Immunization Action Coalition and the Hepatitis B Coalition

IAC EXPRESS

Previous issues index

Home page

Issue Number 369            March 3, 2003

CONTENTS OF THIS ISSUE

  1. CDC's Advisory Committee on Immunization Practices votes on recommendations for the use of Pediarix vaccine
  2. UNICEF's plan to immunize four million Iraqi children against polio goes forward despite threat of war
  3. Three million Rwandan children immunized against measles
  4. CDC publishes update of smallpox vaccine adverse events surveillance
  5. Boost your clinic's immunization rate--IAC's Adult Immunization Record Cards prompt patients to keep immunizations up to date
  6. CDC issues supplemental Recommendations for Using Smallpox Vaccine in a Pre-Event Vaccination Program
  7. Track pending immunization legislation the easy way on the website of the National Conference of State Legislatures
  8. Attention immunization coalitions: The Immunization Coalition Sustainability Project needs your input
  9. Newly available: IOM report from the Los Angeles workshop on immunization finance is in print and online
  10. Immunize for Life conference scheduled for May 15-16 in Grand Forks, ND
  11. MMWR notifies readers about availability of Maxi-Vac smallpox vaccination software

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

Back to Top

(1 of 11)
March 3, 2003
CDC'S ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES VOTES ON RECOMMENDATIONS FOR THE USE OF PEDIARIX VACCINE

The Advisory Committee on Immunization Practices (ACIP) is a committee of 15 national experts that provides advice and guidance to the Centers for Disease Control and Prevention (CDC) regarding the most appropriate use of vaccines.

At its February 26-27 meeting, ACIP voted on three issues regarding the use of Pediarix combination vaccine. The results of the votes were: (1) Pediarix may be given to all infants at 2, 4, and 6 months of age, including infants of mothers who are HBsAg positive or whose HBsAg status is unknown; (2) the recommended immunization schedule when Pediarix is used also includes giving newborns the birth  dose of monovalent hepatitis B vaccine before hospital discharge; (3) Pediarix is recommended for inclusion in CDC's Vaccines for Children (VFC) program.

Manufactured by GlaxoSmithKline, Pediarix was approved by the Food and Drug Administration (FDA) in December 2002 to protect infants six weeks of age and older against diphtheria, tetanus, pertussis, hepatitis B, and polio. Since its approval, some health professionals have questioned whether it is still necessary to give the birth dose of monovalent hepatitis B vaccine before administering Pediarix. ACIP's decisions answer this question and more.

PEDIARIX APPROVED FOR ALL INFANTS, REGARDLESS OF THE MOTHER'S HBsAg STATUS
According to FDA's prescribing information, Pediarix is indicated only for infants of HBsAg-negative mothers. However, ACIP voted that Pediarix may be used for ALL infants six weeks of age and older, including those born to HBsAg-positive mothers and to mothers whose HBsAg status is unknown.

In expanding the use of Pediarix beyond FDA prescribing information, ACIP remained consistent with its 1997 vote, which permitted the use of Comvax (Merck's Hib-hepatitis B combination vaccine) in infants born to HBsAg-positive mothers and to mothers whose HBsAg status is unknown.

WHEN ADMINISTERING PEDIARIX, THE MONOVALENT HEPATITIS B VACCINE BIRTH DOSE IS ALSO RECOMMENDED
ACIP voted to recommend that the birth dose of monovalent hepatitis B vaccine remain a part of the infant immunization schedule when Pediarix is used. When the birth dose is included, up to four hepatitis B vaccine doses may be given. According to ACIP, if the mother is HBsAg negative, the birth dose may be omitted, but this is NOT the preferred hepatitis B vaccination schedule of ACIP.

For complete information on administering the birth dose and subsequent doses of vaccine, refer to Footnote 1: Hepatitis B Vaccine (HepB) of the "Recommended Childhood and Adolescent Immunization Schedule--United States, 2003," which is available in many places, including the website of the Immunization Action Coalition at http://www.immunize.org/cdc/child-schedule.pdf

PEDIARIX WILL BE INCLUDED IN THE VFC PROGRAM
ACIP voted to include Pediarix in the VFC program once a contract is negotiated between CDC and GlaxoSmithKline. When the contract is final, CDC will issue an announcement.

