Issue Number 429            December 8, 2003

CONTENTS OF THIS ISSUE

1. CDC assesses current influenza vaccine supply and encourages vaccination of high-risk persons and health care workers
2. Colorado Department of Public Health and Environment confirms influenza death of five children
3. CDC's "Immunization Works!" electronic newsletter for November includes information on changes to infant hepatitis B schedule
4. New: IAC's latest professional education materials available on the Web
5. HIV Vaccine Awareness Communications Campaign seeks partners for education and outreach
6. Conference on Needle-Free and Auto Injectors to be held in London on February 23-24, 2004

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December 8, 2003
CDC ASSESSES CURRENT INFLUENZA VACCINE SUPPLY AND ENCOURAGES VACCINATION OF HIGH-RISK PERSONS AND HEALTH CARE WORKERS

On December 5, a press release issued by the Centers for Disease Control and Prevention (CDC) announced that most available influenza vaccine supplies have been distributed to health care providers and encouraged high-risk persons and health care workers to be vaccinated. The press release is reprinted below in its entirety.

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For immediate release
December 5, 2003

CDC ASSESSING INFLUENZA VACCINE NOW IN SUPPLY PIPELINE:
High-risk individuals and health care workers should be immunized

The Centers for Disease Control and Prevention (CDC) in response to strong consumer demand for influenza vaccine is working with vaccine manufacturers, state health departments, medical professionals, and others to assess the status of the current flu vaccine supply in the United States. Current reports indicate that most available flu vaccine supplies have now been distributed to doctors, clinics, health departments, and other providers, which is not unusual for this time of year.

"This year it appears that many more people than in recent years received a flu shot during October and November, and unlike other years, there is high interest in obtaining flu shots into December. The fact that so many Americans have acted on the recommendation to receive a flu shot is encouraging," said Dr. Julie Gerberding, CDC director.

"CDC is doing everything possible to assess the availability of flu vaccine to identify any locations that have supplies that may be able to be made available to locations that need vaccine," Gerberding said. "Some states have plans in place to redistribute vaccine supplies should that be needed."

In a typical year, 70-75 million Americans receive a flu shot. This year manufacturers produced approximately 83 million doses of flu vaccine. The United States has never used more than 80 million doses of flu vaccine in a season. CDC officials note that it is not unusual at this time of year for influenza vaccine supplies to be limited as many health care providers begin to wind down their vaccination programs. Therefore, people wishing to be vaccinated may need to be persistent to find vaccine.

CDC has observed an earlier onset of the flu this year; therefore the agency continues to encourage individuals at high risk for complications from influenza and health care workers to receive a flu vaccination, while supplies remain available.

High-risk individuals who should be vaccinated against influenza include:

• persons 50 years and older;
• residents of nursing homes and other long-term care facilities that house persons of any age who have long-term illnesses;
• persons 6 months of age and older who have chronic heart or lung conditions, including asthma;
• persons 6 months of age and older who need regular medical care or had to be in a hospital because of metabolic diseases (like diabetes), chronic kidney disease, or weakened immune system (including immune system problems caused by medicine or by infection with HIV/AIDS);
• children and teenagers 6 months to 18 years who are on long-term aspirin therapy and therefore could develop Reye syndrome after the flu; and
• women who will be more than 3 months pregnant during the flu season.

In addition, CDC recommends the following groups of people be vaccinated to prevent spreading flu to individuals at high risk of complications from flu:

• doctors, nurses, and other employees in hospitals and doctors' offices, including emergency response workers;
• employees of nursing homes and long-term care facilities who have contact with patients or residents;
• employees of assisted living and other residences for people in high-risk groups;
• people who provide home care to those in high-risk groups; and
• household members (including children) of people in high-risk groups.

Children aged 6 to 23 months, and caregivers of children younger than 6 months, are also encouraged to receive flu shots because children younger than 24 months may be at higher risk for complications from influenza.

For healthy persons ages 5 to 49 the new nasal flu vaccine mist is another option of protection for the flu season. Other, simple steps available to everyone can also protect against flu. Frequently washing hands and avoiding touching the nose, eyes, and mouth will help people avoid transmitting or getting the flu or other respiratory infections, like a cold.

"Flu is very unpredictable. It is not uncommon for seasons to be quite different in their timing. We still don't know how this season will progress. It is too early to tell if the high level of activity that some parts of the country are experiencing will continue throughout our flu season," said Dr. Keiji Fukuda, a CDC medical epidemiologist specializing in influenza.

