Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 349            November 18, 2002

CONTENTS OF THIS ISSUE

  1. Danish study finds no connection between MMR vaccine and autism
  2. Dr. Neal Halsey reaffirms vaccines do not cause autism
  3. CDC study finds seniors' current influenza and pneumococcal vaccination rates are drastically below goals for 2010
  4. IAC website adds information on state hepatitis A mandates and also provides newest CDC information on state childhood vaccination requirements
  5. IAC updates "Vaccine Administration Record for Adults" for medical charts
  6. IAC updates "Reliable Sources of Immunization Information" educational sheet
  7. MMWR notifies readers about ACIP's supplemental recommendations for the use of anthrax vaccine
  8. First annual edition! "ImmunoFacts" is now available as a bound volume
  9. NIAID releases 20th anniversary edition of "The Jordan Report" on vaccine research
  10. Hepatitis Foundation International launches the California Hepatitis Resource Center website
  11. CDC reports hundreds died in July-August influenza outbreak in Madagascar

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November 18, 2002
DANISH STUDY FINDS NO CONNECTION BETWEEN MMR VACCINE AND AUTISM

On November 7, the "New England Journal of Medicine" published an article titled "A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism," which refutes the hypothesis that the vaccination causes autism. The article is part of an established body of evidence that disproves a connection between vaccines and autism. The complete abstract of the article follows.

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Background

It has been suggested that vaccination against measles, mumps, and rubella (MMR) is a cause of autism.

Methods

We conducted a retrospective cohort study of all children born in Denmark from January 1991 through December 1998. The cohort was selected on the basis of data from the Danish Civil Registration  System, which assigns a unique identification number to every live-born infant and new resident in Denmark. MMR-vaccination status was obtained from the Danish National Board of Health. Information on the children's autism status was obtained from the Danish Psychiatric Central Register, which contains information on all diagnoses received by patients in psychiatric hospitals and outpatient clinics in Denmark. We obtained information on potential confounders from the Danish Medical Birth Registry, the National Hospital Registry, and Statistics Denmark.

Results

Of the 537,303 children in the cohort (representing 2,129,864 person-years), 440,655 (82.0 percent) had received the MMR vaccine. We identified 316 children with a diagnosis of autistic disorder and  422 with a diagnosis of other autistic-spectrum disorders. After adjustment for potential confounders,  the relative risk of autistic disorder in the group of vaccinated children, as compared with the  unvaccinated group, was 0.92 (95 percent confidence interval, 0.68 to 1.24), and the relative risk of  another autistic-spectrum disorder was 0.83 (95 percent confidence interval, 0.65 to 1.07). There was no association between the age at the time of vaccination, the time since vaccination, or the date of vaccination and the development of autistic disorder.

Conclusions

This study provides strong evidence against the hypothesis that MMR vaccination causes autism.

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To access the abstract, go to:
http://content.nejm.org/cgi/content/abstract/347/19/1477

For additional articles on vaccines and autism, go to: the Immunization Action Coalition web page "Autism Information" at http://www.immunize.org/safety/autism.htm
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November 18, 2002
DR. NEAL HALSEY REAFFIRMS VACCINES DO NOT CAUSE AUTISM

On November 14, the Johns Hopkins Bloomberg School of Public Health distributed a press release in  response to public concern over an article titled "The Not-So-Crackpot Autism Theory," which appeared in the "New York Times Magazine" on November 10. The opening paragraph of the press release is reprinted below.

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Recently, there has been some confusion surrounding a hypothesis that the vaccine preservative thimerosal is linked to an increase in autism among children. Neal Halsey, MD, professor of international health and director of the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of Public Health, does not and has not supported the belief that thimerosal or vaccines themselves cause autism in children, saying scientific evidence does not suggest any causal association between any vaccine and autism. Data published in the November 7, 2002, issue of the  "New England Journal of Medicine" conclusively showed that there was no difference in the rate of autism or related disorders in children who received measles, mumps, and rubella (MMR) vaccines than those who did not. Studies from other countries have determined the hypothetical association  between vaccines and autism was not supported by the available evidence.

