Issue
Number 342
October 14, 2002
CONTENTS OF THIS ISSUE
- Ample vaccine supply
is reason to celebrate this year's National Adult Immunization Awareness
Week
- MMWR notifies
readers that the long-awaited harmonized Adult Immunization Schedule is
now available!
- HHS rule expands use
of standing orders to make it easier for Medicare and Medicaid
beneficiaries to get flu and pneumococcal vaccines
- AAP issues policy
statement on smallpox vaccine
- Order now! Popular
"Immunization Techniques" video is going fast, but there's still time to
get yours
- New! CDC's National
Immunization Program releases Influenza Bulletin #5
- New! WHO issues
position paper on meningococcal vaccines
- Meeting of
Immunization Safety Review Committee set for October 28-29
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October 14, 2002
AMPLE VACCINE SUPPLY IS REASON TO CELEBRATE THIS YEAR'S NATIONAL ADULT
IMMUNIZATION AWARENESS WEEK
Health care providers have a lot to cheer about during National Adult
Immunization Awareness Week, October 13-19. For one thing, there's an
abundance of two vaccines for adults that were scarce last year: influenza
vaccine and adult tetanus and diphtheria toxoids (Td). For another,
immunization resources abound.
Vaccine supply
The big news is that a record-setting amount of influenza vaccine is
available for the 2002-2003 flu season. The Centers for Disease Control and
Prevention (CDC) reported the following in the October 4 issue of the
"Morbidity and Mortality Weekly Report" (MMWR): "The three manufacturers
distributing influenza vaccine in the United States are expected to
produce approximately 94 million doses combined, the largest number of
trivalent influenza vaccine doses ever projected for a single season.
Vaccine manufacturers estimate that approximately 80% of the 94 million
doses of influenza vaccine will be distributed by the end of October."
Also, according to "Influenza Vaccine Bulletin #5" of CDC's National
Immunization Program (NIP), which was released October 9, several
million doses of influenza vaccine remain available for purchase. Interested
providers should contact their regular sources of influenza vaccine for
supplies.
According to MMWR's June 21 issue, the supply of Td vaccine is also
plentiful. CDC urges adults and adolescents who were prevented from getting
routine booster doses because of previous vaccine shortages to get them now.
Likewise, there is no reported shortage of other vaccines given to adults,
such as pneumococcal polysaccharide vaccine (PPV23), hepatitis A vaccine,
and hepatitis B vaccine.
Immunization resources
A wealth of continually updated influenza information exists on NIP's "Flu
Season 2002-03" web page. NIP encourages providers to check the page often
throughout flu season.
To access NIP's flu page, go to:
http://www.cdc.gov/nip/flu/
The website of the Immunization Action Coalition (IAC) offers providers
"Give These People Flu Vaccine," a one-page professional education piece.
For an HTML copy, go to:
http://www.immunize.org/catg.d/2013flu.htm
For a camera-ready (PDF) copy, go to:
http://www.immunize.org/catg.d/2013flu.pdf
IAC's site also posts CDC's influenza Vaccine Information Statement (VIS),
as well as VISs for 14 other vaccines (available in up to 28 languages).
For camera-ready (PDF) copies of all VISs, go to:
http://www.immunize.org/vis/
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October 14, 2002
MMWR NOTIFIES READERS THAT THE LONG-AWAITED HARMONIZED ADULT IMMUNIZATION
SCHEDULE IS NOW AVAILABLE!
The Centers for Disease Control and Prevention (CDC) published a Notice to
Readers "Recommended Adult Immunization Schedule--United States, 2002-2003"
in the October 11 issue of Morbidity and Mortality Weekly Report (MMWR).
According to the MMWR, the schedule is an up-to-date tool that will help
health professionals assess an adult patient's need for vaccination during
the office visit. It is anticipated to reduce missed vaccination
opportunities.
The article announced the new harmonized Adult Immunization Schedule,
printed it, explained it, and encouraged immunization providers to use it.
