Issue
Number 616
August 21, 2006
CONTENTS OF THIS ISSUE
- New: CDC posts the provisional recommendations for use
of HPV vaccine on the ACIP web section
- New: August 2006 issue of Vaccinate Women is on the IAC
website
- August issue of CDC's Pandemic Influenza Update now
available on IAC's website
- JAMA publishes study showing Hib vaccination of infants
in Kenya significantly reduces invasive Hib disease rates
- Pharmacy-Based Immunization Summit planned for September
13–14 in Arlington, VA
- 2006 Asian American Pacific Islander Health Summit
scheduled for September 14–16 in San Jose, CA
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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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August 21, 2006
NEW: CDC POSTS THE PROVISIONAL RECOMMENDATIONS FOR USE OF HPV VACCINE ON THE
ACIP WEB SECTION
On August 14, CDC posted provisional recommendations for use of HPV vaccine
on the ACIP web section. The provisional recommendations are reprinted below
in their entirety.
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ACIP PROVISIONAL RECOMMENDATIONS FOR THE USE OF QUADRIVALENT HPV VACCINE
Date of ACIP vote: June 29, 2006
Date of posting of provisional recommendations: August 14, 2006
Tentative date of publication of recommendations in CDC Morbidity and
Mortality Weekly Report: November 2006
Provisional recommendations for use of quadrivalent HPV vaccine:
-
Routine vaccination with three doses of quadrivalent HPV vaccine is
recommended for females 11–12 years of age. The vaccination series can be
started in females as young as 9 years of age.
-
Catch-up vaccination is recommended for females 13–26 years of age who
have not been vaccinated previously or who have not completed the full
vaccine series. Ideally, vaccine should be administered before potential
exposure to HPV through sexual contact.
-
Each dose of quadrivalent HPV vaccine is 0.5 mL, administered
intramuscularly.
-
Quadrivalent HPV vaccine is administered in a three-dose schedule. The
second and third doses should be administered 2 and 6 months after the
first dose.
-
Quadrivalent HPV vaccine can be administered at the same visit when other
age-appropriate vaccines are provided, such as Tdap, Td, and MCV4.
-
At present, cervical cancer screening recommendations have not changed for
females who receive quadrivalent HPV vaccine.
Special situations:
-
Quadrivalent HPV vaccine can be given to females who have an equivocal
or abnormal Pap test, a positive Hybrid Capture II high-risk test, or
genital warts.
Vaccine recipients should be advised that data from clinical trials do not
indicate the vaccine will have any therapeutic effect on existing Pap test
abnormalities, HPV infection, or genital warts. Vaccination of these females
would provide protection against infection with vaccine HPV types not
already acquired.
-
Lactating women can receive quadrivalent HPV vaccine.
-
Females who are immunocompromised either from disease or medication
can receive quadrivalent HPV vaccine. However, the immune response to
vaccination and vaccine effectiveness might be less than in females
who are immunocompetent.
Pregnancy:
-
Quadrivalent HPV vaccine is not recommended for use in pregnancy.
The vaccine has not been associated causally with adverse outcomes
of pregnancy or adverse events to the developing fetus. However,
data on vaccination during pregnancy are limited. Any exposure to
vaccine during pregnancy should be reported to the vaccine pregnancy
registry (800) 986-8999.
-
Contraindications to use of vaccine:
Quadrivalent HPV vaccine is contraindicated for people with a
history of immediate hypersensitivity to yeast or to any
vaccine component.
Precautions:
-
Quadrivalent HPV vaccine can be administered to females with minor
acute illnesses (e.g., diarrhea or mild upper respiratory tract
infections, with or without fever). Vaccination of people with
moderate or severe acute illnesses should be deferred until after
the illness improves.
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To access a ready-to-print (PDF) version of the provisional recommendations,
go to:
http://www.cdc.gov/nip/recs/provisional_recs/hpv.pdf
All provisional ACIP recommendations can be found at
http://www.cdc.gov/nip/recs/provisional_recs
All published ACIP recommendations can be accessed at
http://www.cdc.gov/nip/ACIP
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August 21, 2006
NEW: AUGUST 2006 ISSUE OF VACCINATE WOMEN IS ON THE IAC WEBSITE
The August 2006 issue of Vaccinate Women is now available on the
IAC website. Hard copies were recently mailed to all members of
the American College of Obstetricians and Gynecologists (ACOG).
This publication was supported by a cooperative grant by the
Division of Viral Hepatitis at the Centers for Disease Control and
Prevention. It was distributed free of charge by ACOG.
The new issue is filled with reliable, practical information
intended to assist obstetricians/gynecologists in providing
immunization services in their healthcare settings.
HOW TO READ VACCINATE WOMEN ON THE WEB
You can view selected articles from the table of contents below or
download the entire issue from the Web.
To view the table of contents with links to individual articles,
go to:
http://www.immunize.org/vw
Please note: The PDF file of the entire issue, linked below, is
759,034 bytes. For tips on downloading and printing PDF files, go
to:
http://www.immunize.org/nslt.d/tips.htm
To download a ready-to-print (PDF) version of the entire issue, go
to:
http://www.immunize.org/vw/vw0806.pdf
TO ACCESS INDIVIDUAL ARTICLES
Following are descriptions of and direct links to each of the main
Vaccinate Women articles:
"Ask the Experts"
CDC immunization experts William L. Atkinson, MD, MPH, and Andrew
T. Kroger, MD, MPH, answer general immunization questions.
Hepatitis specialist Eric E. Mast, MD, MPH, answers hepatitis
questions.
