News and Media Resources:
Immunization Works! July 2006 issue
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.
New ACIP Recommendations
On June 29-30, 2006, the Advisory Committee on Immunization Practices (ACIP) met in Atlanta, GA. The ACIP meets three times annually and provides recommendations to the Director of the CDC and the Secretary of the Department of Health and Human Services (HHS) concerning the prevention of vaccine-preventable diseases in the United States. Following is a summary of key votes from the ACIP’s June meeting:
HPV Vaccine
The ACIP voted to recommend that a newly licensed vaccine designed to protect against human papillomavirus (HPV) be routinely given to girls at the age of 11-12 years. The ACIP recommendation also allows for vaccination of girls beginning at 9 years, and supports vaccination of females from 13 to 26 years of age who have not been previously vaccinated. According to the ACIP’s recommendation, 3 doses of the new vaccine should be routinely given to girls when they are 11 or 12 years old. The advisory committee, however, noted that the vaccination series can be started as early as 9 years of age at the discretion of the physician or health care provider. The vaccine should be administered before onset of sexual activity (i.e., before women are exposed to the viruses), but females who are sexually active should still be vaccinated. The ACIP passed a resolution that included HPV vaccine in the Vaccines for Children (VFC) program. VFC-eligible children 9 through 18 years of age are entitled to receive VFC vaccine. HPV is the leading cause of cervical cancer in women. The vaccine is the first developed to prevent cervical cancer, precancerous genital lesions and genital warts due to HPV. The vaccine is highly effective against four types of HPV virus, including two that cause about 70 percent of cervical cancer. Those who have not acquired HPV would get the full benefits of the vaccine. On average, there are 9,710 new cases and 3.700 deaths from cervical cancer in the United States each year. For more information about HPV and the HPV vaccine, please visit www.cdc.gov/vaccines/vpd-vac/hpv/default.htm
Varicella Vaccine
The ACIP voted to recommend a second dose of varicella (chickenpox) vaccine for children aged 4-6 years to further improve protection against the disease. The first dose of varicella vaccine is recommended at the age of 12 to 15 months. The ACIP also recommended that children, adolescents, and adults who previously received 1 dose should receive a second dose. The ACIP passed a VFC resolution to include the second dose of varicella in the Vaccines for Children program. Fifteen to 20 percent of children who have received one dose of the vaccine are not fully protected and may develop chickenpox after coming in contact with varicella zoster virus. Additionally, 1 dose of the vaccine may not continue to provide protection into adulthood when chickenpox is more severe. A second dose of varicella vaccine provides increased protection against varicella disease compared to one dose. Before licensure of the varicella vaccine in 1995, each year there were about four million cases of varicella, 13,500 hospitalizations and 150 deaths. Cases of varicella have steadily declined by 80 to 85 percent since vaccine licensure. From 1995 to 2001, varicella hospitalizations declined by 72 percent and deaths among those 50 years old and younger decreased by 75 percent or more. However, in recent years varicella outbreaks have continued to occur among vaccinated school children. During these chickenpox outbreaks, between 11 and 17 percent of vaccinated children developed varicella. Varicella in vaccinated children is usually mild, but the children are contagious and can transmit the virus to others including their parents who are at higher risk of severe disease. For more information about varicella and the varicella vaccine, please visit www.cdc.gov/vaccines/vpd-vac/varicella.
Slide presentations and the full report from the ACIP meeting can be found at www.cdc.gov/vaccines/recs/acip/. The next ACIP meeting will be held at the CDC Global Communications Center in Atlanta, Georgia, on October 25-26, 2006.
