Issue Number 493            November 22, 2004


  1. November 22 is the day for CDC's audio conference about influenza vaccine and antivirals for persons with HIV/AIDS
  2. New: CDC issues adult immunization schedule for October 2004-September 2005
  3. New: November issue of the Immunization Works electronic newsletter now available on CDC's website
  4. New: CDC revises VIS for yellow fever
  5. New VIS translation: Spanish version of the supplement to the inactivated influenza vaccine VIS now on IAC's website
  6. Updated: CDC continues to supplement its website with information related to the influenza vaccine shortage
  7. New: November issue of HEP EXPRESS electronic newsletter now available on IAC's website
  8. Updated: IAC revises two hepatitis-related education pieces
  9. Updated: IAC revises its parent-education brochure "Questions parents ask about baby shots"
  10. BEFORE THE HOLIDAY RUSH, be sure to register for CDC's 2005 National Immunization Conference


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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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November 22, 2004

CDC recently announced that its audio conference about the "2004-2005 Guidelines: Influenza Vaccine/Antivirals for Persons Living with HIV/AIDS" is scheduled for today, November 22, from 7PM to 8PM ET. No registration is required.

The conference is intended for clinicians and organizations that provide care for persons living with HIV/AIDS. Speakers include the following: Raymond Strikas, MD, NIP, CDC; Scott Harper, MD, Division of Viral Diseases, National Center for Infectious Diseases, CDC; and Ida Onorato, MD, National Center for HIV, STD, and TB Prevention, CDC.

Here are the call-in instructions:

  • Call in 5-10 minutes before the conference start time
  • The U.S. dial-in number is (800) 369-3302
  • When requested, provide this passcode: FLU
  • Place phones and background music on mute
  • Join the audio conference silently
  • Do not use cellular phones
  • Very important: Do not place your phone on hold before or during this call

Participants may fax or phone in their questions during the conference; questions submitted by email will not be accepted. To submit questions by fax, use the fax number provided by the moderator during the conference. Mark faxes "Attention: Audio Conference-FLU."

Materials for the conference include fact sheets, FAQs, and speaker slides. To access them, go to:

To access additional online information about the conference, go to:

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November 22, 2004

CDC published "Recommended Adult Immunization Schedule--United States, October 2004-September 2005" as an MMWR QuickGuide in the November 19 issue of MMWR. The article is reprinted below in its entirety, excluding references and two figures.


CDC's Advisory Committee on Immunization Practices (ACIP) annually reviews the recommended Adult Immunization Schedule to ensure that the schedule reflects current recommendations for the use of licensed vaccines. In June 2004, ACIP approved the Adult Immunization Schedule for October 2004-September 2005. This schedule has also been approved by the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists.

Changes in the Schedule for October 2004-September 2005

The 2004-2005 schedule differs from the previous schedule as follows:

  • Both figures now provide a separate row for each vaccine.
  • Healthcare workers have been added to the figure that provides immunization recommendations by medical indications and other conditions.
  • The special note regarding influenza vaccination of pregnant women reflects the revised ACIP recommendations that all pregnant women should receive influenza vaccination regardless of preexisting chronic conditions.

Healthcare workers were added to the Adult Immunization Schedule in response to provider requests; this change should facilitate assessment of the vaccination status of healthcare workers and administration of needed vaccinations. In 2002, 38.4% of healthcare workers reported influenza vaccination, and 62.3% reported having completed hepatitis B vaccination series (National Health Interview Survey, CDC, unpublished data, 2003). Influenza vaccination of healthcare workers is an important preventive measure for persons at high risk for complications from influenza infection. Healthcare workers involved in direct patient care are among the priority groups recommended to receive influenza vaccination for the 2004-05 influenza season, despite the vaccine shortage.

The Adult Immunization Schedule is available in English and Spanish at [IAC EXPRESS editor's note: According to recent information from NIP, the Adult Immunization Schedule will be available in English at the above web address in late November and will be available in Spanish in late January 2005.] General information about adult immunization, including recommendations concerning vaccination of persons with human immunodeficiency virus (HIV) and other immunosuppressive conditions, is available from state and local health departments and from the National Immunization Program at Vaccine information statements are available at ACIP statements for each recommended vaccine can be viewed, downloaded, and printed from CDC's National Immunization Program at Instructions for reporting adverse events after vaccination to the Vaccine Adverse Event Reporting System (VAERS) are available at or by telephone, (800) 822-7967.


To access a web-text (HTML) version of the complete article, go to:

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: Adobe Acrobat 6.0 is required to open this file.

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to:

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November 22, 2004

The November 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 November issue has already appeared in previous issues of "IAC EXPRESS." Following is the text of four articles we have not covered.


UPDATE ON 2004-2005 FLU VACCINE SHORTAGE: On October 5, 2004, CDC was notified by Chiron Corporation that none of its influenza vaccine (Fluvirin) would be available for distribution in the United States for the 2004–05 influenza season. Chiron was to make 46-48 million doses of the vaccine for the United States. This action reduced the expected supply of trivalent inactivated vaccine (flu shot) available in the United States for the 2004–05 influenza season by approximately one half.

