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IAC Express 2010 |
| Issue number 866: May 10, 2010 |
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Contents
of this Issue
Select a title to jump to the article. |
- CDC
publishes recommendations for use of combination
measles, mumps, rubella, and varicella (MMRV) vaccine
- VIS for PCV7 vaccine is temporarily re-posted on CDC's
and IAC's websites
- CDC
announces Hepatitis Awareness Month
- CDC reports on the results of California's Adult
Hepatitis Vaccine Project during 2007-08
- CDC reports on U.S. rotavirus vaccination coverage among
infants age 5 months during June 2006-June 2009
- Five more healthcare organizations join IAC'S Honor Roll
for Patient Safety
- Video presents a mother's account of the devastating
effects pneumococcal disease had on her children
- IAC updates the popular print piece "Are you 11-19 years
old?" and two other print pieces
- IAC updates its two standing orders for administering
hepatitis A vaccine
- IAC updates online "Ask the Experts" Q&A section related
to rotavirus vaccine
- CDC reports on U.S. trends in hepatocellular carcinoma
incidence during 2001-06
- Turkish translations available for IAC's parent-education
piece on hepatitis B vaccination and VIS for PCV13
vaccine
- MMWR corrects errors in "Human Rabies--Kentucky/Indiana, 2009," which was published April 9, 2010
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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 866: May 10, 2010 |
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1. |
CDC publishes recommendations for use of combination measles, mumps, rubella,
and varicella (MMRV) vaccine
CDC published "Use of Measles, Mumps, Rubella,
and Varicella
Vaccine: Recommendations of the Advisory Committee on
Immunization Practices (ACIP)" in the May 7 MMWR
Recommendations and Reports. The Summary section is
reprinted below in its entirety.
This report presents new recommendations adopted in June
2009 by CDC's Advisory Committee on Immunization Practices
(ACIP) regarding use of the combination measles, mumps,
rubella, and varicella vaccine (MMRV, ProQuad, Merck & Co.,
Inc.). MMRV vaccine was licensed in the United States in
September 2005 and may be used instead of measles, mumps,
rubella vaccine (MMR, M-M-RII, Merck & Co., Inc.) and
varicella vaccine (VARIVAX, Merck & Co., Inc.) to implement
the recommended 2-dose vaccine schedule for prevention of
measles, mumps, rubella, and varicella among children aged
12 months-12 years. At the time of its licensure, use of
MMRV vaccine was preferred for both the first and second
doses over separate injections of equivalent component
vaccines (MMR vaccine and varicella vaccine), which was
consistent with ACIP's 2006 general recommendations on use
of combination vaccines (CDC. General recommendations on
immunization: recommendations of the Advisory Committee on
Immunization Practices [ACIP]. MMWR 2006;55;[No. RR-15]).
Since July 2007, supplies of MMRV vaccine have been
temporarily unavailable as a result of manufacturing
constraints unrelated to efficacy or safety. MMRV vaccine is
expected to be available again in the United States in May
2010.
In February 2008, on the basis of preliminary data from two
studies conducted postlicensure that suggested an increased
risk for febrile seizures 5-12 days after vaccination among
children aged 12-23 months who had received the first dose
of MMRV vaccine compared with children the same age who had
received the first dose of MMR vaccine and varicella vaccine
administered as separate injections at the same visit, ACIP
issued updated recommendations regarding MMRV vaccine use
(CDC. Update: recommendations from the Advisory Committee on
Immunization Practices [ACIP] regarding administration of
combination MMRV vaccine. MMWR 2008;57:258-60). These
updated recommendations expressed no preference for use of
MMRV vaccine over separate injections of equivalent
component vaccines for both the first and second doses.
The final results of the two postlicensure studies indicated
that among children aged 12-23 months, one additional
febrile seizure occurred 5-12 days after vaccination per
2,300-2,600 children who had received the first dose of MMRV
vaccine compared with children who had received the first
dose of MMR vaccine and varicella vaccine administered as
separate injections at the same visit. Data from
postlicensure studies do not suggest that children aged 4-6
years who received the second dose of MMRV vaccine had an
increased risk for febrile seizures after vaccination
compared with children the same age who received MMR vaccine
and varicella vaccine administered as separate injections at
the same visit.
