Immunization News Archive
The Florida Department Of Health Encourages Floridians To Get Ready For Flu Season
October 10, 2008 -- The Florida Department of Health (DOH) recognizes fall as the historical beginning of influenza (flu) season and urges Floridians who have not already done so to get their flu shots today. In Florida, the disease usually peaks in late January or February and continues through March. It is important to start vaccinating early and to continue flu vaccination throughout the winter months and beyond. (Flu Season)
Focus on Adolescent Immunizations
September 26, 2008 -- In order to promote vaccination among adolescents, the Centers for Disease Control and Prevention (CDC) has launched the It’s Their Turn! initiative. This initiative provides state and local health departments with a comprehensive set of tools and materials to assist them in implementing educational and awareness campaigns to promote adolescent immunization. The initiative website presents a complete set of adaptable materials for use in this initiative. Please contact the It’s Their Turn! initiative team at 404-639-2761 to consult with on how best to optimize these tools to your needs.
You may also visit the Bueau of Immunization Adolescent Immunization web page for more information.
The Bureau of Immunization has developed adolescent-targeted materials, which can be found on our publications page.
Materials presented on these pages can be ordered from the State Distribution Center using the information presented on the publication page. Materials without form or stock numbers are presented for downloading and local printing. Press-quality files can be obtained upon request for professional printing. Please contact the bureau at Immunization@doh.state.fl.us to request these files.
Please share the link to these materials with you coalitions and immunization partners. Local immunization coalitions, service organizations, hospitals, schools, and active community businesses, now, more than ever, can play important roles in promoting messages to protect our youth.
Updated Vaccine Information Statements
September 26, 2008 -- The Bureau of Immunization would like to remind our partners of the importance of using the current Vaccine Information Statements (VIS). By Federal law, all vaccine providers must give patients, or their parents or legal representatives, the appropriate VIS whenever a vaccination is given.
During the month of September, minor updates were made to several VISs. Changes could include correcting the web addresses of VAERS or the Vaccine Injury Compensation Program on some of the older VISs, adding the new statement about the availability of translations, cleaning up fonts that don't print properly, etc. None of these changes affect the mandated purpose of VISs (i.e., to inform parents or patients about the benefits and risks of vaccines). Edition dates on these VISs have not changed, and it is not necessary to replace existing stocks. Affected VISs are anthrax, DTaP, hepatitis A, hepatitis B, Hib, HPV, Japanese encephalitis, pneumococcal conjugate, pneumococcal polysaccharide, polio, rabies, rotavirus, shingles, Tdap, typhoid, and yellow fever.
Rotavirus VIS Update
A new interim rotavirus VIS available that replaces the interim VIS dated 4/12/06. The interim VIS, dated 8/28/08, includes information about the ROTARIX® (GSK) vaccine schedule. Providers may use up stocks of the 4/12/06 interim VIS for patients receiving RotaTeq® (Merck) vaccine; patients receiving ROTARIX® should receive the 8/28/08 interim VIS.
Multi-vaccine VIS Update
An updated interim edition of the pediatric multi-vaccine VIS has been posted. 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.
This VIS may be used in place of individual VISs whenever routine birth through 6-month of age vaccines are administered at the same visit. The vaccines included are diptheria-tetanus-pertusiss (DTaP), inactivated polio vaccine (IPV), Haemophilus influenzae type b (Hib), hepatitis B (Hep B), pneumococcal conjugate vaccine (PCV), and Rotavirus and also include the combination vaccines (e.g., Pediarix® Comvax®, Pentacel®) containing those components. When using this VIS, please check the boxes on the first page indicating which antigens are being administered.
Note that this VIS is four pages, front and back, instead of the usual two pages, front and back. Use of the Multi-vaccine VIS is optional. The individual VISs for these vaccines may still be used.
VIS links in the Florida SHOTS program always point to the current versions of all vaccine information statements.
For the latest information concerning VIS updates, frequently visit the CDC's VIS web site.
Many Vaccine Information Statements are available in Spanish and other languages. As new editions are translated, they are posted on the Immunization Action Coalition's website. As needed, providers should supplement VISs orally, with videotapes, with additional printed material, or in any other way that will help recipients understand the disease and vaccine.
ACIP Recommendations for New Pentacel® and Kinrix™ Combination Vaccines
September 10, 2008 -- The Centers for Disease Control and Prevention (CDC) has published indications and guidance for use for the new diphtheria and tetanus toxoids and acellular pertussis adsorbed (DTaP), inactivated poliovirus vaccine (IPV), and Haemophilus influenzae type b conjugate (Hib) combination vaccine (DTaP-IPV-Hib), Pentacel®, and the new diphtheria and tetanus toxoids and acellular pertussis adsorbed (DTaP) and inactivated poliovirus (IPV) combination vaccine (DTaP-IPV), Kinrix™.
Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Inactivated Poliovirus, and Haemophilus b Conjugate Vaccine and Guidance for Use in Infants and Children
On June 20, 2008 the Food and Drug Administration (FDA) licensed a combined vaccine, DTaP-IPV/Hib (Pentacel®, Sanofi Pasteur), for use as a four-dose series in infants and children 2, 4, 6, and 15 through 18 months of age. This report summarizes the indications for Pentacel® and provides guidance from the Advisory Committee on Immunization Practices (ACIP) for its use.
***It is important to note that the 4th dose should be deferred until there is an ample supply of Hib vaccine. Single antigen products can be used for the 4th dose.
Additionally, the Morbidity and Mortality Weekly Report (MMWR) discusses the documentation of the lot numbers. Different lot numbers for the different components of DTaP-IPV/Hib are included on the DTaP-IPV vial and on the Hib powder vial.
While it is recommended that providers should record lot numbers separately for the DTaP-IPV and Hib components, Florida SHOTS has not yet been modified to accept two vaccine lot numbers for the same combined vaccine. At a minimum, providers must record the lot number located on the outside of the box. We will notify you when there are any changes to this process.
The recommendations can be accessed online at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5739a5.htm
Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus Vaccine and Guidance for Use as a Booster Dose
On June 24, 2008, the Food and Drug Administration licensed a combined vaccine, DTaP-IPV (Kinrix™, GlaxoSmithKline Biologicals, Rixensart, Belgium). Kinrix™ is licensed for use as the fifth dose of the DTaP vaccine series and the fourth dose of the IPV series in children 4 through 6 years of age. DTaP-IPV administered to children 4 through 6 years of age would reduce by one the number of injections needed to complete DTaP and IPV immunization. This report summarizes the indications for Kinrix™ and provides guidance from the Advisory Committee on Immunization Practices (ACIP) for its use.
The recommendations can be accessed online at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5739a4.htm
Data are limited on the safety and immunogenicity of interchanging DTaP vaccines from different manufacturers. ACIP recommends that, whenever feasible, the same manufacturer's DTaP product should be used for the pertussis series; however, that vaccination should not be deferred if the specific DTaP vaccine brand previously administered is unavailable or unknown.
SAVE THE DATE!
May 5-6, 2009
2009 Florida Immunization Summit
Immunizations Across the Lifespan
The Suwannee River Area Health Education Center (AHEC) and the Florida Department of Health, Bureau of Immunization, are pleased to announce the 2009 Florida Immunization Summit to be held May 5-6, 2009, at the Marriott Tampa Airport. (Immunization Summit)
Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices, 2008
August 29, 2008 -- The Florida Department of Health, Bureau of Immunization announces publication by the Centers for Disease Control and Prevention (CDC) of Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008 in the August 8 MMWR Recommendations and Reports. (Influenza Recomendations)
Update: Measles: United States, January through July 2008
August 25, 2008 -- The Florida Department of Health, Bureau of Immunization announces publication of the Centers for Disease Control and Prevention's (CDC) , Morbidity and Mortality Weekly Report (MMWR); August 22, 2008 / 57(33);893-896 - Update: Measles --- United States, January--July 2008.
During January through July 2008, 131 measles cases were reported to the CDC, compared with an average of 63 cases per year during 2000-2007. This report updates an earlier report on measles in the United States during 2008 and summarizes two recent U.S outbreaks among unvaccinated school-aged children. Among those measles cases reported during the first 7 months of 2008, 76% were in persons less than 20 years of age, and 91 percent were in persons who were unvaccinated or of unknown vaccination status. Of the 131 cases, 89% were imported from or associated with importations from other countries, particularly countries in Europe, where several outbreaks are ongoing. The findings demonstrate that measles outbreaks can occur in communities with a high number of unvaccinated persons and that maintaining high overall measles, mumps, and rubella (MMR) vaccination coverage rates in the U.S. is needed to continue to limit the spread of measles.
Of particular interest is figure 2, showing that from January until July 2008, 2/3 of measles cases in the U.S. occurred in persons who were not immunized due to religious or philosophical exemption.
The MMWR can be accessed on the web at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5733a1.htm?s_cid=mm5733a1_e.
Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes
August 8, 2008 -- The Bureau of Immunization is pleased to announce the release of the revised Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes, effective July 2008 and incorporated by reference in amended Rule 64D-3.046, Florida Administrative Code, which became effective July 28, 2008.
The Guidelines are located at the Bureau of Immunization website at: http://www.immunizeflorida.org/schoolguide.pdf. Due to budget constraints, the Bureau has not yet determined if they can print a supply for the distribution center and will let you know the outcome.
