Issue Number 568            December 5, 2005


  1. CDC issues press release about the appointment of three new center directors
  2. Important: Deadline for nominations to ACIP is December 19; ACIP's provisional recommendations are now online
  3. Heads up: One-word error now corrected on Spanish-language VISs for injectable and nasal-spray influenza vaccines
  4. New: Interim VIS for Tdap vaccine now available in Spanish
  5. CDC provides information about newly licensed measles-mumps-rubella-varicella vaccine
  6. CDC updates its Influenza web section with English- and Spanish-language materials
  7. New: December 2 issue of Hep Express now available online


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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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December 5, 2005

On November 23, CDC published a press release announcing the appointment of three new directors, including the director of the National Immunization Program. Portions of the press release are reprinted below.

Following the reprinted material from the press release is a link to an article, "CDC Announces Restructuring Details," from the November 2005 issue of the newsletter published by Every Child by Two (ECBT). The article includes an organizational chart depicting the future structure of CDC's Coordinating Center for Infectious Diseases, which includes the current National Immunization Program, National Center for Infectious Diseases, and National Center for HIV, STD, and TB Prevention.

This IAC Express article concludes with IAC's expression of thanks for the leadership provided by Stephen L. Cochi, MD, MPH, acting director of NIP.


For immediate release
November 23, 2005


Centers for Disease Control and Prevention (CDC) Director Dr. Julie Gerberding announced today the appointment of new directors for three key organizational components of the federal agencyresponsible for protecting the nation's health. . . .

The appointments include Anne Schuchat, MD, as director of the National Immunization Program. Dr. Schuchat began her career at CDC as an Epidemic Intelligence Service (EIS) Officer in 1988 and most recently served as the acting director of the National Center for Infectious Diseases (NCID). She has made critically important contributions to prevention of infectious diseases in children, including her role in group B streptococcal disease prevention, where she spearheaded the development of CDC's guidelines, which have led to an 80 percent reduction in newborn infections and a 75 percent narrowing of racial disparity in this infectious disease. She has also been instrumental in pre- and post-licensure evaluations of conjugate vaccines for bacterial meningitis and pneumonia and in accelerating availability of these new vaccines in resource-poor countries through WHO and the Global Alliance for Vaccine and Immunization.

In a second appointment, Rima Khabbaz, MD, was named as the director of the National Center for Infectious Diseases (NCID). Dr. Khabbaz began her career at CDC as an EIS Officer in 1980 and most recently served as acting deputy director of NCID. She has worked in research and epidemiology of hospital-acquired infections [and] viral diseases and played a leading role in coordinating CDC's programs around blood safety [and] food safety, as well as emerging infectious diseases. She has played critical roles in CDC's responses to bioterrorism, outbreaks of new diseases, and infectious disease responses to natural disasters.

In addition, Kevin Fenton, MD, PhD, was named director of the National Center for HIV, STD, and TB Prevention (NCHSTP). Dr. Fenton has served as chief of CDC's National Syphilis Elimination Effort since January 2005. He has worked in research, epidemiology, and the prevention of HIV and other STDs since 1995 and was previously the director of the HIV and STI Department at the United Kingdom's Health Protection Agency. Dr. Fenton has spearheaded the development of a number of national HIV, STD, and behavioral surveillance and research programs in the U.K. and Western Europe including the National Chlamydia Screening Programme in England, the 2nd British National Survey of Sexual Attitudes and Lifestyles, and the European Surveillance of STI (ESSTI) Network. . . .


To access the press release from the CDC website, go to:

IAC staff look forward to working with Dr. Schuchat, Dr. Khabbaz, and Dr. Fenton in their new roles as CDC center directors to meet the challenging public health issues that lie ahead.

For more information on CDC's restructuring, see "CDC Announces Restructuring Details" in the November 2005 issue of the Every Child by Two newsletter at

IAC staff express our great appreciation to Stephen L. Cochi, MD, MPH, for his outstanding leadership as acting director at CDC's National Immunization Program for the past 22 months. We also thank him for his services as NIP liaison to IAC's Advisory Board for the past two years and his personal commitment to IAC's mission and work.

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December 5, 2005

On November 28, CDC published a special "read immediately" issue of its email newsletter Immunization Works. The newsletter announces that CDC is soliciting nominations to fill five vacancies on its Advisory Committee on Immunization Practices (ACIP). The "read immediately" issue is reprinted below in its entirety.

Following the reprinted material is information about NIP's web page of provisional ACIP recommendations.


