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Immunization Works! February 2008 issue
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The Centers for Disease Control and Prevention’s Immunization Works Monthly Update is provided to national health care provider and consumer groups for distribution to their members and constituencies. The immunization information provided is non-proprietary and is encouraged to be widely disseminated and shared.
Seasonal Influenza Update
Note: because of the recent increase in influenza activity, this edition of Immunization Update contains a special section devoted to seasonal influenza.
Influenza Activity:
From September through early December, influenza activity remained low in the United States. Activity increased from early December through the end of the year and has continued to increase in January and February. For the week ending February 9, a total of 49 states reported either widespread or regional activity. During the most recent three influenza seasons (2004-05, 2005-06, and 2006-07), the number of states reporting regional or widespread activity peaked at 41-48 states. Ten child death from laboratory confirmed influenza-complications have now been officially reported to CDC for the 2007-08 flu season. Tragically, every year in the United States, some children die of complications from influenza infection. During the past four years that CDC has tracked deaths among children with influenza infections, the number of deaths reported to CDC each year has ranged from 44 to 153 deaths. Since influenza activity typically peaks in February or March, it is too early to predict the severity of the current flu season compared to other years. However, the latest surveillance information about influenza activity is posted weekly at CDC’s Flu Activity & Surveillance Website. In addition, CDC has published an Early Release Article in its Morbidity and Mortality Weekly Report concerning seasonal flu activity.
Vaccine Effectiveness:
Surveillance information indicates that H3N2 viruses are currently the virus that are circulating most widely in the United States, and the majority of these are not optimally matched to the strains represented in the vaccine. Influenza viruses are constantly changing so it's common for new strains of influenza viruses to appear each year. The effectiveness of the vaccine depends in part on the match between the viruses in the vaccine and influenza viruses that are circulating in the community. If these are closely matched, vaccine effectiveness is higher. If they are not closely matched, vaccine effectiveness can be reduced. However, even when the viruses are not closely matched, the vaccine can still protect many people and prevent flu-related complications. Such protection is possible because antibodies made in response to the vaccine can provide some protection (called cross-protection) against different, but related strains of influenza viruses. Vaccination remains the best method for preventing influenza and its potentially severe complications in children and adults even in years where there is a suboptimal match between vaccine and circulating strains of influenza viruses. CDC will continue to study this season’s vaccine’s effectiveness and will make more information available in the coming weeks. For more information about the effectiveness of seasonal influenza vaccine, see CDC’s fact sheet, How Well Does the Seasonal Flu Vaccine Work?
New Influenza Resources:
CDC has recently added many more influenza resources for the public, health care providers, and the media. To support partners’ continuing efforts to prevent influenza this season, CDC has developed the "Take 3" Campaign with information and materials on vaccination, hand hygiene and cough etiquette, and the appropriate use of antiviral drugs. CDC's Newly Revised Flu Website features the “Take 3” campaign, as well as supplemental materials free for download. Additional flu messages and materials can be found on CDC’s Late Season Vaccination Activities Website. Also, transcripts from recent CDC press calls about seasonal influenza are available at CDC's Transcripts Website.
Front Page News
Regional Meetings for Healthy People 2020:
A series of Healthy People 2020 Regional Meetings (exit), is planned this spring so partners can help to establish a framework to address risk factors and determinants of health and the diseases and disorders that affect communities. There is no fee for registration, but pre-registration (exit), is required.
Since 1979, Healthy People has set and monitored national health objectives to meet a broad range of health needs, encourage collaborations across sectors, guide individuals toward making informed health decisions, and measure the impact of our prevention activity. Healthy People 2020 (exit), will reflect assessments of major risks to health and wellness, changing public health priorities, and emerging technologies related to our nation's health preparedness and prevention. Public participation will shape Healthy People 2020; its purpose, goals, organization, and action plans. HHS will seek input from communities and stakeholders across the nation through public meetings and public comment periods. As a national initiative, Healthy People's success depends on a coordinated commitment to improve the health of the nation.
