Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 363            February 3, 2003

CONTENTS OF THIS ISSUE

  1. CDC publishes "Recommended Childhood and Adolescent Immunization Schedule--United States, 2003"
  2. CDC notifies readers that use of standing orders for influenza and pneumococcal vaccination can increase vaccination rates among persons age 65 and over
  3. New! "What If You Don't Immunize Your Child" brochure can help convince hesitant parents to choose vaccination
  4. New edition! Canadian Paediatric Society publishes revised vaccination guide for parents
  5. Reminder: CDC satellite broadcast series on vaccine-preventable diseases begins February 13
  6. Reminder: CDC's National Immunization Conference is set for March 17-20 in Chicago
  7. Revised! CDC issues updated version of smallpox Vaccine Information Statement
  8. Website of the National Alliance for Hispanic Health offers bilingual health information
  9. New! Hepatitis C video "The Hidden Epidemic" now available from HFI
  10. IOM report lists immunization as one of twenty priority areas that can transform U.S. health care system
  11. March 10 is application deadline for hepatitis C educational workshop grants
  12. IOM Immunization Safety Review Committee to meet about the safety of influenza vaccine on March 13-14

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February 3, 2003
CDC PUBLISHES "RECOMMENDED CHILDHOOD AND ADOLESCENT IMMUNIZATION SCHEDULE--UNITED STATES, 2003"

The Centers for Disease Control and Prevention (CDC) published "Recommended Childhood and Adolescent Immunization Schedule--United States, 2003" in the January 31 issue of the "MMWR QuickGuide" (MMWR).

MMWR prefaced the 2003 schedule with several introductory paragraphs. Following is the preface,  reprinted in its entirety with the exception of references.

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Each year, CDC's Advisory Committee on Immunization Practices (ACIP) reviews the recommended childhood and adolescent immunization schedule to ensure that it is current with changes in manufacturers' vaccine formulations and contains revised recommendations for the use of licensed vaccines, including those newly licensed. The recommended childhood immunization schedule for 2003 has remained the same in content and format since January 2002. The recommendations and format have been approved by ACIP, the American Academy of Family Physicians, and the American Academy of Pediatrics.

Catch-Up Childhood and Adolescent Immunization Schedule A new catch-up immunization schedule for children and adolescents who start late or who are more than 1 month behind is presented for the first time in 2003. Minimum ages and minimum intervals between doses are provided for each of the routinely recommended childhood and adolescent vaccines. The schedule is divided into two age groups, children aged 4 months–6 years and children/adolescents aged 7–18 years.

Hepatitis B Vaccine
The schedule indicates a preference for administering the first dose of hepatitis B vaccine to all newborns soon after birth and before hospital discharge. Administering the first dose of hepatitis B vaccine soon after birth should minimize the risk for infection caused by errors or delays in maternal hepatitis B surface antigen (HBsAg) testing or reporting, or by exposure to persons with chronic hepatitis B virus (HBV) infection in the household, and can increase the child's likelihood of completing the vaccine series. Only monovalent hepatitis B vaccine can be used for the birth dose. Either monovalent or combination vaccine can be used to complete the series. Four doses of hepatitis B  vaccine can be administered to complete the series when a birth dose is given. In addition to receiving hepatitis B immune globulin (HBIG) and the hepatitis B vaccine series, infants born to HBsAg-positive  mothers should be tested for HBsAg and antibody to HBsAg (anti-HBs) at age 9–15 months to identify those with chronic HBV infection or those who might require revaccination.

Influenza Vaccine
In addition to the recommendation to administer annual influenza vaccine to children at high risk, healthy children aged 6–23 months are encouraged to receive influenza vaccine when feasible. Children in this age group are at substantially increased risk for influenza-related hospitalizations.

Inactivated Poliovirus Vaccine
The inactivated poliovirus (IPV) vaccine footnote has been removed from the Recommended Childhood and Adolescent Immunization Schedule, reflecting the cessation of the use of oral poliovirus (OPV) vaccine in the United States. An all-IPV schedule for routine childhood poliovirus vaccination has been recommended in the United States since January 1, 2000. All children should receive 4 doses of IPV at age 2, 4, and 6–18 months, and at age 4–6 years. For children who received an all-IPV or all-OPV series, a fourth dose is not necessary if the third dose was administered at age 4 years or over. If both OPV and IPV were administered as part of a series, a total of 4 doses should be administered  regardless of the child's current age. These statements clarify the "Dose Three to Booster Dose" column in Table 2 of the catch-up schedule. Routine poliovirus vaccination is not generally recommended for persons age 18 years or over residing in the United States.

