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IAC Express 2010 |
| Issue number 881: August 9, 2010 |
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Contents
of this Issue
Select a title to jump to the article. |
- ACIP
makes recommendations for use of CSL's Afluria seasonal influenza vaccine
during 2010-11
- CDC
Health Advisory Network notifies providers about seasonal influenza A
(H3N2) virus infections
- CDC
publishes ACIP influenza recommendations in MMWR Recommendations and
Reports
- CDC
updates information on supply of Hib and hepatitis B vaccines
- IAC
updates screening questionnaires and standing orders for seasonal
influenza vaccination
- CDC
Health Advisory Network notifies providers about shortened shelf life of
sanofi pasteur's H1N1 2009 monovalent influenza vaccine in multi-dose
vials
- IAC's
Video of the Week features an original song about vaccination
- IAC
updates "Pneumococcus: Questions and Answers"
- "CDC
Features" educates the public about shingles vaccination
- Texas
Immunization Summit scheduled for September 30-October 1 in Fort Worth
-
Hepatitis Foundation International summits to be held in four locations
this fall
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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 881: August 9, 2010 |
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1. |
ACIP makes recommendations for use of CSL's Afluria seasonal influenza
vaccine during 2010-11
On August 6, CDC issued a media statement titled
"ACIP
Recommendation for Use of CSL Influenza Vaccine." Portions
of the statement are reprinted below. At the end of this IAC
Express article, you will find links to the complete
statement, as well as to a Q&A on CSL vaccine safety and to
a table of influenza vaccines recommended for use in the
United States during the 2010-11 influenza season.
Background
On Thursday, August 5, 2010, CDC's Advisory Committee on
Immunization Practices (ACIP) met to discuss recommendations
for use in the United States of seasonal influenza trivalent
inactivated vaccine (TIV) [Afluria] manufactured by CSL
Limited during 2010-11. . . .
Recommendation
Based upon the data to date suggesting an increased risk of
febrile seizures in children aged 6 months through 4 years
following 2010 Fluvax or Fluvax Jr, and a higher frequency
of reported fever in children aged 5 years through 8 years
following Fluvax compared to previous seasons; and based on
a higher frequency of fever in children aged 5 years through
8 years following Afluria in one clinical trial in 2009,
ACIP recommends that for the 2010-11 influenza season in the
United States:
- Afluria should not be used in children aged 6 months
through 8 years.
- Other age-appropriate, licensed seasonal influenza vaccine
formulations should be used for prevention of influenza in
children aged 6 months through 8 years.
- If no other age-appropriate, licensed seasonal influenza
vaccine is available for a child aged 5 years through 8
years old who has a medical condition that increases their
risk for influenza complications, Afluria may be given, and
providers should discuss the benefits and risks of influenza
vaccination with the parents or caregivers before
administering Afluria.
There are two types of seasonal influenza vaccines for
children: the trivalent inactivated vaccine (TIV) (the flu
shot) and the live attenuated vaccine (nasal spray). . . .
[IAC Express editor's note: Because of formatting
difficulties, IAC Express cannot reproduce the table that
appeared in the media statement.]
To access the complete media statement about the ACIP
recommendations, go to:
http://www.cdc.gov/media/pressrel/2010/s100806.htm
To access the Q&A titled "CSL Seasonal Influenza Vaccine
Safety in the United States," go to:
http://www.cdc.gov/flu/protect/vaccine/qa_cslfluvac.htm
To access a newly posted table titled "Recommended Influenza
Vaccines for the U.S. 2010-11 Season," go to:
http://www.cdc.gov/flu/protect/vaccine/vaccines.htm
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2. |
CDC Health Advisory Network notifies providers about seasonal influenza A
(H3N2) virus infections
On August 5, CDC issued a Health Advisory titled
"Seasonal
Influenza A (H3N2) Virus Infections." Excerpts of the
advisory are reprinted below.
