News and Media Resources:
Immunization Works! April 2008 issue
The Centers for Disease Control and Prevention’s (CDC) Immunization Works Monthly Immunization Update is provided to professional organization partners for broad distribution to their members and constituencies. The information provided is non-proprietary.
Front Page News
FDA Approves New Rotavirus Vaccine:
The U.S. Food and Drug Administration (FDA) announced the approval of Rotarix (exit), the second oral U.S. licensed vaccine for the prevention of rotavirus, an infection that causes gastroenteritis (vomiting and diarrhea) in infants and children. Rotarix is a liquid and is given in a two-dose series to infants 6 to 24 weeks years-old.
Although the disease is usually self-limiting, rotavirus causes about 2.7 million cases of gastroenteritis in U.S. children each year—about 55,000 to 70,000 of those require hospitalization; and between 20 and 60 deaths are attributed to it. Without vaccination, nearly every child in the United States would likely be infected at least once with rotavirus by age 5.
There are many different strains of rotavirus. The vaccine protects against rotavirus gastroenteritis caused by the G1, G3, G4, and G9 strains. During studies involving more than 24,000 infants, Rotarix was effective in preventing both severe and mild cases of rotavirus-caused gastroenteritis during the first two years of life.
In 1999, a different rotavirus vaccine from another manufacturer was voluntarily withdrawn from the U.S. market because of an association with an increased risk of intussusception, or intestinal obstruction, which can lead to potentially life-threatening intestinal blockage. Intussusception can occur in children spontaneously in the absence of vaccination, but to help ensure that Rotarix does not increase the risk of intussusception, its manufacturer conducted a study of more than 63,000 infants.
In that study, there was no increase in the risk of intussusception in those who received Rotarix (31,673 infants) compared to those who received a placebo (31,552 infants). Increased rates of convulsion and pneumonia-related deaths were observed in the Rotarix recipients in the intussusception study, however these events were not observed in other studies conducted by the manufacturer. Although the FDA has concluded that the available data do not establish that these events are related to the vaccine, the agency has requested the manufacturer to conduct post-marketing safety studies involving more than 40,000 infants to provide additional safety information.
Other News & Summaries
Love Them. Protect Them. Immunize Them.
This week, April 19-26, is National Infant Immunization Week (NIIW). NIIW is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and celebrate the achievements of immunization programs and partners in promoting healthy communities. During NIIW 2008, hundreds of communities across the United States have joined those in the Western Hemisphere and Europe to celebrate Vaccination Week in the Americas (VWA) and European Immunization Week. In addition, CDC’s National Center for Immunization and Respiratory Diseases (NCIRD) kicked-off NIIW 2008 with special events in Connecticut, Rhode Island, and the state of Washington, featuring NCIRD Assistant Surgeon General Dr. Anne Schuchat and Deputy Director Melinda Wharton.
42nd NIC Draws Nearly 1500 Attendees:
Nearly 1500 attendees participated in the 42st National Immunization Conference (NIC), which was held March 17-20, 2008, in Atlanta, GA. Dr. Anne Schuchat, Director of CDC’s National Center for Immunization and Respiratory Diseases (NCIRD), and Dr. Renee Jenkins, President of the American Academy of Pediatrics (AAP) (exit), spoke at the opening session. The Phil Horne award was presented to Jane Seward, a deputy director with CDC’s viral diseases division. The Hilleman Lecture was delivered by Dr. Mathu Santosham, of the Johns Hopkins’ Bloomberg School of Public Health, and a primary investigator in an effort to promote the integration of Hib vaccine into immunization programs around the world. Closing remarks were delivered by Joe Lastinger, a founding board member of Families Fighting Flu (exit) and father to Emily, who died at 3½ years-old from influenza. Handouts and audio/video recordings from the conference are available online at the NIC website. Remember to mark your calendars for the 43rd NIC, to be held March 30-April 2, 2009, in Dallas, TX.
Wisconsin Study Measures Effectiveness of Flu Vaccine:
The effectiveness of influenza vaccination typically is lower during those seasons when a suboptimal match between vaccine strains and circulating influenza strains is observed. A new report summarizes interim results of a study to estimate the effectiveness of trivalent inactivated influenza vaccine for prevention of medically attended, laboratory-confirmed influenza during the 2007--08 influenza season, when most circulating influenza A (H3N2) and B viruses were suboptimally matched to vaccine strains. Despite the suboptimal matches, overall vaccine effectiveness of 44% was observed. For more information, please see the full article in CDC’s Morbidity and Mortality Weekly Report (MMWR).
