for administering the vaccines, and methods to
increase vaccine coverage.
The facilitator' guide and small group booklet can be downloaded
from the TIME index page at
http://76.12.16.132/resources/curriculum_time.html
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10. |
Franklin Institute sponsoring public forum on HPV vaccine
issues on October 30
The Franklin Institute, in partnership with the
Center for
Vaccine Ethics and Policy, is sponsoring a series of public
forums on vaccine science, ethics, and policy. The second event
in the series, "HPV Vaccines--Issues, Lessons, and Public
Confidence in Vaccines," will take place from 7:00-8:30 PM (ET)
at the Franklin Theater in Philadelphia.
The forum will explore the issues and lessons learned from
ongoing HPV vaccine programs, and how this experience can inform
strategies to address the crisis in public understanding and
confidence around vaccines overall.
To download a flyer about this event, including a list of
featured speakers, go to:
http://www.fi.edu/wellness/oct30.flyer.color.pdf
To read more about this series of public forums, go to:
http://www.fi.edu/wellness
For free tickets, call (215) 448-1254 by October 29.
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11. |
Summary of WHO global immunization work from 2006-07
available online
WHO recently published "WHO Immunization Work:
2006-07
Highlights," a 125-page document that provides an overview of
WHO's immunization activities during that two-year period.
To access a ready-to-print (PDF) version of this report, go to:
http://whqlibdoc.who.int/publications/2008/9789241596749_eng.pdf
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12. |
CDC's "Baby Steps" campaign offers information on early
recognition of developmental disabilities
Given that early recognition of developmental
disabilities such
as autism is key for parents and healthcare providers, CDC has
invested in a campaign to help parents measure their children's
progress by monitoring how they play, learn, speak, and act.
The campaign is called "Baby Steps: Learn the Signs. Act Early,"
and features online information including a video. To access the
campaign web page, go to:
http://www.cdc.gov/ncbddd/autism/ActEarly
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