The Florida Certification of Immunization (DH Form 680) has also been updated. DOH Rule 64D-3.046, F.A.C. may be accessed at: https://www.flrules.org/gateway/ruleNo.asp?id=64D-3.046 and https://www.flrules.org/gateway/readFile.asp?sid=0&tid=5891506&type=1&file=64D-3.046.doc. The updated DH Form 680 provides a selection for either Code 1 (K to 12) or Code 8 (7th Grade requirement).
The guidelines are updated only when there is a legislative or major change. The guidelines provide technical assistance for healthcare providers, schools, childcare facility operators, family daycare home operators, school health personnel, and county health department personnel regarding:
- Immunization requirements
- Clarifications/exceptions to immunization requirements with respect to certain vaccines
- Florida Certification of Immunization (DH 680), including Parts A, B, and C and the electronic signature DH 680 from
- Florida SHOTS
- Religious Exemption from Immunization (DH 681)
- Reporting requirements
- Special conditions for compliance
- Disease Control
- Immunization requirement for public assistance eligibility
- Confidentiality
Effective school year 2008/2009:
Children entering, attending, or transferring to kindergarten through grade 12 in Florida schools will be required to have documentation of a second dose of mumps and rubella, in addition to the present requirement of two measles.
A second dose of varicella will be required for children entering, attending or transferring to kindergarten.
There has been some confusion regarding Temporary Medical Exemptions (TMEs). A number of healthcare providers have been providing a TME to children entering Kindergarten, lasting until they are due to enter 7th grade. A TME should be completed only if a child is not fully immunized for their current school grade based on the proper spacing of vaccines. For more information, please refer to the Immunization Guidelines.
Please note that beginning with the 2009-2010 school year, documentation of a tetanus-diphtheria-pertussis-containing vaccine (Tdap) will be required for students entering/attending 7th grade, instead of tetanus-diphtheria.
Important Haemophilus influenzae Type b Vaccine Update and Ordering Instructions
August 6, 2008 -- We are entering the 9th month of the Haemophilus influenzae Type b (Hib) vaccine shortage that was initiated by Merck’s recall of their Hib-containing vaccines. We continue to hear that Merck’s Hib-containing vaccines will be available during the fourth quarter of this year. Once that happens, the vaccine allocation system that we are currently using will change and more options will be possible.
As a result of the recall, Sanofi Pasteur is currently the only supplier of Hib-containing vaccine for the Nation. While the licensure of the combination vaccine, Pentacel®, has enhanced the supply of Hib-containing vaccine, this addition is not sufficient to resume the booster dose of Hib vaccine.
The Florida Department of Health, Bureau Immunization will continue to receive a limited supply of ActHib®. However, the addition of the newly licensed Pentacel® should assure our continued ability to provide infants with the first three doses of Hib-containing vaccine.
It is important to note that the bureau will only be able to supply a limited amount of monovalent Hib vaccine until Merck resumes distribution of their Hib-containing product. Practices are encouraged to order Pentacel® to supplant their monovalent Hib vaccine supply to assure infants receive the first three doses of Hib during this temporary shortage.
Incorporating Pentacel® into the Immunization Schedule
For practices using single-antigen vaccines, transition to Pentacel® is relatively straightforward. These practices could begin using Pentacel® as the first dose in the primary series for their two-month-olds. Infants who have begun the Hib series with single-antigen vaccines can complete the series with separately administered DTaP, IPV, and Hib vaccines. An alternative is to switch all infants to Pentacel®. See below for these options for single-antigen practices.
For practices using Pediarix® (DTaP/IPV/HepB), the situation will be more challenging. Confusion and administration errors may result when both Pediarix® and Pentacel® are in use simultaneously in the same practice. These two combination vaccines both include DTaP and IPV. However, Pediarix® contains HepB and no Hib, and Pentacel® contains Hib, and no HepB.
For practices incorporating Pentacel®, it is easiest to begin with administration of Pentacel® to their newborns, while infants already started on Pediarix® should complete the series with Pediarix®.
Inventory management will be challenging in a practice that uses both Pediarix® and Pentacel®, and may result in vaccine wastage if inventories are not monitored closely. The risk of children missing a dose of hepatitis B or Hib vaccine increases when both products are available.
Additionally, guidance is available from the Centers for Disease Control and Prevention (CDC) on the use of Pentacel and Pediarix and on the package insert.
Percentage of Adults Aged > 65 Years Who Ever Received a Pneumococcal Vaccination
July 30, 2008 --
The Florida Department of Health, Bureau of Immunization announces publication of the Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR);July 4, 2008 / Vol. 57 / No. 26/page 723 - QuickStats: Percentage of Adults Aged >65 Years Who Ever Received a Pneumococcal Vaccination.