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To view the complete press release online, go to:
http://www.jhsph.edu/Press_Room/Press_Releases/Halsey_autism.html
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November 18, 2002
CDC SURVEY FINDS SENIORS' CURRENT INFLUENZA AND PNEUMOCOCCAL VACCINATION RATES ARE DRASTICALLY BELOW GOALS FOR 2010

The Centers for Disease Control and Prevention (CDC) published "Influenza and Pneumococcal Vaccination Levels Among Persons Aged 65 Years and Older--United States, 2001" in the November  15 issue of "Morbidity and Mortality Weekly Report" (MMWR).

Based on data collected from CDC's 2001 Behavioral Risk Factor Surveillance System, the article states that overall, influenza vaccine reaches 64.9 percent of people 65 and older and pneumococcal  vaccine only 60.0 percent. Coverage of both vaccines is lower among African Americans and Hispanics than among non-Hispanic whites.

The article noted that 90 percent of the 20,000 people influenza kills annually in the United States are  people age 65 and older. National health objectives for 2010 include increasing influenza and pneumococcal immunization rates to 90 percent or higher in this population.

The Editorial Note addresses strategies for increasing influenza and pneumococcal immunization rates among the 65-years-and-older population in general, and among African Americans and Hispanics in  particular. It reads in part:

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Strategies for addressing [racial/ethnic disparities in adult vaccine coverage] will be investigated by CDC's Racial and Ethnic Adult Disparities Immunization Initiative (READII) through 2-year demonstration projects in Chicago, Illinois; Milwaukee, Wisconsin; a rural area of Mississippi;  Rochester, New York; and San Antonio, Texas. Local and state health departments in these areas will work with community partners, CDC, and other federal agencies to identify and implement effective ways to improve influenza and pneumococcal vaccination levels among older non-Hispanic blacks and Hispanics.

Health-care providers should assess the vaccination status of their patients and offer indicated vaccines. Annual influenza vaccination provides such an opportunity; persons reporting recent  influenza vaccination were 2.5 times more likely to report having received pneumococcal vaccine than  were persons who did not report recent influenza vaccination. Administration of influenza and pneumococcal vaccine simultaneously does not increase the incidence or severity of adverse reactions. Nevertheless, approximately one fourth of persons reporting recent influenza vaccination did not report having ever received pneumococcal vaccine. . . .

The optimal time to administer influenza vaccination is during October-November. However, influenza vaccination should continue into December and later because many persons at high risk for influenza-related complications, household members of these persons, health-care workers, and other persons  who want to decrease their risk for influenza remain unvaccinated by the end of November. Current projections indicate that 93 million doses of influenza vaccine will be available during the 2002-03 influenza season, and several million doses remain available for purchase. To maximize coverage among target groups and overall use, physicians should offer influenza vaccine throughout the influenza season. Influenza activity peaked in January or later in 21 of the preceding 25 influenza seasons. During influenza season and all year, pneumococcal vaccination also should be offered to persons aged 65 years and older and others at high risk who have not been vaccinated or whose vaccination status is unknown. Physicians can improve coverage by using strategies such as improved record keeping, standing orders, reminder/recall systems, and offering vaccinations to hospitalized patients before discharge. Additional information about influenza and pneumococcal vaccination is available at http://www.cdc.gov/nip.
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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5145a3.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5145.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 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.
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November 18, 2002
IAC WEBSITE ADDS INFORMATION ON STATE HEPATITIS A MANDATES AND ALSO PROVIDES NEWEST CDC INFORMATION ON STATE CHILDHOOD VACCINATION REQUIREMENTS

The Immunization Action Coalition (IAC) has updated its "State Mandates on Immunization and Vaccine-Preventable Disease" web pages. These pages now include a page describing hepatitis A vaccine mandates and also incorporate some of the pages found in the booklet "State Immunization Requirements 2001-2002," recently published by the Centers for Disease Control and Prevention (CDC).

Hepatitis A Information

In developing the "Hepatitis A Vaccination Recommendations and Policies" web page, IAC compiled information on hepatitis A vaccine mandates surveying all 50 states. To access the new web page, go to: http://www.immunize.org/laws/hepa.htm

CDC Information

The updated information from CDC on state childhood vaccination requirements is for the following vaccine-preventable diseases that IAC has selected to include: diphtheria, tetanus, and pertussis (DTP); measles, mumps, and rubella (MMR); polio; and Haemophilus influenzae type b (Hib). The last time CDC published requirements for these diseases was for the 1998-99 school year.

