IAC Express 2008
Issue number 712: February 18, 2008
 
Contents of this Issue
Select a title to jump to the article.
  1. NCIRD website posts update on shortage of Merck's pediatric and adult hepatitis A vaccine
  2. New: Fifth edition of "Vaccines," the foremost vaccine textbook, now available for order
  3. CDC issues update on influenza activity in the United States during September 30, 2007-February 9, 2008
  4. CDC reports on status of invasive pneumococcal disease in children five years after PCV7 introduction
  5. February issue of CDC's Immunization Works electronic newsletter now online
  6. Reported pediatric influenza death prompts response from CIIC; new brochure urges annual influenza vaccination
  7. Important: Be sure to give influenza vaccine throughout the influenza season--from now through spring
  8. WHO recommends composition of 2008-09 influenza vaccine for Northern Hemisphere; CDC website posts Q&A on selecting viruses for influenza vaccine
  9. February 14 issue of IAC's Hep Express electronic newsletter now online
  10. On-site course, Epidemiology and Prevention of Vaccine-Preventable Diseases, scheduled for Atlanta on April 15-16
  11. CDC reports on progress in introducing Hib vaccine in low-income countries worldwide during 2004-07
 
Abbreviations
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.
  
Issue 712: February 18, 2008
1.  NCIRD website posts update on shortage of Merck's pediatric and adult hepatitis A vaccine

[The following is cross posted from IAC's Hep Express electronic newsletter, 2/14/08.]

On February 13, the website of the National Center for Immunization and Respiratory Diseases (NCIRD) posted updated information about the production of Merck's and GSK's pediatric and adult hepatitis A vaccines. The updated information is reprinted below in its entirety.


Merck & Co., Inc., are experiencing production delays for Pediatric and Adult hepatitis A vaccine (Pediatric & Adult VAQTA). Merck has temporarily discontinued accepting orders for Pediatric VAQTA and Adult VAQTA in the vial formulation. Based on current information, it is estimated that VAQTA will be available in early third quarter 2008 and Adult VAQTA in fourth quarter 2008. GSK production and supply of their Pediatric and Adult hepatitis A vaccine (Pediatric & Adult Havrix) and their Adult hepatitis A/hepatitis B combination vaccine (Twinrix) are currently in good supply to meet demand. GSK has initiated plans to increase production of Havrix and Twinrix, to help ensure uninterrupted supply for the U.S. market.

To access the update, go to: http://www.cdc.gov/vaccines/vac-gen/shortages and scroll down to Note 3.

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2 New: Fifth edition of "Vaccines," the foremost vaccine textbook, now available for order

Book publisher Elsevier recently announced that the fifth edition of the highly esteemed textbook "Vaccines" is available for order. Excerpts from the publisher's website are reprinted below.


Completely revised and updated, this respected reference offers comprehensive and current coverage of every aspect of vaccination--from development to use in reducing disease. It provides authoritative information on vaccine production, available preparations, efficacy, and safety; recommendations for vaccine use, with rationales; data on the impact of vaccination programs on morbidity and mortality; and more. And now, as an Expert Consult title, Vaccines includes a companion website offering this unparalleled guidance where and when you need it most!

Key Features:
  • Provides a complete understanding of each disease, including clinical characteristics, microbiology, pathogenesis, diagnosis, and treatment, as well an epidemiology and public health issues
     
  • Offers comprehensive coverage of both existing vaccines and vaccines currently in the research and development stage
     
  • Examines vaccine stability, immunogenicity, efficacy, duration of immunity, adverse events, indications, contraindications, precautions, administration with other vaccines, and disease control strategies
     
  • Analyzes the cost-benefit and cost-effectiveness of vaccines
     
  • Discusses the proper use of immune globulins and antitoxins
     
  • Illustrates concepts and objective data with approximately 600 tables and figures

Author Information:
Stanley A. Plotkin, MD, emeritus professor of pediatrics, University of Pennsylvania; Walter A. Orenstein, MD, professor of medicine and pediatrics, Emory University and former director of CDC's National Immunization Program; and Paul A. Offit, MD, chief, Division of Infectious Diseases, Children's Hospital of Philadelphia and Maurice R. Hilleman Professor of Vaccinology, the University of Pennsylvania School of Medicine, Philadelphia.