DATE: November 28, 2005
FROM: Executive Secretary, ACIP
SUBJECT: Request for the Advisory Committee on Immunization Practices Nominations
TO: ACIP Members, Ex Officio and Liaison Representatives
Director, National Center for HIV, STD, and TB Prevention
Director, National Immunization Program
Director, National Center for Infectious Diseases Vaccine Manufacturers

The purpose of this correspondence is to solicit proposals for nominations for five vacancies on the Advisory Committee on Immunization Practices. These vacancies will occur June 30, 2006. The positions being vacated [are] presently held by Dr. Judith Campbell, Dr. Reginald Finger, Dr. Janet Gilsdorf, Dr. Edgar Marcuse, and Dr. Gregory Poland. All [nominations] must be submitted to Dee Gardner by December 19, 2005.

Selection of members will be based on their qualifications to contribute to the accomplishment of the committee's objectives ( Department of Health and Human Services policy provides that committee membership will be fairly balanced in terms of points of view represented and the committee's function. Consideration will be given to a broad representation of geographic areas; nominations of women, ethnic and racial minority representatives, and the handicapped are encouraged. Nominees must be U.S. citizens.

Please submit your suggestions for nomination to the committee, along with a letter of support and curriculum vitae, by December 19, 2005, to

Demetria Gardner
Centers for Disease Control and Prevention
1600 Clifton Road, Mailstop E-61
Atlanta, Georgia 30333
Ph: (404) 639-8836
Fax: (404) 639-8616

Please share this request with anyone who may be interested in nominating an individual to serve as a member on the committee.

Larry K. Pickering, MD
Executive Secretary


To access the "read immediately" issue from the CDC website, go to:

NIP recently announced the availability of a web page containing information about ACIP's provisional recommendations. Provisional recommendations are those that ACIP has voted on but that have not yet been officially approved by CDC and the Department of Health and Human Services and published in MMWR.

To access the web page of provisional recommendations, go to:

To access a complete list of ACIP recommendations already published in MMWR, go to:

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December 5, 2005

IAC recently became aware of a one-word error in the Spanish-language VISs for the trivalent inactivated influenza vaccine (TIV; injectable) and the live intranasal influenza vaccine (LAIV; nasal spray). IAC is grateful to the California Department of Health Services for correcting the error. IAC regrets any inconvenience the error may have caused.

The error appeared in the first section of the VISs, which is titled Por que vacunarse? (Why get vaccinated?). In the last sentence of the fourth paragraph, the word "deaths" was mistakenly translated as "vidas" ("lives"). It has now been correctly translated as "muertes." The beginning of the sentence now reads, "Cada ano la influenza causa unas 36,000 muertes . . ."

To obtain a ready-to-print (PDF) version of the corrected VIS for TIV vaccine in Spanish, go to:

To obtain VIS for TIV vaccine in English, go to:

To obtain a ready-to-print (PDF) version of the corrected VIS for LAIV vaccine in Spanish, go to:

To obtain VIS for LAIV vaccine in English, go to:

For information about the use of VISs, and for VISs in a total of 33 languages, visit IAC's VIS web section at

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December 5, 2005

The current version of the interim VIS for tetanus-diphtheria-acellular pertussis vaccine (Tdap; dated 9/22/05) is now available on the IAC website in Spanish. IAC gratefully acknowledges the California Department of Health Services for the translations.

To obtain a ready-to-print (PDF) version of the VIS for Tdap vaccine in Spanish, go to:

To obtain it in English, go to:

For information about the use of VISs, and for VISs in a total of 33 languages, visit IAC's VIS web section at

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December 5, 2005

CDC published "Notice to Readers: Licensure of a Combined Live Attenuated Measles, Mumps, Rubella, and Varicella Vaccine" in the December 2 issue of MMWR. Portions of the article are reprinted below.


On September 6, 2005, the Food and Drug Administration licensed a combined live attenuated measles, mumps, rubella, and varicella (MMRV) vaccine (ProQuad, Merck & Co., Inc., Whitehouse Station, New Jersey) for use in children aged 12 months-12 years. The attenuated measles, mumps, and rubella vaccine viruses in ProQuad are identical and of equal titer to those in the measles, mumps, and rubella (MMR) vaccine, MMRII (Merck). The titer of Oka/Merck varicella-zoster virus is higher in MMRV vaccine than in single-antigen varicella vaccine, VARIVAX (Merck), a minimum of 3.13 log 10 plaque-forming units (pfu) versus 1,350 pfu (approximately 1.13 log 10), respectively.

