Issue Number
151
March 28,
2000
CONTENTS OF THIS ISSUE
- CDC publishes "Recommendations and Reports" on strategies to
increase adult immunization rates
- CDC publishes report on rubella outbreaks among
Hispanic adults
- Most recent polio VIS (1-1-00) now available in 22 languages on
IAC's website!
- Check out these resources for National Infant Immunization Week,
including a new Spanish-language campaign
- "Advances in Childhood Disease Prevention" teleconference is
offered April 17 until May 18, 2000
- Protecting college students from meningococcal disease is the
focus of California's satellite broadcast in May
- New resource! IAC adds "CDC Resources You Should Know
About" web page
- New resource! IAC adds "Vaccine Safety" web page
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(1)
March 24, 2000
CDC PUBLISHES "RECOMMENDATIONS AND REPORTS" ON STRATEGIES TO INCREASE ADULT IMMUNIZATION RATES
Strategies for successful adult immunization efforts are the focus of a new issue of "MMWR Recommendations and
Reports" published by the Centers for Disease Control and Prevention (CDC) on March 24, 2000. In this MMWR
issue, CDC has combined two important documents. First, CDC presents a report of the National Vaccine Advisory
Committee (NVAC) titled "Adult Immunization Programs in Nontraditional Settings: Quality Standards and
Guidance for Program Evaluation." Following this report are recommendations of the Advisory Committee on Immunization
Practices titled "Use of Standing Orders Programs to Increase Adult Vaccination Rates."
According to the "Conclusion" of the NVAC report, "The efforts that effectively
lowered vaccine-preventable disease rates among children now need to be targeted
toward developing new and effective immunization programs that will make appropriate vaccines readily accessible
to adults."
Both of the documents in this MMWR issue provide information on practical programs for vaccinating
adults at every opportunity. The following sections describe their content.
1. ADULT IMMUNIZATION PROGRAMS IN NONTRADITIONAL SETTINGS: QUALITY STANDARDS AND GUIDANCE FOR PROGRAM EVALUATION
(A Report of the National Vaccine Advisory Committee)
The "Summary" of this report reads:
"This report provides a summary of the National Vaccine Advisory Committee's (NVAC) workshop on adult immunization
programs in nontraditional settings, quality standards for such programs, and guidance for
program evaluation. Throughout the United States, an increasing number of adults are receiving vaccine in nontraditional settings
(e.g., pharmacies and churches). Immunization programs in nontraditional settings are often more
accessible and convenient than a health-care provider's office or a public health clinic, especially for medically underserved
adults (e.g., economically disadvantaged, inner city, and minority populations). Medically underserved
adults might be at particular risk for undervaccination because they are often
without a medical home (i.e., a regular point of contact where their health-care needs are met).
Immunization programs in nontraditional settings might enhance the capacity of the health-care system to
effectively deliver vaccine to adults by increasing the number and types of sites where adults
can receive vaccine. NVAC has recognized that strategies need to be developed
to make vaccines available to all adults and that the number of immunization programs in nontraditional
settings is increasing. Therefore, the Committee issues the following report, including quality standards and
guidance for program evaluation."
To obtain the text version (HTML format) of this NVAC report, go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4901a1.htm
2. USE OF STANDING ORDERS PROGRAMS TO INCREASE ADULT VACCINATION RATES (Recommendations of the Advisory Committee on
Immunization Practices)
The "Introduction" to these recommendations reads:
"Standing orders programs authorize nurses and pharmacists to administer vaccinations according to
an institution- or physician-approved protocol without a physician's exam. These programs have documented
improved vaccination rates among adults. Standing orders programs can be used in
inpatient and outpatient facilities, long-term-care facilities, managed-care
organizations, assisted living facilities, correctional facilities, pharmacies, adult workplaces, and home
health-care agencies to vaccinate patient, client, resident, and employee populations. The Advisory
Committee on Immunization Practices (ACIP) recommends standing orders for influenza and
pneumococcal vaccinations. Recently, systematic literature reviews by the Task Force for Community Preventive Services and the
Southern California Evidence-Based Practice Center-RAND endorsed these programs for adult
populations.
