Issue
Number 538
July 18, 2005
CONTENTS OF THIS ISSUE
- New: CDC issues the latest ACIP influenza
recommendations in an "MMWR Early Release"
- MMWR notifies readers about August 9 webcast on
prevention of human papilloma virus infection and cervical cancer
- Teleconference on communicating with legislatures about
vaccine safety is scheduled for August 9
- CDC releases guidance statement on HIPAA and perinatal
hepatitis B
- Learn about proposed hepatitis B vaccination strategies
for U.S. adults
- Study reveals that handwashing with soap can save
children's lives by reducing the incidence of certain diseases
- New: July 15 issue of IAC's Hep Express electronic
newsletter now available online
- CDC reports on a survey of U.S. syringe exchange
programs operating during 2002
- CDC reports on the use of a rapid analysis system to
assess influenza vaccination coverage among California HMO members
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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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July 18, 2005
NEW: CDC ISSUES THE LATEST ACIP INFLUENZA RECOMMENDATIONS IN AN "MMWR EARLY
RELEASE"
On July 13, CDC issued "Prevention and Control of Influenza: Recommendations
of the Advisory Committee on Immunization Practices (ACIP)" as an electronic
"MMWR Early Release." A hard copy of the recommendations will be printed in
a future issue of MMWR. PLEASE NOTE: An error occurred on page 20 of the
recommendations in the section Vaccination Before October. The last sentence
should read, "For previously vaccinated children, 1 dose is needed to
provide optimal protection against influenza."
Two sections of the recommendations are reprinted below: (1) the Summary and
(2) a portion of the introduction titled Primary Changes and Updates in the
Recommendations.
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SUMMARY
This report updates the 2004 recommendations by the Advisory Committee on
Immunization Practices (ACIP) regarding the use of influenza vaccine and
antiviral agents (CDC. Prevention and control of influenza: recommendations
of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2004;53[No.
RR-6]:1-40). The 2005 recommendations include new or updated information
regarding (1) vaccination of persons with conditions leading to compromise
of the respiratory system; (2) vaccination of health-care workers; (3)
clarification of the role of live, attenuated influenza vaccine (LAIV) in
vaccine shortage situations; (4) the 2005-06 trivalent vaccine virus
strains: A/California/7/2004 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like,
and B/Shanghai/361/2002-like antigens (for the A/California/7/2004
[H3N2]-like antigen, manufacturers may use the antigenically equivalent
A/New York/55/2004 virus, and for the B/Shanghai/361/2002-like antigen,
manufacturers may use the antigenically equivalent B/Jilin/20/2003 virus or
B/Jiangsu/10/2003 virus); and (5) the assessment of vaccine supply, timing
of influenza vaccination, and prioritization of inactivated vaccine in
shortage situations. A link to this report and other information can be
accessed at http://www.cdc.gov/flu . .
. .
[From the Introduction]
PRIMARY CHANGES AND UPDATES IN THE RECOMMENDATIONS
The 2005 recommendations include five principal changes or updates:
- ACIP recommends that persons with any
condition (e.g., cognitive dysfunction, spinal cord injuries, seizure
disorders, or other neuromuscular disorders) that can compromise
respiratory function or the handling of respiratory secretions or that can
increase the risk for aspiration be vaccinated against influenza (see
Target Groups for Vaccination).
- ACIP emphasizes that all healthcare
workers should be vaccinated against influenza annually, and that
facilities that employ healthcare workers be strongly encouraged to
provide vaccine to workers by using approaches that maximize immunization
rates.
- Use of both available vaccines
(inactivated and LAIV) is encouraged for eligible persons every influenza
season, especially persons in recommended target groups. During periods
when inactivated vaccine is in short supply, use of LAIV is especially
encouraged when feasible for eligible persons (including healthcare
workers) because use of LAIV by these persons might considerably increase
availability of inactivated vaccine for persons in groups at high risk.
- The 2005-06 trivalent vaccine virus
strains are A/California/7/2004 (H3N2)-like, A/New Caledonia/20/99
(H1N1)-like, and B/Shanghai/361/2002-like antigens. For the
A/California/7/2004 (H3N2)-like antigen, manufacturers may use the
antigenically equivalent A/New York/55/2004 virus, and for the
B/Shanghai/361/2002-like antigen, manufacturers may use the antigenically
equivalent B/Jilin/20/2003 virus or B/Jiangsu/10/2003 virus (see Influenza
Vaccine Composition).
