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Immunization Action Coalition
Errata
Introduction
All of us at the Immunization Action Coalition (IAC) work tirelessly to ensure the accuracy of the information we make available. As part of this effort, we have created an errata page to serve as the central location for all important changes to items we have published in our periodicals, Needle Tips, Vaccinate Adults!, Vaccinate Women, as well as in IAC Express, our Internet news and announcement service, and on this website.
Our procedure will be to publish in IAC Express notices of corrections to our publications and to present them chronologically on this "Errata Page."
We welcome your eagle-eyed oversight of the content of our publications. If you believe you have found an error, please notify us as soon as possible so that we may evaluate the item immediately and determine the need for a formal erratum. On the errata page, you will find only serious corrections, for example, those that misrepresent fact and/or could result in clinical errors. Though we are also concerned about correcting administrative information such as contact names and phone numbers presented in our publications, these types of revisions will probably not appear on this page. Whether an error is big or small, we always want to know whenever you spot one.
To ensure that everyone receives the most up-to-date information, we ask that you encourage your colleagues and anyone else who might receive IAC publications to subscribe to IAC Express. Once they have subscribed, they will begin to receive any notices of corrections to Coalition publications as soon as these changes are made available.
With your help, we will continue to provide you with the most accurate information possible.
signature
Deborah L. Wexler, MD
Executive Director
 
Errata
Needle Tips, February 2013
Posted February 25, 2013

The answer to the following "Ask the Experts" question was incorrect.

QUESTION:
A 7-year-old who needed a tetanus shot for wound management came into our emergency department. My question is, if a child has received the complete 5-dose series of DTaP but has never had Tdap, should the child receive Tdap or Td for wound management?
REVISED ANSWER:
Neither. A child who has completed 5 doses of DTaP has by definition received the fifth dose on or after his/her 4th birthday. In this child's case, it has been less than four years since receipt of the complete series, so the child does not need either Tdap or Td. The child is fully vaccinated against tetanus according to CDC tetanus wound management guidelines.
[View corrected issue]
Handout: Medical Management of Vaccine Reactions in Children and Teens
Posted May 4, 2011

The Immunization Action Coalition (IAC) has posted a second correction to its educational piece for healthcare professionals: "Medical Management of Vaccine Reactions in Children and Teens."

The maximum single dose of 50 mg of diphenhydramine (Benadryl) for adolescents cited on page 2 of 3, differed from the maximum single dose of 100 mg noted in the table on page 3. IAC has revised the table on page 3 to correspond with the information given on page 2 (i.e., 50 mg is the maximum single dose). We apologize for any confusion this has caused and thank our readers for calling attention to this discrepancy in the educational piece.
Note: Recommendations differ for the use of diphenhydramine. The source materials IAC referenced for this piece recommend a maximum single dose of 50 mg of diphenhydramine (Benadryl) for adolescents (>100 lbs), whereas other sources recommend a maximum single dose of 100 mg of diphenhydramine (Benadryl) for adolescents (>100 lbs). The sources IAC referenced are included at the end of the handout.
If you obtained "Medical Management of Vaccine Reactions in Children and Teens" from our website prior to May 4, 2011, be sure to download the updated and corrected version at www.immunize.org/catg.d/p3082a.pdf
Handout: Medical Management of Vaccine Reactions in Children and Teens
Posted April 12, 2011

IAC has posted the following important correction to its educational piece for healthcare professionals: "Medical Management of Vaccine Reactions in Children and Teens."

On page 3 of 3, an incorrect epinephrine dose is listed in the table titled "First-Line Treatment, Epinephrine." In the row for infants and children age 5–7 years, 40–56 lb, 18–25.5 kg, the incorrect dose read "0.2–25 mL (or mg)" and now has been corrected to read "0.2–0.25 ml (or mg)."
From April 7 until the afternoon of April 12, the incorrect version was posted on IAC's website. If you downloaded "Medical Management of Vaccine Reactions in Children and Teens" prior to April 13, 2011, be sure to download the updated and corrected version at www.immunize.org/catg.d/p3082a.pdf
IAC thanks Robin Candace, RN, BSN, Compliance Manager, LifeLong West Berkeley Family Practice, Berkeley, California, for notifying us of this significant error.
Needle Tips, March 2008
Posted May 14, 2009

IAC incorrectly stated that vaccination errors such as giving the wrong vaccine or dose should be reported to the Vaccine Adverse Event Reporting System (VAERS); however, VAERS only collects information about adverse events (possible side effects) that occur after the administration of U.S. licensed vaccines.

