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IAC Express 2007
Issue number 644: February 5, 2007
Contents of this Issue
Select a title to jump to the article.
  1. Revised VIS: CDC makes minor change to interim VIS for HPV vaccine
  2. CDC offers email update service for many CDC web pages
  3. HHS unveils two new efforts to advance pandemic influenza preparedness
  4. Death of St. Paul boy reminds professionals and parents of the importance of influenza vaccination
  5. IDSA calls for mandatory influenza vaccination for healthcare workers
  6. Pennsylvania Immunization Education Program provides slides and speaker notes online
  7. CDC scientists discover more about the 1918 influenza virus
  8. Teleconference on National Infant Immunization Week scheduled for February 20
AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; AMA, American Medical Association; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NCIRD, National Center for Immunization and Respiratory Diseases; NIVS, National Influenza Vaccine Summit; VIS, Vaccine Information Statement; VPD, vaccine-preventable disease; WHO, World Health Organization.
Issue 644: February 5, 2007
1.  Revised VIS: CDC makes minor change to interim VIS for HPV vaccine

On February 2, CDC made a minor change to the interim VIS for human papillomavirus (HPV) vaccine. After receiving a number of comments from providers that Section 3 was confusing, particularly regarding the recommendations for catch-up, CDC revised that section. The edition date is now 2/2/07.

Note: CDC advises healthcare professionals that existing stores of the previous VIS for HPV vaccine, dated 9/5/06, may be used up. There is no reason to discard them.

To access a ready-to-print (PDF) version of the updated (2/2/07) interim VIS from the CDC website, go to:

To access it from the IAC website, 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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2 CDC offers email update service for many CDC web pages

CDC has recently added Email Update Service to many CDC web pages. Visitors to the CDC website can sign up to receive email update notifications by clicking on one of the many "Get Email Updates" links throughout the website, entering their email address, and selecting topics they are interested in. Email updates are sent to the subscribers when a web page is updated.

You can sign up for specific page updates in two ways:

1. Go to, click on "Get Email Updates," and follow the directions provided. You will be given a choice of categories (e.g., Vaccines and Immunizations, Sexually Transmitted Diseases). Choose your topics of interest, and you will automatically receive updates for all related pages. For example, there are dozens of immunization-related pages, including ones related to VISs, schedules, ACIP recommendations, statistics, registries, news, and more.

2. Alternatively, you can click on the "Get Email Update" link on any CDC web page that offers that choice. Again, follow directions and you will receive updates for that particular page.

There are more than 200 items now available for subscription on the CDC website, with more being added in the near future.

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3 HHS unveils two new efforts to advance pandemic influenza preparedness

On February 1, the U.S. Department of Health and Human Services released a news bulletin about new pandemic influenza initiatives. The press release is reprinted below in its entirety.

Planning guidance to assist community decision-makers; PSAs to raise public awareness

The Department of Health and Human Services (HHS) and its Centers for Disease Control and Prevention (CDC), in cooperation with departments and agencies across the Federal Government, today announced two new efforts designed to improve state, local, and community preparedness for an influenza pandemic, which can occur when a new strain of flu appears for which people have no immunity, and disease spreads rapidly around the world.

CDC released new guidance on community planning strategies that state and local community decision-makers, as well as individuals, need to consider based on the severity of an influenza pandemic. These strategies are important because the best protection against pandemic influenza—a vaccine—is not likely to be available at the outset of a pandemic. Community strategies that delay or reduce the impact of a pandemic (also called non-pharmaceutical interventions) may help reduce the spread of disease until a vaccine that is well-matched to the virus is available.

The CDC guidance released today was developed in collaboration with other federal agencies and public health and private partners. The federal government has undertaken many efforts in the last few years to encourage and strengthen the nation's pandemic influenza preparedness, and this guidance builds upon previously released planning documents and guidelines.

"The threat of a pandemic continues to be real. We need to continue helping state and local decision-makers determine some of the specific actions they could take during the course of a pandemic to reduce illness and save lives," said HHS Secretary Mike Leavitt. "An important consideration for action is the severity of a pandemic once it emerges. The new CDC guidelines are a step forward in that direction."

The new guidelines focus primarily on community-level measures that could be used during an influenza pandemic in an effort to reduce the spread of infection. In order to help authorities determine the most appropriate actions to take, the guidelines incorporate a new pandemic influenza planning tool for use by states, communities, businesses, schools, and others. The tool, a Pandemic Severity Index (PSI), takes into account the fact that the amount of harm caused by pandemics can vary greatly, with that variability having an impact on recommended public health, school, and business actions.

