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Issue Number 608            July 10, 2006


  1. VIS translation: Interim VIS for rotavirus vaccine now available in Spanish
  2. July issue of CDC's Immunization Works electronic newsletter now available on the NIP website
  3. New: HHS releases second part of its pandemic influenza planning update
  4. WHO analyzes 205 confirmed cases of human avian influenza from December 2003 to April 30, 2006


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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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July 10, 2006

Dated 4/12/06, the interim VIS for rotavirus vaccine is now available on the IAC website in Spanish. IAC gratefully acknowledges the California Department of Health Services for the translation.

To obtain a ready-to-copy (PDF) version in Spanish, go to:

To obtain a ready-to-copy (PDF) version in English, go to:

For information about the use of VISs, and for VISs in more than 30 languages, visit IAC's VIS web section at

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July 10, 2006

The July 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. Portions of the July issue are reprinted below.



On June 29-30, 2006, the Advisory Committee on Immunization Practices (ACIP) met in Atlanta, GA. The ACIP meets three times annually and provides recommendations to the Director of the CDC and the Secretary of the Department of Health and Human Services (HHS) concerning the prevention of vaccine-preventable diseases in the United States.

Following is a summary of key votes from the ACIP's June meeting:

HPV VACCINE: The ACIP voted to recommend that a newly licensed vaccine designed to protect against human papillomavirus (HPV) be routinely given to girls at the age of 11-12 years. The ACIP recommendation also allows for vaccination of girls beginning at 9 years, and supports vaccination of females from 13 to 26 years of age who have not been previously vaccinated. According to the ACIP's recommendation, 3 doses of the new vaccine should be routinely given to girls when they are 11 or 12 years old. The advisory committee, however, noted that the vaccination series can be started as early as 9 years of age at the discretion of the physician or healthcare provider. The vaccine should be administered before onset of sexual activity (i.e., before women are exposed to the viruses), but females who are sexually active should still be vaccinated.

The ACIP passed a resolution that included HPV vaccine in the Vaccines for Children (VFC) program. VFC-eligible children 9 through 18 years of age are entitled to receive VFC vaccine.

HPV is the leading cause of cervical cancer in women. The vaccine is the first developed to prevent cervical cancer, precancerous genital lesions, and genital warts due to HPV. The vaccine is highly effective against four types of HPV virus, including two that cause about 70 percent of cervical cancer. Those who have not acquired HPV would get the full benefits of the vaccine. On average, there are 9,710 new cases and 3,700 deaths from cervical cancer in the United States each year. For more information about HPV and the HPV vaccine, please visit

VARICELLA VACCINE: The ACIP voted to recommend a second dose of varicella (chickenpox) vaccine for children aged 4-6 years to further improve protection against the disease. The first dose of varicella vaccine is recommended at the age of 12-to-15 months. The ACIP also recommended that children, adolescents, and adults who previously received 1 dose should receive a second dose. The ACIP passed a VFC resolution to include the second dose of varicella in the Vaccines for Children program.

Fifteen to 20 percent of children who have received one dose of the vaccine are not fully protected and may develop chickenpox after coming in contact with varicella zoster virus. Additionally, 1 dose of the vaccine may not continue to provide protection into adulthood when chickenpox is more severe. A second dose of varicella vaccine provides increased protection against varicella disease compared [with] one dose.

Before licensure of the varicella vaccine in 1995, each year there were about four million cases of varicella, 13,500 hospitalizations, and 150 deaths. Cases of varicella have steadily declined by 80 to 85 percent since vaccine licensure. From 1995 to 2001, varicella hospitalizations declined by 72 percent and deaths among those 50 years old and younger decreased by 75 percent or more. However, in recent years varicella outbreaks have continued to occur among vaccinated school children. During these chickenpox outbreaks, between 11 and 17 percent of vaccinated children developed varicella. Varicella in vaccinated children is usually mild, but the children are contagious and can transmit the virus to others including their parents who are at higher risk of severe disease. For more information about varicella and the varicella vaccine, please visit

Slide presentations and the full report from the ACIP meeting will be posted soon at The next ACIP meeting will be held at the CDC Global Communications Center in Atlanta, Georgia, on October 25-26, 2006.


