Issue
Number 550
September 6, 2005
CONTENTS OF THIS ISSUE
- CDC website posts interim immunization recommendations
for persons displaced by Hurricane Katrina
- CDC website posts interim immunization recommendations
for emergency responders assisting with Hurricane Katrina
- DHHS establishes web page and toll-free number to
identify health professionals to assist in Hurricane Katrina relief
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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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September 6, 2005
CDC WEBSITE POSTS INTERIM IMMUNIZATION RECOMMENDATIONS FOR PERSONS DISPLACED
BY HURRICANE KATRINA
On September 6, the CDC website posted interim immunization recommendations
for persons displaced by Hurricane Katrina. The interim recommendations are
reprinted below in their entirety.
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INTERIM IMMUNIZATION RECOMMENDATIONS FOR INDIVIDUALS DISPLACED BY HURRICANE
KATRINA
The purpose of these recommendations is two-fold:
1. To ensure that children, adolescents, and adults are protected against
vaccine-preventable diseases in accordance with current recommendations.
Immunization records are unlikely to be available for a large number of
displaced children and adults. It is important that immunizations are kept
current if possible.
2. To reduce the likelihood of outbreaks of vaccine-preventable diseases in
large crowded group settings. Although the possibility of an outbreak is low
in a vaccinated U.S. population, it is possible that outbreaks of varicella,
rubella, mumps, or measles could occur. Although measles and rubella are no
longer endemic to the United States, introductions do occur, and crowded
conditions would facilitate their spread. Hepatitis A incidence is low in
the affected areas, but postexposure prophylaxis in these settings would be
logistically difficult and so vaccination is recommended. In addition, the
influenza season will begin soon and influenza can spread easily under
crowded conditions.
I. RECOMMENDED IMMUNIZATIONS
If immunization records are available:
Children and adults should be vaccinated according to the recommended child,
adolescent, and adult immunization schedules.
If immunization records are not available:
Children aged 10 years and younger should be treated as if they were
up-to-date with recommended immunizations and given any doses that are
recommended for their current age. This includes the following vaccines:
- Diphtheria and tetanus toxoids and
acellular pertussis vaccine (DTaP)
- Inactivated poliovirus vaccine (IPV)
- Haemophilus influenzae type b vaccine (Hib)
- Hepatitis B vaccine (HepB)
- Pneumococcal conjugate vaccine (PCV)
- Measles-mumps-rubella vaccine (MMR)
- Varicella vaccine unless reliable
history of chickenpox
- Influenza vaccine if in Tier 1.* This
includes all children from 6-23 months and children up to age 10 with a
high-risk condition (MMWR 2005;54:749-750). See:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5434a4.htm
- Hepatitis A is not routinely recommended
in all states; state immunization practice should be followed.
Children and adolescents (aged 11-18 years)
should receive the following recommended immunizations:
- Adult formulation tetanus and
diphtheria toxoids and acellular pertussis vaccine (Tdap)
- Meningococcal conjugate vaccine [MCV
(ages 11-12 and 15 years only)]
- Influenza vaccine if in Tier 1* (MMWR
2005;54:749-750). See:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5434a4.htm
Adults (aged older than 18 years) should
receive the following recommended immunizations:
School requirements
States affected by Hurricane Katrina had immunization requirements for
school and daycare and it is likely that children enrolled prior to the
disaster would be vaccinated appropriately. There is no recommendation to
begin repeating vaccinations for children displaced by the disaster.
II. CROWDED GROUP SETTINGS
In addition to the vaccines given routinely as part of the child and
adolescent schedules, the following vaccines should be given to displaced
person living in crowded group settings:
Influenza:
- Everyone 6 months of age [and
older] should receive influenza vaccine. Children 8 years old or
younger should receive 2 doses, at least one month apart.
Varicella:
- Everyone [older than] 12 months
of age should receive one dose of this vaccine unless they have
a history of chickenpox.
MMR:
- Everyone [older than] 12
months of age and born after 1957 should receive one dose of
this vaccine.
Hepatitis A:
- Everyone 2 years of age [and
older] should receive one dose of hepatitis A vaccine unless
they have a clear history of hepatitis A.
Immunocompromised individuals, such as
HIV-infected persons, pregnant women, and those on systemic steroids, should
not receive the live viral vaccines, varicella and MMR. Screening should be
performed by self-report.
