Immunization Action Coalition and the Hepatitis B Coalition

IAC EXPRESS

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Issue Number 371            March 17, 2003

CONTENTS OF THIS ISSUE

  1. Reader alert: CDC to clarify its notification about Pediarix pediatric combination vaccine
  2. CDC makes corrections to recommendations on prevention and control of hepatitis infections in correctional settings
  3. IOM Immunization Safety Review Committee's study indicates no link between SIDS and childhood vaccines
  4. New translations: Updated smallpox VIS now available in nine languages
  5. New: Learn the fine points of vaccine storage and handling from IAC's latest education sheet
  6. New: IAC adds to its library of reliable immunization resources
  7. New: Pro-vaccine experts and parents available for vaccine safety interviews
  8. CDC notifies readers about the National Vaccine Advisory Committee's report on strengthening the vaccine supply
  9. Updated: IAC revises its information sheet about vaccines distributed in the United States
  10. CDC publishes update of smallpox vaccine adverse events surveillance

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March 17, 2003
READER ALERT: CDC TO CLARIFY ITS NOTIFICATION ABOUT PEDIARIX PEDIATRIC COMBINATION VACCINE

The Centers for Disease Control and Prevention (CDC) published a Notice to Readers, "FDA Licensure of Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Hepatitis B (Recombinant), and Poliovirus Vaccine Combined, (PEDIARIX) for use in Infants," in the March 14 issue of the "Morbidity and Mortality Weekly Report" (MMWR).

This Notice to Readers contains information that might be misinterpreted. "IAC EXPRESS" has learned that MMWR will issue a clarification shortly, perhaps as soon as its March 21 issue. As the clarification is expected soon, we have decided not to reprint the March 14 Notice to Readers; instead, we will reprint the Notice to Readers and the clarification simultaneously in a future issue of "IAC EXPRESS."

To obtain the complete text of the notice online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5210a8.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5210.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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March 17, 2003
CDC MAKES CORRECTIONS TO RECOMMENDATIONS ON PREVENTION AND CONTROL OF HEPATITIS INFECTIONS IN CORRECTIONAL SETTINGS

The Centers for Disease Control and Prevention (CDC) published "Errata: Vol. 52, No. RR-1" in the March 14 issue of the "Morbidity and Mortality Weekly Report" (MMWR). It concerns the "MMWR Recommendations and Reports" publication titled "Prevention and Control of Infections with Hepatitis Viruses in Correctional Settings," published January 24.

A portion of the text follows.
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. . . an error occurred on page 4 in the second sentence of the paragraph under Occupational Exposures. The sentence should read, "Occupational transmission of HBV infection among hospital-based workers has been linked to percutaneous and mucous membrane exposures, and HCV infection has been primarily associated with percutaneous exposure."

On page 12, in Box 6, the fourth item under Type of Exposure should read, "Household (e.g., cell or dormitory) contact--to person with chronic HBV infection."

On page 2, errors occurred in Table 1, and on page 20, errors occurred in Table 5. ["IAC EXPRESS" Editor's Note: the tables mentioned are included in the Errata but not in this "IAC EXPRESS" article.]

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To obtain the complete text of the Errata online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5210a9.htm

To obtain a camera-ready (PDF format) copy of the "MMWR Recommendations and Reports" publication "Prevention and Control of Infections with Hepatitis Viruses in Correctional Settings, go to: http://www.cdc.gov/mmwr/PDF/RR/RR5201.pdf
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March 17, 2003
IOM IMMUNIZATION SAFETY REVIEW COMMITTEE'S STUDY INDICATES NO LINK BETWEEN SIDS AND CHILDHOOD VACCINES

On March 12, the National Academy of Science's Institute of Medicine (IOM) released a study, "Immunization Safety Review: Vaccinations and Sudden Unexpected Death in Infancy." The study concludes that sudden infant death syndrome (SIDS) is not linked to the number or variety of childhood vaccines currently recommended in the United States.

A summary of an IOM press release states the following: "The available scientific evidence does not support a causal link between sudden infant death syndrome and exposure to the diphtheria, tetanus, and whole-cell pertussis [DTwP] vaccine or to multiple childhood vaccines . . . Only an older diphtheria-[tetanus]-pertussis vaccine, no longer used in the United States, is causally related to a rare and fatal inflammatory reaction in infants. These and other findings about links between childhood vaccines and SIDS or other types of sudden unexpected death in infancy do not warrant a review of the childhood vaccination schedule."

