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IAC Express 2008 |
| Issue number 738: June 23, 2008 |
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Contents
of this Issue
Select a title to jump to the article. |
- FDA
approves new combination DTaP-IPV-Hib vaccine for use in infants and young
children
- IAC
website has VIS translations in 36 languages; the most recently added is
Karen
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International coalition of health agencies announces the "final push" to
end polio
- CDC
issues HAN Advisory announcing a temporary decrease in human rabies
vaccine supply
- CDC
reports only about one-third of persons with asthma received influenza
vaccine in 2005-06 influenza season
- Revised
and updated, "Vaccines" textbook has comprehensive information about all
aspects of vaccination
- AMA
offers physicians practical information on improving immunization among
racial and ethnic populations
- June 18
issue of IAC's Hep Express electronic newsletter now online
- WHO
committee makes recommendations on the use of alternative diagnostic
samples for measles and rubella surveillance
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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 738: June 23, 2008 |
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1. |
FDA approves new combination
DTaP-IPV-Hib vaccine for use in infants and young children
On June 20, the Food and Drug Administration
(FDA) approved the use of sanofi pasteur's Pentacel, Diphtheria and Tetanus Toxoids
and Acellular Pertussis Adsorbed, Inactivated Poliovirus and
Haemophilus b Conjugate (Tetanus Toxoid Conjugate) Vaccine.
Pentacel vaccine is indicated for active immunization against
diphtheria, tetanus, pertussis, poliomyelitis, and invasive
disease due to Haemophilus influenzae type b (Hib). Pentacel
vaccine is approved for use in infants and children ages 6 weeks
through 4 years (prior to fifth birthday). Pentacel vaccine is
approved for administration as a four-dose series at 2, 4, 6,
and 15-18 months of age.
To view the license approval information on the FDA website, go
to: http://www.fda.gov/cber/products/pentacel.htm
To read the package insert, go to:
http://www.fda.gov/cber/label/pentacelLB.pdf
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2. |
IAC website has VIS translations in 36 languages; the most recently added is
Karen
With the addition of Karen (spoken in Burma), IAC
now offers
healthcare professionals VIS translations in 36 languages. IAC
gratefully acknowledges the Minnesota Department of Health for
the Karen translations. To access them, go to:
http://www.immunize.org/vis/vis_karen.asp
CHECK OUT IAC'S REDESIGNED VIS WEB SECTION
The recent redesign of IAC's VIS web section speeds the process
of locating VIS-related resources. Following are some of the web
section's features:
Visit IAC's VIS redesigned web section at
http://www.immunize.org/vis
The IAC website has many other immunization materials in
translation. All are FREE and ready-to-print. To access them, go
to: http://www.immunize.org/printmaterials/translations.asp
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3. |
International coalition of health agencies announces the "final push" to end
polio
On June 18, the Center for Infectious Disease
Research & Policy
(CIDRAP) at the University of Minnesota issued a news article,
"Coalition declares 'final push' to end polio." It discusses a
plan, jointly developed and announced by WHO, CDC, UNICEF, and
Rotary International, to eradicate polio once and for all.
Portions of the news article are reprinted below.
The international coalition of health agencies dedicated to
ending polio yesterday declared a "final push" toward the long-delayed goal of eradicating the disease. But its members coupled
the announcement with a plea for millions of dollars in
donations to fill shortfalls, and with an admission that the 20-year-old campaign continues to face stubborn challenges.
Leaders of the organizations that make up the Global Polio
Eradication Initiative (GPEI)--the World Health Organization
(WHO), the U.S. Centers for Disease Control and Prevention
(CDC), UNICEF, and Rotary International--announced the effort
and fundraising drive in Los Angeles at Rotary's annual
convention. Members of Rotary International have been polio
eradication's volunteer shock troops since the campaign was
launched in 1988 and have donated about $700 million to the
effort.
"The greatest danger we have now is the danger of stopping too
soon," Dr. Robert Scott, chair of The Rotary Foundation, said at
a press conference. "We have to keep after this virus and
finally eradicate it."
Dr. Margaret Chan, the WHO director-general, said she is
"committing the entire [WHO] to putting polio as our top
operational priority," but declined to offer details of how
staff or funds might be shifted to carry that out. She ruled out
hiring additional personnel. "We have people who can be
mobilized for a short time," she said.
Yesterday's event showcased the launch of a "$100 Million
Challenge," an effort to raise matching funds for a 3-year $100
million challenge grant given to Rotary in November 2007 by the
Bill and Melinda Gates Foundation. The challenge is aimed at
Rotarians, but the organization is also seeking contributions
from nonmembers.
"We cannot afford to not eradicate polio," Dr. Julie Gerberding,
the director of the CDC, said at the press conference. "It's an
economic imperative for us on a global basis. It's also a moral
imperative. . . ."
To access the complete CIDRAP news article, go to:
http://www.cidrap.umn.edu/cidrap/content/other/news/jun1808polio.html
To access a press release from Rotary International, click
here.