In addition to posting these four updated childhood vaccination mandates and the new hepatitis A mandates, IAC also compiles and continually updates information on state vaccination requirements for hepatitis B, varicella, and meningococcal disease.

To access IAC's updated state mandates web pages, go to: http://www.immunize.org/laws/
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November 18, 2002
IAC UPDATES "VACCINE ADMINISTRATION RECORD FOR ADULTS" FOR MEDICAL CHARTS

The Immunization Action Coalition (IAC) has revised its "Vaccine Administration Record for Adults," a one-page chart designed to help health professionals keep track of an adult patient's immunization history.

The revised sheet has an added space to record information about the second dose of pneumococcal polysaccharide vaccine (PPV23), which is recommended for some high-risk patients. In addition, the columns for route of vaccine administration and Vaccine Information Statements have been modified.

For an HTML version of the revised sheet, go to:
http://www.immunize.org/catg.d/p2023b.htm

For a camera-ready (PDF) copy of the sheet, go to:
http://www.immunize.org/catg.d/p2023b.pdf
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November 18, 2002
IAC UPDATES ITS "RELIABLE SOURCES OF IMMUNIZATION INFORMATION" EDUCATIONAL SHEET

The Immunization Action Coalition (IAC) has added the address of its newest website to the one-page educational sheet "Reliable Sources of Immunization Information: Where To Go To Find Answers!"

The sheet describes several sources of valuable information that the public and health professionals can access on the Web and by phone. Four book titles are also provided.

For an HTML version of the revised educational sheet, go to:
http://www.immunize.org/catg.d/p4012.htm

For a camera-ready (PDF) copy of the sheet, go to:
http://www.immunize.org/catg.d/p4012.pdf

To access IAC's newest website, "Vaccine Information for the Public and Health Professionals," go to:
http://www.vaccineinformation.org/
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November 18, 2002
MMWR NOTIFIES READERS ABOUT ACIP'S SUPPLEMENTAL RECOMMENDATIONS FOR THE USE OF ANTHRAX VACCINE

The Centers for Disease Control and Prevention (CDC) published a Notice to Readers, "Use of Anthrax Vaccine in Response to Terrorism: Supplemental Recommendations of the Advisory Committee on Immunization Practices," in the November 15 issue of "Morbidity and Mortality Weekly Report" (MMWR). The first paragraph of the notice follows, with the exception of one note.

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In December 2000, the Advisory Committee on Immunization Practices (ACIP) released its recommendations for using anthrax vaccine in the United States. Because of recent terrorist attacks involving the intentional exposure of U.S. civilians to Bacillus anthracis spores and concerns that the current anthrax vaccine supply is limited, ACIP developed supplemental recommendations on using anthrax vaccine in response to terrorism. These recommendations supplement the previous ACIP statement in three areas: use of anthrax vaccine for pre-exposure vaccination in the U.S. civilian population, the prevention of anthrax by postexposure prophylaxis (PEP), and recommendations for additional research related to using antimicrobial agents and anthrax vaccine for preventing anthrax.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5145a4.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5145.pdf
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November 18, 2002
FIRST ANNUAL EDITION! "IMMUNOFACTS" IS NOW AVAILABLE AS A BOUND VOLUME

The first annual, bound version of "ImmunoFacts: Vaccines & Immunologic Drugs" by LTC John D. Grabenstein, RPh, PhD, is now available from the publisher, Facts & Comparisons. Intended for hospitals, public health programs, and institutions that handle frequent and diverse immunologics, the bound version replaces the blue 3-ring, loose-leaf version. Annual updated editions will be published each spring, beginning in 2003.

Following is a brief description of the book's content and format, excerpted from the preface.

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The goal of "ImmunoFacts: Vaccines & Immunologic Drugs" is to provide comprehensive drug information about this specific category of drugs. The format is intended to allow quick, reliable access to discrete pieces of information, while also helping readers compare and contrast information for similar products or uses.

