IAC Express 2009
Issue number 824: September 21, 2009
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Contents of this Issue
Select a title to jump to the article.
  1. Reminder: September 2009 issue of Needle Tips now available online
  2. FDA licenses four 2009 H1N1 influenza vaccines
  3. MMWR publishes information on Hiberix and updated Hib recommendations
  4. MMWR publishes recommendations on hepatitis A vaccination for close contacts of certain international adoptees
  5. VIS translation: Seasonal influenza VISs now available in Spanish
  6. CDC updates Pink Book with regard to polio vaccine scheduling
  7. MMWR reports on vaccination coverage of adolescents
  8. CDC provides updated influenza guidance related to pregnant women and small businesses
  9. CMS offers billing guidance for H1N1 influenza vaccination
  10. CDC posts three web documents with information related to H1N1 influenza vaccine safety
  11. IAC's Video of the Week features Families Fighting Flu PSA with soccer player Mia Hamm
  12. IAC's padded screening questionnaires for contraindications now have English on the front, Spanish on the back--a popular translation at no added cost!
  13. Keep vaccinating against seasonal influenza!
  14. Important: During H1N1 influenza outbreak, administer PPSV to all people with existing indications
  15. MMWR provides update on U.S. influenza activity
  16. Childhood Influenza Immunization Coalition redesigns website
  17. MMWR reports on vaccine-derived polioviruses worldwide
  18. California Department of Public Health announces influenza PSA contest
 
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 824: September 21, 2009
1.  Reminder: September 2009 issue of Needle Tips now available online

The September 2009 issue of Needle Tips is now available for viewing, downloading, and printing online at http://www.immunize.org/nt

This is the second issue of Needle Tips that is online-only. Postal mail copies are no longer available. You may obtain a hard copy of the September issue by printing out the 24-page PDF available at http://www.immunize.org/nslt.d/n41/n41.pdf

Needle Tips is IAC's semiannual periodical for healthcare professionals, packed with practical, easy-to-read, CDC-reviewed educational material covering childhood, adolescent, and adult immunization.

Complete information about this issue of Needle Tips is available at http://www.immunize.org/nt

There you will find a link for displaying and printing the entire 24-page PDF of this issue, along with a Table of Contents for viewing and printing individual sections of Needle Tips.

If you would like to download the entire issue of Needle Tips right now, go to:
http://www.immunize.org/nslt.d/n41/n41.pdf

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2 FDA licenses four 2009 H1N1 influenza vaccines

On September 15, FDA announced that it had approved four vaccines against the 2009 H1N1 influenza virus. The related FDA press release is reprinted below in its entirety.


The U.S. Food and Drug Administration announced today that it has approved four vaccines against the 2009 H1N1 influenza virus. The vaccines will be distributed nationally after the initial lots become available, which is expected within the next four weeks.

"Today's approval is good news for our nation's response to the 2009 H1N1 influenza virus," said Commissioner of Food and Drugs Margaret A. Hamburg, MD. "This vaccine will help protect individuals from serious illness and death from influenza."

The vaccines are made by CSL Limited, MedImmune LLC, Novartis Vaccines and Diagnostics Limited, and sanofi pasteur Inc. All four firms manufacture the H1N1 vaccines using the same processes, which have a long record of producing safe seasonal influenza vaccines.

"The H1N1 vaccines approved today undergo the same rigorous FDA manufacturing oversight, product quality testing, and lot release procedures that apply to seasonal influenza vaccines," said Jesse Goodman, MD, FDA acting chief scientist.

Based on preliminary data from adults participating in multiple clinical studies, the 2009 H1N1 vaccines induce a robust immune response in most healthy adults eight to 10 days after a single dose, as occurs with the seasonal influenza vaccine.

Clinical studies under way will provide additional information about the optimal dose in children. The recommendations for dosing will be updated if indicated by findings from those studies. The findings are expected in the near future.

As with the seasonal influenza vaccines, the 2009 H1N1 vaccines are being produced in formulations that contain thimerosal, a mercury-containing preservative, and in formulations that do not contain thimerosal.

People with severe or life-threatening allergies to chicken eggs, or to any other substance in the vaccine, should not be vaccinated.

