IZ Express Issue 823 | Immunize.org

IAC Express 2009
Issue number 823: September 14, 2009

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Contents of this Issue Select a title to jump to the article.
September 2009 issue of Needle Tips now available online IAC revises two guides for healthcare professionals: Summary of Recommendations for Childhood and Adolescent Immunization and Pneumococcal Polysaccharide Vaccine: CDC answers your questions National Institute of Allergy and Infectious Diseases provides information on early results from clinical trials of 2009 H1N1 influenza vaccines MMWR Early Release provides update on national influenza activity MMWR reports on influenza vaccination during pregnancy It's not too early to be vaccinating patients against seasonal influenza Are you experiencing challenges in purchasing seasonal influenza vaccine? CDC updates guidelines on use of antivirals for treatment and prevention of H1N1 and seasonal influenza MMWR reports on oseltamivir-resistant H1N1 influenza infection in two summer campers CDC releases toolkit to help with planning school-located H1N1 influenza vaccination clinics PreventInfluenza.org website offers new resources for healthcare providers, including record card for patients IAC's Video of the Week section features people sharing their personal experiences with bacterial meningitis IAC adds new topic to Vaccine Concerns web section: Responding to Dr. Sears' Alternative Schedule IAC updates two educational pieces that emphasize the importance of the hepatitis B vaccine birth dose IAC announces two Unprotected People reports: a personal account of pneumococcal pneumonia in an elderly woman and a report about two toddlers with invasive Hib disease Order IAC's laminated U.S. immunization schedules today! HHS offers influenza PSAs that feature members of Congress CDC's World Rabies Day toolkit now available for state and local health departments MMWR article provides information about post-eradication wild polio virus containment

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 823: September 14, 2009

September 2009 issue of Needle Tips now available online

The September 2009 issue of Needle Tips is now available for viewing, downloading, and printing online at http://www.immunize.org/nt

This is the second issue of Needle Tips that is online-only. Postal mail copies are no longer available. You may obtain a hard copy of the September issue by printing out the 24-page PDF available at http://www.immunize.org/nslt.d/n41/n41.pdf

Needle Tips is IAC's semiannual periodical for healthcare professionals, packed with practical, easy-to-read, CDC-reviewed educational material covering childhood, adolescent, and adult immunization.

Here are a few of the topics included in this issue of Needle Tips:

Ask the Experts: answers from CDC immunization experts
Unprotected People: Influenza Ends Martin McGowan's Life
Don't take chances with your family's health--make sure you all get vaccinated against influenza every year!
More than a dozen influenza educational materials, some for patients, some for staff
Pneumococcal Polysaccharide Vaccine: CDC answers your questions
Give the Birth Dose: Hepatitis B vaccine at birth saves lives!
Summary of Recommendations for Childhood and Adolescent Immunization
Summary of Recommendations for Adult Immunization
Question & Answers about various diseases and the vaccines that prevent them (for patients)
All healthcare personnel need seasonal and H1N1 influenza vaccination, by Deborah L. Wexler, MD, IAC's executive director

Complete information about this issue of Needle Tips is available at http://www.immunize.org/nt

There you will find a link for displaying and printing the entire 24-page PDF of this issue along with a Table of Contents for viewing and printing individual sections of Needle Tips.

If you would like to download the entire issue of Needle Tips right now, go to:
http://www.immunize.org/nslt.d/n41/n41.pdf

IAC revises two guides for healthcare professionals: Summary of Recommendations for Childhood and Adolescent Immunization and Pneumococcal Polysaccharide Vaccine: CDC answers your questions

IAC has updated two resources for healthcare providers: "Summary of Recommendations for Childhood and Adolescent Immunization" and "Pneumococcal Polysaccharide Vaccine: CDC answers your questions."

"Summary of Recommendations for Childhood and Adolescent Immunization" was updated to reflect new recommendations for polio, seasonal influenza, Hib, hepatitis A, and MCV vaccination, as well as incorporating minor edits.

To access the revised "Summary of Recommendations for Childhood and Adolescent Immunization," go to:
http://www.immunize.org/catg.d/p2010.pdf

IAC changed a Q&A on "Pneumococcal Polysaccharide Vaccine: CDC answers your questions" to reflect ACIP's October 2008 provisional recommendations related to smoking and asthma.

