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Issue Number 118            October 11, 1999


  1. CDC publishes article about influenza activity worldwide
  2. CDC publishes article on reasons Medicare beneficiaries miss vaccinations
  3. FDA publishes information sheet on Influenza Virus Vaccine on the Web
  4. Spanish language influenza education materials available from NCAI
  5. CDC announces International Infection Control Week, October 17-23, 1999
  6. Immunization Action Coalition's offer of free adult immunization posters has ended


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October 8, 1999

The Centers for Disease Control and Prevention (CDC) published "Update: Influenza Activity -- Worldwide, May-September 1999" in the October 8, 1999, issue of the MMWR. 

This article details worldwide influenza activity by region during May-September 1999 and includes information collected from May-August 1999 on circulating strains of the influenza virus. The article's "Editorial Note"  addresses influenza immunization and treatment, and is reprinted in part as follows:

"Annual influenza vaccination is recommended for persons aged greater than or equal to 65 years, persons residing in nursing homes or long-term-care  facilities, anyone aged 6 months-64 years with certain chronic medical conditions such as heart or lung disease (including asthma); diabetes; renal  insufficiency; hemoglobinopathies; immunocompromising illnesses or conditions requiring the use of immunosuppressive medications; and children and adolescents aged 6 months-18 years receiving long-term aspirin therapy who may be at risk for developing Reye syndrome after influenza. Health-care providers, family members, and others in close contact with high-risk persons should be vaccinated to diminish virus transmission. Serious complications from influenza include pneumonia and worsening of underlying medical conditions and have resulted in an average of approximately 110,000 hospitalizations and 20,000 deaths annually in the United States.

"Pregnant women with high-risk medical conditions should be vaccinated before the start of the influenza season regardless of their stage of pregnancy. Pregnant women without high-risk medical conditions, but who will be in their second or third trimester during the influenza season, are at elevated risk of complications and should be vaccinated. Some experts prefer to vaccinate these women during the second trimester to avoid a coincidental association with spontaneous abortion, which is common in the first trimester, and because exposures to vaccines traditionally have been avoided during the first trimester.

"In the United States, the optimal time for organized influenza vaccination campaigns is October through mid-November; however, after mid-November, health-care providers should continue to offer influenza vaccine to high-risk unvaccinated persons throughout the influenza season even after influenza activity has begun in the community. The timing of influenza activity varies from year to year, and local influenza surveillance reports can be useful for determining when influenza viruses are in local circulation.

"Although vaccination against influenza is the most effective method of reducing the impact of influenza, antiviral agents provide a useful adjunct. Amantadine and rimantadine are approved for the prophylaxis or treatment of influenza type A but neither is effective against influenza type B viruses. Zanamivir, an orally inhaled neuraminidase inhibitor drug, was approved by the Food and Drug Administration in July 1999 to treat uncomplicated influenza A and B infections.

"Information about influenza surveillance and vaccination is available through the toll-free CDC Voice Information System, telephone (888) 232-3228, fax (888) 232-3299 (document no. 361100), or through CDC's World-Wide Web  site, From October through May, information is updated weekly."

To obtain a text version (HTML format) of this MMWR article, visit:

To obtain the 1999-2000 Influenza Vaccine Information Statement (VIS) in English, as well as in Cambodian, Hmong, Laotian, Russian, Somali, Spanish, and Vietnamese, go to the Immunization Action Coalition's website at: VISs are also available from your state health department. For a list of state immunization coordinator phone numbers, visit:

Looking for a checklist to remind you about who should receive influenza vaccine? The Immunization Action Coalition has developed just such a checklist entitled "Give These People Influenza Vaccine!"
For a camera-ready copy (PDF format), visit:
To obtain this document in text version (HTML format), go to:

For information on how to obtain a free electronic subscription to the MMWR, see the instructions that follow article five below.

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October 8, 1999

The Centers for Disease Control and Prevention (CDC) published a study entitled "Reasons Reported by Medicare Beneficiaries for Not Receiving Influenza and Pneumococcal Vaccination -- United States, 1996" in the October 8, 1999, issue of the MMWR.

According to the report, "In 1997, 65% of adults aged greater than or equal to 65 years reported receiving influenza vaccination during the previous 12 months and 45% reported ever receiving pneumococcal vaccination."

The findings of this study indicate that those who had not received influenza vaccine were not aware that they needed influenza vaccination and/or had misconceptions about its safety and efficacy. Most persons who had never received pneumococcal vaccination did not think they needed it. In addition, the study found that "physicians miss opportunities to vaccinate older persons during office visits."

