News and Media Resources:

Immunization Works! January 2007 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 Childhood and Adolescent Immunization Schedules

The Advisory Committee on Immunization Practices (ACIP) has published new immunization schedules for children and adolescents that reflect revised recommendations for the use of licensed vaccines, including those newly licensed. There is also a significant formatting change; for the first time, there is a separate schedule for adolescents. Specific changes are listed below:

• The new rotavirus vaccine ( Rota) is recommended in a 3-dose schedule at ages 2, 4, and 6 months. The first dose should be administered at ages 6 weeks through 12 weeks with subsequent doses administered at 4--10 week intervals. Rotavirus vaccination should not be initiated for infants older than12 weeks and should not be administered after age 32 weeks.

• The influenza vaccine is now recommended for all children aged 6--59 months.

• Varicella vaccine recommendations are updated. The first dose should be administered at age 12--15 months, and a newly recommended second dose should be administered at age 4--6 years.

• The new human papillomavirus vaccine (HPV) is recommended in a 3-dose schedule with the second and third doses administered 2 and 6 months after the first dose. Routine vaccination with HPV is recommended for females 11--12 years old; the vaccination series can be started in females as young as age 9 years; and a catch-up vaccination is recommended for females 13--26 years old who have not been vaccinated previously or who have not completed the full vaccine series.

• The main change to the format of the schedule is the division of the recommendation into two schedules: one schedule for children 0--6 years old and another for adolescents 7--18 years old. Special populations are represented with purple bars; the 11--12 years assessment is emphasized with the bold, capitalized fonts in the title of that column. Rota, HPV, and varicella vaccines are incorporated in the catch-up immunization schedule.

The new childhood and adolescent immunization schedules can be found in CDC’s Morbidity and Mortality Weekly Report (MMWR) at www.cdc.gov/mmwr/preview/mmwrhtml/mm5551a7.htm
The printable versions of the new childhood and adolescent immunization schedules will be posted on CDC’s website soon.

Other News and Summaries

Getting Flu Vaccine Messages to the Public: In August 2006, CDC launched a multi-pronged education campaign concerning influenza vaccination. Using print ads, radio and television public service announcements (PSAs) and many other mediums, the campaign has spread messages about flu vaccination far and wide. As of December 5, 2006, 12,939 broadcast and radio stations have aired at least one of CDC’s campaign products, with 470 of these stations located in “Top 10” U.S. media markets. Based on the overall size of each station, it is estimated that 634 million audience members have been exposed to CDC messages. In addition to campaign activities that were planned well in advance of the influenza vaccination season, CDC worked rapidly with their campaign contractor, the Academy for Educational Development (AED), on a plan to promote the first National Influenza Vaccination Week (NIVW), held November 27 to December 3. AED produced NIVW radio and television public service announcements and a full-page print ad for placement in USA TODAY. The radio and television ads played in 96 markets, covering 67% of the U.S. population, reaching a potential audience of 155.8 million, including Spanish and English-speaking individuals. The USA TODAY ad reached a potential audience of 2.2 million readers.

As always, partners played a critical role in shaping CDC campaign messages. Groups such as the National Association of County and City Health Officials (NACCHO), Association of Immunization Managers (AIM), Association of State and Territorial Health Officials (ASTHO) and the National Influenza Vaccine Summit helped define the rationale for and purpose of the first NIVW. Partners were also vital for getting CDC campaign materials distributed to public and provider audiences. For example, over a two-month period, the New York Medical Society mailed out over 40,000 CDC posters promoting health care worker vaccination to its members.

Working with the media and partners to map out a campaign across the country proved that an important vaccination message could be delivered quickly and with real impact. Utilizing new means of outreach (via the web and targeted new media outlets) helped the campaign reach a broad audience. The campaign will continue through the end of January 2007.