The PSI, which is modeled after the approach used to characterize hurricanes, has five different categories of pandemics, with a category 1 representing moderate severity and a category 5 representing the most severe. The severity of pandemic is primarily determined by its death rate, or the percentage of infected people who die. A category 1 pandemic is as harmful as a severe seasonal influenza season, while a pandemic with the same intensity of the 1918 flu pandemic, or worse, would be classified as category 5.

"It's important that we try in advance to imagine and evaluate some of the steps that could be taken to slow the spread of pandemic influenza in communities," said Dr. Julie Gerberding, CDC director. "That requires a great deal of forethought, vision, and collaboration. I'm proud of CDC's efforts to guide the efforts of many federal and state partners to develop the severity index—and to then link severity with potential actions. We recognize that much work remains, but this new approach should help communities, schools, businesses, and others strengthen their pandemic influenza plans."

Based on the projected severity of the pandemic, government and health officials may recommend different actions communities can take in order to try to limit the spread of disease. These actions, which are designed primarily to reduce contact between people, may include

(1) Asking ill persons to remain at home or not go to work until they are no longer contagious (seven to 10 days). Ill persons will be treated with antiviral medication if drugs are available and effective against the pandemic strain.(2) Asking household members of ill persons to stay at home for seven days (3) Dismissing students from schools and closing child care programs for up to three months for the most severe pandemics, and reducing contact among kids and teens in the community (4) Recommending social distancing of adults in the community and at work, which may include closing large public gatherings, changing workplace environments, and shifting work schedules without disrupting essential services.

These measures will be most effective if they are implemented early and uniformly across communities during a pandemic, objectives that can only be met through advance planning. The guidance illustrates the interventions that are likely to be recommended at each category of severity.

While these actions could significantly reduce the number of persons who become ill during a flu pandemic, they each carry potentially adverse consequences that community planners should anticipate and address in their planning efforts. The guidance describes many of these consequences, and provides planners with initial recommendations on strategies to address them. These recommendations may be revised in the coming months based on feedback that the government will seek from a variety of specific communities, including the private sector, education community, faith and community-based organizations, and the public health community.

Planning guides for businesses and other employers, child care programs, elementary and secondary schools, colleges and universities, faith-based and community organizations, and individuals and families are included in the appendix of the guidance.

This guidance was developed through a collaborative process that included public health officials, mathematical modelers, researchers, and stakeholders from government, academia, private industry, education, and civic and faith-based organizations. It will be refined as needed, based on further knowledge gained from research, exercises, and practical experience.

Also today, as part of the continuing effort to raise awareness and educate the public about pandemic influenza and the need to prepare in advance, HHS unveiled a number of new radio and television public service announcements (PSAs). The PSAs encourage people to learn more about pandemic influenza and to know more about their state and local community's efforts to prepare for a potential pandemic.

"We need to keep up our efforts to educate the public before a pandemic emerges, and these PSAs will help people 'know what do to about pandemic flu,'" Secretary Leavitt said.

The PSAs and the community planning guidance, titled Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States—Early Targeted Layered Use of Non-Pharmaceutical Interventions, are available at

To read this press release online, go to:

To read the transcript of a related February 1 press conference about these initiatives, go to:

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4 Death of St. Paul boy reminds professionals and parents of the importance of influenza vaccination

On January 31, eight-year-old Lucio Satar, a previously healthy child, died of pneumonia, a complication he developed after contracting influenza.

His parents say he was "the greatest kid in the world" and was "loving and very energetic," until the previous Wednesday when he started feeling sick. A week later, his fellow second grade classmates were given a letter to take home, which explained that their friend had died.

Kris Ehresmann, the immunization program director at the Minnesota Department of Health, called the death "a sad reminder of how significant influenza can be, even in a normal year."

Lucio was among the children who did not get influenza vaccine.

Special immunization clinics are being held in the Twin Cities area to accommodate parents who wish their children to be vaccinated against influenza after hearing about Lucio's death. Hundreds of children attended clinics over the weekend.

Nationwide, there is plenty of influenza vaccine available for anyone who wishes to be immunized. It's not too late in the season to vaccinate against this potentially deadly disease.

Visit the following websites to find the information you need to keep vaccinating. Both are continually updated with the latest resources.

