Issue
Number 607
July 3, 2006
CONTENTS OF THIS ISSUE
- New: CDC issues the latest ACIP influenza
recommendations in an MMWR Early Release
- New: ACIP votes to recommend human papillomavirus
vaccination for girls and women ages 9-26 years
- New: ACIP votes to recommend changes in varicella
vaccination
- New: Influenza VISs for 2006-07 season now available on
the CDC and IAC websites
- CDC website posts HPV vaccine fact sheet for healthcare
professionals and updates fact sheet for public
- June 29 issue of Hep Express electronic newsletter now
online
- New: Pediatric Dengue Vaccine Initiative launches
newsletter
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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 3, 2006
NEW: CDC ISSUES THE LATEST ACIP INFLUENZA RECOMMENDATIONS IN AN MMWR EARLY
RELEASE
On June 28, CDC issued "Prevention and Control of Influenza: Recommendations
of the Advisory Committee on Immunization Practices (ACIP)" as an MMWR Early
Release. CDC publishes the web-based MMWR Early Release only for the
immediate release of important public health information. The article will
be published in the standard MMWR format in the future.
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 2005 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 2005;54[No.
RR-8]:1-44). The 2006 recommendations include new and updated information.
Principal changes include (1) recommending vaccination of children aged
24-59 months and their household contacts and out-of-home caregivers against
influenza; (2) highlighting the importance of administering 2 doses of
influenza vaccine for children aged 6 months-<9 years who were previously
unvaccinated; (3) advising healthcare providers, those planning organized
campaigns, and state and local public health agencies to (a) develop plans
for expanding outreach and infrastructure to vaccinate more persons than
[during] the previous year and (b) develop contingency plans for the timing
and prioritization of administering influenza vaccine, if the supply of
vaccine is delayed and/or reduced; (4) reminding providers that they should
routinely offer influenza vaccine to patients throughout the influenza
season; (5) recommending that neither amantadine nor rimantadine be used for
the treatment or chemoprophylaxis of influenza A in the United States until
evidence of susceptibility to these antiviral medications has been
re-established among circulating influenza A viruses; and (6) using the
2006-07 trivalent influenza vaccine virus strains: A/New Caledonia/20/1999
(H1N1)-like, A/Wisconsin/67/2005 (H3N2)-like, and B/Malaysia/2506/2004-like
antigens. For the A/Wisconsin/ 67/2005 (H3N2)-like antigen, manufacturers
may use the antigenically equivalent A/Hiroshima/52/2005 virus; for the
B/Malaysia/2506/2004-like antigen, manufacturers may use the antigenically
equivalent B/Ohio/1/2005 virus. 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 2006 recommendations include six principal changes or updates:
-
ACIP recommends that healthy children aged 24-59 months and their
household contacts and out-of-home caregivers be vaccinated against
influenza (see Target Groups for Vaccination). This change extends the
recommendations for vaccination of children so that all children aged
6-<=59 months receive annual vaccination.
-
ACIP emphasizes that all children aged 6 months-<9 years who have not been
previously vaccinated at any time with either live, attenuated influenza
vaccine (LAIV) or trivalent inactivated influenza vaccine (TIV) should
receive 2 doses of vaccine. Those children aged 6 months-<9 years who
receive TIV should have a booster dose of TIV administered >=1 month after
the initial dose, before the onset of influenza season, if possible. Those
children aged 5-<9 years who receive LAIV should have a second dose of LAIV
6-10 weeks after the initial dose, before the influenza season, if
possible. If a child aged 6 months-<9 years received influenza vaccine for
the first time during a previous season but did not receive a second dose
of vaccine within the same season, only 1 dose of vaccine should be
administered this season (see Efficacy and Effectiveness of Inactivated
Influenza Vaccine, Children; TIV Dosage; and LAIV Dosage and
Administration).