"ImmunoFacts" brings together, for the first time in one volume, detailed information about the pharmaceutic and pharmacologic characteristics of immunologic drugs, along with authoritative recommendations for their use.

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The 1,200-page book is available from the publisher for $69.95. To order online, go to:
http://www.factsandcomparisons.com/ProdPage.asp?ID=129

For additional information, call (800) 223-0554.

To access the publisher's "ImmunoFacts" web page, go to: http://www.immunofacts.com/
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November 18, 2002
NIAID RELEASES 20TH ANNIVERSARY EDITION OF "THE JORDAN REPORT" ON VACCINE RESEARCH

Earlier this month, the National Institute of Allergy and Infectious Diseases (NIAID) released "The Jordan Report 20th Anniversary: Accelerated Development of Vaccines 2002." The report was prepared under the supervision of NIAID, the Division of Microbiology and Infectious Diseases, and the National Institutes of Health.

Forty-five vaccine experts and NIAID scientists produced this year's 300-page report with contributions from outside researchers. Two articles of special interest include one written by William Jordan, MD, on the history of vaccinology, and the other by Stanley A. Plotkin, MD, on the ten most important discoveries in vaccinology in the past twenty years.

Other key topics in the report include the following: vaccines against drug-resistant, emerging and re- merging diseases; public-private vaccine research partnerships; and new vaccine technologies.

A NIAID press release dated November 6 announcing the publication of the report reads in part:

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Vaccines have become an increasingly important medical tool against a variety of public health problems, both in the United States and abroad. To inform policy-makers, researchers and the public about recent accomplishments and future trends in vaccine research, the National Institute of Allergy and Infectious Diseases (NIAID) today released a new edition of its comprehensive vaccine report, "The Jordan Report 20th Anniversary. . . ."

Besides describing the state of the science, this edition of The Jordan Report reviews the last two decades and highlights important achievements in the field of vaccinology. . . .

The report also includes expert perspectives on a variety of vaccine research-related topics such as vaccine regulations, safety evaluations, economic considerations and vaccine risk communication.

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To access the report online, go to:
http://www.niaid.nih.gov/dmid/vaccines/jordan20/

To download a camera-ready (PDF) copy of the report, go to:
http://www.niaid.nih.gov/dmid/vaccines/jordan20/jordan20_2002.pdf

For further information or to order a free print copy of the report, call (301) 496-5717.
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November 18, 2002
HEPATITIS FOUNDATION INTERNATIONAL LAUNCHES THE CALIFORNIA HEPATITIS RESOURCE CENTER WEBSITE

On November 3, the Hepatitis Foundation International (HFI) announced the launch of its new website--the California Hepatitis Resource Center. Funded by the Centers for Disease Control and Prevention, the new site provides health professionals, patients, caregivers, educators, legislators, and members of the media with comprehensive information on all forms of viral hepatitis.

According to Thelma King Thiel, HFI's Chairman and CEO, the point of organizing a site specifically for California was to create a demonstration project that other states can use as a template for developing their own state-specific hepatitis sites.

To access the new site, go to: http://www.hepatitisrcca.info/

For additional information, call (800) 891-0707.
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November 18, 2002
CDC REPORTS HUNDREDS DIED IN JULY-AUGUST INFLUENZA OUTBREAK IN MADAGASCAR

The Centers for Disease Control and Prevention (CDC) published "Influenza Outbreak--Madagascar, July-August 2002" in the November 15 issue of "Morbidity and Mortality Weekly Report" (MMWR).

Part of the press summary made available by CDC is reprinted below.

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A large influenza outbreak occurred in southeastern Madagascar during July and August with thousands of respiratory illnesses and hundreds of deaths reported. The most affected persons were those living in remote highland villages. Nearly all deaths occurred far away from healthcare facilities. Madagascar is the world's 4th largest island country and one of the poorest countries in the world. An investigation by a team from the World Health Organization and CDC concluded that the outbreak was attributed to influenza A (H3N2) viruses. The influenza virus strain associated with this outbreak is similar to strains that have been circulating worldwide for several years. This season's 2002-03 U.S. influenza vaccine includes a similar strain to the one that caused this outbreak.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5145a2.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5145.pdf

 

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 November 18, 2002