CDC recommends that people get their flu vaccines as early as possible, typically in October and November, but December is not too late. The flu is still circulating in the community even in January and February, so it’s never too lat to get the vaccine. CDC has a variety of tools and resources for providers and the general public available through the “2004-05 Flu Gallery.” Materials include educational materials, posters, flyers, and brochures targeting healthcare providers, seniors, pregnant women, parents of 6-23 month olds and other children at high risk, as well as people 18 years or older with high risk conditions. Most materials are in English and Spanish. The Gallery may be located at www.cdc.gov/flu/gallery.

There are 2 types of influenza vaccine: an injectable “flu shot” and a nasal-spray vaccine. The flu shot contains killed virus. It is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions. The nasal-spray vaccine contains weakened live viruses. It is approved for use in healthy people 5 years to 49 years of age who are not pregnant.

While flu vaccine is encouraged for anyone who wants to lower their chances of getting influenza, specific populations should seek vaccination early. These include:

• People at high risk for complications from influenza:
• People 65 years or older
• People who live in nursing homes and other long-term care facilities
• Adults and children 6 months and older with chronic heart or lung conditions
• Adults and children 6 months and older who need regular medical care or were in a hospital during the previous year because of a metabolic disease, chronic kidney disease or weakened immune system
• Children 6 months to 18 years of age who are on long-term aspirin therapy
• Women who will be pregnant during the influenza season
• All children 6 to 23 months of age
• People 50 to 64 years of age
• People who can transmit influenza to others at high risk for complications, including children and adults living with someone in a high-risk group, health care workers, individuals working in health care settings even if they don’t provide direct care, and those working in long-term care facilities
  

Childhood Influenza Vaccination Coverage for the 2002-2003 Influenza Season was also released last week by the CDC. CDC estimates that only 4.4 percent of the nation’s children aged 6-23 months were fully vaccinated against influenza during the 2002-03 influenza season, the first season CDC encouraged influenza vaccination for healthy children. This first CDC report on childhood influenza vaccination coverage also estimates that only 7.4 percent of the children aged 6 to 23 months had received at least one dose of the vaccine.

To be fully vaccinated, previously unvaccinated children should receive two doses. Children who have received any dose of influenza vaccine in previous years require only one annual dose.

Recent studies show that children less than two years old, even healthy children, are more likely than older children to be hospitalized with serious complications if they get the flu. Because children younger than two are at increased risk for influenza-related hospitalization, vaccination is also recommended for their family members, other people living or working in their household and childcare providers. It is particularly important that people who are contacts of children younger than six months be vaccinated because influenza vaccination is not approved for children younger than six months of age. For the full MMWR article, including state coverage rates, visit http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a1.htm.

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American Lung Association Offers Web-Based Directory of Influenza Vaccination Clinics: The American Lung Association implemented a web-based directory of influenza vaccination clinics throughout the nation during the 2003-2004 season and the public response was overwhelming. There were a record-setting 150 million links to the Flu Shot Directory during October and November, 2003. For the upcoming season, all local health departments and others who have scheduled flu clinics have the opportunity to be included in this directory by sending an e-mail request to findaflushot@lungusa.org. A reply to this e-mail promptly will be sent from the ALA with further instructions. For more detailed information, visit the Lung Association Flu Shot Directory web page at www.lungusa2.org/embargo/flushotdirectory04/.

Pneumococcal Conjugate Vaccine Shortage Resolved: Since February 2004, CDC has recommended that 7-valent pneumococcal conjugate vaccine (PCV7) be administered to healthy children on an abbreviated schedule to conserve the limited supply. Production capacity has been increased and supply is now sufficient to meet the national demand for vaccine on the routine, 4-dose schedule. Effective immediately, CDC, in consultation with the Advisory Committee on Immunization Practices, the American Academy of Family Physicians, and the American Academy of Pediatrics, recommends that providers resume administration of PCV7 according to the routine schedule. For more information visit: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5336a8.htm.