-
To ensure optimal use of available doses of influenza vaccine, projected
to be approximately 100 million doses, healthcare providers, those
planning organized campaigns, and state and local public health agencies
should (1) develop plans for expanding outreach and infrastructure to
vaccinate more persons than during the previous year and (2) develop
contingency plans for the timing and prioritization of administering
influenza vaccine, if the supply of vaccine is delayed and/or reduced
because of the complexity of the production process (see Influenza Vaccine
Supply and Timing of Annual Influenza Vaccination).
-
ACIP emphasizes that influenza vaccine should continue to be offered
throughout the influenza season even after influenza activity has been
documented in a community. In addition, ACIP encourages all community
vaccinators and public health agencies to schedule clinics that serve
target groups and to help extend the routine vaccination season by
offering at least one vaccination clinic in December (see Influenza
Vaccine Supply and Timing of Annual Influenza Vaccination).
-
ACIP recommends that neither amantadine nor rimantadine be used for the
treatment or chemoprophylaxis of influenza A in the United States because
of recent data indicating widespread resistance of influenza virus to
these medications. Until susceptibility to adamantanes has been
re-established among circulating influenza A viruses, oseltamivir or
zanamivir may be prescribed if antiviral treatment or chemoprophylaxis of
influenza is indicated (see Recommendations for Using Antiviral Agents for
Influenza).
-
The 2006-07 trivalent vaccine virus strains are A/New Caledonia/20/1999
(H1N1)-like, A/Wisconsin/67/2005 (H3N2)-like, and
B/Malaysia/2506/2004-like antigens. For the A/Wisconsin/67/2005
(H3N2)-like antigen, manufacturers may use the antigenically equivalent
A/Hiroshima/52/2005 virus; for the B/Malaysia/2506/2004-like antigen,
manufacturers may use the antigenically equivalent B/Ohio/1/2005 virus
(see Influenza Vaccine Composition). . . .
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To access a ready-to-print (PDF) version of it, go to:
http://www.cdc.gov/mmwr/pdf/rr/rr55e628.pdf
To access a web-text (HTML) version of the MMWR Early Release, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr55e628a1.htm
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July 3, 2006
NEW: ACIP VOTES TO RECOMMEND HUMAN PAPILLOMAVIRUS VACCINATION FOR GIRLS
AND WOMEN AGES 9-26 YEARS
On June 29, CDC issued a media advisory announcing that ACIP has voted to
recommend human papillomavirus vaccination for girls and women ages 9-26
years. Also on June 29, CDC posted on its website a transcript of a press
briefing on the same subject. The speaker is Dr. Anne Schuchat, director
of CDC's National Center for Immunization and Respiratory Diseases. A link
to the transcript is given at the end of this IAC Express article.
The media advisory is reprinted below in its entirety.
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Media Advisory
For immediate release
June 29, 2006
CDC'S ADVISORY COMMITTEE RECOMMENDS HUMAN PAPILLOMAVIRUS VIRUS VACCINATION
CDC's Advisory Committee Recommends Human Papillomavirus Virus Vaccination
Vaccine considered highly effective in preventing infections that are the
cause of most cervical cancers.
The Advisory Committee on Immunization Practices (ACIP) voted Thursday to
recommend that a newly licensed vaccine designed to protect against human
papillomavirus virus (HPV) be routinely given to girls when they are 11-12
years old. The ACIP recommendation also allows for vaccination of girls
beginning at nine years old as well as vaccination of girls and women
13-26 years old. HPV is the leading cause of cervical cancer in women.
According to the ACIP's recommendation, three doses of the new vaccine
should be routinely given to girls when they are 11 or 12 years old. The
advisory committee, however, noted that the vaccination series can be
started as early as nine years old at the discretion of the physician or
healthcare provider. The recommendation also includes girls and women
13-26 years old because they will benefit from getting the vaccine. The
vaccine should be administered before onset of sexual activity (i.e.,
before women are exposed to the viruses), but females who are sexually
active should still be vaccinated. . . .
"This vaccine represents an important medical breakthrough," said Dr. Anne
Schuchat, director of CDC's National Center for Immunization and
Respiratory Diseases. "As a result, these vaccine recommendations address
a major health problem for women and represent a significant advance in
women's health. It has been tested in thousands of women around the world
and has been found to be safe and effective in providing protection
against the two types of HPV that cause most cervical cancers."