To access the revised "Pneumococcal Polysaccharide Vaccine: CDC answers your questions," go to:
http://www.immunize.org/catg.d/p2015.pdf

IAC's Print Materials web section offers healthcare professionals and the public approximately 250 FREE English-language materials (many also available in translation), which we encourage website users to print out, copy, and distribute widely. To access all of IAC's free print materials, go to:
http://www.immunize.org/printmaterials

National Institute of Allergy and Infectious Diseases provides information on early results from clinical trials of 2009 H1N1 influenza vaccines

On September 11, Dr. Anthony Fauci, Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health, released a statement to the press regarding early results from clinical trials of 2009 H1N1 influenza vaccines in healthy adults. The text of this news release follows in its entirety.

We are encouraged by reports that are now emerging from various clinical trials of 2009 H1N1 influenza vaccines, conducted by various vaccine manufacturers. We expect additional companies to announce their preliminary trial results shortly. The early data from these trials indicate that 2009 H1N1 influenza vaccines are well tolerated and induce a strong immune response in most healthy adults when administered in a single unadjuvanted 15-microgram dose. We congratulate the companies on these trials, which are an important part of the ongoing worldwide effort to develop vaccines to protect the public from 2009 H1N1 influenza.

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, also is conducting clinical trials of 2009 H1N1 influenza vaccines, produced by Sanofi Pasteur and CSL Limited. The NIAID trials are testing two different dosages (15 micrograms versus 30 micrograms) and evaluating the immune response to one and two doses of these vaccines. More than 2,800 people are participating in ongoing NIAID trials of these vaccines.

We are pleased to note that preliminary analyses of early data from the NIAID trials align with the recently announced findings and those to be announced imminently by other companies in that both vaccines studied induced what is likely to be a protective immune response in most adults following a single dose in the same amount (15 micrograms) used in seasonal flu vaccines. Specifically, in blood samples obtained 8 to 10 days after vaccination:

Among healthy adults who received a single 15-microgram dose of the Sanofi Pasteur vaccine, a robust immune response was measured in 96 percent of adults aged 18 to 64 and in 56 percent of adults aged 65 and older.
Similarly, among healthy adults who received a single 15-microgram dose of the CSL Limited vaccine, a robust immune response was measured in 80 percent of adults aged 18 to 64 and in 60 percent of adults aged 65 and older.

Additional data from the NIAID trials are forthcoming. However, on the basis of these strong early data, our results are consonant with other reports that a single 15-microgram dose of unadjuvanted 2009 H1N1 influenza vaccine is well tolerated and induces a robust immune response in healthy adults between the ages of 18 and 64. For adults aged 65 and over, the immune response to 2009 H1N1 influenza vaccine is somewhat less robust, as is the case with seasonal influenza vaccines.

We note that the slight discrepancies seen in our trials between the Sanofi Pasteur and CSL Limited vaccines may be due to technical differences in the preliminary measurement of the amounts of antigen in the doses used in the clinical trial lots and the relatively limited numbers of samples studied to date, as well as the fact that our data are drawn from a very early time point after immunization.

NIAID will continue to provide timely updates on these trials as well as those in children and in pregnant women, which began later.

Information from the NIAID studies will help inform the development of recommendations for immunization schedules, including the optimal dosage and number of doses for different age groups.

NIAID is conducting these clinical trials through its longstanding vaccine clinical trials infrastructure: the Vaccine and Treatment Evaluation Units, a network of medical centers that offers rapid response capability to test vaccines for emerging public health concerns. Detailed information is available from the NIAID Web site (http://www.niaid.nih.gov) and from http://ClinicalTrials.gov

For more information on influenza, visit http://www.flu.gov for one-stop access to U.S. government information on avian and pandemic influenza. Also, visit NIAID's Flu Portal (http://www3.niaid.nih.gov/topics/Flu).

To read the news release online, go to:
http://www.hhs.gov/news/press/2009pres/09/20090911a.html

MMWR Early Release provides update on national influenza activity

On September 10, CDC published an MMWR Early Release titled, "Update: Influenza Activity--United States, April-August 2009." The first paragraph is reprinted below, excluding references.

