News and Media Resources:

Immunization Works! October 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

Protect Yourself, Your Patients, and Family From Flu: Influenza vaccine manufacturers are projecting that as many as 143-146 million doses of vaccine will be available for this season. All six US manufacturers have already begun to ship this season’s influenza vaccine, with almost all of the vaccine expected to be shipped and distributed by mid-November.

CDC's Advisory Committee on Immunization Practices (ACIP) recommends that health-care providers begin offering vaccination soon after vaccine becomes available and continue vaccinating into December and later. This is important because, during most years, influenza does not peak until February or later. Since influenza is unpredictable - and different types and strains of influenza circulate throughout the flu season -influenza vaccine should be offered throughout the influenza season, even after influenza has appeared or begun appearing in a community. To help get the word out about late season vaccination, National Influenza Vaccination Week (NIVW) will take place December 8-14.

CDC has many influenza resources available at the Flu Website including free materials such as flyers, posters, stickers, and public service announcements for various public audiences and healthcare providers at the Flu Gallery. Please check the Gallery for new materials throughout the influenza season. Also, see the websites below for answers to common questions from providers, immunization partners, and the general public.

Where can I get a flu shot?
www.flucliniclocator.org (exit)

How can I advertise my public flu clinics?
http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=23670 (exit)

How can I let healthcare providers know I have flu vaccine for sale?
http://www.preventinfluenza.org/ivats (exit)
(Scroll down to Enrollment and click on "enroll".)

Where can I purchase influenza vaccine?
http://www.preventinfluenza.org/ivats (exit)

Other News & Summaries

How to Collect Immunization Data in a Changing World: Currently, CDC is exploring methods that will allow the collection of information on immunization coverage at a time when fewer people are using landline phones. The evaluation study is a pilot that will be carried out with the US Census. This will involve using the American Community Survey as a sampling frame to find households with age-eligible children, including those in households that rely on cell phones or have no phone service. CDC is also conducting studies to: 1) evaluate potential bias in National Immunization Survey (NIS) estimates because of exclusion of non-landline households; 2) evaluate ways to supplement the landline sampling frame with a sampling frame that includes non-landline households e.g., cell telephone number sampling frame, Immunization Information Systems (IIS); and 3) evaluate potential replacements for the landline sampling frame e.g., address-based sampling frame. Please see the item in the Federal Register (scroll to "Department of Commerce, Census Bureau"). Written comments must be received by Dec 1, 2008.

CDC Releases Influenza Coverage Data for All Age Groups: CDC recently released new data concerning influenza vaccination coverage for different populations. Key findings are listing below:

State-Specific Influenza Vaccination Coverage Among Adults: Data from the 2006 and 2007 Behavioral Risk Factor Surveillance System (BRFSS) surveys indicate that influenza vaccination coverage among adults for the 2006-07 season increased significantly compared with the 2005-06 season, reaching 35 percent among 18-49 year-olds with high-risk conditions, 42 percent among all 50-64 year-olds, and 72 percent among 65 year-olds and older. However, vaccination coverage remained well below Healthy People 2010 targets. For more information, please see the full MMWR article in CDC’s Morbidity and Mortality Weekly Report (MMWR).

Influenza Vaccination Coverage Among Children 6-23 Months-Old: Influenza Vaccination Coverage in this age group remains low according to the most recent data from the National Immunization Survey (NIS). During September through December of the 2006-07 influenza season, only 32 percent of children 6-23 months-old received at least one dose of influenza vaccine and only 21 percent were fully vaccinated against influenza. In other words, only about 1 in 5 children 6-23 months-old were fully vaccinated against influenza. For more information, please see the full MMWR article in CDC’s Morbidity and Mortality Weekly Report (MMWR).

Influenza Vaccination Coverage Among Children Aged 6-59 Months: Influenza Vaccinate Coverage in this age group remains low. The Immunization Information System (ISS) Sentinel Site Project showed that 22 percent of children 6-23 months-old and 17 percent of children 24-59 months-old were fully vaccinated against influenza in the 2007-08 influenza season. These estimates are similar to previous years and indicate no substantial increase in influenza vaccination coverage. For more information, please see the full MMWR article in CDC’s Morbidity and Mortality Weekly Report (MMWR).

