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IAC Express 2009 |
| Issue number 774: January 12, 2009 |
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Contents
of this Issue
Select a title to jump to the article. |
- New: CDC,
AAFP, ACOG, and ACP release the 2009 Recommended Adult Immunization
Schedule
- Erratum:
MMWR corrects an error in its January 2 article about the 2009 Recommended
Immunization Schedule for Persons Ages 0 Through 18 Years
- AAP
article answers parents' questions about the number and timing of vaccines
recommended in the childhood immunization schedule
- CDC study
reveals that poor infection control practices by healthcare personnel
expose patients to hepatitis B and C
-
IAC's Video of the Week presents stories from families affected by
influenza
- January
16 is the nomination deadline for the 2009 National Influenza Vaccine
Summit's Immunization Excellence Awards
- Merck
reports shortage of the adult formulation of its hepatitis B vaccine
- CDC
issues media statement about oseltamivir resistance and antiviral
recommendations
- January
is Cervical Health Awareness Month: CDC encourages the public to learn
about cervical cancer and HPV vaccination
- Use the
Michigan Department of Public Health's monthly posters to encourage
influenza immunization through April
- NAPNAP's
immunization brochure encourages immunization for healthcare professionals
who take care of children
-
Important: Be sure to give influenza vaccine throughout the influenza
season--through spring 2009
- Summary
Report from the October 2008 ACIP meeting is now online
- January
29 Current Issues in Immunization Net Conference to focus on antiviral
resistance among influenza A (H1N1) viruses
- January
12 issue of People magazine includes interview with Amanda Peet voicing
support for childhood immunization
- Final
Statement of October 2008 NIH Consensus Development Conference on
Management of Hepatitis B now online
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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 774: January 12, 2009 |
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1. |
New: CDC, AAFP, ACOG, and ACP release the 2009 Recommended Adult Immunization
Schedule
CDC, the American Academy of Family Physicians (AAFP),
the
American College of Obstetricians and Gynecologists (ACOG), and
the American College of Physicians (ACP) have endorsed and
released the "Recommended Adult Immunization Schedule--United
States, 2009." On January 9, CDC published the schedule as an
MMWR QuickGuide; it is reprinted below in its entirety,
excluding references and two figures.
The Advisory Committee on Immunization Practices (ACIP) annually
reviews the recommended Adult Immunization Schedule to ensure
that the schedule reflects current recommendations for the
licensed vaccines. In October 2008, ACIP approved the Adult
Immunization Schedule for 2009. No new vaccines were added to
the schedule; however, several indications were added to the
pneumococcal polysaccharide vaccine footnote, clarifications
were made to the footnotes for human papillomavirus, varicella,
and meningococcal vaccines, and schedule information was added
to the hepatitis A and hepatitis B vaccine footnotes.
Additional information is available as follows: schedule (in
English and Spanish) at
http://www.cdc.gov/vaccines/recs/schedules/adult-schedule.htm
[IAC Express editor's note: the Spanish-language version is not
yet available; it is anticipated to be available at the end of
January]; adult vaccination at
http://www.cdc.gov/vaccines/default.htm; ACIP statements for
specific vaccines at http://www.cdc.gov/vaccines/pubs/acip-list.htm; and reporting
adverse events at http://www.vaers.hhs.gov or by telephone,
(800) 822-7967.
CHANGES FOR 2009
FORMAT CHANGES (Figures 1 and 2)
To make the figures easier to understand, several formatting
changes were implemented to both the age group-based schedule
and the medical and other indications schedule. The changes
include (1) increasing the number of age groups; (2) deleting
the hatched yellow bar for tetanus, diphtheria, pertussis
(Td/Tdap) vaccine while adding explanatory text to the Td/Tdap
bar; (3) simplifying the figures by removing schedule text from
the vaccine bars; (4) revising the order of the vaccines to more
appropriately group the vaccines, and (5) adding a legend box to
clarify the meaning of blank spaces in the table.
FOOTNOTE (Figures 1 and 2)
- The human papillomavirus (HPV) footnote (#2) has language
added to indicate that healthcare personnel are not at increased
risk because of occupational exposure, but they should be
vaccinated consistent with age-based recommendations. Also, text
has been added to indicate that vaccination with HPV may begin
at age 9 years.
- The varicella footnote (#3) has language added to clarify that
adults who previously received only 1 dose of vaccine should
receive a second dose.
