July 24, 2002
CONTENTS OF THIS ISSUE
- "NEEDLE TIPS" summer
2002 issue is in the mail and on the web!
- CDC publishes
findings from high-risk adolescent and adult hepatitis B vaccination
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(1 of 2)
July 24, 2002
"NEEDLE TIPS" SUMMER 2002 ISSUE IS IN THE MAIL AND ON THE
Look for your hard copy of the current "NEEDLE TIPS and
the Hepatitis B Coalition News" in your
mailbox soon--you can't miss the summery
teal-green ink. Meanwhile, the entire summer 2002
issue is now available on IAC's
This mid-year issue of "NEEDLE TIPS" contains so much new
information and material, you might want to
preview and print individual pieces from it. For
instance, we've produced a great new refrigerator
temperature log for you to use on a daily
basis in your clinic--why not download a copy and
start logging temps properly today?
And don't let another questioning patient leave your
office without a copy of IAC's list of
"Reliable Sources of Immunization Information."
You will also want to read our special
welcome to Diane Peterson, IAC's new associate
director for immunization projects; she will be an
important point person on many topics for the Coalition.
You can read more about the "NEEDLE TIPS" summer issue's
features and departments below, with links
to each article provided for your convenience. But
it's easy to see already how valuable "NEEDLE
TIPS" is as a source of practical
immunization information for health professionals.
"NEEDLE TIPS" gathers the most important,
up-to-date, expert-approved, clinical vaccination
information in one 28-page publication.
Every word in "NEEDLE TIPS" is reviewed for
accuracy by immunization specialists at the
federal Centers for Disease Control and
In addition to being valuable, "NEEDLE TIPS" is
accessible: it is offered to all public and private
immunizers free of charge. However, this year IAC lost
some of its traditional funding and had to cut
back publication distribution, so please
take a moment to read IAC Executive Director
Deborah Wexler's request for
financial support on the back page of "NEEDLE TIPS." If
you are not already a contributor to
IAC, we hope that you will acknowledge the value
of "NEEDLE TIPS" and all of IAC's work by sending
in a tax-deductible contribution. We thank
you for your help.
HOW TO READ "NEEDLE TIPS" ON THE WEB:
You can download the entire issue of "NEEDLE TIPS" from
the web or view selected articles from the
table of contents below.
To view the table of contents with links to individual
articles, go to:
Please note: The PDF file of the entire summer 2002 issue,
linked below, is large at 899,993 bytes.
Some printers cannot print such a large file. For
tips on downloading and printing PDF files, go to:
To download the entire PDF version of the summer 2002
issue of "NEEDLE TIPS," go to:
Here are direct links to some of the main "NEEDLE TIPS"
pages following brief descriptions:
- "Ask the Experts"
CDC immunization expert William Atkinson, M.D., M.P.H.,
answers general immunization questions.
Hepatitis specialists Stephen C. Hadler, M.D.,
and Linda A. Moyer, R.N.,
answer hepatitis questions.
- "IAC Welcomes New Associate Director for
IZ Projects" and "Welcome New Board Member!"
Meet Diane Peterson, IAC's new associate director for
immunization projects, and Thomas Stenvig,
IAC's new board member representing the American
- "Vaccine Highlights"
Be sure to read this digest of recent recommendations and
news about vaccine supply, influenza
vaccine, smallpox, and more.
- "Unprotected People: Young Doctor Learns
He Has Liver Cancer Too Late"
This story about a young doctor's death from hepatitis B-related liver
cancer is a tragic example of the
consequence of inadequate medical attention to people with
chronic hepatitis B.
- "Vaccines and Autism" by Dr. Paul Offit
Here is a definitive article on the topic by a renowned
physician who critically dissects the
hypothesis--and the research investigating
it--that MMR vaccine might be causally related
to autism in children. By the end, you
will understand why autism is not caused by MMR vaccine
and why the issue must be put to rest.
- "Reliable Sources of Immunization
This is a list of IAC's top picks for books, websites, and
other sources of information for patients
- "How to Administer IM and SC Injections"
Two full-page charts show and tell how to give
intramuscular (IM) and subcutaneous (SC)
injections. They are a great training tool. Use
these to make sure your staff vaccinators are
giving shots correctly. Adapted from
similar charts by the Minnesota Department of Health.