Measles Outbreak, 2005: Measles is a highly infectious, acute viral illness that can be complicated by severe pneumonia, diarrhea, and encephalitis and can result in death. Before the measles vaccine, approximately 500,000 cases of measles occurred annually in the United States. During 2005, 66 confirmed cases of measles were reported to CDC. Of the 66 persons with measles, 1% had been vaccinated with 2 doses of a measles-containing vaccine and 11% had been vaccinated with 1 dose. However, 76% were unvaccinated and 12% had unknown vaccination status. These findings show the need to maintain the highest possible measles vaccination coverage and to adhere to measles vaccination recommendations. To view the complete article in CDC’s Morbidity and Mortality Weekly Report (MMWR), please visit www.cdc.gov/mmwr/preview/mmwrhtml/mm5550a2.htm

Eliminating Hepatitis B Transmission: A new report provides updated recommendations for increasing hepatitis B vaccination of adults at risk for hepatitis B virus (HBV) infection. Hepatitis B vaccination is the most effective measure to prevent HBV infection and its consequences; including cirrhosis of the liver, liver cancer, liver failure, and death. In adults, ongoing HBV transmission occurs primarily among unvaccinated persons with behavioral risks for HBV transmission. Hepatitis B vaccination is the most effective measure to prevent HBV infection and its consequences. In settings in which a high proportion of persons are likely to be at risk for HBV infection (e.g., STD/HIV testing and treatment facilities, drug-abuse treatment and prevention settings, health-care settings targeting services to IDUs, health-care settings targeting services to MSM, and correctional facilities), the Advisory Committee on Immunization Practices (ACIP) recommends universal hepatitis B vaccination for all adults who have not completed the vaccine series. In primary care and specialty medical settings, ACIP recommends implementation of standing orders to identify adults recommended for hepatitis B vaccination and administer vaccination as part of routine services. To view the complete report in CDC’s Morbidity and Mortality Weekly Report (MMWR), please visit www.cdc.gov/mmwr/preview/mmwrhtml/rr5516a1.htm

Preventing Tetanus, Diphtheria, and Pertussis in Adults: A report in CDC’s Morbidity and Mortality Weekly Report (MMWR) summarizes the rationale and recommendations for use of Tdap vaccine among adults. Despite longstanding routine vaccination, pertussis remains endemic in the United States. Pertussis is an acute, infectious cough illness that remains endemic in the United States despite longstanding routine childhood pertussis vaccination. Immunity to pertussis wanes approximately 5-10 years after completion of childhood vaccination, leaving adolescents and adults susceptible to pertussis. In 2005, a tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine adsorbed (Tdap) product was licensed for use in the United States for persons aged 11-64 years. The complete report can be found at www.cdc.gov/mmwr/preview/mmwrhtml/rr5517a1.htm

Immunization Information Systems: A report in CDC’s Morbidity and Mortality Weekly Report (MMWR) summarizes data about immunization registries. Immunization Information Systems (IIS) IISs are used increasingly as a decision-making tool for immunization programs and healthcare providers to generate patient reminders and recalls; perform vaccine inventory management and distribution tasks; conduct routine public health surveillance; conduct school assessments; and identify clusters of under-vaccinated children. Data from 50 states showed that about half of U.S. children under 6 years old participated in an IIS. Moreover, 75% percent of public vaccination provider sites and 44% of private vaccination provider sites submitted vaccination data to an IIS. Of these submissions, only 14% of private vaccination provider sites reported over 95% vaccination data submission to IIS, compared with 39% of public vaccination providers. As participation in IIS increases and data quality improves, data from IIS will improve the effectiveness and efficiency of immunization programs throughout the United States. The complete report can be found at www.cdc.gov/mmwr/preview/mmwrhtml/mm5549a3.htm