Vaccine Supply Recommendations
As a result of the vaccine supply shortage, deferral of some doses of pneumococcal conjugate vaccine (PCV) has been recommended; health-care providers should record patients for whom vaccination has been deferred and should contact them once the supply has been restored. Supplies of tetanus and diphtheria toxoids (Td) vaccine; diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine; measles, mumps, and rubella (MMR) vaccine; and varicella vaccine in the United States have become  sufficient to permit the resumption of the routine schedule for use as recommended by ACIP. The range of recommended ages for the Td vaccine has been extended to 18 years to emphasize that the  vaccine can be administered during any visit if at least 5 years have elapsed since the last dose of tetanus and diphtheria toxoid–containing vaccine. Information about vaccine shortages is available from CDC's National Immunization Program at http://www.cdc.gov/nip/news/shortages/default.htm

Vaccine Information Statements
The National Childhood Vaccine Injury Act requires that all health-care providers give parents or patients copies of Vaccine Information Statements before administering each dose of the vaccines  listed in the schedule. Additional information is available from state health departments and at http://www.cdc.gov/nip/publications/vis

Detailed recommendations for using vaccines are available from the manufacturers' package inserts, ACIP statements on specific vaccines, and the 2000 Red Book. ACIP statements for each recommended childhood vaccine can be viewed, downloaded, and printed from CDC's National Immunization Program at http://www.cdc.gov/nip/publications/acip-list.htm

Instructions on the use of the Vaccine Information Statements are available at http://www.cdc.gov/nip/publications/vis/vis-instructions.pdf

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To access the article in camera-ready (PDF) format, go to:
http://www.cdc.gov/mmwr/pdf/wk/mm5204-Immunization.pdf

To obtain a camera-ready (PDF) version of the 2003 schedule on the IAC website, go to:
http://www.immunize.org/cdc/child-schedule.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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February 3, 2003
CDC NOTIFIES READERS THAT USE OF STANDING ORDERS FOR INFLUENZA AND PNEUMOCOCCAL VACCINATION CAN INCREASE VACCINATION RATES AMONG PERSONS AGE 65 AND OVER

The Centers for Disease Control and Prevention (CDC) published a Notice to Readers, "Facilitating  Influenza and Pneumococcal Vaccination Through Standing Orders Programs," in the January 31 issue of the "Morbidity and Mortality Weekly Report" (MMWR). The notice, with the exception of references, is reprinted below in its entirety.

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Influenza and pneumococcal vaccines are underused for persons in the United States aged 65 years and over (66% receive influenza vaccine and 55% pneumococcal vaccine), even among patients in nursing homes (68% for influenza and 38% for pneumococcal vaccine). Systematic literature reviews by the Task Force on Community Preventive Services and the Southern California Evidence-Based  Practice Center-RAND have shown that standing orders programs improve vaccination rates. Standing orders programs authorize nurses and pharmacists, where allowed by state law, to administer vaccinations according to an institution- or physician-approved protocol without the need for a  physician's examination or direct order. Several studies have shown improved influenza and pneumococcal vaccination rates through standing orders programs specifically in long-term care facilities (LTCFs) and hospitals. Based on the strength of available evidence, the Advisory Committee on Immunization Practices recommends the use of standing orders programs in both outpatient and inpatient settings.

As a result of this recommendation, on October 2, 2002, the Centers for Medicare and Medicaid published an interim final rule that removes the physician signature requirement for influenza and  pneumococcal vaccinations from the Conditions of Participation for Medicare and Medicaid participating hospitals, LTCFs, and home health agencies (HHAs). The Conditions of Participation for these types of facilities require orders for drugs and biologicals to be in writing and signed by the practitioner(s) responsible for the care of the patient, with the exception of influenza and pneumococcal polysaccharide vaccines, which can be administered per physician-approved facility or agency policy after an assessment for contraindications. State agencies should be informed about this change so that appropriate policy revisions can be implemented.

This modification will improve access to influenza and pneumococcal vaccination in hospitals, LTCFs, and HHAs as allowed by state law, consistent with standing orders programs already allowed in community and physician's outpatient office settings. If implemented rapidly, this change will facilitate achievement of the national health objective for 2010 of vaccinating at least 90% of the institutionalized and noninstitutionalized population aged 65 years and over.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5204a4.htm

To obtain a camera-ready copy (PDF format) of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5204.pdf
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February 3, 2003
NEW! "WHAT IF YOU DON'T IMMUNIZE YOUR CHILD?" BROCHURE CAN HELP CONVINCE HESITANT PARENTS TO CHOOSE VACCINATION

The Immunization Action Coalition (IAC) is pleased to announce the availability of a new parent-education brochure that can help providers convince hesitant parents to vaccinate their children.