In June 2009, after consideration of the postlicensure data
and other evidence, ACIP adopted new recommendations
regarding use of MMRV vaccine for the first and second doses
and identified a personal or family (i.e., sibling or
parent) history of seizure as a precaution for use of MMRV
vaccine. For the first dose of measles, mumps, rubella, and
varicella vaccines at age 12-47 months, either MMR vaccine
and varicella vaccine or MMRV vaccine may be used. Providers
who are considering administering MMRV vaccine should
discuss the benefits and risks of both vaccination options
with the parents or caregivers. Unless the parent or
caregiver expresses a preference for MMRV vaccine, CDC
recommends that MMR vaccine and varicella vaccine should be
administered for the first dose in this age group. For the
second dose of measles, mumps, rubella, and varicella
vaccines at any age (15 months-12 years) and for the first
dose at age >=48 months, use of MMRV vaccine generally is
preferred over separate injections of its equivalent
component vaccines (i.e., MMR vaccine and varicella
vaccine). This recommendation is consistent with ACIP's 2009
provisional general recommendations regarding use of
combination vaccines (available at
http://www.cdc.gov/vaccines/recs/provisional/downloads/combo-vax-Aug2009-508.pdf),
which state that use of a combination vaccine generally is
preferred over its equivalent component vaccines.
To access a ready-to-print (PDF) version of the
recommendations, go to:
http://www.cdc.gov/mmwr/pdf/rr/rr5903.pdf
To access the recommendations in web-text (HTML) format, go
to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5903a1.htm
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2. |
VIS for PCV7 vaccine is temporarily re-posted on CDC's and IAC's websites
On May 5, CDC's "News about Vaccine Information
Statements"
web section was updated with this announcement: "PCV7 VIS
available temporarily. Due to a groundswell of popular
demand, we have re-posted the PCV7 VIS for use by those
providers who have not completed the transition to PCV13. It
will be available as long as PCV7 supplies are being used.
Please use the VIS appropriate to the formulation being
administered. Both VISs can be downloaded from the
Pneumococcal Conjugate section of CDC's VIS webpage."
IMPORTANT NOTE: IAC also has re-posted the VIS for PCV7
vaccine to its website.
To access the VIS for PCV7 vaccine, go to:
http://www.immunize.org/vis/vis_pcv7.pdf
To access the VIS for PCV13 vaccine, go to:
http://www.immunize.org/vis/vis-pcv.pdf
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3. |
CDC announces Hepatitis Awareness Month
CDC published "Hepatitis Awareness Month--May
2010" in the
May 7 issue of MMWR. It is reprinted below.
May 2010 marks the 15th anniversary of Hepatitis Awareness
Month in the United States, and May 19 is World Hepatitis
Day. Globally, viral hepatitis is the cause of most (78%)
primary liver cancer, the third leading cause of cancer
deaths in the world. Prevention of hepatitis B and hepatitis
C virus transmission and treatment for early disease can
prevent primary liver cancer. This issue of MMWR includes a
report describing vaccination of at-risk adults with
hepatitis B vaccine in California and a report on continued
increases in hepatocellular carcinoma incidence in the
United States.
The Institute of Medicine (IOM) recently issued Hepatitis
and Liver Cancer: A National Strategy for Prevention and
Control of Hepatitis B and Hepatitis C. The IOM strategy has
four components: (1) accurate public health surveillance,
(2) innovative approaches to community education, (3)
immunization capacity to eliminate hepatitis B virus
transmission, and (4) development of viral hepatitis
services, including screening with referral for medical
management. Taken together, these strategies can reduce
morbidity associated with viral hepatitis, including primary
liver cancer.