"This report briefly reviews the evidence regarding the effectiveness of standing orders programs in improving
adult vaccination coverage rates and recommends prioritizing these programs for influenza and pneumococcal
vaccinations, to have the greatest impact on the burden of vaccine-preventable diseases in the United States. Standing
orders programs are also recommended for other vaccines, including hepatitis B vaccine and
diphtheria and tetanus toxoid vaccines, when feasible."
To obtain the text version (HTML format) of these ACIP recommendations, go to:
http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/rr4901a2.htm
To obtain both the NVAC report and the ACIP recommendations as a combined camera-ready document (PDF format), go to:
ftp://ftp.cdc.gov/pub/Publications/mmwr/rr/rr4901.pdf
For information on how to obtain a free electronic subscription to the MMWR,
see the instructions that follow article two below.
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March 24, 2000
CDC PUBLISHES REPORT ON RUBELLA OUTBREAKS AMONG HISPANIC ADULTS
The Centers for Disease Control and Prevention (CDC) published an article titled "Rubella Among Hispanic
Adults--Kansas, 1998, and Nebraska, 1999" in the March 24, 2000, issue of the MMWR. This report describes two
workplace-associated outbreaks of rubella, and summarizes the characteristics of recent rubella outbreaks in the
United States. The "Editorial Note" for this article reads in part:
"During 1969-1989, the annual number of reported cases of rubella in the United States decreased 99.6% as a
result of a successful childhood vaccination program. Indigenous rubella is targeted for elimination in the
United States by the end of 2000. However, approximately two thirds of other
countries did not routinely vaccinate against rubella before 1997. Rubella remains endemic in
many Latin American countries, and large epidemics of rubella occur periodically. For example, during
January-June 1998, approximately 25,000 cases of rubella were reported to the Ministry of Health
in Mexico....
"Although rubella is near record low levels in the United States, epidemics continue to occur among susceptible
foreign-born adults. Workers born outside the United States are a potentially susceptible population in which
outbreaks may occur after importation of the virus from areas outside the United States where rubella is endemic.
Vaccinating against rubella in workplaces is a strategy to reach this susceptible population and can be a
critical step in eliminating indigenous rubella. Public health professionals,
other health-care professionals, and industrial health-care services should design appropriate
programs to assure high coverage of foreign-born employees with rubella vaccine."
To obtain the complete text version (HTML format) of this MMWR article, go to:
http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4911a1.htm
HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
To obtain a free electronic subscription to the "Morbidity and Mortality Weekly
Report" (MMWR), visit CDC's MMWR website at: http://www2.cdc.gov/mmwr
Select "Free MMWR Subscription" from the menu at the left of the screen.
Once you have submitted the required information, weekly issues of the MMWR and all new ACIP statements
(published as MMWR's "Recommendations and Reports") will arrive automatically by e-mail.
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March 28, 2000
MOST RECENT POLIO VIS (1-1-00) NOW AVAILABLE IN 22 LANGUAGES ON IAC'S WEBSITE!
The most current polio Vaccine Information Statement (VIS) dated 1-1-00 is now available in 22 languages
on the website of the Immunization Action Coalition (IAC). Languages in which this polio VIS is now available
include Arabic, Armenian, Cambodian, Chinese, Croatian, English, Farsi, French,
German, Hmong, Japanese, Korean, Laotian, Portuguese, Romanian, Russian, Samoan,
Serbo-Croatian, Somali, Spanish, Tagalog, and Vietnamese.
This current polio VIS reflects the most recent recommendations of the Advisory Committee on Immunization
Practices (ACIP), which support an all-inactivated polio vaccine (IPV) schedule for routine childhood polio
vaccination in the United States. Effective January 1, 2000, children should
receive IPV at ages 2 months, 4 months, 6-18 months, and 4-6 years. Oral polio vaccine (OPV) is
no longer recommended except in special situations.
