Issue Number 458            May 3, 2004

CONTENTS OF THIS ISSUE

  1. New: CDC publishes "Recommended Childhood and Adolescent Immunization Schedule--United States, July-December 2004"
  2. New: CDC issues the latest ACIP influenza recommendations in an "MMWR Early Release"
  3. New: IAC's comprehensive guide to adult immunization is now available for order
  4. April issue of CDC's "Immunization Works!" electronic newsletter is now posted on the NIP website
  5. CDC issues "Summary of Notifiable Diseases--United States, 2002"
  6. National Conference on Immunization Coalitions scheduled for September 20-22 in Norfolk, VA
  7. IOM workshop on pandemic influenza to be held June 16-17 in Washington, DC
  8. CDC reports on progress toward polio eradication in Nigeria

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ABBREVIATIONS: AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NIP, National Immunization Program; VIS, Vaccine Information Statement; VPD, vaccine-preventable disease; WHO, World Health Organization.
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May 3, 2004
NEW: CDC PUBLISHES "RECOMMENDED CHILDHOOD AND ADOLESCENT IMMUNIZATION SCHEDULE--UNITED STATES, JULY-DECEMBER 2004"

CDC published "Recommended Childhood and Adolescent Immunization Schedule--United States, July-December 2004" in the April 30 issue of "MMWR Quick Guide." This schedule updates one that was published on January 16, which pertained to January-June 2004. The preface to the July-December 2004 schedule is reprinted below in its entirety, with the exception of references.

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CDC's Advisory Committee on Immunization Practices (ACIP) periodically reviews the recommended childhood and adolescent immunization schedule to ensure that the schedule is current with changes in manufacturers' vaccine formulations and reflects revised recommendations for the use of licensed vaccines, including those newly licensed. Recommendations and format of the childhood and adolescent immunization schedule for January–June 2004 were approved by ACIP, the American Academy of Family Physicians (AAFP), and the American Academy of Pediatrics (AAP) and published in January 2004. This report updates that schedule with the recommendation that, beginning in fall 2004, children aged 6–23 months, as well as household and out-of-home caregivers for such children, receive annual influenza vaccine. This change is reflected in the revised childhood and adolescent immunization schedule for July–December 2004. A catch-up immunization schedule for children and adolescents who start late or who are >1 month behind remains unchanged from that published in January 2004.

Changes in the Schedule for July–December 2004
The childhood and adolescent immunization schedule for July–December 2004 differs from the previous schedule in the following ways:

  • The range of recommendations bar for influenza vaccine for children aged 6-23 months has been moved above the dotted red line, indicating that these children should be vaccinated annually.
     
  • The influenza vaccine footnote has been updated to highlight the recommendation that healthy children aged 6-23 months and close contacts of healthy children aged 0-23 months receive influenza vaccine because children in this age group are at substantially increased risk for influenza related hospitalizations.
     
  • The influenza vaccine footnote has been updated to highlight the recommendation that health-care workers and other persons (including household members) in close contact with persons in groups at high risk be vaccinated annually.

Vaccine Information Statements
The National Childhood Vaccine Injury Act requires that all health-care providers provide parents or patients with copies of Vaccine Information Statements before administering each dose of the vaccines listed in the schedule. Additional information is available from state health departments and at http://www.cdc.gov/nip/publications/vis

Detailed recommendations for using vaccines are available from the manufacturers' package inserts, ACIP statements on specific vaccines, and the 2003 Red Book. ACIP statements for each recommended childhood vaccine can be viewed, downloaded, and printed from CDC's National Immunization Program website at http://www.cdc.gov/nip/publications/acip-list.htm Instructions on the use of Vaccine Information Statements are available at http://www.cdc.gov/nip/publications/vis/vis-instructions.pdf In addition, guidance on how to obtain and complete a Vaccine Adverse Event Reporting System (VAERS) form is available at http://www.vaers.org or by telephone, (800) 822-7967.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5316-Immunizationa1.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5316.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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May 3, 2004
NEW: CDC ISSUES THE LATEST ACIP INFLUENZA RECOMMENDATIONS IN AN "MMWR EARLY RELEASE"

On April 30, CDC issued "Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)" as an electronic "MMWR Early Release." A hard copy of the recommendations will be printed in a future issue of MMWR.

Two sections of the recommendations are reprinted below: (1) the "Summary" and (2) a portion of the introduction titled "Primary Changes and Updates in the Recommendations."