Priced at $325, "Vaccines" contains 1,748 pages and 600 illustrations. For additional information, including access to the table of contents and online ordering, go to:
http://www.us.elsevierhealth.com/product.jsp?isbn=9781416036111

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3 CDC issues update on influenza activity in the United States during September 30, 2007-February 9, 2008

On February 15, CDC published "Update: Influenza Activity--United States, September 30, 2007-February 9, 2008" as an MMWR Early Release. Portions of the article are reprinted below.


This report summarizes U.S. influenza activity since the beginning of the 2007-08 influenza season (September 30, 2007) and updates the previous summary. From September through early December, influenza activity remained low in the United States. Activity increased from early December through the end of the year and has continued to increase in January and February.

Viral Surveillance
During September 30, 2007-February 9, 2008, World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories in the United States reported testing 94,502 specimens for influenza viruses, and 10,568 (11%) tested positive. Of these positive specimens, 8,889 (84%) were influenza A viruses, and 1,679 (16%) were influenza B viruses. A total of 2,299 (26%) of the influenza A viruses have been subtyped: 1,033 (45%) were influenza A (H1N1) viruses, and 1,266 (55%) were influenza A (H3N2) viruses. Although influenza A (H1N1) viruses predominated through mid-January, an increasing proportion of subtyped influenza A viruses are influenza A (H3N2) viruses. Influenza A (H3N2) viruses were reported more frequently than influenza A (H1N1) viruses during January 20-February 9. During the week ending February 9, H3N2 became the predominant virus for the season overall.

This season, more influenza A viruses than influenza B viruses have been identified in all regions. Among influenza A viruses, influenza A (H1N1) has predominated in the New England, Mid-Atlantic, West North Central, Mountain, and Pacific regions, and influenza A (H3N2) has predominated in the East North Central, South Atlantic, East South Central, and West South Central regions. This season, laboratory-confirmed influenza has been reported by the District of Columbia and 47 states from all nine surveillance regions.

Antigenic Characterization
Since September 30, 2007, CDC has antigenically characterized 250 influenza viruses submitted by U.S. laboratories: 117 influenza A (H1N1), 65 influenza A (H3N2), and 68 influenza B viruses. One hundred seven (91%) of the 117 influenza A (H1N1) viruses were characterized as A/Solomon Islands/3/2006-like, the influenza A (H1N1) component of the 2007-08 influenza vaccine for the Northern Hemisphere and the 2008 influenza A (H1N1) component of the vaccine for the Southern Hemisphere; 10 (9%) of the 117 influenza A (H1N1) viruses were observed to have somewhat reduced titers with antisera produced against A/Solomon Islands/3/2006. Nine (14%) of the 65 influenza A (H3N2) viruses were characterized as A/Wisconsin/67/2005-like, the influenza A (H3N2) component of the 2007-08 influenza vaccine for the Northern Hemisphere. Fifty-three (81%) of the 65 influenza A (H3N2) viruses were characterized as A/Brisbane/10/2007-like, a recent antigenic variant that has evolved from A/Wisconsin/67/2005-like. A/Brisbane/10/2007-like virus is the recommended influenza A (H3N2) component for the 2008 Southern Hemisphere vaccine. Three (5%) of the 65 influenza A (H3N2) viruses were observed to have somewhat reduced titers with antisera produced against A/Wisconsin/67/2005 and A/Brisbane/10/2007.

Influenza B viruses currently circulating can be divided into two antigenically distinct lineages represented by B/Victoria/02/87 and B/Yamagata/16/88. Four (6%) of the 68 influenza B viruses characterized belong to the B/Victoria lineage of viruses. One virus with B/Victoria lineage, B/Malaysia/2506/2004, is the influenza B component of the 2007-08 influenza vaccine. Sixty-four (94%) of the 68 influenza B viruses belong to the B/Yamagata lineage of viruses.

Outpatient Illness Surveillance
For the week ending February 9, the percentage of outpatient visits for influenza-like illness (ILI) reported by approximately 1,400 U.S. sentinel providers in 50 states, Chicago, the District of Columbia, and New York City was 5.7%. This marks the seventh consecutive week that the percentage of outpatient visits for ILI exceeded the national baseline of 2.2%. ILI was reported above region-specific baselines in all nine influenza surveillance regions. Also for the week ending February 9, the percentage of outpatient visits for acute respiratory illness (ARI) reported by approximately 800 U.S. Department of Defense (DoD) and Department of Veterans' Affairs (VA) BioSense outpatient treatment facilities was 3.5%, which was above the national baseline of 3.2%.