A "Notice to Readers" article summarizing ACIP's decisions on the use of Pediarix will be published in a future issue of the "Morbidity and Mortality Weekly Report."
----------------------------------------------------------------

Back to Top

(2 of 11)
March 3, 2003
UNICEF'S PLAN TO IMMUNIZE FOUR MILLION IRAQI CHILDREN AGAINST POLIO GOES FORWARD DESPITE THREAT OF WAR

In a press release dated February 18, UNICEF announced that it and its partners planned to immunize four million Iraqi children against polio during February 23-27. The strategy was to have more than  14,000 health workers go door to door making sure each child was protected.

Carol Bellamy, UNICEF's executive director, said the undertaking would not be possible without the combined effort of UNICEF, the Iraqi Ministry of Health, the World Health Organization (WHO), and the Red Crescent.

UNICEF said the polio campaign is crucial to protecting not only Iraqi children against the disease but also to preventing polio outbreaks elsewhere in the region. Iraq experienced a major polio outbreak in 1999, but increased assistance from UNICEF and WHO has reduced the incidence of polio to zero since January 2000.

To access the press release from the UNICEF website, go to:
http://www.unicef.org/newsline/2003/03pr10iraq.htm
----------------------------------------------------------------

Back to Top

(3 of 11)
March 3, 2003
THREE MILLION RWANDAN CHILDREN IMMUNIZED AGAINST MEASLES

In a press release dated February 18, UNICEF announced its support for a major campaign to immunize more than 3 million children against measles in Rwanda. The campaign, which ran February 10-23, targeted children from 9 months to 15 years of age, with children less than 5 years of age also receiving supplemental doses of vitamin A.

Part of a global initiative to reduce child mortality and morbidity from measles, the campaign received support from the Rwandan government, UNICEF, the World Health Organization, the Red Cross, and the Centers for Disease Control and Prevention.

To access the press release from the UNICEF website, go to:
http://www.unicef.org/newsline/2003/03nn06measles.htm
----------------------------------------------------------------

Back to Top

(4 of 11)
March 3, 2003
CDC PUBLISHES UPDATE OF SMALLPOX VACCINE ADVERSE EVENTS SURVEILLANCE

The Centers for Disease Control and Prevention (CDC) published "Smallpox Vaccine Adverse Events Among Civilians--United States, February 18-24, 2003" in the February 28 issue of "Morbidity and Mortality Weekly Report" (MMWR). The article updates the information published in the February 21 MMWR.

The February 28 report includes information on 3,141 vaccinees not included in the February 21 report. Two moderate-to-severe adverse events were included in the latest report: a 39-year-old woman experienced a suspected case of generalized vaccinia, and a 60-year-old man experienced angina,  which is not known to be associated causally with smallpox vaccination.

Among 23 vaccinees with reported other nonserious adverse events during January 24-February 24, the most common signs and symptoms were fever (n = six), pruritus (n = five), rash (n = four), vasodilation (n = four), asthenia (n = three), headache/migraine (n = three), malaise (n = three), paresthesia (n = three), and redness at injection site (n = three). Some vaccinees reported multiple signs and symptoms.

Surveillance for adverse events during the civilian smallpox vaccination program is ongoing; regular surveillance reports will be published in MMWR.

To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5208a4.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5208.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.
----------------------------------------------------------------

Back to Top

(5 of 11)
March 3, 2003
BOOST YOUR CLINIC'S IMMUNIZATION RATE--IAC'S ADULT IMMUNIZATION RECORD CARDS PROMPT PATIENTS TO KEEP IMMUNIZATIONS UP TO DATE

Just one look at the Adult Immunization Record Cards will convince you that they're a great tool for reminding adults that vaccines aren't just for kids. The card lists seven vaccines that all adults, adults with certain medical conditions, or adults with an unreliable vaccination history should receive.

Use the card during patient visits to discuss a patient's vaccination status with them. Then give it to them and encourage them to refer to it to find out when they're due for their next Td booster, pneumococcal shot, or other immunization.

Since introducing Adult Immunization Record Cards in May 2002, the Immunization Action Coalition (IAC) has shipped approximately three-quarters of a million cards to health care providers across the United States. Health professionals nationwide have found the card invaluable for educating patients that immunization is a lifelong process and for giving patients the means to keep a lifetime record of  their immunization status.

Printed on smudge-proof, rip-proof, waterproof paper, the card comes pre-folded to fit in a wallet. Its bright, canary-yellow color makes it easy to spot among credit cards and other items.

The cost for one 250-count box is $25; two boxes (500 cards), $45; three boxes (750 cards), $60; four boxes (1,000 cards), $70. Additional pricing for larger quantities can be found on the online order form (see link below).

