IAC Express 2009
Issue number 801: May 26, 2009
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Contents of this Issue
Select a title to jump to the article.
  1. HHS directs $1 billion toward development of vaccine for novel influenza A (H1N1); new HHS ad campaign planned to encourage the public to protect itself against H1N1 influenza
  2. MMWR reports on antibody response to H1N1 after vaccination with seasonal influenza vaccine
  3. MMWR reports on patients hospitalized with H1N1 influenza
  4. MMWR publishes surveillance summary on acute viral hepatitis
  5. President Obama appoints Dr. Thomas Frieden as CDC director
  6. CDC offers new H1N1 influenza resources in translation
  7. IAC's Video of the Week helps healthcare professionals talk to parents about vaccine concerns
  8. IAC revises "Admission Orders for Labor & Delivery and Newborn Units to Prevent HBV Transmission" and "Standing Orders for Administering Rotavirus Vaccine to Infants"
  9. IAC updates and redesigns "After the shots. . . What to do if your child has discomfort"
  10. IAC updates three print pieces that answer the public's questions about rotavirus, diphtheria, and Hib
  11. Mark your calendar: July 30 is the date for "Immunization Update 2009"
  12. The 11th edition of CDC's Pink Book can now be downloaded
  13. IAC's laminated versions of the 2009 child/teen and adult immunization schedules offer significant advantages over paper versions. Place your order today and use them throughout 2009!
  14. May issue of CDC's Immunization Works electronic newsletter recently released
  15. IZTA plans June 16 conference call on influenza and June 30 call on making new media work for immunization coalitions
  16. MMWR reports on progressive vaccinia in a military smallpox vaccinee
  17. Erratum: MMWR corrects two sentences in its report on H1N1 influenza in pregnant women
 
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 801: May 26, 2009
1.  HHS directs $1 billion toward development of vaccine for novel influenza A (H1N1); new HHS ad campaign planned to encourage the public to protect itself against H1N1 influenza

On May 22, HHS Secretary Kathleen Sebelius announced that the department will direct approximately $1 billion toward development of a vaccine for H1N1 influenza. The press release is reprinted below in its entirety.

Also, on May 22, HHS issued a press release about a new ad campaign to encourage the public to protect itself against H1N1 influenza. A link to the press release about the ad campaign is given at the end of this IAC Express story.


HHS Secretary Kathleen Sebelius announced today that the department will take important steps necessary to prepare for potential commercial-scale production of a candidate vaccine for the novel Influenza A (H1N1). The Secretary is directing approximately $1 billion in existing funds that will be used for clinical studies that will take place over the summer and for commercial-scale production of two potential vaccine ingredients for the pre-pandemic influenza stockpile.

"Preparation and planning are critical to keep Americans safe in the face of a potential pandemic," Secretary Sebelius said. "Our goal throughout this new H1N1 outbreak has been to stay one step ahead of the virus. An important part of this effort has been our work to develop a potential vaccine because vaccines can help prevent and control influenza virus outbreaks. The actions we are taking today will help us be prepared if a vaccine is needed."

The funds will be used to place new orders on existing contracts with companies that hold U.S. licenses for flu vaccines. With these orders, they will produce a bulk supply of vaccine antigen and adjuvant. Antigen is the active ingredient in a vaccine that causes the human body's immune system to develop antibodies that help fight an invading virus. Depending on the results of clinical studies, adjuvants could be added to a vaccine to improve the immune system's response and potentially reduce the amount of antigen necessary for the body to recognize and fight a virus.

Having both antigen and adjuvant on hand provides maximum flexibility in a future immunization program, if a program is recommended. For example, if needed these ingredients could be used in vaccine to help protect health providers and other members of the critical workforce, as recommended by the National Strategy for Pandemic Influenza.

With these funds manufacturers will also prepare pilot lots of potential vaccine for use in clinical studies to determine the proper dose for a vaccine, determine if adjuvants are appropriate and ensure a vaccine is safe and effective. The U.S. government will share as much information as possible from the results of these clinical studies with the World Health Organization and the global community so that other countries can benefit from the U.S. efforts to determine dosage, safety and effectiveness.

