Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 389            June 9, 2003

CONTENTS OF THIS ISSUE

  1. Vaccines For Children (VFC) program supports a universal hepatitis B birth dose policy
  2. CDC reports on 2002-03 influenza activity in the U.S. and worldwide and on composition of the 2003-04 influenza vaccine
  3. Information from the National Influenza Summit 2003 now posted on the American Medical Association website
  4. CDC allows immunization providers to use VISs with old Vaccine Injury Compensation Program Web address
  5. Reminder: June 26 is the date for CDC's "Adult Immunization Update 2003" satellite broadcast
  6. Minnesota passes new immunization law for pharmacists
  7. California Distance Learning Health Network's broadcast on eliminating immunization disparities set for July 10
  8. IAC makes minor correction to an attachment to its "Vaccination Record for Adults" professional education sheet
  9. Institute of Medicine releases third letter report on CDC's smallpox vaccination program implementation
  10. CDC reports on recent progress in eradicating polio in Southern Africa
  11. MMWR issues a correction to the Recommendations and Reports for Prevention and Control of Influenza

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June 9, 2003
VACCINES FOR CHILDREN (VFC) PROGRAM SUPPORTS A UNIVERSAL HEPATITIS B BIRTH DOSE POLICY

[The following is cross posted from the Immunization Action Coalition's "HEP EXPRESS" electronic newsletter, 6/6/03]

The Vaccines for Children (VFC) program recently agreed to support requests from grantees for four doses of hepatitis B vaccine for routine vaccination of infants. VFC based its decision on the Advisory Committee on Immunization Practices' preference for giving all infants the birth dose of hepatitis B vaccine before hospital discharge and on reports of numerous errors in perinatal hepatitis B prevention.

In a memorandum dated June 2, Lance E. Rodewald, MD, Director, Immunization Services Division, National Immunization Program at CDC, outlined the VFC program's rationale for making the decision and listed eligibility criteria for purchasing hepatitis B vaccine with VFC funds. The memorandum is reprinted below in its entirety, excluding one table.

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Date: June 2, 2003
From: Director, Immunization Services Division/NIP
Subject: VFC Support for a Universal Hepatitis B Birth Dose Policy
To: Immunization Program Managers

The Advisory Committee on Immunization Practices (ACIP) and the National Immunization Program (NIP) support the implementation of a universal hepatitis B birth dose policy for several reasons:

  1. Approximately 20,000 infants born to hepatitis B surface antigen (HBsAg) positive women are born annually in the United States. These infants require hepatitis B vaccine and hepatitis B  immune globulin (HBIG) within 12 hours of birth to prevent perinatal hepatitis B transmission. However, because errors or delays in documenting, testing, and reporting maternal HBsAg status  can and do occur, administering the first dose of hepatitis B vaccine soon after birth to all infants acts as a safety net and reduces the risk for perinatal infection in infants whose mothers' HBsAg status is either unknown or incorrectly documented at the time of delivery.
     
  2. Childhood transmission of hepatitis B virus does occur in infants whose mothers are HBsAg negative but who are exposed to persons in the household with chronic hepatitis B virus (HBV) infection. Two out of three cases of childhood transmission occur in this manner and these children could be protected with a birth dose of hepatitis B vaccine.
     
  3. Initiating the hepatitis B vaccine series at birth has been shown to increase a child's likelihood of completing the vaccine series according to the recommended childhood schedule.

As indicated in the 2003 Childhood and Adolescent Immunization Schedule, the ACIP prefers the birth dose of hepatitis B vaccine over vaccination after discharge from the hospital recommending that "all infants should receive the first dose of hepatitis B vaccine soon after birth and before hospital discharge; the first dose may also be given by age two months if the infant's mother is HBsAg negative."

The VFC Resolution for hepatitis B (Resolution 02/03-1) also explicitly indicates a preference for administering the first dose of hepatitis B vaccine at birth, as outlined in the table on the following page. [The table is available by clicking on the link at the end of this article.]

