Issue Number 530            June 6, 2005

CONTENTS OF THIS ISSUE

  1. The May 2005 issue of "Vaccinate Adults" is in the mail and on the Web
  2. AAP endorses new meningococcal vaccine guidelines
  3. New: AAP's "Red Book Online" now tracks new vaccines' licensure and recommendation status
  4. Recent journal articles discuss pertussis in adults and parents who refuse immunization for their children
  5. Plan ahead: Online resources are now available for promoting National Immunization Awareness Month
  6. CDC reports on Colorado's surveillance of influenza-associated hospitalizations during 2004-05
  7. New: Partnership for Prevention publishes its report on strengthening adult immunization
  8. New VIS translation: IAC posts MMR vaccine VIS in Ilokano

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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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June 6, 2005
THE MAY 2005 ISSUE OF "VACCINATE ADULTS" IS IN THE MAIL AND ON THE WEB

IAC recently mailed the latest issue of "Vaccinate Adults" (May 2005) to 130,000 adult medicine specialists and others who work in the field of immunization. Packed with immunization resources for health professionals and patients, the 12-page issue is well worth downloading. All articles and education pieces, except editorials, have been thoroughly reviewed by immunization and hepatitis experts at CDC.

HOW TO READ "VACCINATE ADULTS" ON THE WEB
You can view selected articles from the table of contents below or download the entire issue from the Web.

To view the table of contents with links to individual articles, go to: http://www.immunize.org/va.

The PDF file of the entire issue, linked below, is large at 526,246 bytes. Some printers cannot print such a large file. For tips on downloading and printing PDF files, go to:
http://www.immunize.org/nslt.d/tips.htm.

To download a ready-to-print (PDF) version of the May issue, go to: http://www.immunize.org/va/va15.pdf.

Below are descriptions of articles published in the May issue, followed by links:


GENERAL IMMUNIZATION INFORMATION (three articles)
(1) In "Ask the Experts--Immunization Questions," CDC specialists answer questions about the newly licensed meningococcal conjugate vaccine, as well as questions about hepatitis B disease and vaccine.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/va/va15exprt.pdf.

To access a web-text (HTML) version, go to:
http://www.immunize.org/va/va15exprt.htm.

(2) "Vaccine Highlights" presents information on new vaccines that protect against meningococcal disease and tetanus-diphtheria-pertussis; it also gives the rates for 2003 adult vaccination with influenza and pneumococcal (PPV23) vaccines.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/va/va15vacc.pdf.

To access a web-text (HTML) version, go to:
http://www.immunize.org/va/va15vacc.htm.

(3) "Vaccine Storage and Handling" presents links to four online IAC resources.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/va/vaccinestorage.pdf.

No web-text (HTML) version is available.


VIRAL HEPATITIS INFORMATION (one article)
(1) "Hepatitis B Virus Transmitted in U.S. Long-Term-Care Facilities" is reprinted from an article published in MMWR on March 11, 2005.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/va/hepb_ltc.pdf.

To access a web-text (HTML) version of the article as published in MMWR, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5409a2.htm.


ADULT IMMUNIZATION RESOURCES (one article)
(1) Updated in May, "Pneumococcal polysaccharide vaccine (PPV23): CDC answers your questions" presents the latest information about pneumococcal disease and PPV23 administration.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/2015pne.pdf.

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/2015pne.htm.
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June 6, 2005
AAP ENDORSES NEW MENINGOCOCCAL VACCINE GUIDELINES

On May 25, AAP announced that it has released a policy statement endorsing the new ACIP recommendations concerning prevention and control of meningococcal disease. The ACIP recommendations call for routine use of the newly licensed quadrivalent meningococcal vaccine (MCV4) to vaccinate groups at high risk of contracting the disease. Portions of the announcement are reprinted below.

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The American Academy of Pediatrics (AAP) has released a new policy statement recommending routine meningococcal vaccination for certain age groups. The guidelines call for the quadrivalent meningococcal vaccine (MCV4) for

  • Young adolescents (11-12 years of age)
  • Adolescents at high school entry or 15 years of age (whichever comes first) for those who have not previously been vaccinated
  • All college freshmen living in dormitories
  • Other groups at high risk such as those with underlying medical conditions or travelers to areas with high rates of meningococcal disease

The recommendations will help prevent meningococcal disease, a potentially fatal bacterial infection. Although rare, meningococcal disease is dangerous because the disease progresses rapidly, and within hours of the onset of symptoms it may cause permanent disability or death. . . .

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To access the complete announcement, go to:
http://www.aap.org/advocacy/releases/may05mv.htm.

To access the AAP policy statement, go to:
http://www.aap.org/advocacy/releases/mengpolicyfinal.pdf.

To access a ready-to-print (PDF) version of the ACIP meningococcal recommendations, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5407.pdf.

