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Immunization Works! October 2006 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.
FDA Approves Additional Influenza Vaccine
The U.S. Food and Drug Administration (FDA) approved FluLaval, an influenza vaccine to immunize people 18 years of age and older against the disease caused by strains of influenza virus judged likely to cause seasonal flu in the Northern Hemisphere in 2006-2007.
With this additional vaccine, CDC projects a total of about 115 million doses of influenza vaccine for the 2006–2007 Season, but these projections could change as manufacturing continues. Furthermore, 75 million doses are projected for distribution by October 31st.
FluLaval was approved using FDA's accelerated approval pathway, which allows the agency to approve products for serious or life-threatening diseases based on early evidence of a product's effectiveness, reducing the time it takes for needed medical products to become available to the public. In this case, the manufacturer demonstrated that the vaccine induced levels of antibodies in the blood likely to be effective in preventing seasonal influenza. As part of the accelerated approval process, the manufacturer will conduct further studies to verify that the vaccine will decrease seasonal influenza disease after vaccination. FluLaval is the second seasonal influenza vaccine approved using the accelerated approval process; GlaxoSmithKline's Fluarix received approval in 2005. To view the complete FDA press release on FluLaval, please visit www.fda.gov/bbs/topics/NEWS/2006/NEW01478.html (exit)
CDC encourages anyone who wants to be protected against influenza to seek vaccination, especially those at increased risk for influenza-related complications as well as those who live with or care for people at high risk – including health care providers, children between 6 months and up to 5 years old and people with chronic diseases such as diabetes, asthma and heart disease, as well as people 50 years old and older. For the 2006-07 season, CDC projects that vaccine supplies will be adequate for children ages 6-23 months. There is also likely to be sufficient influenza vaccine for 4 year olds. Vaccine doses licensed for 3 year olds; however, are limited in supply and CDC anticipates that there will be insufficient vaccine for this age group. More information about influenza and influenza vaccine can be found at www.cdc.gov/flu and CDC’s Flu Gallery can be found at www.cdc.gov/flu/gallery
Other News and Summaries
Influenza Vaccine Coverage Among Children 6--23 Months: Children less than 2 years old are at increased risk for influenza-related hospitalizations, and children 24--59 months old are more likely than older children to visit a clinic, hospital, or emergency department with influenza-associated illness. In 2002, the Advisory Committee on Immunization Practices (ACIP) encouraged annual influenza vaccinations for children 6--23 months old (and for household contacts of and out-of-home caregivers for children less than 2 years old). For the 2004--05 influenza season, ACIP strengthened its encouragement to a full recommendation. The National Immunization Survey (NIS) assesses influenza vaccination coverage among children 6--23 months old during the 2004--05 influenza season. The findings demonstrate that vaccination coverage in that age group approximately doubled from the 2003--04 influenza season, with substantial variability among states and urban areas. However, the percentage of fully vaccinated children remained low, underscoring the need for increased measures to improve pediatric vaccination coverage and ongoing monitoring of coverage among young children and their close contacts. To view the complete article in CDC’s Morbidity and Mortality Weekly Report (MMWR), please visit www.cdc.gov/mmwr/preview/mmwrhtml/mm5539a1.htm
Influenza and Pneumococcal Vaccine Coverage Among Persons > 65:
During the 1990--1999 influenza seasons, approximately 36,000 deaths were attributed annually to influenza infection, with approximately 90% of deaths occurring among adults 65 years and older. In 1998, an estimated 3,400 adults 65 years and older died as a result of invasive pneumococcal disease. One of the Healthy People 2010 objectives is to achieve 90% coverage of non-institutionalized adults 65 years and older for both influenza and pneumococcal vaccinations. During the influenza vaccine shortage in the 2004--05 Season, the Advisory Committee on Immunization Practices (ACIP) issued temporary recommendations that influenza vaccine be provided first to persons in priority groups, including persons 65 years and older. The Behavioral Risk Factor Surveillance System (BRFSS) survey tracks influenza and pneumococcal vaccine coverage for persons 65 years and older. Data from the 2004 and 2005 BRFSS surveys indicated that, overall, influenza vaccination coverage was lower in the 2005 survey year than in 2004. However, pneumococcal vaccination coverage was nearly unchanged from 2004 to 2005. Continued measures are needed to increase the proportion of older adults who receive influenza and pneumococcal vaccines; health-care providers should offer pneumococcal vaccine all year. Also, health-care providers should continue to offer influenza vaccine during December and throughout the influenza season, even after influenza activity has been documented in the community. To view the complete article in CDC’s Morbidity and Mortality Weekly Report (MMWR), please visit www.cdc.gov/mmwr/preview/mmwrhtml/mm5539a2.htm
