Issue Number 408            September 2, 2003

CONTENTS OF THIS ISSUE

  1. CDC updates providers about issues related to the power outage and vaccine storage
  2. CDC expects influenza vaccine supply to meet demand
  3. Death of Dr. Natalie Smith is a great loss to the U.S. immunization community
  4. August "Immunization Works!" electronic newsletter now available on IAC website
  5. Reminder: NNii website maintains information on state vaccine mandates
  6. September 5 is the registration deadline for CHOP's Vaccine Education Symposium
  7. Revised: IAC updates its patient education sheet "If you have chronic hepatitis B (HBV) infection . . ."
  8. CDC reports on adverse events following civilian smallpox vaccination
  9. CDC reports on polio eradication in Angola and the Democratic Republic of Congo

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September 2, 2003
CDC UPDATES PROVIDERS ABOUT ISSUES RELATED TO THE POWER OUTAGE AND VACCINE STORAGE

On August 27, the National Immunization Program, Centers for Disease Control and Prevention (CDC)  updated its information for providers regarding issues related to the recent power outage and vaccine storage. To access the update, go to: http://www.cdc.gov/nip/news/poweroutage.htm
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September 2, 2003
CDC EXPECTS INFLUENZA VACCINE SUPPLY TO MEET DEMAND

On August 25, the Centers for Disease Control and Prevention (CDC) issued a press release announcing the supply of influenza vaccine for the 2003-04 influenza season is expected to meet the demand. The press release is reprinted below.

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PRESS RELEASE
For immediate release
August 25, 2003

INFLUENZA VACCINE SUPPLY EXPECTED TO MEET DEMAND: CDC RECOMMENDS INFLUENZA VACCINATIONS BEGIN IN OCTOBER

Sufficient supplies of flu vaccine should be available during the coming influenza season. The Centers for Disease Control and Prevention (CDC) predicts that everyone wanting to get a flu shot to avoid influenza, regardless of age or health status, should be able to get vaccinated as soon as vaccine becomes available in October.

CDC estimates that vaccine manufacturers will produce approximately 85.5 million doses of influenza vaccine during the 2003 influenza season. This projection represents 9.5 million fewer doses than were produced last year. However, influenza vaccine production is expected to exceed the estimated 79 million doses that were actually sold to providers in 2002.

"Influenza vaccination is the best way to prevent influenza and its severe complications," said Dr. Walter Orenstein, director of the CDC National Immunization Program. "The best time to be vaccinated against influenza continues to be October and November. However, vaccination in December or later can still be beneficial."

Although anyone who wishes to avoid influenza should be vaccinated, CDC strongly recommends influenza vaccination as soon as vaccine is available for any person who is 6 months old or older and is at increased risk for complications from influenza. Those at highest risk for complications from influenza include people 65 years old and older, those with chronic, long-term health problems such as heart or lung disease, kidney problems, diabetes, asthma, anemia, HIV/AIDS, or any other illness that suppresses the immune system. CDC also recommends vaccination for people age 50 to 64 years because this group has an increased prevalence among those with high-risk conditions. In addition, health care workers and others in close contact with those at high risk should be vaccinated in order to reduce the possibility of transmitting influenza to those at high risk.

Because young children also are at increased risk of influenza-related complications, vaccination of children 6 to 23 months old, their household contacts, and out-of-home caregivers is encouraged . . .

"Protect yourself and those you love against influenza," Orenstein said. "Get your influenza vaccine."

Production and distribution of the influenza vaccine was delayed in the years 2000 and 2001. These delays prompted CDC to recommend that people 65 years of age and older and people with health conditions that put them at high risk for complications from influenza be the first to receive the vaccine. This recommendation helped to ensure that an adequate vaccine supply was available to those at the greatest risk. Individuals without risk factors were asked to wait until November to receive their vaccinations.

Influenza causes approximately 36,000 deaths and 114,000 hospitalizations each year. More than 90 percent of deaths occur among people age 65 and older.

Winter is the prime time for influenza. Influenza season typically ranges from November through March or beyond. Flu activity peaked in January or later during 22 of the past 26 influenza seasons. Heaviest influenza activity occurred in December in four years, January in six years, February in 11 years, March in three years, April in one year, and May in one year.