Influenza Vaccination Coverage Among Children Aged 6-23 Months: Since 2004, the Advisory Committee on Immunization Practices (ACIP) has recommended that all children aged 6--23 months receive influenza vaccinations annually. Other children recommended to receive influenza vaccinations include children 6 months -18 years old who have certain high-risk medical conditions, children on chronic aspirin therapy, children who are household contacts of persons at high risk for influenza complications, and, since 2006, all children 24-59 months old. Previously unvaccinated children less than 9 years old need 2 doses administered at least 1 month apart to be considered fully vaccinated. Data from six immunization information system (IIS) sentinel sites indicate that there is a range of vaccination from 6-60%. However, less than 23% of children in five of the sites were fully vaccinated, underscoring the need for increased measures to improve the proportion of children who are fully vaccinated. State health departments should consider using IIS as a means for rapidly assessing influenza vaccination coverage. Prompt reporting of influenza vaccinations to the IIS can enable local or statewide assessments during the current influenza season, aiding measures to increase the proportion of fully vaccinated children. To view the complete article in CDC’s Morbidity and Mortality Weekly Report (MMWR), please visit www.cdc.gov/mmwr/preview/mmwrhtml/mm5549a4.htm

Meetings, Conferences, & Resources

CDC Materials Temporarily Unavailable: Due to circumstances beyond CDC’s control, all CDC materials – including National Immunization Program (NIP) materials – are temporarily unavailable for order. CDC deeply regrets the inconvenience, and appreciates your patience until ordering can resume (possibly in the next two weeks). In the meantime, please visit the Vaccines & Immunizations website at www.cdc.gov/vaccines where the majority of materials are available for download. An update concerning this issue will be included in the next edition of Immunization Works.

Upcoming Netconference: The National Immunization Program (NIP) will present a live netconference on January 18, 2007 from 12:00 noon to 1:00 PM ET. The netconferences are designed to provide clinicians with the most up-to-date information on immunization issues. The January netconference will focus on adult Hepatitis B and adult Tdap vaccinations. Internet access and a separate phone line are needed to participate. Please note that registration closes the morning of the day preceding the netconference. Registration information can be found at www.cdc.gov/vaccines/ed/ciinc/

International Immunization Job Openings: The Global Immunizations Division (GID), within CDC’s proposed National Center for Immunization and Respiratory Diseases (NCIRD), is currently recruiting for positions in the Global Migration Branch (GMB) and the Polio Eradication Branch (PEB). Interested candidates may send a letter of interest and CV to NIPglobaljobs@cdc.gov. The following positions are available:

• SEARO - Medical Officer/Epidemiologist - Indonesia - GMB
• ATLANTA/FAST Team - Medical Officer/Epidemiologist - PEB
• AFRO - Medical Officer/Epidemiologist - Zimbabwe -GMB
• AFRO - Medical Officer/Epidemiologist - Burkina Faso - GMB
• EURO - Technical PHA - Denmark - GMB
• EMRO - Medical Officer/Epidemiologist - Egypt
  (June 2007) - GMB
• AFRO - Technical PHA - Congo-Brazzaville (July 2007) - GMB
• EURO - Medical Officer - Denmark (July 2007) - GMB/PEB
• SEARO - Medical Officer/Epidemiologist - India
  (August 2007) - PEB
• UNICEF - Medical Officer/Epidemiologist - New York (September 2007) - GMB
• UNICEF - Medical Officer/Epidemiologist or Public Health Advisor – New York (November 2007) - PEB

New Resource for Hepatitis B Prevention: CDC has created a Hepatitis B Vaccination for Adults’ Resource Center which provides the newly posted Advisory Committee on Immunization Practices (ACIP) recommendations for adults, in addition to links for resources and materials. The Resource Center can be found at www.cdc.gov/ncidod/diseases/hepatitis/recs/index.htm

Save the Dates: CDC's annual four-part series, Epidemiology and Prevention of Vaccine-Preventable Diseases, is scheduled for Jan. 25, Feb. 1, Feb. 8, & Feb. 15, 2007. Each session is scheduled for 12 to 4 pm Eastern time. More information can be found at www.cdc.gov/vaccines/ed/broadcasts.htm

Register for NIC: The 41st National Immunization Conference (NIC) -- to be held from March 5–8, 2007 in Kansas City, Missouri -- will be comprised of six topic tracks: Adolescent and Adult Vaccination, Epidemiology and New Vaccines, Influenza, Immunization Information Systems, Programmatic Issues, and Health and Risk Communication. Please register before January 12, 2007 to obtain the best rate. Participants can register online at the NIC Web site at www.cdc.gov/vaccines/events/nic

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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