QUESTION:
If we inadvertently give a 12-year-old child Zostavax instead of Varivax, what should we do?
REVISED ANSWER:
"This is a serious vaccine administration error. The event should be documented and procedures put in place to prevent this from happening again. Zostavax vaccine contains about 14 times as much varicella vaccine virus as Varivax."
Needle Tips, October 2007
Posted May 14, 2009

IAC incorrectly stated that vaccination errors such as giving the wrong vaccine or dose should be reported to the Vaccine Adverse Event Reporting System (VAERS); however, VAERS only collects information about adverse events (possible side effects) that occur after the administration of U.S. licensed vaccines.

QUESTION:
Someone gave Tdap to an infant instead of DTaP. Now what should be done?
REVISED ANSWER:
"This error sometimes happened because the packaging for the sanofi products (Daptacel® [DTaP] and Adacel® [Tdap]) was quite similar. You'll be glad to know that sanofi pasteur has changed their packaging and you should notice more distinct tabs, new package colors and vial labels, and clear use-descriptions next to the package logos.

If Tdap was inadvertently administered to a child, it should not be counted as either the first, second, or third dose of DTaP. The dose should be repeated with DTaP. Continue vaccinating on schedule. If the dose of Tdap was administered for the fourth or fifth DTaP dose, the Tdap dose can be counted as valid. Please remind your staff to always check and double check the vaccine vial before administering any vaccine.

Needle Tips, October 2007
Posted May 14, 2009

IAC incorrectly stated that vaccination errors such as giving the wrong vaccine or dose should be reported to the Vaccine Adverse Event Reporting System (VAERS); however, VAERS only collects information about adverse events (possible side effects) that occur after the administration of U.S. licensed vaccines.

QUESTION:
Someone in our clinic gave DTaP to a 50-year-old instead of Tdap. How should this be handled?
REVISED ANSWER:
"The DTaP recipient received the appropriate amount of tetanus toxoid and MORE diphtheria toxoid and pertussis antigen than is recommended. Count the dose, but take measures to prevent this error in the future.
Needle Tips, March 2008; Vaccinate Adults, March 2008; and Vaccinate Women, June 2008
Posted August 3, 2008

IAC was informed by a careful reader that an incorrect answer was published in "Ask the Experts" to a question concerning pre-exposure prophylaxis for travelers to protect them from hepatitis A virus infection. CDC provided the correct answer.

QUESTION:
What are the new recommendations for vaccination of travelers to protect them from hepatitis A virus (HAV) infection?
REVISED ANSWER:
"The new recommendations (www.cdc.gov/mmwr/preview/mmwrhtml/mm5641a3.htm) state that (1) hepatitis A vaccine is recommended for healthy susceptible persons ages 1 through 40 years who travel to or work in regions where hepatitis A is endemic and (2) hepatitis A vaccine should be given as soon as travel is considered, but it can be given any time prior to departure. For optimal protection, persons older than age 40 years, immunocompromised persons, and persons with diagnosed chronic liver disease or other chronic medical conditions, if departure will take place within two weeks, should also receive IG simultaneously with the first dose of hepatitis A vaccine but at a different anatomic injection site. For travelers younger than age 1 year, IG alone is recommended because hepatitis A vaccine is not licensed for use in this age group. Hepatitis A is endemic in all regions except the United States, Western Europe, New Zealand, Australia, Canada, and Japan."
Needle Tips [View corrected issue]
Vaccinate Adults! [View corrected issue]
Vaccinate Women [View corrected issue]
Needle Tips, March 2008
Posted April 14, 2008

IAC has received some questions asking for clarification of an "Ask the Experts" Q&A concerning a dosing error in which an adult patient was mistakenly given a pediatric dose of hepatitis A vaccine.