Advisory Committee on Immunization Practices (ACIP) current recommendations are that children aged 12 months-12 years receive 2 doses of MMR vaccine at least 1 month apart and 1 dose of varicella vaccine. MMRV vaccine can decrease the number of injections received by children when all of the component antigens are indicated for administration. One dose of MMRV vaccine should be administered on or after the first birthday, preferably as soon as the child becomes eligible for vaccination. . . .

Indications and Usage

1. MMRV vaccine is indicated for simultaneous vaccination against measles, mumps, rubella, and varicella among children aged 12 months-12 years; MMRV is not indicated for persons outside of this age group. Use of licensed combination vaccines, such as MMRV vaccine, is preferred over separate injection of equivalent component vaccines. MMRV vaccine can reduce the number of injections when administered to children aged 12 months-12 years for whom (1) the first dose of MMR and varicella vaccines is indicated and (2) the second dose of MMR and either the first or second dose (e.g., during a varicella outbreak) of varicella vaccine is indicated. MMRV vaccine is administered subcutaneously as a single 0.5-mL dose.

2. MMRV vaccine may be used whenever any components of the combination vaccine are indicated and the other components are not contraindicated. Using combination vaccines containing some antigens not indicated at the time of administration might be justified when (1) products that contain only the needed antigens are not readily available or would result in extra injections and (2) potential benefits to the child outweigh the risk of adverse events associated with the extra antigen(s).

3. At least 1 month should elapse between a dose of measles-containing vaccine, such as MMR vaccine, and a dose of MMRV vaccine. Should a second dose of varicella vaccine be indicated for children aged 12 months-12 years (e.g., during a varicella outbreak), at least 3 months should elapse between administration of any 2 doses of varicella-containing vaccine, including single-antigen varicella vaccine or MMRV vaccine.

4. Simultaneous administration of the most widely used live and inactivated vaccines have produced seroconversion rates and rates of adverse reactions similar to those observed when the vaccines are administered separately. Therefore, MMRV may be administered simultaneously with other vaccines recommended at ages 12 months-12 years, although data are absent or limited for the concomitant use of MMRV vaccine with DTaP, inactivated polio, pneumococcal conjugate, influenza, and hepatitis A vaccines.

5. MMRV vaccine must be stored frozen at an average temperature 5 degrees F [or less] (-15 degrees C [or less]) for up to 18 months. Adequacy of the freezer should be checked before obtaining or storing MMRV vaccine. Unlike single-antigen varicella vaccine, MMRV vaccine cannot be stored at refrigerator temperature. Once reconstituted, the vaccine should be used immediately to minimize loss of potency and should be discarded if not used within 30 minutes. The diluent should be stored separately at room temperature or in the refrigerator.

6. MMRV vaccine should not be administered as a substitute for the component vaccines when vaccinating children with human immunodeficiency virus (HIV) infection until revised recommendations can be considered for the use of MMRV vaccine in this population; current recommendations for vaccination of HIV-infected children with MMR and varicella vaccines are available.

ACIP recommendations for MMR and varicella vaccines have been previously published and are applicable for the respective components of MMRV vaccine. Additional information regarding ProQuad is available from the package insert provided by the manufacturer (


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

To access a ready-to-print (PDF) version of this issue of MMWR, go to:

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

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December 5, 2005

CDC recently updated three pages of its Influenza web section:

  1. "Key facts about avian influenza (bird flu) and avian influenza A (H5N1) virus" (11/25/05)
  2. "Informacion importante sobre el virus de la gripe aviar (gripe del pollo) y de la gripe aviar A (H5N1)" (the Spanish-language version of the piece listed above; 11/25/05)
  3. "Guidelines and recommendations: Infection control guidance for the prevention and control of influenza in acute-care facilities" (formerly known as "Updated infection control measures for the prevention and control of influenza in healthcare facilities"; 11/16/05)

To access these materials, go to: and click on the pertinent links.

To access a broad range of continually updated influenza information, go to:

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December 5, 2005

The December 2 issue of Hep Express, an electronic newsletter published by IAC, is now available online. It is intended for health and social service professionals involved in the prevention and treatment of viral hepatitis. IAC Express has already covered some of the information presented in the December 2 Hep Express; titles of articles we have not yet covered follow.

  • Visit IAC's booth at the National Viral Hepatitis Prevention Conference next week
  • Ribavirin Pregnancy Registry established
  • Multi-center treatment trial for children with chronic HVC now enrolling patients

To access the December 2 issue, go to:

To sign up for a free subscription to Hep Express, go to:

To access previous issues of Hep Express, go to:

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
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    Kayla Ohlde

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