Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 388            June 2, 2003

CONTENTS OF THIS ISSUE

  1. American Academy of Pediatrics paper rebuts article purporting a connection between thimerosal and autism
  2. Article traces the American Academy of Pediatrics' history of support for the hepatitis B vaccine birth dose
  3. National Immunization Program releases Influenza Vaccine Bulletin #1 for influenza season 2003-04
  4. New: Updated editions of three significant immunization resources available for order
  5. NFID report offers lots of ideas for boosting childhood influenza immunization rates
  6. Know someone with chronic hepatitis B infection? If so, be sure to tell them about the "B-Informed 2003" conference!
  7. New: English- and Spanish-language hepatitis B Vaccine Information Statements available in audio format
  8. CDC publishes an update about cardiac-related events during the smallpox vaccination program

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June 2, 2003
AMERICAN ACADEMY OF PEDIATRICS PAPER REBUTS ARTICLE PURPORTING A CONNECTION BETWEEN THIMEROSAL AND AUTISM

In response to an article by Geier and Geier that has received media attention, the American Academy of Pediatrics (AAP) recently issued a paper, "Study Fails to Demonstrate a Connection Between Thimerosal and Autism."

The paper informs clinicians about numerous flaws in the article, which claims to show a correlation between thimerosal and autism. The AAP advises clinicians that the Geiers' article uses data from the  Vaccine Adverse Event Reporting System inappropriately and contains abundant conceptual and scientific flaws, omissions of fact, inaccuracies, and misstatements.

Titled "Thimerosal in Childhood Vaccines, Neurodevelopment Disorders, and Heart Disease in the United States," the Geiers' article was published in the "Journal of American Physicians and Surgeons," Vol. 8, No. 1, Spring 2003.

To access a camera-ready (PDF) copy of the AAP paper, go to:
http://www.cispimmunize.org/pro/pdf/Geiersummary.pdf

To access a camera-ready (PDF) copy of the Geiers' article, go to: http://www.jpands.org/vol8no1/geier.pdf
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June 2, 2003
ARTICLE TRACES THE AMERICAN ACADEMY OF PEDIATRICS' HISTORY OF SUPPORT FOR THE HEPATITIS B VACCINE BIRTH DOSE

An article that appeared in a newsletter of the American Academy of Pediatrics (AAP) summarizes the history of the professional organization's long-standing preference for the birth dose of hepatitis B  vaccine. Written by AAP fellow Thomas N. Saari, MD, the article was published in the "Section on Infectious Diseases Newsletter" (Vol.6, Issue 1, Spring 2003). To access a camera-ready (PDF) copy of the article from the AAP website, go to:
http://www.cispimmunize.org/pro/pdf/Hep%20B%20guidance.pdf

For a wealth of information about the importance of the birth dose, go to the Immunization Action Coalition birth dose web page at http://www.immunize.org/birthdose
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June 2, 2003
NATIONAL IMMUNIZATION PROGRAM RELEASES INFLUENZA VACCINE BULLETIN #1 FOR INFLUENZA SEASON 2003-04

On May 22, the National Immunization Program of the Centers for Disease Control and Prevention (CDC) issued "Influenza Vaccine Bulletin #1." It is reprinted below in its entirety.

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INFLUENZA VACCINE BULLETIN #1
Influenza Season 2003-04
May 22, 2003

The National Immunization Program (NIP) of the Centers for Disease Control and Prevention (CDC) publishes and distributes periodic bulletins to update partners about recent developments related to the  production, distribution, and administration of influenza vaccine. All recipients of this bulletin are encouraged to distribute each issue widely to colleagues, members, and constituents.

INFLUENZA VACCINE SUPPLY AND PRODUCTION

2003-2004 influenza vaccine strains

The 2003-2004 influenza vaccine formulation includes A/New Caledonia/20/99-like (H1N1), A/Panama/2007/99 (H3N2), and B/Hong Kong/330/2001-like virus strains, exactly the same formulation as in the 2002-03 season.