Regarding the use of the VIS, under federal law anyone who receives a dose of polio vaccine must be given a polio
VIS prior to the dose being administered.
To obtain camera-ready copies (PDF format) of any or all of the polio VISs, go to the VIS index page (organized by
language) on IAC's website at: http://www.immunize.org/vis/
NOTE: To read the ACIP recommendation titled "Revised Recommendations for Routine Poliomyelitis Vaccination,"
which was published as a "Notice to Readers" in the July 16, 1999, MMWR, go to:
http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4827a4.htm
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March 28, 2000
CHECK OUT THESE RESOURCES FOR NATIONAL INFANT IMMUNIZATION WEEK, INCLUDING A NEW SPANISH-LANGUAGE CAMPAIGN
National Infant Immunization Week (NIIW) is just around the corner! The theme of this year's NIIW, set for April
16-22, 2000, is "You Gave Them Life, Protect It." Fortunately, many resources are available to help you plan
your community's participation in this important event.
A new Spanish-language public service campaign will be unveiled on April 16 at the NIIW national kickoff in
Houston, TX. Advance copies of radio and television media kits, which include Spanish-language public service
announcements, are available in limited quantities to official media outlets and
affiliates. In addition, Spanish-language t-shirts and posters are available in
limited quantities to health professionals and community health organizations
that work with Latino communities. To request these materials, call HMA Associates at
(202) 342-0676.
The English-language public service campaign and NIIW promotion kit, which will remain the same as last year,
are currently available from the Centers for Disease Control and Prevention (CDC). NIIW kits can be requested
by sending a fax to (404) 639-8555, or by visiting http://www.cdc.gov/nip/publications/niiw/niiw-order.htm
NOTE: You will need to make two changes to the 1999 NIIW promotion kit once you receive it from CDC. First, because
rotavirus vaccine is no longer recommended, the materials in the NIIW kit that refer to the administration of
rotavirus vaccine will need to be edited. In addition, last year's kit contains the
1999 childhood immunization schedule. You will need to remove the 1999 schedule and replace it
with the 2000 childhood immunization schedule, which is available in camera-ready version (PDF format) at:
http://www.cdc.gov/nip/pdf/child-schedule.pdf
Also available at CDC's website are camera-ready copies (PDF format) of "The Community Guide" and "The
Implementation Handbook," which contain activities, ideas, and sample documents that can be used during NIIW and
throughout the year to promote immunization. Users should be forewarned that the files are both in excess of 40 pages
and may be difficult to download. These documents can be found at: http://www.cdc.gov/nip/publications/niiw/index.htm
Many useful print materials are also available from the Immunization Action Coalition's website. The following
materials have been revised for the year 2000 and can be downloaded, reproduced, and distributed free of charge:
"Immunization for Babies"
Text version (HTML format) available at:
http://www.immunize.org/catg.d/p4010.htm
Camera-ready version (PDF format) available at:
http://www.immunize.org/cat.d/p4010imm.pdf
"When Do Children and Teens Need Vaccinations?"
Text version (HTML format) available at:
http://www.immunize.org/nslt.d/n17/when1.htm
Camera-ready version (PDF format) available at:
http://www.immunize.org/catg.d/when1.pdf
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March 28, 2000
"ADVANCES IN CHILDHOOD DISEASE PREVENTION" TELECONFERENCE IS OFFERED APRIL 17 UNTIL MAY 18, 2000
"Advances in Childhood Disease Prevention" is a live teleconference (telephone conference) coming soon to your
home or office! Offered on 16 different dates and times from April 17-May 18, 2000, this 30-minute
teleconference will provide valuable information about what's new in the 2000
Recommended Childhood Immunization Schedule and will cover emerging trends in polio, pertussis, pediatric
influenza, meningitis, and pneumococcal disease.
