Issue
Number 398
July 7, 2003
CONTENTS OF THIS ISSUE
- June issue of CDC's "Immunization Works!"
electronic newsletter is packed with timely news
- Article about hepatitis B vaccination of
high-risk adults makes case for federal funding
- NNii combs national and international press to
generate content for "Immunization Newsbriefs"
- New website for MSM lists clinics providing free
or low-cost hepatitis A and B vaccination
- Wisconsin Hepatitis Conference set for September
5
- CDC updates interim guidance for use of smallpox
vaccine, cidofovir, and vaccinia immune globulin for prevention and
treatment of monkeypox infections
- CDC publishes an update on current monkeypox
outbreak
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July 7, 2003
JUNE ISSUE OF CDC'S "IMMUNIZATION WORKS!" ELECTRONIC NEWSLETTER IS PACKED
WITH TIMELY NEWS
"Immunization Works!" a monthly email newsletter published by the Centers
for Disease Control and Prevention, offers a number of articles
pertinent to persons in the immunization community. Some of the information
in the June issue has already appeared in previous issues of "IAC EXPRESS."
Following is the text of six articles we have not covered.
**************************
FIRST NASAL VACCINE APPROVED FOR USE: On June 17, 2003, the Food and Drug
Administration (FDA) approved the use of FluMist, an influenza vaccine that
is the first nasally administered vaccine to be marketed in the United
States. It is also the first live virus influenza vaccine approved in the
U.S.
FluMist is approved to prevent influenza illness due to influenza A and B
viruses in healthy children and adolescents, ages 5-17 years, and healthy
adults, ages 18-49.
In clinical trials, FluMist was evaluated in 20,228 individuals, including
over 10,000 healthy children 5-7 years old. The efficacy of the vaccine in
preventing influenza was approximately 87 percent among children included in
the trial. In healthy adults ages 18-49 years, FluMist was effective in
reducing severe illnesses with fever, and upper respiratory problems
which may be caused by influenza infection.
As with any live virus vaccines, FluMist should not be given for any reason
to people with immune suppression, including those with immune deficiency
diseases, such as AIDS or cancer, and people who are being treated
with drugs that cause immunosuppression.
The safety of FluMist in people with asthma or other reactive airway
diseases has not been established; FluMist should not be given to people
with a history of these problems. In a large safety study, children under
five years of age were found to have increased rate of asthma and wheezing
within 42 days of vaccination compared to placebo recipients, and thus
FluMist is not recommended for young children. For people age 50 years
and over, the safe and effective use of FluMist has also not been
established.
The vaccine should also not be administered to those with therapies
including aspirin, a history of Guillain-Barre syndrome, chronic diseases,
allergies to eggs or those who are pregnant.
The most common adverse events associated with the vaccine were nasal
congestion, runny nose, sore throat, and cough.
FluMist is produced by MedImmune Vaccines and will be distributed by Wyeth.
Both companies will market the product.For more information visit
www.fda.gov or
www.cdc.gov/nip
**************************
ACIP HIGHLIGHTS: The Advisory Committee on Immunization Practices (ACIP) met
earlier this month in Atlanta. Besides offering unanimous support for the
new influenza vaccine, FluMist, as outlined above, the ACIP also took
the following actions:
- Smallpox: The committee unanimously passed
a draft statement that states "ACIP feels it is unwise to expand
beyond the current, ACIP pre-event smallpox vaccination recommendations.
ACIP is concerned about a new and unanticipated safety concern, i.e., myo/pericarditis,
whose extent and severity, particularly of long term sequelae, are not yet
known." The statement does encourage the continued activities related to
smallpox preparedness as well as continued vaccination of established
response teams.
- Pneumococcal Vaccine for Individuals with
Cochlear Implants: ACIP unanimously extended pneumoccocal vaccination
recommendation to include individuals who have or are scheduled to receive
cochlear implants.