Other News & Summaries
New Guidance for Presenting Economic Studies to ACIP:
The Advisory Committee on Immunization Practices (ACIP) now states in its charter that committee deliberations on the appropriate use of vaccines should include consideration of population-based studies such as efficacy, cost-benefit, and risk-benefit analyses. As the number and cost of vaccines have increased, economic analyses have become an essential aspect of the development of policy recommendations for their use. To ensure that economic data presented to the ACIP and its working groups are of the highest scientific quality, readily understandable, and uniform in presentation, CDC economists have developed mandatory procedures to be followed for any economic analysis to be presented to the ACIP. Guidance for Health Economics Studies Presented to the ACIP was approved by ACIP on June 27, 2007. The new procedures will be effective as of the ACIP meeting, June 25--26, 2008.
Hepatitis A Vaccine Delays:
Merck & Co., Inc. are experiencing production delays for Pediatric and Adult hepatitis A vaccine (Pediatric & Adult VAQTA®). Merck has temporarily discontinued accepting orders for Pediatric VAQTA® and Adult VAQTA® in the vial formulation. Based on current information, it is estimated that VAQTA® will be available in early third quarter 2008 and Adult VAQTA® in fourth quarter 2008. GSK production and supply of their Pediatric and Adult hepatitis A vaccine (Pediatric & Adult Havrix®) and their Adult hepatitis A/hepatitis B combination vaccine (Twinrix®) are currently in good supply to meet demand. GSK has initiated plans to increase production of Havrix® and Twinrix®, to help ensure uninterrupted supply for the U.S. market. Further updates on vaccine shortages and delays can be found on CDC's Current Vaccine Shortages & Delays Website.
Yellow Fever Vaccine Shortage:
CDC has recently become aware of a temporary shortage of single-dose vials of YF-VAX®, the only yellow fever vaccine marketed in the United States. The 5-dose vials of YF-VAX® continue to be available in sufficient supply. According to the manufacturer, sanofi pasteur, there is no shortage of the vaccine itself, but there is a temporary issue related to the specialized production equipment necessary to insert the vaccine into single-dose vials. Delays occurred when the supplier of this equipment went out of business, making it necessary to validate a new supplier. This issue has been rectified, and the single-dose vials are expected to be back in stock in March 2008. The manufacturer has advised clinics and CDC that the 5-dose vials continue to be available. For information about where the yellow fever vaccine is needed, please visit CDC’s Travelers’ Health Website. Further updates on vaccine shortages and delays can be found on CDC's Current Vaccine Shortages & Delays Website.
More Nursing Home Employees Protected against Flu:
In 2004, the majority (63%) of nursing homes reported less than 60% employees had received an influenza shot during the last influenza season. In 2004, nursing homes used different strategies to promote influenza vaccination among employees. Three of these strategies (offering free vaccinations, furloughing employees with influenza-like illness, and requiring proof of vaccination) were significantly associated with staff influenza vaccination rates increasing to 60%. Only 1% of surveyed facilities did not use at least one of the strategies. Data from the 2004 National Nursing Home Survey can be found in CDC’s Morbidity and Mortality Weekly Report under “QuickStats.”
State Grantees Tested in Emergency Response:
CDC recently concluded an eight week pilot test to assess the capability of CDC and the 62 Public Health Emergency Preparedness grantees to collect and transmit vaccine doses data administered through the Countermeasure and Response Administration (CRA) System. CRA is a CDC-developed application for tracking and reporting countermeasure use during public health emergencies. The system covers 50 states, 3 U.S. territories, 5 Pacific Island Jurisdictions and the localities of Chicago, Los Angeles County, New York City and Washington D.C. For this exercise, data from seasonal influenza vaccine clinics was used as a proxy for pandemic influenza vaccine. During the initial stages of an influenza pandemic, tracking doses administered will be important to ensure priority groups are being vaccinated expeditiously. Overall, 89% (55/62) of project areas submitted data for at least one seasonal influenza clinic during the pilot period. Fifty-five percent (34/62) of project areas met the criteria to be considered fully successful: 1) transmit the minimum data set for two distinct clinic dates; 2) transmit the data within 48 hours of the vaccine doses administration date. CDC plans to hold a follow-on exercise during the 2008-2009 influenza seasons.