State-Specific Activity Levels
Until the week ending January 5, widespread influenza activity had not been reported in any state. During the week ending January 5, widespread influenza activity was reported in Colorado. The number of states reporting widespread activity has increased each week. For the week ending February 9, widespread activity was reported by 44 states, and regional activity was reported by five states.

Pneumonia and Influenza-Related Mortality
Pneumonia and influenza (P&I) was listed as an underlying or contributing cause of death for 7.6% of all deaths reported through the 122 Cities Mortality Reporting System for the week ending February 9. This percentage was above the epidemic threshold of 7.2% for the week and marked the fifth consecutive week that P&I deaths were above the epidemic threshold since influenza activity began rising in the United States.

Influenza-Associated Pediatric Hospitalizations
Pediatric hospitalizations associated with laboratory-confirmed influenza infections are monitored by two population-based surveillance networks, the Emerging Infections Program (EIP) and the New Vaccine Surveillance Network (NVSN). During November 4, 2007-January 26, 2008, the preliminary laboratory-confirmed influenza-associated hospitalization rate reported by NVSN for children aged 0-4 years was 0.73 per 10,000. During September 30, 2007-February 2, 2008, EIP sites reported a preliminary laboratory-confirmed influenza-associated hospitalization rate of 0.36 per 10,000 for children aged 0-17 years. For children aged 0-4 years, the rate was 1.0 per 10,000, and for children aged 5-17 years, the rate was 0.1 per 10,000.

Influenza-Related Pediatric Mortality
As of February 9, a total of 10 pediatric deaths among children with laboratory-confirmed influenza had been reported to CDC through the National Notifiable Diseases Surveillance System for the 2007-08 influenza season. Ages of children who died ranged from 4 months to 14 years, with a median of 5.5 years. During the preceding three influenza seasons, the numbers of influenza-related pediatric deaths reported to CDC have ranged from 46 to 74.

Resistance to Antiviral Medications
During this influenza season, a small increase in the number of influenza viruses resistant to the neuraminidase inhibitor, oseltamivir, has been observed. Among the 350 influenza A and B viruses tested during the 2007-08 influenza season, 16 (4.6%) have been found to be resistant to oseltamivir. All of the oseltamivir-resistant viruses have been influenza A viruses (16 of 270, 5.9%). Of the resistant viruses, all are of the H1N1 subtype and have been determined to share the same genetic mutation that confers oseltamivir resistance. These 16 viruses represent 8.1% of the 198 influenza A (H1N1) viruses that have been tested, an increase from four (0.7%) of 588 influenza A (H1N1) viruses tested during the 2006-07 season. No resistance to oseltamivir has been determined among the 72 influenza A (H3N2) or the 80 influenza B viruses tested, and no antiviral resistance to zanamivir has been detected in any subtype. Adamantane resistance continues to be high; 87 (32%) of 271 influenza A viruses tested were resistant to adamantanes (i.e., amantadine or rimantadine), including 99% of influenza A (H3N2) viruses and 7.6% of influenza A (H1N1) viruses tested. Adamantanes are not recommended for the prevention or treatment of influenza this season because of the high rate of resistance among circulating influenza A viruses.

Editorial Note . . .
Since 1977, influenza A (H1N1), influenza A (H3N2), and influenza B viruses have circulated globally. Each year's influenza vaccine contains a virus representing each of these three distinct influenza virus groups. The three viruses selected to be included in this season's vaccine were selected in February 2007 as the viruses that appeared most likely to be circulating during this influenza season. The degree of antigenic match between current influenza vaccine strains and the influenza viruses that are circulating this season will continue to be assessed as more viruses become available for analysis. To date, 91% of influenza A (H1N1) viruses sent to CDC for antigenic characterization were similar to A/Solomon Islands/3/2006, the influenza A (H1N1) component of the 2007-08 influenza vaccine. Although the majority of influenza A (H3N2) and influenza B viruses are not optimally matched, vaccination with the trivalent influenza vaccine continues to be recommended because the vaccine can provide partial protection against related strains and reduce the risk for influenza-related complications and deaths. In addition, the vaccine contains three strains, and communities can experience outbreaks with more than one strain of influenza in a given year.

