On October 20, CDC posted provisional recommendations for use of measles, mumps, rubella, and varicella (MMRV) vaccine on the ACIP web section. 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. The MMRV provisional recommendations are reprinted below in their entirety.

To access all final ACIP recommendations, go to: http://www.immunize.org/acip IAC's ACIP web section allows visitors to sort documents by date, vaccine, or topic. Bookmark this link for easy access to all provisional and final ACIP recommendations.

On October 19, FDA issued a press release, "FDA Approves Seasonal Influenza vaccine Fluarix for Pediatric Use." Fluarix is manufactured by GlaxoSmithKline Biologicals, Dresden, Germany. Portions of the press release are reprinted below. Links to the approval letter and package insert are given at the end of this IAC Express article.

To access the package insert, click here.

On October 24, President Obama signed an emergency declaration for H1N1 influenza. The proclamation enhances the ability of our nation's medical treatment facilities to handle a surge in H1N1 patients by allowing, as needed, the waiver of certain standard federal requirements on a case-by-case basis.

To access details about the declaration, go to:
http://www.flu.gov/professional/federal/h1n1emergency10242009.html

If your healthcare setting is vaccinating a lot more people than usual because of H1N1 influenza, this is a great time for your staff to review the recommended immunization techniques shown in the video Immunization Techniques: Safe, Effective, Caring. This popular and highly lauded 35-minute video offers healthcare providers a way to train their staff--quickly, effectively, and affordably (only $10.50 for each DVD or VHS ordered).

Developed in 2001 by the California Department of Health Services Immunization Branch in collaboration with a team of national experts, the video teaches best practices for administering intramuscular (IM) and subcutaneous (SC) vaccines to infants, children, and adults. PLEASE NOTE, however, that because the video was released in 2001, it does NOT provide instruction on administering the nasal-spray influenza vaccines or the oral rotavirus vaccines. These vaccines were licensed after 2001.

Available in DVD and VHS formats, the video is designed for use as a "hands-on" instructional program for new staff, as well as a refresher course for experienced healthcare professionals. It discusses the following:

• Anatomic sites
• Choice of needle size
• Vaccines and routes of administration
• Demonstrations of infants, toddlers, kindergartners, and adults being vaccinated
• How to "draw up" doses of vaccine

TO ORDER OR FOR ADDITIONAL INFORMATION. The cost is $10.50 per copy of the DVD or VHS.

For additional information about the DVD, or to order online or to download an order form, visit
http://www.immunize.org/shop/toolkit_iztechdvd.asp

For additional information about the VHS, or to order online or to download an order form, visit
http://www.immunize.org/shop/toolkit_iztechvhs.asp

CDC recently added or updated the following H1N1 influenza information for healthcare professionals.

H1N1 Vaccine Administration Billing Q&As
http://www.cdc.gov/h1n1flu/vaccination/statelocal/vaccing_billing_qa.htm

Top 10 Frequently Asked Questions on Use of Influenza A(H1N1) 2009 Monovalent Vaccines (2009 H1N1 Vaccines):  Practical Considerations for Immunization Programs and Providers
http://www.cdc.gov/H1N1flu/vaccination/top10_faq.htm

H1N1 Vaccine Allocation and Distribution Q&A
http://www.cdc.gov/H1N1flu/vaccination/statelocal/centralized_distribution_qa.htm

Updated Interim Recommendations--HIV-Infected Adults and Adolescents: Considerations for Clinicians Regarding 2009 H1N1 Influenza
http://www.cdc.gov/h1n1flu/guidance_HIV.htm

Antiviral Safety Information Web Page
http://www.cdc.gov/H1N1flu/antivirals/safety_info.htm

Health Requirements and Recommendations for Travel to Saudi Arabia during the 2009 Hajj: Information for U.S. Travelers
http://wwwnc.cdc.gov/travel/content/id/2434.aspx

Emergency Use Authorization of N95 Respirators
http://www.cdc.gov/h1n1flu/eua/n95.htm

CDC Health Alert Network (HAN) Info Service Message: Recommendations for Early Empiric Antiviral Treatment in Persons with Suspected Influenza who are at Increased Risk of Developing Severe Disease
http://www.cdc.gov/H1N1flu/HAN/101909.htm

Podcast: Antiviral Drugs for the 2009-2010 Influenza Season
http://www2c.cdc.gov/podcasts/player.asp?f=175219#

Planning Guide for Vaccinating Pediatric Patients against 2009 H1N1 Influenza in Primary Healthcare Settings
http://www.cdc.gov/h1n1flu/vaccination/pediatricpatients.htm

2009-2010 Influenza Triage Algorithm for Children (18 years or Younger) with Influenza-Like Illness
http://www.cdc.gov/h1n1flu/clinicians/pdf/childalgorithm.pdf

Recommendations for Use of Antiviral Medications for the Management of Influenza in Children and Adolescent for the 2009-2010 Season--Pediatric Supplement for Health Care Providers
http://www.cdc.gov/h1n1flu/recommendations_pediatric_supplement.htm

Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season
http://www.cdc.gov/h1n1flu/recommendations.htm

2009 H1N1 Flu (referred to as "swine flu" early on) and Seasonal Flu Information for Rheumatology Health Professionals
http://www.cdc.gov/h1n1flu/arthritis_clinicians.htm

CDC's H1N1 Flu web section contains hundreds of documents for healthcare professionals and the public. To access the web section's home page, go to: http://www.cdc.gov/h1n1flu

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

The next NCIRD live Net Conference will cover new recommendations for human papillomavirus (HPV) vaccine. An additional topic will be discussed, but it has not yet been determined. The Net Conference is scheduled from noon to 1PM ET on November 12. Dr. Lauri Markowitz will speak on HPV; Dr. Andrew Kroger will moderate. Participation in the Q&A section of the program is available by phone and Internet.