- "Protect Your Vaccines: Check Temperatures
Twice a Day!"
We have adapted this Fahrenheit temperature log from the
Michigan Department of Community Health.
Once you try using it, you'll make a habit of
it--which is, of course, the point! This log
makes recording temperatures easy.
- "The Truth about Using VISs"
Too many doctors and nurses remain unsure about how and
when to give vaccine recipients a Vaccine
Information Statement (VIS). This sheet was
created to answer the "to give, or not to give"
question both simply and clearly.
- "Summary of Rules for Childhood
The revised two-sided table is about as concise as the
official vaccination recommendations for
children can get.
- "Labor and Delivery and Nursery Unit
Guidelines to Prevent Hepatitis B Virus
The new birth dose of hepatitis B vaccine recommendation
is now included in this updated piece
along with other important information on
preventing perinatal transmission of hepatitis B
- "Immunization Resources"
New books, booklets, websites, CD-ROMs, and organization
- "Need Help?"
A list of immunization, hepatitis, and VFC coordinators in
state health departments.
- "IAC Catalog"
Order materials for patients and clinic staff here.
- "Letter from the Executive Director"
Immunization Action Coalition Needs Your Support!
Back to Top
(2 of 2)
July 24, 2002
CDC PUBLISHES FINDINGS FROM HIGH-RISK ADOLESCENT AND ADULT
HEPATITIS B VACCINATION PROGRAM
On July 19, 2002, the Centers for Disease Control and
Prevention (CDC) published "Hepatitis B
Vaccination Among High-Risk Adolescents and
Adults--San Diego, California, 1998-2001" in the
Morbidity and Mortality Weekly Report (MMWR).
According to the Editorial Note to the article,
the findings "suggest that a sustained vaccination
program, when combined with a short counseling
session, might achieve high levels of
vaccine acceptance. . . .Achieving high rates of vaccination
coverage requires that program managers set
vaccination-coverage goals, train staff, review
the vaccination status of all clients
routinely, and use appropriate health-education materials
and counseling services."
The article reads in part as follows (excluding footnotes
and a table):
The national strategy to eliminate hepatitis B virus (HBV)
transmission is based on 1) screening all
pregnant women for hepatitis B surface antigen and
post-exposure vaccination of infants of infected
mothers; 2) vaccinating all infants as part
of the childhood vaccination schedule; 3)
vaccinating children and adolescents not
vaccinated previously; and 4) vaccinating
adolescents and adults in groups at
increased risk for infection. These strategies
have been implemented successfully in the United States
except for the vaccination of adults and older adolescents
at high risk. This report describes the initial
findings of a hepatitis B vaccination
program for potentially high-risk adolescents and adults conducted
in areas of San Diego County, California.
The findings indicate that high rates of hepatitis
B vaccination can be achieved in
clinics and programs that serve persons at high risk for
HBV infection through the integration
of hepatitis B vaccination into routine preventive
health-care services. Improved efforts to
vaccinate adolescents and adults at
increased risk for HBV infection are critical to reduce
disease incidence and prevent chronic HBV
The San Diego Viral Hepatitis Prevention Project (VHPP)
began in February 1998 with the selection of
a convenience sample of sites located
primarily in the central and southeast areas of
San Diego County, where the incidences
of gonorrhea and chlamydia are higher than in other parts
of the county. The population of San Diego
County is approximately 2.9 million persons, and
the population of the
central and southeast areas is approximately 500,000
persons. Sites that serve both clients at high risk
and those with a lower risk for HBV
infection were selected. Hepatitis B vaccine was
provided at no cost to participating
sites, and project staff assisted site personnel in developing
educational materials and administrative
procedures and in monitoring vaccine coverage and
completion. At sites that did not
provide clinical services, the project provided a
vaccination nurse on selected days.
To obtain the complete text of the article online, go to:
To obtain a camera-ready (PDF format) copy of this issue
of MMWR, go to:
To read "Hepatitis B Immunization in an STD Clinic," the
manual that was created in conjunction with the
San Diego program, go to:
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:
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.