The first 2009 pandemic influenza A (H1N1) virus infections were identified in the United States in April 2009. By August, the cumulative number of infections in the United States was estimated to be at least 1 million. This report provides an overview of influenza activity during April-August 2009 and recommendations for the upcoming 2009-10 influenza season. Pandemic H1N1 influenza activity peaked in the United States during May and June and declined during July and early August. However, levels of influenza activity remained above normal for summer months, and focal outbreaks were reported throughout the summer. During the last 2 weeks of August, pandemic H1N1 influenza activity increased in certain areas of the United States. Clinicians and public health officials should be aware that these recent increases might signal an early start to the 2009-10 influenza season, with pandemic H1N1 influenza viruses predominating at least initially. . . .

To access the full MMWR Early Release in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58e0910a1.htm

To access a ready-to-print (PDF) version of this MMWR Early Release, go to:
http://www.cdc.gov/mmwr/pdf/wk/mm58e0910.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP recommendations), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html

MMWR reports on influenza vaccination during pregnancy

CDC published "Receipt of Influenza Vaccine During Pregnancy Among Women With Live Births--Georgia and Rhode Island, 2004-2007" in the September 11 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

Pregnant women are at increased risk for complications from influenza. The Advisory Committee on Immunization Practices (ACIP) and American College of Obstetricians and Gynecologists (ACOG) Committee on Obstetric Practice recommend that pregnant women receive intramuscular, inactivated influenza vaccine during any trimester of pregnancy. CDC analyzed data from the Pregnancy Risk Assessment and Monitoring System (PRAMS) to assess influenza vaccination coverage among women from Georgia and Rhode Island with recent live-births. In Georgia, vaccine coverage prevalence increased from 10.4 percent in 2004 to 15.5 percent in 2006. In Rhode Island, coverage increased from 21.9 percent in 2004 to 33.4 percent in 2007. Women who received advice from their healthcare provider were more likely to report being vaccinated. Increased efforts are needed to assess vaccine coverage and to educate providers and pregnant women about ACIP and ACOG recommendations on obtaining influenza vaccination anytime during pregnancy.

To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5835a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5835.pdf

It's not too early to be vaccinating patients against seasonal influenza

Many healthcare professionals have been asking if it's too soon to start vaccinating patients against seasonal influenza. To address these concerns, on September 2, IAC published the following information from CDC as part of a special "Ask the Experts" edition of IAC Express [http://www.immunize.org/express/issue821.asp].

Q: In anticipation of H1N1 monovalent vaccine arriving later this fall, CDC recommends that we begin vaccinating with seasonal influenza vaccine now. Does protection from seasonal influenza vaccine decline or wane within 3 or 4 months of vaccination? Should I wait until October or November to vaccinate my elderly or medically frail patients?

A: CDC recommends that seasonal influenza vaccine be administered to all age groups as soon as it becomes available. Antibody to seasonal inactivated influenza vaccine declines in the months following vaccination. However, antibody level at a point several months after vaccination does not necessarily correlate with clinical vaccine effectiveness. There are no studies that compare vaccine effectiveness according to the month when the vaccination was given. The authors of a recent review on antibody declines among the elderly after vaccination reported, "In conclusion, we found no compelling evidence for more rapid decline of the influenza vaccine-induced antibody response in the elderly, compared with young adults, or evidence that seroprotection is lost at 4 months if it has been initially achieved after immunization." (see Skowronski et al., Rapid Decline of Influenza Vaccine-Induced Antibody in the Elderly: Is It Real, or Is It Relevant? Journal of Infectious Diseases 2008;197:490-502). In addition, there is a lack of evidence for late season outbreaks among vaccinated persons that can be attributed to waning immunity.

Vaccinating now with seasonal influenza vaccine will allow more time for healthcare providers to focus on later immunization efforts when vaccine for 2009 H1N1 influenza A virus becomes available.

In addition, early vaccination of children younger than age 9 years who are first-time vaccinees (or who failed to get their second dose in the preceding season) can be helpful in assuring routine second doses before the influenza season begins.

Finally, it's always a good rule of thumb to take advantage of an opportunity to vaccinate instead of relying on patients to come back for another appointment.

Many resources regarding influenza disease and vaccination are available to healthcare professionals and the public. Following is a list of some of them.