The National Influenza Vaccine Summit website at

CDC's Influenza web section at

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5 IDSA calls for mandatory influenza vaccination for healthcare workers

On January 25, the Infectious Diseases Society of America (IDSA) issued a press release announcing the publication of its 24-page report, "Pandemic and Seasonal Influenza Principles for U.S. Action." The report offers a comprehensive set of principles to prepare for seasonal and pandemic influenza. Part of it pertains to influenza vaccination of healthcare workers. Portions of the press release are reprinted below.

The top professional society of infectious diseases experts is insisting that all physicians, nurses, and other health workers caring for patients be vaccinated against influenza each year or decline in writing. It is the strongest call yet to plug a critical weakness in the nation's flu preparations.

The Infectious Diseases Society of America (IDSA) is issuing the call to Congress and the Administration as part of a new set of recommendations to better prepare the nation and the world for an inevitable influenza pandemic, as well to improve responses to the perennial threat of seasonal influenza.

The document is one of the most complete assessments to date on the major outstanding issues surrounding flu preparations. IDSA intends its principles to complement Congress' and the Administration's efforts in enacting the Pandemic and All-Hazards Preparedness Act in December 2006. IDSA's principles support many of the concepts found in the new law, but provide additional direction and a level of specificity not found in the Act. . . .

"It's our professional duty to first do no harm," said Andrew T. Pavia, MD, chair of IDSA's National and Global Public Health Committee. "Voluntary systems haven't brought immunization rates up far enough. For the sake of our patients, all healthcare workers must get a flu shot every year or they must be required to opt out in writing. . . ."

To access the news release, click here.

To download the 24-page report in ready-to-print (PDF) format, click here.

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6 Pennsylvania Immunization Education Program provides slides and speaker notes online

The Pennsylvania Immunization Education Program (PA IEP) has posted a set of slides and speaker's notes on its website that users can download and use for health professional education programs. Some of the materials are specific to Pennsylvania but can be easily adapted for use in other geographic areas. The 66-slide program includes information on all recommended vaccines for children, adolescents, and adults; hot topics; practice issues such as storage and handling and missed opportunities; practical tools; and much more.

In Pennsylvania, a three-person team of presenters visits practices or professional meetings to provide a free CME/CEU Immunization Update for physicians, practice staff, students, and other groups. The PA IEP is funded by the Pennsylvania Department of Health and the Philadelphia Department of Public Health and carried out collaboratively by the Pennsylvania chapter of the American Academy of Pediatrics.

To access the PowerPoint presentation and accompanying speaker notes, go to and click on Curriculum and Immunization News.

For more information, contact Program Director Amy Wishner, MSN, RN, by email at or by phone at (800) 375-5214 [PA only] or (484) 446-3004.

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7 CDC scientists discover more about the 1918 influenza virus

CDC experts have shown that a molecular change in the 1918 pandemic influenza virus stops its transmission in ferrets, shedding light on the properties that allowed this virus to spread so quickly and potentially providing clues that could help scientists assess emerging influenza viruses, such as H5N1.

The study, which is published in the February 5 issue of Science, showed that a modest change of two amino acids in the main protein found on the surface of the 1918 virus did not change the virus's ability to cause disease, but stopped respiratory droplet transmission of the virus between ferrets placed in close proximity.

Julie Gerberding, CDC director, said, "By better understanding how this virus spreads, we can be better positioned to slow down or stop the spread of the pandemic virus and hence be better prepared for the next pandemic."

To read the press release about this finding, go to:

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8 Teleconference on National Infant Immunization Week scheduled for February 20

The National Immunization Coalition TA [technical assistance] Network has scheduled a teleconference that will focus on hosting a National Infant Immunization Week (NIIW) event. The network is a program of the Center for Health Communication, Academy for Educational Development.

The teleconference will be held at 1:00PM, ET, February 20. Presenters include Michelle Basket, CDC; Kathe Gustafson, San Diego Immunization Branch; and a representative from the California Department of Health Services, Immunization Branch.

NIIW is an annual observance to promote the benefits of immunizations and to focus on the importance of immunizing infants against vaccine-preventable diseases by age two. This year's NIIW will again be held in conjunction with Vaccination Week in the Americas (VWA) during the week of April 21–28.

To register for the teleconference, send an email to Include this message: "Sign me up for the Hosting a NIIW Event."

For additional information, or to access earlier programs, go to:

In addition, CDC's National Immunization Program is currently requesting suggestions on how to improve its NIIW-VWA observance. To provide them with your feedback, visit

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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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