Note: This CDC Health Alert Network Advisory #00359 includes vaccination recommendations for influenza. Advisory Summary: From November through December 2013, CDC has received a number of reports of severe respiratory illness among young and middle-aged adults, many of whom were infected with influenza A (H1N1) pdm09 (pH1N1) virus. Multiple pH1N1-associated hospitalizations, including many requiring intensive care unit (ICU) admission, and some fatalities have been reported. The pH1N1 virus that emerged in 2009 caused more illness in children and young adults, compared to older adults, although severe illness was seen in all age groups. While it is not possible to predict which influenza viruses will predominate during the entire 2013-14 influenza season, pH1N1 has been the predominant circulating virus so far. For the 2013-14 season, if pH1N1 virus continues to circulate widely, illness that disproportionately affects young and middle-aged adults may occur.
Merck is implementing a voluntary recall of one lot (lot J007354) of Gardasil [Human Papillomavirus Quadrivalent (types 6, 11, 16, and 18) Vaccine, Recombinant] due to the potential for a small number of vials to contain glass particles. This resulted from a breakage during the manufacturing process. Seven practices in Rhode Island received vaccine from this lot. These practices have all been contacted by the Rhode Island Department of Health. However, healthcare providers are asked to check their inventories to ensure that they did not receive vaccine from this lot through a transfer from another practice. Patients do not need to take any action as a result of this recall. If a vaccine containing glass particles was administered, mild reactions routinely seen after vaccination may occur. These could include redness or swelling at the injection site. To date, no adverse events related to this lot of HPV vaccine have been reported other than these types of mild reactions.
Rhode Island's immunization regulations now require healthcare workers with direct patient contact in certain facilities to take specific precautions to limit the transmission of influenza. Healthcare workers in these facilities must either be vaccinated by December 15 each year or wear surgical masks when influenza is widespread.
11/15/2013 14:30 EST
Overstocking influenza Vaccine
To ensure that all vaccine providers have an adequate amount of vaccine to immunize their patients this year, providers are asked to please not overstock influenza vaccine. A practice should only order the amount of influenza vaccine it anticipates administering during the following two weeks. Practices may re-order every 5 business days.
The Rhode Island Department of Health (HEALTH) monitors the amounts of vaccine that practices have ordered and administered. Please report vaccine administration information as quickly and accurately as possible.
11/15/2013 14:30 EST
No vaccine shipments during two upcoming periods
During the upcoming holiday season, vaccine orders will not be shipped during the following periods: November 26, 2013 – November 29, 2013; December 20, 2013 – January 2, 2014.
Healthcare providers who order vaccine before November 26th and December 20th may receive orders during these periods. However, no new orders will be processed and shipped during these periods. Please order accordingly (particularly when ordering flu vaccine for the weeks of December 9th and December 16th).
Providers whose monthly vaccine orders fall between November 18 and December 1 should make sure that they order enough vaccines to cover their needs for the entire blackout period. You will be able to place your December order during the blackout period but it will not be delivered until the first week of January at the earliest.