QUESTION:
"One of our staff gave a dose of pediatric hepatitis A vaccine to an adult patient by mistake. How do we remedy this error?"
REVISED ANSWER:
"If less than a full age-appropriate dose of any vaccine is given, the dose should not be counted. The person should be revaccinated with the appropriate dose as soon as possible."
[View corrected issue]
Needle Tips, October 2007
Posted November 5, 2007

IAC has received some questions asking for clarification of an "Ask the Experts" Q&A, written by CDC's Dr. William Atkinson and Dr. Andrew Kroger, about which children need two doses of influenza vaccine the first year they receive the vaccine.

QUESTION:
"Which children need two doses of influenza vaccine this season?"
REVISED ANSWER:
"Children age eight years and younger who are receiving influenza vaccine (TIV or LAIV) for the first time should receive two vaccine doses given with a minimum interval of four weeks. If the child fails to get the second dose during that season, he should be given two doses in the next influenza vaccination season. If he fails to receive those two doses, he should only get one dose per year from that point on."
[View corrected issue]
Needle Tips and Vaccinate Adults, May 2005
Posted June 30, 2005

In the article "Vaccine Highlights," IAC inadvertently passed along misinformation about the amount the Centers for Medicare & Medicaid Services (CMS) reimburses physicians for administering influenza vaccinations. This information, which we picked up from a CMS press release dated November 3, 2004, is somewhat misleading. The correct information is that the AVERAGE payment for administering injectable influenza vaccine increased from $8 to $18.

STATEMENT:
"For example, payments for administering injectable influenza vaccine increased from $8 to $18."
REVISED STATEMENT::
"For example, the average payment for administering injectable influenza vaccine increased from $8 to $18."
[View corrected issue]
Needle Tips, Summer 2002
Posted September 11, 2002
The article "Vaccines and Autism" by Paul A. Offit, MD, contained a one-word error. In the last paragraph of page 7, in the section titled "Evidence that autism occurs in utero," the phrase "24 weeks" appeared twice. Both instances have been corrected to "24 days" on the web-based version of the article on the Immunization Action Coalition's website.
[View corrected article]
Needle Tips, Fall/Winter 1999-2000
In the fall/winter 1999-2000 issue of Needle Tips, there is incorrect information in the answer to an "Ask the Experts" question appearing under "General Questions" on page 15. The answer provided by Dr. William Atkinson, medical epidemiologist at the National Immunization Program, Centers for Disease Control and Prevention, was incorrect about the components of the pentavalent vaccine for infants in use in Canada. Dr. Atkinson reported that the combination vaccine used in Canada contains whole cell pertussis vaccine when, in fact, it does not. The revised answer which follows should be substituted for the original answer that appeared in Needle Tips.
QUESTION:
"I've heard there is a pentavalent vaccine for infants in use in Canada. When will a pentavalent vaccine be available in the U.S.?"
REVISED ANSWER:
"The Canadian vaccine (PENTACEL distributed by Pasteur Mérieux Connaught, Canada) is a combination of acellular pertussis, diphtheria, and tetanus toxoids, Hib and inactivated polio vaccines. In the United States, trials of new combination vaccines are in progress and some of these may be licensed in the future. SmithKline Beecham has recently applied to the Food and Drug Administration for approval of a new DTaP-IPV-Hep B combination vaccine."
ADDITIONAL COMMENTS:
The current pentavalent vaccine used for primary immunization of infants in all Canadian provinces and territories is a combination of acellular pertussis, diphtheria and tetanus toxoids, and Hib and inactivated polio vaccines (PENTACEL distributed by Pasteur Mérieux Connaught, Canada). PENTACEL was licensed in May 1997 and first introduced into the infant vaccination schedule by some jurisdictions in July 1997, and fully incorporated into the infant schedule by all provinces and territories by April 1998. The pentavalent vaccine which contained whole cell pertussis vaccine is no longer distributed in Canada.
[View corrected issue]
This page was reviewed on February 25, 2013
Immunization Action Coalition  •  1573 Selby Ave  •  St. Paul, MN 55104
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This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 5U38IP000290) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.