To view a color image of IAC's Adult Immunization Record Card, go to:
http://www.immunize.org/adultizcards/pictures.htm

To order IAC's Adult Immunization Record Cards online (including online with a purchase order), go to:
https://www.immunize.org/adultizcards/index.htm

To print an order form to send with payment information by fax or mail, go to:
https://www.immunize.org/adultizcards/izorder.pdf

If you have questions about IAC's Adult Immunization Record Cards, call us at (651) 647-9009, or email us at admin@immunize.org
----------------------------------------------------------------

Back to Top

(6 of 11)
March 3, 2003
CDC ISSUES SUPPLEMENTAL RECOMMENDATIONS FOR USING SMALLPOX VACCINE IN A PRE-EVENT VACCINATION PROGRAM

The Centers for Disease Control and Prevention (CDC) published "Recommendations for Using Smallpox Vaccine in a Pre-Event Vaccination Program: Supplemental Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Healthcare Infection Control Practices Advisory Committee (HICPAC)" in the February 26 issue of "MMWR Dispatch." CDC issues the Web-based Dispatch only for the immediate release of important public health information. The recommendations will be published in a future issue of "Morbidity and Mortality Weekly Report."

The 18-page recommendations include information on smallpox transmission and control, vaccines and vaccinia immune globulin availability, pre-outbreak vaccination of selected groups to enhance smallpox response readiness, contraindications for the use of smallpox vaccine, and reporting and managing adverse events. The entire introduction, excluding references, is reprinted below.

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

In June 2001, the Advisory Committee on Immunization Practices (ACIP) made recommendations for using smallpox (vaccinia) vaccine to protect persons working with orthopoxviruses and to prepare for and respond to a possible terrorist attack involving smallpox. Because of the terrorist attacks in 2001, CDC asked ACIP to review its previous recommendations for smallpox vaccination. These supplemental recommendations update the 2001 recommendations for vaccination of persons designated to respond to or care for a suspected or confirmed case of smallpox. In addition, they clarify and expand the primary strategy for control and containment of smallpox in the event of an outbreak. Recommendations remain unchanged for vaccination of laboratory workers who directly handle recombinant vaccinia viruses derived from nonhighly attenuated vaccinia strains or other orthopoxviruses that infect humans (e.g., monkeypox, cowpox, vaccinia, and variola). The following recommendations were developed after formation of a joint working group of ACIP and the National  Vaccine Advisory Committee (NVAC) in April 2002. That working group was joined in September 2002 by the Healthcare Infection Control Practices Advisory Committee (HICPAC). A series of public  meetings and forums also were held to review available data related to smallpox, smallpox vaccine, smallpox-control strategies, and other concerns related to smallpox vaccination.

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

To obtain the complete text of the recommendations online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/m2d226.htm

To obtain a camera-ready (PDF format) copy of the recommendations, go to:
http://www.cdc.gov/mmwr/pdf/wk/MMWRDispatch2-26-03.pdf
----------------------------------------------------------------

Back to Top

(7 of 11)
March 3, 2003
TRACK PENDING IMMUNIZATION LEGISLATION THE EASY WAY ON THE WEBSITE OF THE NATIONAL CONFERENCE OF STATE LEGISLATURES

If you want to know the status of pending immunization legislation in your state or a neighboring state, you'll want to bookmark the website of the National Conference of State Legislatures (NCSL).

NCSL's "Immunization Legislation 2003" page organizes pending legislation into categories such as "Exemptions" and "School Requirements." Within each category, users will find pending legislation arranged alphabetically by state and numerically by bill number. Each bill is described briefly. By clicking on the bill number, users are taken to a state legislature's home page. From there, users can track the status of any pending bill.

To access NCSL's "Immunization Legislation 2003" page, go to:
http://www.ncsl.org/programs/health/immleg2003.htm#s
----------------------------------------------------------------

Back to Top

(8 of 11)
March 3, 2003
ATTENTION IMMUNIZATION COALITIONS: THE IMMUNIZATION COALITION SUSTAINABILITY PROJECT NEEDS YOUR INPUT

Created to identify effective immunization coalitions and communicate their success to others, the Immunization Coalition Sustainability Project (ICSP) will conduct a nationwide survey of state and local immunization coalitions in April.

Data gathered in the survey will be compiled into a catalog featuring the best practices and best materials developed by coalitions. The catalog will be distributed to immunization coalitions in ICSP's  nationwide database. ICSP's findings will be presented at the Centers for Disease Control and Prevention's National Immunization Conference in 2004.