The Biomedical Advanced Research and Development Authority (BARDA) in the HHS Office of the Assistant Secretary for Preparedness and Response established the existing contracts with these companies in 2004 as part of the National Strategy for Pandemic Influenza.

To learn more about the National Strategy for Pandemic Influenza, visit http://www.pandemicflu.gov/plan/federal/pandemic-influenza.pdf  More about BARDA is available at http://www.hhs.gov/aspr/barda/index.html For the latest on the H1N1 flu virus, see http://www.cdc.gov/h1n1flu


To access the HHS press release about vaccine development, go to: http://www.hhs.gov/news/press/2009pres/05/20090522b.html

Secretary Sebelius also announced on May 22 that HHS will be joining the Ad Council and Sesame Workshop, the nonprofit educational organization behind Sesame Street, to launch a national public service advertising (PSA) campaign designed to encourage American families and children to take steps to protect themselves from the 2009 H1N1 influenza virus. As part of HHS and the Ad Council's campaign, Sesame Workshop produced a television PSA featuring Sesame Street's Elmo and Gordon explaining the importance of healthy habits such as washing your hands, avoid touching your eyes, nose, and mouth, and sneezing into the bend of your arm.

To read the HHS press release about this public service advertising campaign, go to:
http://www.hhs.gov/news/press/2009pres/05/20090522a.html

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2 MMWR reports on antibody response to H1N1 after vaccination with seasonal influenza vaccine

CDC published "Serum Cross-Reactive Antibody Response to a Novel Influenza A (H1N1) Virus After Vaccination with Seasonal Influenza Vaccine" in the May 22 issue of MMWR. The editorial note follows.


Editorial Note:
The results in this report suggest that vaccination with recent (2005-2009) seasonal influenza vaccines is unlikely to provide protection against the novel influenza A (H1N1) virus. Although vaccination of adults with seasonal trivalent inactivated influenza vaccine (TIV) generally resulted in a small increase in antibodies against the novel influenza A (H1N1) virus, whether such levels of cross-reactive antibody provide any protection against infection with novel influenza A (H1N1) virus is unknown. These results are consistent with the substantial degree of genetic divergence of the novel influenza A (H1N1) virus of swine origin from recent seasonal human H1N1 viruses; A/California/04/09 shares only 72%-73% amino acid identity in the HA1 portion of the hemagglutinin molecule with the seasonal viruses used in this study. For comparison, the amino acid sequence identity in the HA1 portion among seasonal vaccine strains used in this study is 97%-98%.

Although the number of sera from children tested in this analysis was small, results indicate that U.S. children are largely serologically naive to the novel influenza A (H1N1) virus and that vaccination with seasonal TIV or live, attenuated influenza vaccine (LAIV) does not elicit any measurable level of cross-reactive antibody to the novel virus. Results among adults suggest that some degree of preexisting immunity to the novel H1N1 strains exists, especially among adults aged >60 years. One possible explanation is that some adults in this age group have had previous exposure, either through infection or vaccination, to an influenza A (H1N1) virus that is genetically and antigenically more closely related to the novel influenza A (H1N1) virus than are contemporary seasonal H1N1 strains. Ongoing assessment of the cross-reactive antibody response among persons in different age groups might identify a particular age group that would allow further clarification of the cross-reactive serologic response. Development of a strain-specific vaccine against the novel influenza A (H1N1) virus is needed for optimal protection against the virus among persons of all ages.


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5819a1.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5819.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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3 MMWR reports on patients hospitalized with H1N1 influenza

CDC published "Hospitalized Patients with Novel Influenza A (H1N1) Virus Infection--California, April-May, 2009" in the May 22 issue of MMWR. The first paragraph follows, excluding references.