SUMMARY
Influenza A (H3N2) virus infections have been recently
detected in people in a number of states across the U.S.,
including two small localized outbreaks. Sporadic cases of
influenza and localized summer outbreaks from seasonal
influenza viruses are detected each summer. Clinicians are
reminded to consider influenza as a possible diagnosis when
evaluating patients with acute respiratory illnesses,
including pneumonia, even during the summer months.
Treatment decisions should not be made on the basis of a
negative rapid influenza diagnostic test result since the
test has only moderate sensitivity. False positive results
also can occur, particularly at times when overall influenza
prevalence is low. For patients for whom laboratory
confirmation is desired, or to confirm initial influenza
cases in a community in which cases have been tested by
rapid influenza diagnostic tests, it is recommended that
reverse transcriptase-polymerase chain reaction (RT-PCR),
and/or viral culture is utilized. Clinicians should use
empirical treatment with influenza antiviral medications for
persons hospitalized with suspected influenza, and for
suspected influenza infection of any severity in high-risk
individuals, regardless of influenza immunization status.
Early initiation of treatment provides more optimal clinical
responses, although treatment of moderate, severe, or
progressive disease begun after 48 hours of symptoms can
still provide benefit. . . .
RECOMMENDATIONS
Healthcare providers are reminded to consider influenza as a
possible diagnosis when evaluating patients with acute
respiratory illnesses, including pneumonia, even during the
summer months. The neuraminidase inhibitors oseltamivir
(Tamiflu) and zanamivir (Relenza) are currently recommended
for use against circulating influenza viruses. The
adamantanes (amantadine and rimantadine) are not recommended
because of high levels of resistance to these drugs among
recently circulating influenza A (H3) and 2009 H1N1 pandemic
viruses.
Clinical judgment is an important factor in treatment
decisions for patients presenting with influenza-like
illness. Prompt empiric antiviral treatment with influenza
antiviral medications is recommended while results of
definitive diagnostic tests are pending, or if diagnostic
testing is not possible, for patients with clinically
suspected influenza illness who have:
- Illness requiring hospitalization,
- Progressive, severe, or complicated illness, regardless of
previous health status, and/or
- Patients at increased risk for severe disease.
Persons at high risk of influenza complications include
people aged 65 years and older, young children, pregnant
women, people with long-term health conditions like asthma,
diabetes, neurologic and neuro-developmental disorders,
heart disease, and people with immunosuppressive conditions
or medications.
Antiviral treatment, when clinically indicated, should not
be delayed pending definitive laboratory confirmation of
influenza. Influenza antiviral medications are most
effective when initiated within the first 2 days of illness,
but these medications may also provide benefits for severely
ill patients when initiated even after 2 days. Point of care
rapid tests capable of detecting influenza A and B virus
infections are available, but healthcare providers and
public health personnel should be aware that rapid influenza
diagnostic tests have limited sensitivity and false negative
results are common. Thus, negative results from rapid
influenza diagnostic test should not be used to guide
decisions regarding treating patients with influenza
antiviral medications. In addition, false positive tests can
occur and are more likely when influenza is rare in the
community. When laboratory confirmation is desired, testing
by RT-PCR and/or viral culture is recommended.
Providers are asked to report unusual increases in febrile
respiratory disease outbreaks to their local and state
health departments and to confirm positive rapid test
results with PCR or culture when community circulation of
influenza viruses is low.
FOR MORE INFORMATION
More information on influenza prevention, diagnosis and
treatment can be found at http://www.cdc.gov/flu Beginning
this influenza season, the Advisory Committee on
Immunization Practices (ACIP) recommends influenza
vaccination of all persons 6 months of age and older. These
updated recommendations can be found at
http://www.cdc.gov/mmwr/pdf/rr/rr5908.pdf
To access the complete text of the CDC Health Advisory, go
to: http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00316
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3. |
CDC publishes ACIP influenza recommendations in MMWR Recommendations and
Reports
CDC published "Prevention and Control of
Influenza with
Vaccines: Recommendations of the Advisory Committee on
Immunization Practices (ACIP), 2010" in the August 6 issue
of MMWR. This report was previously published as an MMWR
Early Release on July 29, and was previously covered in IAC
Express on August 2.