**************************
OTHER ACIP NEWS: The Committee also discussed education for parents about
meningococcal vaccine, thimerosal, research and development of safe,
disposable cartridge jet injectors for mass immunization campaigns as well
as other issues. More information regarding ACIP actions can be found at
www.cdc.gov/nip
**************************
INTERNATIONAL IMMUNIZATION OPPORTUNITIES: The Global Immunization Division
at the National Immunization Program at CDC is currently accepting
applications for the September '03 and January '04 Stop Transmission
of Polio (STOP) teams. CDC is recruiting candidates to work both in field
surveillance assignments, as well as data management assignments. In order
to qualify for consideration, candidates must either have obtained a
graduate degree or licensure in health and have three years of relevant work
experience (for example, MD, PA, RN, DVM, MPH) OR have five years of
relevant work experience. Particularly desirable is field surveillance
and/or immunization program experience, especially in developing countries,
in addition to a demonstrated ability to work in French, Portuguese, or
Arabic. For more information and application procedures, please visit
www.cdc.gov/nip/global
Also, CDC periodically recruits Medical Officers and Epidemiologists to work
on measles, polio, and other activities in Atlanta-based positions as
well as long-term assignments (2 yrs. minimum) in various overseas
locations. We are especially interested in mid-career professionals with at
least five years of international public health management, disease
surveillance and/or immunization program experience, and excellent
interpersonal skills. Please contact Liz Bell at
ebell@cdc.gov or Carla Lee at
cel1@cdc.gov for further information.
**************************
EPIDEMIOLOGY AND PREVENTION OF VACCINE-PREVENTABLE DISEASES COURSE: The
Epidemiology and Prevention of Vaccine-Preventable Diseases two-day course
will be offered this fall in Indiana and California. The courses will be
held in Indianapolis, Indiana, September 9-10, 2003, Torrance, California,
November 17-18, 2003, and Sacramento, California, November 20-21, 2003. This
course provides the latest information for providers on immunizations and
the diseases they can prevent. Continuing education credits will be offered
for various professions based on 15 hours of instruction. For Indiana
information, contact Susan Meece-Hinh at
smeecehi@iupui.edu or (317)
274-3178. For California information, contact Melissa Dahlke at
mdahlke@dhs.ca.gov or (510)
540-2379.
**************************
EARN FREE CONTINUING EDUCATION CREDITS: Continuing Education Credits,
including CME, CNE, CEU, and CECH, are available for the 4-part series
"Epidemiology and Prevention of Vaccine Preventable Diseases 2003." The
series is available on 4 VHS videotapes available individually or as a set.
The videotapes can be requested using an online order form at
https://www2.cdc.gov/nchstp_od/PIWeb/niporderform.asp The series is
also available through archived webcast at
http://www.phppo.cdc.gov/PHTN/webcast/epv03/default.asp Also, there
will be an Immunization Update satellite broadcast on August 21, 2003.
Please click on this link for more information
http://www.phppo.cdc.gov/PHTN/imm-up2003/default.asp
**************************
To access the complete June issue from the website of the Immunization
Action Coalition, go to:
http://www.immunize.org/news.d/news603.htm
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July 7, 2003
ARTICLE ABOUT HEPATITIS B VACCINATION OF HIGH-RISK ADULTS MAKES CASE FOR
FEDERAL FUNDING
[The following is cross posted from the Immunization Action Coalition's "HEP
EXPRESS" electronic newsletter, 7/2/03.]
"A Review of the Case for Hepatitis B Vaccination of High-Risk Adults"
examines the history of providing hepatitis B vaccine to high-risk adults in
the United States, and illustrates the need for a clear national objective
and federal funding in this area.
The article describes how the hepatitis B vaccine continues to be
underutilized in high-risk adults. For example, a survey of 65 federally
funded STD projects in 1997 found that only 24 percent offered the
hepatitis B vaccine in some or all of their clinics. In another national
survey, only three of 36 responding state and federal correctional systems
reported offering the vaccine to all inmates. In another study, only 13 to
25 percent of injection drug users reported being offered vaccination.
Although targeting high-risk adults for hepatitis B vaccination is likely to
be cost-effective, most programs providing services to such clients--such as
STD clinics, drug treatment centers, mental health facilities, prisons, and
homeless shelters--will not be able to add hepatitis B vaccination without
additional funding.
The article concludes, "Beyond the issue of feasibility and
cost-effectiveness, however, lies the reality of politics and public
consciousness. Hepatitis B is prevalent in prisoners, injection drug users,
commercial sex workers, and men who have sex with men, and current political
agendas are not likely to increase funding to these marginalized groups for
preventative health. What is needed is a clear national objective and
federal funding for vaccinating high-risk adults."
The full citation for this article follows:
"A Review of the Case for Hepatitis B Vaccination of High-Risk Adults"
Authors: Rich JD, Ching CG, Lally MA, Gaitanis MM,
Schwartzapfel B, Charuvastra A, Beckwith CG, Flanigan TP
Source: The American Journal of Medicine, March 2003, Vol. 114(4):316-8
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12681460&dopt=
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July 7, 2003
NNii COMBS NATIONAL AND INTERNATIONAL PRESS TO GENERATE CONTENT FOR
"IMMUNIZATION NEWSBRIEFS"
Each Monday, Wednesday, and Friday, subscribers to the electronic newsletter
"Immunization Newsbriefs" receive up-to-the-minute U.S. and international
immunization news. A service of the National Network for Immunization
Information (NNii), the newsletter is published by Information, Inc.,
Bethesda, MD.
