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IAC Express 2007 |
| Issue number 648: February 26, 2007 |
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Contents
of this Issue
Select a title to jump to the article. |
- Reminder:
Be sure to continue administering influenza vaccine during the early
months of 2007
- Merck
notifies CDC of low yield of varicella-zoster virus in its bulk vaccine
- New:
"Shots 2007" version of childhood and adult immunization schedules now
available for handhelds
- CDC
reports on measles cases among three U.S. adults visiting China for child
adoptions during July-August 2006
- New:
Standing orders protocol for administering rotavirus vaccine to infants is
available on IAC's website
- Pediatric
Dengue Vaccine Initiative seeks applicants for program officer in its
Vaccine Access Program
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| Abbreviations |
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AAFP, American Academy of Family Physicians; AAP,
American Academy of Pediatrics; ACIP, Advisory Committee on Immunization
Practices; AMA, American Medical Association; CDC, Centers for Disease
Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization
Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NCIRD,
National Center for Immunization and Respiratory Diseases; NIVS, National
Influenza Vaccine Summit; VIS, Vaccine Information Statement; VPD,
vaccine-preventable disease; WHO, World Health Organization. |
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Issue 648: February 26, 2007 |
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1. |
Reminder: Be sure to continue administering influenza vaccine during the
early months of 2007
Remember, influenza vaccination should continue
through the early months of 2007. Visit the following websites often to find
the information you need to keep vaccinating. Both are continually updated
with the latest resources.
The National Influenza Vaccine Summit website at
http://www.preventinfluenza.org
CDC's Influenza web section at
http://www.cdc.gov/flu
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2. |
Merck notifies CDC of low yield
of varicella-zoster virus in its bulk vaccine
CDC published "Notice to Readers: Supply of
Vaccines Containing
Varicella-Zoster Virus" in the February 23 issue of MMWR. The
article is reprinted below in its entirety, excluding
references.
CDC received notice from Merck & Co., Inc., that it has lower
amounts of varicella-zoster virus (VZV) than expected from
recently manufactured bulk vaccine. Bulk vaccine production is
an intermediate step in the manufacture of VZV-containing
vaccines. Varicella bulk is stored frozen until it is needed in
the final preparation phase of each vaccine. Production of VZV
bulk has been suspended temporarily while the manufacturer
identifies the cause of the low virus yield. Merck is the only
U.S. supplier of VZV-containing vaccine, including varicella
vaccine (Varivax); combined measles, mumps, rubella, and
varicella (MMR-V) vaccine (ProQuad); and zoster vaccine
(Zostavax). This lower virus yield does not affect the quality
of any of Merck's VZV-containing vaccines currently on the
market, any lots of vaccine manufactured and ready for release
to the market, or any VZV-containing vaccines presently being
manufactured.
To conserve existing bulk vaccine with adequate VZV potency,
Merck is prioritizing continued production of varicella and
zoster vaccines over production of MMR-V vaccine. Merck is
taking this approach because the production of varicella vaccine
requires less VZV than the production of MMR-V vaccine. Although
zoster vaccine requires a similar amount of VZV for production
as MMR-V vaccine, projected supply needs for zoster vaccine are
much lower than projected supply needs for MMR-V vaccine. Merck
also will increase production of combined measles, mumps, and
rubella (MMR) vaccine (M-M-R II).
Current supply assessments in the United States indicate that
this interruption in bulk vaccine supply will not affect the
supply of either varicella vaccine or zoster vaccine. The U.S.
varicella vaccine supply is expected to be adequate to fully
implement the recommended immunization schedule for varicella
vaccine for all age groups, including the routine 2-dose
schedule for children at 12-15 months and at 4-6 years, catch-up
vaccination with the second dose for children and adolescents
who received only 1 dose, and vaccination with 2 doses for other
children, adolescents, and adults without evidence of immunity.