Documentation
It is critical that all vaccines administered be properly documented.
Immunization records should be provided in accordance with the practice of
the state in which the vaccine is administered. Immunization cards should be
provided to individuals at the time of vaccination.
Standard immunization practices should be followed for delivery of all
vaccines, including provision of Vaccine Information Statements.
Diarrheal diseases
Vaccination against typhoid and cholera are not recommended. Both diseases
are extremely rare in the Gulf States, and there is no vaccine against
cholera licensed for use in the United States.
Rabies vaccine should only be used for postexposure prophylaxis (e.g., after
an animal bite or bat exposure) according to CDC guidelines.
Tier 1 recommendations include the following
priority groups:
- Persons ages 65 years
[and older] with comorbid conditions
- Residents of long-term
care facilities
- Persons aged 2-64 years
with comorbid conditions
- Persons 65 years [and
older] without comorbid conditions
- Children aged 6-23
months
- Pregnant women
- Healthcare personnel who
provide direct patient care
- Household contacts and
out-of-home caregivers of children aged [less than] 6
months
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To access a ready-to-print (PDF) version of the interim recommendations, go
to:
http://www.bt.cdc.gov/disasters/hurricanes/katrina/pdf/vaccrecdisplaced.pdf
To access a web-text (HTML) version, go to:
http://www.bt.cdc.gov/disasters/hurricanes/katrina/vaccrecdisplaced.asp
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September 6, 2005
CDC WEBSITE POSTS INTERIM IMMUNIZATION RECOMMENDATIONS
FOR EMERGENCY RESPONDERS ASSISTING WITH HURRICANE
KATRINA
On September 1, the CDC website posted interim
immunization recommendations for emergency responders
involved in relief efforts for Hurricane Katrina. The
recommendations are reprinted below in their entirety.
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INTERIM IMMUNIZATION RECOMMENDATIONS FOR EMERGENCY
RESPONDERS: HURRICANE KATRINA
Required immunizations:
1. Tetanus and diphtheria toxoid (receipt of primary
series, and Td booster within 10 years)
2. Hepatitis B vaccine series for persons who will be
performing direct patient care or [are] otherwise
expected to have contact with bodily fluids
There is no indication for the following vaccines given
the anticipated conditions in the region:
- Hepatitis A vaccine
(low probability of exposure, even under these
conditions, in U.S.). No transmission from
contaminated water has been identified in the U.S.
since the 1980s. Hepatitis A outbreaks have not
occurred following other hurricanes or floods in other
parts of the country, including the devastating
hurricanes in Florida last year, and the Midwestern
floods of the late 1990s. The Gulf Region has had few
hepatitis A cases in recent years, with less than 10
in the past 3 months reported from the New Orleans
area. Thus, even though the water and sewage systems
are damaged or out of operation in many areas along
the Gulf Coast, the risk of a hepatitis A epidemic is
extremely low. Vaccine will take at least one to two
weeks to provide substantial immunity.
- Typhoid vaccine (low
probability of exposure, even under these conditions,
in U.S. ).
- Cholera vaccine (low
probability of exposure, even under these conditions,
in U.S., plus no licensed cholera vaccine available in
the U.S.).
- Meningococcal vaccine
(no expectation of increased risk of meningococcal
disease among emergency responders).
- Rabies vaccine series
(the full series is required for protection). Persons
who are exposed to potentially rabid animals should be
evaluated and receive standard post-exposure
prophylaxis, as clinically appropriate.
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To access a ready-to-print (PDF) version of the interim recommendations, go
to:
http://www.bt.cdc.gov/disasters/hurricanes/pdf/katrina-responder-immun.pdf
To access a web-text (HTML) version of them, go to:
http://www.bt.cdc.gov/disasters/hurricanes/responderimmun.asp
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September 6, 2005
DHHS ESTABLISHES WEB PAGE AND TOLL-FREE NUMBER TO
IDENTIFY HEALTH PROFESSIONALS TO ASSIST IN HURRICANE
KATRINA RELIEF
On September 3, the Department of Health and Human
Services (DHHS) established a web page and a toll-free
number to help identify healthcare professionals and
relief personnel to assist in Hurricane Katrina relief
efforts.
To access the web page, go to:
https://volunteer.ccrf.hhs.gov
To contact the toll-free number, call (866) 528-6334. |