To access a web-text (HTML) version, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5407a1.htm.
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June 6, 2005
NEW: AAP'S "RED BOOK ONLINE" NOW TRACKS NEW VACCINES' LICENSURE AND RECOMMENDATION STATUS

AAP recently announced that it has added a new information page to its publication "Red Book Online." The page, formatted as a table, tracks the status of licensure and recommendations for new vaccines. The table's content is based on information from vaccine manufacturers, ACIP meetings, and AAP. It will be updated as changes occur.

To access a ready-to-print (PDF) version of the table, go to:
http://aapredbook.aappublications.org/news/vaccstatus.pdf.

To access a web-text (HTML) version, go to:
http://aapredbook.aappublications.org/news/vaccstatus.shtml.
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June 6, 2005
RECENT JOURNAL ARTICLES DISCUSS PERTUSSIS IN ADULTS AND PARENTS WHO REFUSE IMMUNIZATION FOR THEIR CHILDREN

In May, two journal articles were published that will be of interest to health professionals who treat adults with prolonged coughing or who see children whose parents refuse vaccination. On May 17, the Annals of Internal Medicine published "Adults are whooping, but are internists listening?" by Mark Dworkin, MD, MPH, TM. In May, Pediatrics published an AAP clinical report, "Responding to parental refusals of immunization to children," by Douglas S. Diekema, MD, MPH, and AAP's Committee on Bioethics. Abstracts for both articles follow.

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"Adults are whooping, but are internists listening?"
(Source: Annals of Internal Medicine, May 17, 2005, Vol.142[10]:832-835)

Abstract. Although studies have shown that pertussis is responsible for approximately 20% to 30% of cases of cough lasting more than 2 weeks in adults and adolescents, physicians have generally considered pertussis a disease that affects only children. Epidemiologic trends demonstrate that the incidence of pertussis has been rising, especially in adolescents and adults. Consequently, pertussis is not a "zebra" diagnosis but deserves a place among the community-acquired list of adult pathogens. Increased awareness among physicians about pertussis is important because adults may transmit the infection to infants, in whom the disease often leads to hospitalization and may result in death. Reporting this disease to the local health department is critical to its control because both case-patients and their close contacts should receive antimicrobial prophylaxis. A booster vaccine for adolescents and adults is likely to become available in the near future, so this is an important time to ensure that all physicians, not just pediatricians, are knowledgeable about the diagnosis, treatment, and reporting requirements for pertussis.

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The full article is available only to subscribers to the Annals of Internal Medicine. To access the abstract, go to: http://www.annals.org/cgi/content/abstract/142/10/832.


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"Responding to parental refusals of immunization of children"
(Source: Pediatrics, May 2005, Vol.115[5]:1428-1431)

Abstract. The American Academy of Pediatrics strongly endorses universal immunization. However, for childhood immunization programs to be successful, parents must comply with immunization recommendations. The problem of parental refusal of immunization for children is an important one for pediatricians. The goal of this report is to assist pediatricians in understanding the reasons parents may have for refusing to immunize their children, review the limited circumstances under which parental refusals should be referred to child protective services agencies or public health authorities, and provide practical guidance to assist the pediatrician faced with a parent who is reluctant to allow immunization of his or her child.

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To access the full article, go to:
http://pediatrics.aappublications.org/cgi/content/full/115/5/1428
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June 6, 2005
PLAN AHEAD: ONLINE RESOURCES ARE NOW AVAILABLE FOR PROMOTING NATIONAL IMMUNIZATION AWARENESS MONTH

August is National Immunization Awareness Month (NIAM). CDC's National Immunization Program and the National Partnership for Immunization have recently posted an array of promotional materials pertaining to NIAM on their websites. Use them during August to promote immunization across the lifespan in your community.

MATERIALS FROM CDC'S NATIONAL IMMUNIZATION PROGRAM (NIP)
NIP has created a web section of 2005 NIAM materials, including resources such as the immunization schedules for adults, adolescents, and children and the NIP publication "Parents Guide to Childhood Immunization."

To access the NIAM web section, go to:
http://www.cdc.gov/nip/events/niam/default.htm.

MATERIALS FROM THE NATIONAL PARTNERSHIP FOR IMMUNIZATION (NPI)
NPI's page of promotional materials contains a variety of samples that you can adapt to publicize NIAM through the news media in your community. These include sample letters to the editor, press releases, talking points, and more.

To access them, go to:
http://www.partnersforimmunization.org/niam.html.

The NPI site also offers patient-education materials such as brochures, bookmarks, stickers, and posters.

To access them, go to:
http://www.partnersforimmunization.org/niam_prkit.html.
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June 6, 2005
CDC REPORTS ON COLORADO'S SURVEILLANCE OF INFLUENZA-ASSOCIATED HOSPITALIZATIONS DURING 2004-05

CDC published "Surveillance for Laboratory-Confirmed, Influenza-Associated Hospitalizations--Colorado, 2004-05 Influenza Season" in the June 3 issue of MMWR. Portions of the article are reprinted below.