Measles Outbreak in Arizona:
CDC recently issued a Health Advisory about a Measles Outbreak in Arizona through the Health Alert Network (HAN). The first case of the outbreak, with rash onset on February 12, 2008, occurred in an adult visitor from Switzerland who was hospitalized with measles and pneumonia. Through March 31, 2008, nine confirmed cases have been reported to the Arizona Department of Health Services, and there are two suspected cases (one in a Colorado resident) and hundreds of contacts under investigation. Although measles is no longer an endemic disease in the United States, it remains endemic in most countries of the world, including some countries in Europe. Healthcare providers should remain aware that measles cases may occur in their facility; they can minimize the risk of transmission by 1) ensuring that all healthcare personnel have evidence of measles immunity and 2) practicing appropriate infection control measures. More information about measles and measles vaccine can be found on the CDC Measles Vaccination website.
PCV7 Recommendations Updated for 24-59 Month-Old Children:
CDC has updated the recommendations for the use of seven-valent pneumococcal conjugate vaccine (PCV7) among children aged 24-59 months who are either unvaccinated or who have a lapse in PCV7 administration. The updated recommendations are as follows:
- For all healthy children 24-59 months-old who have not completed any recommended schedule for PCV7, administer one dose of PCV7.
- For all children with underlying medical conditions 24-59 months-old who have received three doses, administer one dose of PCV7.
- For all children with underlying medical conditions 24-59 months-old who have received less than three doses, administer two doses of PCV7 at least 8 weeks apart.
For more information, see the notice in CDC’s Morbidity and Mortality Weekly Report.
Coverage Measured for Rotavirus Vaccine:
Routine vaccination is anticipated to be the most effective public health intervention for reducing rotavirus disease in children. Healthcare providers should remain vigilant in following the Advisory Committee on Immunization Practices (ACIP) recommended vaccination schedule for rotavirus vaccine. Worldwide, rotavirus is the leading cause of severe gastroenteritis in children less than 5 years old, and each year it results in more than 200,000 emergency room visits and 55,000-70,000 hospitalizations in the U.S. alone. In February 2006, a new rotavirus vaccine, RotaTeq® (Merck & Co., Inc. Whitehouse Station, NJ), was recommended by ACIP for routine vaccination of U.S. infants as a 3-dose schedule, to be administered at 2, 4, and 6 months of age. A CDC study found that by May 15, 2007, nearly half of 3-month-old infants had received 1 dose of rotavirus vaccine and that the majority of doses were administered according to ACIP recommendations. For more information, please see the Coverage Measured for Rotavirus Vaccine full article in CDC’s Morbidity and Mortality Weekly Report (MMWR).
Risk of Laboratory-Acquired Vaccinia Infections:
Researchers who handle non-attenuated strains of vaccinia virus should follow the Advisory Committee on Immunization Practices (ACIP) recommendations for vaccination against vaccinia. Vaccinia virus (VACV) is used in research laboratories, and accidental inoculation in the laboratory can result in severe infection. ACIP recommends vaccination with the vaccinia (smallpox) vaccine at least every 10 years for researchers who have contact with non-attenuated strains of VACV. In a new report, five recent instances of laboratory-related VACV exposure, including four infections, and two hospitalizations are described. In all instances, the researchers recovered, but had not met ACIP recommendations for vaccination. These observations underscore the need for laboratory researchers and occupational health clinics to review vaccination status of researchers who handle non-attenuated VACV strains, as well as reinforce laboratory safety practices. For more information, please see the Risk of Lab-Aquired Vaccinia Infections full article in CDC’s Morbidity and Mortality Weekly Report (MMWR).
Polio in Pakistan and Afghanistan:
Security and access are limited in the border areas of Pakistan and Afghanistan, which limits access to children for immunization and continues to hamper polio eradication efforts there against both wild polivirus type 1 and type 3. In some areas of Pakistan without security concerns, improving the quality of immunization activities must be addressed to stop circulation of poliovirus. Pakistan and Afghanistan share borders in remote areas of both countries with rugged terrain and constant population movements across borders. In 2007, limited progress was made toward interrupting wild poliovirus transmission in Pakistan and Afghanistan. In Afghanistan, in August 2007, the support of antigovernment groups was obtained, which increased access to areas for vaccinators during immunization campaigns in the south region. However, despite intensive efforts, both type 1 and type 3 wild poliovirus continue to circulate into 2008 in areas of both countries. For more information, please see the Polio in Pakistan and Afghanistan full article in CDC’s Morbidity and Mortality Weekly Report (MMWR).