Aventis Pasteur had already shipped 33 million of its expected total 58 million vaccine doses prior to Chiron's announcement. The remaining 25 million doses have been allocated at a rate of about 3 million doses per week--or about 14 million doses--since October 11, under a joint distribution plan developed by CDC and Aventis.

On November 9, working closely with public health officials nationwide, the CDC announced plans to distribute the remaining 10.6 million doses of Aventis Pasteur influenza vaccine based upon decisions made by state health departments, which will then help ensure the doses reach those people at highest risk for complications from influenza. The vaccine will be distributed over several weeks through December and into January.

Under the outlined plan, states and territories will be receiving 100 percent of any orders they had originally placed under federal, state, and multi-state contracts. Overall, this accounts for 3.4 million doses of vaccine. The distribution plan for the 7.2 million doses takes into account three things: (1) the number of high-priority individuals in the state, (2) the number of doses the state has already received and (3) the state's unmet needs. In the coming weeks, another 1.3 million doses of pediatric vaccine will be allocated to states using the same approach.

This year's expected vaccine supply also includes 3 million doses of FluMist, which is approved for use by healthy people between the ages of 5 and 49. In addition, CDC is continuing to work with HHS and the Food and Drug Administration (FDA) on the possibility of obtaining several million doses of foreign-produced influenza vaccine for use in the United States this influenza season. These vaccines are not currently licensed for use in the U.S., but if deemed safe by the FDA, could be used under an "investigational new drug" protocol that meets FDA requirements. To ensure the safety of this flu vaccine, FDA inspectors are visiting the overseas plants of these manufacturers.

In addition, a supply of antiviral drugs to treat influenza will be available this flu season. Supplies of antiviral drugs are available through private health providers, and the federal government has purchased a stockpile of antiviral drugs to treat more than 7 million people. FDA has estimated that approximately 40 million people could be treated this flu season with the antiviral drugs available.

To provide more information to health care professionals and the public about influenza and influenza vaccine, CDC has launched (800) CDC-INFO [232-4636], a new 24/7 central telephone hotline available in English and Spanish. This number will enable people to obtain information from CDC. The number for hearing impaired is (800) 243-7889 (TTY/TDD).

CDC also has available a wealth of resources to help educate health care professionals and consumers. Some of these materials include:

Additional information and resources are available at


ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES MEETING: The Advisory Committee on Immunization Practices (ACIP) met October 27-28, 2004, in Atlanta, Georgia. Along with discussion of the influenza vaccine shortage, outlined above, the ACIP approved the Harmonized Childhood and Adolescent Immunization Schedule for 2005. No policy changes have occurred since the schedule was last published in April 2004 that require revisions of the schedule. Therefore, ACIP voted to approve a 2005 schedule that is identical to that published in the MMWR in April 2004 and in the Red Book 2003.

NEW IMMUNIZATION COOPERATIVE AGREEMENTS ANNOUNCED: CDC's National Immunization Program recently awarded new cooperative agreements to five organizations. The first set of awards will support coalition building and information dissemination activities for two organizations. The Academy for Educational Development (AED) will conduct a needs assessment of coalitions and will develop skills-based trainings for coalition members. The Immunization Action Coalition (IAC) will maintain immunization listserves and websites and publish and disseminate immunization newsletters. The second set of awards will support activities in minority communities. The three awardees--the National Asian Women's Health Organization (NAWHO), the Black Women's Health Imperative (BWHI), and the Migrant Clinicians Network (MCN)--will educate healthcare providers about cultural barriers to immunizations and will create and distribute linguistically appropriate and culturally sensitive immunization materials to public audiences. Information about future CDC funding opportunities can be found on or in the Federal Register.


FREE IMMUNIZATION-RELATED BROCHURES: For a limited time, the National Immunization Program has a number of immunization brochures available for health care professionals and consumers that can be ordered in large quantities. These brochures include topics such as VFC, Vaccine Safety, Schools, Registries and Traveler's Health. Some Spanish resources are also available. Supplies are limited. Visit and click on CDC Online Order Form. Additional resources are also listed. These resources are free of charge, and there is no cost for shipping.


To access the complete November issue from the NIP website, go to:

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November 22, 2004

CDC recently revised the VIS for yellow fever vaccine and posted it on the NIP website; the issue date is 11/9/04. Changes include the following:

  • In the section titled "Who should NOT get yellow fever vaccine?" persons who have had their thymus gland removed have been added to the list of those who should check with their doctor before receiving yellow fever vaccine.
  • In the section titled "How can I learn more?" interested persons are now encouraged to access CDC's Traveler's Health website for further information.

To access a ready-to-print (PDF) version, go to:

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November 22, 2004

IAC recently posted on its website a Spanish-language version of CDC's supplement to the VIS for trivalent inactivated influenza vaccine (TIV). IAC gratefully acknowledges the California Department of Health Services for the translation.

