Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 381            April 28, 2003

CONTENTS OF THIS ISSUE

  1. CDC releases recommendations on prevention and control of influenza
  2. CDC clarifies hepatitis B birth dose information presented in its earlier notification about PEDIARIX combination vaccine
  3. American College of Obstetricians and Gynecologists makes its guidelines on immunization during pregnancy available on the Internet
  4. New on the Web: "Vaccines Across the Life Span, 2003"
  5. Maine adopts regulations requiring hepatitis B vaccination for children attending licensed daycare facilities
  6. Act today: April 28 is early bird registration deadline for the National Conference on Immunization Coalitions
  7. New vaccination website offers valuable vaccine information plus an online childhood/adolescent immunization scheduler
  8. CDC presents progress report on global eradication of poliomyelitis
  9. Angola launches campaign to immunize seven million children against measles by May 19
  10. CDC reports on success of the 2002 Afghani measles vaccination campaign
  11. CDC publishes an update of smallpox vaccine adverse events surveillance
  12. CDC notifies readers about "M Guide Online Knowledge Centers"

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April 28, 2003
CDC RELEASES RECOMMENDATIONS ON PREVENTION AND CONTROL OF INFLUENZA

The Centers for Disease Control and Prevention (CDC) published "Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)" in the April 25 issue  of "MMWR Recommendations and Reports" (MMWR). The summary is reprinted below in its entirety.

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This report updates the 2002 recommendations by the Advisory Committee on Immunization Practices (ACIP) on the use of influenza vaccine and antiviral agents (CDC. Prevention and Control of Influenza:  Recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2002;51[No. RR-3]:1-31). The 2003 recommendations include new or updated information regarding 1) the timing of influenza vaccination by age and risk group; 2) influenza vaccine for children aged 6-23  months; 3) the 2003-2004 trivalent inactivated vaccine virus strains: A/Moscow/10/99 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like, and B/Hong Kong/330/2001-like antigens (for the A/Moscow/10/99 [H3N2]-like antigen, manufacturers will use the antigenically equivalent A/Panama/2007/99 [H3N2] virus, and for the B/Hong Kong/330/2001-like antigen, manufacturers will use either B/Hong Kong/330/2001 or the antigenically equivalent B/Hong Kong/1434/2002); 4)  availability of certain influenza vaccine doses with reduced thimerosal content, including single 0.25 mL-dose syringes; and 5) manufacturers of influenza vaccine for the U.S. market. Although the optimal time to vaccinate against influenza is October and November, vaccination in December and later continues to be strongly recommended. A link to this report and other information regarding influenza can be accessed at http://www.cdc.gov/ncidod/diseases/flu/fluvirus.htm


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To obtain the complete text of the recommendation online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5208a1.htm

To obtain a camera-ready (PDF format) copy of the recommendation, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5208.pdf

The PDF version includes a free CDC-sponsored continuing education activity that can be completed online or submitted via U.S. mail for CME, CEU, or CNE credit. Simply read the MMWR recommendation, answer the questions at the end, and follow the instructions for submitting your answers.

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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April 28, 2003
CDC CLARIFIES HEPATITIS B BIRTH DOSE INFORMATION PRESENTED IN ITS EARLIER NOTIFICATION ABOUT PEDIARIX COMBINATION VACCINE

The Centers for Disease Control and Prevention (CDC) published "Clarification: Vol. 52, No. 10" in the April 25 issue of the "Morbidity and Mortality Weekly Report" (MMWR). It concerns the Notice to Readers titled "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. The clarification is reprinted below in its entirety.

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In the 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," there were two potentially misleading statements in the paragraph following the heading "ACIP Approval for DTaP-HepB-IPV for the Vaccines for Children Program." First, the statement "3 doses of PEDIARIX can be administered to an infant who is born to a woman who is hepatitis B surface antigen (HBsAg)-positive or whose HBsAg status is unknown" is potentially misleading. A birth dose of single-antigen vaccine is preferred for all infants but must be administered to infants who are born to women who are HBsAg-positive or whose HBsAg status is unknown. The birth dose can then be followed by 3 doses of PEDIARIX at ages 2, 4, and 6 months. Second, the third dose of PEDIARIX should be administered at least 16 weeks after the first dose and at least 8 weeks after the second dose but not before age 6 months.