Vaccination with trivalent influenza vaccines remains the best method for preventing influenza and its potentially severe complications. Although influenza activity is on the rise, vaccination during the current season still can provide benefit. Because persons require approximately 2 weeks after vaccination to develop immune response to vaccination, use of neuraminidase inhibitors for prevention of influenza in the 2 weeks after vaccination might be considered, especially for persons at high risk during a documented influenza outbreak.

Antiviral medications are an important tool for treatment of influenza and also can be used for prevention. Recent studies have identified a considerable protective effect of antiviral treatment against complications associated with influenza, including death among older adults hospitalized with laboratory-confirmed influenza. This season, a low level of resistance to the influenza antiviral drug oseltamivir among influenza A viruses (16 of 270 tested, 5.9%) has been detected. All 16 resistant viruses identified this season were of the influenza A (H1N1) subtype and share the same genetic mutation; this mutation is the most common mutation in this subtype that confers resistance to oseltamivir. Given the low level of resistance to oseltamivir, the finding of resistance only in influenza A (H1N1) viruses, and no resistance to zanamivir, these drugs continue to be recommended for the treatment and prophylaxis of influenza. Although recommendations for use of antiviral medications have not changed, enhanced surveillance for detection of oseltamivir-resistant viruses is ongoing and will enable continued monitoring for changing trends over time. In addition to vaccination and antivirals, other means of decreasing the spread and impact of influenza include frequent hand washing, staying home from work or school when ill, and covering the nose or mouth with a tissue when coughing or sneezing. Additional information is available at http://www.cdc.gov/flu/protect/habits.htm


To access a web-text (HTML) version of the complete Early Release, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e215a1.htm

To access a ready-to-print (PDF) version of it, go to:
http://www.cdc.gov/mmwr/pdf/wk/mm57e215.pdf

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4 CDC reports on status of invasive pneumococcal disease in children five years after PCV7 introduction

CDC published "Invasive Pneumococcal Disease in Children 5 Years After Conjugate Vaccine Introduction--Eight States, 1998-2005" in the February 15 issue of MMWR. Portions of the article are reprinted below.


Streptococcus pneumoniae (pneumococcus) is a major cause of meningitis, pneumonia, and bacteremia, especially among young children and older adults. Before the 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in the United States in 2000, the seven pneumococcal serotypes covered by the vaccine (4, 6B, 9V, 14, 18C, 19F, and 23F) caused 80% of invasive pneumococcal disease (IPD) cases among young children, and the incidence of IPD was relatively stable. In October 2000, the Advisory Committee on Immunization Practices recommended PCV7 for all children aged <2 years and for older children at increased risk for IPD. Introduction of PCV7 in the United States led to substantial reductions in the incidence of IPD among the target population of children aged <5 years. Use of the vaccine also reduced IPD among unvaccinated populations through reductions in nasopharyngeal colonization and transmission of vaccine-type pneumococci from vaccinated children (i.e., indirect, or herd, effects of PCV7). To evaluate the effect of continued PCV7 use on IPD incidence among children aged <5 years in the United States, CDC analyzed population- and laboratory-based surveillance data. Results of that analysis indicated that in 2005, overall IPD rates among children aged <5 years were 77% lower, and an estimated 13,000 fewer cases of IPD occurred, compared with the years preceding vaccine introduction (1998-1999). Although IPD caused by PCV7 serotypes declined through 2005, overall IPD rates leveled off beginning in 2002, primarily because of increases in the incidence of IPD caused by non-PCV7 serotype 19A. Given these trends, use of expanded-valency conjugate vaccines might further reduce IPD incidence. Continued surveillance is needed to guide development of future formulations of conjugate vaccines and to monitor the effects of continued vaccine use.

Cases of IPD were defined as isolation of pneumococcus from normally sterile sites (e.g., blood, cerebrospinal fluid, or pleural fluid). Cases were identified through CDC's Active Bacterial Core surveillance (ABCs), a population- and laboratory-based system ongoing since 1995. During 1998-2005, ABCs continuously monitored IPD in California (one county); the state of Connecticut; Georgia (20 counties); Maryland (six counties); Minnesota (seven counties); New York (seven counties); Oregon (three counties); and Tennessee (four counties). The total population aged <5 years under surveillance in 2005 was 1.26 million persons. Surveillance personnel at each site maintain routine contact with all clinical laboratories in the surveillance area and conduct laboratory audits every 6 months to ensure completeness of reporting. . . .