Additional information about viral hepatitis is available at
http://www.cdc.gov/hepatitis The IOM report is available at
http://www.iom.edu Information about World Hepatitis Day
activities is available at http://www.nvhr.org
To access the announcement in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5917a1.htm
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4. |
CDC reports on the results of California's Adult Hepatitis Vaccine Project
during 2007-08
CDC published " The Adult Hepatitis Vaccine
Project--California, 2007-2008 " in the May 7 issue of MMWR. The
first paragraph is reprinted below.
Since hepatitis B vaccine was first released in 1981, a
public health goal has been to vaccinate adults at risk for
infection because of risky sexual behaviors and needle-sharing practices. However, vaccination coverage for this
group has remained low. During 2007, in the United States,
among the estimated 43,000 persons newly infected with
hepatitis B virus (HBV), the highest rate was reported among
persons aged 25-44 years, and the majority of these
infections were among at-risk adults. Surveillance data were
similar in California. In 2006, when the Advisory Committee
on Immunization Practices (ACIP) recommended that hepatitis
B vaccination be offered to all adults as part of routine
prevention services in settings where a high proportion of
those served are at increased risk, CDC launched a national
initiative encouraging states to use existing federal funds
to purchase adult hepatitis B-containing (HepB) vaccine. In
response, the California Department of Public Health (CDPH)
established the Adult Hepatitis Vaccine Project (AHVP) to
expand hepatitis B vaccination in sites serving at-risk
adults. This report summarizes results for 2007-2008, which
indicated that 28,824 doses of HepB vaccine were
administered at 29 participating sites in the first 19
months of AHVP; 13 sites administered HepB vaccine for the
first time. Federal provision of vaccine resulted in
vaccination of many adults who otherwise might not have been
vaccinated against HBV. Increased capacity to vaccinate all
adults at risk is needed for the elimination of HBV
transmission in the United States.
To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5917a2.htm
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5. |
CDC reports on U.S. rotavirus vaccination coverage among infants age 5 months
during June 2006-June 2009
CDC published "Rotavirus Vaccination Coverage
Among Infants
Aged 5 Months--Immunization Information System Sentinel
Sites, United States, June 2006-June 2009" in the May 7
issue of MMWR. The first paragraph is reprinted below.
In February 2006, the Advisory Committee on Immunization
Practices (ACIP) recommended routine vaccination of all U.S.
infants with 3 doses of a pentavalent rotavirus vaccine
administered at ages 2, 4, and 6 months. In June 2008, ACIP
updated its recommendations to include use of a second
rotavirus vaccine, a 2-dose monovalent vaccine, administered
at ages 2 and 4 months. The maximum age for the first dose
of either rotavirus vaccine (RV) is 14 weeks and 6 days. CDC
recently analyzed data from Immunization Information System
(IIS) sentinel sites (1) to assess trends in coverage with
>=1 dose of RV during June 2006-June 2009 among infants aged
5 months and (2) to compare RV coverage in the second
quarter of 2009 with that of two other routinely recommended
vaccines for U.S. infants: diphtheria, tetanus, and
acellular pertussis (DTaP) vaccine, and 7-valent
pneumococcal conjugate vaccine (PCV7). RV coverage increased
following vaccine introduction and, in June 2009, averaged
72% at the eight currently participating IIS sentinel sites.
However, >=1 dose RV coverage among infants aged 5 months
was 13% lower than the average coverage with >=1 dose of
DTaP and PCV7 at these same sites. Lower RV coverage could
reflect typical new-vaccine coverage dynamics, the presence
of RV-specific barriers, or both. Identifying and reducing
barriers to vaccination and educating parents and providers
about the health benefits of rotavirus vaccination should
increase coverage and help prevent severe rotavirus disease.
To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5917a4.htm
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6. |
Five more healthcare organizations join IAC'S Honor Roll for Patient Safety
IAC encourages qualifying healthcare
organizations to apply
for its Honor Roll for Patient Safety. Since April 19, when
IAC Express last reported on the Honor Roll for Patient
Safety, one public health department (and its associated
facilities) and four institutions have enrolled. The honor
roll recognizes hospitals, medical practices, professional
organizations, and government entities that have taken a
stand for patient safety by strengthening mandatory
influenza vaccination policies for healthcare workers.