For zoster vaccine, the supply is expected to be adequate to
vaccinate adults aged >=60 years in accordance with current
provisional vaccine policy recommendations. The MMR-V vaccine
supply is adequate to continue ordering this combination
vaccine; however, the manufacturer expects supplies of MMR-V
vaccine to be depleted toward the end of 2007, depending on
market demand. When this occurs, supplies of separate MMR and
varicella vaccines are expected to be adequate to fulfill the
need for these two products in place of MMR-V vaccine. CDC will
continue to work with Merck and vaccine-provider stakeholders to
monitor the supply of VZV-containing vaccines. Updates on
vaccine shortages and delays are available at
http://www.cdc.gov/nip/news/shortages/default.htm
To access a web-text (HTML) version of the complete notice, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5607a4.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5607.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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3. |
New: "Shots 2007" version of
childhood and adult immunization schedules now available for handhelds
On February 22, the NIP website posted news that
the "Shots
2007" quick-reference guides to the childhood and adult
immunization schedules are now available for Palm-OS handhelds
and Pocket-PCs handhelds. Both are available on the website of
the Group on Immunization Education of the Society of Teachers
of Family Medicine.
To access "Shots 2007" for Palm-OS handhelds and Pocket-PCs
handhelds, as well as "Shots 2007 Online," go to:
http://www.immunizationed.org/anypage.aspx?pagename=shotshome
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4. |
CDC reports on measles cases
among three U.S. adults visiting China for child adoptions during July-August
2006
CDC published "Measles Among Adults Associated
with Adoption of
Children in China—California, Missouri, and Washington, July-August 2006" in the February 23 issue of MMWR. Portions of the
article are reprinted below.
On August 15, 2006, the Missouri Department of Health and Senior
Services (MoDHSS) was notified of a measles case in a Missouri
resident who had recently traveled to China. The patient had
traveled with a group of 11 families seeking to adopt children
from three orphanages in Guangdong Province. Members of the
group, which was sponsored by a Missouri-based adoption agency,
traveled separately but stayed at the same hotel in Guangdong
Province during July 13-27. This report describes the multistate
investigation that followed, which identified two additional
measles cases. . . .
Editorial Note:
During 2001-2005, import-associated measles cases (i.e.,
imported, import-linked, or imported virus cases) accounted for
the majority of cases reported in the United States. Imported
measles cases among adoptees from China have been reported
previously. This report documents imported measles cases during
July-August 2006 among adopting parents from the United States
who were exposed to measles while visiting China.
China is the leading country of origin for foreign-born children
adopted in the United States. During 1998-2005, annual U.S.
adoptions of children from China increased by 88%, from 4,206 to
7,906. A national measles outbreak in China increased reported
measles cases there from 70,549 in 2004 to 124,219 in 2005. In
Guangdong Province, 11,146 measles cases were reported during
January-June 2006, a 30% increase compared with the same period
in 2005. This situation in China presented an increased risk for
measles exposure to travelers and potential importation into the
United States. China has set a measles-elimination goal for
2012, and the country is conducting activities to achieve this
goal (e.g., conducting an international field review [November
2006] and convening the first National Technical Advisory
meeting on measles elimination [December 2006]).
According to the Advisory Committee on Immunization Practices
(ACIP), persons born during 1957 or later without (1) adequate
documentation of immunity by previous vaccination with 2 doses
of MCV, (2) laboratory evidence of immunity, or (3) physician-diagnosed measles should be vaccinated with the measles, mumps,
and rubella (MMR) vaccine before travel abroad. The U.S.
Department of State requires that internationally adopted
children aged >10 years receive the following vaccines before
entry into the United States: measles, mumps, and rubella;
polio; tetanus and diphtheria toxoids; pertussis; Haemophilus
influenzae type B; hepatitis B; varicella; and pneumococcal. For
those aged <=10 years, the adopting parents must sign an
affidavit promising to provide these vaccinations within 30 days
of entry to the United States. The education that most adoptive
parents receive regarding their own medical preparations before
travel can vary substantially. In this instance, the adoption
agency provided the ACIP recommendations to the clients and
repeatedly advised their clients about the importance of being
properly vaccinated; however, no standard mechanisms were in
place to ensure that these recommendations were followed before
travel abroad. In the United States and internationally, several
organizations (e.g., the American Academy of Pediatrics Section
on Adoption and Foster Care and the Joint Council for
International Children's Services) are working to improve
immunization and education standards regarding international
adoptions. Healthcare providers should continue to promote
appropriate pre-travel vaccination for their patients.