Other Immunization News
Update -- Mumps Outbreak
CDC and state and local health departments continue to investigate an outbreak of mumps that began in Iowa in December 2005 and involved 14 additional states as of June 27, 2006. Through June 27, 2006, 4724 mumps cases have been reported to the CDC from 15 outbreak-affected states. Of the total number of current cases, 1921 confirmed and probable cases have been reported by the Iowa Department of Public Health. Another 2717 probable and confirmed mumps cases have been reported from seven additional states where outbreaks are occurring (Kansas, Illinois, Nebraska, Missouri, South Dakota, Pennsylvania, and Wisconsin). Another seven states (Colorado, Minnesota, Mississippi, New York, New Mexico, Michigan, and Texas) have reported a total of 86 probable and confirmed mumps cases, 15 of which are related to travel to or temporary residence in one of the eight mumps outbreak states. The current reported number of hospitalizations is 72 (68 from outbreak states and 4 from states with outbreak-associated cases). Some of these are for complications of mumps including meningitis, encephalitis and orchitis, but at least 11 are likely to be coincidental hospitalizations (i.e., hospitalized for an unrelated condition and found to have mumps). As of July 5, 2006, there have been no deaths related to the mumps outbreak and reports from affected states show that the outbreak is declining in every state. While this decline is encouraging, CDC continues to work with state and local health departments to conduct mumps surveillance, assist with prevention and control activities, and evaluate vaccine effectiveness, duration of immunity, and risk factors for mumps illness. CDC has also provided technical assistance and education to organizations serving those most affected by the outbreak, including the American College Public Health Association, and four national camp associations. For more information about mumps and resources for healthcare professionals, the general public and travelers, please visit CDC’s mumps website at www.cdc.gov/vaccines/vpd-vac/mumps/outbreak/
Prevention and Control of Influenza
A report recently published in CDC’s Morbidity and Mortality Weekly Report (MMWR) updates the 2005 influenza recommendations by the Advisory Committee on Immunization Practices (ACIP). Principal changes include 1) recommending vaccination of children aged 24--59 months and their household contacts and out-of-home caregivers against influenza; 2) highlighting the importance of administering 2 doses of influenza vaccine for children aged 6 months--<9 years who were previously unvaccinated; 3) advising health-care providers, those planning organized campaigns, and state and local public health agencies to a) develop plans for expanding outreach and infrastructure to vaccinate more persons than the previous year and b) develop contingency plans for the timing and prioritization of administering influenza vaccine, if the supply of vaccine is delayed and/or reduced; 4) reminding providers that they should routinely offer influenza vaccine to patients throughout the influenza season; 5) recommending that neither amantadine nor rimantadine be used for the treatment or chemoprophylaxis of influenza A in the United States until evidence of susceptibility to these antiviral medications has been re-established among circulating influenza A viruses; and 6) using the 2006--07 trivalent influenza vaccine virus strains: A/New Caledonia/20/1999 (H1N1)-like, A/Wisconsin/67/2005 (H3N2)-like, and B/Malaysia/2506/2004-like antigens. For the A/Wisconsin/67/2005 (H3N2)-like antigen, manufacturers may use the antigenically equivalent A/Hiroshima/52/2005 virus; for the B/Malaysia/2506/2004-like antigen, manufacturers may use the antigenically equivalent B/Ohio/1/2005 virus. The complete MMWR report on this topic can be found at www.cdc.gov/mmwr/preview/mmwrhtml/rr55e628a1.htm
2005--06 Influenza Season Update
During the 2005--06 Influenza Season, influenza A (H1N1), A (H3N2), and B viruses co-circulated worldwide. In the United States, influenza A (H3N2) viruses predominated overall, but influenza B viruses were isolated more frequently than influenza A viruses late in the season. Influenza activity in the United States peaked in early March, and the number of pneumonia and influenza deaths did not exceed the epidemic threshold. Worldwide, influenza B viruses were the most commonly reported influenza type in Europe; influenza A (H1N1) and influenza B viruses predominated in Asia. Through June 13, 2006, outbreaks of influenza A (H5N1) viruses (avian influenza) among migratory birds and poultry flocks were associated with severe human illness or death in 10 countries (Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey, and Vietnam). The complete MMWR report on this topic can be found at www.cdc.gov/mmwr/preview/mmwrhtml/mm5523a2.htm
Meetings, Conferences, and Resources
Upcoming Satellite Broadcasts
CDC will host the following net-conferences this summer:
1) Current Issues in Immunization is scheduled for July 20 at 12:00 PM ET. Anticipated topics include vaccine administration, current recommendations and 2006 influenza recommendations. More information can be found at www.cdc.gov/vaccines/ed/ciinc/
2) Immunization Update 2006 is scheduled for August 10 at 9:00 AM ET. Anticipated topics include influenza vaccine, pertussis vaccine for adolescents and adults, revised recommendations for hepatitis A vaccination of children and the new vaccines for rotavirus and herpes zoster. For further details, please visit www.phppo.cdc.gov/phtn/immup-2006
New Influenza Supply Q&As
CDC has developed two sets of influenza questions and answers (Q&As) to assist healthcare professionals and consumers with planning for the upcoming influenza season. The first set of Q&As provides information about vaccine supply for the 2006-07 influenza season and can be found at www.cdc.gov/flu/about/qa/vaxprioritygroups.htm. The second set of Q&As provides general information about influenza vaccine production, supply, and distribution in the United States and can be found at www.cdc.gov/flu/about/qa/vaxsupply.htm
CDC Needs Pilot Testers
CDC has an ongoing need for volunteers to pilot test immunization training courses. Volunteers are particularly needed in the following occupations: physicians, pharmacists, health educators, medical assistants and nurses. To learn more about becoming a pilot tester, please send an email to nippilot@cdc.gov.
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, please visit www.cdc.gov/hrmo/hrmo.htm
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Content last reviewed on July 10, 2006
Content Source: National Center for Immunization and Respiratory Diseases