Culled from news sources worldwide, the newsletter's content consists of
summaries of articles from newspapers and occasional medical
publications. A link to the source publication accompanies each summary.
To access the current issue of "Immunization Newsbriefs" from the NNii
website, go to:
http://www.immunizationinfo.org/newsbriefs
To subscribe, go to:
http://www.immunizationinfo.org/newsbriefs/subscribe.cfm
To access the NNii home page, go to:
http://www.immunizationinfo.org
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July 7, 2003
NEW WEBSITE FOR MSM LISTS CLINICS PROVIDING FREE OR LOW-COST HEPATITIS A AND
B VACCINATION
[The following is cross posted from the Immunization Action Coalition's "HEP
EXPRESS" electronic newsletter, 7/2/03.]
Men who have sex with men (MSM) should be vaccinated against both hepatitis
A and hepatitis B, yet many remain unprotected. GayHealth.com recently
compiled a list of clinics nationwide providing free or low-cost hepatitis A
and hepatitis B vaccines to MSM.
The list of clinics is available as part of GayHealth.com's new website,
HepClinics.com, which also provides links to other viral hepatitis
information of interest to persons at high risk of infection; not only MSM,
but also persons with multiple sex partners, users of intravenous drugs,
travelers to endemic areas, and others.
Visit this new website at
http://www.hepclinics.com The editors are always looking for more
clinics to add, so if you work for a clinic offering free or low-cost
hepatitis A and hepatitis B vaccines to high-risk adolescents and adults,
and your clinic isn't listed, please inform GayHealth.com by writing to
editor@hepclinics.com
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July 7, 2003
WISCONSIN HEPATITIS CONFERENCE SET FOR SEPTEMBER 5
The Wisconsin Hepatitis Conference will be held September 5 in Madison. The
Wisconsin Department of Health and Family Services and the Office of
Continuing Medical Education, University of Wisconsin Medical School are
joint sponsors.
The conference is intended for health care providers, local health
departments, family practitioners, nurse practitioners, physician
assistants, tribal health clinics, and community health clinics. Featured
speakers are Joanna Buffington, MD, MPH, Medical Epidemiologist, Centers for
Disease Control and Prevention and Michael R. Lucey, MD, Professor of
Medicine, Chief of Gastroenterology and Hepatology, University of Wisconsin
Medical School.
For additional information, including registration information, contact
Cathy Means at (608) 263-6637.
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July 7, 2003
CDC UPDATES INTERIM GUIDANCE FOR USE OF SMALLPOX VACCINE, CIDOFOVIR, AND
VACCINIA IMMUNE GLOBULIN FOR PREVENTION AND TREATMENT OF MONKEYPOX
INFECTIONS
On June 25, the Centers for Disease Control and Prevention (CDC) issued
"Updated Interim CDC Guidance for Use of Smallpox Vaccine, Cidofovir, and
Vaccinia Immune Globulin (VIG) for Prevention and Treatment in the Setting
of an Outbreak of Monkeypox Infections."
To access a copy of updated interim guidance from the CDC website, go to:
http://www.cdc.gov/ncidod/monkeypox/treatmentguidelines.htm
To access a camera-ready (PDF) copy, go to:
http://www.cdc.gov/ncidod/monkeypox/pdf/mphan.pdf
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July 7, 2003
CDC PUBLISHES AN UPDATE ON CURRENT MONKEYPOX OUTBREAK
The Centers for Disease Control and Prevention (CDC) published "Update:
Multistate Outbreak of Monkeypox--Illinois, Indiana, Kansas, Missouri, Ohio,
and Wisconsin, 2003" in the July 4 issue of the "Morbidity and Mortality
Weekly Report" (MMWR). The opening paragraph is reprinted below in its
entirety, excluding references.
*********************
CDC and state and local health departments continue to investigate cases of
monkeypox among persons who had contact with wild or exotic mammalian pets
or persons with monkeypox. This report updates epidemiologic,
laboratory, and smallpox vaccine use data for U.S. cases, and summarizes
laboratory-based evidence implicating imported African rodents as the
probable source of the outbreak.
*********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5226a5.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5226.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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