In the ongoing clinical studies, the vaccines have been well tolerated. Potential side effects of the H1N1 vaccines are expected to be similar to those of seasonal flu vaccines.

For the injected vaccine, the most common side effect is soreness at the injection site. Other side effects may include mild fever, body aches, and fatigue for a few days after the inoculation. For the nasal spray vaccine, the most common side effects include runny nose or nasal congestion for all ages, sore throats in adults, and--in children 2 to 6 years old--fever.

As with any medical product, unexpected or rare serious adverse events may occur. The FDA is working closely with governmental and nongovernmental organizations to enhance the capacity for adverse event monitoring, information sharing, and analysis during and after the 2009 H1N1 vaccination program. In the U.S. Department of Health and Human Services, these agencies include the Centers for Disease Control and Prevention.

Vaccines against three seasonal virus strains are already available and should be used (see information on the seasonal flu: http://pandemicflu.gov/individualfamily/about/seasonalflu). However, they do not protect against the 2009 H1N1 virus (see information on H1N1 flu: http://www.cdc.gov/h1n1flu).


To read the press release online, go to:
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm182399.htm

For FDA licensing information about these four new vaccines, including links to approval letters and package inserts, go to:
http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm181950.htm

To access the four package inserts on IAC's website, go to:
http://www.immunize.org/packageinserts/pi_h1n1.asp

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3 MMWR publishes information on Hiberix and updated Hib recommendations

CDC published "Licensure of a Haemophilus influenzae Type b (Hib) Vaccine (Hiberix) and Updated Recommendations for Use of Hib Vaccine" in the September 18 issue of MMWR. Several paragraphs from the article are reprinted below.


On August 19, 2009, the Food and Drug Administration (FDA) licensed Hiberix (GlaxoSmithKline Biologicals, Rixensart, Belgium), a Haemophilus influenzae type b (Hib) conjugate vaccine composed of H. influenzae type b capsular polysaccharide (polyribosyl-ribitol-phosphate [PRP]) conjugated to inactivated tetanus toxoid (PRP-T). Hiberix is licensed for use as the booster (final) dose of the Hib vaccine series for children aged 15 months through 4 years (before the 5th birthday) who have received previously the primary series of Hib vaccination (consisting of 2 or 3 doses, depending on the formulation). The Advisory Committee on Immunization Practices (ACIP) recommends Hib booster vaccination for children at ages 12 through 15 months; however, because of the recent shortage of Hib vaccines, many children have deferred the booster dose and therefore require catch-up vaccination. This report summarizes the indications for Hiberix use and provides guidance on Hib booster dose administration based on increasing vaccine supplies. Vaccination recommendations in this report update the previous advisory on Hib booster administration (June 26, 2009), which advised that children with deferred booster doses receive it at the next regularly scheduled visit. Vaccination providers are now recommended to begin recall of children in need of the booster dose when feasible and monovalent Hib vaccine supply in the office is adequate. . . .

Indications and Guidance for Use
Hiberix is licensed for use as the booster (final) dose for Hib vaccination for children aged 15 months through 4 years (before the 5th birthday) who have received a primary Hib vaccination series of 2 or 3 doses (depending on the formulation of the primary series vaccines). ACIP recommends Hib booster dosing at ages 12 through 15 months. To facilitate timely booster vaccination, Hiberix and other Hib conjugate vaccines can be administered as early as age 12 months, in accordance with Hib vaccination schedules for routine and catch-up immunization. Hiberix is not licensed for the primary Hib vaccination series; however, if Hiberix is administered inadvertently during the primary vaccination series, the dose should be counted as a valid PRP-T dose that does not need to be repeated if it was administered according to schedule. In these children, a total of 3 doses will complete the routine primary series.

Children aged 12 months through 4 years (before the fifth birthday) who did not receive a booster because of the recent shortage of Hib vaccines should receive a booster with any of the available Hib-containing vaccines at the earliest opportunity. With licensure of Hiberix and anticipated distribution, the increased supply of Hib-containing vaccines will be sufficient to support a provider-initiated notification process to contact all children whose Hib booster dose had been deferred. When feasible and when vaccine supply in the office is sufficient, vaccination providers should review electronic or paper medical records or immunization information system (e.g., registry) records to identify and recall children in need of a booster dose. If supplies are not adequate, providers should continue to follow previous recommendations to provide the booster dose at the child's next regularly scheduled visit.