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Summary

This report updates the 2003 recommendations by the Advisory Committee on Immunization Practices (ACIP) on the use of influenza vaccine and antiviral agents (CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2003;52[No. RR-8]:1-34). The 2004 recommendations include new or updated information regarding (1) influenza vaccine for children aged 6-23 months; (2) vaccination of health care workers with live, attenuated influenza vaccine (LAIV); (3) personnel who may administer LAIV; (4) the 2004-05 trivalent inactivated vaccine virus strains: A/Fujian/411/2002 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like, and B/Shanghai/361/2002-like antigens (for the A/Fujian/411/2002 (H3N2)-like antigen, manufacturers may use the antigenically equivalent A/Wyoming/3/2003 [H3N2] virus, and for the B/Shanghai/361/2002-like antigen, manufacturers may use the antigenically equivalent B/Jilin/20/2003 virus or B/Jiangsu/10/2003 virus); and (5) the assessment of vaccine supply and timing of influenza vaccination. A link to this report and other information regarding influenza can be accessed at http://www.cdc.gov/flu . . . .

[From the Introduction]
Primary Changes and Updates in the Recommendations

The 2004 recommendations include four principal changes or updates:

  1. ACIP recommends that healthy children aged 6-23 months, and close contacts of children aged 0-23 months, be vaccinated against influenza . . .
     
  2. Inactivated vaccine is preferred over live, attenuated influenza vaccine (LAIV) for vaccinating household members, health care workers, and others who have close contact with severely immunosuppressed persons during periods when such persons require care in a protected environment. If a health care worker receives LAIV, the health care worker should refrain from contact with severely immunosuppressed patients for 7 days after vaccine receipt. No preference exists for inactivated vaccine use by health care workers or other persons who have close contact with persons with lesser degrees of immunosuppression . . .
     
  3. Severely immunosuppressed persons should not administer LAIV. However, other persons at high risk for influenza complications may administer LAIV . . .
     
  4. The 2004-05 trivalent vaccine virus strains are A/Fujian/411/2002 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like, and B/Shanghai/361/2002-like antigens. For the A/Fujian/411/2002 (H3N2)-like antigen, manufacturers may use the antigenically equivalent A/Wyoming/3/2003 [H3N2] virus, and for the B/Shanghai/361/2002-like antigen, manufacturers may use the antigenically equivalent B/Jilin/20/2003 virus or B/Jiangsu/10/2003 virus . . .
     
  5. CDC and other agencies will assess the vaccine supply throughout the manufacturing period and will make recommendations in the summer preceding the 2004-05 influenza season regarding the need for tiered timing of vaccination of different risk groups. . . .

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To access a web-text (HTML) version of the recommendations, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr53e430a1.htm

To access a ready-to-copy (PDF) version, go to:
http://www.cdc.gov/mmwr/pdf/rr/rr53e430.pdf
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May 3, 2004
NEW: IAC'S COMPREHENSIVE GUIDE TO ADULT IMMUNIZATION IS NOW AVAILABLE FOR ORDER

In production for more than three years, "Adults Only Vaccination: A Step-by-Step Guide" is ready to take its place on your bookshelf alongside such indispensable resources as CDC's "Pink Book" and AAP's "Red Book." Designed to help integrate immunization services into settings new to adult vaccination, the guide is equally valuable for use in settings experienced in vaccine delivery to adult and pediatric patients alike.

Developed by IAC staff, the 157-page spiral-bound guide has been thoroughly reviewed for technical accuracy by immunization experts from CDC. In addition, the introductory letter has been signed by heads of four divisions at CDC, Department of Health and Human Services (Women's Health), American Medical Association, National Medical Association, American College of Obstetricians & Gynecologists, American College Health Association, and Planned Parenthood Federation of America.

CONTENTS OF THE GUIDE AND ACCOMPANYING TOOLS
The guide. Divided into seven chapters, the guide presents practical information on getting started, setting up vaccination services, handling and storing vaccines, deciding whom to vaccinate, administering vaccines, documenting vaccination delivery, and financing vaccine services. In addition, the guide's two appendices include approximately 50 educational tools for providers and patients; these will never go out of date because each is actively linked to the most current version on IAC's website.