To access the Rotary fund-raising website, go to:
http://www.rotary.org/en/EndPolio/Pages/ridefault.aspx
To visit the CIDRAP website for more information on
bioterrorism, biosecurity, influenza, and food safety or to sign
up for their free electronic news service on these topics, go
to:
http://www.cidrap.umn.edu
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4. |
CDC issues HAN Advisory
announcing a temporary decrease in human rabies vaccine supply
On June 20, CDC issued a Health Alert Network
(HAN) Advisory
announcing a temporary decrease in the supply of human rabies
vaccine. The Advisory is reprinted below in its entirety.
TEMPORARY DECREASE IN HUMAN RABIES VACCINE SUPPLIES
The Centers for Disease Control and Prevention (CDC) has been
notified that Novartis Vaccines, maker of RabAvert (Rabies
Vaccine), will temporarily cease to provide their rabies vaccine
for both pre- and post-exposure prophylaxis uses to healthcare
providers. This includes physicians, nurse practitioners,
hospitals, clinics, etc. A second company, sanofi pasteur,
produces IMOVAX Rabies (Rabies Vaccine), and will continue to
supply vaccine to healthcare providers for post-exposure
prophylaxis (PEP). In certain circumstances, such as an allergic
reaction to one company's vaccine product, the other company's
vaccine product can be obtained to complete a vaccination series
after consultation with state health departments and CDC, on a
case-by-case basis. Overall, both manufacturers have limited
supplies of rabies vaccine, necessitating the need for judicious
use of these products by health care providers. (It is expected
that additional RabAvert will be available on the market in July
2008. When that occurs, it is expected that the demand for pre-exposure vaccinations can be fully met with RabAvert.)
Due to temporarily limited supplies, distribution of vaccine for
pre-exposure prophylaxis (PreP) will be approved by state and
federal public health authorities. Priority will be given for
those individuals at greatest rabies exposure risk (e.g., rabies
laboratory workers, animal control officers, veterinary staff,
wildlife workers) and in consideration of available rabies
vaccine supplies. In lower risk rabies exposure categories
(e.g., travelers, veterinary students, etc.), human rabies PreP
should be delayed until vaccine supply levels are restored.
Priority use of rabies vaccine will be for post-exposure
prophylaxis (PEP) following ACIP human rabies prevention
recommendations
(http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5703a1.htm). IMOVAX
rabies vaccine is available for PEP and providers should
carefully review the ACIP recommendations and guidelines from
their states to ensure that PEP is needed. They are also
strongly encouraged to consult with local/state public health
departments.
Public health authorities and healthcare providers are
encouraged to educate the public concerning the need to take
appropriate precautions to avoid rabies exposure and actions to
take if an exposure occurs. Appropriate precautions include
vaccination of pets, as well as livestock having close human
contact, avoiding stray and wild animals, and safely capturing
or detaining biting animals or obtaining owner contact
information for follow up. Such practices will decrease the need
for rabies PEP and thus allow for the responsible management of
currently limited vaccine supplies.
CDC is working closely with both vaccine companies and state and
federal public health authorities to ensure that healthcare
providers receive up-to-date information on supply fluxes.
Discussions among federal, state, and local public health
personnel are ongoing to review additional strategies to manage
the current supply of rabies vaccines. State and local health
departments are working to ensure that healthcare providers are
informed and have available consultation regarding best
practices for the use of rabies vaccine.
Information about rabies, its prevention, and updates on the
rabies vaccine situation can be obtained on the CDC rabies
website http://www.cdc.gov/rabies or by calling (800) 232-4636
([800] CDC-INFO). The rabies web site will be updated as new
information becomes available.
To access the HAN Advisory, go to:
http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00276
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5. |
CDC reports only about one-third of persons with asthma received influenza
vaccine in 2005-06 influenza season
CDC published "Influenza Vaccination Coverage
Among Persons with
Asthma--United States, 2005-06 Influenza Season" in the June 20
issue of MMWR. Portions of the article are reprinted below.
During 2006, approximately 6.8 million (9.3%) U.S. children and
16.1 million (7.3%) U.S. adults were reported to have asthma.
Since 1964, the Advisory Committee on Immunization Practices
(ACIP) has recommended influenza vaccination of all persons with
asthma because of the higher risk for medical complications from
influenza for those persons. Influenza vaccination coverage of
persons with asthma varies by age group and remains below
Healthy People 2010 targets of 60% coverage of persons aged 18-64 years with high-risk conditions and 90% of all persons aged >=65 years. Influenza vaccination rates of children and older
adults with asthma have not been well studied. Using 2006
National Health Interview Survey (NHIS) data, this report
provides the first examination of influenza vaccination rates
and related factors across a national sample of persons with
asthma aged >=2 years. The results indicated that 36.2% received
influenza vaccination during the 2005-06 influenza season.
