Issue
Number 453
March 29, 2004
CONTENTS OF THIS ISSUE
- New: NIP releases Influenza Vaccine Bulletin #1 for the
2004-05 influenza season
- New: CDC publishes guidelines for preventing
health-care-associated pneumonia
- CDC publishes report on recent Iowa measles case associated
with nonmedical vaccination exemption
- CDC issues report on polio eradication in India
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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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March 29, 2004
NEW: NIP RELEASES INFLUENZA VACCINE BULLETIN #1 FOR THE 2004-05 INFLUENZA
SEASON
On March 26, NIP issued the first influenza vaccine bulletin designed to
update health professionals on the production, distribution, and
administration of influenza vaccine for the 2004-05 influenza season.
The bulletin is reprinted below with the exception of a section on
miscellaneous information.
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INFLUENZA VACCINE BULLETIN #1
March 26, 2004
Influenza Season 2004-05
The National Immunization Program (NIP) of the Centers for Disease Control
and Prevention (CDC) publishes and distributes periodic bulletins to update
partners about recent developments related to the production, distribution,
and administration of influenza vaccine. All recipients of this bulletin are
encouraged to distribute each issue widely to colleagues, members, and
constituents.
INFLUENZA VACCINE SUPPLY AND PRODUCTION
2004-2005 Influenza Vaccine Strains
- The Vaccines and Related Biological
Products Advisory Committee (VRBPAC) of the Food and Drug Administration
(FDA) met on February 18-19, and March 17, 2004, to determine the
influenza vaccine formulation for the United States during the upcoming
season. The formulation includes one virus from last year's vaccine [A/New
Caledonia/20/99 (H1N1)-like] and two new viruses [A/Fujian/411/2002
(H3N2-like) and B/Shanghai/361/2002-like]. For the A/Fujian component,
manufacturers may use A/Wyoming/3/2003 (H3N2) or A/Kumamoto/102/2002
(H3N2). An available alternate for the B/Shanghai component is B/Jilin/20/2003.
Projection for 2004-2005 Influenza Vaccine
Supply
- Based on early projections, the three
manufacturers anticipate total influenza vaccine production of between
90 and 100 million doses. A more precise estimate will be available
later in the production cycle once the companies have some experience
working with the new viruses and can begin to quantify yields. Total
production in 2003 was 86.9 million doses.
Place orders for influenza vaccine
- Healthcare providers should place
influenza vaccine orders now if they have not already done so.
Distributors began taking orders in December of 2003.
- Additional information on sources of
vaccine can be found at
www.hidanetwork.com/govtrelations/flulinks.asp a service
provided by the Health Industry Distributors Association.
INFLUENZA VACCINE DISTRIBUTION AND
ADMINISTRATION
Distribution Totals for the 2003-04 Influenza Season
- During the 2003-04 influenza
vaccination campaign, manufacturers distributed approximately 83.1
million doses of vaccine, about the same as in 2002-03.
Changes to Recommendations for the 2004-05
Influenza Season
- On February 24-25, 2004, the
Advisory Committee on Immunization Practices (ACIP) met in Atlanta
to consider updates to its annual influenza vaccine
recommendations. The updated version for 2004-05 will be published
in the "Morbidity and Mortality Weekly Report" in late April or
early May 2004. Among the changes are the following:
- Influenza vaccine is now
routinely recommended for all infants and children ages 6-23
months.
- Influenza vaccine has been
covered by the VFC Program since March 1, 2003. The following
groups of VFC-eligible children can now receive influenza
vaccine through the VFC Program: all infants and children ages
6-23 months and children and adolescents 2-18 years of age who
have risk factors or are household contacts of people with risk
factors.
- All women who will be pregnant
at any time during influenza season should be vaccinated.
- The guidance for use of the live
attenuated influenza vaccine (FluMist) versus inactivated
vaccine among health care workers and other contacts of high
risk persons will be narrowed to recommend that the inactivated
influenza vaccine is preferred only for persons who have close
contact with severely immunosuppressed persons (e.g., patients
with hematopoietic stem cell transplants) during those periods
in which the immunosuppressed person requires care in a
protective environment. There is no preference for inactivated
influenza vaccine use by contacts of persons with lesser degrees
of immunosuppression or other high risk conditions (e.g.,
persons with diabetes mellitus, persons with asthma taking
corticosteroids, or persons infected with human immunodeficiency
virus).
- The length of time that persons
vaccinated with live attenuated vaccine are recommended to avoid
contact with severely immunosuppressed persons is changed to 7
days from 21 days after vaccination.
Update on Medicare Payment for Influenza
Vaccine Purchase and Administration
- Based on Medicare's 2004 Physician Fee Schedule, the average
payment rate for administration of influenza vaccine to
Medicare beneficiaries has increased from $7.72 to $8.21 per
dose. Rates vary by locale and range from $5.68 to $13.72.