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To access the press release from the CDC website, go to:
http://www.cdc.gov/od/oc/media/pressrel/r030825b.htm

For additional influenza information, visit the CDC website at
http://www.cdc.gov/nip/flu
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September 2, 2003
DEATH OF DR. NATALIE SMITH IS A GREAT LOSS TO THE U.S. IMMUNIZATION COMMUNITY

Natalie J. Smith, MD, MPH, died of cancer on August 22. She was 41.

Most recently, Dr. Smith served as the Deputy Director of the National Immunization Program, Centers for Disease Control and Prevention. She accepted the position at the National Immunization Program after serving eight years as the Chief of the Immunization Branch, California Department of Health Services.

In announcing Dr. Smith's death, Walter A. Orenstein, MD, Director, National Immunization Program, wrote: "Let us take from Natalie the essence of her life . . . . she knew who she was and what she believed in and brought it into her daily life. Children and adults, both now and in the future, will owe their protection from vaccine-preventable diseases, in large part, to Natalie's outstanding contributions to the field of immunization."

A graduate of Stanford University, UCLA School of Medicine, and UC Berkeley, Dr. Smith wrote numerous significant publications on immunization and frequently presented/consulted on immunization-related issues to groups representing public and private health sectors. She also sat on various committees at the national level, including the Advisory Committee on Immunization Practices.

All at the Immunization Action Coalition join in mourning the loss of Dr. Smith.

Two funds have been established in Dr. Smith's memory:

  1. The Natalie Joy Smith Memorial Fund (to be used to fund child immunization programs). Send donations to CDC Foundation, Attn.: Natalie Joy Smith Fund, 50 Hurt Plaza, Suite 765, Atlanta, GA 30303.
     
  2. The Natalie J. Smith Memorial Fund (to be used for the future education of Dr. Smith's daughter). Send donations to 1631 Geary Road, Walnut Creek, CA 94597.

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September 2, 2003
AUGUST "IMMUNIZATION WORKS!" ELECTRONIC NEWSLETTER NOW AVAILABLE ON IAC WEBSITE

"Immunization Works!" a monthly email newsletter published by the Centers for Disease Control and Prevention, offers members of the immunization community information about current topics. Some of the information in the August issue has already appeared in previous issues of "IAC EXPRESS." Following is the text of three articles we have not covered.

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ANALYSIS OF STATE IMMUNIZATION LAWS: The Center for Health Services Research and Policy [CHSRP] at George Washington University recently completed the most comprehensive analysis undertaken to date of state laws regulating immunization coverage. The study found that privately insured Americans face potential and severe underinsurance where critical immunization protections are concerned. Despite the fact that 32 states and the District of Columbia include immunization coverage as a mandatory benefit under their health insurance laws, CHSRP researchers found that state immunization mandates are so limited that in most cases they offer children and adults little or no insurance protection against the cost of essential immunizations. Tens of millions of privately insured children and adults in the state-regulated market are at risk for non-coverage of immunizations, not only in the case of established vaccines, but even more significantly, for newly emerging vaccines that may be recommended for public health protection by the CDC. The report can be found at www.gwhealthpolicy.org/news.htm

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ADULT IMMUNIZATION ASSESSMENT TOOL: CDC provides a computer-based program which allows health care providers to assess the adult immunization rates within their clinics. The program, ACASA, can be downloaded from www.cdc.gov/nip/casa A separate program for childhood immunizations is also provided.

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VOLUNTEERS NEEDED: CDC is seeking people who would like to be pilot testers for immunization training programs. These are mostly self-study programs that can be done through a CD-ROM or over the Internet. We are seeking physicians, nurses, and health educators. The typical pilot testing effort is to review a training program, take the evaluation, and provide feedback. The process can take from 2 to 4 hours. Upcoming pilot testing activities include "Smallpox Vaccine: Storage and Handling" and "Increasing Adult Vaccination: What Works." Pilot testers can obtain continuing education credits once the training program becomes approved for CE credit. If interested, please contact Susan Farrall at sfarrall@cdc.gov or (404) 639-8852.

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To access the entire August issue from the website of the Immunization Action Coalition, go to: http://www.immunize.org/news.d/news803.htm
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September 2, 2003
REMINDER: NNii WEBSITE MAINTAINS INFORMATION ON STATE VACCINE MANDATES

The website of the National Network for Immunization Information (NNii) maintains information on state vaccine mandates. Parents and providers who need information about which vaccines are required for school entry in their state can easily access the information by going to the NNii website at http://www.immunizationinfo.org/vaccineInfo/index.cfm#state

Scroll down to Search for State Vaccine Requirements for School Entry and click on your state. You will be taken to a page that lists all the childhood vaccines and gives detailed information about entry requirements for your state.