Information Regarding Supply of Hiberix, ActHib, and Pentacel
At this time, production of Merck Hib vaccine products remains suspended; however, supplies of sanofi pasteur vaccines ActHIB (monovalent Hib vaccine) and Pentacel (DTaP-IPV/Hib) are available for use for the primary Hib vaccination series and booster in infants and children. Vaccination providers with questions about supplies of Hiberix monovalent Hib vaccine purchased with nonpublic funds should contact GlaxoSmithKline Biologicals' customer service department (telephone, [866] 475-8222). Providers with questions about supplies of ActHIB or Pentacel purchased with nonpublic funds should contact sanofi pasteur's customer service department (telephone, [800] 822-2463). For public vaccine supplies, including Vaccines for Children Program vaccine, providers should contact their state/local immunization program to obtain vaccine. Providers ordering Hiberix through the Vaccines for Children Program may place orders in early October.

This recommendation reflects CDC's assessment of the existing national Hib vaccine supply and will be updated if the supply changes. Updated information about the national Hib vaccine supply is available at http://www.cdc.gov/vaccines/vac-gen/shortages/default.htm Details about the routine Hib vaccination schedule are available at http://www.cdc.gov/vaccines/recs/schedules/default.htm#child Adverse events after receipt of any vaccine should be reported to the Vaccine Adverse Event Reporting System at http://vaers.hhs.gov


To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a5.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5836.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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4 MMWR publishes recommendations on hepatitis A vaccination for close contacts of certain international adoptees

CDC published "Updated Recommendations from the Advisory Committee on Immunization Practices (ACIP) for Use of Hepatitis A Vaccine in Close Contacts of Newly Arriving International Adoptees" in the September 18 issue of MMWR. The first and last paragraphs of the article are reprinted below.


On February 25, 2009, the Advisory Committee on Immunization Practices (ACIP) recommended routine hepatitis A vaccination for household members and other close personal contacts (e.g., regular babysitters) of adopted children newly arriving from countries with high or intermediate hepatitis A endemicity. This new recommendation complements previous ACIP recommendations for hepatitis A vaccination for persons traveling from the United States to countries with high or intermediate hepatitis A endemicity (including persons with travel related to international adoption), and postexposure prophylaxis for contacts of persons with hepatitis A. This report introduces the new recommendation and outlines the underlying epidemiologic and programmatic rationale. . . .

Updated Recommendation
Based on this evidence, on February 25, ACIP updated its guidance by recommending hepatitis A vaccination for all previously unvaccinated persons who anticipate close personal contact (e.g., household contact or regular babysitting) with an international adoptee from a country of high or intermediate endemicity during the first 60 days following arrival of the adoptee in the United States. The first dose of the 2-dose hepatitis A vaccine series should be administered as soon as adoption is planned, ideally 2 or more weeks before the arrival of the adoptee.


To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5836.pdf

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5 VIS translation: Seasonal influenza VISs now available in Spanish

The 2009-10 VISs for seasonal trivalent inactivated influenza vaccine (TIV; injectable) and live attenuated influenza vaccine (LAIV; nasal spray) are now available in Spanish. IAC gratefully acknowledges the California Department of Public Health, Immunization Branch, for the translations.

More translations of the seasonal influenza VISs will be coming soon. IAC relies on other organizations to provide translations of VISs; though we cannot guarantee any delivery date, we post all translations on our website as soon as they become available.

For the Spanish-language version of the VIS for seasonal TIV, go to:
http://www.immunize.org/vis/spflu06.pdf

For the English-language version of the VIS for seasonal TIV, go to:
http://www.immunize.org/vis/2flu.pdf

For the Spanish-language version of the VIS for seasonal LAIV, go to:
http://www.immunize.org/vis/spliveflu06.pdf

For the English-language version of the VIS for seasonal LAIV, go to:
http://www.immunize.org/vis/liveflu.pdf

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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6 CDC updates Pink Book with regard to polio vaccine scheduling

On September 15, CDC updated information for the poliomyelitis chapter and the "Recommended Minimum Ages and Intervals" table in Appendix A of its Pink Book (formally titled "Epidemiology and Prevention of Vaccine-Preventable Diseases"). The new information is reprinted below.