The article's "Editorial Note" states, "The reasons reported by this national sample of Medicare beneficiaries for not receiving influenza or pneumococcal vaccination were consistent with previously reported data that indicated a lack of knowledge, misconceptions about vaccines and vaccine-associated illnesses, and lack of recommendations from physicians. In 1996, lack of knowledge and lack of physician recommendations were the predominant reasons cited by Medicare beneficiaries for not receiving pneumococcal vaccination; 57% of beneficiaries who reported not receiving pneumococcal vaccination, i.e., 31% of the total 1996 Medicare population aged greater than or equal to 65 years, were unaware that this vaccination was recommended.

"Because physicians provide the greatest proportion of vaccinations to Medicare beneficiaries (Health Care Financing Administration, unpublished data, 1999), the 26% of beneficiaries who received influenza but not  pneumococcal vaccination indicates that physicians miss opportunities to vaccinate older persons during office visits. Because physicians' recommendations for influenza and pneumococcal vaccination are accepted by patients even when they have negative perceptions about the vaccinations, health-care providers should include patient education with vaccination recommendations during scheduled appointments."

To read the full text version (HTML format) of this report, go to:

For information on how to obtain a free electronic subscription to the MMWR, see the instructions that follow article five below.

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October 11, 1999

Now available on the website of the U.S. Food and Drug Administration (FDA), is an information sheet which describes the yearly process of developing influenza vaccine and provides some information about this year's influenza vaccine lots.

The information sheet entitled "Availability of Influenza Virus Vaccine - 1999" can be found on the FDA's Center for Biologics Evaluation and Research (CBER) website at:

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October 11, 1999

"Help Prevent Influenza" and "Get a Flu Shot Every Year" are the messages highlighted in a Spanish language influenza poster and brochure developed by the National Coalition for Adult Immunization (NCAI) and the National Foundation for Infectious Diseases. A useful resource for the office,  pharmacy or other health care setting, the materials are designed for Spanish-speaking populations and emphasize the importance of yearly vaccination against influenza. Topics covered in these materials are the symptoms of influenza,vaccine safety, and recommendations for vaccine use.

You can order one sample set of these influenza educational materials at no charge. The poster costs $11.50/10 copies. The brochure costs $13.50/50 copies. Allow 4 weeks for delivery.

For more information about these materials and/or to request an order form, call NCAI at (301) 656-0003 or send a fax to (301) 907-0878 or send an e-mail to:

The order form for the materials is also available on NCAI's website at: (link discontinued)

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October 8, 1999 

The Centers for Disease Control and Prevention (CDC) issued a "Notice to Readers" entitled "International Infection Control Week -- October 17-23, 1999" in the October 8, 1999, issue of the MMWR. The notice reads as  follows: 

"Each year, approximately 2 million health-care-associated infections occur in the United States. As many as one third of these infections is preventable, but prevention requires vigilance on the part of the entire health-care team. International Infection Control Week (October 17-23), observed by health-care facilities around the world, is intended to heighten public awareness of and professional commitment to, infection control. During the fall and winter months, infection-control professionals worldwide emphasize efforts to vaccinate persons against diseases such as influenza and pneumonia while confronting antimicrobial resistance in pathogens and emerging pathogens in the health-care setting. The Association for Professionals in Infection Control and Epidemiology has created an Infection Control Week Resource Kit addressing issues such as needlestick injuries, vaccinations, food safety, Lyme disease, and sexually transmitted diseases.  This free kit is available on the World-Wide Web at Information about health-care-associated diseases also is available on the website of CDC's Hospital Infections Program, National Center for Infectious Diseases, at

A text version (HTML format) of this notice can be found at:

HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR To obtain a free electronic subscription to the MMWR (delivered weekly), go to the MMWR website and sign up. When you sign up, you will automatically begin to receive all new ACIP statements which are published as MMWR's  "Recommendations and Reports." To go to the MMWR website, click here:

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October 11, 1999

Thank you to everyone who responded to the Immunization Action Coalition's offer of free "Immunization...Not Just Kids' Stuff" posters. Once again, we've had a deluge of requests. To ensure that we have enough posters to fill  existing orders, we must close the offer, effective today, Monday, October 11, 1999 at 5:00pm (Central Time). However, the posters are still available from IAC's catalog (Item #Q2020) and cost $1 for 10 posters. To obtain a copy of  IAC's catalog, visit:

Please watch IAC EXPRESS for future resource "giveaways" like this one. The Coalition will continue to announce free resources in upcoming months.

Happy Adult Immunization Awareness Week!

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 and do not necessarily represent the official views of CDC.

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ISSN 2771-8085

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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