The report notes that in 2007, approximately 58 percent of adults older than 65 years of age had ever received a pneumococcal vaccination. In this population, statistically significant differences by sex, age group, and race/ethnicity were observed. Women were more likely than men to have ever received a pneumococcal vaccination. Adults older than 75 years of age were more likely to have ever received a pneumococcal vaccination, compared with adults 65 to 74 years of age. Non-Hispanic white adults older than 65 years of age were more likely than Hispanic and non-Hispanic black adults in that age group to have received the vaccination. The MMWR can be accessed on the web at: www.cdc.gov/mmwr/preview/mmwrhtml/mm5726a4.htm?s_cid=mm5726a4_e.
The detailed 2007 National Health Interview Survey report is available at: www.cdc.gov/nchs/about/major/nhis/released200806.htm.
2008 Florida Vote & Vax Campaign
July 30, 2008 -- The Department of Health, Bureau of Immunization is pleased to announce the 2008 Vote & Vax adult flu and pneumococcal immunization campaign. Vote & Vax efforts are held in conjunction with general elections. (Vote & Vax)
Vaccine Safety Monitoring and Human Papillomavirus Vaccination
July 28, 2008 -- Human Papillomavirus (HPV) vaccine safety has recently been mentioned in both the national and state news. The Department of Health, Bureau of Immunization provides the following summary of points: (Vaccine Safety Monitoring and HPV)
Delayed Onset and Diminished Magnitude of Rotavirus Activity: United States, November 2007 through May 2008
June 27, 2008 -- The Florida Department of Health, Bureau of Immunization announces publication of the Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR); June 25, 2008, Vol. 57, Early Release; Delayed Onset and Diminished Magnitude of Rotavirus Activity: United States, November 2007 through May 2008.
In the United States, rotavirus causes few deaths, but results in approximately 55,000 to 70,000 hospitalizations and 205,000 to 272,000 emergency department visits each year. In February 2006, a rotavirus vaccine was recommended for routine use among infants in the United States. The CDC analyzed rotavirus activity through May 3 of the current 2007-08 season. The results indicated that, compared with seasons spanning 1991 through 2006, rotavirus activity during the current season appeared delayed in onset by 2 to 4 months and diminished in magnitude by greater than 50 percent.
Standards for Immunization Practices
June 27, 2008 -- More than a decade ago, two sets of standards were introduced to guide the delivery of immunizations for children and adults. Under leadership of the National Vaccine Advisory Committee (NVAC), both sets of standards were revised in 2002. The standards focus on:
- Making vaccines easily accessible.
- Effectively communicating vaccination information.
- Implementing strategies to improve vaccination rates.
- Developing community partnerships to reach target patient populations.
More than 40 organizations have formally endorsed the Standards for Child and Adolescent Immunization Practices. The standards are available in the Pink Book-Appendix H and online at the Revised Standards for Immunization Practices web-site.
In 1990, the National Coalition for Adult Immunization (NCAI) developed the first Standards for Adult Immunization Practices, which were endorsed by more than 60 professional organizations from the public and private sectors. In January 1994, the National Vaccine Advisory Committee (NVAC) reviewed the status of adult immunization in the United States and presented specific goals and recommendations for improvement. The NVAC and NCAI revised the Standards in 2002. The Standards for Adult Immunization Practices provide a concise, convenient summary of the most desirable immunization practices. The standards are available in the Pink Book-Appendix H and online at the Revised Standards for Immunization Practices web-site.
Immunization Education & Training
June 27, 2008 -- The date for the 2008 Immunization Update webcast has changed and is now scheduled for August 28th. There will not be a satellite broadcast for this program. Anticipated topics for this webcast include:
- Influenza vaccination
- Zoster vaccination against shingles
- Recently approved vaccines
- Updates on vaccine supplies and vaccine safety
The webcast will feature a live question-and-answer session in
which participants can interact with course instructors via
toll-free telephone lines. Continuing Education credits will be provided.
The format for the 2008 Epidemiology & Prevention of Vaccine-Preventable Diseases has changed and is now available as a four-part self-study webcast or may be ordered in DVD format. This four-part self-study series provides the most current information available in the constantly
changing field of immunization. Together, the four sessions offer a comprehensive overview of
immunization. Session one discusses principles and general recommendations on immunization.
Sessions two, three, and four discuss specific vaccine-preventable diseases and their respective
vaccines. Each of the four sessions is three hours in duration. Continuing Education credits will be provided.