Hib Vaccine Shortage Will Continue to Mid-2009: On October 17, 2008, Merck Vaccine Division announced that they will be unable to return to the U.S. Hib vaccine market by the end of 2008 as originally planned. Merck stated that they will make a regulatory filing with the Food and Drug Administration for a manufacturing process change. The manufacturer now projects returning to the U.S. Hib vaccine market in mid-2009.

CDC is not changing the current shortage recommendations for Hib vaccination. The remaining U.S. supplier of Hib vaccine is Sanofi Pasteur, which makes a monovalent Hib Vaccine, ActHIB, and a combination vaccine, Pentacel (DTaP/IPV/Hib). Sanofi Pasteur projects sufficient Hib vaccine production to maintain the current 3-dose recommendation of Hib vaccine for most children until mid-2009, using a combination of Pentacel and ActHIB.

The CDC vaccine stockpile has a sufficient supply of unrecalled Merck PedvaxHIB vaccine to continue the current policy of vaccinating American Indian and Alaska Native children living in American Indian or Alaska Native communities with PedvaxHIB.

Thus far, we have not yet seen an increase in disease because of deferral of the booster dose at 12 to 15 months. The incidence of invasive Hib disease has declined dramatically in the U. S., resulting from high Hib vaccine coverage levels. Currently, the incidence of invasive Hib disease in children less than 5 years of age is 0.21 per 100,000 representing a greater than 99% reduction in disease compared to the pre-vaccine incidence. Children have a cushion of indirect protection against Hib infection due to high immunization coverage levels in the U.S. We are not certain how long this indirect protection will last. It is very important to directly protect infants by timely vaccination with the three-dose primary series at 2, 4, and 6 months of age.

Information on the Hib vaccine shortage is available and kept up-to-date on the CDC vaccines web site at: http://www.cdc.gov/vaccines/vac-gen/shortages/default.htm

More Teens Vaccinated, but Rates Fall Short of 2010 Goals: According to a recent study published by CDC, the nation′s immunization coverage rates for preteens and teens are increasing for routinely recommended vaccines, but most still do not have all of the recommended immunizations, and rates fall short of Healthy People 2010 Goals. Since 2006, CDC has conducted the National Immunization Survey-Teen (NIS-Teen) to estimate vaccination coverage from a national sample of adolescents 13-17 years-old. For more information, please see the full MMWR article in CDC’s Morbidity and Mortality Weekly Report (MMWR).

Updated Recommendation for Isolation of Persons with Mumps: The CDC, American Academy of Pediatrics (AAP) and Healthcare Infection Control Practices Advisory Committee (HICPAC) now recommend a 5 day period after onset of parotitis, non-suppurative swelling and tenderness of the parotid gland, either unilateral or bilateral, for 1) isolation of persons with mumps in either community or health-care settings and 2) use of standard and droplet precautions. The best strategy for preventing mumps in both the community and among health care workers is to promote high levels of immunity via vaccination. For more information, please see the full MMWR article in CDC’s Morbidity and Mortality Weekly Report (MMWR).

Japan Approves Plan to Eliminate Measles: In response to the 2007 outbreak, and to achieve the measles elimination goal by 2012 agreed on by Member States of the WHO Western Pacific Region, the Japanese government approved a 5-year National Measles Elimination Plan in December 2007. With implementation of the national Measles Elimination Plan, Japan is expected to make progress toward achieving the WPR measles elimination goal. For more information, please see the full MMWR article in CDC’s Morbidity and Mortality Weekly Report (MMWR).

CDC Responds to Szilagyi Study: A study of influenza vaccine effectiveness (VE) among children was recently published and can be found in the Archives of Pediatrics & Adolescent Medicine (exit). The article, by Peter Szilagyi and colleagues indicates low (although not statistically significant) VE among children 6-59 months old. It is important to note that there are other studies, some using LAIV such as the Belshe study (exit), that show vaccine efficacy in the same population even when there was a strain mismatch. CDC has prepared a commentary (exit) including key talking points, on this paper.