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5706a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5706.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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5 February issue of CDC's Immunization Works electronic newsletter now online

The February issue of Immunization Works, a monthly email newsletter published by CDC, is available on the website of the National Center for Immunization and Respiratory Diseases (NCIRD). The newsletter offers members of the immunization community non-proprietary information about current topics. CDC encourages its wide dissemination.

Some of the information in the February issue has already appeared in previous issues of IAC Express. Following is the text of four articles we have not covered.


SEASONAL INFLUENZA UPDATE

NOTE: because of the recent increase in influenza activity, this edition of Immunization Update contains a special section devoted to seasonal influenza.

INFLUENZA ACTIVITY: From September through early December, influenza activity remained low in the United States. Activity increased from early December through the end of the year and has continued to increase in January and February. For the week ending February 9, a total of 49 states reported either widespread or regional activity. During the most recent three influenza seasons (2004-05, 2005-06, and 2006-07), the number of states reporting regional or widespread activity peaked at 41-48 states. Ten child death from laboratory confirmed influenza-complications have now been officially reported to CDC for the 2007-08 flu season. Tragically, every year in the United States, some children die of complications from influenza infection. During the past four years that CDC has tracked deaths among children with influenza infections, the number of deaths reported to CDC each year has ranged from 44 to 153 deaths. Since influenza activity typically peaks in February or March, it is too early to predict the severity of the current flu season compared to other years. However, the latest surveillance information about influenza activity is posted weekly at CDC's Flu Activity & Surveillance Website [http://www.cdc.gov/flu/weekly/fluactivity.htm]. In addition, CDC has published an Early Release Article [http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e215a1.htm] in its Morbidity and Mortality Weekly Report concerning seasonal flu activity.

VACCINE EFFECTIVENESS: Surveillance information indicates that H3N2 viruses are currently the virus that are circulating most widely in the United States, and the majority of these are not optimally matched to the strains represented in the vaccine. Influenza viruses are constantly changing so it's common for new strains of influenza viruses to appear each year. The effectiveness of the vaccine depends in part on the match between the viruses in the vaccine and influenza viruses that are circulating in the community. If these are closely matched, vaccine effectiveness is higher. If they are not closely matched, vaccine effectiveness can be reduced. However, even when the viruses are not closely matched, the vaccine can still protect many people and prevent flu-related complications. Such protection is possible because antibodies made in response to the vaccine can provide some protection (called cross-protection) against different, but related strains of influenza viruses. Vaccination remains the best method for preventing influenza and its potentially severe complications in children and adults even in years where there is a suboptimal match between vaccine and circulating strains of influenza viruses. CDC will continue to study this season's vaccine's effectiveness and will make more information available in the coming weeks. For more information about the effectiveness of seasonal influenza vaccine, see CDC's fact sheet, How Well Does the Seasonal Flu Vaccine Work? [http://www.cdc.gov/flu/about/qa/vaccineeffect.htm].

NEW INFLUENZA RESOURCES: CDC has recently added many more influenza resources for the public, healthcare providers, and the media. To support partners' continuing efforts to prevent influenza this season, CDC has developed the "Take 3" Campaign [http://www.cdc.gov/flu/protect/preventing.htm] with information and materials on vaccination, hand hygiene, and cough etiquette, and the appropriate use of antiviral drugs. CDC's Newly Revised Flu Website [http://www.cdc.gov/flu] features the "Take 3" campaign, as well as supplemental materials free for download. Additional flu messages and materials can be found on CDC's Late Season Vaccination Activities Website [http://www.cdc.gov/flu/protect/late-season.htm]. Also, transcripts from recent CDC press calls about seasonal influenza are available at CDC's Transcripts Website [http://www.cdc.gov/od/oc/media/transcripts.htm].


FRONT PAGE NEWS

REGIONAL MEETINGS FOR HEALTHY PEOPLE 2020: A series of Healthy People 2020 Regional Meetings [http://www.healthypeople.gov/hp2020/regional/default.asp] is planned this spring so partners can help to establish a framework to address risk factors and determinants of health and the diseases and disorders that affect communities. There is no fee for registration, but pre-registration is required [http://www.healthypeople.gov/hp2020/regional/Registration.aspx]

Since 1979, Healthy People [http://www.healthypeople.gov/hp2020] has set and monitored national health objectives to meet a broad range of health needs, encourage collaborations across sectors, guide individuals toward making informed health decisions, and measure the impact of our prevention activity. Healthy People 2020 will reflect assessments of major risks to health and wellness, changing public health priorities, and emerging technologies related to our nation's health preparedness and prevention. Public participation will shape Healthy People 2020; its purpose, goals, organization, and action plans. HHS will seek input from communities and stakeholders across the nation through public meetings and public comment periods. As a national initiative, Healthy People's success depends on a coordinated commitment to improve the health of the nation.