To access the National Influenza Vaccine Summit website, go to:
http://www.preventinfluenza.org

To access IAC's Seasonal Influenza web section, go to:
http://www.immunize.org/influenza

To access IAC's H1N1 Influenza web section, go to:
http://www.immunize.org/h1n1

To access CDC's Seasonal Flu web section, go to:
http://www.cdc.gov/flu

To access CDC's Novel H1N1 Flu web section, go to:
http://www.cdc.gov/h1n1flu

To access IAC's print pieces related to influenza, including screening questionnaires, patient education pieces, and sample standing orders, go to:
http://www.immunize.org/printmaterials/dis_inf.asp

Healthcare professionals may find IAC's print piece, "Don't take chances with your family's health--make sure you all get vaccinated against influenza every year!" especially useful when talking to patients. The piece explains how easy it is to become infected with and transmit influenza, and outlines the range of health consequences the disease can have on the individual and family. To obtain a copy, go to: http://www.immunize.org/catg.d/p4069.pdf

Are you experiencing challenges in purchasing seasonal influenza vaccine?

On September 8, Jeanne M. Santoli, MD, MPH, Acting Chief, Vaccine Supply and Assurance Branch, Immunization Services Division, NCIRD, CDC, released information to public immunization managers related to seasonal influenza vaccine supply. This information may be of interest to the many healthcare providers who are finding it hard to purchase the desire quantity of seasonal influenza vaccine.

An excerpt from Dr. Santoli's email follows.

. . . In late June/early July, vaccine production estimates for seasonal flu vaccine for the 09-10 season were shared publicly at the ACIP and National Influenza Vaccine Summit meetings. At that time, overall production estimate for the U.S. was 118 million doses of vaccine across all five manufacturers. The estimate from manufacturers this week is between 114-115 million doses, which is slightly lower (3%) than, but not substantially changed from, the earlier estimate. Slight changes in production estimates are to be anticipated because of the uncertainties involved in making biological products. Of note, this updated estimate for the season still slightly exceeds the amount of flu vaccine that has been distributed in a single year in the U.S. by (113 million doses were distributed in the 08-09 season).

H1N1 vaccine production efforts currently underway are being carried out in such a way to minimize any impact upon the total amount of seasonal vaccine available. In fact, the timing of H1N1 vaccine production, as directed by the federal government, was designed to allow sufficient time for manufacturers to be able to carry out their planned production of seasonal influenza vaccine.

Despite the vaccine production estimates that exceed past usage, however, providers seeking to order vaccine currently and during the past several weeks have experienced challenges in doing so. There are several reasons for these challenges. First, in early June, one of the manufacturers adjusted down their seasonal flu vaccine estimates, which resulted in some customers switching prebooks to other products. These switches reserved unprebooked vaccines that were still available for order, making doses that are normally available for order during the summer and early fall months no longer available. Second, there may be more providers seeking to purchase vaccine at this time of year than normally occurs due to (1) recent H1N1 disease and its coverage in the media that may have increased the demand for seasonal flu vaccination, and (2) a desire to complete seasonal flu vaccination efforts in advance of H1N1 vaccination efforts to the extent possible.

As in past seasons, availability of seasonal vaccine may change as the season progresses because some prebooks do not materialize into purchases. Providers looking to order additional vaccine should be encouraged to use the supplies that they have now and continue to look for additional flu vaccine for purchase in the coming weeks. . . .

To assist providers in finding seasonal influenza vaccine available for purchase, the National Influenza Vaccine Summit supports IVATS, the Influenza Vaccine Availability Tracking System, which provides information about vaccine manufacturers and distributors with vaccine available for purchase. To access this information in Excel spreadsheet format, go to:
http://www.preventinfluenza.org/ivats/ivats_09_10.xls

For more information on IVATS (including tips on printing the spreadsheet referenced above), go to:
http://www.preventinfluenza.org/ivats

More information about the dynamics of influenza vaccine supply and demand can be found at
http://www.preventinfluenza.org/profs_production.asp

CDC updates guidelines on use of antivirals for treatment and prevention of H1N1 and seasonal influenza