The Food and Drug Administration (FDA) does not recommend the use of any vaccine beyond its expiration date. Influenza vaccine produced in 2002 outdates June 30, 2003. The FDA has issued a  statement, posted on its web site at http://www.fda.gov/cber/flu/flu.htm to address issues concerning use of last season's influenza vaccine.

Place orders now for influenza vaccine!

Healthcare providers who have not yet placed orders should do so as soon as possible. Additional information about sources of vaccine can be found at http://www.hida.org/link_frame.asp?URL=http://www.hida.org/govtrelations/flulinks.asp a service provided by the Health Industry Distributors Association.

Projection for this year's influenza vaccine supply Vaccine manufacturers Aventis Pasteur and Powderject Vaccines (Powderject produces the Evans vaccines brand) project an aggregate total of 80-85 million doses of influenza vaccine for the U.S. market this year. This is 10-15 million doses  below last year's total, yet greater than the estimated 79 million doses sold to individuals in 2002.

INFLUENZA VACCINE DISTRIBUTION

The Advisory Committee on Immunization Practices (ACIP) has released its influenza vaccine recommendations for the 2003-04 flu season, published in the April 25 CDC Morbidity and Mortality Weekly Report (MMWR). The recommendations refer specifically to the timing of vaccinations for at-risk and target groups.

The best time to be vaccinated against influenza continues to be October and November. Because of vaccine distribution delays during the period 2000-2002, ACIP recommends that the following persons should be vaccinated in October:

  • Adults aged 50 or older
  • Infants and children aged 6 through 23 months
  • Anyone aged 2-49 years who is at increased risk for influenza-related complications
  • Children aged less than 9 years who are receiving their first influenza vaccination
  • Healthcare workers
  • All household contacts of persons at high risk for influenza

All other groups can be vaccinated in November. To see this issue of MMWR (MMWR 2003; 52(RR-8)), go to http://www.cdc.gov/mmwr/PDF/rr/rr5208.pdf

New Medicare payment rates for influenza, pneumococcal, and hepatitis B vaccine administration became effective March 1, 2003.

Medicare's 2003 vaccine administration rate allowances average $7.72 for 2003, a 94% increase over 2002. The rates range from $5.34 to $10.98, depending on geographic location. To determine the rate for  a specific locale, go to http://www.cms.hhs.gov/preventiveservices/2.asp

To download an Excel table for rates, look for the link 03 Pay Rates in the yellow "News" box on the right side of the page. Please note, the payment rate for the 2003 influenza vaccine has not yet been determined.

Amendment to Medicare Standing Orders Rule Eliminates Physician Signature Requirement

The Centers for Medicare and Medicaid published a rule on October 2, 2002, that eliminates the physician signature requirement for the administration of influenza and pneumococcal vaccinations from the Conditions of Participation for Medicare and Medicaid participating hospitals, long-term care facilities, and home health agencies. Influenza and pneumococcal vaccines can now be administered per physician-approved facility or agency following assessment of contraindications.

To review the details of this and other recommendations, see MMWR article in the January 31, 2003 issue "Facilitating Influenza and Pneumococcal Vaccination Through Standing Orders Programs" (MMWR 2003;52(04): 68-69). The entire issue is available at http://www.cdc.gov/mmwr/PDF/wk/mm5204.pdf

INFLUENZA VACCINE COMMUNICATIONS

2003 Influenza Vaccine Summit

The 2003 Influenza Vaccine Summit was held May 20-21 in Chicago, Illinois. Additional information about the summit can be found on the American Medical Association web site, http://www.ama-assn.org, at http://www.ama-assn.org/ama/pub/article/1826-7688.html Watch the AMA site and this Flu Bulletin for additional information from the 2003 Flu Summit.

