Issue
Number 512
February 21, 2005
CONTENTS OF THIS ISSUE
- CDC and NIH support influenza vaccination of elderly,
though study states it may not prevent as many deaths as assumed
- CDC reports on hepatitis A vaccination coverage among
U.S. children ages 24-35 months during 2003
- New: CDC website posts numerous resources for National
Infant Immunization Week and Vaccination Week in the Americas
- New: Journal of Family Practice's immunization
supplement, "Vaccines Across the Life Span, 2005," is now online
- New: February issue of CDC's Immunization Works
electronic newsletter now available on the NIP website
- State officials: Betty Bumpers to speak at February 23
web conference on Vaccine Safety: What Legislators Need to Know
- AED launches listserv for members of the National
Immunization Coalition TA Network
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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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February 21, 2005
CDC AND NIH SUPPORT INFLUENZA VACCINATION OF ELDERLY, THOUGH STUDY STATES IT
MAY NOT PREVENT AS MANY DEATHS AS ASSUMED
On February 15, CDC and the National Institutes of Health (NIH) issued a
statement supporting the ACIP recommendation that persons 65 years and older
receive influenza vaccine yearly. A study, "Impact of Influenza Vaccination
on Seasonal Mortality in the U.S. Elderly Population," published February 14
in the Archives of Internal Medicine, raises questions about the efficacy of
influenza vaccination in preventing death among persons in this age group.
The CDC/NIH statement is reprinted below in its entirety. Following the
statement is a link to the abstract of the article published in the Archives
of Internal Medicine.
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"Impact of Influenza Vaccination on Seasonal Mortality in the U.S. Elderly
Population" by Simonsen et al. (2005): A Statement by the Centers for
Disease Control and Prevention (CDC) and the National Institutes of Health (NIH)
A study published this week in the Archives of Internal Medicine reports
that vaccination of the elderly population against influenza may be less
effective in preventing death among the elderly than previously assumed.
This study's findings have caused some confusion about whether people 65
years old and older should receive an influenza vaccination.
CDC and NIH continue to support the Advisory Committee on Immunization
Practices (ACIP) recommendation that people aged 65 and older get vaccinated
against influenza each year. People aged 65 and older are at highest risk
for complications, hospitalizations, and deaths from influenza. Vaccination
remains the best protection from influenza available for people 65 and older
and their loved ones.
Numerous studies have shown that influenza vaccination works--including to
help protect the elderly from serious illness and hospitalizations--but the
degree to which it works varies from year to year and can be difficult to
measure. For example, influenza seasons differ each year in length and
severity, and the health status of individuals also matters.
In the current study by Simonsen et al., the authors in no way imply that
the elderly should not receive influenza vaccine. Rather, the study
concludes that the vaccine may prevent fewer deaths among the elderly than
previous studies would have suggested. Therefore, the authors note that
there is room for improvement in influenza prevention efforts, including
research into developing more effective vaccines for the elderly and the
increased use of medicines to treat flu.
In addition, recently published studies raise the possibility that it may be
beneficial to vaccinate larger numbers of healthy persons, including
children, to prevent transmission of influenza viruses to high-risk persons
such as the elderly.
Expansion of groups for whom influenza vaccination is recommended is under
discussion by the ACIP and CDC, and is partly contingent on adequate vaccine
supply in the future.
The CDC and ACIP continually review their influenza vaccine recommendations
as well as studies and published research in order to develop the best
recommendations for protecting all Americans from influenza. This study is a
reminder that there is room for improvement in how we protect the elderly
from influenza, and CDC and NIH encourage research that strengthens our
ability to do so.
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To access the CDC/NIH statement, go to:
http://www.cdc.gov/flu/pdf/statementeldmortality.pdf
To access the abstract of the article published in the Archives of Internal
Medicine, go to:
http://archinte.ama-assn.org/cgi/content/abstract/165/3/265
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February 21, 2005
CDC REPORTS ON HEPATITIS A VACCINATION COVERAGE AMONG U.S. CHILDREN AGES
24-35 MONTHS DURING 2003
CDC published "Hepatitis A Vaccination Coverage Among Children Aged 24-35
Months--United States, 2003" in the February 18 issue of MMWR. The article
is reprinted below in its entirety with the exception of one table, one
figure, and references.
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Hepatitis A vaccine was first licensed in the United States in 1995. In
1996, the Advisory Committee on Immunization Practices (ACIP) recommended
vaccination of children aged >=24 months in populations with the highest
incidence of hepatitis A (e.g., American Indian/Alaska Native [AI/AN],
Asian/Pacific Islander, and selected Hispanic and religious communities). In
1999, these guidelines were expanded to recommend routine vaccination for
children residing in 11 states where average annual hepatitis A incidence
during 1987-1997 was at least 20 per 100,000 population (twice the national
average) and to consider routine vaccination for children in six states
where average annual incidence was 10-20 per 100,000 population. This report
is the first national analysis of hepatitis A vaccination coverage among
children. The results indicate that, in 2003, vaccination coverage levels
with at least 1 dose of hepatitis A vaccine for children aged 24-35 months
varied from 6.4% to 72.7% in areas where routine vaccination is recommended.