Prevention of Herpes Zoster: Recommendations of the Advisory Committee on Immunization Practices
June 13, 2008 -- The Florida Department of Health, Bureau of Immunization announces publication of the Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 2008; volume June 6, 2008 / 57);1-30 concerning the prevention of herpes zoster through vaccination. A Continuing Education Activity has been approved for this report and is included in the print and electronic format on June 06, 2008, in Vol. 57, No. RR-5. The credits awarded are as follows: CME, 2.75; CNE, 2.75; CEU, .25; and CHES, 3.0.
These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a live attenuated vaccine for the prevention of herpes zoster (zoster) (i.e., shingles) and its sequelae, which was licensed by the U.S. Food and Drug Administration (FDA) on May 25, 2006. This report summarizes the epidemiology of zoster and its sequelae, describes the zoster vaccine, and provides recommendations for its use among adults older than 60 years of age in the United States.
The CDC's Shingles Disease - Questions and Answers provides additional information.
Prevention of Pertussis, Tetanus, and Diphtheria Among Pregnant and Postpartum Women and Their Infants: Recommendations of the Advisory Committee on Immunization Practices
May 28, 2008 -- The Florida Department of Health, Bureau of Immunization announces publication of the Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report Early Release (MMWR) 2008; volume 57, 1-47 on May 14, 2008 concerning tetanus-diphtheria-pertussis (Tdap) vaccine use among pregnant and postpartum women.
The CDC's Advisory Committee on Immunization Practices (ACIP) recommends that pregnant women who were not vaccinated previously with Tdap:
- Receive Tdap in the immediate postpartum period before discharge from hospital or birthing center.
- May receive Tdap at an interval as short as two years since the most recent tetanus-diphtheria (Td) vaccine.
- Receive Td during pregnancy for tetanus and diphtheria protection when indicated.
- Defer the Td vaccine indicated during pregnancy to substitute Tdap vaccine in the immediate postpartum period if the woman is likely to have sufficient protection against tetanus and diphtheria.
This report:
- Describes the clinical features of pertussis, tetanus, and diphtheria among pregnant and postpartum women and their infants.
- Reviews available evidence of pertussis vaccination during pregnancy as a strategy to prevent infant pertussis.
- Summarizes Tdap vaccination policy in the United States.
- Presents recommendations for use of Td and Tdap vaccines among pregnant and postpartum women.
Haemophilus influenzae Type b Vaccine Interim Recommendations Update
May 5, 2008 -- The Florida Department of Health, Bureau of Immunization would like to remind providers that the Haemophilus influenzae Type b (Hib) vaccine booster dose administered at 12 to 15 months of age should continue to be deferred, except for specific high-risk groups described below and in the Morbidity and Mortality Weekly Report (MMWR).
The basic interim recommendations are as follows:
- Do not give the Hib vaccine booster to healthy children 12 to 15 months of age. Defer administering the routine Hib vaccine booster administered at 12 to 15 months of age, except for specified high-risk groups. Stocking vaccine to give the booster dose during the shortage can take away from providers who are struggling to provide the primary series.
- Continue to give booster to high-risk children with asplenia, sickle cell disease, HIV, other immune syndromes, or those who are Alaskan or Native American.
- Plan for when the shortage is over. Utilize best practice/recall-reminder systems and review the catch-up schedule at: http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm.
Temporary Medical Exemptions (TMEs) can/should be extended for children 12 to 15 months of age who are attending/entering child care as the Florida Certification of Immunization (DH Form 680) is issued or expires. Continue to keep track of children given TME extensions in order to recall them when vaccine supplies allow.
Please ensure that providers are reminded of the interim recommendations and that everything is done to follow them.
Please provide this information to colleagues, members, coalitions, and partners with an interest in the supply, distribution, management, and administration of Hib conjugate vaccines.
For questions regarding vaccine supply, contact the bureau at 850-245-4342.
Please remember that revised Hib recommendations are NOT office-specific—these affect the whole country.
Following are some Centers for Disease Control and Prevention (CDC) resources related to the Hib vaccine shortage:
Report from the Advisory Committee on Immunization Practices: Decision Not to Recommend Routine Vaccination of All Children 2 to 10 Years of age with Quadrivalent Meningococcal Conjugate Vaccine
At its February 2008 meeting, the Advisory Committee on Immunization Practices (ACIP) decided not to recommend routine vaccination of children 2 to 10 years of age against meningococcal disease, unless the child is at increased risk for the disease. This report summarizes the deliberations of the ACIP and the rationale for its decision, and restates existing recommendations for meningococcal vaccination among children 2 to 10 years of age at increased risk for meningococcal disease. The ACIP continues to recommend routine vaccination against meningococcal disease for all persons 11 to 18 years of age and those persons 2 to 55 years who are at increased risk for meningococcal disease.
The Morbidity and Mortality Weekly Report; volume 57, number 12, released on May 2, 2008, can be accessed at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5717a4.htm.