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To access the bulletin from the CDC website, go to:
http://www.cdc.gov/nip/Flu/bulletins-flu/2003-04/bulletin1_052203.htm

To access a camera-ready (PDF) version of the bulletin from the Immunization Action Coalition website, go to: http://www.immunize.org/news.d/flubul1-03.pdf
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June 2, 2003
NEW: UPDATED EDITIONS OF THREE SIGNIFICANT IMMUNIZATION RESOURCES AVAILABLE FOR ORDER

The Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), and Lippincott Williams and Wilkins recently made newly revised editions of important immunization resources available for order. The three are "Health Information for International Travel, 2003-2004 (the Yellow Book); "2003 Report of the Committee on Infectious Diseases" (the Red Book); and "Vaccine Handbook: A Practical Guide for Clinicians." A brief synopsis of each book and ordering information follows:

  1. "Health Information for International Travel, 2003-2004" (CDC, 2003; softbound, $29). Described as the preeminent reference for health care providers who administer pre- and post-travel counseling and care, the new edition includes changes in vaccine recommendations, a new chapter focusing on recommendations for children and infants, and updated text on injury during travel and travelers with disabilities. Available now.
     
    To order the Yellow Book from the website of the Public Health Foundation, go to: http://bookstore.phf.org/prod159.htm

     
    Available in the summer, the Yellow Book in combination with a CD-ROM can be ordered for $40 at http://bookstore.phf.org/prod281.htm
     
    To place an order by phone, call (877) 252-1200.
     
  2. "2003 Report of the Committee on Infectious Diseases" (AAP, 2003; softbound, $95 or $90 [AAP members]). Described as the most reliable and clinically useful information on the manifestations, etiology, epidemiology, diagnosis and treatment of 200 childhood infectious diseases. The 26th edition has expanded information on passive and active immunizations, vaccine shortages, and immunization of pre-term infants, among a wealth of other information. Available in July.
     
    To preorder the Softbound Red Book from the AAP website, go to:
    http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=755&CatID=132
     
    The Red Book comes in six additional formats. Following is ordering information for all (see A-F below).
  1. The Hardbound Red Book ($115 or $110 [AAP members]) includes a 32-page full-color atlas of new photos. To preorder go to: http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=1927&CatID=132
     
  2. The Visual Red Book on CD-ROM ($170 or $165 [AAP members]) has the complete Red Book text (including PDA download), more than 1,300 images; and a Red Book Online subscription (see entry C below for information). To preorder go to: http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=757&CatID=132
     
  3. The Red Book Online ($145 or $140 [AAP members]) has the complete Red Book text (including PDA download), all images from the CD-ROM, and an online life-of-the edition subscription to updated news and resources. To preorder go to: http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=3828&CatID=132
     
  4. The Red Book for PDA ($95 or $90 [AAP members]) has the complete Red Book text formatted for the user's PDA; it's compatible with Palm OS and Pocket PC. To preorder go to: http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=3829&CatID=132
     
  5. The Softbound Red Book with Multimedia Set ($195 or $190 [AAP members]) has both the softbound book and the Red Book Online (see entry C above). To preorder go to: http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=1267
     
  6. The Hardbound Red Book with Multimedia Set ($215 or $210 [AAP members]) has both the hardbound book and the Red Book Online (see entry C above). To preorder go to: http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=2294
     
    To place an order by phone, call (866) 843-2271.
  1. "The Vaccine Handbook: A Practical Guide for Clinicians" (Lippincott Williams & Wilkins, softbound, $40). The handbook discusses a spectrum of vaccines, each separately, and presents information about the disease the vaccine prevents and its epidemiology, the vaccine's efficacy and safety, and the practical questions most frequently asked about the vaccine's use. A chapter addresses specific parental concerns about vaccines and their safety. Available in September.
     
    To preorder the handbook from the publisher's website, go to: http://www.lww.com/productPrint.html?intProductID=540917826
     
    To place an order by phone, call (800) 638-3030.

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June 2, 2003
NFID REPORT OFFERS LOTS OF IDEAS FOR BOOSTING CHILDHOOD INFLUENZA IMMUNIZATION RATES

The National Foundation for Infectious Diseases (NFID) recently issued a consensus report, "Increasing Influenza Immunization Rates in Infants and Children: Putting Recommendations into Practice." The 34-age report is based on the work of a panel of 15 experts NFID convened to address the changes the Advisory Committee on Immunization Practices and the American Academy of Pediatrics made in their pediatric influenza vaccination recommendations for the 2002-03 influenza season.