Vaccine Coverage Among Children 19--35 Months: The National Immunization Survey (NIS) provides vaccination coverage estimates among children 19--35 months old for each of the 50 states and selected urban areas. Findings from the 2005 NIS include nationwide increases in coverage with greater than 3 and greater than 4 doses of pneumococcal conjugate vaccine (PCV) and continued high levels of coverage for the other recommended vaccines and vaccine series. In addition, no racial/ethnic disparities in coverage estimates were observed in the 4:3:1:3:3:1 vaccine series, the recommended series for children 19--35 months old that includes diphtheria and tetanus toxoids and pertussis vaccines, diphtheria and tetanus toxoids vaccine, or diphtheria and tetanus toxoids vaccine and any acellular pertussis vaccine (DTP/DT/DTaP); poliovirus vaccine; measles, mumps, and rubella vaccine (MMR); haemophilus influenzae type b vaccine; hepatitis B vaccine; and varicella vaccine. This is an improvement over 2002-2004 coverage, when rates were lower among black children than white children in the 4:3:1:3:3:1 vaccine series. As in previous years, estimated vaccination coverage levels varied substantially among states. In addition, estimated coverage varied significantly by race/ethnicity for three individual vaccines: DTP/DT/DTaP, varicella and PCV. To view the complete article in CDC’s Morbidity and Mortality Weekly Report (MMWR), please visit www.cdc.gov/mmwr/preview/mmwrhtml/mm5536a2.htm
Impact of Measles Control Activities in Africa: A new study demonstrates that the strategies used in the accelerated measles control program in the World Health Organization (WHO) African Region, when implemented effectively, can result in a sharp drop in measles cases. Measles is the leading cause of death worldwide among vaccine preventable diseases, causing nearly half a million deaths annually. In 1999, of approximately 871,000 deaths from measles worldwide, 61% occurred in sub-Saharan Africa. In 2001, countries in the World Health Organization (WHO) African Region began an accelerated measles-control program to reduce by half by 2005 the number of deaths that were caused by measles in 1999. Strategies included large-scale vaccination campaigns, improvements in routine immunization services, case management and surveillance activities. As a result, reported measles cases in 32 African countries were cut by 93%, from nearly 203,000 in 1999 to just over 14,000 in 2005. By the end of 2006, the remaining children in Africa will have been targeted by measles vaccination campaigns. Successful control of measles in these countries is important to reducing child mortality and reaching global goals of measles mortality reduction. To view the complete article in CDC’s Morbidity and Mortality Weekly Report (MMWR), please visit www.cdc.gov/mmwr/preview/mmwrhtml/mm5537a3.htm
Rotavirus Prevention in Infants and Young Children: Rotavirus is the most common cause of severe gastroenteritis in infants and young children worldwide. In developing countries, rotavirus gastroenteritis is a major cause of childhood death and is responsible for approximately half a million deaths per year among children less than 5 years old. Rotavirus gastroenteritis results in relatively few childhood deaths in the United States (approximately 20--60 deaths per year among children less than 5 years old). However, nearly every child in the United States is infected with rotavirus by age 5, and the majority will have gastroenteritis. This results in approximately 410,000 physician visits, 205,000--272,000 emergency department (ED) visits, and 55,000--70,000 hospitalizations each year and direct and indirect costs of approximately $1 billion. In February 2006, a live, oral, human-bovine reassortant rotavirus vaccine (RotaTeq®) was licensed for use among U.S. infants. The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of U.S. infants with 3 doses of this rotavirus vaccine administered orally at ages 2, 4, and 6 months. The success of a rotavirus vaccination program depends on the acceptance and enthusiasm of physicians and other health-care providers who care for children and caretakers of infants. To view the complete article in CDC’s Morbidity and Mortality Weekly Report (MMWR), please visit www.cdc.gov/mmwr/preview/mmwrhtml/rr5512a1.htm