Gardasil, manufactured by Merck, is the first vaccine developed to prevent
cervical cancer, precancerous genital lesions, and genital warts due to
HPV幽PV causes genital warts in men and women. The vaccine is highly
effective against four types of the HPV virus, including two that cause
about 70 percent of cervical cancer. Those who have not acquired HPV would
get the full benefits of the vaccine. On average, there are 9,710 new
cases and 3,700 deaths from cervical cancer in the United States each
year.
HPV is the most common sexually transmitted infection in the United
States. More than 20 million men and women in the United States are
currently infected with HPV and there are 6.2 million new infections each
year. HPV is most common in young women and men who are in their late
teens and early 20s. By age 50, at least 80 percent of women will have
acquired HPV infection.
"Although an effective vaccine is a major advance in the prevention of
genital HPV and cervical cancer, it will not replace other prevention
strategies, such as cervical cancer screening for women or protective
sexual behaviors," said Dr. Schuchat. "Women should continue to get pap
tests as a safeguard against cervical cancer."
The ACIP, consisting of 15 members appointed by the Secretary of the
Department of Health and Human Services (HHS), advises the director of CDC
and Secretary of HHS on control of vaccine-preventable disease and vaccine
usage. Recommendations of the ACIP become CDC policy when they are
accepted by the director of CDC and are published in CDC's Morbidity and
Mortality Weekly Report (MMWR). There are no federal laws requiring the
immunization of children. All school and daycare entry laws are state laws
and vary from state to state.
For more information, visit www.cdc.gov
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To access the complete media advisory, go to:
http://www.cdc.gov/od/oc/media/pressrel/r060629.htm
To access the transcript of the press briefing, go to:
http://www.cdc.gov/od/oc/media/transcripts/t060629.htm
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July 3, 2006
NEW: ACIP VOTES TO RECOMMEND CHANGES IN VARICELLA VACCINATION
On June 29, CDC issued a media advisory announcing that ACIP has voted to
recommend a second dose of varicella vaccine for children ages 4-6 years,
as well as other changes. Portions of the media advisory are reprinted
below.
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Media Advisory
For immediate release
June 29, 2006
CDC'S ADVISORY COMMITTEE RECOMMENDS CHANGES IN VARICELLA VACCINATIONS
Second dose of varicella vaccine to offer more protection for children,
adolescents, and adults
The Advisory Committee on Immunization Practices (ACIP) to the Centers for
Disease Control and Prevention (CDC), in its meeting in Atlanta today,
voted to recommend a second dose of varicella (chickenpox) vaccine for
children four to six years old to further improve protection against the
disease. The first dose of varicella vaccine is recommended at 12 to 15
months old.
Fifteen to 20 percent of children who have received one dose of the
vaccine are not fully protected and may develop chickenpox after coming in
contact with varicella zoster virus. Additionally, one dose of the vaccine
may not continue to provide protection into adulthood when chickenpox is
more severe. A second dose of varicella vaccine provides increased
protection against varicella disease compared [with] one dose. The ACIP
also recommended that children, adolescents, and adults who previously
received one dose should receive a second dose.
"We have made great progress in reducing chickenpox during the past ten
years," said Dr. Anne Schuchat, director of CDC's National Center for
Immunization and Respiratory Diseases. "This recommendation will further
reduce outbreaks of chickenpox and provide better individual protection."
Before licensure of the varicella vaccine in 1995, each year there were
about four million cases of varicella, 13,500 hospitalizations, and 150
deaths. Cases of varicella have steadily declined 80 to 85 percent in
surveillance sites since the licensure. From 1995 to 2001, varicella
hospitalizations declined by 72 percent and deaths, among those 50 years
old and younger, decreased by 75% or more.
However, in recent years varicella outbreaks have continued to occur among
vaccinated school children. During these chickenpox outbreaks, between 11
and 17 percent of vaccinated children developed varicella. Varicella in
vaccinated children is usually mild, but the children are contagious and
can transmit the virus to others including their parents who are at higher
risk of severe disease. . . .