On September 8, CDC posted new information to the Guidance sub-section of its H1N1 Flu web section. "Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season," is available at
http://www.cdc.gov/h1n1flu/recommendations.htm

In addition to the guidance itself, CDC has developed a section of Q&As related to the revised antiviral recommendations at http://www.cdc.gov/h1n1flu/antiviral.htm

The home page of CDC's H1N1 Flu web section can be accessed from http://www.cdc.gov/h1n1flu

IAC has gathered important information related to H1N1 influenza in a new web section to make it easier to keep up to date with developments. To access this resource, go to:
http://www.immunize.org/h1n1

MMWR reports on oseltamivir-resistant H1N1 influenza infection in two summer campers

CDC published "Oseltamivir-Resistant 2009 Pandemic Influenza A (H1N1) Virus Infection in Two Summer Campers Receiving Prophylaxis--North Carolina, 2009" in the September 11 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

Oseltamivir resistance was found in 2009 pandemic H1N1 virus from two patients who developed influenza while taking oseltamivir. These patients attended a summer camp in North Carolina where oseltamivir was given to most campers and staff to prevent influenza. Oseltamivir resistance is still rare in 2009 pandemic H1N1. However, using oseltamivir to prevent influenza in patients who are not at high risk might lead to development of resistant virus. CDC recommends using antivirals to prevent 2009 pandemic H1N1 only for those at high risk for complications from the infection and to consider the alternative of early treatment once symptoms develop. Oseltamivir and zanamivir are the only available medications for preventing or treating pandemic H1N1. No evidence suggests spread of oseltamivir- esistant virus beyond the summer camp.

To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5835a1.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5835.pdf

10.

CDC releases toolkit to help with planning school-located H1N1 influenza vaccination clinics

On September 13, CDC released "School-Located Vaccination Planning Materials and Templates" to assist those planning and conducting 2009 H1N1 influenza vaccination clinics in schools. The targeted audience for these materials is primarily state and local public health department immunization and preparedness staff who are responsible for carrying out 2009 H1N1 influenza vaccination, but also education officials, school nurses, and others who are responsible for planning and carrying out such activities.

The toolkit includes template letters, consent forms, and a record card. To access these resources, go to:
http://www.cdc.gov/h1n1flu/vaccination/slv

11.

PreventInfluenza.org website offers new resources for healthcare providers, including record card for patients

The National Influenza Vaccine Summit (NIVS) website, PreventInfluenza.org, offers many resources related to influenza for healthcare professionals and their patients.

One new resource is a ready-to-print Influenza Vaccination Record card to give to patients. This record card is nearly identical to the card that will be packaged in quantities and included with the shipments of H1N1 vaccine, beginning next month. By downloading and printing the influenza vaccination record cards from PreventInfluenza.org, healthcare providers will be able to provide vaccinees with a hand-held record of their seasonal and H1N1 influenza vaccination information. A link to a PDF version of the card suitable for printing 6 cards to a page, as well as instructions for use of the card, can be found at
http://www.preventinfluenza.org/profs_strategies.asp#record

Another new resource is a poster developed by the Hawaii Immunization Program: "Fight the Flu--It starts with you." This poster illustrates the various ways an individual can protect themselves and others and can be customized with local information. To access this resource, go to:
http://www.preventinfluenza.org/patients_who.asp

Individuals with questions about the poster can contact Gail Ogawa at gail.a.ogawa@doh.hawaii.gov

Visit the home page of National Influenza Vaccine Summit website at http://www.preventinfluenza.org to discover many more valuable resources.

12.

IAC's Video of the Week section features people sharing their personal experiences with bacterial meningitis

IAC encourages IAC Express readers to watch several short videos featuring personal stories about meningococcal disease. The Voices of Meningitis campaign was developed by the National Association of School Nurses to reach parents with an important message: meningococcal disease is a serious bacterial illness that can cause death or disability of an otherwise healthy teen within just 1 day.

The link to the collection of meningitis videos will be available on the home page of IAC's website as the Video of the Week feature through September 20. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week.

To obtain more information about the Voices of Meningitis campaign, go directly to their home page at http://www.voicesofmeningitis.org You'll find fact sheets, brochures, and other useful information.

Remember to bookmark IAC's home page to view a new video every Monday. To view an IAC Video of the Week from the past, go to the video archive at http://www.immunize.org/votw

13.