- Asthma and cigarette smoking have been added as indications
for pneumococcal polysaccharide vaccination (#7). Also, text has
been added to clarify vaccine use in Alaska Natives and American
Indians.
- The Hepatitis A footnote (#9) has additional schedule
information for the 4-dose combined hepatitis A/hepatitis B
vaccine.
- The Hepatitis B footnote (#10) has additional schedule
information for the 4-dose combined hepatitis A/hepatitis B
vaccine, and a clarification of schedule information for special
formulation indications has been added.
- The meningococcal vaccine footnote (#11) clarifies that the
revaccination interval is 5 years.
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5753a6.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5753.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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2. |
Erratum: MMWR corrects an error in its January 2 article about the 2009
Recommended Immunization Schedule for Persons Ages 0 Through 18 Years
CDC published "Erratum: Vol. 57, Nos. 51 & 52" in
the January 9
issue of MMWR. The erratum concerns an error that appears in the
MMWR QuickGuide article titled "Recommended Immunization
Schedules for Persons Aged 0 Through 18 Years--United States,
2009," which was published on January 2. The error appeared only
in the article about the immunization schedule; the information
in the actual PDF-format schedule is correct. The erratum is
reprinted below in its entirety.
In the "Recommended Immunization Schedules for Persons Aged 0
Through 18 Years--United States, 2009," an error occurred on
page Q-1. The first bulleted sentence should read as follows:
- "Recommendations for rotavirus vaccines include changes for
the maximum age for the first dose (14 weeks 6 days) and the
maximum age for the final dose of the series (8 months 0 days)."
To access a web-text (HTML) version of the erratum, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5753a5.htm
To access a ready-to-print (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5753.pdf
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3. |
AAP article answers parents' questions about the number and timing of
vaccines recommended in the childhood immunization schedule
AAP published "Adhering to Vaccine Schedule Is
Best Way to Protect Children from Disease" in the January issue of AAP News.
Written in a Q&A format, the article gives succinct, clearly written answers
to questions many parents ask their healthcare providers, such as "why so
many vaccines?" "why start so early?" "why not spread out the schedule?" and
more.
To access the article, go to:
http://www.cispimmunize.org/fam/schedule_whysomany.html
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4. |
CDC study reveals that poor infection control practices by healthcare
personnel expose patients to hepatitis B and C
On January 6, CDC issued a press release, "CDC
Study: Failures
to Follow Infection Practices Have Placed More than 60,000
Patients at Risk for Hepatitis B and C." Portions of the press
release are reprinted below.
In the last decade, more than 60,000 patients in the United
States were asked to get tested for hepatitis B virus (HBV) and
hepatitis C virus (HCV) because healthcare personnel in settings
outside hospitals failed to follow basic infection control
practices, according to a new study by the CDC.
This first full review of all the CDC investigations over the
past 10 years of healthcare-associated viral hepatitis outbreaks
appears in the January 6th issue of the journal Annals of
Internal Medicine.
"This report is a wake-up call," said Dr. John Ward, director of
CDC's Division of Viral Hepatitis. "Thousands of patients are
needlessly exposed to viral hepatitis and other preventable
diseases in the very places where they should feel protected.
No patient should go to their doctor for health care only to
leave with a life-threatening disease."
In the United States, transmission of HBV and HCV while
receiving health care has been considered uncommon. However, a
review of CDC outbreak information revealed a total of 33
identified outbreaks outside of hospitals in 15 states, during
the past decade: 12 in outpatient clinics, six in hemodialysis
centers, and 15 in long-term care facilities, resulting in 450
people acquiring HBV or HCV infection. . . .
To access the complete press release, go to:
http://www.cdc.gov/media/pressrel/2009/r09106.htm
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5. |
IAC's Video of the Week presents stories from families affected by influenza
IAC encourages IAC Express readers to watch a
seven-minute video
narrated by parents who have lost a child to influenza or have a
child who has experienced severe medical complications from
influenza. Titled "Why Flu Vaccination Matters: Personal Stories
from Families Affected by Flu," the video was produced by CDC
and Families Fighting Flu. To safeguard children from influenza,
CDC recommends influenza vaccination every year for children
ages 6 months through 18 years.