UPDATE
Poliomyelitis Chapter
The Polio chapter states, on page 238, that "the minimum interval between all doses of IPV is 4 weeks, and the minimum age for the fourth dose is 18 weeks" and that "If all four IPV doses are administered after 6 weeks of age and are all separated by at least 4 weeks, a fifth dose is not needed, even if the fourth dose was administered before 4 years of age. . . ."

These statements are superseded by updated ACIP recommendations (MMWR, Vol. 58, No. 30, August 7, 2009), stating that the final dose in the IPV series should be administered at 4 years of age or older, regardless of the number of previous doses, and that the minimum interval between dose 3 and dose 4 has been extended from 4 weeks to 6 months.

The third slide on page 237 should also reflect these changes. The "4-6 years" minimum interval should be 6 months (not 4 weeks), and the footnote "the fourth dose of IPV may be given as early as 18 weeks of age" should say instead "the final dose of IPV should be given on or after the 4th birthday."

UPDATE
Appendix A
The "Recommended Minimum Ages and Intervals" table (page A8) should reflect updated recommendations for IPV (see above). The "Minimum age for this dose" for IPV-4 should be 4 years (not 18 weeks) and the "Minimum interval to next dose" for IPV-3 should be 6 months, not 4 weeks. These changes have been made on the online version of this table.


To access all errata, updates, and clarifications for the 11th edition of the Pink Book, go to:
http://www.cdc.gov/vaccines/pubs/pinkbook/pink-errata.htm

To access the Pink Book itself, go to:
http://www.cdc.gov/vaccines/pubs/pinkbook/pink-chapters.htm

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7 MMWR reports on vaccination coverage of adolescents

CDC published "National, State, and Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years--United States, 2008" in the September 18 issue of MMWR. A summary made available to the press is reprinted below in its entirety.


This is the third annual report of national adolescent vaccination coverage estimates based on provider-reported vaccination histories from the NIS-Teen and the first report of state and local area estimates. For the first time, Healthy People 2010 objectives of 90% coverage among adolescents 13-15 years of age were met for childhood administered vaccines (measles-mumps-rubella and hepatitis B). Coverage levels for vaccines routinely recommended for adolescents (tetanus, diphtheria, acellular pertussis, meningococcal conjugate, and quadrivalent human papillomavirus vaccines), continue to increase nationally, though there is substantial variation between state and local areas. Only three states had vaccination coverage estimates greater than 50% for all three adolescent vaccines. There were also some differences in coverage by race/ethnicity and poverty status. Vaccination coverage among adolescents is improving; however continued efforts are needed in order to achieve higher coverage levels in this population.


To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5836.pdf

CDC released a related statement to the press on September 17. To read "Nation's Teen Vaccination Coverage Increasing, Variability Observed By Area, Race/Ethnicity, and Poverty Status," go to:
http://www.cdc.gov/media/pressrel/2009/r090917.htm

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8 CDC provides updated influenza guidance related to pregnant women and small businesses

On September 17, CDC posted new information to the Guidance sub-section of its H1N1 Flu web section. "Updated Interim Recommendations for Obstetric Health Care Providers Related to Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season" is available at
http://www.cdc.gov/H1N1flu/pregnancy/antiviral_messages.htm

On September 16, CDC posted a new document to the same Guidance section titled, "Planning for 2009 H1N1 Influenza: A Preparedness Guide for Small Business." To access this resource, go to:
http://www.cdc.gov/H1N1flu/business/guidance/smallbiz.htm

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

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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9 CMS offers billing guidance for H1N1 influenza vaccination

The Centers for Medicare & Medicaid Services (CMS) has released guidance for billing for H1N1 influenza vaccination.

To access "Medicare Fee-for-Services (MFFS) Billing for the Administration of the Influenza A (H1N1) Virus Vaccine," go to:
http://www.cms.hhs.gov/MLNMattersArticles/downloads/se0920.pdf

For CMS information on adult immunization, go to:
http://www.cms.hhs.gov/adultImmunizations

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10.  CDC posts three web documents with information related to H1N1 influenza vaccine safety

CDC recently posted three web documents to answer questions on issues related to H1N1 influenza vaccine safety. Healthcare professionals, as well as members of the public, will likely find these resources useful.