Titled "What If You Don't Immunize Your Child?" the piece succinctly relates the risks unvaccinated children face and the risk they pose to others. It also offers parents several reliable sources of vaccination information.

IAC is grateful to the Immunization Branch of the California Department of Health for permission to adapt the brochure.

Designed for double-sided printing, the camera-ready (PDF) version can be made into an attractive duo-fold brochure. To access it from the IAC website, go to:
http://www.immunize.org/catg.d/p4017.pdf

To access the HTML version, go to:
http://www.immunize.org/catg.d/p4017.htm
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February 3, 2003
NEW EDITION! CANADIAN PAEDIATRIC SOCIETY PUBLISHES REVISED VACCINATION GUIDE FOR PARENTS

Updated and expanded, the second edition of "Your Child's Best Shot: A Parent's Guide to Vaccination" is a comprehensive, clearly written, and well-organized book. It was written by Ronald  Gold, MD, MPH, professor emeritus of pediatrics, University of Toronto, and reviewed by the 2001-02 Infectious Diseases and Immunization Committee of the Canadian Paediatric Society (CPS).

Developed to give parents reliable information about childhood vaccination, the book contains general information on how vaccines work and on their safety and effectiveness. The next section contains  exhaustive information on each of the 13 vaccine-preventable childhood diseases, the vaccines that prevent them, possible side effects, and contraindications. The book concludes with chapters on vaccines for travel, answers to common questions, and vaccine tables.

Available in English and French versions, the book costs $19.95 (Canadian dollars) for the general public or $16.95 for CPS members.

To order by phone, call (613) 526-9397; to order online from the CPS website, go to:
http://www.cps.ca/english/publications/bookstore/YourChildsBestShotnew.htm
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February 3, 2003
REMINDER: CDC SATELLITE BROADCAST SERIES ON VACCINE-PREVENTABLE DISEASES BEGINS FEBRUARY 13

Intended for professionals who either give vaccinations or set policy in their workplaces, the satellite broadcast series "Epidemiology and Prevention of Vaccine-Preventable Diseases," is scheduled from  noon to 3:30 pm ET on four consecutive Thursdays: February 13, 20, and 27, and March 6.

The course is cosponsored by the National Immunization Program (NIP) of the Centers for Disease Control and Prevention (CDC) and the Public Health Training Network. Its content is described as a comprehensive overview of the principles of vaccination, general recommendations, immunization  strategies for providers, and specific information about vaccine-preventable diseases and the vaccines that prevent them.

Presenters are William Atkinson, MD, MPH; Judy Schmidt, RN, EdD; and Donna Weaver, MN, RN. All are with CDC's immunization program.

Participants are strongly encouraged to buy a copy of the primary course text, "Epidemiology and Prevention of Vaccine-Preventable Diseases" (The Pink Book), 7th Edition. It is available for $25 from the Public Health Foundation by phone at (877) 252-1200 or online at http://bookstore.phf.org/prod171.htm

Registration is online only, at
http://www.phppo.cdc.gov/phtnonline

For additional registration information and questions, email ce@cdc.gov or call (800) 418-7246.

Webcast information and viewing options are available at
http://www.phppo.cdc.gov/phtn/webcast/epv03/default.asp

Technical support for the webcast is available at
http://www.phppo.cdc.gov/phtn/webcast/techsupport.asp

For general course information online, go to:
http://www.phppo.cdc.gov/phtn/epv03/factsheet.asp
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February 3, 2003
REMINDER: CDC'S NATIONAL IMMUNIZATION CONFERENCE IS SET FOR MARCH 17-20 IN CHICAGO

The Centers for Disease Control and Prevention's National Immunization Conference, "Immunization: A  Strong Foundation for Today's Challenges," will bring together local, state, federal, and private-sector immunization partners to explore science, policy, education, and planning issues related to  immunization and vaccine-preventable diseases. It will be held in Chicago March 17-20.

Meeting topics will include immunization for all age groups, barriers to vaccination, global immunization, surveillance, health education policy, new vaccines and vaccine development, immunization registries, and vaccine safety.

To register online, go to:
http://conferences.taskforce.org/NIC2/Registration-Form.asp

For registration information, call (800) 765-7173 or (404) 639-8225 or email nipnic@cdc.gov

For information on the conference program and objectives, meeting agenda, and accommodations, go to: http://www.cdc.gov/nip/nic
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February 3, 2003
REVISED! CDC ISSUES UPDATED VERSION OF SMALLPOX VACCINE INFORMATION STATEMENT

On January 16, the Centers for Disease Control and Prevention (CDC) issued the revised smallpox Vaccine Information Statement (VIS). The revised VIS is part of CDC's Smallpox Information Packet, which includes five supplements (A through E). The VIS should be used with the supplements.