Since April 15 and 17, 2009, when the first two cases of novel influenza A (H1N1) infection were identified from two southern California counties, novel influenza A (H1N1) cases have been documented throughout the world, with most cases occurring in the United States and Mexico. In the United States, early reports of illnesses associated with novel influenza A (H1N1) infection indicated the disease might be similar in severity to seasonal influenza, with the majority of patients not requiring hospitalization and only rare deaths reported, generally in persons with underlying medical conditions. As of May 17, 2009, 553 novel influenza A (H1N1) cases, including 333 confirmed and 220 probable cases, had been reported in 32 of 61 local health jurisdictions in California. Of the 553 patients, 30 have been hospitalized. No fatal cases associated with novel influenza A (H1N1) infection had been reported in California. This report summarizes the 30 hospitalized cases as of May 17, including a detailed description of four cases that illustrate the spectrum of illness severity and underlying risk factors. This preliminary overview indicates that, although the majority of hospitalized persons infected with novel influenza A (H1N1) recovered without complications, certain patients had severe and prolonged disease. All hospitalized patients with novel influenza A (H1N1) infection should be monitored carefully and treated with antiviral therapy, including patients who seek care >48 hours after illness onset. . . .


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5819a6.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5819.pdf

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4 MMWR publishes surveillance summary on acute viral hepatitis

CDC published "Surveillance for Acute Viral Hepatitis--United States, 2007" as a MMWR Surveillance Summary on May 22. The abstract follows.


Abstract

Problem: In the United States, acute viral hepatitis most frequently is caused by infection with any of three distinct viruses: hepatitis A virus (HAV), hepatitis B virus (HBV), or hepatitis C virus (HCV). These unrelated viruses are transmitted through different routes and have different epidemiologic profiles. Safe and effective vaccines have been available for hepatitis B since 1981 and for hepatitis A since 1995. No vaccine exists against hepatitis C. HBV and HCV can persist as chronic infections and represent a leading cause of chronic liver disease and hepatocellular carcinoma in the United States.

Reporting Period Covered: Cases in 2007, the most recent year for which data are available, are compared with those from previous years.

Description of System: Cases of acute viral hepatitis are reported voluntarily to CDC by state and territorial health departments via CDC's National Notifiable Disease Surveillance System (NNDSS). Reports are received electronically via CDC's National Electronic Telecommunications System for Surveillance (NETSS).

Results: Acute hepatitis A incidence has declined 92%, from 12.0 cases per 100,000 population in 1995 to 1.0 case per 100,000 population in 2007, the lowest rate ever recorded. Declines were greatest among children and in those states where routine vaccination of children was recommended beginning in 1999. Acute hepatitis B incidence has declined 82%, from 8.5 cases per 100,000 population in 1990 to 1.5 cases per 100,000 population in 2007, the lowest rate ever recorded. Declines occurred among all age groups but were greatest among children aged <15 years. Following a peak in 1992, incidence of acute hepatitis C declined; however, since 2003, rates have plateaued. In 2007, as in previous years, the majority of these cases occurred among adults, and injection-drug use was the most common risk factor.

Interpretation: The results documented in this report suggest that implementation of the 1999 recommendations for routine childhood hepatitis A vaccination in areas of the United States with consistently elevated hepatitis A rates has reduced rates of infection. In addition, universal vaccination of children against hepatitis B beginning in 1991 has reduced disease incidence substantially among younger age groups. Higher rates of hepatitis B continue among adults, particularly among males aged 30-44 years, reflecting the need to vaccinate adults at risk for HBV infection. The decline in hepatitis C incidence after 1992 was attributable primarily to a decrease in incidence among injection-drug users. The reasons for this decrease were unknown but probably reflected changes in behavior and practices among injection-drug users.