Following are the first two paragraphs of the article (excluding reference
numbers).
*************************
Although the childhood immunization program in the United States has reduced
the burden of vaccine-preventable disease substantially among children,
substantial vaccine-preventable morbidity and mortality from diseases such
as hepatitis A, hepatitis B, influenza, and pneumococcal infections continue
to occur among adults. In February 2002, the Advisory Committee on
Immunization Practices (ACIP) approved for the first time a schedule for the
routine vaccination of persons aged 19 years and older. The Adult
Immunization Schedule has been accepted by the American Academy of Family
Physicians (AAFP) and the American College of Obstetricians and
Gynecologists (ACOG). ACIP will review and approve annually both the
recommended adult and childhood immunization schedules. Together, these
schedules provide a comprehensive summary of recommendations for prevention
of vaccine-preventable diseases during the life span of persons in the
United States.
The Adult Immunization Schedule is based on published recommendations of
ACIP, AAFP, ACOG, and the American College of Physicians--American
Society of Internal Medicine (ACP-ASIM) with the Infectious Diseases Society
of America and was developed by members of these organizations and CDC. The
schedule presents a tabular, color-coded summary of vaccine indications by
age group and medical condition. Footnotes included in Figure 1 are
summaries of the ACIP recommendations for specific vaccines since 1991.
Figure 2 includes special considerations or contraindications for
vaccinating persons with specific medical conditions. Licensed combination
vaccines can be used whenever any components of the combination are
indicated and the vaccine's other components are not contraindicated.
Providers should consult manufacturers' package inserts for detailed
recommendations. CDC and ACIP will update the schedule annually through
collaboration with members of AAFP, ACOG, and ACP-ASIM.
*************************
A printable, annotated, color version of the schedule is available; it can
also be printed in black and white. For a camera-ready (PDF) version, go to:
http://www.cdc.gov/nip/recs/adult-schedule.pdf
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5140a5.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5140.pdf
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://www.cdc.gov/mmwr Select
"Free 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 email.
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October 14, 2002
HHS RULE EXPANDS USE OF STANDING ORDERS TO MAKE IT EASIER FOR MEDICARE AND
MEDICAID BENEFICIARIES TO GET FLU AND PNEUMOCOCCAL VACCINES
On October 1, Department of Health and Human Services (HHS) secretary, Tommy
G. Thompson, announced a change in federal rules that will make it easier
and faster to give flu and pneumococcal vaccinations in hospitals, long-term
care facilities, and home health agencies that serve Medicare and Medicaid
beneficiaries.
In "Influenza Vaccine Bulletin #5," dated October 9, the National
Immunization Program of the Centers for Disease Control and Prevention
described the crux of the change as follows:
***********************
On October 2, 2002, the Centers for Medicare and Medicaid Services (CMS)
published an interim final rule in the Federal Register which removes from
the Conditions of Participation the physician signature requirement for
influenza and pneumococcal vaccinations in Medicare and Medicaid
participating hospitals, long-term care facilities, and home health
agencies.
To the extent allowed by state law, these facilities and agencies may now
implement standing orders for influenza and pneumococcal vaccination of
Medicare- and Medicaid-eligible patients.
***********************
Before the change, a physician's order was required for vaccinations given
in Medicare- or Medicaid-participating hospitals, nursing homes, and home
health agencies, even though vaccinations could be given using standing
orders in other settings, such as clinics and doctors' offices.
To read the complete press release from HHS, go to:
http://www.hhs.gov/news/press/2002pres/20021001.html
To learn more about using standing orders in your health care setting,
contact your local or state health department.
To access a camera-ready (PDF) copy of the complete text of the interim
final rule from the Federal Register, go to:
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=2002_register&docid=02-25096-filed.pdf
The Immunization Action Coalition (IAC) is developing a web page on the use
of standing orders for immunization. Look for an announcement about it in an
up-coming issue of IAC EXPRESS.