IAC adds new topic to Vaccine Concerns web section: Responding to Dr. Sears' Alternative Schedule

IAC recently added a new topic to its Vaccine Concerns web section. The new section, "Responding to Dr. Sears' Alternative Schedule," provides health professionals with background information and practical resources that will help them discuss the problems with using alternative schedules with concerned parents.

Be sure to check out this updated resource at http://www.immunize.org/concerns/drsears.asp

The Vaccine Concerns web section on immunize.org offers easy access to resources on specific topics that parents and patients have questions about: adjuvants, alternative medicine, autism, MMR vaccine, multiple injections, Poling case, religious concerns, and thimerosal. In addition, this section features information about and links to materials that broadly address the importance of vaccines, ways to talk with vaccine-hesitant patients and parents, and vaccine safety.

To access the entire Vaccine Concerns web section, go to
http://www.immunize.org/concerns

14.

IAC updates two educational pieces that emphasize the importance of the hepatitis B vaccine birth dose

IAC has reformatted a print piece about an infant's death from hepatitis B virus infection that was previously only available as an Unprotected People Report on its website. "Unprotected people. . . Infant dies of fulminant hepatitis B, 1999" describes the medical errors that resulted in the death of a 3-month-old infant in Michigan. Besides the case history, the piece includes guidance for healthcare professionals to ensure such a tragedy doesn't occur in any children under their care.

To access "Unprotected people. . .Infant dies of fulminant hepatitis B, 1999," go to:
http://www.immunize.org/catg.d/p2126.pdf

IAC also updated the one-page editorial, "Give the birth dose. . . Hepatitis B vaccine at birth saves lives!" This piece written by Dr. Deborah Wexler, IAC's executive director, urges healthcare professionals to provide the birth dose of hepatitis B vaccine to all newborns prior to hospital discharge. It describes several medical errors that can lead to newborns becoming infected with HBV.

To access "Give the birth dose. . . Hepatitis B vaccine at birth saves lives!" go to:
http://www.immunize.org/catg.d/p2125.pdf

15.

IAC announces two Unprotected People reports: a personal account of pneumococcal pneumonia in an elderly woman and a report about two toddlers with invasive Hib disease

For years, IAC has published Unprotected People Reports about people who have suffered or died from vaccine-preventable diseases. The Unprotected People Report web section (http://www.immunize.org/reports) is a compilation of more than 100 case reports, personal testimonies, and newspaper and journal articles about people who have suffered or died from vaccine-preventable diseases, as well as opinion pieces about the value of immunization.

Two reports have been added to the Unprotected People Report web section. The first is a personal account of pneumococcal pneumonia and the second describes two cases of invasive Haemophilus influenzae type b (Hib) in children, one of which turned deadly.

(1) In "Pneumococcal Pneumonia: How I let down my friend," Linda Ohri, PharmD, writes about how an elderly friend's illness with pneumococcal pneumonia reminded her that vaccine advocacy begins at home.

To access the ready-to-print (PDF) version of "Pneumococcal Pneumonia: How I let down my friend," go to:
http://www.immunize.org/reports/report095.pdf

To view a web-text version of Dr. Ohri's story, go to:
http://www.immunize.org/reports/report095.asp

To read more IAC Unprotected People Reports about pneumococcal cases, go to:
http://www.immunize.org/reports/pneumococcus.asp

(2) In January 2008, the New York State Department of Health (Bureau of Communicable Disease Control, Immunization Program) issued a health advisory on invasive Hib disease. The advisory, "Invasive Hib Disease Kills Unvaccinated Toddler, Sickens Another," is reprinted in its entirety and includes case summaries of Hib disease in two children from Erie County. One of the children, a two-year-old, died of Hib disease. The advisory was submitted by Richard Judelsohn, MD, Medical Director of the Erie County Department of Health, New York.

To access the ready-to-print (PDF) version of "Invasive Hib Disease Kills Unvaccinated Toddler, Sickens Another," go to:
http://www.immunize.org/reports/report099.pdf

To view a web-text version of the case summaries, go to:
http://www.immunize.org/reports/report099.asp

To read more IAC Unprotected People Reports about Hib cases, go to:
http://www.immunize.org/reports/hib.asp

16.