To access the recommendations, go to:
http://www.cdc.gov/mmwr/pdf/rr/rr5908.pdf
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4. |
CDC updates information on supply of Hib and hepatitis B vaccines
On August 3, CDC posted updated information about
the
availability of Hib and adult hepatitis B vaccines and their
combination products. The information is reprinted below.
Hib: Effective July 1, 2009, CDC, in consultation with ACIP,
AAFP, and AAP, recommended reinstatement of the booster dose
of Hib vaccine for children aged 12 through 15 months who
have completed the primary 3-dose series. Based on available
supply, providers are now recommended to recall children in
need of a booster dose. Currently available Hib vaccine
products include monovalent Hib vaccines from GSK (Hiberix,
licensed for use as the booster dose only); Merck
(PedvaxHIB); and sanofi pasteur (ActHIB). Currently
available Hib-containing combination vaccines include sanofi
pasteur's Pentacel (DTaP-IPV/Hib) and Merck's Comvax (Hep B-Hib). The combination product from sanofi pasteur (DTaP-Hib, TriHIBit) is currently not available.
Hepatitis B: As of August 2, 2010, Merck's dialysis
formulation of their hepatitis B vaccine (Recombivax) is now
available. Production and supply of GSK's adult hepatitis B
vaccine (Adult Engerix-B) and Adult hepatitis A/hepatitis B
combination vaccine (Twinrix) currently are sufficient to
meet demand for routine adult usage of this vaccine as well
as CDC's ongoing High Risk Adult Hepatitis B Initiative.
For continuing vaccine supply information, go to:
http://www.cdc.gov/vaccines/vac-gen/shortages
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5. |
IAC updates screening questionnaires and standing orders for seasonal
influenza vaccination
IAC recently revised the following four handouts
for
healthcare professionals to use during the 2010-11 influenza
season.
(1) IAC made minor edits to "Screening Questionnaire for
Inactivated Injectable Influenza Vaccination."
Go to: http://www.immunize.org/catg.d/p4066.pdf
(2) IAC added one question to "Screening Questionnaire for
Live Attenuated Intranasal Influenza Vaccination" and made
other minor edits.
Go to: http://www.immunize.org/catg.d/p4067.pdf
(3) IAC updated "Standing Orders for Administering Seasonal
Influenza Vaccine to Adults" to take into account the ACIP
recommendation to vaccinate all people age 6 months and
older.
Go to: http://www.immunize.org/catg.d/p3074.pdf
(4) IAC updated "Standing Orders for Administering Seasonal
Influenza Vaccines to Children & Adolescents" to take into
account the ACIP recommendation to vaccinate all people age
6 months and older.
Go to: http://www.immunize.org/catg.d/p3074a.pdf
Standing orders for all other routinely administered
vaccines are available at http://www.immunize.org/standing-orders
IAC's Handouts for Patients and Staff web section offers
healthcare professionals and the public approximately 250
FREE English-language handouts (many also available in
translation), which we encourage website users to print out,
copy, and distribute widely. To access all of IAC's free
handouts, go to: http://www.immunize.org/handouts
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6. |
CDC Health Advisory Network notifies providers about shortened shelf life of
sanofi pasteur's H1N1 2009 monovalent influenza vaccine in multi-dose vials
On August 6, CDC issued a Health Advisory titled
"Sanofi
pasteur Influenza A (H1N1) 2009 Monovalent Vaccine in Multi-Dose Vials--Shortened Shelf Life." Excerpts from the
advisory are reprinted below.