Bakalian Consulting Group, Santa Cruz, CA, administers ICSP. Pat Bakalian, the group's principal,  was formerly a regional outreach consultant with the Centers for Disease Control and Prevention (CDC) National Immunization Program for seven years and has been involved in community coalition building for 15 years.

"When working for CDC, it was always a challenge to identify what immunization coalitions were doing and systematically share best practices," Bakalian said. "I'm excited to be undertaking a project that  can help fill that gap. By increasing peer-to-peer collaborative learning, and decreasing duplicating efforts, we hope to minimize the constant re-invention of the wheel."

To ensure your coalition is entered in the ICSP database and represented in the survey, sign up at http://www.bakalianconsulting.com

For additional information, call Pat Bakalian at (831) 420-1935, or email her at pat@bakalianconsulting.com

Also, be sure your coalition is registered in the Immunization Action Coalition's online database of coalitions; sign up on our Directory of Immunization Coalitions website at http://www.izcoalitions.org
----------------------------------------------------------------

Back to Top

(9 of 11)
March 3, 2003
NEWLY AVAILABLE: IOM REPORT FROM THE LOS ANGELES WORKSHOP ON IMMUNIZATION FINANCE IS IN PRINT AND ONLINE

A new report titled "Setting the Course: A Strategic Vision for Immunization. Part 3: Summary of the Los Angeles Workshop" was recently published by the National Academies Institute of Medicine (IOM).

The report summarizes the discussions of the IOM workshop held in Los Angeles in January 2002 and is part of the immunization finance dissemination effort associated with the release of an earlier IOM report, "Calling the Shots: Immunization Finance Policies and Practices."

The Los Angeles workshop report summarizes the findings of "Calling the Shots" and reviews the challenges that remain in establishing a reliable financial base for the U.S. immunization system, with  specific reference to challenges and strategies in California, and Los Angeles and San Diego counties in particular.

To access the report and order it online for $14.40 (which is 20 percent off the $18 list price), go to:
http://www.nap.edu/catalog/10607.html

For further information, call customer service at (888) 624-8373.

To access links to several IOM immunization publications from the website of the Immunization Action Coalition, go to: http://www.immunize.org/iom
----------------------------------------------------------------

Back to Top

(10 of 11)
March 3, 2003
IMMUNIZE FOR LIFE CONFERENCE SCHEDULED FOR MAY 15-16 IN GRAND FORKS, ND

Sponsored by the Greater Grand Forks Immunization Coalition, the Immunize for Life conference will be held at the Alerus Center in Grand Forks, ND, May 15-16. William L. Atkinson, MD, MPH, medical epidemiologist at the Centers for Disease Control and Prevention National Immunization Program, is one of the featured speakers.

Intended for public and private health care providers, the conference will address immunization practices for people of all ages, from infants to the elderly. Workshop topics include vaccine safety, pediatric travel medicine, West Nile virus, Native American health issues, the anti-vaccine movement, the history of smallpox, varicella vaccine, and future practices.

For more information, call Kathy Dunn of Grand Forks Public Health at (701) 787-8100 or email her at kdunn@grandforksgov.com
----------------------------------------------------------------

Back to Top

(11 of 11)
March 3, 2003
MMWR NOTIFIES READERS ABOUT AVAILABILITY OF MAXI-VAC SMALLPOX VACCINATION SOFTWARE

The Centers for Disease Control and Prevention (CDC) published a Notice to Readers, "Availability of Maxi-Vac Smallpox Vaccination Software," in the February 28 issue of "Morbidity and Mortality Weekly Report" (MMWR).

MMWR noted the following: "Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services." The notice is reprinted below in its entirety.

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

Free copies of the Maxi-Vac software program are now available. Maxi-Vac allows officials to refine smallpox vaccination clinic human resource allocations (e.g., physicians, nurses, and other staff) to maximize patient flow-through.

Maxi-Vac software and the accompanying manual can be downloaded at http://www.bt.cdc.gov/agent/smallpox/vaccination/maxi-vac Operation of Maxi-Vac requires the use of Visual Basic Runtime v. 6.0, which also can be downloaded at the Maxi-Vac web page. The Maxi-Vac manual can be downloaded in either a Microsoft Word format or an Adobe Acrobat format. The Maxi-Vac software and manual are in the public domain and may be used and copied without permission; however, citation as to source is appreciated.

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

To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5208a5.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5208.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 March 3, 2003