The public health department that has joined since April 19
is Cook County Health & Hospitals System, Oak Park, IL; the
institutions are Altru Health, Grand Forks, ND; Davidson
HealthCare, Lexington, NC; Emory Healthcare, Atlanta, GA;
and Waverly Health, Waverly, IA. The addition of these five
organizations brings the total number of enrolled
institutions and medical practices to 54.
To be included in the honor roll, an organization's mandate
must require influenza vaccination for employees and must
include serious measures to prevent transmission of
influenza from unvaccinated workers to patients. Such
measures might include a mask requirement, reassignment to
non-patient-care duties, or dismissal of the employee.
To find out specific information on the mandates of the
enrolled organizations, go to: http://www.immunize.org/honor-roll This web page also
includes information about applying to be included on the
honor roll.
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7. |
Video presents a mother's account of the devastating effects pneumococcal
disease had on her children
IAC encourages IAC Express readers to watch a
4-minute video
developed by PKIDs. It features a mother recounting her
daughter's death from pneumococcal disease and her son's
hospitalization with the same disease.
The video will be available on the home page of IAC's
website through May 16. To access it, go to:
http://www.immunize.org and click on the image under the
words Video of the Week.
Material from the video is available in 30- and 60-second
video and audio public service announcements (PSAs). To
access the PSAs, go to: http://www.pkids.org/im_videos_pneumo.php
A 2-page transcript is available at
http://pkids.org/transcripts/Pneumococcal%20Disease.pdf
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
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8. |
IAC
updates the popular print piece "Are you 11-19 years old?" and two other print
pieces
IAC recently revised the following three print
resources.
(1) "Are you 11-19 years old? Then you need to be vaccinated
against these serious diseases!" was recently updated to
include new recommendations related to human papillomavirus
(HPV) vaccine and influenza vaccine.
To access the revised ready-to-print (PDF) piece "Are you
11-19 years old?" go to:
http://www.immunize.org/catg.d/p4020.pdf
(2) "Supplies You May Need at a Community Adult Immunization
Clinic" (formerly titled "Suggested Supplies Checklist for
an Adult Immunization Clinic") was reorganized, and minor
content changes were made.
To access the revised "Supplies You May Need at a Community
Adult Immunization Clinic," go to:
http://www.immunize.org/catg.d/p3047.pdf
(3) "Supplies You May Need at a Community Immunization
Clinic" (formerly titled "Suggested Supplies Checklist for a
Pediatric and Adult Immunization Clinic") was reorganized,
and minor content changes were made.
To access the revised "Supplies You May Need at a Community
Immunization Clinic," go to:
http://www.immunize.org/catg.d/p3046.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
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9. |
IAC
updates its two standing orders for administering hepatitis A vaccine
IAC recently revised its "Standing Orders for
Administering
Hepatitis A Vaccine to Children & Teens" and "Standing
Orders for Administering Hepatitis A Vaccine to Adults."
Both were updated to include new recommendations related to
the need for vaccinating contacts of certain international
adoptees and the need to consider pregnancy as a precaution
for vaccination.
To access the revised ready-to-print (PDF) piece "Standing
Orders for Administering Hepatitis A Vaccine to Children &
Teens," go to: http://www.immunize.org/catg.d/p3077a.pdf
To access the revised ready-to-print (PDF) piece "Standing
Orders for Administering Hepatitis A Vaccine to Adults," go
to: http://www.immunize.org/catg.d/p3077.pdf
To access a table with links to all IAC's standing orders
protocols for vaccine administration and medical management
of vaccine reactions, as well as standing orders for
newborn-nursery hepatitis B vaccination, go to:
http://www.immunize.org/standingorders
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10. |
IAC updates online "Ask the Experts" Q&A section related to rotavirus vaccine
IAC's online "Ask the Experts" Q&A section about
rotavirus
vaccine was recently updated with input from vaccination
experts at CDC. IAC's "Ask the Experts" Q&As are reviewed
and updated annually. The process is ongoing; IAC Express
will inform readers as sections are reviewed and revised.