To find out more, go to: http://www.familiesfightingflu.org
The video will be available on the home page of IAC's website
through January 18. To access it, go to: http://www.immunize.org
and click on the image under the words Video of the Week, which
you'll find toward the top of the page.
Remember to bookmark IAC's home page to view a new video every
Monday. While you're at our home page, we encourage you to
browse around--you're sure to find resources and information
that will enhance your practice's immunization delivery.
To view IAC's video collection, go to:
http://www.vaccineinformation.org/video
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6. |
January 16 is the nomination deadline for the 2009 National Influenza Vaccine
Summit's Immunization Excellence Awards
The nomination form for National Influenza
Vaccine Summit's
Immunization Excellence Awards is now available. The awards
recognize individuals and organizations that have made
extraordinary contributions toward improved adult and/or
childhood influenza vaccination within their communities. Awards
will be presented during the National Immunization Conference,
which will be held in Dallas during March 30-April 2. The
deadline for nominations is January 16 (this coming Friday).
To access complete information and the online nomination form,
go to: http://fs16.formsite.com/APhA/2009NIVSAwards
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7. |
Merck reports shortage of the adult formulation of its hepatitis B vaccine
On December 30, 2008, NCIRD posted information on
its Current
Vaccine Shortages & Delays web section about a shortage in
Recombivax HB, Merck's adult hepatitis B vaccine. The
information is reprinted below in its entirety.
Beginning in January 2009, Merck expects to experience a supply
interruption in the U.S. for the adult formulation of their
hepatitis B vaccine, Recombivax HB. Merck anticipates that
supplies of the different images of the adult formulation of
Recombivax HB (vials and syringes) as well as the dialysis
formulation will be depleted over the first quarter of 2009.
Merck will provide updates on supply of the adult formulations
as additional information becomes available. At this time Merck
does not anticipate the pediatric formulation will be affected,
and expects it to be available in adequate supply to meet
anticipated demand. Supply of GSK's Adult hepatitis B vaccine
(Adult Engerix-B) and Adult hepatitis A/hepatitis B combination
vaccine (Twinrix) is currently sufficient to meet demand for
routine adult usage of this vaccine as well as CDC's ongoing
High Risk Adult Hepatitis B Initiative. GSK is gearing up
production of these vaccines, to meet ongoing demand.
To access the information from the CDC website, go to:
http://www.cdc.gov/vaccines/vac-gen/shortages The information
will be updated as needed to provide public information on
vaccine shortages and/or delays.
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8. |
CDC
issues media statement about oseltamivir resistance and antiviral
recommendations
On January 9, CDC issued a media statement titled
"CDC Statement
on Oseltamivir (Tamiflu) Resistance and Antiviral
Recommendations." Portions of it are reprinted below.
On December 19, 2008, CDC issued interim guidance for healthcare
professionals on the use of influenza antiviral medications this
flu season. The guidance was issued in response to early data
from a limited number of states indicating that a high
proportion of influenza A (H1N1) viruses are resistant to the
influenza antiviral medication oseltamivir (Tamiflu). Worldwide,
the proportion of H1N1 viruses that are resistant to oseltamivir
has been increasing so this development is not surprising.
Recent media reports may have led some to believe that these
developments mean physicians are without influenza treatment
options for the 2008-2009 flu season.
At this time, it's not possible to predict how common H1N1
viruses will be during the rest of this flu season, as there are
many different flu viruses and every influenza season is
different. The current samples studied come from a handful of
states, and may not be indicative of how the rest of the season
will progress or what viruses will circulate in other states.
However the circulation of oseltamivir-resistant viruses does
have treatment implications for healthcare professionals. CDC is
continuing to monitor this situation very closely, but has
issued interim guidance for healthcare professionals to guide
their treatment decisions in the current situation.
In fact, the interim CDC guidance provides advice for clinicians
on how to treat patients with influenza antiviral medications
this season. Clinicians can use influenza test results and
information, if available, about which viruses are circulating,
to help decide which antiviral(s) should be used. If H1N1
viruses are circulating in the community, or it's not clear
which viruses are circulating, healthcare providers are
recommended to use an alternative antiviral, zanamivir
(Relenza), or to use combination therapy of oseltamivir and
rimantadine. Use of zanamivir or dual therapy with oseltamivir
and rimantadine would provide effective treatment against all
circulating influenza viruses. In some instances, oseltamivir
alone can still be used, such as when influenza B is diagnosed,
or H1N1 viruses are not circulating.