UPDATE柚UMPS OUTBREAK: CDC and state and local health departments continue to investigate an outbreak of mumps that began in Iowa in December 2005 and involved 14 additional states as of June 27, 2006. Through June 27, 2006, 4,724 mumps cases have been reported to the CDC from 15 outbreak-affected states. Of the total number of current cases, 1,921 confirmed and probable cases have been reported by the Iowa Department of Public Health. Another 2,717 probable and confirmed mumps cases have been reported from seven additional states where outbreaks are occurring (Kansas, Illinois, Nebraska, Missouri, South Dakota, Pennsylvania, and Wisconsin). Another seven states (Colorado, Minnesota, Mississippi, New York, New Mexico, Michigan, and Texas) have reported a total of 86 probable and confirmed mumps cases, 15 of which are related to travel to or temporary residence in one of the eight mumps-outbreak states. The current reported number of hospitalizations is 72 (68 from outbreak states and 4 from states with outbreak-associated cases). Some of these are for complications of mumps including meningitis, encephalitis, and orchitis, but at least 11 are likely to be coincidental hospitalizations (i.e., hospitalized for an unrelated condition and found to have mumps). As of July 5, 2006, there have been no deaths related to the mumps outbreak and reports from affected states show that the outbreak is declining in every state.

While this decline is encouraging, CDC continues to work with state and local health departments to conduct mumps surveillance, assist with prevention and control activities, and evaluate vaccine effectiveness, duration of immunity, and risk factors for mumps illness. CDC has also provided technical assistance and education to organizations serving those most affected by the outbreak, including the American College Health Association, and four national camp associations. For more information about mumps and resources for healthcare professionals, the general public, and travelers, please visit CDC's mumps website at


NEW INFLUENZA SUPPLY Q&As: CDC has developed two sets of influenza questions and answers (Q&As) to assist healthcare professionals and consumers with planning for the upcoming influenza season. The first set of Q&As provides information about vaccine supply for the 2006-07 influenza season and can be found at The second set of Q&As provides general information about influenza vaccine production, supply, and distribution in the  United States and can be found at


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

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July 10, 2006

On June 29, Michael Leavitt, Secretary of HHS (Department of Health and Human Services), released a report titled "Pandemic Planning Update II." The 12-page report provides an update on the department's five priorities related to pandemic planning. The five priorities were outlined in the original report, "Pandemic Planning Update," which HHS released on March 13.

To access a ready to print (PDF) version of the June 29 report, go to:

To access a ready-to-print (PDF) version of the March 13 report, go to:

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July 10, 2006

WHO published "Epidemiology of WHO-confirmed human cases of avian influenza A (H5N1) infection" in the June 30 issue of its publication Weekly Epidemiological Record (WER). Also on June 30, WHO posted a synopsis of the WER article on its web section Disease Outbreak News. Portions of the synopsis are reprinted below.


This week's issue of the Weekly Epidemiological Record, published online by WHO [on June 30], sets out results from the first analysis of epidemiological data on all 205 laboratory-confirmed H5N1 cases officially reported to WHO by onset date from December 2003 to 30 April 2006.

Data used in the analysis were collected for surveillance purposes. Quality, reliability, and format were not consistent across data from different countries. Despite this limitation, several conclusions could be reached.

  • The number of new countries reporting human cases increased from 4 to 9 after October 2005, following the geographical extension of outbreaks among avian populations.
  • Half of the cases occurred in people under the age of 20 years; 90% of cases occurred in people under the age of 40 years.
  • The overall case-fatality rate was 56%. Case fatality was high in all age groups but was highest in persons aged 10-to-39 years.
  • The case-fatality profile by age group differs from that seen in seasonal influenza, where mortality is highest in the elderly. . . .


To access a ready-to-print (PDF) version of the June 30 issue of WER, go to:

To access the June 30 Disease Outbreak News synopsis, 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
  • Technical Reviewer
    Kayla Ohlde

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