To read the complete press release from the website of the National Academies Press (NAP), go to:
http://www4.nationalacademies.org/news.nsf/isbn/0309088860?OpenDOcument

To access a text-only version of the study from the NAP website, go to:
http://www.nap.edu/books/0309088860/html

The study will be published later this year. For ordering information, call NAP customer service at (800) 624-6242 or (202) 334-3313.
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March 17, 2003
NEW TRANSLATIONS: UPDATED SMALLPOX VIS NOW AVAILABLE IN NINE LANGUAGES

Updated on January 16, the current smallpox Vaccine Information Statement (VIS) was initially available only in English. The Minnesota Department of Health (MDH) recently translated the smallpox VIS into eight languages: Cambodian (Khmer), Hmong, Laotian, Russian, Serbo-Croatian, Somali, Spanish, and Vietnamese. The Immunization Action Coalition (IAC) gratefully acknowledges MDH for making the translations available to us.

USING A TRANSLATED VIS WITH SUPPLEMENTS A THROUGH E

When updating the smallpox VIS in January, the Centers for Disease Control and Prevention (CDC) made the VIS part of a Smallpox Information Packet, which includes five supplements (A through E). The supplements and other material in the Smallpox Information Packet are available from the CDC website in English and Spanish.

Like the English smallpox VIS, the other smallpox VISs must be used with supplements A through E. To access the Smallpox Information Packet in English or Spanish from the CDC website, click on the links below.

For an English-language packet (including the VIS), go to:
http://www.bt.cdc.gov/agent/smallpox/vaccination/pdf/smallpox-vax-info-packet.pdf

For a Spanish-language packet (including the VIS), go to:
http://www.bt.cdc.gov/agent/smallpox/vaccination/espanol/pdf/viruela-paquete.pdf

IAC's smallpox web page also has a link to the English and Spanish packets. To access it, go to:
http://www.immunize.org/vis/index.htm#smallpox


ACCESSING THE SMALLPOX VIS IN NINE LANGUAGES

To access a camera-ready (PDF) version of the smallpox VIS in Cambodian (Khmer) from the IAC website, go to:
http://www.immunize.org/vis/casmal03.pdf

To access it in Hmong, go to:
http://www.immunize.org/vis/hmsmal03.pdf

To access it in Laotian, go to:
http://www.immunize.org/vis/lasmal03.pdf

To access it in Russian, go to:
http://www.immunize.org/vis/rusmal03.pdf

To access it in Serbo-Croatian, go to:
http://www.immunize.org/vis/scsmal03.pdf

To access it in Somali, go to:
http://www.immunize.org/vis/sosmal03.pdf

To access it in Spanish, go to:
http://www.immunize.org/vis/spsmal03.pdf

To access it in Vietnamese, go to:
http://www.immunize.org/vis/vnsmal03.pdf

To access it in English from the CDC website, go to:
http://www.bt.cdc.gov/agent/smallpox/vaccination/pdf/smallpox-vis.pdf

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

For information about the use of VISs, as well as VISs for additional vaccines (some in up to 28 languages), visit the IAC website at http://www.immunize.org/vis
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March 17, 2003
NEW: LEARN THE FINE POINTS OF VACCINE STORAGE AND HANDLING FROM IAC'S LATEST EDUCATION SHEET

Improper vaccine storage and handling can cause headaches for immunization providers. For example, clinics and practices can lose lots of money if they have to discard a box of varicella vaccine because they inadvertently stored it at the wrong temperature. Worse yet, improper storage can cause the vaccine to lose potency and result in unprotected vaccinees.

To help immunization providers avoid costly mistakes, the Immunization Action Coalition (IAC) recently  developed a professional education sheet, "Don't Be Guilty of These Errors in Vaccine Storage and Handling." It is based on the Vaccine Storage and Handling section of the Centers for Disease Control and Prevention's satellite training course "The Immunization Encounter: Critical Issues," which was broadcast June 27, 2002.

The one-page education sheet gives immunization providers an easy way to evaluate their vaccine storage and handling procedures. It succinctly explains the ten most commonly reported errors in  vaccine storage and handling and presents a plan for correcting each.

To access the new piece in camera-ready (PDF) format, go to:
http://www.immunize.org/catg.d/p3036.pdf

To access it in HTML format, go to:
http://www.immunize.org/catg.d/p3036.htm

For further information on vaccine storage and handling, check out two other IAC resources for health professionals:

  • "Checklist for Safe Vaccine Handling and Storage" is a one-page sheet of the 20 most important things to do to safeguard your vaccine supply.
     
    To access it in camera-ready (PDF) format, go to:
    http://www.immunize.org/catg.d/p3035chk.pdf

    To access it in HTML format, go to:
    http://www.immunize.org/catg.d/p3035chk.htm

     
  • "Protect Your Vaccines: Check Temperatures Twice a Day!" is a two-page vaccine temperature  log with space for recording a month's worth of temperatures in your vaccine-storage refrigerator and freezer. IAC is grateful to the Michigan Department of Community Health for giving us permission to adapt the log.
     