Order IAC's laminated U.S. immunization schedules today!

IAC has two laminated immunization schedules for 2009--one for children/teens ages 0 through 18 years and one for adults. Based on CDC's 2009 immunization schedules, the laminated schedules offer two significant advantages over paper schedules:

(1) They are covered with a tough, washable coating that lets them stand up to a year's worth of use as guides to immunization and as teaching tools you can use to give patients and parents authoritative immunization information.

(2) Each schedule includes a guide to vaccine contraindications and precautions, a feature that will help you to make on-the-spot determinations about vaccinating patients of any age.

IAC's laminated schedules come complete with essential footnotes and are printed in color for easy reading. Each schedule has six pages (i.e., three double-sided pages), and when folded, measures 8.5" x 11".

An image of each schedule is available, as is specific information about each, and a downloadable order form and online ordering information.

To access an image of the child/teen schedule and related information, go to:
http://www.immunize.org/shop/schedule_child.asp

To access an image of the adult schedule and related information, go to:
http://www.immunize.org/shop/schedule_adult.asp

Prices start at $10 each for 1-4 copies and drop to $6.50 each for 5-19 copies. Discount pricing is available for 20 or more copies. For quotes on customizing or placing orders in excess of 999 schedules, call (651) 647-9009 or email mailto:admininfo@immunize.org

17.

HHS offers influenza PSAs that feature members of Congress

On September 9, the U.S. Department of Health and Human Services (HHS) announced the availability of influenza public service announcements (PSAs) recorded by 48 members of Congress. The PSAs deliver the message that there are simple steps that every American can take to reduce the risk on contracting seasonal or 2009 H1N1 influenza.

All PSAs are available in English, with some available in Spanish as well. These 30-second audio and video PSAs can be accessed at http://www.flu.gov/psa/psacongress.html

Those interested in broadcast quality video should email their name, telephone number, call letters, and shipping address to Ira Dreyfuss at HHS. Contact Ira by email at ira.dreyfuss@hhs.gov or by phone at (202) 401-5920.

18.

CDC's World Rabies Day toolkit now available for state and local health departments

September 28 is World Rabies Day, a global health observance that promotes rabies awareness and seeks to enhance rabies prevention and control efforts.Co-sponsored by CDC and the Alliance for Rabies Control, World Rabies Day was first observed in 2007 and since then has been celebrated in numerous countries around the world.

To help address rabies awareness in U.S. communities, a promotional toolkit has been developed for state and local health departments. The toolkit includes resources that can help health officials plan outreach efforts and pre-written materials to educate the public, healthcare providers, and the media about how rabies is transmitted, the severity of the disease in humans, and steps that can be taken to prevent transmission. In addition, the toolkit includes ideas to help create local World Rabies Day events such as rabies vaccination clinics for pets, community run/walks, and grand rounds for healthcare providers.

The toolkit is available on the World Rabies Day Web site at
http://www.workingtogethertomakerabieshistory.org/EN/Get_Involved/health_departments.html

19.

MMWR article provides information about post-eradication wild polio virus containment

CDC published "National Laboratory Inventories for Wild Poliovirus Containment--Western Pacific Region, 2008" in the September 11 issue of MMWR. A summary made available to the press is reprinted below in its entirety.

In the future, when WPV [wild poliovirus] transmission is interrupted worldwide, laboratory facilities could still hold the virus. After global eradication of smallpox, two laboratories working with the virus in the 1970s did not maintain high biosafety standards (laboratory containment) resulting in deaths. The World Health Organization and partners have derived guidelines on arriving at a minimum number of facilities holding WPV materials and with high biosafety. Throughout the areas of the world that are certified polio-free, extensive surveys of laboratories and inventories of their storage materials have been undertaken. This survey phase of the WPV laboratory containment process was completed in the WHO Western Pacific Region in 2008, in the WHO European Region in 2006 and scheduled to be completed in the Americas by the end of 2009. Surveys of 77,260 laboratories in the 37 countries and areas of the Western Pacific region were conducted during 1999-2008. The number of laboratories holding WPV decreased over this time until only 45 laboratories in four countries were in 2008.

To access the full article in web-text (HTML) format, go to:
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