- CDC and other agencies will assess the
vaccine supply throughout the manufacturing period and will make
recommendations preceding the 2005-06 influenza season regarding the need
for tiered timing of vaccination of different risk groups. In addition,
CDC will publish ACIP recommendations regarding inactivated vaccine
subprioritization (tiering) on a later date in MMWR. . . .
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To access a web-text (HTML) version of the recommendations, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr54e713a1.htm
To access a ready-to-print (PDF) version, go to:
http://www.cdc.gov/mmwr/pdf/rr/rr54e713.pdf
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July 18, 2005
MMWR NOTIFIES READERS ABOUT AUGUST 9 WEBCAST ON PREVENTION OF HUMAN
PAPILLOMA VIRUS INFECTION AND CERVICAL CANCER
CDC published "Notice to Readers: Webcast on Human Papilloma Virus (HPV)"
in the July 15 issue of MMWR. The notice is reprinted below in its
entirety.
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CDC will present a webcast, "HPV and Cervical Cancer: An Update on
Prevention Strategies," on August 9, 2005, 1:00-2:00PM EDT. Genital HPV
infection is one of the most common sexually transmitted diseases. New
information is available about the natural history of HPV infection, the
association of different HPV types with various clinical manifestations,
HPV transmission, and methods of HPV prevention. In addition, the Food and
Drug Administration recently approved the use of a commercially available
HPV DNA test for two purposes: (1) management of patients with abnormal
Pap test results and (2) as an adjunct to the Pap test for cervical cancer
screening in women aged >=30 years. This new information about HPV might
require changes in approaches to cervical cancer screening in primary-care
practices and in counseling and educating patients and their sex partners.
The webcast will address cervical cancer screening guidelines and
strategies for preventing genital HPV infection, including appropriate
patient counseling messages.
Information about content, registration, continuing education credit, and
accessing the webcast is available at
http://www.phppo.cdc.gov/phtn/hpv-05 Information about registration is
also available from CDC, telephone (800) 418-7246 or (404) 639-1292.
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5427a5.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5427.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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July 18, 2005
TELECONFERENCE ON COMMUNICATING WITH LEGISLATURES ABOUT VACCINE SAFETY IS
SCHEDULED FOR AUGUST 9
The National Immunization Coalition TA [technical assistance] Network has
scheduled a teleconference on communicating with your legislature about
vaccine safety. It will be held at 1PM ET on August 9. The network is a
program of the Center for Health Communication, Academy for Educational
Development.
The teleconference facilitator is Diane Peterson, associate director for
immunization projects, Immunization Action Coalition.
In winter and spring 2005, several members of the Minnesota immunization
community collaborated to defeat proposed anti-thimerosal legislation.
Using this experience as a model, the teleconference discussion will cover
the following: (1) key steps for building effective support/opposition to
legislative initiatives; (2) resources helpful in achieving the above
objective; and (3) importance of collaborating to support/oppose
legislative initiatives.
To register for the teleconference, send an email to
IZTA@aed.org and include the following
in your message: "Sign me up for the Communicating with Your Legislature
call."
For additional information go to:
http://www.izcoalitionsta.org/confcall.cfm
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July 18, 2005
CDC RELEASES GUIDANCE STATEMENT ON HIPAA AND PERINATAL HEPATITIS B
[The following is cross posted from IAC's Hep Express electronic
newsletter, 7/15/05.]
The CDC Office of General Counsel has released the second in a series of
guidance statements regarding the Health Insurance Portability and
Accountability Act (HIPAA) Privacy Rule. "HIPAA and Perinatal Hepatitis B
Prevention" was developed to answer common questions about the intent and
implementation of the rule as it relates to accessing patient records for
immunization assessment and surveillance.
To read "HIPAA and Perinatal Hepatitis B" and the first guidance
statement, "HIPAA Privacy Rule and Public Health," go to:
http://www.immunize.org/birthdose/hepb_hipaa.pdf
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July 18, 2005
LEARN ABOUT PROPOSED HEPATITIS B VACCINATION STRATEGIES FOR U.S. ADULTS
[The following is cross posted from IAC's Hep Express electronic
newsletter, 7/15/05.]