OTHER NEWS AND SUMMARIES

STATE GRANTEES TESTED IN EMERGENCY RESPONSE: CDC recently concluded an eight week pilot test to assess the capability of CDC and the 62 Public Health Emergency Preparedness grantees to collect and transmit vaccine doses data administered through the Countermeasure and Response Administration (CRA) System [http://www.cdc.gov/phin/activities/applications-services/cra]. CRA is a CDC-developed application for tracking and reporting countermeasure use during public health emergencies. The system covers 50 states, 3 U.S. territories, 5 Pacific Island Jurisdictions and the localities of Chicago, Los Angeles County, New York City and Washington D.C. For this exercise, data from seasonal influenza vaccine clinics was used as a proxy for pandemic influenza vaccine. During the initial stages of an influenza pandemic, tracking doses administered will be important to ensure priority groups are being vaccinated expeditiously. Overall, 89% (55/62) of project areas submitted data for at least one seasonal influenza clinic during the pilot period. Fifty-five percent (34/62) of project areas met the criteria to be considered fully successful: (1) transmit the minimum data set for two distinct clinic dates; (2) transmit the data within 48 hours of the vaccine doses administration date. CDC plans to hold a follow-on exercise during the 2008-2009 influenza seasons.


MEETINGS, CONFERENCES & RESOURCES

Get Ready for NIC: The 42nd National Immunization Conference (NIC) will be held from March 17–20, 2008, in Atlanta, Georgia, and will be comprised of six topic tracks: Adolescent and Adult Vaccination, Epidemiology and New Vaccines, Health and Risk Communication, Immunization Information Systems, Influenza, and Programmatic Issues. Abstract submission is now closed. More information can be found on the NIC Website [http://www.cdc.gov/vaccines/events/nic]. Or, questions can be addressed to the Conference Planning Team at nipnic@cdc.gov

Issues of Immunization Works are posted on CDC's Vaccines & Immunizations website a few days after publication. To access the February issue, go to: http://www.cdc.gov/vaccines/news/newsltrs/imwrks Click on the link titled "Feb" under the banner titled "2008 Newsletters Available Online."

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6 Reported pediatric influenza death prompts response from CIIC; new brochure urges annual influenza vaccination

On February 12, the Childhood Influenza Immunization Coalition (CIIC) issued a statement in response to recent reports of at least one pediatric death from influenza. In addition, the CIIC website has posted a new parent education brochure, "Kids Need Flu Vaccine, Too!" It urges parents to protect their children, themselves, and others by getting annual influenza vaccination.

Portions of the statement are reprinted below. A link to the new brochure is given at the end of this IAC Express article.


The recent influenza outbreaks across the country, resulting in at least one confirmed death of a child, are a stark reminder that the influenza virus is a serious disease and as widespread as ever.

The reality is that influenza hospitalizes more than 20,000 children younger than 5 years of age each year in the United States--and causes approximately 100 [pediatric] deaths. These statistics are particularly tragic because many childhood influenza infections through annual immunization; however, vaccination rates among children are dismally low. . . .

The Childhood Influenza Immunization Coalition is committed to increasing vaccination rates among children. Disturbed by low rates of only 20.6% among children recommended for the influenza vaccine, the Coalition recently issued a report outlining strategies for parents and healthcare professionals to help improve immunization rates among this vulnerable population. Two key findings of the report are offering influenza vaccinations at all medical visits and making use of the full season--vaccinating as soon as vaccines are available and also using every opportunity to vaccinate throughout the winter into February and March because the influenza vaccine continues to be of benefit while the virus circulates. . . .


To access the entire statement, click here.