The first part of the report discusses the feasibility of universal pediatric influenza immunization given concerns about the following: vaccine safety, efficacy, and supply; parental acceptance of universal immunization; and provider reimbursement and liability. Based on reports from providers in different practice settings who achieve high pediatric influenza immunization rates, the second part presents proven strategies to increase rates in various populations and health care settings.

To access a camera-ready (PDF) copy of the report from the NFID website, go to:
http://www.nfid.org/publications/pediatricflu.pdf

For information about NFID, go to: http://www.nfid.org
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June 2, 2003
KNOW SOMEONE WITH CHRONIC HEPATITIS B INFECTION? IF SO, BE SURE TO TELL THEM ABOUT THE "B-INFORMED 2003" CONFERENCE!

Sponsored by the Hepatitis B Foundation (HBF), "B-Informed 2003: A Gathering of Friends" will be held July 20-22 at Delaware Valley College, Doylestown, PA. Intended for patients, parents, and families of persons affected by chronic hepatitis B, the conference will give participants the opportunity to meet others who understand what it's like to live with the disease and share their personal experiences.

Samuel So, MD, Director, Asian Liver Center, Stanford, CA, will give the keynote address, "Eliminating the Voodoo from Hepatitis B." The conference program includes the latest updates on research, drug treatments, and management of hepatitis B given by scientific, medical, and pharmaceutical experts.

For information from the HBF website, go to:
http://www.hepb.org/2-00-02-416.hepb

To access the registration form, go to:
http://hepb.org/pdf/BInformed_registration.pdf

For additional information, email Sarah, the conference coordinator, at sarah@hepb.org or call her at (215) 489-4900.
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June 2, 2003
NEW: ENGLISH- AND SPANISH-LANGUAGE HEPATITIS B VACCINE INFORMATION STATEMENTS AVAILABLE IN AUDIO FORMAT

The hepatitis B Vaccine Information Statements (VISs) in English and Spanish are available in audio format for the first time as links on the Immunization Action Coalition (IAC) website. IAC gratefully acknowledges Healthy Roads Media, National Library of Medicine Multilingual Health Education Resource Project for providing the audio versions.

To access the VISs in audio format from the IAC website, go to: http://www.immunize.org/vis/index.htm#hepatitisb and click on either English Audio VIS or Spanish Audio VIS.

To obtain a camera-ready (PDF) copy of the hepatitis B VIS in English, go to: http://www.immunize.org/vis/hepb01.pdf

To obtain a camera-ready (PDF) copy of the hepatitis B VIS in Spanish, go to: http://www.immunize.org/vis/sphepb01.pdf

For information on the use of VISs, and for VISs in a total of 28 languages, visit IAC's VIS web page at http://www.immunize.org/vis

For information about Healthy Roads Media, go to: http://www.healthyroadsmedia.org
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June 2, 2003
CDC PUBLISHES AN UPDATE ABOUT CARDIAC-RELATED EVENTS DURING THE SMALLPOX VACCINATION PROGRAM

The Centers for Disease Control and Prevention (CDC) published "Update: Cardiac-Related Events During the Civilian Smallpox Vaccination Program--United States, 2003" in the May 30 issue of the "Morbidity and Mortality Weekly Report" (MMWR).

The report includes the case definition of myo/pericarditis and updates information on all reports of cardiac adverse events among 36,217 civilian vaccinees since the beginning of the civilian smallpox vaccination program reported through May 9 to CDC from the Vaccine Adverse Event Reporting System (VAERS). Through May 9, a total of 21 cases of myo/pericarditis were ascertained; all have been reported previously. In addition, nine cases of ischemic cardiac events (i.e., myocardial infarction [MI] or angina) among civilian vaccinees have been reported previously.

To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5221a2.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5221.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.   

 

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 June 2, 2003