Public Health Actions: The expansion in 2006 of recommendations for routine hepatitis A vaccination to include all children in the United States aged 12-23 months is expected to reduce hepatitis A rates further. Ongoing hepatitis B vaccination programs ultimately will eliminate domestic HBV transmission, and increased vaccination of adults with risk factors will accelerate progress toward elimination. Further prevention of hepatitis B and hepatitis C relies on identifying and preventing transmission of HBV or HCV in hospital and nonhospital healthcare associated settings. In addition, prevention of hepatitis C relies on identifying and counseling uninfected persons at risk for hepatitis C (e.g., injection-drug users) regarding ways they can protect themselves from infection. Public health management of persons with chronic HBV or HCV infection will help to interrupt the transmission to susceptible persons, and their medical management will help to reduce the development of the sequelae from chronic liver disease. . . .


To access a web-text (HTML) version of the complete surveillance summary, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5803a1.htm

To access a ready-to-print (PDF) version of this surveillance summary, go to:
http://www.cdc.gov/mmwr/PDF/ss/ss5803.pdf

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5 President Obama appoints Dr. Thomas Frieden as CDC director

On May 15, President Barack Obama announced that he had appointed Thomas Frieden, MD, MPH, currently commissioner of the New York City Health Department, as director of the Centers for Disease Control and Prevention.

President Obama also announced that acting CDC director Dr. Richard Besser, who has led the CDC's Coordinating Office for Terrorism Preparedness and Emergency Response for the past four years, will continue in this role.

To read the related White House press release, go to:
http://www.whitehouse.gov/the_press_office/President-Obama-Appoints-Dr-Thomas-Frieden-as-CDC-Director

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6 CDC offers new H1N1 influenza resources in translation

CDC now offers two fact sheets on H1N1 influenza in Spanish, Arabic, Simplified Chinese, French, and Russian as well as English. The fact sheets are titled "Key Facts About Swine Flu" and "H1N1 (Swine Flu) and You." For sources of continually updated H1N1 influenza information, see the end of this IAC Express article.

To access the English version of "Key Facts About Swine Influenza," go to:
http://www.cdc.gov/h1n1flu/key_facts.htm

To access the Spanish version of "Key Facts About Swine Influenza," go to:
http://www.cdc.gov/h1n1flu/espanol/datos.htm

To access the Arabic version of "Key Facts About Swine Influenza," go to:
http://www.cdc.gov/h1n1flu/Arabic/key_facts_AR.pdf

To access the Chinese version of "Key Facts About Swine Influenza," go to:
http://www.cdc.gov/h1n1flu/Simplified_Chinese/key_facts_SCH.pdf

To access the French version of "Key Facts About Swine Influenza," go to:
http://www.cdc.gov/h1n1flu/Francais/key_facts_FR.pdf

To access the Russian version of "Key Facts About Swine Influenza," go to:
http://www.cdc.gov/h1n1flu/Russian/key_facts_RU.pdf

To access the English version of "H1N1 Flu (Swine Flu) and You," go to:
http://www.cdc.gov/h1n1flu/qa.htm

To access the Spanish version of "H1N1 Flu (Swine Flu) and You," go to:
http://www.cdc.gov/h1n1flu/espanol/influenza-porcina-y-usted.htm

To access the Arabic version of "H1N1 Flu (Swine Flu) and You," go to:
http://www.cdc.gov/h1n1flu/Arabic/qa_AR.pdf

To access the Chinese version of "H1N1 Flu (Swine Flu) and You," go to:
http://www.cdc.gov/h1n1flu/Simplified_Chinese/qa_SCH.pdf

To access the French version of "H1N1 Flu (Swine Flu) and You," go to:
http://www.cdc.gov/h1n1flu/Francais/qa_FR.pdf

To access the Russian version of "H1N1 Flu (Swine Flu) and You," go to:
http://www.cdc.gov/h1n1flu/Russian/qa_RU.pdf

SOURCES OF CONTINUALLY UPDATED INFORMATION

The home page of CDC's H1N1 Flu web section can be accessed from http://www.cdc.gov/h1n1flu

Interim guidance documents from CDC can be accessed directly from http://www.cdc.gov/H1N1flu/guidance

IAC has gathered important information related to H1N1 influenza in a new web section to make it easier to keep up to date with developments. To access this resource, go to:
http://www.immunize.org/h1n1

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7 IAC's Video of the Week helps healthcare professionals talk to parents about vaccine concerns

IAC's Video of the Week is a webcast from the California Immunization Coalition (CIC) that deals with parents' concerns about vaccine safety. The video is intended for health professionals, and features a panel that includes physicians, scientists, a communications expert, public health professionals, and parents. The panel advises a mother whose child is scheduled to receive a vaccine the next day.

