Immunization Action Coalition and the Hepatitis B Coalition

IAC EXPRESS

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Issue Number 333            August 26, 2002

CONTENTS OF THIS ISSUE

  1. National Immunization Program issues "Vaccine Supply Update"

  2. New! Tattooing and Body Piercing Information page on IAC's website

  3. PEDIATRICS commentators call getting reimbursement for pneumococcal conjugate vaccine a Herculean task

  4. Letter from Surgeon General urges hepatitis B immunization for Asian American and Pacific Islander high-schoolers

  5. Safe Injection Global Network (SIGN) meeting will take place October 24-26 in Cambodia

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August 26, 2002
NATIONAL IMMUNIZATION PROGRAM ISSUES "VACCINE SUPPLY UPDATE"

The National Immunization Program (NIP) has provided the following brief update on the supply of vaccines in the United States, listing those vaccines that are now in sufficient supply and those still in short supply.

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This is an update on the present availability of vaccines that are routinely used in the pediatric schedule.

SUFFICIENT SUPPLY

The following vaccines are in sufficient supply to allow health care providers to vaccinate in accordance with the full dosing schedule as recommended by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP) Red Book Committee, and the American Academy of Family Physicians (AAFP).

  • DTaP
  • Hepatitis B
  • Hib (Vaccine supply is sufficient at this time only for Aventis Pasteur, brand name ActHIB. Please see below regarding other Hib vaccines.)
  • IPV
  • MMR
  • Td
  • Varicella
  • Hepatitis A (pediatric)

SHORTAGES AND/OR DELAYS REMAIN IN EFFECT

- Hepatitis B - Hib Vaccine - (HepB-Hib vaccine supply from Merck, brand name COMVAX, is taking about 2 to 4 weeks to supply, from the time of order placement. Expect delays into the Fall, 2002.)

- Hib Vaccine - (Hib vaccine supply from Wyeth, brand name HibTITER, is taking 8 weeks between order placement and vaccine receipt. Expect delays into Fall, 2002.)

- Pneumococcal Conjugate Vaccine (PCV) - (The supply of PCV remains critically low. Expect delays  at least into late 2002.)

OTHER VACCINES

Meningococcal Vaccine - (Supply is sufficient to meet demand.)

Pneumococcal Polysaccharide Vaccine (PPV) - (Wyeth is currently out of PPV but will have supplies available in late fall/early winter. Merck has an adequate supply of PPV.)

Influenza Vaccine - (All three vaccine manufacturers are reporting that influenza vaccine production for the 2002-03 season is proceeding satisfactorily. According to the latest data provided by the manufacturers, the projected total production for the U.S. market should approximate 95 million doses.)

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For more information on the vaccine supply, go to: http://www.cdc.gov/nip
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August 26, 2002
NEW! TATTOOING AND BODY PIERCING INFORMATION PAGE ON IAC'S WEBSITE

Because tattooing and body piercing have become popular even in mainstream American culture, and because these procedures can be associated with increased risk for blood-borne infectious diseases such as hepatitis B and hepatitis C, the Immunization Action Coalition (IAC) has created a web page containing links to relevant articles from medical journals and publications from national sources such as the Centers for Disease Control and Prevention (CDC).

Theoretically, tattooing and body piercing carry the risk of transmitting blood-borne infections; however, in practice it has been difficult to isolate the risk associated with tattooing and body piercing from other risk factors. We hope this page will help you advise patients who are considering one or both of these forms of body art.

To visit IAC's new Tattooing and Body Piercing Information web page, go to:
http://www.immunize.org/tattoos/index.htm
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August 26, 2002
PEDIATRICS COMMENTATORS CALL GETTING REIMBURSEMENT FOR PNEUMOCOCCAL CONJUGATE VACCINE A HERCULEAN TASK

According to the five authors of a 2-page commentary in the August issue of PEDIATRICS (vol. 110, no. 2), the tale of the year-plus struggle by physicians to get adequate reimbursement for administering pneumococcal conjugate vaccine to children contains important lessons for future vaccine policy implementation.