Accompanying tools. Packaged as a kit, the guide comes with two videos, a pack of 25 adult immunization record cards, and other useful clinic materials. The videos, "How to Protect Your Vaccine Supply" (25 minutes long, produced by CDC in 2004) and "Immunization Techniques: Safe, Effective, Caring" (35 minutes long, produced by California Department of Health Services in 2001), present comprehensive, easy-to-follow information and make valuable viewing for beginners and seasoned professionals alike. The adult immunization record cards give patients helpful information about vaccines commonly given to adults and remind them of their next vaccination due dates.

ADDITIONAL INFORMATION, PRICE, AND ORDERING METHODS
For additional information about the kit (including access to a ready-to-copy [PDF] version of the guide), pricing (including discounts for orders of more than nine kits), and ordering methods, go to: http://www.immunize.org/guide
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May 3, 2004
APRIL ISSUE OF CDC'S "IMMUNIZATION WORKS!" ELECTRONIC NEWSLETTER IS NOW POSTED ON THE NIP WEBSITE

The April issue of "Immunization Works!" a monthly email newsletter published by CDC, is available on NIP's website. 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 April issue has already appeared in previous issues of "IAC EXPRESS." Following is the text of five articles we have not covered.

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CDC FUTURES INITIATIVE UPDATE: CDC continues with its Futures Initiative, a program to better organize and align CDC's structure and processes to meet CDC public health goals. Based on input from within CDC and from outside partners, CDC has determined that we can achieve many of our priorities by retaining the best elements of the current structure, while enhancing our ability to address our strategic imperatives. Agency-wide priorities and goals will drive CDC, and elements of CDC's organizational structure will be designed to support the functions needed to achieve agency goals. For example, CDC will create an organizational unit dedicated to agency-wide strategy and goal development. Specific goals that related both to preparedness and to health promotion and prevention throughout the lifespan are being developed. CDC's partners, current and future, are critical to achieving our public health goals and to delivering our products. Government public health--federal, state, and local health agencies--will continue to be the backbone of the public health system. For more information on the Futures Initiative, visit www.cdc.gov/futures

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NATIONAL MINORITY ORGANIZATIONS IMMUNIZATION PROJECTS: CDC has made available funding to assist national minority organizations with the promotion and improvement of childhood, adolescent, and adult immunization coverage levels among racial and ethnic minorities. Letters of Intent are due May 24, 2004, the application deadline is June 21, 2004, and expected funding will be around August 1, 2004. For a copy of the announcement, visit www.cdc.gov/od/pgo/funding/04051.htm

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REQUEST FOR PROPOSAL FOR IMMUNIZATION COALITION TECHNICAL ASSISTANCE AND TRAINING: The CDC announces the availability of fiscal year 2004 funds for a cooperative agreement program for technical assistance and training for immunization coalitions and immunization information dissemination. The purpose of the program is to provide support for immunization coalitions and for the dissemination of immunization information to enhance the effectiveness of disease prevention programs that reduce the annual burden of vaccine preventable diseases. The complete program announcement was published in the Federal Register, March 4, 2004, Volume 69, No. 43, Page 10233. It can also be accessed at http://www.access.gpo.gov/su_docs/fedreg/frcont04.html Click on Thursday, March 4, scroll down to CDC, and select TEXT or PDF version. Application materials can be found on CDC's funding website at http://www.cdc.gov/od/pgo/funding/grantmain.htm The application deadline is May 3.

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FREE CMES AVAILABLE RELATED TO THE VACCINE ADVERSE EVENT REPORTING SYSTEM (VAERS): Health care providers may access the "Vaccine Safety Post-Marketing Surveillance: The Vaccine Adverse Event Reporting System" with free CMEs through September 19, 2004. To access the CME article, visit http://www.cdc.gov/nip/vacsafe/VAERS/CME-post-mktg-surv.htm Additional information related to VAERS is available at www.vaers.org

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2004 HHS GRANT OPPORTUNITIES NOTEBOOK: The U.S. Department of Health and Human Services Center for Faith-Based and Community Initiatives in partnership with other HHS agencies has developed a guide to this year's federal funding opportunities for faith-based and community organizations across the U.S. Included in the notebook is grant information in the following areas: At-Risk Children and Youth, Economic Development, Health, Substance Abuse, and significant Block and Formula Grants. Also included is information on the Compassion Capital Fund, how to be a grant reviewer, how to make a Freedom of Information request, and web resources for organizations interested in federal funding. The notebook is downloadable in PDF format at www.hhs.gov/fbci

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To access the complete April issue from the NIP website, go to: http://www.cdc.gov/nip/news/newsltrs/imwrks/2004/200404.htm
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May 3, 2003
CDC ISSUES "SUMMARY OF NOTIFIABLE DISEASES--UNITED STATES, 2002"

The Centers for Disease Control and Prevention (CDC) published "Summary of Notifiable Diseases--United States, 2002" in the April 30, "MMWR Summary of Notifiable Diseases."

