Immunization Action Coalition and the Hepatitis B Coalition

IAC EXPRESS

Previous issues index

Home page

Issue Number 289            January 7, 2002

CONTENTS OF THIS ISSUE

  1. CDC publishes Notice to Readers on DTaP shortage
  2. CDC publishes article on drug-resistant Streptococcus pneumoniae in a child care center in Georgia
  3. Important finding: Routine childhood hepatitis A vaccination can lower disease in whole community
  4. Easy online video explains Medicare billing process
  5. DHHS offers two further treatment options for those exposed to anthrax
  6. Reminder: Every Child By Two newsletter covers immunization events on Capitol Hill
  7. New translation! 2001 Summary of Adult Recommendations available in Turkish

----------------------------------------------------------

Back to Top

(1 of 7)
January 7, 2002
CDC PUBLISHES NOTICE TO READERS ON DTAP SHORTAGE

On January 4, 2002, CDC published "Notice to Readers: Update: Supply of diphtheria and tetanus toxoids and acellular pertussis vaccine" in the Morbidity and Mortality Weekly Report (MMWR).

The complete text of the Notice, excluding references and one footnote, reads as follows:

*****************************

Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) remains in short supply, and the shortage will continue into mid-2002. Shortages are greatest in the public sector. Despite high vaccination rates, pertussis continues to cause serious illness and death, particularly among infants aged <6 months who are too young to have completed the 3-dose primary series of  DTaP. In 2000, a total of 1,873 pertussis cases (rate: 99 per 100,000 infants aged <6 months) and 16 deaths were reported among infants aged <6 months. Vaccinating infants on time with the 3-dose primary series of DTaP to protect them from serious disease remains a priority during this vaccine shortage.

The shortage began in 2000 when two manufacturers (Wyeth Lederle, Pearl River, New York, and Baxter Hyland Immuno Vaccines, Baltimore, Maryland)  stopped production of DTaP. Aventis Pasteur (Swiftwater, Pennsylvania) and GlaxoSmithKline (Philadelphia, Pennsylvania), producers of Tripedia* and Infanrix**, respectively, are the only two U.S. suppliers.

DTaP is recommended as a 5-dose series: 3 doses administered to infants at ages 2, 4, and 6 months, followed by 2 additional doses at age 15-18 months and at age 4-6 years. During the shortage of DTaP, the Advisory Committee on Immunization Practices recommends that providers who do not have enough DTaP to vaccinate all children with 5 doses give priority to vaccinating infants with the first 3 doses. To ensure an adequate supply of DTaP to vaccinate infants, providers should first defer vaccination of children aged 15-18 months with the fourth DTaP dose. If deferring the fourth dose does not leave enough DTaP to vaccinate infants, then the fifth DTaP dose (given to children aged 4-6 years) also should be deferred. In areas with severe DTaP shortages, local public health officials might elect to recommend communitywide deferral of the fourth DTaP dose, and, if necessary, the fifth DTaP dose. 

When the DTaP shortage ends, providers should recall and administer DTaP to all children who missed a dose. Vaccination of children aged 4-6 years is needed to ensure immunity to pertussis, diphtheria, and tetanus during the elementary school years.

*****************************

* Registered trademark
** Trademark

To obtain the complete text of this Notice online, go to:
http://www.cdc.gov/mmwr//preview/mmwrhtml/mm5051a3.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr//PDF/wk/mm5051.pdf

HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
To obtain a free electronic subscription to the "Morbidity and Mortality Weekly Report" (MMWR), visit CDC's MMWR website at: http://www.cdc.gov/mmwr Select "Free MMWR Subscription" from the menu at the left of the screen. Once you have submitted the required information, weekly issues of the MMWR and all new ACIP statements (published as MMWR's "Recommendations and Reports") will arrive automatically by email.
-----------------------------------------------------------

Back to Top

(2 of 7)
January 7, 2002
CDC PUBLISHES ARTICLE ON DRUG-RESISTANT STREPTOCOCCUS PNEUMONIAE IN A CHILD CARE CENTER IN GEORGIA

On January 4, 2002, CDC published "Multidrug-resistant Streptococcus pneumoniae in a child care center--Southwest Georgia, December 2000" in the Morbidity and Mortality Weekly Report (MMWR).

The first paragraph of the article reads as follows:

*****************************

On December 18, 2000, public health officials in southwest Georgia contacted the Georgia Division of Public Health (GDPH) about a child aged 11 months  hospitalized for refractory otitis media. Eight days before hospitalization, a culture of drainage obtained from the child's middle ear revealed Streptococcus pneumoniae resistant to penicillin, clindamycin, erythromycin, trimethoprim/sulfamethoxazole, and tetracycline (index strain). The child attended a local child care center. GDPH and CDC conducted an investigation to determine the rate of pneumococcal carriage among attendees of the child care center, to identify risk factors for carriage of the index strain, and to characterize parental knowledge and use of antibiotics and of pneumococcal conjugate vaccine (PCV7) (Prevnar*, Wyeth Lederle Vaccine, Philadelphia, Pennsylvania). GDPH met with parents and physicians of children attending the child care center to discuss the results of the investigation and the importance of vaccination with PCV7. This report summarizes the results of the investigation, which suggest that  person-to-person transmission of the index strain had occurred at the child care center and indicate that most parents had been unaware of the dangers of frequent antibiotic use and of the availability of PCV7. A multifaceted intervention targeting parents and health-care providers might improve prescribing practices and vaccination in this community.