Meetings, Conferences & Resources
New Vaccine Information Statements:
CDC has updated its Meningococcal Vaccine Information Statement (VIS) to be consistent with the new licensure of meningococcal conjugate vaccine (MCV) for children 2-10 years old. Existing stocks of the last version can be used up, although the new version should be used when administering MCV to anyone 2-10 years old. Also, a new "Multi-Vaccine" VIS has been published. This four-page (two pages front & back) VIS contains information on routine 0-6 month vaccines, DTaP, hepatitis B, IPV, PCV, Hib, and rotavirus. It can be used as an optional alternative to the existing individual VISs when any combination of the routine vaccines is administered during the same visit, including combinations like Pediarix or Comvax. Use of the Multi-Vaccine VIS is optional, and the individual VISs for these vaccines may still be used. This VIS may also be used when two or more of these vaccines are given together at other pediatric visits (e.g., 12-15 months or 4-6 years). It should not be used for vaccines given to adolescents or adults. CDC would appreciate hearing any feedback about the Multi-Vaccine VIS from either programs or individual providers. Please direct any comments to the NIPINFO mailbox at nipinfo@cdc.gov.
New Spanish Adult Immunization Schedule:
A new, Spanish-Language Version, 2007-2008 Recommended Adult Immunization Schedule 
is now available. The schedule, which was released in English in October 2007, has been approved by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, and the American College of Physicians.
Fighting Flu:
Families Fighting Flu (FFF) (exit), an organization made up of parents whose children died or who became seriously ill from influenza, has recently established an e-newsletter called Fighting Flu. The e-newsletter contains information about FFF activities, personal stories, and influenza educational materials. It can be downloaded from the home page of FFF’s website.
Next ACIP Meeting:
The Advisory Committee on Immunization Practices (ACIP) will hold its next meeting on February 27-28, 2008 at the CDC in Atlanta, Georgia. This meeting is open to the general public, but advanced registration is required. More information, and a draft agenda, can be found on the ACIP Website.
Get Ready for NIC:
The 42nd National Immunization Conference (NIC) will be held from March 17–20, 2008 in Atlanta, Georgia, and will be comprised of six topic tracks: Adolescent and Adult Vaccination, Epidemiology and New Vaccines, Health and Risk Communication, Immunization Information Systems, Influenza, and Programmatic Issues, and Health and Risk Communication. Abstract submission is now closed. More information can be found on the NIC Website. Or, questions can be addressed to the Conference Planning Team at nipnic@cdc.gov.
National Conference on Immunizations and Health Coalitions Conference:
Register now for the 8th National Conference on Immunization and Health Coalitions. The conference will be held in San Francisco, CA from May 21-23, 2008. This year’s conference will be expanded to include participants across all health issues. Visit the Coalition Conference Website (exit), for more information about the conference and how to submit an abstract.
On-Site Training in Atlanta:
A two-day Epidemiology and Prevention of Vaccine-Preventable Diseases course will be held in Atlanta on April 15 - 16, 2008 at CDC. Space is limited. Questions can be directed to Laverne Graham at 404-639-8225.
CDC Training Opportunities:
Through established programs, CDC offers many unique training opportunities in infectious disease, including international opportunities. For a current listing of CDC training opportunities, please visit the CDC Public Health Training Website.
CDC Job Openings:
CDC is committed to recruiting and hiring qualified candidates for a wide range of immunization positions. Researchers, Medical Officers and Epidemiologists as well as other specialties are often needed to fill positions within CDC. For a current listing of positions available at CDC, including international opportunities, please visit the CDC Employment Website.
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Content last reviewed on February 19, 2008
Content Source: National Center for Immunization and Respiratory Diseases