For additional information, go to:
http://www.cdc.gov/vaccines/ed/ciinc

This is a limited-entry event. Registration will close on November 10 or when the course is full. To register, go to:
http://www2.cdc.gov/vaccines/ed/ciinc

On October 19, the website of Wired magazine posted "An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All." Written by Amy Wallace, the article profiles Dr. Paul A. Offit in the context of his work to dispel the myth that vaccines cause autism. A science advocate, Dr. Offit is chief of Infectious Diseases and director of the Vaccine Education Center at Children's Hospital of Philadelphia. He is also a co-inventor of the rotavirus vaccine RotaTeq.

To access the article "An Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All," go to:
http://www.wired.com/magazine/2009/10/ff_waronscience

Earlier this month, the American Academy of Pediatrics presented Dr. Offit with its President's Certificate for Outstanding Service in recognition of his ongoing commitment to promote immunization.

To access the AAP press release about the award, go to:
http://www.aap.org/advocacy/releases/nce09outstandingaward.htm

With vaccination against 2009 H1N1 influenza underway, it is important to remember that seasonal influenza vaccination efforts must continue. To aid in these efforts, the Immunization Action Coalition is inviting IAC Express readers to place orders now for the National Influenza Vaccine Summit's 2009-10 Seasonal Influenza Vaccination Pocket Information Guides. They're free!

These laminated, 3.75 x 6.75-inch, 2-color cards serve as a convenient reference for front-line healthcare professionals who vaccinate patients. The cards provide the following information:

• Indications, contraindications, and precautions for the injectable and intranasal seasonal influenza vaccines
   
• Populations targeted for seasonal influenza vaccination
   
• Dosage and route of administration for all the various seasonal influenza vaccine products
   
• Talking points for discussing seasonal influenza vaccination with patients

See an image of the seasonal influenza vaccine pocket guide at
http://www.preventinfluenza.org/fluguide/pocketguide_flu.pdf

These pocket guides also serve as a reminder to keep giving seasonal influenza vaccine throughout the influenza season (through the spring months).

The Summit is also pleased to be able to offer pocket guides for the administration of pneumococcal polysaccharide vaccine (PPSV). See an image of the PPSV pocket guide at
http://www.immunize.org/ppvguide/pocketguide.pdf

Each of these pocket guides is designed to be used by healthcare professionals only; THEY ARE NOT PATIENT HANDOUTS.

HOW TO ORDER
Each order must be for a minimum of 100 pocket guides. Place your order at http://www.preventinfluenza.org/pocketguides There is no cost for the pocket guides, shipping, or handling within the U.S. Quantities are limited, so to avoid disappointment, place your order today!

If you have questions, email admininfo@immunize.org

BACKGROUND
These pocket guides were developed by, and are being provided under the sponsorship of the National Influenza Vaccine Summit, http://www.preventinfluenza.org The Summit brings together public and private stakeholders to facilitate and promote influenza vaccination. The pocket guides are also distributed by many major medical, nursing, and pharmacist organizations, specialty societies, state health departments, Indian Health Service Area facilities, Quality Improvement Organizations, Visiting Nurse Associations, community vaccinators, and many others.

Thanks for your dedication to immunization, and don't forget to keep vaccinating against seasonal influenza through the spring months!

IAC encourages IAC Express readers to watch a 9-minute video of CBS correspondent Scott Pelley's report on the H1N1 influenza. The report, which aired on October 18, looks at how H1N1 influenza is striking at young, healthy people and presents information about the federal government's plans to fight the H1N1 pandemic.

The video will be available on the home page of IAC's website through November 1. 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!

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

IAC recently revised its Q&A patient-education print piece "Seasonal Influenza: Questions and Answers." The word "seasonal" was added to the title and throughout the piece, and very small revisions were made to incorporate changes in vaccine recommendations.

The revised piece is a ready-to-print version 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 "Seasonal Influenza: Questions and Answers," go to:
http://www.immunize.org/catg.d/p4208.pdf

For a web-text (HTML) version of this and other fully formatted documents, go to: http://www.vaccineinformation.org You will be taken to a list of Q&As about vaccine-preventable diseases and the vaccines that prevent them. Click on the disease(s) of interest to you.

