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IAC Express 2007 |
| Issue number 650: March 12, 2007 |
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Contents
of this Issue
Select a title to jump to the article. |
- New: CDC
issues ACIP recommendations for the use of quadrivalent human
papillomavirus vaccine
- New VIS
translation: Spanish-language version of the interim VIS for varicella
vaccine now online
- Reminder:
Be sure to continue administering influenza vaccine during the early
months of 2007
- CDC's
report on aging includes a call to action to increase adult immunization
in racial/ethnic minority populations
- New
formats: 2007 Immunization Schedule for Children and Adolescents now
available in pocket and brochure sizes
- Fewer
than one in three asthmatic children received inactivated influenza
vaccine in the 2004-05 influenza season
- CDC
website posts presentation slides from the February 2007 ACIP meeting
- CDC's
Adult Immunization Quiz now advises on the need for shingles vaccination
- New:
March 7 issue of IAC's Hep Express electronic newsletter now online
-
Pre-travel health advice is the topic for CDC's April 12 Current Issues in
Immunization Net Conference
- March 13
teleconference to focus on pandemic influenza and the role of immunization
coalitions
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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 650: March 12, 2007 |
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1. |
New: CDC issues ACIP recommendations for the use of quadrivalent human
papillomavirus vaccine
On March 12, CDC published an
MMWR Early Release, "Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory
Committee on Immunization Practices." CDC issues the web-based
Early Release only for the immediate release of important public
health information. The recommendations will be published in a
future issue of Morbidity and Mortality Weekly Report. The
recommendation's summary is reprinted below.
These recommendations represent the first statement by the
Advisory Committee on Immunization Practices (ACIP) on the use
of a quadrivalent human papillomavirus (HPV) vaccine licensed by
the U.S. Food and Drug Administration on June 8, 2006. This
report summarizes the epidemiology of HPV and associated
diseases, describes the licensed HPV vaccine, and provides
recommendations for its use for vaccination among females aged
9-26 years in the United States.
Genital HPV is the most common sexually transmitted infection in
the United States; an estimated 6.2 million persons are newly
infected every year. Although the majority of infections cause
no clinical symptoms and are self-limited, persistent infection
with oncogenic types can cause cervical cancer in women. HPV
infection also is the cause of genital warts and is associated
with other anogenital cancers. Cervical cancer rates have
decreased in the United States because of widespread use of
Papanicolaou testing, which can detect precancerous lesions of
the cervix before they develop into cancer; nevertheless, during
2007, an estimated 11,100 new cases will be diagnosed and
approximately 3,700 women will die from cervical cancer. In
certain countries where cervical cancer screening is not
routine, cervical cancer is a common cancer in women.
The licensed HPV vaccine is composed of the HPV L1 protein, the
major capsid protein of HPV. Expression of the L1 protein in
yeast using recombinant DNA technology produces noninfectious
virus-like particles (VLP) that resemble HPV virions. The
quadrivalent HPV vaccine is a mixture of four HPV type-specific
VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18
combined with an aluminum adjuvant. Clinical trials indicate
that the vaccine has high efficacy in preventing persistent HPV
infection, cervical cancer precursor lesions, vaginal and vulvar
cancer precursor lesions, and genital warts caused by HPV types
6, 11, 16, or 18 among females who have not already been
infected with the respective HPV type. No evidence exists of
protection against disease caused by HPV types with which
females are infected at the time of vaccination. However,
females infected with one or more vaccine HPV types before
vaccination would be protected against disease caused by the
other vaccine HPV types.
The vaccine is administered by intramuscular injection, and the
recommended schedule is a 3-dose series with the second and
third doses administered 2 and 6 months after the first dose.
The recommended age for vaccination of females is 11-12 years.
Vaccine can be administered as young as age 9 years. Catch-up
vaccination is recommended for females aged 13-26 years who have
not been previously vaccinated. Vaccination is not a substitute
for routine cervical cancer screening, and vaccinated females
should have cervical cancer screening as recommended. . . .
To access a web-text (HTML) version of the Early Release, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr56e312a1.htm
To access a ready-to-print (PDF) version of it, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr56e312.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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2. |
New VIS translation:
Spanish-language version of the interim VIS for varicella vaccine now online
Dated 1/10/07, the most recent
version of the interim VIS for
varicella vaccine is now available on the IAC website in
Spanish. IAC gratefully acknowledges the California Department
of Health Services for the translation.
To obtain a ready-to-copy (PDF) version of the interim VIS for
varicella vaccine in Spanish, go to:
http://www.immunize.org/vis/spvaric.pdf
To obtain it in English, go to:
http://www.immunize.org/vis/varic07.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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3. |
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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4. |
CDC's report on aging includes a
call to action to increase adult immunization in racial/ethnic minority
populations
CDC recently released "The State
of Aging and Health in America
2007." The report presents the most current national data
available on 15 key health indicators for older adults related
to health status, health behaviors, preventive care and
screening, and injuries. The "State-by-State Report Card"
included in the report provides similar information for each of
the 50 states and the District of Columbia, and enables states
to see where they are on each indicator, as well as in relation
to other states.