For more information about influenza and steps to protect individuals and families, visit www.cdc.gov

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To access the press release from the CDC website, go to:
http://www.cdc.gov/od/oc/media/pressrel/r031205.htm

To access a wealth of information about influenza from the website of the National Immunization Program, go to: http://www.cdc.gov/nip/Flu
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December 8, 2003
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT CONFIRMS INFLUENZA DEATH OF FIVE CHILDREN

A press release issued December 3 by the Colorado Department of Public Health and Environment indicates the state is experiencing its worst influenza season in several years and confirms the death of five Colorado children. The press release is reprinted below in its entirety.

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Denver, Colorado
December 3, 2003

STATE HEALTH DEPARTMENT REPORTS 6,306 CONFIRMED FLU CASES

A total of 6,306 confirmed cases of the flu have been reported to the Colorado Department of Public Health and Environment as of Wednesday, December 3.

This number is a 1,619 increase from 4,687 confirmed flu cases reported by the department on Monday, December 1.

The total includes the death of five Colorado children from the flu, including a 15-year-old; an 8-year-old; a 21-month-old; a 4-year-old and a 2-year-old. The death of a sixth Colorado child, which is suspected to have been from the flu, is still being investigated by the department to determine the exact cause of the death. The sixth child was 2-years-old.

Texas, a state that has also been hard hit by the flu this year, has reported a few flu-related deaths involving children, which they see every year.

Dr. Ken Gershman, director of the Department of Public Health and Environment's Communicable Disease Program, said, "During a normal flu year in Colorado, we see an average of 0-2 flu-related deaths in children.

"Last year, Colorado had 19 confirmed deaths of all ages from the flu and 748 deaths due to flu and pneumonia."

The department first reported 694 confirmed flu cases on Monday, November 17; 1,525 cases on Wednesday, November 19; 2,648 cases on Monday, November 24; and 3,957 cases on Wednesday, November 26.

Colorado had a total of 2,681 confirmed flu cases during the 2002-2003 flu season; 3,558 during the 2001-2002 flu season; 1,518 during the 2000-2001 flu season; and 1,210 during the 1999-2000 flu season.

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To access the press release, go to:
http://www.cdphe.state.co.us/release/2003/120303.html
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December 8, 2003
CDC'S "IMMUNIZATION WORKS!" ELECTRONIC NEWSLETTER FOR NOVEMBER INCLUDES INFORMATION ON CHANGES TO INFANT HEPATITIS B SCHEDULE

The November issue of "Immunization Works!" a monthly email newsletter published by the Centers for Disease Control and Prevention (CDC), is available on the website of the Immunization Action Coalition (IAC). The newsletter offers members of the immunization community non-proprietary information about current topics. CDC encourages its wide dissemination.

Some of the information in the November issue has already appeared in previous issues of "IAC EXPRESS." Following is the text of six articles we have not covered. A notable article is the one about the decision the Advisory Committee on Immunization Practices made concerning the minimum age for administering the last dose of pediatric hepatitis B vaccine. It follows:

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CHANGE IN THE MINIMUM AGE FOR ADMINISTRATION OF THE LAST DOSE OF HEPATITIS B VACCINE: At its October meeting, the Advisory Committee on Immunization Practices (ACIP) voted to change the minimum age at which the last dose of hepatitis B vaccine (either the third or fourth dose) can be given to 24 weeks of age. The recommendation for a minimum age of 24 weeks is a change from the minimum age of 6 months published in the ACIP and American Academy of Family Physicians (AAFP) General Recommendations on Immunization. This change is effective immediately. As with other vaccines, there is a four-day grace period around this dose; therefore the earliest age at which the last dose of hepatitis B vaccine can be administered is 164 days of age. Questions on dosage can be directed to nipinfo@cdc.gov

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CDC LAUNCHES LATE SEASON FLU CAMPAIGN: Bilingual "Late Season" flu campaign materials will be available on Monday, December 1. To view or download the materials, visit: http://www.cdc.gov/nip/Flu/gallery.htm

"IAC EXPRESS" editor's note: Please be advised that the National Immunization Program has removed the "Late Season" flu campaign materials from its website.

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PREVNAR DELAYS: Wyeth Vaccines has announced that it is currently experiencing delays in the supply of pneumococcal conjugate vaccine (PCV-7), brand name Prevnar. Wyeth projects there will be sufficient supply to meet the national demand. However, the amount of time between order receipt by the company and order shipment will be longer. Instead of orders being filled within 1 to 3 days, the turnaround time will be longer, possibly 12 to 15 calendar days. It is possible that this situation may last through February 2004. At this time there is no recommendation for change in the PCV-7 immunization schedule. Updated information regarding vaccine availability can be found at www.cdc.gov/nip or www.fda.gov or the Wyeth website [www.wyeth.com].

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RABIES VACCINE INFORMATION STATEMENT AVAILABLE: A rabies Vaccine Information Statement (VIS) is now available. The VIS can be accessed at www.cdc.gov/nip/publications/VIS/default.htm.