In addition, hepatitis A vaccination coverage rates for children aged 24-35
months are lower than overall rates for other vaccines recommended for
children. Sustaining and improving vaccination coverage among young children
is needed to ensure continued declines in hepatitis A incidence in the
United States.
The National Immunization Survey (NIS) provides annual estimates of
vaccination coverage as of the time of household interview among children
aged 19-35 months for the 50 states and 28 selected urban areas. In 2003,
NIS began to collect data regarding hepatitis A vaccination coverage.
Hepatitis A vaccine is a 2-dose regimen (administered at least 6 months
apart) licensed for use in children aged >=24 months. Hepatitis A
vaccination coverage data were limited to children aged 24-35 months and
calculated by considering children who had received at least 1 vaccine dose.
To collect vaccination data for all age-eligible children, NIS uses a
quarterly, random-digit-dialing sample of telephone numbers for each of the
78 survey areas and determines vaccination status from healthcare provider
records. During 2003, information on vaccination history was collected from
telephone interviews for 19,979 children; provider verified vaccination
records were available for 13,731 (68.7%).
Among children aged 24-35 months residing in the 11 states where routine
hepatitis A vaccination is recommended, 50.9% (95% confidence interval [CI]
= 47.6%-54.2%; range among states: 6.4%-72.7%) received at least 1 dose of
hepatitis A vaccine. Among children aged 24-35 months residing in the six
states where routine hepatitis A vaccination should be considered, 25.0% (CI
= 21.8%-28.2%; range: 0.6%-32.3%) had received at least 1 dose of hepatitis
A vaccine. Among children aged 24-35 months residing in the 33 states
without a specific recommendation, 1.4% (CI = 1.0%-1.8%; range: 0.0%-4.3%)
had received at least 1 dose of hepatitis A vaccine. Two states (Alaska and
Arizona) and four urban areas had coverage estimates >60%. Hispanic and
AI/AN children had higher coverage rates than non-Hispanic white or black
children in areas where routine vaccination is recommended or should be
considered.
Editorial Note:
The national hepatitis A vaccination coverage estimates described in this
report indicate that, in 2003, current hepatitis A childhood vaccination
recommendations were being implemented in many states. However, coverage
varied among areas and populations, likely because of targeted programs
within these states. For example, higher coverage in El Paso County, Texas
(71%), compared with the overall Texas coverage rate (32%), likely is
attributable to vaccination requirements in Texas border counties for all
children attending child care programs.
Vaccination coverage also varied by race/ethnicity. Higher coverage among
Hispanic and AI/AN children than among children of other racial/ethnic
populations might be related to greater disease recognition in these
populations and local and national vaccination recommendations that have
identified these populations as having higher hepatitis A rates.
The findings in this report are subject to at least three limitations.
First, NIS is a telephone survey; although statistical weights adjust for
nonresponse and households without telephones, some bias might remain.
Second, although NIS relies on provider-verified vaccination histories,
incomplete records or reporting could result in underestimates of coverage.
Finally, although national estimates are reliable, estimates for states and
urban areas and for racial/ethnic populations should be interpreted with
caution.
The 1999 ACIP hepatitis A prevention
recommendations encouraged state and local immunization programs to analyze
their surveillance data and implement vaccination strategies that address
the epidemiology of hepatitis A in their areas. The variation by state in
coverage among children aged 24-35 months likely reflects the varying
vaccination strategies adopted by state and local public health officials in
response to the ACIP recommendations. Higher coverage among Hispanic and
AI/AN children is one indication that vaccination efforts targeting children
at higher risk for illness have been successful.
These data do not provide information on why hepatitis A vaccination
coverage for children aged 24-35 months remains below that for other
childhood vaccinations in most areas where it is recommended. Low coverage
rates for young children might be the result of (1) a focus by healthcare
providers and immunization programs on vaccinating older children, (2) the
few areas with hepatitis A vaccine mandates, or (3) the lack of a licensed
hepatitis A vaccine that can be administered to children aged <24 months.
Sustaining and improving vaccination coverage among young children is needed
to ensure continued declines in hepatitis A incidence in the United States.
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To access a web-text (HTML) version of this article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5406a1.htm
To access a ready-to-copy (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5406.pdf
To receive a FREE electronic subscription to MMWR (which includes new ACIP
statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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February 21, 2005
NEW: CDC WEBSITE POSTS NUMEROUS RESOURCES FOR NATIONAL INFANT IMMUNIZATION
WEEK AND VACCINATION WEEK IN THE AMERICAS
On February 10, the website of CDC's National Immunization Program posted
several resources that communities can use to promote vaccination during
National Infant Immunization Week (NIIW), which is being held in conjunction
with Vaccination Week in the Americas (VWA). This year, NIIW is April 24-30,
and VWA is April 23-30.