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October 14, 2002
AAP ISSUES POLICY STATEMENT ON SMALLPOX VACCINE
The October 2002 issue of "Pediatrics," the journal of the American Academy
of Pediatrics, contains the Academy's new policy statement on smallpox
vaccine. Following is the abstract.
*******************
After an extensive worldwide eradication program, the last nonlaboratory
case of smallpox occurred in 1977 in Somalia. In 1972, routine smallpox
immunization was discontinued in the United States, and since 1983, vaccine
production has been halted. Stockpiled vaccine has been used only for
laboratory researchers working on orthopoxviruses. In recent years, there
has been concern that smallpox virus stocks may be in the hands of
bioterrorists, and this concern has been heightened by the terrorist attack
on the World Trade Center and the Pentagon on September 11, 2001. Because
most of the population is considered to be nonimmune, there is debate as to
whether smallpox immunization should be resumed. This statement reviews the
current status of smallpox vaccine, the adverse effects that were associated
with smallpox vaccine in the past, and the major proposals for vaccine use.
The statement provides the rationale for a policy based on the so-called
ring vaccination strategy recommended by the Centers for Disease Control and
Prevention, in which cases of smallpox are rapidly identified, infected
individuals are isolated, and contacts of the infected individuals as well
as their contacts are immunized immediately.
*******************
To access the text of the complete smallpox policy statement from the AAP
website, go to:
http://www.aap.org/policy/s040209.html
To access the abstract from "Pediatrics," October 2002, Vol.110(4):841-45,
go to:
http://www.pediatrics.org/cgi/content/abstract/110/4/841
For additional information about the AAP, visit the AAP website at
http://www.aap.org/
To access many other AAP vaccine policy
statements, go to the Immunization Action Coalition's web page "Immunization
Policy Statements from the American Academy of Pediatrics," at
http://www.immunize.org/aap/
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October 14, 2002
ORDER NOW! POPULAR "IMMUNIZATION TECHNIQUES" VIDEO IS GOING FAST, BUT
THERE'S STILL TIME TO GET YOURS
Since we first offered the video "Immunization Techniques: Safe, Effective,
Caring" in IAC EXPRESS #273 in September 2001, IAC has sold more than 6,300
videotapes! More than a third of those orders were placed in the last three
months.
One reason for the recent high sales volume is that some organizations have
found the video to be such a powerful staff-training tool that they have
placed large orders. For example, the Pennsylvania VFC Program ordered 1,800
videos, the Georgia Chapter of the American Academy of Pediatrics ordered
105, and the Connecticut Department of Public Health ordered 101.
The 35-minute video, titled "Immunization Techniques: Safe, Effective,
Caring," was developed by the California Department of Health Services
Immunization Branch in collaboration with a team of national experts.
Designed for use as a "hands-on" instructional program, the video is
intended to train new staff and provide a refresher course for
experienced staff who administer vaccines.
It teaches best practices for administering intramuscular (IM) and
subcutaneous (SC) vaccines to infants, children, and adults and discusses
the following:
Anatomic sites
Choice of needle size
Vaccines and routes of administration
How to "draw up" doses of vaccine from a vial
People of various ages--from infants to
adults--are vaccinated in the video to demonstrate these techniques.
The video comes with presenter's notes that include instructional
objectives, pre- and post-tests, photos showing vaccination sites
appropriate for vaccinating people of different ages, and a skills checklist
to help you document that your staff is well trained.
IAC distributes the video and presenter's notes at $15 per set (to U.S.
addresses). California Distance Learning Health Network (CDLHN) offers it at
$25 per set. The versions are the same except that IAC's video comes in a
plain cardboard sleeve and the presenter's notes are printed in black and
white, while CDLHN's video box and presenter's notes are printed in color.
The videotape and text of presenter's notes are identical. CDLHN also
has a Spanish version available.