Two new web pages offer information related to proposed strategies for
adult hepatitis B vaccination in the United States.
First, CDC's Division of Viral Hepatitis (DVH) has posted notes online
from an adult hepatitis B vaccination consultation meeting held in May
2005. DVH convened the meeting to discuss the implementation of proposed
Advisory Committee on Immunization Practices (ACIP) strategies for adult
hepatitis B vaccination.
Continuing low rates of hepatitis B vaccination among adults are
attributed mainly to challenges in implementation. To address these
challenges and accelerate elimination of HBV transmission in the United
States, the ACIP drafted an updated statement on hepatitis B vaccination
that includes new strategies for implementation of adult vaccination. This
consultation was convened to consider the feasibility of these strategies
and to address barriers, challenges, and opportunities. Lessons learned
from the experiences of the invited participants and their comments on the
proposed strategies will inform the final version of the ACIP statement on
adult hepatitis B vaccination, which will be presented for a vote at the
October 2005 ACIP meeting.
The meeting summary, highlights, PowerPoint presentations, and participant
information can be viewed at
http://www.cdc.gov/ncidod/diseases/hepatitis/partners/consultants_mtg_2005.htm
Second, the National Viral Hepatitis Roundtable (NVHR) has started a web
page to advocate for a universal, age-based hepatitis B immunization
recommendation. NVHR states, "We believe that vaccinating adults is a
necessary and important step to eliminating hepatitis B in the United
States, and that a recommendation [that] endorses age-based, rather than
risk-based immunization, is the most effective way to achieve this goal."
Anyone interested in learning more about this issue is encouraged to visit
NVHR's website where letters to ACIP from several organizations and
individuals are posted. Go to:
http://www.nvhr.org/acip_letters/acip.htm
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July 18, 2005
STUDY REVEALS THAT HANDWASHING WITH SOAP CAN SAVE CHILDREN'S LIVES BY
REDUCING THE INCIDENCE OF CERTAIN DISEASES
On July 14, CDC issued a press release summarizing the results of a study
published in the Lancet, a British medical journal. Conducted in Pakistan
the study indicates that teaching children to wash their hands with soap
and water can dramatically decrease the incidence of pneumonia, diarrhea,
and impetigo. Portions of the press release are reprinted below.
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NEW STUDY DEMONSTRATES SIMPLE HANDWASHING WITH SOAP CAN SAVE CHILDREN'S
LIVES
Handwashing with Soap Halved Incidence of Pneumonia--Leading Cause of
Death in Children under Five Globally
Handwashing with soap can reduce the number of pneumonia-related
infections in children under the age of five by more than 50 percent,
according to a study published in the Lancet. The research, conducted in
Pakistan by the Centers for Disease Control and Prevention (CDC) and P&G
Beauty, a division of the Procter & Gamble Company (P&G), is the first
field study to show that handwashing can help prevent pneumonia, the
leading killer of children under age 5 worldwide.
The study in the Lancet's July 16 edition, also showed that handwashing
with soap significantly reduced the number of diarrheal infections, the
second leading cause of death in children under age 5. In addition, there
was a 47 percent reduction in the prevalence of impetigo, a skin
infection, in children who bathed daily with soap.
"Handwashing with soap is something that is within the reach of hundreds
of millions of at-risk families worldwide," said Dr. Stephen Luby, the
study's lead investigator and a medical epidemiologist at CDC. "This
research can be used by families worldwide to greatly improve the health
and save the lives of their children."
Acute respiratory infections account for an estimated 2 million children's
deaths a year. Nearly 75 percent of those who die are less than a year
old. Approximately 5 to 10 percent of all children living in developing
countries under the age of 5 develop pneumonia each year. When combined,
diarrhea and acute respiratory tract infections, both prevalent in
low-income communities, kill an estimated 4 million children under age 5
each year.
"Many people, even in well-developed countries like the United States, do
not realize that they should wash their hands with soap and water for at
least 15 seconds, and that water alone is not as effective," said Tim
Long, PhD, a principal scientist with P&G Beauty, which provided the soap
used in the study. "Parents should encourage children to wash their hands
with soap and water as long as it takes them to sing their ABCs. . . ."