Vaccination rates remained below target levels among all
subgroups examined, including those reporting the greatest
number of healthcare visits in the past 12 months. The results
of this study indicate that influenza vaccination coverage of
all persons with asthma can be improved by increasing access to
health care and using opportunities for vaccination during
healthcare visits. . . .
Editorial Note: This report presents the first estimates of influenza vaccination coverage in the United States among the
civilian, noninstitutionalized population of persons with asthma
and reinforces the need to increase vaccination throughout this
at-risk population. Healthcare visits provide an opportunity for
vaccination, but even among persons with the highest number of
visits, nearly half remained unvaccinated in the 2005-06
influenza season. Even so, access to health care is an important
factor associated with receiving influenza vaccination. Persons
with asthma who had health insurance had a greater rate of
influenza vaccination than did those who lacked insurance.
Likewise, the vaccination rate for persons with asthma who had a
usual place for health care was significantly greater than the
rate for those who did not have a regular place for health care.
After the vaccine shortage of the 2004-05 influenza season,
vaccination coverage of persons with asthma in 2005-06 failed to
improve among households with the lowest incomes, among persons
without health insurance, and among persons without a regular
place for medical care, emphasizing the need for interventions
that include the medically underserved.
During the 2005-06 influenza season, the oldest age groups (50-64 years and >=65 years) had the highest vaccination coverage.
Influenza vaccination is recommended for both age groups,
regardless of asthma status, because the influenza-related death
rate increases sharply among older adults. In February 2006,
ACIP recommended that all children aged 24-59 months be
vaccinated against influenza, regardless of risk status.
Examination of the 2007 NHIS data could determine whether the
expanded recommendation affected coverage among the subset of
children with asthma, who already had been recommended for
vaccination under previous guidelines. Because ACIP voted in
February 2008 to recommend influenza vaccination for all
children, data soon will be available to also study the effects
on coverage for older children. . . .
The findings in this report emphasize the need for measures to
uniformly increase influenza vaccination rates among persons
with asthma. Interventions that target patients, healthcare
access, and healthcare providers have demonstrated benefits in
similar settings and should be implemented to improve influenza
vaccination coverage. Such interventions include automated
reminders, standing orders, multicomponent educational programs,
reduction of travel distances or out-of-pocket vaccine costs,
and provider performance feedback. Persons with inadequate
access to health care and those treated at multiple facilities
would be less likely to miss opportunities for vaccination if
they consistently sought care at a single medical facility. That
continuity of care could reduce the diffusion of responsibility
that occurs when patients are treated at multiple healthcare
facilities. Providing vaccination through at least January and
February of the influenza season can further reduce missed
opportunities for effective vaccination of persons in this group
at high risk.
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5724a2.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5724.pdf
To receive a FREE electronic subscription to MMWR (which
includes new ACIP recommendations), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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6. |
Revised and updated, "Vaccines" textbook has comprehensive information about
all aspects of vaccination
Publisher Elsevier recently reminded us 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!
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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7. |
AMA
offers physicians practical information on improving immunization among racial
and ethnic populations
The website of the American Medical Association
(AMA) recently
added a self-study course on immunizing racial and ethnic
populations. The course is part of AMA's Roadmaps for Clinical
Practice series.
Titled "Improving Immunization: Addressing Racial and Ethnic
Populations" the course includes four booklets: (1) Overview,
(2) Childhood and Adolescent Immunizations, (3) Adult
Immunizations, and (4) Resources for Physicians and Patients.
The course provides background information, practical
recommendations, and solutions to commonly encountered questions
that physicians face from diverse patient populations; case
presentations for improving healthcare delivery; and resources.
A collaboration between AMA and the Department of Health and
Human Services, the Roadmaps for Clinical Practice series is
intended to assist physicians in integrating disease prevention
and health promotion into routine clinical care.
To access "Improving Immunization: Addressing Racial and Ethnic
Populations," go to:
http://www.ama-assn.org/ama/pub/category/9958.html
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8. |
June
18 issue of IAC's Hep Express electronic newsletter now online
The June 18 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 June 18 Hep Express; titles of articles we have
not yet covered follow.
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ECRI Institute provides resources related to medical device
reuse issues
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AASLD [American Association for the Study of Liver Diseases]
2008 Liver Meeting to be held in San Francisco, October 31-November 4
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California Central Valley Viral Hepatitis Summit scheduled for
August 8 in Atwater
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Minnesota Viral Hepatitis Symposium to take place on July 30
in Bloomington
To access the June 18 issue, go to:
http://www.hepprograms.org/hepexpress/issue72.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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9. |
WHO committee makes recommendations on the use of alternative diagnostic
samples for measles and rubella surveillance
CDC published "Recommendations from an Ad Hoc
Meeting of the WHO
Measles and Rubella Laboratory Network (LabNet) on Use of
Alternative Diagnostic Samples for Measles and Rubella
Surveillance" in the June 20 issue of MMWR.
To access a web-text (HTML) version of the article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5724a3.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5724.pdf
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