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To access the complete press release, go to:
http://www.cdc.gov/od/oc/media/pressrel/r060629-b.htm
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July 3, 2006
NEW: INFLUENZA VISs FOR 2006-07 SEASON NOW AVAILABLE ON THE CDC AND IAC
WEBSITES
On June 30, CDC issued new VISs for the two influenza vaccines: trivalent
inactivated influenza vaccine (TIV; injectable) and live attenuated
influenza vaccine (LAIV; nasal spray). Both are available on the CDC and
IAC websites. At this time, these VISs are available in English only.
TIV VACCINE VIS (dated 6/30/06)
To obtain a ready-to-print (PDF) version of the VIS for TIV in English
from the CDC website, go to:
http://www.cdc.gov/nip/publications/VIS/vis-flu.pdf
To obtain it from the IAC website, go to:
http://www.immunize.org/vis/2flu.pdf
LAIV VACCINE VIS (dated 6/30/06)
To obtain a ready-to-print (PDF) version of the VIS for LAIV in English
from the CDC website, go to:
http://www.cdc.gov/nip/publications/VIS/vis-flulive.pdf
To obtain it from the IAC website, go to:
http://www.immunize.org/vis/liveflu.pdf
For information about the use of VISs, and for VISs in more than 30
languages, visit IAC's VIS web section at
http://www.immunize.org/vis
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July 3, 2006
NEW: CDC WEBSITE POSTS HPV VACCINE FACT SHEET FOR HEALTHCARE PROFESSIONALS
AND UPDATES FACT SHEET FOR PUBLIC
CDC's Sexually Transmitted Diseases web section recently posted a fact
sheet on human papillomavirus (HPV) infection and vaccine for healthcare
professionals and updated the existing fact sheet for the public.
To access the fact sheet for healthcare professionals, go to:
http://www.cdc.gov/std/HPV/STDFact-HPV-vaccine-hcp.htm
To access the fact sheet for the public, go to:
http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm
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July 3, 2006
JUNE 29 ISSUE OF HEP EXPRESS ELECTRONIC NEWSLETTER NOW ONLINE
The June 29 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.
Six articles in the June 29 issue are of particular note; these are their
titles:
-
Free and now available: Asian Liver Center's new brochure, "Hepatitis B
and Moms-to-Be," in English and Chinese
-
Review the key issues of HBV treatment options as presented at Digestive
Disease Week 2006
-
Hepatitis B Foundation updates English chapters
-
Viral Hepatitis Prevention Board website features presentations from a
meeting on hepatitis B, hepatitis C, and other bloodborne infections in
healthcare workers
-
Asian Liver Center releases unique documentary on HBV: "Another Life:
The Untold Story of an Asian Epidemic"
-
Viral hepatitis integration brochure and other educational materials
available free from CDC
Titles of additional articles from the June 29 Hep Express include the
following:
-
Hepatitis B Congressional briefing raises awareness about hepatitis B
-
Hepatitis C awareness event called Hep Fest coming to Florida on
September 1-4
-
Conference on hepatitis C, HIV, and other bloodborne pathogens planned
for Chicago on October 26-27
To access the June 29 issue, go to:
http://www.hepprograms.org/hepexpress/issue45.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
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July 3, 2006
NEW: PEDIATRIC DENGUE VACCINE INITIATIVE LAUNCHES NEWSLETTER
The Pediatric Dengue Vaccine Initiative (PDVI), housed at the
International Vaccine Institute in Seoul, Korea, has launched a
newsletter猶DVI News. PDVI is funded by the Bill and Melinda Gates
Foundation and the Rockefeller Foundation. It promotes the
development, evaluation, and introduction of dengue vaccines for
developing countries.
The newsletter may be accessed at
http://www.pdvi.org/Newsletter.htm
Subscription requests should be send to Ms. Nam Hee Kim at
nhkim@pdvi.org |