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To access the complete press release, go to:
http://www.cdc.gov/od/oc/media/pressrel/r050714a.htm
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July 18, 2005
NEW: JULY 15 ISSUE OF IAC'S HEP EXPRESS ELECTRONIC NEWSLETTER NOW
AVAILABLE ONLINE
The July 15 issue of Hep Express, an electronic newsletter published by
IAC, is now available online. It is intended for health and social service
professionals involved in the prevention and treatment of viral hepatitis.
IAC Express has already covered some of the information presented in the
July 15 Hep Express; titles of articles we have not yet covered follow.
- National Alliance of State and
Territorial AIDS Directors launches listserv related to viral hepatitis
- Hillsborough County, Florida, shares
perinatal hepatitis B prevention resources
- Conference on methamphetamine, HIV, and
hepatitis scheduled for August 19-20
- IAC adds five programs to its hepatitis
prevention programs website
- VHPB updates its website with new
meeting report
To access the July 15 issue, go to:
http://www.hepprograms.org/hepexpress/issue32.asp
To sign up for a free subscription to Hep Express, go to:
http://www.hepprograms.org/hepexpress/signup.asp
To access previous issues of Hep Express, go to:
http://www.hepprograms.org/hepexpress/index.asp
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July 18, 2005
CDC REPORTS ON A SURVEY OF U.S. SYRINGE EXCHANGE PROGRAMS OPERATING
DURING 2002
CDC published "Update: Syringe Exchange Programs--United States, 2002"
in the July 15 issue of MMWR. Syringe exchange programs can help prevent
transmission of bloodborne pathogens such as HIV and hepatitis B virus.
A summary made available to the press is reprinted below in its
entirety.
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A national survey conducted by New York's Beth Israel Medical Center
finds that the total number of syringe exchange programs (SEPs) known by
the North American Syringe Exchange Network to be operating in the
United States decreased nearly 4 percent between 2000 and 2002. The
total number of syringes exchanged by the programs participating in the
survey, however, increased more than 10 percent, from 22.6 million to
24.9 million. The survey summarizes activities of 126 SEPs operating in
102 cities. In addition to providing new sterile syringes in exchange
for used, often potentially infectious ones, nearly all of the SEPs
offer other important public health services, including HIV prevention
education (90%), education on safer injection practices (88%),
substance-abuse treatment referrals (77%), and voluntary HIV counseling
and testing (72%). As a result of such efforts, SEPS can provide a
pathway to prevention, treatment, and care for individuals at risk for
HIV. In addition, SEPs provide for the safe disposal of millions of
potentially infectious syringes that might otherwise end up in the
community.
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5427a1.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5427.pdf
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July 18, 2005
CDC REPORTS ON THE USE OF A RAPID ANALYSIS SYSTEM TO ASSESS INFLUENZA
VACCINATION COVERAGE AMONG CALIFORNIA HMO MEMBERS
CDC published "Rapid Assessment of Influenza Vaccination Coverage Among
HMO Members--Northern California Influenza Seasons, 2001-02 Through
2004-05" in the July 15 issue of MMWR. The article's opening paragraph
is reprinted below.
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The Vaccine Safety Datalink (VSD) is a collaborative project involving
CDC and eight health maintenance organizations (HMOs) in the United
States. Computerized data on vaccination, medical outcomes, and patient
demographics are collected and linked under a standard protocol at
multiple HMOs. Beginning with the 2003-04 influenza season, the VSD team
and one of the HMOs, Kaiser Permanente Northern California (KPNC),
established an automated system for rapid detection of potentially
adverse events after vaccinations among its members. During the 2004-05
influenza season, in response to the influenza vaccine shortfall and
resulting prioritization of vaccine distribution, this rapid analysis
system also was used to assess influenza vaccination coverage weekly
among KPNC members. The results indicated that KPNC followed Advisory
Committee on Immunization Practices (ACIP) prioritization guidelines by
targeting influenza vaccination to children aged 6-23 months and adults
aged >=65 years. For the 2005-06 influenza season, the rapid analysis
system should be expanded to include data from additional HMOs and more
detailed information on vaccinees (e.g., high risk for influenza
complications) to better characterize influenza vaccination coverage
during the 2005-06 influenza season on a weekly basis. . . .
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5427a2.htm
To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5427.pdf |