The video will be available on the home page of IAC's website through May 31. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week, which you'll find toward the top of the page. It may take a few moments for the video to begin playing; please be patient!

Remember to bookmark IAC's home page to view a new video every Monday. While you're at our home page, we encourage you to browse around--you're sure to find resources and information that will enhance your practice's immunization delivery.

All the videos featured as an IAC Video of the Week have recently been archived in a new section of IAC's website. To view any of the videos previously featured, go to:
http://www.immunize.org/votw/apr09.asp

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8 IAC revises "Admission Orders for Labor & Delivery and Newborn Units to Prevent HBV Transmission" and "Standing Orders for Administering Rotavirus Vaccine to Infants"

IAC has made many small changes to its 2-page piece for healthcare professionals, "Admission Orders for Labor & Delivery and Newborn Units to Prevent Hepatitis B Virus (HBV) Transmission" (formerly "Guidelines for Standing Orders in Labor & Delivery and Nursery Units to Prevent Hepatitis B Virus Transmission to Newborns"). The piece also now includes sample text for an admission order for routine newborn hepatitis B vaccination.

To access the revised "Admission Orders for Labor & Delivery and Newborn Units to Prevent Hepatitis B Virus (HBV) Transmission," go to: http://www.immunize.org/catg.d/p2130.pdf

IAC has also updated "Standing Orders for Administering Rotavirus Vaccine to Infants." Changes include clarification of step #4 (changing "dosing tube" to "dosing applicator" and noting that Rotarix needs to be reconstituted and RotaTeq does not), and changing the last date for administering rotavirus vaccine from "before age 8 months 0 days" to "by age 8 months 0 days."

To access the revised "Standing Orders for Administering Rotavirus Vaccine to Infants," go to:
http://www.immunize.org/catg.d/p3087.pdf

To access a table with links to all of IAC's standing orders protocols for vaccine administration and medical management of vaccine reactions, go to: http://www.immunize.org/standingorders

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9 IAC updates and redesigns "After the shots. . . What to do if your child has discomfort"

IAC has updated its parent piece, "After the shots. . . What to do if your child has discomfort." The piece includes medicines and dosages for reducing pain and fever and features a new look.

To access the revised "After the shots. . . What to do if your child has discomfort, go to:
http://www.immunize.org/catg.d/p4015.pdf

IAC's Print Materials web section offers healthcare professionals and the public approximately 250 FREE English-language materials (many also available 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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10.  IAC updates three print pieces that answer the public's questions about rotavirus, diphtheria, and Hib

IAC recently revised three of its Q&A patient-education print pieces: "Rotavirus: Questions and Answers," "Diphtheria: Questions and Answers," and "Haemophilus influenzae type b (Hib): Questions & Answers." All were updated to incorporate changes recently made in vaccine recommendations and licensure.

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

To access the revised ready-to-print (PDF) print piece "Rotavirus: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4217.pdf

To view an HTML version of these Q&As, go to the following:

(1) Rotavirus disease:
http://www.vaccineinformation.org/rotavirus/qandadis.asp

(2) Rotavirus vaccine:
http://www.vaccineinformation.org/rotavirus/qandavax.asp

To access the revised ready-to-print (PDF) print piece "Diphtheria: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4203.pdf

To view an HTML version of these Q&As, go to the following:

(1) Diphtheria disease:
http://www.vaccineinformation.org/diphther/qandadis.asp

(2) Diphtheria vaccine:
http://www.vaccineinformation.org/diphther/qandavax.asp

To access the revised ready-to-print (PDF) print piece
"Haemophilus influenzae type b (Hib): Questions & Answers," go to:
http://www.immunize.org/catg.d/p4206.pdf