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

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

If you're wondering if you should continue to vaccinate against seasonal influenza when 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 are having difficulty finding available seasonal influenza vaccine to purchase. Be assured that though vaccine may be in temporary short supply in some settings right now, supplies are 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 (Influenza Vaccine Availability Tracking System). IVATS 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

CDC published "Reduction in Rotavirus After Vaccine Introduction--United States, 2000-2009" in the October 23 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

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

Dated 8/11/09, the interim VIS for seasonal trivalent inactivated influenza vaccine (TIV; injectable) and the VIS for seasonal live attenuated influenza vaccine (LAIV; nasal spray) are now available in Bengali, Haitian Creole, and Urdu. IAC gratefully acknowledges the New York City Department of Education and the New York City Department of Health and Mental Hygiene for the translations.

INTERIM VIS FOR THE SEASONAL INJECTABLE INFLUENZA VACCINE

To access the Bengali version of the interim VIS for seasonal injectable influenza vaccine, go to:
http://www.immunize.org/vis/be_flu.pdf

To access the Haitian Creole version of the interim VIS for seasonal injectable influenza vaccine, go to:
http://www.immunize.org/vis/ha_flu06.pdf

To access the Urdu version of the interim VIS for seasonal injectable influenza vaccine, go to:
http://www.immunize.org/vis/ur_flu.pdf

To access the English version of the interim VIS for seasonal injectable influenza vaccine, go to:
http://www.immunize.org/vis/2flu.pdf

NOTE: The interim VIS for seasonal injectable influenza 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.

VIS FOR THE SEASONAL NASAL-SPRAY INFLUENZA VACCINE

To access the Bengali version of the VIS for seasonal nasal-spray influenza vaccine, go to:
http://www.immunize.org/vis/be_LAIV.pdf

To access the Haitian Creole version of the VIS for seasonal nasal-spray influenza vaccine, go to:
http://www.immunize.org/vis/haliveflu06.pdf

To access the Urdu version of the VIS for seasonal nasal-spray influenza vaccine, go to:
http://www.immunize.org/vis/ur_LAIV.pdf

To access the English version of the VIS for seasonal nasal-spray influenza vaccine, go to:
http://www.immunize.org/vis/liveflu.pdf

NOTE: The VIS for seasonal nasal-spray influenza 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

The website of Childhood Influenza Immunization Coalition (CIIC) was recently updated with new videos, public service announcements (PSAs), and the results of a survey conducted by the National Foundation for Infectious Diseases (NFID). Details follow.

CIIC's new attention-grabbing online videos use humor to help clear up some common misperceptions among parents about influenza and the benefit of immunization for their children. Titled "Flu Funnies," the videos are available at http://www.preventchildhoodinfluenza.org/families/influenza_flu_funnies_videos.php or http://www.youtube.com/user/NFIDVideos

Through brief vignettes about a family, CIIC's PSAs illustrate the potentially devastating impact influenza has on children and the importance of immunization. They are available in English and Spanish; email CIIC@NFID.org to access them, free of charge.

As part of a CIIC effort, NFID conducted a national survey to better understand mothers' perceptions of seasonal influenza immunization. In general, mothers view seasonal influenza vaccine as safe and effective, yet misperceptions still cause some to avoid this immunization for their children. Read more at www.PreventChildhoodInfluenza.org/survey

CIIC was established by NFID. Its members represent more than 30 of the nation's leading public health, medical, patient, and parent groups committed to protecting children's health and encouraging wellness.

To access the CIIC website's homepage, go to:
http://www.preventchildhoodinfluenza.org

A new website for the Vaccine Adverse Event Reporting System (VAERS) has been launched and is available at http://www.vaers.hhs.gov VAERS is a national program co-managed by CDC and FDA to monitor the safety of all vaccines licensed in the United States.

VAERS is a passive surveillance system that collects and analyzes important information from reported adverse events that occur after vaccination. The system relies on reports from healthcare providers, vaccine manufacturers, and the general public. You may report to VAERS electronically, by mail, or fax. You can also search the VAERS database, via the website, for information and summaries on particular adverse events reported for specific vaccines. Please note that VAERS cannot determine if an adverse event was caused by a vaccine, but can help determine if further investigations are needed.

In addition, VAERS print and web material are now available on the CDC website at
http://www.cdc.gov/vaccinesafety/vaers/vaers_campaign.htm

On October 21, WHO's Department of Immunization, Vaccines and Biologicals (IVB) posted a summary of the content of the recently released third edition of a report titled "State of the World's Vaccines and Immunization." The report is a collaboration among WHO, UNICEF, and the World Bank.

The IVB summary is reprinted below in its entirety. Links to the recently released report and to a related WHO press release and a related "CDC Feature" are given at the end of this IAC Express article.

To access the "CDC Feature" on the report, go to:
http://www.cdc.gov/Features/GlobalImmunizations

CDC published "Introduction and Transmission of 2009 Pandemic Influenza A (H1N1) Virus--Kenya, June-July 2009" in the October 23 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5841.pdf

CDC published "Progress Toward Poliomyelitis Eradication--Nigeria, January 2008-July 2009" in the October 23 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5841.pdf

The conference planning organization Phacilitate has scheduled a North American Vaccine Forum for January 25-27 in Washington, DC. For comprehensive information on the event, go to:
http://www.phacilitate.co.uk/pages/washington_vac

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