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To obtain the complete text of the clarification online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a7.htm

To obtain the March 14 Notice to Readers, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5210a8.htm

The Immunization Action Coalition (IAC) wants to make sure you have the information you need about the importance of the hepatitis B birth dose. Following are links to a variety of resources from the IAC website.

To visit all the IAC birth dose web pages, go to:
http://www.immunize.org/birthdose

To obtain a camera-ready (PDF) copy of a professional education sheet about medical errors in perinatal hepatitis B prevention, go to:
http://www.immunize.org/catg.d/p2062.pdf

To obtain an HTML version of it, go to:
http://www.immunize.org/catg.d/p2062.htm

To obtain a camera-ready (PDF) copy of an open letter to health professionals written by Deborah L. Wexler, MD, IAC's executive director, about the importance of the hepatitis B birth dose, go to:
http://www.immunize.org/catg.d/p2125.pdf

To obtain an HTML version of it, go to:
http://www.immunize.org/catg.d/p2125.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5216.pdf
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Please note: A correction has been published for this article. To view the correction, click here.
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April 28, 2003
AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS MAKES ITS GUIDELINES ON IMMUNIZATION DURING PREGNANCY AVAILABLE ON THE INTERNET

The American College of Obstetricians and Gynecologists (ACOG) Committee Opinion No. 282, "Immunization During Pregnancy," is now available on the ACOG website. Originally published in January in ACOG's journal, "Obstetrics & Gynecology," the document reflects emerging clinical and scientific advances and is subject to change because the effects of many diseases and vaccines on the pregnant woman or the fetus may be rare and infrequently reported.

The substance of the opinion document is a five-page table that presents the following information about each immunobiologic agent: Risk from disease to a pregnant woman and her fetus or newborn; type of immunizing agent and its risk to the fetus; indications for immunization during pregnancy; dose schedule; and other comments.

To access a ready-to-print (PDF) version of the complete opinion from the ACOG website, go to:
http://www.acog.org/from_home/publications/misc/bco282.pdf

To access a web-text (HTML) version, go to:
http://www.acog.org/from_home/publications/misc/bco282.cfm

To access the ACOG home page, go to: http://www.acog.org
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April 28, 2003
NEW ON THE WEB: "VACCINES ACROSS THE LIFE SPAN, 2003"

A five-article document, "Vaccines Across the Life Span, 2003," first appeared as a supplement to the January 2003 issue of the "Journal of Family Practice" (vol.52, no. 1). Produced by the Group on Immunization Education of the Society of Teachers of Family Medicine and the Department of Family Medicine at the University of Pittsburgh School of Medicine, it is now available on the website of the Journal of Family Practice.

The document, which was edited by Richard K. Zimmerman, MD, MPH, and funded by a grant from the Centers for Disease Control and Prevention, is a practical resource on immunization written by family physicians for their colleagues. Following is a synopsis of each article.

The first article, "Routine Vaccines Across the Life Span, 2003," discusses age-based indications for vaccination and other topics including disease burden, rationale for vaccination, vaccine efficacy, adverse reactions, and specific vaccine recommendations. A color centerfold with photographs of vaccine-preventable diseases and the current immunization schedules amplifies the material in this article.

The second article, "Vaccines for Persons at High Risk Due to Medical Conditions, Occupation, Environment, or Lifestyle, 2003," reviews the safety and efficacy of current vaccines for high-risk populations, such as pregnant women, health care workers, and those with underlying medical conditions.

"Vaccine Schedules and Procedures, 2003," the third article, reviews current age-based recommendations for vaccination as well as the contraindications, precautions, administration techniques, and storage procedures for routinely administered vaccines.

The fourth article, "Addressing Immunization Barriers, Benefits, and Risks," presents suggestions for explaining vaccine benefits and risks and a summary of practical, proven strategies for increasing immunization rates.

"Vaccines and Bioterrorism: Smallpox and Anthrax," the fifth article, discusses pre- and post-exposure management and containment strategies for smallpox and anthrax.