The three new documents are

General Questions and Answers on 2009 H1N1 Influenza A Vaccine Safety
http://www.cdc.gov/h1n1flu/vaccination/vaccine_safety_qa.htm

General Questions and Answers on Thimerosal
http://www.cdc.gov/h1n1flu/vaccination/thimerosal_qa.htm

General Questions and Answers on Guillain-Barre Syndrome (GBS)
http://www.cdc.gov/h1n1flu/vaccination/gbs_qa.htm

Links to these resources and many more can be found on CDC's H1N1 Flu Vaccination Resources web section at
http://www.cdc.gov/h1n1flu/vaccination

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11.  IAC's Video of the Week features Families Fighting Flu PSA with soccer player Mia Hamm

IAC encourages IAC Express readers to watch Families Fighting Flu's 30-second public service announcement (PSA) about influenza vaccination featuring soccer legend and mother, Mia Hamm. The PSA was developed by Families Fighting Flu in partnership with the American Youth Soccer Organization to encourage entire families to get vaccinated against seasonal influenza.

The video will be available on the home page of IAC's website through September 28. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week. It may take a few moments for the video to begin playing; please be patient!

The video is also available on YouTube at http://www.youtube.com/watch?v=6Qe-ytQbk2c Share this message with your family, friends, and patients.

Remember to bookmark IAC's home page to view a new video every Monday. To view an IAC Video of the Week from the past, go to the video archive at http://www.immunize.org/votw

To visit Families Fighting Flu website, go to:
http://familiesfightingflu.org

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12.  IAC's padded screening questionnaires for contraindications now have English on the front, Spanish on the back--a popular translation at no added cost!

In response to demand, IAC now has a Spanish-language translation of the questions on its padded Screening Questionnaire for Child and Teen Immunization and Screening Questionnaire for Adult Immunization. Printed on the back of the English-language form, the Spanish-language form has been added to this product at no additional cost.

The questionnaires give you and your patients a quick, easy, and thorough way to determine if they have contraindications and precautions to vaccination. Patients fill out the questionnaire with yes-or-no answers while waiting to be seen, allowing you to review their responses quickly and be confident you're not missing any contraindications or precautions.

The questionnaires come in convenient tear-off pads of 100 sheets. The price per pad is economical (discounts for two pads or more), so you'll be able to keep pads at the receptionist's desk, the nurse's station, and in every exam room. Each pad comes with four English- language reference sheets (printed on heavy-weight paper) for health professionals.

Prices start at $16 each for one pad and drop to $12 each for two, $11 each for three, and $10 each for four. For quotes on larger quantities or customizing, call (651) 647-9009 or email admininfo@immunize.org

To learn more about the padded screening questionnaires, or to order online or download an order form, visit the following:

Screening Questionnaire for Child and Teen Immunization
http://www.immunize.org/shop/pad_sqchild.asp

Screening Questionnaire for Adult Immunization
http://www.immunize.org/shop/pad_sqadult.asp

IAC's offers other products for sale, including educational videos and personal immunization record cards, at
http://www.immunize.org/shop

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13.  Keep vaccinating against seasonal influenza!

A number of healthcare professionals are questioning whether they should continue to vaccinate against seasonal influenza once H1N1 influenza vaccine becomes available. The answer is YES! The 2009 H1N1 influenza vaccine will not protect people against seasonal influenza, and seasonal influenza vaccine will not protect against H1N1 influenza.

Unfortunately, some healthcare facilities with good intentions of providing protection against seasonal influenza in September are finding it hard to find vaccine to purchase this month. As reported in last week's issue of IAC Express (http://www.immunize.org/express/issue823.asp#n7), seasonal influenza vaccine may be in temporary short supply this month, but production is expected to catch up to demand soon.

To assist providers in finding seasonal influenza vaccine available for purchase, the National Influenza Vaccine Summit supports IVATS, the Influenza Vaccine Availability Tracking System, which provides information about vaccine manufacturers and distributors with vaccine available for purchase. To access this information in Excel spreadsheet format, go to:
http://www.preventinfluenza.org/ivats/ivats_09_10.xls

Many resources regarding influenza disease and vaccination are available to healthcare professionals and the public. Following is a list of some of them.