Likening the reimbursement process through different insurance carriers and the federal government to one of the 12 labors of the Greek hero Hercules--slaying a multi-headed monster named Hydra--the authors write about this modern medical saga:

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Our story begins back in October 1999, when the Advisory Committee on Immunization Practices first voted to recommend the conjugate pneumococcal vaccine (contingent on licensure) for administration to children (the king's order). . . . [A letter from the manufacturer of the vaccine] stated that the average wholesale price was set at $72.50 per dose and the Current Procedural Terminology (CPT) code had been established as 90669 as opposed to 90732, the code for the already existing 23-valent pneumococcal polysaccharide vaccines for older children and adults. . . . This important distinction would later prove confusing for health plans and problematic for our hero because the reimbursement for Pneumovax is less than $10. . . .

Although appropriate reimbursement for future Prevnar use was won in the battle, our hero's initial financial investment was never fully regained. Over the course of the ordeal, the primary care physician had to contend not only with the aggravation of the mistakes related to the CPT code and other financial issues, but also with the de facto establishment of a 2-tier system of care for those patients with private insurance and those covered by public sources. . . .

Epilogue: In the story above, our "hero" is actually the medical director of a group practice on which this tale is based, chair of the state advisory committee on immunizations, board chair of insurer C, and a long-time consultant to insurer B on immunization issues. The group practice has dedicated staff assigned to resolve insurance issues like these. The above experiences were not a result of information deficit or naivete. As such, other practices may have experienced even greater difficulties.

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This commentary is currently available for free online only to current PEDIATRICS subscribers. If you are unable to obtain a hard copy of the commentary through your medical library, online access is available to non-subscribers on a Pay Per Article basis ($10) at: http://www.pediatrics.org/cgi/content/full/110/2/399
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August 26, 2002
LETTER FROM SURGEON GENERAL URGES HEPATITIS B IMMUNIZATION FOR ASIAN AMERICAN AND PACIFIC ISLANDER HIGH-SCHOOLERS

In recognition of both Asian/Pacific American Heritage Month and Hepatitis Awareness Month, which coincide in May, the Office of the Surgeon General issued a letter this year "to strongly encourage" hepatitis B immunization in high schools, particularly in high schools with a high proportion of Asian students. The letter, originally distributed by mail to health-care colleagues, is now available online.

The letter is signed by Kenneth Moritsugu, M.D., M.P.H., Acting Surgeon General; John B. Tsu, Ph.D., Chair of the President's Advisory Committee on AAPIs; and Moon S. Chen, Jr., Ph.D., M.P.H., Executive Director of the National Task Force on Hepatitis B Immunization, Focus on Asians and Pacific Islanders.

"Currently in the United States," the letter informs, "there are 1.25 million people with chronic Hepatitis B virus (HBV) infection. Each year, 5,000 of these die from liver failure resulting from chronic HBV infection. Fifty percent of the 1.25 million and of the 5,000 are Asian American and Pacific Islanders (AAPI), even though only 4.5% of the U.S. population is AAPI."

In the fourth and last paragraph of the letter, Drs. Moritsugu, Tsu, and Chen say: "Please continue efforts to educate, motivate, and vaccinate for Hepatitis B prevention in high schools where 30% are AAPI."

To read the letter on the Surgeon General's website, go to: http://www.surgeongeneral.gov/topics/hepatitisb/hepbletter.htm
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August 26, 2002
SAFE INJECTION GLOBAL NETWORK (SIGN) MEETING WILL TAKE PLACE OCTOBER 24-26 IN CAMBODIA

A tentative agenda has been drafted for the annual SIGN meeting to be held Thursday, October 24 through Saturday, October 26 in Cambodia.

SIGN meeting topics will include "Assessing Injection Practices," "Biologicals in 2000-2002," and "Planning for Safe and Appropriate Use of Injections." A major objective will be the presentation of the World Health Organization (WHO) injection safety planner.

Details will be announced in IAC EXPRESS as they become available.

For more information immediately, contact SIGN by email at sign@who.int 

 

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 August 26, 2002