To access a camera-ready (PDF) copy of the articles from the "Journal of Family Practice" website, go to: http://www.jfponline.com/supplements/jan_03_supplement.asp

For an array of practical immunization information from the website of the Group on Immunization Education, go to: http://www.immunizationed.org
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April 28, 2003
MAINE ADOPTS REGULATIONS REQUIRING HEPATITIS B VACCINATION FOR CHILDREN ATTENDING LICENSED DAYCARE FACILITIES

Effective November 2002, Maine adopted regulations to require hepatitis B vaccination for children attending licensed daycare facilities. This information was recently added to the table of state mandates for hepatitis B prevention maintained by the Immunization Action Coalition (IAC).

To access the table on the IAC website, go to:
http://www.immunize.org/laws/hepb.htm

To access additional information about state immunization mandates, go to: http://www.immunize.org/laws

We depend on our readers to help us stay informed and to ensure this is the most current and accurate information available. Please let us know when any changes occur in your state.
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April 28, 2003
ACT TODAY: APRIL 28 IS EARLY BIRD REGISTRATION DEADLINE FOR THE NATIONAL CONFERENCE ON IMMUNIZATION COALITIONS

Register today and get $100 off the regular conference fee for the Fifth National Conference on Immunization Coalitions. Scheduled for May 28-30, the conference will take place at the Westin Kierland Resort and Spa in Phoenix-Scottsdale, AZ. The conference will provide information, resources, and skills-building sessions to energize and strengthen immunization coalitions at every stage of development.

For a copy of the conference brochure and registration form, go to:
http://www.publichealth.usf.edu/conted/pdf/ImmBroch03.pdf

April 28 is also the cut-off date for the special hotel conference rate of $119. To receive the special rate, call the Westin Kierland Resort and Spa directly at (480) 624-1000 and reference the National Conference on Immunization Coalitions.

For more information, call (888) 873-2674 or email conted@hsc.usf.edu
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April 28, 2003
NEW VACCINATION WEBSITE OFFERS VALUABLE VACCINE INFORMATION PLUS AN ONLINE CHILDHOOD/ADOLESCENT IMMUNIZATION SCHEDULER

The new website VaccineCheck gives patients, parents, and health professionals an excellent source of credible, comprehensive vaccine information. Written and reviewed by board-certified pediatricians, the website provides users with extensive information about vaccines across the life span and an exhaustive array of links to other immunization websites.

A unique feature of VaccineCheck is an interactive program that lets health professionals and parents create an instant, printable immunization schedule for any child or adolescent up to age 21. The goal of the program is to make vaccine scheduling an easier, more exact process.

To learn about the program from the VaccineCheck website, go to:
http://www.vaccinecheck.com/aboutprogram.jsp

To access the abundance of information the website offers, visit the VaccineCheck homepage at
http://www.vaccinecheck.com
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April 28, 2003
CDC PRESENTS PROGRESS REPORT ON GLOBAL ERADICATION OF POLIOMYELITIS

The Centers for Disease Control and Prevention (CDC) published "Progress Toward Global Eradication of Poliomyelitis, 2002" in the April 25 issue of the "Morbidity and Mortality Weekly Report" (MMWR). A summary made available to the press is reprinted below in its entirety.

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Progress made toward global polio eradication has been tremendous, however important challenges still remain.

Since the 1988 World Health Assembly resolution to eradicate poliomyelitis globally, the number of countries where polio is endemic declined from 125 to 7, and the estimated incidence of polio decreased more than 99%. Three World Health Organization Regions (American, Western Pacific, and European) have been certified polio-free. Despite these achievements, a provisional total of 1,920 polio cases were reported during 2002, a substantial increase from 483 in 2001, reflecting primarily the large polio epidemic in India. Efforts must be focused on India and the other polio-endemic countries to ensure global polio eradication as quickly as possible.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a4.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5216.pdf
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April 28, 2003
ANGOLA LAUNCHES MASSIVE CAMPAIGN TO IMMUNIZE SEVEN MILLION CHILDREN AGAINST MEASLES BY MAY 19

On April 21, Angola began the biggest health campaign in the nation's history, aiming to inoculate seven million children against measles by May 19. The campaign goal is to reduce by 75 percent the number of deaths caused by measles, which claims the lives of more than 7,000 Angolan children annually.

Spearheaded by the country's Ministry of Health, with key financial, logistical, and training support from the United Nations Children's Fund (UNICEF), the campaign seeks to vaccinate every child from age nine months to 15 years. In planning for the campaign the health ministry and UNICEF have trained 24,000 vaccinators nationwide; 35,000 teachers have been recruited as campaign advocates and educators.