The 88-page summary has three primary sections: Part 1: Summaries of Notifiable Diseases in the United States; Part 2: Graphs and Maps for Selected Notifiable Diseases in the United States; and Part 3: Historical Summaries of Notifiable Diseases in the United States, 1971-2002. The opening paragraph of the preface follows:

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The "Summary of Notifiable Diseases, United States, 2002" contains the official statistics, in tabular and graphic form, for the reported occurrence of nationally notifiable diseases in the United States for 2002. The data are final totals for 2002 reported as of June 30, 2003, unless otherwise noted. These statistics are collected and compiled from reports sent by state health departments to the National Notifiable Diseases Surveillance System (NNDSS), which is operated by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE).

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To obtain a web-text (HTML) version of the summary online, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5153a1.htm

Because the summary is a large file (2.30 MB), printing problems may occur because of printer memory size. One solution is to print a few pages at a time. To access more tips on downloading and printing large PDF files, go to:
http://www.immunize.org/nslt.d/tips.htm

To obtain a ready-to-copy (PDF) version, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5153.pdf
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May 3, 2004
NATIONAL CONFERENCE ON IMMUNIZATION COALITIONS SCHEDULED FOR SEPTEMBER 20-22 IN NORFOLK, VA

Hosted by the Center for Pediatric Research, a program of Children's Hospital of the King's Daughters, and Eastern Virginia Medical School, the National Conference on Immunization Coalitions will be held September 20-22 in Norfolk, VA.

Intended to provide training in creating, leading, and sustaining effective local and state coalitions that address childhood, adolescent, and adult immunization, the conference will bring together more than 400 attendees from immunization coalitions across the nation. This year's program will focus on coalitions as agents of social change, elements of a successful coalition, and social and ethnic diversity in coalitions.

For information, go to: http://www.cme.hsc.usf.edu/coph/immcoal

Contact Annemarie Beardsworth with questions about content by email at annemarieb@doh.state.ri.us or by phone at (401) 222-5658. Contact Tracey Ryan with questions about logistics by email at tryan@hsc.usf.edu or by phone at (813) 974-6682.
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May 3, 2004
IOM WORKSHOP ON PANDEMIC INFLUENZA TO BE HELD JUNE 16-17 IN WASHINGTON, DC

The Institute of Medicine (IOM) will hold the workshop "Pandemic Influenza: Steps toward Prevention and Response" on June 16-17 in Washington, DC. An agenda will be available on the IOM website in the near future.

To register, go to: http://www.iom.edu/event.asp?id=19995

For additional information, contact Laura Sivitz by email at Lsivitz@nas.edu or by phone at (202) 334-3826.
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May 3, 2004
CDC REPORTS ON PROGRESS TOWARD POLIO ERADICATION IN NIGERIA

CDC published "Progress Toward Poliomyelitis Eradication--Nigeria, January 2003-March 2004" in the April 30 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

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The suspension of polio immunization campaigns in key northern states in Nigeria has resulted in previously polio-free states in Nigeria and nine previously polio-free countries in Africa to be re-infected with the disease. If the goal of polio eradication is to be achieved, it is essential that Kano State, along with all other states in Nigeria, participate fully in polio immunization campaigns and vaccinate all target-aged children against polio.

After gains toward polio eradication during 1996-2002, Nigeria suffered a resurgence of wild polio virus transmission due to the suspension of vaccination campaigns in several northern states, particularly Kano, in fall 2003. This resurgence resulted in the reintroduction of wild polio virus into previously polio-free Nigerian states and the exportation of the virus to nine polio-free countries in Africa (Benin, Botswana, Burkina Faso, Cameroon, the Central African Republic, Chad, Ghana, Ivory Coast, and Togo). To address this outbreak, Nigeria and its polio partner agencies have endorsed a strategic plan that proposes conducting six supplementary polio immunization campaigns in all states with endemic disease by December 2004.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5316a3.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5316.pdf

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