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[From the article text]
The number of annual hospitalizations for influenza and pneumonia associated with influenza viruses in the United States is estimated at 95,000; however, no state-based or national surveillance system exists to monitor these events in all age groups, and population-based numbers of laboratory-confirmed, influenza hospitalizations are unknown. Certain existing surveillance systems provide population-based national estimates of influenza-related hospitalizations based on sampling methodology (i.e., the National Hospital Discharge Survey) or sentinel surveillance; however, these systems are not timely, population-based for all ages, and available at the state level. . . . The U.S. Department of Health and Human Services recommends that states develop strategies to monitor influenza-related hospitalizations. This report describes a surveillance system for laboratory-confirmed, influenza-associated hospitalizations in all age groups in Colorado that was implemented for the 2004-05 influenza season. The findings indicate that implementation of statewide, population-based surveillance for influenza-associated hospitalizations is feasible and useful for assessing the age-specific burden of serious influenza-associated morbidity and the relative severity of influenza seasons.

On September 30, 2004, influenza-associated hospitalizations became a condition reportable by Colorado healthcare providers. An influenza-associated hospitalization was defined for surveillance purposes as a hospital admission accompanied by an appropriate laboratory test result for influenza, including results from rapid diagnostic tests. Population estimates for 2003 (overall 4.6 million) by age group were obtained from the Colorado Department of Local Affairs and used to compute annual age-specific rates of influenza-associated hospitalization. Case reports of influenza-associated hospitalization contained the same core variables that are collected for all reportable diseases in Colorado, including patient identifying, locating, and demographic information; name of reporting agency; physician name and contact information; specimen collection date, specimen type, and test type; test result and date, and report date. . . .

As of April 16, 2005, a total of 964 influenza-associated hospitalizations had been reported by 50 hospitals, producing a rate of 21.0 per 100,000 persons during the 2004-05 influenza season. Reported cases peaked during the week ending February 19, 2005, which was also the peak week for the percentage of patient visits for ILI [influenza-like illness] reported by sentinel healthcare providers in Colorado. Influenza virus type-specific testing results were available for 896 (92.9%) reported cases, of which 86.3% were influenza A and 13.7% were influenza B. The most frequently reported test type was rapid influenza testing (88.0%), followed by direct fluorescent antibody (5.8%) and viral culture (5.6%). The highest influenza-associated hospitalization rates were in persons aged >=80 years (207.3 per 100,000 population) and children aged <6 months (183.0 per 100,000), followed by persons aged 70-79 years (78.0 per 100,000) and children aged 6-23 months (66.3 per 100,000). Persons aged >=60 years accounted for 51.4% of reported cases. . . .

[From the Editorial Note]
Surveillance for influenza-associated hospitalizations can provide multiple benefits to Colorado and other states that might adopt similar systems. The system provides improved ability to assess the severity of influenza seasons, track the time course of the season, determine which populations are most affected by severe influenza-related illness, and focus prevention and control efforts on those populations.

A national surveillance system similar to the one implemented in Colorado could provide data to (1) monitor and describe the incidence, distribution, and basic epidemiologic characteristics of hospitalizations related to influenza virus infection; (2) guide future influenza immunization policy (e.g., expansion of immunization recommendations for children); (3) rapidly recognize influenza seasons in which the number of hospitalizations appears unusually high; and (4) help identify an influenza pandemic and direct public health response. The recent development and widespread use of rapid influenza testing makes it feasible and desirable to use case reporting based on positive laboratory testing to monitor influenza-associated hospitalizations.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5421a3.htm.

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5421.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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June 6, 2005
NEW: PARTNERSHIP FOR PREVENTION PUBLISHES ITS REPORT ON STRENGTHENING ADULT IMMUNIZATION

In February, the Partnership for Prevention convened a panel of experts to identify feasible policies for reducing VPDs among U.S. adults by increasing adult vaccination rates. The result was a 24-page report, "Strengthening Adult Immunization: A Call to Action," published in April. The report presents six actions the federal government should take to increase adult immunization rates.

To access the full report, go to:
http://www.prevent.org/docs/CalltoAction.pdf.

To access the two-page report summary, go to:
http://www.prevent.org/docs/CalltoActionSummary.pdf.
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June 6, 2005
NEW VIS TRANSLATION: IAC POSTS MMR VACCINE VIS IN ILOKANO

Dated 1/15/03, the current version of the VIS for measles-mumps-rubella (MMR) vaccine is now available on the IAC website in Ilokano. IAC gratefully acknowledges the Hawai'i Department of Health for the translation.

To obtain a ready-to-copy (PDF) version of the VIS for MMR in Ilokano, go to: http://www.immunize.org/vis/il_mmr03.pdf.

To obtain it in English, go to:
http://www.immunize.org/vis/mmr03.pdf.

For information about the use of VISs, and for VISs in a total of 33 languages, visit IAC's VIS web section at http://www.immunize.org/vis.

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Editorial Information

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

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