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.
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2004
Third Dose of Pneumococcal Conjugate Vaccine Reinstated |
In February 2004, production of the 7-valent pneumococcal conjugate vaccine (PCV7), marketed as Prevnar by Wyeth Vaccines, failed to meet demand, resulting in shortages. To conserve the limited supply, CDC recommended that the fourth dose of PCV be withheld from healthy children. In March, because evidence indicated that production would be curtailed for several months, CDC recommended that the third dose also be withheld. Production problems now appear to have been resolved. As a result, deliveries are projected during the near term to permit the recommendation that every child receive 3 doses. Some providers might have short-term difficulties obtaining vaccine because of distribution delays; however, every effort will be made to provide sufficient vaccine to all providers.
Effective immediately, CDC, in consultation with the Advisory Committee on Immunization Practices (ACIP), the American Academy of Family Physicians, and the American Academy of Pediatrics, recommends that providers administer 3 doses of vaccine. The fourth dose should still be deferred for healthy children until further production and supply data demonstrate that a 4-dose schedule can be sustained. The full, 4-dose series should continue to be administered to children at increased risk for pneumococcal disease because of certain immunocompromising or chronic conditions. Alaska Native children and American Indian children who live in Alaska, Arizona or New Mexico and Navajo children who live in Colorado and Utah have a risk for invasive pneumococcal disease more than twice the national average. These children should receive the standard 4-dose PCV7 series during the shortage.
An interim catch-up schedule is provided for children who are incompletely vaccinated. The high priority for catch-up vaccination is to ensure that children aged <5 years at high risk for invasive pneumococcal disease are fully vaccinated. Second priorities include vaccination of healthy children aged <24 months who have not received any doses of PCV7 and vaccination of healthy children aged <12 months who have not yet received 3 doses.
For more information on the recommendations refer to the July 9, 2004 MMWR at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5326a7.htm.
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New Studies Show Parental Vaccine Safety Concerns May Pose Risk to Immunization Rates:
Two
studies published this month in Pediatrics link parental vaccine
safety concerns to lack of immunizations. The first study,
by Dr. Philip Smith and colleagues at CDC's National Immunization
Program, assessed whether the characteristics of children
with no vaccinations differ from those of under-vaccinated
children, and identified states with high rates and counties
with large numbers of unvaccinated children. The study found
that under-vaccinated children tend to be black, have younger,
unmarried mothers who do not have college degrees, live in
households near the poverty level, and live in a central city.
In contrast unvaccinated children tend to be white, to have
married mothers who have college degrees, live in households
with annual incomes exceeding $75,000/year, and have parents
who express concerns over the safety of vaccines and indicate
that medical doctors have little influence over vaccination
decisions for their child. The results also found that unvaccinated
children cluster geographically, increasing the risk of transmitting
vaccine-preventable diseases to both unvaccinated and under-vaccinated
children. The estimated number of unvaccinated children aged
19-35 months increased significantly between 1995 and 2000
from 14,719 in 1995 to 24,073 in 2000.
The second study, conducted by Dr. Deborah Gust and colleagues, examined the attitudes, beliefs, and behaviors of parents whose children was under-immunized for two or more vaccines that have recently received negative attention, and compared them with parents whose child was fully immunized for recommended vaccines. The results indicate that while socioeconomic, family and health care factors are key contributors for the majority of children who are not up-to-date, about 15% of under-immunization can be attributed to negative parental attitudes, beliefs, and behaviors. In addition, although overall immunization rates remain high and vaccine safety concerns are more common among parents of under-immunized children, many parents of fully immunized children also demonstrated similar attitudes, beliefs, and behaviors, suggesting a potential risk of currently high vaccination rates in the U.S.
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Fact Sheets for Parents and Healthcare Professionals on the IOM Report on Vaccines and Autism:
The fact sheets for parents and healthcare professionals summarize important conclusions from a report by the Institute of Medicine (IOM) on Vaccines and Autism. If you are involved in the administration of vaccines, you likely are familiar with allegations asserting that vaccines cause autism. In fact, you may have had patients, or their parents, raise concerns about vaccines and autism. In one study, 27% of family practitioners and pediatricians reported that parents sometimes or often raise concerns about possible neurologic effects of vaccination. The IOM's conclusions on vaccines and autism may be helpful to you in reassuring concerned parents about the safety of vaccines. In their 2004 report, the IOM concluded that neither thimerosal-containing vaccines nor MMR vaccine are associated with autism. The fact sheets can be found at http://www.cdc.gov/nip/news/iom-thim5-18-04.htm.