Once these rates are posted on the CMS website, the Influenza
Vaccine Bulletin will provide a link to the information so
that people wishing to determine payment rates for their
respective locales may do so.
- The Medicare payment rate for influenza vaccine has not yet
been determined but is expected to be similar to last year's
$9.95 per dose. (The payment for vaccine is in addition to
payment for its administration.)
Cost for Influenza Vaccine
- The prices for influenza vaccine this year are expected to be
similar to, if not the same as, last year. Purchasers should
check with their regular sources of vaccine to determine
exact prices. The least expensive price per dose will be for
the 10-dose vial presentation while product packaged in
pre-filled syringes will be more expensive.
Latest Influenza Vaccine Coverage Data
- From the 2002 National Health Interview Survey, coverage
level data for selected groups targeted for influenza vaccine
are as shown below.
Group: Ages 18-49, high risk; 23% coverage. Group: Ages
50-64, high risk; 44% coverage. Group: Ages 50-64, total;
34% coverage. Group: Ages >=65; 64% coverage. Group: Pregnant
women; 12% coverage. Group: Health care providers;
38% coverage. Group: Household contacts; 18% coverage.
INFLUENZA VACCINE COMMUNICATIONS AND RESOURCES
Resource Materials
- "Influenza Immunization Among Health Care Workers"
A call for action, published by The National Foundation for
Infectious Diseases, suggests a comprehensive approach is
essential to improve influenza vaccination rates among health
care workers.
You may download the entire Call to Action at
www.nfid.org/publications/calltoaction.pdf
- Review recently published "Morbidity and Mortality Weekly
Report" (MMWRs) related to influenza by clicking on the
following links.
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For a ready-to-copy (PDF) version of Influenza Vaccine Bulletin
#1, go to: http://www.immunize.org/cdc/flubull_1.pdf
For more influenza information from CDC's influenza web section,
go to:
http://www.cdc.gov/flu
For influenza information from the IAC website, go to:
http://www.immunize.org/influenza
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March 29, 2004
NEW: CDC PUBLISHES GUIDELINES FOR PREVENTING HEALTH-CARE-ASSOCIATED PNEUMONIA
CDC published "Guidelines for Preventing Health-Care-Associated
Pneumonia, 2003: Recommendations of CDC and the Healthcare
Infection Control Practices Advisory Committee" in the March 26
issue of "MMWR Recommendations and Reports." It includes
information on pneumococcal vaccination, standing orders,
prevention of pertussis transmission, influenza vaccination
(including influenza vaccination of health care workers), and
control of influenza outbreaks.
Portions of the summary to the guidelines are reprinted below.
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SUMMARY
This report updates, expands, and replaces the previously
published CDC "Guideline for Prevention of Nosocomial
Pneumonia." The new guidelines are designed to reduce the
incidence of pneumonia and other severe, acute lower respiratory
tract infections in acute-care hospitals and in other health-care settings (e.g., ambulatory and long-term care institutions)
and other facilities where health care is provided. . . .
In addition to the revised recommendations, the guideline
contains new sections on pertussis and lower respiratory tract
infections caused by adenovirus and human parainfluenza viruses
and refers readers to the source of updated information about
prevention and control of severe acute respiratory syndrome.
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To access a web-text (HTML) version of the guidelines, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5303a1.htm
To access a ready-to-copy (PDF) version of them, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5303.pdf
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March 29, 2004
CDC PUBLISHES REPORT ON RECENT IOWA MEASLES CASE ASSOCIATED WITH
NONMEDICAL VACCINATION EXEMPTION
CDC published "Brief Report: Imported Measles Case Associated
with Nonmedical Vaccine Exemption--Iowa, March 2004" in the
March 26 issue of MMWR. Originally published in the web-based
"MMWR Dispatch," the report has not been available in hard-copy
format until now.
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5311a6.htm
To access a ready-to-copy (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5311.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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March 29, 2004
CDC ISSUES REPORT ON POLIO ERADICATION IN INDIA
CDC published "Progress Toward Poliomyelitis Eradication—India,
2003" in the March 26 issue of MMWR. A portion of a summary made
available to the press is reprinted below.
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Since the World Health Assembly resolved in May 1988 to
eradicate poliomyelitis, the estimated global incidence of polio
has decreased by more than 99%, and three World Health
Organization (WHO) regions (American, Western Pacific, and
European) have been certified as polio-free. The countries of
the WHO South East Asia Region began accelerating polio
eradication activities in 1994, and have made substantial
progress toward that goal. By 2001, poliovirus circulation in
India had largely been limited to the two northern states of
Uttar Pradesh (UP) and Bihar; 268 cases were reported
nationwide. However, a major resurgence of polio occurred during
2002, with 1,600 cases detected nationwide, of which 1363 (85%)
occurred in these two states.
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To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5311a3.htm
To access a ready-to-copy (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5311.pdf |