Immunization Information Systems Increase Enrollments:
Immunization Information Systems (IIS) have made progress enrolling children and healthcare providers in their systems. A new report highlights selected data from CDC′s 2006 Immunization Information System Annual Report (IISAR). The data indicated that 65 percent of all U.S. children less than 6 years-old, approximately 15 million children, participated in an Immunization Information System (IIS), an increase from 56 percent in 2005. IISs can provide accurate data on which to make informed immunization decisions and better protect against vaccine-preventable diseases. Most grantees (70 percent) reported that their IISs have the capacity to track vaccinations for persons of all ages. Data concerning vaccinations were entered within 30 days of vaccine administration for 69 percent of children less than 6 years-old. However, results for several data completeness measures are low. These findings underscore the need to continue efforts to address challenges to full participation and ensure high quality information. For more information, please see the IIS Increase Enrollments full article in CDC’s Morbidity and Mortality Weekly Report (MMWR).
Measles Mortality Reduced in Eastern Mediterranean Region:
Countries of the World Health Organization’s Eastern Mediterranean Region (EMR) have succeeded in reducing the estimated number of measles-related deaths by more than 75 percent since 2000; however, much work remains to be done to achieve the goal of measles elimination in the region. In 1997, EMR countries adopted the goal to eliminate indigenous measles by 2010. Measles immunization and surveillance strategies have been developed and implemented to help achieve that goal, as well as to reduce the measles-associated mortality in the region in accordance with the goal set by the World Health Assembly in 2005 to achieve a 90 percent reduction in global measles-associated mortality by 2010 compared to 2000. To sustain measles mortality reduction and to achieve the regional measles elimination goal, all EMR countries will need to achieve a high coverage with the first dose of measles vaccine and with the second opportunity for measles immunization offered either as a routine second dose and/or provided through supplemental immunization activities (SIAs). For more information, please see the Measles Mortality Reduced...full article in CDC’s Morbidity and Mortality Weekly Report (MMWR).
Meetings, Conferences & Resources
Pink Book, New Printing:
The second printing of the 10th Edition of CDC’s immunization textbook, Epidemiology and Prevention of Vaccine-Preventable Diseases, “The Pink Book,” has been completed and is now available online “The Pink Book” provides comprehensive information about routinely recommended vaccines, vaccine-preventable diseases and much more. A hard copy of the “Pink Book” can be purchased for $35.
IIS Data Interactive Query Tool:
CDC has launched a new tool for research concerning Immunization Information Systems (IIS) called the IIS Data Interactive Query Tool. The searchable database contains detailed calendar year 2004-2006 data -- previously unavailable to the public -- from the Immunization Information Systems Annual Report (IISAR). IISAR is an annual assessment of IIS activity among the 64 immunization program grantees that receive funding under section 317b of the Public Health Service Act. For more information, please contact Bobby Rasulnia at bba9@cdc.gov.
IIS Searchable Publications Database:
CDC has launched a new tool for searching Immunization Information Systems (IIS) publications called the IIS Publications Searchable Database. The database contains references for IIS-related articles published in peer-reviewed journals, IIS guidance documents and CDC Morbidity and Mortality Weekly Reports (MMWRs) from 2000 to the present. This database will be updated as new articles and guidance documents are published. For more information, please contact Bobby Rasulnia at bba9@cdc.gov.
Best Practices for Healthcare Work Influenza Vaccination:
NFID has recently released a new “Best Practices” report called Immunizing Healthcare Personnel Against Influenza (exit). The basis for the report, which was developed with input from The National Influenza Vaccine Summit (exit), was to locate successful programs for immunizing healthcare workers against influenza, and present them as models that could be replicated by other organizations.
Immunization Legislation Tracking Website:
The Association of State and Territorial Health Officials (ASTHO) has created an Immunization Legislation Tracking website (exit) which follows state and federal legislation, and provides links to external immunization legislation resources. For more information, please contact Olivia Chang, Analyst, Immunization Policy, at ochang@astho.org.
Provisional Influenza Recommendations Available Now:
At its February meeting, the Advisory Committee on Immunization Practices (ACIP) voted for provisional recommendations for the prevention and control of influenza. They are now posted and will be in place until the final recommendations are published later this year in CDC’s Morbidity and Mortality Weekly Report (MMWR).
Spanish Language Materials:
A Spanish-language version of the Recommended Immunization for Babies is now available (scroll down the webpage to “Spanish Versions”.) In addition, a Spanish-language version of CDC's Multi-Vaccine Schedule (exit) is now available.
National Influenza Vaccine Summit:
The 2008 National Influenza Vaccine Summit (NIVS) (exit) will be held on May 12-13 in Atlanta, GA. NIVS, co-sponsored by the American Medical Association (exit) and CDC, meets annually to provide a forum for discussing influenza vaccine issues with diverse stakeholders.
National Conference on Immunization and Health Coalitions:
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.
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 and 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 April 28, 2008
Content Source: National Center for Immunization and Respiratory Diseases