Fact Sheet and Talking Points: Measles United States, January 1 - April 25, 2008
The Florida Department of Health, Bureau of Immunization announces publication of the Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) Early Release 2008; volume 57; 1-4 on May 1, 2008, concerning important information regarding measles outbreaks in the U.S. The outbreak information includes 64 measles cases in 9 states, with outbreaks in 4 states from January 1 through April 24, 2008. While none of the cases are in Florida, a number of county health departments are conducting surveillance with contacts to the cases referenced in the attachment.
These cases and outbreaks resulted primarily from failure to vaccinate, many because of personal or religious belief exemption. This fact highlights:
- Ongoing risk of measles in unvaccinated persons.
- Risk that unvaccinated persons may transmit measles to others, including infants too young to be vaccinated, and the importance of maintaining high levels of vaccination.
Transmission has occurred in community and healthcare settings, including homes, childcare centers, schools, hospitals, emergency rooms, and physicians’ offices. The majority of cases are associated with importation from other countries.
Most important: immunization with the measles-mumps-rubella (MMR) vaccine is the most effective preventive measure. Unless there is other evidence of measles immunity, two doses of MMR vaccine are recommended for all school students, students in post–high school educational facilities, healthcare personnel, and international travelers who are older than 12 months of age (NOTE: infants 6 to 11 months of age should receive one dose prior to travel abroad).
The MMWR: Measles --- United States, January 1--April 25, 2008 can be accessed at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm57e501a1.htm. Further information is available in the CDC Fact Sheet: Measles, United States, January 1--April 25, 2008 [PDF 91 KB].
National Infant Immunization Week
Working together with Vaccination Week in the Americas
April 21-28, 2007
National Infant Immunization Week (NIIW) is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and celebrate the achievements of immunization programs and their partners in promoting healthy communities. Since 1994, NIIW has served as a call to action for parents, caregivers, and healthcare providers to ensure that infants are fully immunized against 14 vaccine-preventable diseases. This year NIIW will be held April 19-26, 2008. (National Infant Immunization Week).
Additionally, the National Immunization for Polio Prevention in Infants and Toddlers - or "NIPP IT" Campaign is being highlighted during this week. NIPP IT promotes immunization of all children against polio at two months of age, four months of age, six months of age, and a booster at four years of age. The NIPP IT theme is, “Don't wait to vaccinate!”
Update to Immunization Schedules for Human Papillomavirus
April 4, 2008 -- The Florida Department of Health, Bureau of Immunization directs your attention to the Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report (MMWR) 2008; volume 57, number 12 on March 28, 2008. This MMWR contains an erratum on page 319 (Errata: Vol 57, No. 1) for the Recommended Immunization Schedules for Persons Aged 0--18 Years---United States, 2008.
Most important is the change/clarification to the intervals on the catch-up schedule for Human Papillomavirus (HPV) vaccine as follows:
On page Q-4, in the lower section of the Table titled, "Catch-up schedule for persons aged 7--18 years," in row Human Papillomavirus, under column heading Dose 2 to Dose 3, the text should read: "12 weeks (and 24 weeks after the first dose)."
This change reflects addition of a 24-week minimum interval for the HPV series between dose 1 and dose 3. This means that the third dose needs to be administered no earlier than 6 months/24 weeks from the first dose. The minimum intervals between dose one and dose two, as well as between dose two and dose three, remain unchanged.
- Dose 1 to 2: 4 weeks
- Dose 2 to 3: 12 weeks (and 24 weeks after the first dose)
The erratum may be viewed at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5712a6.htm.
The revised HPV interval was published on March 5, 2008 , and the correction to the human papillomavirus (HPV) vaccine regimen can be viewed on the CDC web-site at: http://www.cdc.gov/vaccines/recs/schedules/child-schedule.htm.
The MMWR may be viewed at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm.
Food and Drug Administration Approves New Vaccine to Prevent Gastroenteritis Caused by Rotavirus
April 3, 2008 -- The U.S. Food and Drug Administration (FDA) today announced the approval of Rotarix®, 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, given in a two-dose series to infants from 6 to 24 weeks of age. (FDA Press Release)
Updated Recommendation for Use of 7-Valent Pneumococcal Conjugate vaccine
April 7, 2008 -- The Florida Department of Health, Bureau of Immunization announces publication of the Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) 2008; volume 57, number 13 on April 4, 2008, concerning 7-valent pneumococcal conjugate vaccine (PCV7). The complete MMWR can be accessed on the web at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5713a4.htm
This notice updates the recommendation for use of PCV7 vaccine among children 24 to 59 months of age, who are either unvaccinated or who have a lapse in PCV7 administration. The Advisory Committee on Immunization Practices (ACIP) Pneumococcal Vaccines Work Group reviewed data on PCV7, and on the basis of that review, the ACIP approved the following revised recommendation for use of PCV7 in children 24 to 59 months of age:
- For all healthy children 24 to 59 months of age, who have not completed any recommended schedule for PCV7, administer 1 dose of PCV7.