SUMMARY
Sanofi pasteur has notified CDC and FDA that their influenza
A (H1N1) 2009 monovalent vaccine manufactured in 2009 in
multi-dose vials will have a shorter expiration period than
indicated on the label, and they will provide more specific
notification of which lots will be affected and the new
expiration date in the very near future. This is to ensure
that the vaccine is used while it remains within its potency
specification. There are no safety concerns with these lots
of 2009 H1N1 vaccine. People who were immunized with sanofi
pasteur influenza A (H1N1) 2009 monovalent vaccine from
multi-dose vials do not need to take any action.
2009 H1N1 viruses, along with influenza A H3N2 viruses and
influenza B viruses are circulating internationally. While
it cannot be known in advance which influenza viruses will
predominate in any given year, the 2009 H1N1 virus, along
with influenza A H3N2 viruses and influenza B viruses may
circulate in the United States during its upcoming influenza
season. The 2010-2011 influenza vaccine will protect against
an influenza A H3N2 virus, an influenza B virus, and the
2009 H1N1 virus. Initial shipping of the 2010-2011 influenza
vaccine has begun.
BACKGROUND
. . . Sanofi pasteur influenza A (H1N1) 2009 monovalent
vaccine in multi-dose vials is the only remaining
presentation of monovalent 2009 H1N1 influenza vaccine whose
expiration date has not yet passed.
Sanofi pasteur will send a notification to providers who
received this product regarding the specific lot numbers and
the new expiration date.
FOR MORE INFORMATION
For Questions and Answers on Using Monovalent 2009 Influenza
A (H1N1) Vaccine Prior to the Availability of Trivalent
2010-11 Seasonal Influenza Vaccine, go to:
http://www.cdc.gov/flu/about/qa/infohealthcare.htm
Questions about the Federal H1N1 Influenza Vaccine Central
Recovery Program should be directed to state immunization
programs or the HHS Supply Service center (1-800-642-0263,
7:00 am to 7:00 pm EST).
For other inquiries, please contact sanofi pasteur Customer
Services:
1-800-VACCINE (1-800-822-2463) or visit:
http://www.vaccineshoppe.com
To access the complete text of the CDC Health Advisory
online, go to:
http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00317
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7. |
IAC's Video of the Week features an original song about vaccination
IAC encourages IAC Express readers to watch a
3.5-minute
video titled "The Vaccine Song," created by Brain Warm-Ups
Entertainment (http://brainwarmups.com). This original musical
number teaches viewers about the importance of vaccination
and counters anti-vaccine arguments, all in an entertaining
manner.
The video will be available on the home page of IAC's
website through August 15. To access it, go to:
http://www.immunize.org and click on the image under the
words Video of the Week. After this date, the video will
continue to be available at http://thevaccinesong.org
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 "Pneumococcus: Questions and Answers"
IAC recently revised "Pneumococcus: Questions and
Answers,"
a resource for both healthcare professionals and their
patients. The piece was updated to take into account the
licensure of PCV13 vaccine.Go to:
http://www.immunize.org/catg.d/p4213.pdf
To access a table with links to IAC's Q&A handouts for each
vaccine, go to:
http://www.immunize.org/handouts/vaccine-questions.asp
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9. |
"CDC
Features" educates the public about shingles vaccination
The "CDC Features" web section includes new
information for
the public about preventing shingles with vaccination.
To access "Protect Yourself against Shingles: Get
Vaccinated," go to: http://www.cdc.gov/Features/Shingles
To access an alphabetical index of all "CDC Features," go
to: http://www.cdc.gov/az
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10. |
Texas Immunization Summit scheduled for September 30-October 1 in Fort Worth
The 2010 Texas Immunization Summit is scheduled
for
September 30-October 1, in Fort Worth. The summit will bring
together stakeholders from all over the state, including
physicians, nurses, and public health officials.
For more information, go to: http://www.immunizeusa.org
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11. |
Hepatitis Foundation International summits to be held in four locations this
fall
Hepatitis Foundation International will host four
viral
hepatitis summits this fall, beginning September 10 in
Atlanta. Subsequent programs will be held in New Orleans,
Indianapolis, and Richmond. For more information, go to:
http://www.hepfi.org/summit%20page/index-summit.htm
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