Part of Montefiore Medical Center's CME teleconference series, the teleconference is a live forum presented by
Sharon G. Humiston, MD, MPH, a medical epidemiologist at the National Immunization Program, Centers for
Disease Control and Prevention (CDC), and Nancy Rosenstein, MD, a meningitis specialist at CDC's National Center for
Infectious Diseases. A 15-minute interactive question-and-answer session will follow each
teleconference. CME credit is available through Albert Einstein College of Medicine. CEU credit is offered
through the New York State Nurses Association Council on Continuing Education.
To register or to obtain a schedule of teleconference dates and times, call (888) 375-9573 between 9:00 am
and 5:30 pm Eastern Time.
For a detailed list of additional upcoming immunization and hepatitis conferences, visit the Immunization Action
Coalition's "Calendar of Events" at: http://www.immunize.org/calendar/
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March 28, 2000
PROTECTING COLLEGE STUDENTS FROM MENINGOCOCCAL DISEASE IS THE FOCUS OF CALIFORNIA'S SATELLITE BROADCAST IN MAY
"Armed with Information: Protecting College Students from Meningococcal Disease" is a live, interactive satellite
broadcast for health professionals who want to know more about meningococcal disease prevention and management
strategies aimed at the high-risk, college-aged population. Produced by the California Distance Learning Health
Network, this program is set for May 18, 2000, from 9:00 am to 10:30 am Pacific Time.
This course will address the history and changing epidemiology of meningococcal disease in the United
States as well as specific risk factors for the disease, and will emphasize the importance of providing information
about and access to vaccination for college-bound students and their parents. A
question-and-answer session, in which participants can interact with infectious disease experts
via toll-free telephone lines, will be included in this broadcast. Course instructors include William Schaffner,
MD, professor and chair, Department of Preventive Medicine, Vanderbilt School of Medicine; and
Georges Peter, MD, director, Division of Pediatric Infectious Diseases, Rhode
Island Hospital, professor of Pediatrics, Brown University School of Medicine.
CME and CEU credit will be available for participation in this program. For more information on registration or
locations where you can view this broadcast, contact the California Distance Learning Health Network at (619)
594-3348 or by e-mail at cdlhn@mail.sdsu.edu
For a detailed list of additional upcoming immunization and hepatitis conferences, visit the Immunization Action
Coalition's "Calendar of Events" at: http://www.immunize.org/calendar/
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March 28, 2000
NEW RESOURCE! IAC ADDS "CDC RESOURCES YOU SHOULD KNOW ABOUT" WEB PAGE
If you want quick and easy access to information from the Centers for Disease Control and Prevention (CDC) website,
check out the new "CDC Resources You Should Know About" page on the website of the Immunization
Action Coalition (IAC). Here you will find links to valuable information that IAC
references daily when people call us looking for resources.
The page contains links to numerous CDC documents and publications, including recommendations of the Advisory
Committee on Immunization Practices (ACIP), Vaccine Information Statements (VISs), current adult and
childhood immunization schedules, and other publications on immunization issues. Links are also included for
various immunization-related CDC programs and informational websites, including the National
Immunization Program (NIP), the Vaccines for Children program, the NIP Vaccine Safety
web page, the NIP Immunization Registry Clearinghouse, the National Center
or Infectious Diseases' Hepatitis Branch, and the Travelers' Health web page.
Other government immunization resource websites are indexed as well, including the National Vaccine Injury
Compensation Program and Vaccine Adverse Event Reporting System.
To visit IAC's "CDC Resources You Should Know About," go to: http://www.immunize.org/news.d/cdc-resr.htm
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March 28, 2000
NEW RESOURCE! IAC ADDS "VACCINE SAFETY" WEB PAGE
If you have questions or concerns about vaccine safety, be sure to visit the
new "Vaccine Safety" page on the website of the Immunization Action Coalition
(IAC). This page includes links to more than two dozen publications and websites that provide recent and reliable information
about this important issue. Links are provided to general resources on vaccine safety, as well as to
information on specific topics of concern such as hepatitis B vaccine, autism,
thimerosal, fetal tissue research, and anthrax vaccine.
To visit IAC's "Vaccine Safety" web page, go to: http://www.immunize.org/genr.d/vaxsafe.htm
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