To reach children across the nation, the campaign is scheduled to be conducted in three phases: first, children in schools and institutions will be vaccinated, followed by children in urban areas, and concluding with children in rural areas.

To access a press release about the campaign from the UNICEF website, go to:
http://www.unicef.org/newsline/2003/03ma05measles.htm

To access several pertinent press releases from the Angola web pages of the AllAfrica.com website, go to: http://allafrica.com/angola
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April 28, 2003
CDC REPORTS ON SUCCESS OF THE 2002 AFGHANI MEASLES VACCINATION CAMPAIGN

The Centers for Disease Control and Prevention (CDC) published "Nationwide Measles Vaccination Campaign for Children Aged 6 Months-12 Years--Afghanistan, 2002" in the April 25 issue of the "Morbidity and Mortality Weekly Report" (MMWR). A summary made available to the press is reprinted below in its entirety.

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A measles campaign for children below 12 years of age prevented between 20,000 to 25,000 children's deaths in Afghanistan in 2002.

Measles accounts for an estimated 30,000 to 35,000 deaths every year in Afghanistan. To reduce measles-related mortality, the Ministry of Health of the Interim Government of Afghanistan, with the support of international organizations, organized a nationwide measles vaccination campaign for children aged 6 months to 12 years in 2002. As of December 31, 2002, 10,299,878 children were reported to have been vaccinated representing 82% of the national target population. The number of reported measles cases decreased from 8,762 in 2001 to 2,574 in 2002. The cost of the campaign was approximately $0.78 per child vaccinated.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a3.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5216.pdf
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April 28, 2003
CDC PUBLISHES AN UPDATE OF SMALLPOX VACCINE ADVERSE EVENTS SURVEILLANCE

The Centers for Disease Control and Prevention (CDC) published "Update: Adverse Events Following Civilian Smallpox Vaccination--United States, 2003" in the April 25 issue of the "Morbidity and Mortality Weekly Report" (MMWR). It includes reports on one new case each of myopericarditis, myocardial infarction, atypical chest pain, and anoxic encephalopathy. One inadvertent contamination of a vaccine vial was also observed. Excerpts from the article are reprinted below.

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During January 24-April 18, 2003, smallpox vaccine was administered to 33,444 civilian health-care and public health workers in 54 jurisdictions to prepare the United States for a possible terrorist attack using smallpox virus. This report updates information on vaccine-associated adverse events among civilians vaccinated since the beginning of the program and among contacts of vaccinees, received by CDC from the Vaccine Adverse Event Reporting System (VAERS) as of April 18. . . .

As of April 18, a total of 10 cases of myopericarditis have been reported; one new report was received during April 14-18. During the same period, one new case of acute myocardial infarction (MI) was reported. . . .

During April 14-18, in addition to the MI, nine other serious adverse events were reported, including one case of atypical chest pain and one case of anoxic encaphalopathy. . .

During the current reporting period, information was received about one inadvertent contamination of a vaccine vial when a vaccinator was observed placing a needle from a vaccinee back into the vial, then removing the needle from the vial and discarding it. The vial was then used to vaccinate additional persons, but new needles were used. The initial vaccinee was tested for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus; all tests were negative. Investigation is ongoing for evidence of any complications from this event.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a2.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5216.pdf
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April 28, 2003
CDC NOTIFIES READERS ABOUT "M GUIDE ONLINE KNOWLEDGE CENTERS"

The Centers for Disease Control and Prevention (CDC) published a Notice to Readers, "Introduction of 'M Guide'" in the April 25 issue of the "Morbidity and Mortality Weekly Report" (MMWR). It is reprinted below in its entirety.

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To ensure that MMWR publications are both useful and easy to access, MMWR has introduced "M Guide Online Knowledge Centers." Available through MMWR Online (http://www.cdc.gov/mmwr), each "M Guide" provides an online grouping of MMWR reports related to a single health topic. Features of the "M Guide" include a chronological list of MMWR reports relevant to the topic,  summaries of the reports, links to the full reports, and links to other resources.

The first "M Guide" was introduced on April 23, 2003, and focused on severe acute respiratory syndrome (SARS). The SARS "M Guide" is available at http://www.cdc.gov/mmwr/mguide_sars.html

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a6.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5216.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 14, 2005