    To access the Fahrenheit version of the log in camera-ready (PDF) format, go to:
    http://www.immunize.org/catg.d/p3039.pdf
     
    To access the Celsius version of the log in camera-ready (PDF) format, go to:
    http://www.immunize.org/news.d/celsius.pdf

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March 17, 2003
NEW: IAC ADDS TO ITS LIBRARY OF RELIABLE IMMUNIZATION RESOURCES

In keeping with its goal to provide the public and health professionals with a virtual library of high-quality, reliable immunization resources, the Immunization Action Coalition (IAC) has recently collected  immunization material from the Institute of Medicine and the Children's Vaccine Program at PATH (Program for Appropriate Technology in Health) and posted it on the IAC website.

The material in the IAC virtual library is constantly updated; plan to visit it often.

INSTITUTE OF MEDICINE (IOM) MATERIALS
To date, IAC has culled thirty immunization publications from IOM. Some publications are based on presentations made at national immunization workshops organized by IOM. Others are reports from the Immunization Safety Review Committee, an IOM project that addresses vaccine-safety concerns and provides independent, non-biased advice to vaccine policy makers, health practitioners, and the public.

Created in 1970, IOM is part of the National Academy of Sciences (NAS). IOM's mission is to advance and disseminate scientific knowledge to improve human health. As a part of NAS, IOM is private; the studies it undertakes for the federal government are usually funded from appropriations made available to federal agencies.

To access IOM materials from the IAC website, go to: http://www.immunize.org/iom

To access IOM directly, go to: http://www.iom.edu

CHILDREN'S VACCINE PROGRAM (CVP) MATERIALS
IAC's collection of CVP immunization resources currently comprises nine training modules for providers; all were published between 2000-2003. Some are available in French, Russian, and/or Spanish, as well as English, which is in keeping with CVP's focus on global immunization.

PATH launched CVP in 1998 with funds from the Bill and Melinda Gates Foundation. CVP works with such international partners as the World Health Organization (WHO) and the United Nations Children's Fund to leverage the resources of the global health community to build equitable, sustainable, safe, and efficient immunization systems.

To access CVP materials from the IAC website, go to: http://www.immunize.org/cvp

To access CVP directly, go to: http://www.childrensvaccine.org

MATERIALS FROM OTHER SOURCES
For the past several years, IAC has collected and posted immunization materials from a variety of sources: statements from the Advisory Committee on Immunization Practices (ACIP), policy statements from the American Academy of Pediatrics (AAP), and immunization information from WHO. Many materials are available in both HTML and PDF formats. To access these collections from the IAC website, go to the following links:

ACIP statements, http://www.immunize.org/acip

AAP policy statements, http://www.immunize.org/aap

WHO immunization information, http://www.immunize.org/who
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March 17, 2003
NEW: PRO-VACCINE EXPERTS AND PARENTS AVAILABLE FOR VACCINE SAFETY INTERVIEWS

In the interest of helping the press and the public understand the pro-vaccine viewpoint, the Sabin Vaccine Institute and PKIDS (Parents of Kids with Infectious Diseases) issued a joint press release introducing a panel of medical experts and parents available for vaccine safety interviews. The experts will comment on the science and safety of vaccines; the parents will discuss their experience in caring  for or losing an unimmunized child who contracted a vaccine-preventable illness.

The press release is reprinted below.

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EXPERTS
Peter Hotez, MD, PhD, is Professor and Chair of the Department of Microbiology at George Washington University and a Senior Fellow and Chair of the Sabin Vaccine Institute's Scientific Advisory Council. The father of an autistic child, Dr. Hotez offers a unique perspective on the current debate about vaccines. He can be reached at (202) 994-3532 or mtmpjh@gwumc.edu

Samuel Katz, MD, was co-developer of the measles vaccine in conjunction with Nobel Prize winner Dr. John Enders. Chairman of Pediatrics at Duke University for 22 years, Dr. Katz is currently the Wilburt C. Davison Professor of Pediatrics Emeritus at the University. Dr. Katz can be reached at (919) 684-3734 or katz0004@mc.duke.edu

Sharon Humiston, MD, MPH, works in the Pediatric Emergency Department of the University of Rochester Medical Center, Rochester, N.Y., and is the author of "Vaccinating Your Child; Questions and Answers for the Concerned Parent." In addition to her public health and immunization expertise, Dr. Humiston is the mother of an autistic child. Dr. Humiston can be reached at (585) 275-6657 or at sharon_humiston@urmc.rochester.edu

Paul Offit, MD, is Chief of Infectious Diseases at the Children's Hospital of Philadelphia and a Professor of Pediatrics at the University of Pennsylvania School of Medicine. A scientist and co-author  of "Vaccines: What Every Parent Should Know," Dr. Offit educates the public about vaccines as Director of the Vaccine Education Center. He can be reached at (215) 590-2020 or offit@email.chop.edu


PARENTS [To arrange to interview a parent, call PKIDs at (360) 695-0293 or email ckukka@pkids.org]

Suzanne and Leonard Walther of Murfreesboro, Tennessee, postponed their daughter's immunizations based on misinformation they found on the Internet. She subsequently contracted Haemophilus influenzae type b (Hib), a vaccine-preventable disease, and spent her first birthday in a hospital emergency room. Their daughter survived, and today Suzanne Walther urges parents to trust their pediatrician and science--not unfounded allegations--when deciding whether to protect their children against infectious diseases.