If you wish to order online (U.S. addresses only), go to:
https://www.immunize.org/iztech
To order by mail or fax, print an IAC order form, available at
http://www.immunize.org/catg.d/2020a.pdf
Send your order payment (check, credit card information, or purchase order)
to Immunization Action Coalition, 1573 Selby Ave., Ste. 234, St. Paul, MN
55104, and include your complete mailing information and phone number. You
can fax your order form with payment information to IAC at (651) 647-9131.
If you are placing an order from outside the United States, please call IAC
at (651) 647-9009 for shipping cost information.
To order through CDLHN, call (619) 594-3348, email
cdlhn@projects.sdsu.edu, or
visit CDLHN online at
http://www.cdlhn.com/
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October 14, 2002
NEW! CDC'S NATIONAL IMMUNIZATION PROGRAM RELEASES INFLUENZA BULLETIN #5
On October 9, the National Immunization Program (NIP) of the Centers for
Disease Control and Prevention (CDC) issued the fifth in a series of
influenza vaccine bulletins designed to update health professionals on the
production, distribution, and administration of influenza vaccine for the
2002-2003 influenza season. Following is a summary of Influenza Bulletin #5.
Influenza vaccine supply and production
Several million doses of influenza vaccine remain available for the
2002-2003 flu season; providers are encouraged to contact their regular
sources of influenza vaccine to make purchases.
Influenza vaccine distribution
Effective October 2, the Department of Health and Human Services changed the
rule for administering influenza and pneumonia vaccines in hospitals,
long-term care facilities and home health agencies that serve Medicare and
Medicaid beneficiaries. The change allows these facilities and agencies to
use standing orders, rather than physicians' signed orders, when giving flu
and pneumonia vaccines. For more information, see article #3 in this week's
issue of "IAC EXPRESS."
Effective October 16, the Health Insurance Portability and Accountability
Act (HIPAA) requires providers to use standard formats for electronic
transmission of health care claims. However, HIPAA legislation allows
providers not in compliance with the act to file for a one-year extension
before October 16. To find out more about HIPAA and the extension, go
to: http://www.cms.hhs.gov/hipaa/
Influenza vaccine communications
The Centers for Disease Control and Prevention (CDC) has new education
materials for this season, including the chart "Pediatric Influenza Vaccine
Dosages." CDC warns providers that another pediatric influenza vaccine
dosage chart--WITH INCORRECT INFORMATION--is circulating. To avoid
confusion, providers should use only the chart that displays the CDC logo.
To view new materials, go to the CDC's web page "Patient Education Materials
for the 2002-03 Season" at
http://www.cdc.gov/nip/flu/Provider.htm#Education
To view or obtain a complete copy of the bulletin, go to:
http://www.cdc.gov/nip/flu/Bulletins_2002-03/bulletin_5.htm
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October 14, 2002
NEW! WHO ISSUES POSITION PAPER ON MENINGOCOCCAL VACCINES
The World Health Organization (WHO) published a new position paper,
"Meningococcal Vaccines: Polysaccharide and Polysaccharide Conjugate
Vaccines," in the October 4 issue of the "Weekly Epidemiological Record."
The paper is the latest in a series on vaccines and vaccine combinations
against diseases that have an international public health impact. The papers
are primarily intended for national public health officials and program
managers of large-scale immunization programs.
A link to the new position paper is included on the website of the
Immunization Action Coalition (IAC), along with links to all WHO position
papers on vaccines and other WHO vaccination resources.
For links to IAC's "WHO Immunization Information" web page, go to:
http://www.immunize.org/who/
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October 14, 2002
MEETING OF IMMUNIZATION SAFETY REVIEW COMMITTEE SET FOR OCTOBER 28-29
The seventh meeting of the Institute of Medicine's Immunization Safety
Review Committee will be held October 28-29 at Beckman Center on the campus
of the University of California, Irvine. The meeting topic is the
potential role of vaccination in sudden, unexpected infant death.
For information about the meeting and to register online, go to:
http://www.iom.edu/IOM/IOMHome.nsf/Pages/sudi
For additional information, call (202) 334-1342 or email
imsafety@nas.edu
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