It is important to remember that CDC recommends annual
influenza vaccination as the first and best step in preventing
the flu. It is not too late to get vaccinated and this
year's influenza vaccine is expected to be effective against
currently circulating oseltamivir-resistant influenza A (H1N1)
viruses. . . .
To access the complete media statement, go to:
http://www.cdc.gov/media/pressrel/2009/s090109.htm
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9. |
January is Cervical Health Awareness Month: CDC encourages the public to learn
about cervical cancer and HPV vaccination
CDC recently updated its online cervical cancer
information for
the public, in time for the January observance of Cervical
Health Awareness Month. The updated information covers the
following: cervical cancer prevention, including HPV
vaccination; risk factors; signs and symptoms; and treatment.
To access the updated information, go to:
http://www.cdc.gov/cancer/cervical/basic_info
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10. |
Use the Michigan Department of Public Health's monthly posters to encourage
influenza immunization through April
To encourage healthcare providers to talk with
patients about
influenza vaccination throughout the influenza season, the
Michigan Department of Public Health (MDPH) has developed a
series of monthly posters for use through April.
In addition to the monthly posters, MDPH offers other resources
directed at extending the influenza vaccination season,
including a poster from the National Foundation for Infectious
Diseases that tells providers to continue vaccinating because
influenza activity typically peaks in February.
To access these and other resources, click
here.
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11. |
NAPNAP's immunization brochure encourages immunization for healthcare
professionals who take care of children
The National Association of Pediatric Nurse
Practitioners
(NAPNAP) recently developed an immunization brochure for
healthcare providers who care for children. The brochure
encourages healthcare providers to get immunized, not only to
protect themselves but to protect the children and families that
they care for.
To access the brochure, go to:
http://www.napnap.org/userfiles/File/NAP_NAP_BROCHURE.pdf
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12. |
Important: Be sure to give influenza vaccine throughout the influenza
season--through spring 2009
Influenza activity is increasing, and yearly
vaccination is the
first and most important step in protecting against influenza
and its complications. It is important to continue vaccinating
into the spring months. The supply of influenza vaccine is
robust; if you run out of vaccine in your work setting, please
place another order.
For abundant information about influenza vaccination, visit the
following two websites often. They 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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13. |
Summary Report from the October 2008 ACIP meeting is now online
The CDC website recently posted the Summary
Report of the ACIP
meeting held on October 22-23, 2008. To access a ready-to-print
(PDF) version of the report, go to:
http://www.cdc.gov/vaccines/recs/acip/downloads/min-oct08.pdf
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14. |
January 29 Current Issues in Immunization Net Conference to focus on
antiviral resistance among influenza A (H1N1) viruses
CDC's next "Current Issues in Immunization" net
conference will
be held on January 29 from noon to 1PM ET. Moderated by Dr.
Andrew T. Kroger, the net conference will feature Dr. Anthony
Fiore speaking on antiviral resistance among influenza A (H1N1)
viruses and interim guidance for antivirals.
Registration is limited and will close on January 28 or when the
course is full. To register, go to:
http://www2.cdc.gov/vaccines/ed/ciinc
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15. |
January 12 issue of People magazine includes interview with Amanda Peet voicing
support for childhood immunization
Every Child By Two (ECBT) recently announced that
actress Amanda
Peet, the campaign spokesperson for ECBT's Vaccinate Your Baby
campaign, is featured in the January 12 issue of People
magazine. In the article, Ms. Peet discusses the research she
did before deciding to vaccinate her daughter and the importance
of parents' making vaccination decisions based on hard
scientific evidence.
Healthcare professionals might want to make the parents of young
children aware of the interview or might want to provide parents
with copies of it. The magazine was on newsstands as of January
7.
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16. |
Final Statement of October 2008 NIH Consensus Development Conference on
Management of Hepatitis B now online
On October 20-22, 2008, the National Institutes
of Health
convened a consensus development conference on the management of
hepatitis B. The final statement of the conference is available
at http://consensus.nih.gov/2008/2008HepatitisBCDC120main.htm
To order free print copies of the final statement, which will be
available in the spring, go to:
http://www.meetinglink.org/OMAR/hepb/orderfinal.aspx
For additional information, email consensus@mail.nih.gov or call
(888) 644-2667.
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