Immunization Works May 2013
Pentacel, Daptacel, and Pediarix Shortages: CDC has issued Guidance for Vaccinating Children during the 2013 Pentacel, Daptacel, and Pediarix Shortages. The Guidance has been issued in response to Sanofi Pasteur’s Pentacel (DTaP-IPV/Hib) and Daptacel shortages and the reduced allocation of GlaxoSmithKline’s Pediarix vaccine. The shortages are expected to last throughout the summer of 2013.
The guidance encourages vaccine providers to:
- Continue to follow the recommended immunization schedule and ensure patients receive all recommended doses of DTaP, Hib, and polio vaccines
- Search for alternative vaccines during the shortage (including single-component DTaP, IPV, HepB, and Hib vaccines and other licensed combination vaccines which should be readily available)
- Contact your state and local immunization program for guidance about ordering vaccine if you participate in the VFC program.
The Guidance Document, including possible scheduling scenarios, and further information about vaccine shortages, can be found at CDC Current Vaccine Shortages and Delays.
Minor Update to Gardasil VIS: The pregnancy registry for Gardasil has been terminated by the manufacturer. Consequently, the reference to the registry has been removed from section four of the Gardasil VIS. This is the only change. Stocks of the previous VIS may still be used as long as patients are made aware that the registry no longer exists. The updated VIS is available from the CDC VIS web page.
Updated Tdap VIS: The Tdap VIS has recently been updated and is now available. This VIS contains information about Tdap only; for patients receiving Td, continue using the 1/24/12 Td/Tdap VIS until a VIS dedicated exclusively to Td (currently in development) is available. Changes to the updated VIS relate primarily to recent changes in ACIP recommendations regarding use of Tdap during pregnancy.
Progress Toward Worldwide Eradication of Polio, January 2011-March 2013: In May 2012, the World Health Assembly of the World Health Organization (WHO) declared the completion of polio eradication a programmatic emergency. Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, the number of annual polio cases has decreased by more than 99%. As of March 2013, circulation of indigenous wild poliovirus (WPV) continued in only three countries: Afghanistan, Nigeria, and Pakistan (the last case in India had onset in January 2011). The May 3, 2013, MMWR provides an update on progress toward global polio eradication during January 2011-March 2013, using data reported as of April 23, 2013. The number of WPV cases reported globally decreased 66%, from 650 in 2011 to 223 in 2012; WPV cases decreased 53% (from 80 to 37) in Afghanistan and 71% (from 198 to 58) in Pakistan, but increased 97% (from 62 to 122) in Nigeria. The number of imported WPV cases in previously polio-free countries decreased from 309 in 12 countries in 2011 to six in two countries in 2012. During January-March 2013, a total of 22 WPV cases were reported worldwide, compared with 48 cases during the same period in 2012. An estimated 2.05 billion doses of oral poliovirus vaccine (OPV) were administered in 2012 to approximately 448 million persons, primarily children younger than 5 years, in supplemental immunization activities (SIAs) conducted in 46 countries. SIAs were temporarily suspended in areas of Pakistan and Nigeria after attacks against health workers occurred in December 2012 and the first quarter of 2013. The number of confirmed WPV cases has decreased to the lowest level ever, but security concerns continue to threaten the overall goal of global eradication.
Prevention and Control of Influenza With Vaccines-Interim Recommendations of the ACIP: The May 10, 2013, MMWR summarizes recommendations approved on February 21, 2013, by the Advisory Committee on Immunization Practices (ACIP) for the use of influenza vaccines. An expanded 2013 ACIP influenza vaccination recommendation statement is scheduled to be published in MMWR before the start of the 2013-2014 influenza season. Providers should consult the expanded 2013 ACIP influenza vaccination statement for complete and updated information.
Routine annual influenza vaccination is recommended for all persons aged six months and older. Immunization providers should consult Food and Drug Administration-approved prescribing information for 2013-2014 influenza vaccines and the 2013-2014 ACIP influenza recommendation statement for the most current information concerning indications, contraindications, and precautions.
Influenza vaccines that are currently licensed and expected to be available for the 2013-2014 season and their approved age indications are summarized in a table on the seasonal flu web page. The information in the table is current as of April 15, 2013. Any changes in product availability or other information will be reflected in the expanded 2013-2014 ACIP influenza recommendation statement. The table lists four newly licensed influenza vaccines that are expected to be available during the 2013-2014 influenza season. These vaccines are acceptable alternatives to other licensed products listed in the table, to the extent that their specific indications allow. For persons for whom more than one type of vaccine is appropriate and available, ACIP does not express a preference for use of any particular product over another.