To access the revised rotavirus Q&As, go to:
http://www.immunize.org/askexperts/experts_rota.asp
To access the index page of "Ask the Experts" Q&As for all
other vaccines, go to: http://www.immunize.org/askexperts
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11. |
CDC reports on U.S. trends in hepatocellular carcinoma incidence during
2001-06
CDC published "Hepatocellular Carcinoma--United
States,
2001-2006" in the May 7 issue of MMWR. The first paragraph
is reprinted below.
Liver cancer, primarily hepatocellular carcinoma (HCC), is
the third leading cause of death from cancer worldwide and
the ninth leading cause of cancer deaths in the United
States. Chronic hepatitis B virus (HBV) and hepatitis C
virus (HCV) infections account for an estimated 78% of
global HCC cases. To determine trends in HCC incidence in
the United States, CDC analyzed data for the period 2001-2006 (the most recent data available) from CDC's National
Program of Cancer Registries (NPCR) and the National Cancer
Institute's Surveillance, Epidemiology, and End Results
(SEER) surveillance system. This report summarizes the
results of that analysis, which determined that the average
annual incidence rate of HCC for 2001-2006 was 3.0 per
100,000 persons and increased significantly from 2.7 per
100,000 persons in 2001 to 3.2 in 2006, with an average
annual percentage change in incidence rate (APC) of 3.5%.
The largest increases in HCC incidence rates were among
whites (APC = 3.8), blacks (APC = 4.8), and persons aged 50-59 years (APC = 9.1). Among states, HCC incidence rates
varied widely, ranging from 1.4 per 100,000 in South Dakota
to 5.5 in Hawaii. The results demonstrate a continuation of
long-term increases in HCC incidence and persistent HCC
racial/ethnic disparities. Development of viral hepatitis
services, including screening with care referral for persons
chronically infected with HBV or HCV, full implementation of
vaccine-based strategies to eliminate hepatitis B, and
improved public health surveillance are needed to help
reverse the trend in HCC.
To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5917a3.htm
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12. |
Turkish translations available for IAC's parent-education piece on hepatitis
B vaccination and VIS for PCV13 vaccine
Updated in March 2010, IAC's parent-education
piece
"Hepatitis B shots are recommended for all new babies" is
now available in Turkish, as is the VIS for pneumococcal
conjugate vaccine (PCV13), which is dated 4/16/10. IAC
gratefully acknowledges Dr. Mustafa Kozanoglu for the
translations.
To access the Turkish version of "Hepatitis B shots are
recommended for all new babies," go to:
http://www.immunize.org/catg.d/p4110-21.pdf
To access the English version of "Hepatitis B shots are
recommended for all new babies", go to:
http://www.immunize.org/catg.d/p4110.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
To access the Turkish translation of the VIS for PCV 13
vaccine, as well as this VIS in English, go to:
http://www.immunize.org/vis/vis_pcv.asp Click on the
pertinent languages.
For information about the use of VISs, and for VISs in more
than 35 languages, visit IAC's VIS web section at
http://www.immunize.org/vis
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13. |
MMWR corrects errors in "Human Rabies--Kentucky/Indiana, 2009," which was
published April 9, 2010
CDC published " Errata: Vol. 59, No. 13" in the
May 7 issue
of MMWR. It is reprinted below.
In the report "Human Rabies--Kentucky/Indiana, 2009," an
error occurred in the third sentence of the fourth paragraph
on page 395. The sentence should read, "Ample use of a 10%
solution of bleach for disinfection is recommended both
during and after the procedure to ensure decontamination of
all exposed surfaces and equipment." In addition, the fifth
bulleted item in the box on page 396 should read, "Use ample
amounts of a 10% solution of bleach during and after the
procedure to ensure decontamination of all exposed surfaces
and equipment."
To access errata in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5917a8.htm
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