Public Health Response to Varicella Outbreaks: Since introduction of varicella vaccine in 1995, the incidence of varicella has decreased as vaccination coverage has increased. However, varicella outbreaks continue to occur, even among populations with high vaccination coverage. Although varicella typically is mild, the outbreaks can last for several months and be challenging and costly for health departments to control. In 2005, CDC conducted a national survey to determine the distribution and extent of reported varicella outbreaks during 2003--2004 and the public health response. The survey found that varicella outbreaks are still common despite increasing vaccination coverage. In addition, the survey found that health jurisdictions do respond to these outbreaks, although they have varying definitions and guidelines for varicella-outbreak management. To view the complete article in CDC’s Morbidity and Mortality Weekly Report (MMWR), please visit www.cdc.gov/mmwr/preview/mmwrhtml/mm5536a3.htm
Meetings, Conferences, & Resources
Immunization Provider Awards Announced: CDC awarded five cooperative agreements to immunization provider organizations. Approximately $140,000 will be awarded to each of five organizations: American Academy of Family Physicians (AAFP), American College of Obstetricians and Gynecologists (ACOG), American College of Physicians (ACP), American Pharmacists Association (APhA), and Interamerican College of Physicians and Surgeons. The new funding will support a range of new and continuing projects that inform and educate immunization providers about immunization issues, and promote the improvement of immunization coverage. Funding for this cooperative agreement is expected to be available for three years, concluding in September 2009. Information about future CDC funding opportunities can be found on www.grants.gov
Submit Abstracts for NIC: The 41st National Immunization Conference (NIC) will be held from March 5–8, 2007 in Kansas City, Missouri. The deadline for abstract submission is November 1, 2006. Additional information, including information about abstract submission and registration, can be found at www.cdc.gov/vaccines/events/nic/
Adolescent and Adult Vaccine Quiz - Now Updated: An updated version of the Adolescent and Adult Vaccine Quiz is now available on the NCIRD website: www2a.cdc.gov/nip/adultimmsched/. Updates include new vaccine recommendations and a re-designed provider page. The Vaccine Quiz is designed for the general public, specifically adolescents and adults (ages 11 and older). It asks questions about age, lifestyle, and medical conditions and provides general guidelines about possible vaccines users may need. The Vaccine Quiz also encourages users to discuss the suggested vaccines with their healthcare provider. No personal data are collected.
VIS for Zoster (Shingles): CDC recently posted an interim Vaccine Information Statement (VIS) for shingles at www.cdc.gov/vaccines/pubs/VIS/ . The Advisory Committee on Immunization Practices (ACIP) has not yet voted on recommendations for zoster vaccine. The final VIS will be produced after the ACIP's recommendations have been published, and could differ from this edition.
Join IZTA: Local or state immunization coalition members are encouraged to join the Immunization Coalitions National Technical Assistance Network (IZTA). This CDC-funded project provides free technical assistance and resources to immunization coalitions across the country including monthly presentations on hot immunization topics (via conference call); free individual technical assistance; access to information about coalition building, social marketing, evaluation and other topics; opportunities to share ideas and experiences with other coalitions across the country; and bi-weekly updates on IZTA events and immunization news. IZTA is managed by The Academy for Educational Development (AED). To sign up, please visit www.izcoalitionsta.org
MMWR Needs Pilot Testers: CDC’s MMWR (Morbidity and Mortality Weekly Report) has a need for volunteers to pilot-test upcoming articles. MMWR will soon publish articles on the new General Recommendations and on Tdap vaccination for adults. Those interested in pilot-testing these articles should contact Barbara Stallworth at BStallworth@cdc.gov. Volunteers are particularly needed in the following occupations: physicians, pharmacists, health educators, medical assistants and nurses. For those who are already on NIP’s pilot-testing list, please note that this is a separate pool of volunteers. Volunteers can serve with both groups.
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 October 10, 2006
Content Source: National Center for Immunization and Respiratory Diseases