The Immunization Action Coalition (IAC) also maintains a web section on state vaccine mandates organized by disease on its website. The section also has information about states that authorize pharmacists to vaccinate and states that mandate influenza and/or pneumococcal vaccines for residents of long-term health care facilities. In addition, IAC has recently added U.S. maps that depict this information visually.

To access the information from the IAC website, go to:
http://www.immunize.org/laws
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September 2, 2003
SEPTEMBER 5 IS THE REGISTRATION DEADLINE FOR CHOP'S VACCINE EDUCATION SYMPOSIUM

The Vaccine Education Center at the Children's Hospital of Philadelphia (CHOP) announced it will be hosting its third annual Vaccine Education Symposium on September 13 in Philadelphia. The registration deadline is September 5.

The one-day course will focus on new vaccines, how vaccines are made and tested for safety, and how health care professionals can address some of the concerns parents have about vaccines. William L. Atkinson, MD, MPH, National Immunization Program, Centers for Disease Control and Prevention, will give the keynote lecture, "What's new in vaccines?" A panel will discuss the topic "Talking to the 'immunization-hesitant' parent."

To access a camera-ready (PDF) copy of the symposium brochure, go to: http://www.chop.edu/cme/2003/vaccine/i/vec_cme03.pdf

Registration is required. To register online, go to:
https://www.chop.edu/cme/2003/vaccine/regis.cfm

For additional information, contact Catrice Butler by phone at (215) 590-5263 or by email at butlerca@email.chop.edu
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September 2, 2003
REVISED: IAC UPDATES ITS PATIENT EDUCATION SHEET "IF YOU HAVE CHRONIC HEPATITIS B (HBV) INFECTION . . ."

The Immunization Action Coalition (IAC) recently revised its patient education sheet "If you have chronic hepatitis B virus (HBV) infection . . ." The sheet now contains information about adefovir dipivoxil as a treatment option.

To access a camera-ready (PDF) copy of the updated sheet, go to:
http://www.immunize.org/catg.d/p4120eng.pdf

To access a text (HTML) copy, go to:
http://www.immunize.org/catg.d/p4120.htm
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September 2, 2003
CDC REPORTS ON ADVERSE EVENTS FOLLOWING CIVILIAN SMALLPOX VACCINATION

The Centers for Disease Control and Prevention (CDC) published "Update: Adverse Events Following Civilian Smallpox Vaccination--United States, 2003" in the August 29 issue of the "Morbidity and Mortality Weekly Report" (MMWR). A summary made available to the press is reprinted below in its entirety.

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Few adverse events, historically associated with smallpox vaccine, have been reported, but monitoring for adverse events continues at CDC and state vaccination programs.

During January 24-August 8, 2003, smallpox vaccine was administered to 38,257 civilian health-care and public health workers. Ongoing monitoring for vaccine adverse events has shown that few adverse events have been reported. And, no cases of vaccine virus transmission from civilian vaccinees to their contacts have been reported.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5234a4.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5234.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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September 2, 2003
CDC REPORTS ON POLIO ERADICATION IN ANGOLA AND THE DEMOCRATIC REPUBLIC OF CONGO

The Centers for Disease Control and Prevention (CDC) published "Progress Toward Poliomyelitis Eradication--Angola and the Democratic Republic of Congo, January 2002-June 2003" in the August 29 issue of the "Morbidity and Mortality Weekly Report" (MMWR). A summary made available to the press is reprinted below in its entirety.

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In order to sustain the gains made in polio eradication in Angola and in the Democratic Republic of Congo (DRC), high-quality polio surveillance and immunization must be maintained.

The estimated global occurrence of poliomyelitis has decreased more than 99% since 1988, when the World Health Assembly resolved to eradicate polio worldwide. Although wild poliovirus (WPV) has not been detected for over a year in Angola and the DRC, these countries remain a concern because of factors which favor poliovirus transmission; including low routine immunization coverage, recent civil conflict, and dense urban populations. The detection of wild poliovirus in 2002 in Angolan refugees in western Zambia and of high numbers of polio-compatible cases in northeastern DRC where large groups of internally displaced persons have congregated due to ethnic conflict highlights the potential for circulation of poliovirus in these poorly vaccinated, high-risk populations. This report summarizes progress made toward polio eradication during January 2002–June 2003.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5234a3.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5234.pdf

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