To view an HTML version of these Q&As, go to the following:

(1) Hib disease:
http://www.vaccineinformation.org/hib/qandadis.asp

(2) Hib vaccine:
http://www.vaccineinformation.org/hib/qandavax.asp

To access Q&As about other diseases and vaccines in PDF format, go to:
http://www.immunize.org/printmaterials/questions.asp

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11.  Mark your calendar: July 30 is the date for "Immunization Update 2009"

July 30 is the date for this year's highly anticipated "Immunization Update," presented by CDC experts. The 2009 course instructors include William L. Atkinson, MD, MPH; Donna L. Weaver, RN, MN; Andrew T. Kroger, MD, MPH; Iyabode Akinsanya-Beysolow, MD, MPH, FAAP; and guest experts.

This live satellite broadcast and webcast will provide up-to-date information on the rapidly changing field of immunization. Anticipated topics include influenza (including H1N1 influenza), rotavirus, vaccine safety, and vaccine supply. So-called "alternative" vaccine schedules and other emerging vaccine issues will also be discussed.

The 2.5-hour broadcast will occur live from 9:00 to 11:30 AM and will be re-broadcast that day from 12:00 noon to 2:30 PM (Eastern Time). Both broadcasts will feature a live question-and-answer session in which participants nationwide can interact with the course instructors via toll-free telephone lines.

To register to attend the broadcast at a specific location, or to search for available locations, visit the CDC/ATSDR Training and Continuing Education Online System at http://www2a.cdc.gov/TCEOnline Site registration begins on June 4, 2009. Individual registration begins on July 16, 2009. For questions about registration, call (800)418-7246 or email ce@cdc.gov

Note: You do not need to register to participate in the webcast. The webcast will be available online for one month following the broadcast at http://www2a.cdc.gov/phtn/webcast/immupdate2009

For additional questions regarding program content, please email nipinfo@cdc.gov

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12.  The 11th edition of CDC's Pink Book can now be downloaded

CDC's Pink Book, formally titled "Epidemiology and Prevention of Vaccine-Preventable Diseases," has been updated and the 11th edition is now available for reading or downloading online.

To download chapter files of the Pink Book in PDF format, go to the chapter index at
http://www.cdc.gov/vaccines/pubs/pinkbook/pink-chapters.htm

For information about ordering a print copy, go to:
http://www.cdc.gov/vaccines/pubs/pinkbook/#order

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13.  IAC's laminated versions of the 2009 child/teen and adult immunization schedules offer significant advantages over paper versions. Place your order today and use them throughout 2009!

IAC's 2009 laminated immunization schedules are a must for every immunization setting: from conventional health clinics and private practices to walk-in shot clinics in workplaces, pharmacies, schools, and other sites. IAC offers the laminated schedules for two age groups. The child/teen immunization schedule is for people ages 0 through 18 years; the adult schedule is for those older than 18. Though both are adapted from the immunization schedules that were posted on the CDC website in January, the laminated schedules offer these advantages over downloadable paper versions:

  • Coated in thick plastic, the laminated schedules are washable and will hold up to a year's worth of use as teaching tools that providers in any immunization setting can use to give patients and parents authoritative information about the vaccines recommended for various age groups. You can also use them as a handy reference to consult at a moment's notice.
     
  • For the second year in a row, IAC has added a significant feature to the two laminated schedules. Each includes a guide to contraindications and precautions for the pertinent age group (i.e., the child/teen schedule has a guide to contraindications and precautions for child/teen vaccines, and the adult schedule has a guide for adult vaccines). Healthcare professionals will find these guides extremely valuable in making an on-the-spot determination about vaccinating any patient they see in any immunization setting.

The durable laminated schedules come complete with essential footnotes and are printed in color for easy reading. Each schedule has six pages (i.e., three double-sided pages), and when folded, measures 8.5" x 11".