- For all children with underlying medical conditions, 24 to 59 months of age, who have received 3 doses, administer 1 dose of PCV7.
- For all children with underlying medical conditions, 24 to 59 months of age, who have received less than 3 doses, administer 2 doses of PCV7 at least 8 weeks apart.
No changes were made to previously published recommendations regarding the use of PCV7 in children 24 to 59 months of age; the list of underlying medical or immunocompromising conditions; or the use of 23-valent pneumococcal polysaccharide vaccine in children over 2 years of age, who have previously received PCV7.
The childhood immunization schedule is found at: http://www.cdc.gov/vaccines/recs/schedules/default.htm
Update: Interim Recommendations for the Use of Haemophilus influenzae Type b Conjugate Vaccines
March 6, 2008 -- The Florida Department of Health, Bureau of Immunization reminds providers that the Haemophilus influenzae Type b (Hib) Conjugate vaccine booster dose administered at 12 to 15 months of age should be deferred, except for specific high-risk groups described below and in the Morbidity and Mortality Weekly Report (MMWR). At this time, there are no immediate plans to change the interim recommendations. A cooperative effort for the appropriate use of a valuable resource currently in limited supply will work towards an equitable and appropriate public health use of the vaccine. Interim Recommendations for the Use of Haemophilus influenzae Type b (Hib) Conjugate Vaccines Related to the Recall of Certain Lots of Hib-Containing Vaccines (PedvaxHIB® and Comvax®) were posted on December 19, as an MMWR Dispatch. Additional information regarding the affected lots is available online from the Food and Drug Administration (FDA) at: http://www.fda.gov/consumer/updates/hib121307.html. Merck has suspended production of its Hib conjugate vaccines and does not expect to resume distribution of these vaccines until the fourth quarter of 2008. The recall of PedvaxHIB® and Comvax® and suspension of production are expected to result in short-term disruption to the Hib vaccine supply in the United States.
The basic interim recommendations are as follows:
- Defer administering the routine Hib vaccine booster administered at 12 to 15 months of age, except for specified high-risk groups.
- Certain children at increased risk for Hib disease, including children with asplenia, sickle cell disease, human immunodeficiency virus infection, and certain other immunodeficiency syndromes, and malignant neoplasms should continue to receive the full routinely recommended schedule, including the 12- to 15-month booster dose.
- American Indian/Alaska Native (AI/AN) children should also continue to receive the full routinely recommended schedule, including the 12- to 15-month booster dose. Providers who currently use PRP-OMP-containing Hib vaccines (PedvaxHib® and Comvax®) to serve predominantly AI/AN children in AI/AN communities should continue to use only PRP-OMP-containing Hib vaccines.
The original MMWR is available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5650a4.htm
The CDC shortage web-site can be found at: http://www.cdc.gov/vaccines/vac-gen/shortages/default.htm#hib. A flyer that providers will receive in vaccine shipments is at: http://www.cdc.gov/vaccines/vac-gen/shortages/downloads/hib-flyer-022008.pdf [PDF 552 KB].
Temporary Medical Exemptions (TMEs) can/should be extended 6 months for children 12 to 15 months of age who are attending/entering child care as the Certification of Immunization (DH Form 680) is issued or expires. Continue to keep track of children given TME extensions in order to recall them when vaccine supplies allow.
Wipe Out the Whoop
February 5, 2008 -- Wipe Out the Whoop is the National Foundation for Infectious Disease's (NFID) campaign to raise awareness of whooping cough risks and prevention. Campaign products include TV and radio public service announcments, national and local broadcast and print media interviews, and a consumer education brochure. To access these materials, please visit:
A public education initiative made possible through an unrestricted educational grant to NFID from Sanofi Pasteur.
Multi-Vaccine Information Statement
February 8, 2008 -- On January 30, 2008, the Centers for Disease Control and Prevention (CDC) posted a multi-vaccine Vaccine Information Statement (VIS) on its website. This new four-page (two pages front & back) VIS contains information on routine 0-6 month vaccines -- i.e., diptheria-tetanus-pertussis (DTaP), hepatitis B (hep B), inactivated polio vaccine (IPV), pneumococcal conjugate vaccine (PCV), Haemophilus influenzae type b (Hib), and rotavirus. It can be used as an optional alternative to the existing individual VISs when any combination of these vaccines are administered during the same visit (This includes combinations like Pediarix® or Comvax®.). In addition to the birth, 2, 4, & 6 month visits, this VIS could also be used for the 4th and 5th doses of DTaP and the 4th doses of PCV, IPV, or Hib, if they are given at the recommended ages. The publication date is 01/30/08.