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NIP HOLDS FIRST NATIONAL SYMPOSIUM ON EDUCATION & QUALITY IMPROVEMENT: On October 22-23, 2003, NIP brought together researchers and program developers, an expert review panel, and national partner organizations to evaluate innovative strategies to raise immunization coverage levels and improve prevention services at the practice level. The meeting had 3 goals: 1) identify the universe of locally developed education and QI [quality improvement] programs; 2) critique a sample of programs; and 3) publish the proceedings and promote "model" programs to immunization grantees and NIP's partner organizations. Eight programs, representing child, adolescent, and adult interventions, out of a total of 70 applications submitted to NIP, were selected for the meeting. Presenters discussed office-based educational and practice management interventions to promote sustainable systems change, use of a tiered outreach approach for high-risk patients, and use of electronic patient record systems to prospectively notify medical staff of patients' preventive service needs, monitor visit outcomes, and provide practical feedback to office staff and management. NIP plans to widely distribute the final report of the symposium to state and national partners and work with participants on ways to promote effective programs.

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IMMUNIZATION LEADERS RECOGNIZED FOR OUTSTANDING IMMUNIZATION WORK: At its recent annual meeting, the American Academy of Pediatrics honored pediatrician Walter Orenstein, MD, Director of the National Immunization Program at CDC, for his outstanding leadership and commitment to public service and children's health. He was awarded the 2003 AAP Excellence in Public Service Award. Dr. Orenstein has worked in the arena of immunization at the CDC for more than 25 years.

Denise Johnson, Deputy Chief of the Polio Eradication Branch in the Global Immunization Division at CDC, recently received the 2003 Service to America Medal for Social Services. The Service to America Medals are awarded to only a few federal employees each year for outstanding service to their country, and only one is awarded in the category of social services. Since 1999, Ms. Johnson has served in her position where she manages a staff of 43 individuals in Atlanta and 17 countries.

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To access a ready-to-copy (PDF) of the entire November issue of "Immunization Works," go to:
http://www.immunize.org/news.d/news1103.pdf
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December 8, 2003
NEW: IAC'S LATEST PROFESSIONAL-EDUCATION MATERIALS AVAILABLE ON THE WEB

The Immunization Action Coalition recently posted two newly developed professional-education sheets on its website. Following are brief descriptions of and URLs for each sheet:

1. "Vaccine Handling Tips" offers valuable information on safeguarding vaccines from the time you receive them to the time you administer them.
    
   To access a ready-to-copy (PDF) version of this sheet, go to:
   http://www.immunize.org/catg.d/p3048.pdf
    
2. "Administering Vaccines: Dose, Route, Site, and Needle Size" has information on administering the vaccines most commonly given to children, teens, and adults, including combination vaccines.
    
   To access a ready-to-copy (PDF) version of this sheet, go to:
   http://www.immunize.org/catg.d/p3085.pdf
    
   To access a web-text (HTML) version of it, go to:
   http://www.immunize.org/catg.d/p3085.htm

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December 8, 2003
HIV VACCINE AWARENESS COMMUNICATIONS CAMPAIGN SEEKS PARTNERS FOR EDUCATION AND OUTREACH

[The following is cross posted from the Immunization Action Coalition's "HEP EXPRESS" electronic newsletter, 11/26/03.]

The HIV Vaccine Awareness Communications Campaign recently released a request for proposals for its Community Education and Outreach Partnership Program (CEOPP). This one-time funding opportunity aims to increase the capacity of nonprofit organizations to stress the importance of HIV vaccine research to their clients, particularly among hard-to-reach populations, including Blacks/African Americans, Hispanics/Latinos, and men who have sex with men, where the greatest misinformation and misconceptions about HIV vaccines exist.

Interested organizations are requested to submit a letter of intent by 4:00 PM EST, on December 1, 2003. Proposals must be submitted by mail by 4:00 PM EST, on December 19, 2003.

The complete request for proposals can be accessed at
http://ga1.org/ct/_pzpzJ71Wdw-/NIAID_HIV_Vaccine_RFP
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December 8, 2003
CONFERENCE ON NEEDLE-FREE AND AUTO INJECTORS TO BE HELD IN LONDON ON FEBRUARY 23-24, 2004

The ninth annual International Conference on Needle-free and Auto Injectors will be held in London on February 23-24, 2004.

The Management Forum is the conference organizer; refer to conference No. N2-8004 when registering or requesting information.

To request a conference brochure, go to:
http://www.management-forum.co.uk/forms/info-form.htm

To register, go to:
http://www.management-forum.co.uk/forms/registerform.htm

For additional information, contact the Management Forum in the United Kingdom by email at info@management-forum.co.uk, by phone at +44(0) 1483-570099, or by fax at +44(0) 1483-36424.