[TABLE]

Given the ACIP's preference for the birth dose of hepatitis B vaccine and its preference for combination vaccines, the VFC Program will support requests from grantees for four doses of hepatitis  B vaccine for routine vaccination of infants. Hospitals using VFC vaccine must enroll as VFC providers and must screen for eligibility for the VFC program.

If your state is considering providing the hepatitis B vaccine birth dose to all hospitals, please be aware of the following:

  1. If you are supplying the birth dose of hepatitis B vaccine to hospitals, those hospitals must be registered VFC providers.
     
  2. You may only supply VFC vaccine to a hospital to cover children that are VFC-eligible. If you are supplying vaccine for the hospital to cover all births, you must use vaccine purchased from 317 or state funds to cover non-VFC-eligible children.
     
  3. Please work with your hospitals to make provider profiles as accurate as possible. Hospitals screen everyone for insurance status and can easily tell you how many of their births are covered by Medicaid, private insurance, or self-pay. This information can be used for required VFC-eligibility screening in hospitals.
     
  4. We are very concerned that hospitals may bill for vaccine being supplied by the state. Please  work with your hospitals to assure that they are not billing insurance plans for vaccine supplied by the state.

If you have any questions about implementing a universal hepatitis B birth dose policy in your state, please do not hesitate to contact Tasneem Malik at (404) 639-4213 or your VFC Consultant at (404) 639-8222.

Original Signed By
Lance E. Rodewald, M.D.
Director
Immunization Services Division
National Immunization Program

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To access the CDC memorandum (including the table showing the routine recommended schedule for hepatitis B vaccination for infants born to hepatitis B surface antigen negative mothers), from the website of the Immunization Action Coalition, go to:
http://www.immunize.org/cdc/hepbmemo.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 9, 2003
CDC REPORTS ON 2002-03 INFLUENZA ACTIVITY IN THE U.S. AND WORLDWIDE AND ON COMPOSITION OF THE 2003-04 INFLUENZA VACCINE

The Centers for Disease Control and Prevention (CDC) published "Update: Influenza Activity--United States and Worldwide, 2002-03 Season, and Composition of the 2003-04 Influenza Vaccine" in the June 6 issue of the "Morbidity and Mortality Weekly Report" (MMWR). A portion of a summary made available to the press is reprinted below.

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Influenza A (H1N1), A (H1N2), A (H3N2), and B viruses co-circulated worldwide during the 200203 influenza season in the Northern Hemisphere. Human infections with avian influenza A (H5N1) and A (H7N7) viruses were reported in Hong Kong and the Netherlands, respectively. In the United States, the 200203 influenza season was mild; influenza A (H1) and B viruses circulated widely but the  predominant virus varied by region and time of season. The Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee (VRBPAC) recommended A/New Caledonia/20/99-like (H1N1), A/Moscow/10/99-like (H3N2), and B/Beijing/330/01-like viruses for the 200304 trivalent influenza vaccine for the United States. This recommendation was based on antigenic analyses of recently isolated influenza viruses, epidemiologic data, and post-vaccination serologic studies in humans.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5222a2.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5222.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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June 9, 2003
INFORMATION FROM THE NATIONAL INFLUENZA SUMMIT 2003 NOW POSTED ON THE AMERICAN MEDICAL ASSOCIATION WEBSITE

Sponsored by the Centers for Disease Control and Prevention and the American Medical Association (AMA), the 2003 National Influenza Summit was held in Chicago on May 20-21. Attendance was by invitation only.

Participants considered two major topics: future developments in vaccine production and challenges to improving influenza uptake.

To access the summit's list of participants, final agenda, and speakers' PowerPoint presentations from the AMA website, go to: http://www.ama-assn.org/ama/pub/article/1826-7688.html As additional news and materials become available, they will be posted on this site.
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June 9, 2003
CDC ALLOWS IMMUNIZATION PROVIDERS TO USE VISs WITH OLD VACCINE INJURY COMPENSATION PROGRAM WEB ADDRESS

The Centers for Disease Control and Prevention (CDC) recently updated the Web address for the Vaccine Injury Compensation Program (VICP) on Vaccine Information Statements (VISs) for routine childhood vaccines. The address changed last year.