Mary-Clayton Enderlein contracted whooping cough (pertussis) from her son's unimmunized friend during her ninth month of pregnancy. She consequently infected her newborn son, who became very ill and required hospitalization. Pertussis, or whooping cough, is a highly contagious bacterial disease that causes severe coughing and gasping for breath. Enderlein, who lives outside of Seattle, comments, "I've always felt that immunizations are our social responsibility. Vaccinating children is part of our social contract to help protect the health of everyone who lives in our communities."

Frankie Milley of Conroe, Texas, lost her only child to meningococcal meningitis, which could have been prevented by a vaccine. "I am motivated by the loss of my only child to make sure all children everywhere are protected against infectious diseases," she said. "Vaccines are safe, they work, and they save lives. Our children deserve the best protection we can give them."

Maureen Kane and her husband wanted nothing more than to provide a happy, healthy home for their newly adopted daughter. When they brought her to their small town in Maryland, they soon found that they could provide happiness, but they would have to fight for her health. Like more than 1.2 million Americans, their daughter was infected with chronic hepatitis B, which can lead to cirrhosis and liver cancer. After months of grueling medical treatment, their daughter is healthy, but her struggle has motivated Maureen to advocate for critical childhood immunizations worldwide.

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March 17, 2003
CDC NOTIFIES READERS ABOUT THE NATIONAL VACCINE ADVISORY COMMITTEE'S REPORT ON STRENGTHENING THE VACCINE SUPPLY

The Centers for Disease Control and Prevention (CDC) published a Notice to Readers, "National Vaccine Advisory Committee Report on Strengthening the Vaccine Supply," in the March 14 issue of the "Morbidity and Mortality Weekly Report" (MMWR). The entire notice follows.

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The National Vaccine Advisory Committee has released a report entitled "Strengthening the Supply of Routinely Recommended Vaccines in the United States: A Report of the National Vaccine Advisory Committee." The report describes the immediate and contributing factors leading to the 2001-2002 vaccine supply shortages and outlines 12 recommendations to prevent future shortages. The report is available at http://www.cdc.gov/od/nvpo/nvac-vsr.htm.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5210a6.htm
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March 17, 2003
UPDATED: IAC REVISES ITS INFORMATION SHEET ABOUT VACCINES DISTRIBUTED IN THE UNITED STATES

If you're interested in phoning a vaccine manufacturer's customer service line or accessing a manufacturer's website, you'll want a copy of "Vaccines and Related Products Distributed in the United States, 2003," which was recently revised by the Immunization Action Coalition (IAC).

This one-page information sheet lists all the vaccines and related biologic products licensed for U.S. distribution as of March 2003. It shows the disease(s) each vaccine and biologic protects against, as well as the brand name, manufacturer, type (e.g., inactivated or live attenuated), and supply size (e.g., single- or multi-dose vial) of each.

One notable addition since the sheet was last revised in November 2001 is information about Pediarix, GlaxoSmithKline's pediatric combination vaccine for diphtheria, tetanus, pertussis, hepatitis B, and polio.

To access the revised sheet in camera-ready (PDF) format, go to:
http://www.immunize.org/catg.d/2019prod.pdf

To access it in HTML format, go to:
http://www.immunize.org/catg.d/2019prod.htm
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March 17, 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, March 4-10, 2003" in the March 14 issue of the "Morbidity and Mortality Weekly Report" (MMWR). The article updates information published in the March 7 MMWR. Surveillance for adverse events during the civilian smallpox vaccination program is ongoing; regular surveillance reports will be published in MMWR.

Portions of the article are reprinted below.

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During January 24-March 7, smallpox vaccine was administered to 16,919 civilian health-care and public health workers in 50 jurisdictions. No potentially life-threatening adverse events of a type known  previously to be caused by smallpox vaccination have been reported as of March 10.

During March 4-10, three moderate-to-severe adverse events were reported. All were cases of inadvertent inoculation and were traced to contact with military personnel who received smallpox vaccine. . . .

Four other serious adverse events were reported during March 4-10. None of these events was of a type known to be associated causally with vaccination.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5210a5.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5210.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 17, 2003