Titled "Inactivated Influenza Vaccine: 2004-2005 Supplement--Vaccine Shortage," the one-page supplement lists the people who should get influenza vaccine during the current vaccine shortage; its issue date is 10/29/04. The supplement is intended to be used with the VIS for TIV, which is dated 5/24/04.

To obtain a ready-to-copy (PDF) version of the 10/29/04 supplement in SPANISH, go to:

To obtain it in ENGLISH, go to:

To obtain a ready-to-copy (PDF) version of the 5/24/04 VIS for TIV in ENGLISH, go to:

To obtain it in 16 additional languages, go to: Click on the language(s) you want.

For information about the use of VISs, and for VISs in a total of 32 languages, visit IAC's VIS web section at

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November 22, 2004

CDC recently updated its website with several documents related to the influenza vaccine shortage. Following are links to the new information.

(1) The two-page professional-education piece "Guidelines & Recommendations: 2004-05 Interim Guidance for the Use of Masks to Control Influenza Transmission" outlines how masks can be used in healthcare and other settings with symptomatic and asymptomatic individuals.

To access a ready-to-print (PDF) version, go to:

To access a web-text (HTML) version, go to:

(2) The three-page document "Key Facts About Flu Vaccine" gives a succinct overview of both the trivalent inactivated influenza vaccine (TIV) and the live attenuated intranasal vaccine (LAIV). It was recently updated; the updated version is available in English and Spanish.

To access a ready-to-print (PDF) updated version in ENGLISH, go to:

To access a web-text (HTML) updated version in ENGLISH, go to:

To access a ready-to-print (PDF) updated version in SPANISH, go to:

To access a web-text (HTML) updated version in SPANISH, go to:

(3) A question about the findings of current influenza surveillance activities was added to the web page "Questions & Answers: 2004-05 Flu Season." To access it, go to:

(4) A question about the week-long delay in publishing influenza surveillance information was added to the web page "Questions & Answers: The Disease." To access it, go to:

For ongoing information about new and updated additions to CDC's Influenza web section, go to:

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November 22, 2004

The November issue of HEP EXPRESS, an electronic newsletter published by IAC, is now available online. HEP EXPRESS is intended for health and social service professionals involved in the prevention and treatment of viral hepatitis. The November issue includes articles on the following:

  • CDC's newly created viral hepatitis slide show for high school students
  • New York state's initiative to provide free hepatitis B vaccine to hospitals that adopt a universal birth-dose policy
  • Online availability of a report on Illinois hospital practices related to the hepatitis B birth dose
  • IAC's newly revised hepatitis-related education pieces (see article #8 below)
  • Online availability of a new issue of "Viral Hepatitis," a publication of the Viral Hepatitis Prevention Board

To access the November issue, go to:

To sign up for a free subscription to HEP EXPRESS, go to:

To access previous issues of HEP EXPRESS, go to:

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November 22, 2004

[The following is cross posted from the Immunization Action Coalition's HEP EXPRESS electronic newsletter, 11/18/04.]

IAC recently revised two of its long-standing hepatitis B education pieces.

"Hepatitis B Shots Are Recommended for All New Babies" is a brochure targeted at expectant or new parents who might question the need for, or timing of, infant vaccination against HBV [hepatitis B virus].

To access a ready-to-copy (PDF) version of "Hepatitis B Shots Are Recommended for All New Babies," go to:

To access a web-text (HTML) version of it, go to:

"Hepatitis B Information for Asian and Pacific Islander Americans" was created to answer the questions of Asian and Pacific Islander Americans (APIA), including immigrants and refugees, as well as persons of APIA descent born in the United States. The revised version includes an updated list of related organizations that readers might wish to contact.

To access a ready-to-copy (PDF) version of "Hepatitis B Information for Asian and Pacific Islander Americans," go to:

To access a web-text (HTML) version of it, go to:

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November 22, 2004

IAC recently updated its two-page parent-education brochure "Questions parents ask about baby shots." The major change was the addition of more recent statistics about child mortality from VPDs.

To access a ready-to-print (PDF) version of the updated brochure, go to:

To access a web-text (HTML) version, go to:

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November 22, 2004

Take time NOW--before you start juggling work with Thanksgiving and a long string of winter holiday celebrations--to register for CDC's 2005 National Immunization Conference. Scheduled for March 21-24, 2005, in Washington, DC, the conference will give you a chance to get recharged and revitalized by getting together with old friends and colleagues, meeting people you know only through phone conversations and email messages, touring the conference exhibit space, and getting fresh ideas from poster sessions, workshops, and plenary meetings. You don't want to miss it!

The deadline for early-bird registration ($150) is January 28, but why wait? Register today, and you'll have something to look forward to throughout winter. To register online, go to:

To plan some fun in Washington, visit the official tourism website at

For general conference information, including conference goals and objectives, go to:

For additional information, contact the conference planning team at (404) 639-8225 or

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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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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