To access and/or download the new brochure, go to:
http://preventchildhoodinfluenza.org/resource/Coalition_Brochure.pdf

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7 Important: Be sure to give influenza vaccine throughout the influenza season--from now through spring

Influenza vaccination should continue from now into the early months of 2008. 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 Seasonal Flu web section at http://www.cdc.gov/flu

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8 WHO recommends composition of 2008-09 influenza vaccine for Northern Hemisphere; CDC website posts Q&A on selecting viruses for influenza vaccine

The WHO website recently posted the organization's recommendation for the composition of influenza virus vaccines for use in the Northern Hemisphere in 2008-09. In a related move, on February 12, the CDC website posted a Q&A on selecting viruses for influenza vaccine. A link to the Q&A appears at the end of this IAC Express article.

The WHO recommendation is that influenza vaccines for the 2008-09 influenza season contain the following influenza virus strains:

  • An A/Brisbane/59/2007 (H1N1)-like virus
  • An A/Brisbane/10/2007 (H3N2)-like virus
  • A B/Florida/4/2006-like virus

To access the information on the WHO website, click here.

To access the Q&A from the CDC website, go to:
http://www.cdc.gov/flu/professionals/vaccination/virusqa.htm

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9 February 14 issue of IAC's Hep Express electronic newsletter now online

The February 14 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 February 14 Hep Express; titles of articles we have not yet covered follow.

  • Projects in Knowledge offers two continuing education opportunities related to hepatitis B and Asian Americans
  • Latino Organization for Liver Awareness sponsoring New York City Hepatitis C Walk
  • AAPCHO [Association of Asian Pacific Community Health Organizations] schedules 20th Anniversary conference for March 10-11, in Washington, DC
  • Journal articles you may have missed

To access the February 14 issue, go to:
http://www.hepprograms.org/hepexpress/issue67.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.  On-site course, Epidemiology and Prevention of Vaccine-Preventable Diseases, scheduled for Atlanta on April 15-16

[The following is cross posted, with thanks, from the February issue of CDC's Immunization Works electronic newsletter.]

ON-SITE TRAINING IN ATLANTA: A two-day Epidemiology and Prevention of Vaccine-Preventable Diseases course will be held in Atlanta on April 15-16, 2008 at CDC. Space is limited. Questions can be directed to Laverne Graham at (404) 639-8225.

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11.  CDC reports on progress in introducing Hib vaccine in low-income countries worldwide during 2004-07

CDC published "Progress Toward Introduction of Haemophilus influenzae type b Vaccine in Low-Income Countries--Worldwide, 2004-07" in the February 15 issue of MMWR. Portions of the article are reprinted below.

In addition, on February 14, CDC issued a press release on the topic. A link to the press release appears at the end of this IAC Express article.


Haemophilus influenzae type b (Hib) disease is estimated to cause 3 million cases of meningitis and severe pneumonia and approximately 386,000 deaths worldwide per year in children aged <5 years. Safe and effective Hib conjugate vaccines have been widely used in industrialized countries for nearly 20 years. However, primarily because of financial constraints and lack of awareness among both public health officials and the public regarding Hib disease burden and benefits of the vaccine, use of these vaccines has been low in developing countries, where most Hib disease and deaths occur. In 2000, the GAVI Alliance (formerly known as the Global Alliance for Vaccines and Immunizations) began providing financial support for Hib vaccine in 72 countries that had a gross national income of <=$1,000 (USD) per capita. Despite this support, before 2005, adoption of Hib vaccine by these countries remained low. In response, in June 2005, the GAVI Alliance established the Hib Initiative to accelerate evidence-informed decision making regarding use of Hib vaccine in GAVI-eligible countries. During 2004-2007, the number of GAVI-eligible countries using Hib vaccine or approved to use the vaccine increased from 13 (18%) to 47 (65%). . . .

Editorial Note:
This report indicates that the number of GAVI-eligible countries that have introduced Hib vaccine has accelerated during the past 2 years. Two primary factors have contributed to this increase. First, in November 2006, WHO revised its position statement on Hib vaccine to make a stronger and clearer recommendation that Hib vaccine be included in routine vaccination programs in all countries. Second, the worldwide Hib vaccine supply increased with introduction of a second Hib pentavalent vaccine in 2006, alleviating certain concerns about vaccine shortages. . . .

The success with Hib vaccine introduction suggests that strategies used to accelerate introduction of underused vaccines in developing countries have been effective. With the availability of new vaccines such as rotavirus and pneumococcal vaccines, the approach used for Hib vaccine introduction provides a useful model to increase use of other vaccines.


To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5706a3.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5706.pdf

To access the related CDC press release, go to:
http://www.cdc.gov/od/oc/media/pressrel/2008/r080214a.htm

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