FDA Licenses New Vaccines: The FDA recently licensed two new vaccines. CDC’s Morbidity and Mortality Weekly Report (MMWR) reported on the new vaccines:

1. Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus Vaccine for Use as a Booster Dose; and
   
   
2. Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Inactivated Poliovirus, and Haemophilus b Conjugate Vaccine for Use in Infants and Children.
   

Meetings, Conferences & Resources

CDC's Pre-teen Vaccine Campaign Launches New PSAs: CDC has released new public service announcements (PSAs) targeting the parents of pre-teens. The television and radio spots, part of CDC’s Pre-Teen Vaccine campaign, urge the parents of 11-and 12-year-olds to make an appointment for their child to get an annual check-up and to get vaccinated against meningitis, whooping cough, and for girls, cervical cancer. The PSAs, are available in both English and Spanish at lengths of 60, 30 and 15 seconds. Broadcast quality versions of the PSAs (exit) can be found in the digital newsroom. Versions for use on the web, in presentations, or on voicemail systems can be downloaded from CDC's website for the Preteen Vaccine Campaign webpage.

Video Warns Parents about the Dangers of Flu: Families Fighting Flu, Inc. (FFF) (exit), together with CDC, recently released a video documentary featuring parents who have tragically had a child die as a result of influenza (exit). The video carries a strong message, underscoring the fact that influenza is serious and more than 20,000 children are hospitalized every year due to flu-related complications and some tragically die. Vaccination is the best and most effective way to help prevent the spread of the disease and its potentially severe complications, especially for children ages 6 months through 18 years and children with chronic illnesses such as asthma.

New Resource for Immunization Managers: CDC, in partnership with immunization grantees and stakeholders, has developed a new, web-based education module with entry-level information about immunization information systems (IIS). The module, called Immunization Information Systems 101: What Every Manager Should Know, will serve as a reliable, up-to-date source for ground-level training and orientation within the IIS community. It is intended for use primarily by those new to IIS such as new immunization program and IIS managers, programmers, immunization program staff, and their partners who may use IIS. In addition, the module can be used to educate immunization providers and new partners on the basic principles and functions of IIS. Continuing education credits will be provided. For more information, contact Bobby Rasulnia at bba9@cdc.gov.

Updated Multi-Vaccine VIS: An updated interim edition of the pediatric multi-vaccine VIS, dated September 18, 2008, has been posted on the CDC VIS web page. It has been made consistent with the recently updated rotavirus VIS by noting the availability of two rotavirus vaccines in the "Routine Childhood Vaccines" section and adding "irritability" to the mild problems listed for rotavirus in the "Vaccine Risks" section. Providers using the multi-vaccine VIS when administering Rotarix should begin using the new edition now. When Rotarix is not administered, the older edition may be used until stocks are used up.

ACIP Meeting: The Advisory Committee on Immunization Practices (ACIP) will hold its next meeting on October 22-23, 2008 at the CDC in Atlanta, Georgia. This meeting is open to the general public, but advanced registration is required.

Mark Your Calendars for NIC: Make plans now to attend National Immunization Conference (NIC), scheduled March 30–April 2, 2009, at the Sheraton Dallas, Texas. Abstracts will be accepted through November 14, 2008. Early bird on-line registration is available. The deadline for early-bird registration is January 30, 2009.

Clinical Vaccinology Course: The National Foundation for Infectious Diseases, the Emory Department of Medicine – Division of Infectious Diseases and the Emory Vaccine Center are sponsoring a clinical vaccinology course. This course focuses on new developments and issues related to the use of vaccines. Presentations will provide the latest information on both current and prospective vaccines. This course is specifically designed for physicians, nurses, physician assistants, pharmacists, vaccine program administrators, and other health professionals involved with or interested in the clinical use of vaccines. The Clinical Vaccinology Course (exit), will be held November 14-16, 2008 in Bethesda, Maryland, and again March 6-8, 2009 in San Diego, California.

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.

The Immunization Works Database Manager can be contacted at immunizationworks@cdc.gov

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