For specific information about the child/teen schedule, to view images of it, or to order online or download an order form, visit http://www.immunize.org/shop/schedule_child.asp

For specific information about the adult schedule, to view images of it, or to order online or download an order form, visit http://www.immunize.org/shop/schedule_adult.asp

Prices start at $10 each for 1-4 copies and drop to $6.50 each for 5-19 copies. Discount pricing is available for 20 or more copies. For quotes on customizing or placing orders in excess of 999 schedules, call (651) 647-9009 or email admininfo@immunize.org

To learn about other essential immunization resources available for purchase from IAC, go to: http://www.immunize.org/shop

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14.  May issue of CDC's Immunization Works electronic newsletter recently released

CDC recently released the May issue of its monthly newsletter Immunization Works; it is posted on the website of the National Center for Immunization and Respiratory Diseases (NCIRD). The newsletter offers the immunization community information about current topics. The information is in the public domain and can be reproduced and circulated widely.

Some of the information in the May issue has already appeared in previous issues of IAC Express. Following is the text of some articles we have not covered.


FRONT PAGE NEWS

MORE NOVEL H1N1 NEWS: Novel influenza A (H1N1) activity is now being detected through CDC's routine influenza surveillance systems and reported weekly in FluView. The fact that novel H1N1 activity is now detected through seasonal surveillance systems is an indication that there are higher levels of influenza-like illness in the United States than is normal for this time of year. About half of all influenza viruses being detected through laboratory surveillance are novel H1N1 viruses.

As of May 18th, 5 deaths and 5,123 confirmed and probable cases of novel H1N1 influenza have been reported in the United States and the District of Columbia. Recently, CDC began reporting numbers of confirmed and probable cases of novel H1N1 infection by state as an aggregate, or total. This is because almost all probable cases that have undergone further testing have been found to be the novel H1N1 virus. Reporting aggregate probable and confirmed cases will better reflect the true impact of novel H1N1 flu on the United States. The list of states with the numbers of confirmed and probable cases of novel H1N1 infection is available online and updated Monday-Friday at about 11:00 AM at CDC's H1N1 Flu (Swine Flu) website (http://www.cdc.gov/h1n1flu). This site also contains links to resources for specific groups, such as clinicians, pregnant women, and travelers, as well as CDC's Spanish Language H1N1 Flu website (http://www.cdc.gov/h1n1flu/espanol).

It's important that people continue to take steps to protect their health and the health of their family. Personal health message should continue to reinforce the following:
  • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
     
  • Wash your hands often with soap and water, especially after you cough or sneeze.
     
  • Alcohol-based hand cleaners are also effective.
     
  • Avoid touching your eyes, nose or mouth.
     
  • If you are sick, stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer.

For the latest information about the novel H1N1 outbreak, sign up to receive CDC email updates, subscribe to RSS, or follow CDC Emergency on Twitter. Updated world-wide country counts can be found at the World Health Organization website (http://www.who.int/en).

OTHER NEWS AND SUMMARIES

WHAT DO MEDICAL ASSISTANTS NEED TO KNOW ABOUT VACCINES? A new report focuses on the immunization training needs of medical assistants (http://www.aptrweb.org/resources/assistants.html). Summarizing the results of a survey conducted in 2008 by Emory  University through a Cooperative Agreement between the Association for Prevention Teaching and Research (APTR) and NCIRD, CDC, the report describes the immunization tasks medical assistants frequently perform, their experiences with immunization-related training, their preferences for training topics and delivery methods, and barriers to training. Study results will be used to improve the educational offerings to this group of health professionals.

MEETINGS, CONFERENCES & RESOURCES

2010 NATIONAL COALITION CONFERENCE: Please mark your calendars for the 9th National Conference on Immunization and Health  Coalitions "Strengthening Our Connections." The conference will take place from May 26–28 in Chicago, Illinois. More information will be available in future issues of this publication.

RESPIRATORY NEWS AND RESOURCES

GET SMART ABOUT ANTIBIOTICS WEEK: Mark your calendars for "Get Smart about Antibiotics Week", October 5-11, 2009.