The report includes bold "Calls to Action" and a "Spotlight" on
reducing injuries associated with falls. These features
highlight model intervention programs and thoughtful
recommendations for policymakers, healthcare providers, and
older adults themselves to ensure not just longer, but healthier
lives. Also included are emerging public health opportunities
such as promoting cognitive health and addressing end-of-life
decision-making issues.
Among the items included in the report's National Report Card on
Healthy Aging are data on the percentage of adults age 65 and
older who received an influenza vaccination within the past year
or who ever received a pneumococcal vaccination. The data show
that 68 percent report receiving an influenza vaccination within
the year, and 65 percent report ever receiving a pneumococcal
vaccination. The goal for both interventions is 90 percent,
according to the Healthy People 2010 initiative.
The report's "Call to Action for Increasing Adult Immunization
in Racial/Ethnic Minorities" is reprinted below in its entirety.
National Healthy People 2010 objectives call for 90% of non-institutionalized persons aged 65 years or older to be
vaccinated against influenza and pneumonia . . . Although all
population groups currently fall short of this target, African-Americans and Hispanics have significantly lower influenza and
pneumococcal immunization rates compared with the rest of the
population.
No single factor can be identified that can account for the
significant racial/ethnic disparities in vaccination of older
persons. Recent research provides evidence for multiple factors
that may contribute to this problem, including lower education
levels, lower likelihood of vaccination in non-medical settings
among African-Americans, less awareness about current vaccine
recommendations, and possibly more missed opportunities for
vaccination by providers. Although the differences caused by any
of these individual factors may be slight, in combination these
could lead to the larger disparities observed in vaccination
rates among racial/ethnic groups. Focus group research suggests
that the desire to protect family members, particularly
grandchildren, may be an important motivator for these groups.
The READII [Racial and Ethnic Adult Disparities in Immunization
Initiative] project has been a significant effort to address
these disparities through multi-year demonstration projects.
Conducted in five areas [Monroe County, NY; Milwaukee, WI; San
Antonio, TX; Chicago, IL; and 18 counties in the Mississippi
Delta Region and Hinds County, MS] from August 2002 through
December 2004, these projects aimed to improve influenza and
pneumococcal vaccination levels among elderly non-Hispanic
blacks and/or Hispanics. Each site identified community
partners, and, together, identified a plan for increasing
vaccination rates in their target population[s] based on
evidence-based interventions recommended in the Guide to
Community Preventive Services. Examples of specific activities
conducted included working with pharmacists to offer
vaccinations, collaborating with the faith-based community,
conducting assessment and feedback activities in physician
offices, and implementing a tracking/recall/outreach system in
clinics serving the target population.
Systematic offering of vaccine to all patients, as was conducted in Monroe County, NY, was shown to reduce disparities in
participating practices. Another key outcome was the development
of new partnerships that facilitated reaching the target
populations, and have continued after the end of the
demonstration period.
More information on this program may be found at
http://www.cdc.gov/nip/specint/readii
To access the entire 46-page report, go to:
http://www.cdc.gov/aging/pdf/saha_2007.pdf
To access the report's Executive Summary, go to:
http://www.cdc.gov/aging/pdf/saha_exec_summary_2007.pdf
To access CDC's Healthy Aging web section, go to:
http://www.cdc.gov/aging/saha.htm
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5. |
New formats: 2007 Immunization Schedule for Children and Adolescents now
available in pocket and brochure sizes
The CDC website recently posted
printable versions of the 2007
Recommended Immunization Schedule for Children and Adolescents
Aged 0-18 Years in two additional formats: pocket size (6" x
4.5") and brochure size (11" x 17").
To access them, go to:
http://www.cdc.gov/nip/recs/child-schedule.htm
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6. |
Fewer than one in three asthmatic
children received inactivated influenza vaccine in the 2004-05 influenza
season
CDC published "Influenza
Vaccination Coverage Among Children
with Asthma—United States, 2004-05 Influenza Season" in the
March 9 issue of MMWR. The opening paragraph of the article is
reprinted below.
In 2005, approximately 8.9% (6.5 million) of U.S. children aged
<18 years were reported to have current asthma. Children with
asthma are at high risk for complications from influenza, and
influenza vaccination has been determined to safely and
effectively reduce rates of influenza in these children. Since
its establishment in 1964, the Advisory Committee on
Immunization Practices (ACIP) has recommended that all children
with asthma aged >=6 months receive vaccination with inactivated
influenza vaccine during each influenza season; however,
national influenza vaccination coverage rates specifically for
children with asthma have not been determined. Previous studies
have assessed influenza vaccination rates in children with
asthma at the local level using health maintenance organization
and clinician group-practice information, with estimates ranging
from 10% to 43% for various influenza seasons. Another study
used Behavioral Risk Factor Surveillance System (BRFSS) data to
estimate influenza vaccination coverage in children aged 2-17
years with one or more conditions putting them at high risk for
complications from influenza (including asthma, although asthma
was not assessed separately); in that study, the national rate
was estimated at 34.8% for the 2004-05 influenza season (based
on a sample size of 685, which included all states and the
District of Columbia [DC]). To estimate national influenza
vaccination coverage rates among children aged 2-17 years with
current asthma, CDC analyzed data from the 2005 National Health
Interview Survey (NHIS). This report describes the results of
that analysis and provides the first national estimates of
influenza vaccination coverage among children with asthma. The
findings indicated that although children with current asthma
were more likely to receive influenza vaccination than children
without current asthma, the vaccination coverage rate among
children with asthma was low, at 29.0% (95% confidence interval
[CI] = 24.5-33.9). These findings underscore the need to
increase influenza vaccination coverage in children with asthma
aged 2-17 years by identifying and overcoming barriers to
vaccination. . . .