NIIW will focus on the importance of immunizing infants against 12
vaccine-preventable diseases by age two. Coordinated by the Pan American
Health Organization (PAHO), VWA is devoted to immunizing people in the
Western Hemisphere who are often left behind--children and others residing
in border regions, indigenous people and vulnerable groups, women of
childbearing age, and the elderly.
Materials posted on the NIP website are intended to promote the benefits of
immunization, particularly for infants and children. Materials currently
available include information about creating a kickoff event, sample public
relations materials, and a web-link banner and icon button for use on
organization websites. Posters, stickers, and public service announcements
will be added soon. To access these materials, go to:
http://www.cdc.gov/nip/events/niiw/2005/05default.htm
A particularly valuable resource includes a detailed description of
activities conducted in communities in 17 states during NIIW 2004. Any
organization interested in promoting immunization will benefit from perusing
this information. To access it, go to:
http://www.cdc.gov/nip/events/niiw/2004/04activities.htm
To access the English-language version of PAHO's Vaccines and Immunization
web section, go to:
http://www.paho.org/English/AD/FCH/IM/vaccines.htm
To access the Spanish-language version, go to:
http://www.paho.org/Spanish/AD/FCH/IM/vacunas.htm
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February 21, 2005
NEW: JOURNAL OF FAMILY PRACTICE'S IMMUNIZATION SUPPLEMENT, "VACCINES ACROSS
THE LIFE SPAN, 2005," IS NOW ONLINE
Published in January, the Journal of Family Practice's immunization
supplement, "Vaccines Across the Life Span, 2005," is now available online.
Written by members of the Group on Immunization Education of the Society of
Teachers of Family Medicine, the 72-page supplement contains six articles
(titles below) and a color centerfold with pictures of vaccine-preventable
diseases and immunization schedules.
Following are the titles of the six articles:
- Recent changes in influenza epidemiology
and vaccination recommendations
- Routine vaccines across the life span,
2005
- Vaccines for persons at high risk due to
medical conditions, occupation, environment, or lifestyle, 2005
- Vaccine schedules and procedures, 2005
- Communicating the benefits and risks of
vaccines
- Immunization barriers and solutions
To access the supplement online, go to:
http://www.jfponline.com/supplements/supp_0105.asp
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February 21, 2005
NEW: FEBRUARY ISSUE OF CDC'S IMMUNIZATION WORKS ELECTRONIC NEWSLETTER NOW
AVAILABLE ON THE NIP WEBSITE
The February 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.
To access the February issue from the NIP website, go to:
http://www.cdc.gov/nip/news/newsltrs/imwrks/2005/200502.htm
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February 21, 2005
STATE OFFICIALS: BETTY BUMPERS TO SPEAK AT FEBRUARY 23 WEB CONFERENCE ON
VACCINE SAFETY: WHAT LEGISLATORS NEED TO KNOW
IAC recently posted the following web conference to its Calendar of Events
web section:
VACCINE SAFETY: WHAT LEGISLATORS NEED TO KNOW
SCHEDULED FOR February 23 at 2PM EST.
INTENDED FOR state legislators and others interested in learning about the
importance of immunization and vaccine safety concerns and how state
leaders are handling these issues.
SPEAKERS INCLUDE Betty Bumpers, co-founder and spokesperson for Every
Child By Two and former First Lady of Arkansas; Dr. Melinda Wharton,
acting deputy director, NIP; Dr. Harry Hull, state epidemiologist,
Minnesota Department of Health.
REGISTER SOON; space is limited for this free event. To register online,
go to:
http://www.healthystates.csg.org/Events+and+Conferences Scroll
down to the conference title and click on "click here to register."
PRESENTED BY the Council of State Governments.
FOR ADDITIONAL INFORMATION, contact Sarah Donta by email at
sdonta@csg.org or by phone at
(859) 244-8244.
FOR INFORMATION ON ADDITIONAL CONFERENCES of interest to those in the
immunization community, visit the IAC Calendar of Events web section at
http://www.immunize.org/calendar
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February 21, 2005
AED LAUNCHES LISTSERV FOR MEMBERS OF THE NATIONAL IMMUNIZATION COALITION
TA NETWORK
In January, the Academy for Educational Development (AED) launched
IZNetwork, a listserv for members of the National Immunization Coalition
TA [technical assistance] Network. The listserv's purpose is to increase
networking and information sharing among members, help members respond to
emerging issues collaboratively with coalitions nationwide, and provide
knowledge and tools that can help members meet their coalition's goals.
To subscribe to the listserv, send an email to
iznetwork@listserv.aed.org.
Type "Sign Me Up" in the subject line, and leave the body of the email
empty. |