*****************************

* Trademark

To obtain the complete text of this article online, go to:
http://www.cdc.gov/mmwr//preview/mmwrhtml/mm5051a2.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr//PDF/wk/mm5051.pdf
-----------------------------------------------------------

Back to Top

(3 of 7)
January 7, 2002
IMPORTANT FINDING: ROUTINE CHILDHOOD HEPATITIS A VACCINATION CAN LOWER DISEASE IN WHOLE COMMUNITY

According to an article in the December 19, 2001, issue of JAMA, the Journal of the American Medical Association (vol. 286, no. 23), a 6-year community-based project in Butte County, California, confirmed that vaccinating children against hepatitis A can reduce the incidence of hepatitis A disease in the community at large. As noted in the Introduction to the article, "Available data suggest that young children, frequently asymptomatic when infected, play an important role in hepatitis A virus (HAV) transmission."

"Control of Hepatitis A Through Routine Vaccination of Children" was written by Francisco Averhoff, M.D., M.P.H., National Immunization Program, Centers for Disease Control and Prevention; Craig N. Shapiro, M.D., and Beth P. Bell, M.D., M.P.H., Division of Viral Hepatitis, National Center for Infectious Diseases; Insu Hyams, B.S.R.N., Butte County Department of Health; and nine other authors. These researchers reported that 66.2 percent of the eligible children in Butte County received one dose of hepatitis A vaccine and 39.3 percent received a second dose. The total number of cases of hepatitis A declined from 57 in 1995 to only 4 in 2000, which was the lowest number reported in the county since hepatitis A surveillance began in 1966.

The Conclusion states: "In this population, hepatitis A vaccine was highly effective in preventing disease among recipients. Childhood vaccination appears to have decreased hepatitis A incidence among children and adults and controlled the disease in a community with recurrent epidemics."

To see the Abstract of this article, go to:
http://jama.ama-assn.org/issues/v286n23/abs/joc10974.html

The entire article is available online at no charge only to registered users or subscribers of JAMA. To order the article online on a Pay Per View basis  ($9.00 fee), go to: https://secure.edoc.com/PPV2AMA.html

To order individual reprints, call the JAMA reprint department at (312) 464-4594 or contact one of the independent reprint vendors listed at: http://pubs.ama-assn.org/docdelivery.html
-----------------------------------------------------------

Back to Top

(4 of 7)
January 7, 2002
EASY ONLINE VIDEO EXPLAINS MEDICARE BILLING PROCESS

A 22-minute video shows you how to bill Medicare for influenza and pneumococcal vaccinations. Produced and newly updated by the Centers for Medicare and Medicaid Services (CMS; formerly the Health Care Financing Administration, HCFA), the video covers both carrier and intermediary roster billing. IAC's reviewer described the video as "smoothly paced, an enjoyable way to learn about this important material through sight and sound."

The CMS video is available online through the Missouri Patient Care Review Foundation. You will need to have a 56K modem and Real Player 8, which can be downloaded from Real.com for free.

To watch the video online, go to:
http://www.mpcrf.org/MU/

For the text guide that accompanies the video, go to:
http://www.hcfa.gov/quality/3g8.htm

To order a free copy of the video on tape, contact Linda Horsch at CMS by email at lhorsch@cms.hhs.gov or by phone at (214) 767-4467
-----------------------------------------------------------

Back to Top

(5 of 7)
January 7, 2002
DHHS OFFERS TWO FURTHER TREATMENT OPTIONS FOR THOSE EXPOSED TO ANTHRAX

On December 18, 2001, the Department of Health and Human Services (DHHS) issued a statement titled "Regarding Additional Options for Preventive Treatment for Those Exposed to Inhalational Anthrax."

The statement pertains to people who were exposed to inhalational anthrax in the recent mail incidents and who are concluding their 60-day course of preventive antibiotic treatment. DHHS is providing two options for those who want to pursue them: "an extended course of antibiotics, and investigational post-exposure treatment with anthrax vaccine."

To read the statement on the Department of Health and Human Services website, go to: http://www.hhs.gov/news/press/2001pres/20011218.html
-----------------------------------------------------------

Back to Top

(6 of 7)
January 7, 2002
REMINDER: EVERY CHILD BY TWO NEWSLETTER COVERS EVENTS ON CAPITOL HILL

As we enter a new legislative session, don't forget to keep informed about new vaccination legislation by reading the Every Child By Two (ECBT) bimonthly newsletter and the less-frequent supplement "On the Hill," which covers pertinent committee hearings and other events as they occur.

The December 18, 2001, issue of "On the Hill" includes a discussion of the 2002 funding increase for the National Immunization Program.

To read the ECBT newsletter and the "On the Hill" supplement online, go to: http://www.ecbt.org/allnews.html

To subscribe to the newsletter by email, send a request to info@ecbt.org
-----------------------------------------------------------

Back to Top

(7 of 7)
January 7, 2002
NEW TRANSLATION! 2001 SUMMARY OF ADULT RECOMMENDATIONS AVAILABLE IN TURKISH

IAC now offers the current "Summary of Recommendations for Adult Immunization" in Turkish.

To view or print a camera-ready (PDF format) copy of the summary of adult immunization recommendations in Turkish, go to:
http://www.immunize.org/catg.d/p2011tu.pdf

For the English version, go to:
http://www.immunize.org/catg.d/p2011b.pdf

IAC thanks Dr. Mustafa Kozanoglu, pediatrician, and Dr. Murat Serbest, pediatric hematologist, both from Adana, Turkey, for providing this translation. 

 

Immunization Action Coalition1573 Selby AvenueSt. Paul MN 55104
E-mail: admin@immunize.org Web: http://www.immunize.org/
Tel: (651) 647-9009Fax: (651) 647-9131

This page was updated on January 7, 2002