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5609a2.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5609.pdf
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7. |
CDC website posts presentation
slides from the February 2007 ACIP meeting
The CDC website recently posted
the PowerPoint slides presented
at the February 21-22 ACIP meeting. Slides are available on the
following topics:
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Hepatitis A postexposure prophylaxis
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Rotavirus vaccines
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Thimerosal
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Vaccine supply
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Influenza
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DTaP/IPV/Hib combination vaccine
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Immunization safety
-
Human papillomavirus vaccine (HPV)
To access the slides, go to:
http://www.cdc.gov/nip/ACIP/slides/mtg-slides-feb07.htm
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8. |
CDC's Adult Immunization Quiz now
advises on the need for shingles vaccination
CDC's Adult Immunization Quiz has
been updated with information
about shingles vaccination. Using the following statement, it
advises adults age 60 and older to be vaccinated with the zoster
vaccine: "Your age indicates that you need a single dose of this
vaccine to protect against shingles. You should receive this
vaccine even if you have already had shingles." It also offers
links to information about the disease and vaccine.
To access the updated quiz, go to:
http://www2.cdc.gov/nip/adultImmSched
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9. |
New: March 7 issue of IAC's Hep
Express electronic newsletter now online
The March 7 issue of Hep Express,
an electronic newsletter
published by IAC, is now available online. It is intended for
health professionals, program planners, and advocates involved
in prevention, screening, and treatment of viral hepatitis.
IAC Express has already covered some of the information
presented in the November 7 Hep Express; titles of articles we
have not yet covered follow.
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NASTAD [National Alliance of State & Territorial AIDS
Directors] issues Action Alert to ask Congress for more
federal funding
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CDC's hepatitis C coordinator portal offers useful resources
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Latino Organization for Liver Awareness sponsoring New York
City Hepatitis C Walk
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Journal articles you may have
missed
To access the March 7 issue, go to:
http://www.hepprograms.org/hepexpress/issue53.asp
To sign up for a free subscription to Hep Express, go to:
http://www.immunize.org/subscribe
To access previous issues of Hep Express, go to:
http://www.hepprograms.org/hepexpress
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10. |
Pre-travel health advice is the
topic for CDC's April 12 Current Issues in Immunization Net Conference
Scheduled for April 12, from noon
to 1PM ET, the net conference
Current Issues in Immunization is designed to provide clinicians
with up-to-date information on immunization.
In the April conference, the CDC Traveler's Health Team will
present an overview of issues related to international travel
health and safety. The discussion will highlight current
information about international travel including its status,
epidemiology, risks, safety, vaccines, health counseling, and
available resources. The team will present content followed by a
question and answer session for providers.
Two additional sessions focusing on specific travel topics
(e.g., travel vaccines, malaria) are being planned for late
summer. Because content of the next two net conferences will
build on material presented in April, it is recommended that you
participate in the April conference.
The conference requires pre-registration, as space is limited.
Registration will close when the course is full or on April 11
(midnight ET). To register for the conference, go to:
http://www2.cdc.gov/nip/isd/ciinc
The program will combine a telephone audio conference with
simultaneous online visual content. It will allow for a
question-and-answer segment both by telephone and Internet.
Internet access and a separate phone line are needed to
participate.
For instructions and system requirements, go to:
http://www.cdc.gov/nip/ed/ciinc/instructions.htm
For additional information, go to: nipinfo@cdc.gov
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11. |
March 13 teleconference to focus
on pandemic influenza and the role of immunization coalitions
The National Immunization
Coalition TA [technical assistance]
Network has scheduled a teleconference that will focus on the
current status of the federal government's pandemic influenza
plan and how immunization coalitions can get involved. The
network is a program of the Center for Health Communication,
Academy for Educational Development.
The hour-long teleconference will be held at 2:00PM, ET, March
13. The presenters are Raymond Strikas, MD, coordinator,
Seasonal and Pandemic Influenza, Department of Health and Human
Services (HHS); and Stephanie Marshall, director, Pandemic
Communications, HHS. To register, send an email to
izta@aed.org
Include this message: "Sign me up for the pandemic influenza
call."
For additional information, or to access earlier programs, go
to: http://www.izcoalitionsta.org/confcall.cfm
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