Use of the multi-vaccine VIS is optional and an alternative to providing single-vaccine VISs for each of these six vaccines. The individual VISs for these vaccines may still be used.
Please note: This multi-vaccine VIS should NOT be used when any of these vaccines are administered to adolescents or adults because it doesn't contain information about risk factors, etc. for those ages.
Before you hand this new VIS to the patient, you MUST go to page one of the VIS and place a check-mark in front of the name of each vaccine you will be administering at that visit.
The multi-vaccine VIS is available from the CDC website: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-multi.pdf [PDF 105 KB] and the the Immunization Action Coalition (IAC) website at http://www.immunize.org/vis/vis_multi1.asp. For instructions on how to use this new VIS, go to: http://www.cdc.gov/vaccines/pubs/vis/vis-news.htm#multi. For additional information about the use of VISs, and for VISs in more than 30 languages, visit IAC's VIS webpage at: http://www.immunize.org/vis.
Florida SHOTS: This new VIS form covers DTaP, Hep B, IPV, PCV, Hib, and rotavirus. When recording new vaccinations of these types, the VIS option available by default will be this new form. To record the VIS publication date of any of the other single vaccine forms, click the "Other VIS Options" button.
See the complete list of available VISs on the CDC's VIS webpage: http://www.cdc.gov/vaccines/pubs/vis/default.htm.
Updated Meningococcal Vaccine Information Statement
February 8, 2008 -- The Vaccine Information Statement (VIS) for meningococcal conjugate vaccine (MCV) has been updated to incorporate the recent licensure of MCV for children 2 to 10 years of age, who are at increased risk from meningococcal disease. The new edition is dated 1/28/08. Existing stocks of the last version can be used up, although the new version should be used when administering MCV to anyone in the 2 to 10 age group.
The new VIS is available at: http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-mening.pdf [PDF 63 KB].
See the complete list of available VISs on the CDC's VIS webpage: http://www.cdc.gov/vaccines/pubs/vis/default.htm.
Recommended Immunization Schedules for Persons 0 to 18 Years of Age --- United States, 2008
January 11, 2008 -- The Florida Department of Health, Bureau of Immunization is pleased to announce the 2008 immunization schedule recommendations for children and adolescents. The 2008 Childhood and Adolescent Immunization Schedules represents joint recommendations from the American Academy Of Pediatrics (AAP), the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC), and the American Academy of Family Physicians (AAFP). Key changes to the previous schedules are as follows:
- The pneumococcal conjugate vaccine (PCV) footnote reflects updated recommendations for incompletely vaccinated children 24 to 59 months of age, including those with underlying medical conditions.
- Recommendations for use of the live attenuated influenza vaccine (LAIV) now include healthy children as young as 2 years of age.
- LAIV should not be administered to children less than 5 years of age with recurrent wheezing.
- Children less than 9 years of age who are receiving influenza vaccine for the first time or who were vaccinated for the first time last season, but only received one dose, should have two doses of vaccine, at least four weeks apart.
- For meningococcal vaccines, changes affect certain children 2 to 10 years of age.
- Vaccinating with meningococcal conjugate vaccine (MCV4) is preferred to meningococcal polysaccharide vaccine (MPSV4) for children at increased risk for meningococcal disease, including children who are traveling to, or residents of, countries in which the disease is hyperendemic or epidemic, children who have terminal complement component deficiencies, and children who have anatomic or functional asplenia.
- The catch-up schedule for youths 13 to 18 years of age has been updated.
- MPSV4 is an acceptable alternative for short-term (i.e., 3 to 5 years) protection against meningococcal disease for persons 2 to 18 years of age.
- The tetanus and diphtheria toxoids/tetanus and diphtheria toxoids and acellular pertussis vaccine (Td/Tdap) catch-up schedule for persons 7 to 18 years of age who received their first dose before 12 months of age now indicates that these youths should receive four doses, with at least four weeks (not eight weeks) between doses two and three.
- The catch-up bars for hepatitis B and Haemophilus influenzae type b (Hib) conjugate vaccine have been deleted on the routine schedule for persons 0 to 6 years of age.
The National Childhood Vaccine Injury Act requires that healthcare providers provide parents or patients with copies of Vaccine Information Statements before administering each dose of the vaccines listed in the schedule. Additional information is available from state health departments and from CDC at: http://www.cdc.gov/vaccines/pubs/vis/default.htm.
The complete 2008 schedules can be viewed online at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5701a8.htm?s_cid=mm5701a8_e.