To access the National Influenza Vaccine Summit website, go to:
http://www.preventinfluenza.org

To access IAC's Seasonal Influenza web section, go to:
http://www.immunize.org/influenza

To access IAC's H1N1 Influenza web section, go to:
http://www.immunize.org/h1n1

To access CDC's Seasonal Flu web section, go to:
http://www.cdc.gov/flu

To access CDC's Novel H1N1 Flu web section, go to:
http://www.cdc.gov/h1n1flu

To access IAC's print pieces related to influenza, including screening questionnaires, patient education pieces, and sample standing orders, go to:
http://www.immunize.org/printmaterials/dis_inf.asp

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14.  Important: During H1N1 influenza outbreak, administer PPSV to all people with existing indications

CDC advises healthcare professionals that during the current outbreak of novel influenza A (H1N1), all people who have existing indications for PPSV should be vaccinated according to current ACIP recommendations. This is important because people with existing indications are not only at increased risk for pneumococcal disease, but are also at increased risk for serious complications from influenza. Use of PPSV among people without current indications for vaccination is not recommended at this time.

To access CDC's comprehensive document "Interim guidance for use of 23-valent pneumococcal polysaccharide vaccine during novel influenza A (H1N1) outbreak," go to:
http://www.cdc.gov/h1n1flu/guidance/ppsv_h1n1.htm

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15.  MMWR provides update on U.S. influenza activity

CDC published "Update: Influenza Activity--United States, April-August 2009" in the September 18 issue of MMWR. This report was previously published as an MMWR Early Release on September 10, and was previously covered in IAC Express on August 14.

To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a6.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5836.pdf

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16.  Childhood Influenza Immunization Coalition redesigns website

The Childhood Influenza Immunization Coalition (CIIC) has redesigned its website to make it more user-friendly, with a streamlined home page that now specifically targets families and caregivers.

Visit http://www.PreventChildhoodInfluenza.org to check out the new look. Share this site with parents and consider linking to CIIC from your organization's website.

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17.  MMWR reports on vaccine-derived polioviruses worldwide

CDC published "Update on Vaccine-Derived Polioviruses--Worldwide, January 2008-June 2009" in the September 18 issue of MMWR. The first paragraph is reprinted below.


In 1988, the World Health Assembly resolved to eradicate poliomyelitis worldwide. Subsequently, the Global Polio Eradication Initiative of the World Health Organization (WHO) reduced the global incidence of polio associated with wild polioviruses (WPVs) from an estimated 350,000 cases in 125 countries in 1988 to 1,651 reported cases in 2008 and reduced the number of countries that have never interrupted WPV transmission to four (Afghanistan, India, Nigeria, and Pakistan). Under current WHO plans, when the goal of eradicating all WPV transmission is attained, oral poliovirus vaccine (OPV) use worldwide eventually will be discontinued. However, because vaccine-derived polioviruses (VDPVs) can produce polio outbreaks in areas with low rates of Sabin OPV coverage and can replicate for years in immunodeficient persons, enhanced strategies are needed to limit emergence of VDPVs. This report updates previous summaries and describes VDPVs detected worldwide during January 2008-June 2009. During this period, (1) two new outbreaks of circulating VDPVs (cVDPVs) (accounting for 4-20 cases) were identified in the Democratic Republic of Congo and Ethiopia; (2) a previously identified outbreak in Nigeria ultimately resulted in a cumulative total of 292 cases; (3) two newly identified paralyzed immunodeficient persons in Argentina and the United States were found to excrete VDPVs; and (4) isolated VDPVs were found among persons and environmental samples in 11 countries. All countries need to maintain (1) high rates of poliovirus vaccination coverage to prevent VDPV spread and (2) sensitive poliovirus surveillance to detect VDPVs.


To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5836.pdf

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18.  California Department of Public Health announces influenza PSA contest

The California Department of Public Health is sponsoring a contest to create a video public service announcement to promote prevention of H1N1 and seasonal influenza. The contest is open ONLY to California residents age 14 years and older and the deadline for entries in October 16.

For more information, go to: http://www.cdphfilmfest.org

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About IZ Express

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
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    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
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    Kayla Ohlde

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