Issues of Immunization Works are posted on CDC's Vaccines & Immunizations website a few days after publication. To access the May issue, go to:
http://www.cdc.gov/vaccines/news/newsltrs/imwrks/2009/200905.htm

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15.  IZTA plans June 16 conference call on influenza and June 30 call on making new media work for immunization coalitions

The Immunization Coalitions Technical Assistance Network (IZTA) has two conference calls scheduled in June. Details on each follow.

JUNE 16 CALL ON INFLUENZA:
Dr. L.J Tan, MS, PhD, will present his annual engaging and informative influenza update during this call, including the latest research from the 2008-09 season and predictions and plans for the 2009-10 influenza season.

The June 16 call will be held at 1PM, ET. To sign up, send an email to izta@aed.org with the subject line "Sign me up for the Influenza Update Call."

JUNE 30 CALL ON MAKING NEW MEDIA WORK FOR IMMUNIZATION COALITIONS:
This call will discuss the ins and outs of new media and how these applications can help your coalition. Web expert Shea Van Horn will describe new technologies such as social networking sites, RSS feeds, blogging, and video sharing. Jennifer Bailey and Edgar Ednacot from the California Department of Public Health will discuss their state's new "I Choose" campaign that uses new media technologies to promote vaccination.

The June 30 call will be held at 1PM, ET. To sign up, send an email to izta@aed.org with the subject line "Sign me up for the Web 2.0 call."

IZTA is a program of the Center for Health Communication, Academy for Educational Development.

To access earlier programs, go to:
http://www.izta.org/confcall.cfm

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16.  MMWR reports on progressive vaccinia in a military smallpox vaccinee

CDC published "Progressive Vaccinia in a Military Smallpox Vaccinee--United States, 2009" in the May 22 issue of MMWR. The first paragraph is reprinted below, excluding references.


Progressive vaccinia (PV), previously known as vaccinia necrosum, vaccinia gangrenosum, or disseminated vaccinia, is a rare, often fatal adverse event after vaccination with smallpox vaccine, which is made from live vaccinia virus. During recent vaccination programs potential cases of PV were investigated, but none met standard case definitions. PV has not been confirmed to have occurred in the United States since 1987. On March 2, 2009, a U.S. Navy Hospital contacted the Poxvirus Program at CDC to report a possible case of PV in a male military smallpox vaccinee. The service member had been newly diagnosed with acute mylegenous leukemia M0 (AML M0). During evaluation for a chemotherapy-induced neutropenic fever, he was found to have an expanding and nonhealing painless vaccination site 6.5 weeks after receipt of smallpox vaccine. Clinical and laboratory investigation confirmed that the vaccinee met the Brighton Collaboration and CDC adverse event surveillance guideline case definition for PV. This report summarizes the patient's protracted clinical course and the military and civilian interagency governmental, academic, and industry public health contributions to his complex medical management. The quantities of investigational and licensed therapeutics and diagnostics used were greater than anticipated based on existing smallpox preparedness plans. To support future public health needs adequately, the estimated national supply of therapeutics and diagnostic resources required to care for smallpox vaccine adverse events should be reevaluated. . . .


To access a web-text (HTML) version of the complete article, including references and photos, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5819a5.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5819.pdf

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17.  Erratum: MMWR corrects two sentences in its report on H1N1 influenza in pregnant women

CDC published "Errata: Vol. 58, No. 18" in the May 22 issue of MMWR. The article follows in its entirety.


In the report, "Novel Influenza A (H1N1) Virus Infections in Three Pregnant Women--United States, April-May 2009," on page 498, the second and third sentences in the first complete paragraph should read as follows: "The specimen was forwarded to the Virus Surveillance and Diagnostic Branch Laboratory, Influenza Division, CDC, where it could not be confirmed as novel influenza A (H1N1) virus. On April 30, a repeat nasopharyngeal specimen and sputum specimen were collected that were both positive by rRT-PCR for novel influenza A (H1N1) virus at CDC."


To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5819a8.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5819.pdf

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IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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