To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/vw/expert6.pdf
Revised in April, the one-page "Guidelines for Standing Orders in
Labor & Delivery and Nursery Units to Prevent Hepatitis B Virus
Transmission to Newborns," now reflects ACIP's recommendations for
preventing hepatitis B virus infections in infants, which were
updated in December 2005. The piece includes detailed information
for infants born to HBsAg-negative mothers, infants born to HBsAg-positive
mothers, and infants born to mothers with unknown HBsAg status.
To access a ready-to-print (PDF) two-page version, go to:
http://www.immunize.org/catg.d/p2130per.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2130.htm
The "Summary of Recommendations for Adult Immunization" condenses
hundreds of pages of recommendations into a handy three-page
chart. It was revised in July to add information about the new
vaccines to protect against human papillomavirus (HPV) and herpes
zoster (shingles) and to update information about influenza
vaccines.
To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p2011b.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2011b.htm
The one-page piece "How to Administer IM and SC Injections to
Adults" was revised in July to add information about administering
the new vaccines to protect against human papillomavirus (HPV) and
herpes zoster (shingles).
To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p2020A.pdf
Revised in July, the two-page checklist "Screening Questionnaire
for Adult Immunization" now has updated information on the
following vaccines: MMR, varicella, nasal-spray influenza (LAIV),
and pertussis-containing vaccine for adults (Tdap).
To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p4065scr.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4065scr.htm
The two-page checklist "Do I Need Any Vaccinations Today?" was
revised in July to add information about the new vaccines to
protect against human papillomavirus (HPV) and herpes zoster
(shingles) and to update information about the following vaccines:
pneumococcal, Tdap, and MMR.
To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/4036need.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/4036need.htm
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August 21, 2006
AUGUST ISSUE OF CDC'S PANDEMIC INFLUENZA UPDATE NOW AVAILABLE ON
IAC'S WEBSITE
CDC recently issued the August issue of the email newsletter
Pandemic Influenza Update. To access it, go to:
http://www.immunize.org/pandemic/panflu806.pdf
To access a range of pandemic influenza resources on the IAC
website, go to
http://www.immunize.org/pandemic
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August 21, 2006
JAMA PUBLISHES STUDY SHOWING HIB VACCINATION OF INFANTS IN KENYA
SIGNIFICANTLY REDUCES INVASIVE HIB DISEASE RATES
On August 9 the Journal of the American Medical Association (JAMA)
published an article about research indicating that routine
vaccination of infants in Kenya against Haemophilus influenzae
type b (Hib) reduced invasive Hib disease rates by 88 percent. The
article is titled "Effectiveness of Haemophilus influenzae type b
conjugate vaccine introduction into routine childhood immunization
in Kenya." The abstract is reprinted below.
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Context: Haemophilus influenzae type b (Hib) conjugate vaccine is
not perceived as a public health priority in Africa because data
on Hib disease burden and vaccine effectiveness are scarce. Hib
immunization was introduced in Kenyan infants in 2001.
Objective: To define invasive Hib disease incidence and Hib
vaccine program effectiveness in Kenya.
Design, Setting, and Patients: Culture-based surveillance for
invasive Hib disease at Kilifi District Hospital from 2000 through
2005 was linked to demographic surveillance of 38,000 children
younger than 5 years in Kilifi District, Kenya. Human
immunodeficiency virus (HIV) infection and Hib vaccination status
were determined for children with Hib disease admitted 2002–2005.
Interventions: Introduction of conjugate Hib vaccine within the
routine childhood immunization program at ages 6, 10, and 14 weeks
beginning November 2001.
Main Outcome Measures: Incidence of culture-proven Hib invasive
disease before and after vaccine introduction and vaccine program
effectiveness.
Results: Prior to vaccine introduction, the median age of children
with Hib was 8 months; case fatality was 23%. Among children
younger than 5 years, the annual incidence of invasive Hib disease
1 year before and 1 and 3 years after vaccine introduction was 66,
47, and 7.6 per 100,000, respectively. For children younger than 2
years, incidence was 119, 82, and 16 per 100,000, respectively. In
2004–2005, vaccine effectiveness was 88% (95% confidence interval,
73%-96%) among children younger than 5 years and 87% (95%
confidence interval, 66%–96%) among children younger than 2 years.
Of 53 children with Hib admitted during 2002–2005, 29 (55%) were
age-ineligible to have received vaccine, 12 (23%) had not been
vaccinated despite being eligible, and 12 (23%) had received 2 or
more doses of vaccine (2 were HIV positive).
Conclusions: In Kenya, introduction of Hib vaccine into the
routine childhood immunization program reduced Hib disease
incidence among children younger than 5 years to 12% of its
baseline level. This impact was not observed until the third year
after vaccine introduction.
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To access the abstract, go to:
http://jama.ama-assn.org/cgi/content/abstract/296/6/671
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August 21, 2006
PHARMACY-BASED IMMUNIZATION SUMMIT PLANNED FOR SEPTEMBER 13–14 IN
ARLINGTON, VA
The third annual Pharmacy-Based Immunization Summit will be held
in Arlington, VA, September 13–14. Sponsors include the Academy of
Managed Care Pharmacy, American Pharmacists Association, and
National Association of Chain Drug Stores Foundation.
For complete information and online registration, go to:
http://www.nacdsfoundation.org/wmspage.cfm?parm1=1067
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August 21, 2006
2006 ASIAN AMERICAN PACIFIC ISLANDER HEALTH SUMMIT SCHEDULED FOR
SEPTEMBER 14–16 IN SAN JOSE, CA
The 2006 Asian American Pacific Islander Health Summit will be
held in San Jose, CA, on September 14–16. It is sponsored by the
Asian & Pacific Islander American Health Forum and the Association
of Asian Pacific Community Health Organizations.
Workshops are planned to discuss hepatitis B within the AAPI
community. For comprehensive information, including the program
agenda and registration options, go to:
http://www.apiahf.org/events/summit2006/AAPIsummit2006.html |