In addition to the VIS and supplements A-E, the Smallpox Information Packet includes information about pre-event screening, treatment for certain severe vaccine adverse events, and post-vaccination follow up, among other topics.

To access the complete Smallpox Information Packet from the CDC website, go to:
http://www.bt.cdc.gov/agent/smallpox/vaccination/infopacket.asp

For extensive, up-to-date information about smallpox disease and vaccine, visit the CDC's bioterrorism  website at http://www.cdc.gov/smallpox

For information about the use of other VISs, as well as VISs for additional vaccines (some in up to 28 languages), visit the website of the Immunization Action Coalition at http://www.immunize.org/vis
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February 3, 2003
WEBSITE OF THE NATIONAL ALLIANCE FOR HISPANIC HEALTH OFFERS BILINGUAL HEALTH INFORMATION

The website of the National Alliance for Hispanic Health (NAHH) posts an array of health information in Spanish and English. Topics include environmental hazards, prevalent diseases such as various cancers and diabetes, and childhood and adult vaccination. Information is presented in question-and- answer mode and is available in HTML and PDF formats.

In addition, the website posts telephone numbers for bilingual helplines and publications and has links to hundreds of health-related websites.

To access immunization information in Spanish from the NAHH website, go to:
http://www.hispanichealth.org/immunization_span.htm

To access immunization information in English, go to:
http://www.hispanichealth.org/immunization.htm

To access the entire website, go to:
http://www.hispanichealth.org
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February 3, 2003
NEW! HEPATITIS C VIDEO "THE HIDDEN EPIDEMIC" NOW AVAILABLE FROM HFI

Recently released by the Hepatitis Foundation International (HFI), "The Hidden Epidemic--Unraveling the Mysteries of Hepatitis C" gives patients and their families a comprehensive overview of the disease.

It uses 3-D animation to illustrate how hepatitis C affects the liver and narration to explain the disease's cause, transmission, treatment, and other topics. Interviews with patients and health professionals add interest and provide encouragement to viewers. It runs 28 minutes and costs $45.

To order it online from the HFI website, go to: http://www.hepfi.org/pdfs/orderform.pdf

To order by phone, call HFI at (800) 891-0707.
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February 3, 2003
IOM REPORT LISTS IMMUNIZATION AS ONE OF TWENTY PRIORITY AREAS THAT CAN TRANSFORM U.S. HEALTH CARE SYSTEM

In January, the Institute of Medicine (IOM) of the National Academies released a report advising the Department of Health and Human Services and others in the health care community that attention to 20 priority areas could bring major improvements in health care quality and delivery for all Americans.

In including immunization as a priority area, the report mentioned the need to increase rates of influenza and pneumococcal immunization among nursing-home residents and rates of immunization in general among black and Hispanic adults and low-income, inner-city children.

Titled "Priority Areas for National Action: Transforming Health Care Quality," the report will be available later this year from the National Academies Press at (800) 624-6242 or (888) 624-8373 or on the Internet at http://www.nap.edu
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February 3, 2003
MARCH 10 IS APPLICATION DEADLINE FOR HEPATITIS C EDUCATIONAL WORKSHOP GRANTS

Through a cooperative agreement with the Division of Viral Hepatitis of the Centers for Disease Control  and Prevention (CDC), the National Association of County & City Health Officials (NACCHO) will be awarding eight grants of $10,000 each to convene community-wide and/or state-wide hepatitis C educational training sessions. March 10 is the date applications must be received (not postmarked) by NACCHO.

To access the request for proposal from NACCHO's website, go to:
http://archive.naccho.org/Documents/HepatitisC-RFP.pdf

To access the application, go to:
http://archive.naccho.org/Documents/HepatitisC-ApplicationForm.pdf

For additional information, phone NACCHO at (202) 783-5550.
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February 3, 2003
IOM IMMUNIZATION SAFETY REVIEW COMMITTEE TO MEET ABOUT THE SAFETY OF INFLUENZA VACCINE ON MARCH 13-14

A meeting of the Immunization Safety Review committee (ISR) of the Institute of Medicine (IOM) will explore the influenza vaccine and possible neurological complications. It is scheduled for March 13-14 in Washington, DC.

A part of ISR's information-gathering process, the March 13 session is open to the public and will be webcast live. The webcast address and draft meeting agenda will be posted closer to the meeting date on the IOM website at http://www.iom.edu

Registration for the public session is online; to register go to the IOM website at
http://www4.nationalacademies.org/iom/Registrations.nsf/Register?OpenForm&013

For additional information, email ISR at imsafety@nas.edu or call (202) 334-1361.   

 

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 February 3, 2003