Emergence of Avian Influenza A (H7N9) Virus Causing Severe Human Illness in China: On March 29, 2013, the Chinese Center for Disease Control and Prevention completed laboratory confirmation of three human infections with an avian influenza A (H7N9) virus not previously reported in humans. These infections were reported to the World Health Organization (WHO) on March 31, 2013, in accordance with International Health Regulations. The cases involved two adults in Shanghai and one in Anhui Province. All three patients had severe pneumonia, developed acute respiratory distress syndrome (ARDS), and died from their illness. The cases were not epidemiologically linked. The detection of these cases initiated a cascade of activities in China, including diagnostic test development, enhanced surveillance for new cases, and investigations to identify the source(s) of infection. No evidence of sustained human-to-human transmission has been found, and no human cases of H7N9 virus infection have been detected outside China, including the United States. The May 10, 2013, MMWR summarizes recent findings and recommendations for preparing and responding to potential H7N9 cases in the United States. Clinicians should consider the diagnosis of avian influenza A (H7N9) virus infection in persons with acute respiratory illness and relevant exposure history and should contact their state health departments regarding specimen collection and facilitation of confirmatory testing.
Meetings and Conferences
ACIP Meeting: The most recent ACIP meeting was held on February 20-21, 2013, in Atlanta, Georgia. Please visit the ACIP meeting web page for presentation slides, meeting minutes, an archived video broadcast of the latest meeting, and additional information. The next ACIP meeting will be held on June 19-20, 2013, and the draft meeting agenda is posted on the web page.
National Adult and Influenza Immunization Summit: The 2013 National Adult and Influenza Immunization Summit was held May 14-16 in Atlanta, Georgia. The summit had 400 attendees. Please visit the summit web page for slides and additional information.
One announcement is the launch of the Immunization Action Coalition Adult Vaccination Resources Library (AVRL). This resource data-base gathers adult immunization resources into one location, allowing healthcare providers and the general public to pinpoint adult immunization resources that can be used in a clinic setting or for individual education. Using simple key words and other selected criteria, you can search the library to find the resources that meet your needs.
Resources and Information
Current Issues in Immunization Netconference: The most recent netconference was held on March 21, 2013. The moderator was Andrew Kroger. Carolyn Bridges presented “Update on Adult Immunizations,” Jennifer Liang presented “Updated Tdap Vaccine Recommendations for Pregnant Women,” and Iyabode (Yabo) Beysolow presented “2013 Childhood and Adolescent Immunization Schedules.”
You Call the Shots Modules: The Hepatitis A module was recently added to the NCIRD web-based training course You Call the Shots, and the Vaccine Storage and Handling and Vaccines for Children (VFC) modules were added in February. Please visit the You Call the Shots web page for additional information. Continuing Education (CE) credit is also available.
New Diphtheria Website: CDC’s diphtheria and diphtheria antitoxin content can now be found on this user-friendly diphtheria website.
Adult Vaccine Finder Now Available: If you are interested in letting the public know about vaccines offered at your practice or clinic, please visit the HealthMap Vaccine Finder. The site already includes more than 54,000 locations that provide flu shots and has provided this information to 500,000 users from the general public. On January 28, 2013, the site expanded to include 10 additional adult vaccines. You can also register your location on this website.
Adult Immunization Materials: Resource materials are available for order from the Public Health Foundation. Healthcare providers may find the new prescription pads very helpful. The pad is actually a checklist healthcare providers can use to counsel patients about which vaccines are right for them. Each sheet lists 17 possible vaccinations and serves as a convenient resource for patients and providers.
Also visit the CDC Vaccines for Adult Patients resource web page which has various materials available for download to educate and encourage adult patients to get vaccinated. The resources are part of a new vaccines for adults website providing general information on adult vaccination. Targeted groups include young adults (19-26 years), pregnant women, adults with special health conditions, and older adults (60 years and older).
CDC and Medscape Videos: This special series of commentaries is part of a collaboration between CDC and Medscape and is designed to deliver CDC’s authoritative guidance directly to Medscape’s physicians, nurses, pharmacists, and other healthcare professionals. In this series, experts from CDC offer video commentaries on the current topics important to practicing clinicians. NCIRD has contributed to a variety of commentaries. You will need to sign up as a member to view the videos.
Immunization Publications: Please visit the NCIRD publications ordering form for the latest immunization publications. Copies of the 2012 Immunization Works DVD, Surveillance of Vaccine-Preventable Diseases DVD, the Parents Guide to Childhood Immunizations, and the 2013 immunization schedules are available for ordering.
CDC Job Openings: CDC is committed to recruiting and hiring qualified candidates for a wide range of immunization and other positions. Researchers, Medical Officers, Epidemiologists, and other specialists are often needed to fill positions within CDC. For a current listing, including international opportunities, please visit CDC’s employment web page.
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