Response to Neurology Article on “Recombinant Hepatitis B Vaccine and the Risk of Multiple Sclerosis”: A recently published article in the journal Neurology looks at the potential link between hepatitis B vaccine and an increased risk of multiple sclerosis (MS). The authors concluded that the findings of the study are consistent with the hypothesis that immunization with hepatitis B vaccine is associated with an increased risk of MS. However, CDC agrees with the conclusion of the Neurology editorial accompanying the article that “the data presented do not provide proof of an association sufficient to implement policy changes with regard to immunization programs.” This study only looked at adults - and as noted in the editorial accompanying the article, “the present study stands in contract to multiple studies and expert panels that have concluded that there is no link between hepatitis B vaccine and MS.” There have been at least seven scientific studies and four expert panels that have failed to identify an association between hepatitis B vaccine and MS. As the accompanying editorial states, this study has a number of important weaknesses that greatly limit its ability to make sound conclusions. For example, in the study, only 11 of the 163 people who had ever received hepatitis B vaccine – the other 152 people with MS had never received hepatitis B vaccine. As such, the sample size is too small to draw definitive conclusions. Hepatitis B vaccine provides proven protection against a virus, that before routine childhood immunization programs, was estimated to infect 200,000 to 300,000 people each year in the U.S. Of these, about 11,000 were hospitalized and 20,000 remained chronically infected. Overall, an estimated 1.2 million people in the United States have chronic HBV infection, and 4,000 to 5,000 people die each year from hepatitis B related chronic liver disease or liver cancer.

VAERS Program Promoted: 50,000 pediatricians and travel medicine physicians throughout the U.S. recently received a letter from the CDC and the Food and Drug Administration (FDA) seeking continued use and support of the Vaccine Adverse Event Reporting System (VAERS). This letter, along with other VAERS resources, is available online for all health care providers and interested parties at http://vaers.hhs.gov. VAERS is a cornerstone of U.S. immunization safety monitoring. Although reporting of adverse events following administration of some childhood vaccines are required by law, the system is highly dependent on voluntary submission of reports by health care providers. VAERS provides a central registry where providers can inform CDC and FDA about adverse events that individuals may experience following immunization. For additional information or assistance on vaccine adverse event reporting contact the VAERS Program at info@vaers.org or call 1-800-822-7967.

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New Vaccine Quiz Helps Adolescents and Adults Find Out Which Vaccines They Need: CDC has recently launched a web-based, interactive “Vaccine Quiz” to help adolescents and adults understand which vaccines they need. The quiz provides a list of suggested vaccines and encourages website visitors to ask about these vaccines during their next medical visit. The quiz questions and results are based on the latest recommendations from the Advisory Committee on Immunization Practices (ACIP), and the quiz is updated whenever the recommendations change. Quiz outcomes are confidential. The results are not stored, and no identifying personal information is collected from anyone who takes the quiz. Visitors can take the quiz as often as they like. The Vaccine Quiz for adolescents and adults is available at http://www2.cdc.gov/nip/adultImmSched/. For consumers interested in more detailed vaccine information, the site includes information about specific vaccines, vaccines and pregnancy, international travel and links to additional 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 www.cdc.gov/nip/registry/irc for more information.

Physician and Pharmacist Volunteers Needed: CDC is seeking people who would like to be pilot testers for immunization training programs. These are mostly self-study programs that can be done through a CD-ROM or over the internet. We are currently seeking physicians and pharmacists. The typical pilot testing effort is to review a training program, take the evaluation and provide feedback. The process can take from 2 to 4 hours. Pilot testers can obtain continuing education credits once the training program becomes approved for CE credit. If interested, please contact Melissa Barnett at mbarnett2@cdc.gov or (404)639-6202.

Current Issues in Immunization: Get the latest update on late-breaking immunization topics through CDC’s Quarterly Netconference Series. You can participate in these sessions through an internet hook-up and a speaker phone. The one-hour session includes a power point presentation over the internet and a live question and answer segment. The next netconference is October 14, 2004. For more information visit www.cdc.gov/nip/ed/ciinc/.

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.”