IAC Express 2007
|Issue number 644: February 5, 2007
of this Issue
Select a title to jump to the article.
VIS: CDC makes minor change to interim VIS for HPV vaccine
offers email update service for many CDC web pages
unveils two new efforts to advance pandemic influenza preparedness
- Death of
St. Paul boy reminds professionals and parents of the importance of
calls for mandatory influenza vaccination for healthcare workers
Pennsylvania Immunization Education Program provides slides and speaker
scientists discover more about the 1918 influenza virus
Teleconference on National Infant Immunization Week scheduled for February
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
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.
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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
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.
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You can sign up for specific page updates in two ways:
1. Go to
http://www.cdc.gov/emailupdates, 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.
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.
HHS UNVEILS TWO NEW EFFORTS TO ADVANCE PANDEMIC FLU PREPAREDNESS
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
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
(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
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
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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Death of St. Paul boy reminds
professionals and parents of the importance of influenza vaccination
On January 31, eight-year-old Lucio Satar, a
child, died of pneumonia, a complication he developed after
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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
The National Influenza Vaccine Summit website at
CDC's Influenza web section at http://www.cdc.gov/flu
IDSA calls for mandatory
influenza vaccination for healthcare workers
On January 25, the Infectious Diseases Society of
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
To download the 24-page report in ready-to-print (PDF) format, click
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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.
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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 http://www.paiep.org and click on Curriculum and
For more information, contact Program Director Amy Wishner, MSN,
RN, by email at email@example.com or by phone at (800) 375-5214
[PA only] or (484) 446-3004..
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.
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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:
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.
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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
IZTA@aed.org Include this message: "Sign me up for the Hosting a
For additional information, or to access earlier programs, go
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