2004 NIP Annual Report & Survey:
The National Immunization Program (NIP) at CDC released its 2004 Annual Report in May during the National Immunization Conference. If you have not received a copy of the report, you may download the report or order a print copy by visiting http://www.cdc.gov/nip/webutil/about/annual-rpts/ar2004/2004annual-rpt.htm.
This year's report includes highlights about the distinguished career of Walt Orenstein, NIP's former director, and several innovative features, including an NIP event calendar, an index of topics, and a special section covering individual honors and achievements. One unusual new feature is a survey card that lets readers anonymously evaluate the annual report. NIP wants to know if the annual report serves its readers and provides information they need. The survey results let NIP know how the report is used and how it can be improved. To submit the survey, you can print the post-paid survey, complete it, and mail it to NIP. You may also complete the survey online at http://www.cdc.gov/nip/webutil/about/annual-rpts/feedback2004.htm. Please help NIP to serve you better by sending in your survey.
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Dr. Walter A. Orenstein Receives Shepard Award:
The Charles C. Shepard Science Award for Lifetime Scientific Achievement was awarded to Walter Orenstein M.D. for his 26 years of service in the CDC's National Immunization Program (NIP). During his tenure at NIP, Dr. Orenstein led successful efforts to combat and markedly reduce the occurrence of once common vaccine-preventable diseases of childhood, including meningitis from Haemophilus influenzae type b, rubella, varicella, and invasive pneumococcal disease. The work accomplished under his leadership has been critical to the development of national vaccine policy and global immunization strategies. Of particular note are the elimination of indigenous measles in the United States, the successful introduction of five new vaccines for routine use and the resultant decrease in the incidence of diseases prevented by these vaccines, the development of a national surveillance system for immunization coverage among preschool children, improvements in the surveillance and investigation of vaccine-associated adverse events, development of evidence-based strategies to improve vaccination coverage, and progress in global polio eradication and measles control. Dr. Orenstein has published more than 140 peer-reviewed publications, authored nearly three dozen chapters in the professional literature, and co-edited the 3rd and 4th editions of Vaccines, the premier textbook on immunization. Recently retired from CDC, Dr. Orenstein has joined the Emory University School of Medicine as director of a new Program for Vaccine Policy and Development and associate director of the Emory Vaccine Center. He also serves as associate director of the Southeastern Center for Emerging Biologic Threats, a regional partnership led by Emory.
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| Meetings,
Conferences, and Resources |
Fifth Immunization Registry Conference:
The 5th Immunization Registry Conference will be held October 18-20, 2004, at the Crowne Plaza Ravinia Hotel in Atlanta, Georgia. Please visit our web page at
http://www.cdc.gov/nip/registry/irc
for more information, including the abstract submission system and conference registration.
Sixth National Conference on Immunization Coalitions:
The Sixth National Conference on Immunization Coalitions is scheduled for September 20-22, 2004 at the Sheraton Norfolk Waterside Hotel in Norfolk, Virginia. This year's conference theme, Chart Your Coalition's Course for Norfolk, describes the goal of the meeting. The conference provides training on how to create, lead and sustain effective local or state coalitions and partnerships that address childhood, adolescent and adult immunizations. Specifically, the conference addresses coalitions as agents of social change, the elements of a successful coalition and ethnic diversity in coalitions. For conference brochure and registration information, please visit our website at
www.cme.hsc.usf.edu/coph/immcoal, or call 813-974-6695 or toll-free 888-USF-COPH (Press "2" for Continuing Education).
Free CMEs Available Related to the Vaccine Adverse Event Reporting System (VAERS):
Health care providers may access the "Vaccine Safety Post-Marketing Surveillance: The Vaccine Adverse Event Reporting System" with free CMEs through September 19, 2004. To access the CME article visit
http://www.cdc.gov/nip/vacsafe/VAERS/CME-post-mktg-surv.htm. Additional information related to VAERS is available at http://vaers.hhs.gov.
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Kids Need Flu Vaccine, Too! Resources:
The National Foundation for Infectious Diseases (NFID) now has available online "Kids Need Flu Vaccine, Too!" practice resources program. This program includes helpful information and education materials for conducting pediatric influenza immunization programs. The program can be accessed at http://www.nfid.org.
Job Openings within the National Immunization Program:
NIP is committed to recruiting and hiring qualified candidates for a wide range of positions. Researchers, Medical Officers and Epidemiologists as well as other specialties are often needed to fill positions within NIP. We encourage all interested parties to apply for these jobs. For a current listing of positions available at NIP, please visit http://www.cdc.gov/hrmo/hrmo.htm . Once at the site, conduct a search for "National Immunization Program."
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