Date: March 22, 2006
To: Vaccines for Children (VFC) Providers ( Please post and share with all vaccine providers)
Re: Update on Availability of State-Supplied Vaccines and Guidelines for Use
Influenza Vaccine
According to a recent media release, influenza activity is currently widespread in Rhode Island: http://www.health.ri.gov/media/060316b.php. Flu vaccine is still available from the Immunization Program, and it is not too late to vaccinate. VFC providers with a remaining supply of state-supplied flu vaccine may use the vaccine for any unvaccinated children aged 6 months –18 years. Please consider vaccinating children who recently turned 6 months of age who were not eligible (too young) earlier in the flu season. Providers who do not have any flu vaccine and would like to order some should contact the Immunization Program. Providers may also refer unvaccinated children to the Immunization Clinic at St. Joseph’s Hospital at (401) 456-4359.
Meningococcal Conjugate Vaccine (MCV4), Menactra
Clarification: The Immunization Program has received numerous questions regarding the need for an additional or booster dose of Menactra for children who have previously received the recommended single dose. At this time, there is no recommendation for an additional dose. According to the Advisory Committee on Immunization Practices (ACIP), the vaccine should provide protective immunity for at least 8 years. More data should become available within the next 5 years to guide recommendations on revaccination for persons who were previously vaccinated.
Guidelines for use: A single dose of Menactra should be given routinely to adolescents 11 – 12 years of age at the preadolescent visit. Also, continue vaccinating college-bound students who will be living in dormitories. As vaccine supply permits, Menactra may also be given to adolescents 13 – 18 years of age who have not yet received a dose.
Tdap Vaccine
Guidelines for use: A single dose of Tdap should be given routinely to adolescents 11–12 years of age who have completed the recommended childhood DTP/DTaP vaccination series and have not received a Td booster dose. As vaccine supply permits, Tdap may also be given to adolescents 13–18 years. An interval of at least 5 years between Td and Tdap is encouraged to reduce the risk for local and systemic reactions after Tdap vaccination. However, an interval less than 5 years between Td and Tdap can be used (http://www.cdc.gov/mmwr/preview/mmwrhtml/rr55e223a4.htm). Subsequent Td boosters are recommended every 10 years.
Varicella (Chickenpox) Vaccine
ACIP has expanded the recommendations for varicella vaccine to promote wider use of the vaccine for adolescents and adults, HIV-infected children, and a second dose for outbreak control. Also, the ACIP approved a revised definition for evidence of immunity to varicella, which is available at: http://www.cdc.gov/nip/vaccine/varicella/varicella_acip_recs.pdf.
Note: Effective January 2006, varicella has been added to the Rhode Island list of reportable diseases. All cases of varicella should be reported to the Immunization Program using the Varicella Case Report Form. The form is available at http://www.health.ri.gov/topics/chickenpox.php (KIDSNET providers may access the reporting form on your KIDSNET website through the Forms and Resources link) and should be faxed to the Immunization Program at 222-1442.
For dosage and administration guidelines about any of the above vaccines, please refer to the vaccine package insert.
For more information about ACIP vaccine recommendations go to http://www.cdc.gov/nip/publications/acip-list.htm.
Contacts for questions about this update:
Mark Francesconi, 222- 5988, markf@doh.state.ri.us, for questions about vaccine ordering and supply.
Patricia Raymond, RN, 222-5921, patricia.raymond@health.ri.gov, for questions about vaccine recommendations.
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