Investigation of all three cases was substantially delayed
because of delays in diagnosis and delays in notifying
jurisdictions where exposed travelers resided. Because measles
is rare in the United States (as a result of high immunization
levels), it is often unrecognized by clinicians who might not
consider measles in a differential diagnosis. Healthcare
providers should routinely gather information regarding the
patient's travel history and maintain a high level of suspicion
for measles in patients with rash, fever, and recent travel to
areas of known measles endemicity. Although a single dose of
measles vaccine administered in the second year of life induces
immunity in 95% of vaccinees, cases can occur even among
vaccinated persons. More common than vaccine failure is
incomplete documentation or inaccurate recall of vaccination
status. In the cases described in this report, the patient from
Missouri had 2 MCV doses documented, the patient from Washington
had 1 MCV dose documented, and the patient from California had
no MCV doses documented.
DGMQ [the CDC's Division of Global Migration and Quarantine] is
authorized to conduct investigations involving international
flights arriving in the United States and can assist state
health departments with investigations involving interstate
flights. In the case of interstate flights, DGMQ may request
passenger manifests and passenger-locator information to assist
the state in which the plane lands. Once notified of an
exposure, DGMQ contacts the airline to obtain the passenger
manifest and passenger-locating information of contacts. A
software application developed by DGMQ, eManifest, is used to
securely import, sort, and assign passenger-locator information
to jurisdictions. These data are transmitted securely to state
and territorial health agencies via the Epidemic Information
Exchange (Epi-X) forum. Staff from the 18 CDC quarantine
stations follow up with public health agencies to ensure the
information has been received. DGMQ continues to work with
airlines to develop mechanisms for the timely provision of
passenger-locator information to CDC and with federal and state
partners to improve the process of distributing this
information.
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5607a3.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5607.pdf
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5. |
New: Standing orders protocol for
administering rotavirus vaccine to infants is available on IAC's website
Newly developed, IAC's professional-education
piece "Standing
Orders for Administering Rotavirus Vaccine to Infants" is now
available in ready-to-print (PDF) format on IAC's website at
http://www.immunize.org/catg.d/p3087.pdf
To access a table with links to all IAC's standing orders
protocols for vaccine administration, go to:
http://www.immunize.org/standingorders
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6. |
Pediatric Dengue Vaccine
Initiative seeks applicants for program officer in its Vaccine Access Program
The Pediatric Dengue Vaccine Initiative (PDVI), a
program of the
International Vaccine Institute (IVI), Seoul, Korea, is seeking
to fill program officer position of the Vaccine Access Program.
The PDVI mission is to accelerate evaluation and introduction of
dengue vaccines for children in developing countries. Successful
applicants will participate in PDVI programs to plan for the
introduction and use of dengue vaccines in developing countries.
Applicants should be experts in private and public partnership
to develop and promote plans for national and international
vaccine procurement and distribution and develop effective
communications. Specific knowledge of dengue would be a distinct
advantage. Applicants should have experience in program
development and management, working in public-private
partnerships, and international health.
Qualifications include a master's degree, Ph.D., or equivalent
degree and training in business, marketing, biotechnology, and
product introduction. Past research experience in economic
studies of disease burden and the prevention effectiveness of
vaccination strategies in developing countries is highly
desirable.
The Program Officer, Vaccine Access position requires at least 5
years of public health or equivalent experience, a record of
peer-reviewed publications, and successful management of
research programs.
Salary will be internationally competitive. The Institute
provides appropriate fringe benefits including a housing
allowance, home leave, and income tax reimbursement.
The International Vaccine Institute (IVI) is a non-profit
organization dedicated to accelerating research, evaluation, and
introduction of new and improved vaccines primarily in
developing countries. The IVI was established under the Vienna
Convention of 1969. These positions are located at the IVI and
PDVI headquarters in Seoul, Korea.
Further information can be obtained from Dr. Richard Mahoney,
Director, Vaccine Access, Pediatric Dengue Vaccine Initiative
(rmahoney@pdvi.org). Letters of application, along with current
curriculum vitae and three references, should be addressed to
Mr. Hong-ki Jong
Senior Administrative Officer
International Vaccine Institute
Kwanak PO Box 14
Seoul, Korea
Tel: 82-2-872-2801 Fax: 82-2-872-2803
Email: hjong@ivi.int
Absolute confidentiality will be respected.
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