CDC advises immunization providers that it did not change the VIS issue date or anything else on these VISs. Providers may use VISs with the old VICP Web address (as long as the VIS is otherwise current) with the understanding that the VICP Web address is nonfunctional. The new Web address is www.hrsa.gov/osp/vicp

The address was changed on VISs for the following vaccines: diphtheria, tetanus, and pertussis (DTaP), pneumococcal conjugate (PCV7), inactivated polio (IPV), Haemophilus influenzae type b (Hib), hepatitis B, and varicella. Updated versions of these VISs are posted on the National Immunization program website at http://www.cdc.gov/nip/publications/VIS/default.htm

To access copies of the newly revised VISs for routine childhood vaccines from the VIS web page of the Immunization Action Coalition, go to: http://www.immunize.org/vis The VIS web page has information about the use of VISs and also has VISs in up to 28 languages.
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June 9, 2003
REMINDER: JUNE 26 IS THE DATE FOR CDC'S "ADULT IMMUNIZATION UPDATE 2003" SATELLITE BROADCAST

"Adult Immunization Update 2003" is a live satellite broadcast for health care providers on current adult immunization practice and improving adult immunization coverage levels. Sponsored by the Centers for Disease Control and Prevention (CDC), the broadcast is scheduled for June 26 from noon to 2:30 pm ET. It will feature a Q&A session in which participants nationwide can interact with the course instructors via toll-free telephone lines.

The course instructors are William L. Atkinson, MD, MPH, medical epidemiologist, and Donna L. Weaver, RN, MN, nurse educator. Both are with the CDC's National Immunization Program. For information about program content, email nipinfo@cdc.gov

Only online registration is available. To register on the Public Health Training Network website, go to:
http://www.phppo.cdc.gov/phtnonline

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

The program will have a live webcast at
http://www.phppo.cdc.gov/phtn/webcast/adult-imm03

For technical support and to prepare for the webcast ahead of time, go to:
http://www.phppo.cdc.gov/phtn/webcast/techsupport.asp
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June 9, 2003
MINNESOTA PASSES NEW IMMUNIZATION LAW FOR PHARMACISTS

On May 27, Minnesota's governor signed a law allowing pharmacists who have had special training to administer influenza and pneumococcal vaccine to adult patients using a physician's standing orders or by written protocol with a physician. This makes Minnesota the 37th state to allow pharmacists to administer vaccinations. The law goes into effect July 1.

To access information about laws, rules, and regulations regarding pharmacists' providing vaccinations from the website of the Immunization Action Coalition (IAC), go to:
http://www.immunize.org/laws/pharm.htm

IAC thanks the American Pharmacists Association (APhA) for providing us with this information. To access information about APhA, go to: http://www.aphanet.org

To access 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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June 9, 2003
CALIFORNIA DISTANCE LEARNING HEALTH NETWORK'S BROADCAST ON ELIMINATING IMMUNIZATION DISPARITIES SET FOR JULY 10

"Eliminating Health Disparities: A Satellite Broadcast for Outreach Workers" will be broadcast July 10 from noon to 2 pm ET. Produced by California Distance Learning Health Network (CDLHN), the program will offer insights into working with diverse communities and present the latest immunization outreach strategies. It will focus particularly on California but has information applicable to outreach workers across the nation.

The program has three main objectives:

  • Define the scope of immunization disparities in California
  • Identify key community resources, groups, and services
  • Describe effective entry points for working with key communities, and review the skills needed to build effective long-term relationships with them

It will cover four subjects:

  • How to do outreach with minimal resources
  • Outreach support for media campaigns
  • How to present your program to a community
  • Community partnerships and maximizing resources

Registration, which is required, is through CDLHN. Contact CDLHN online at http://www.cdlhn.com, by email at cdlhn@projects.sdsu.edu, by phone at (619) 594-3348, or by fax at (619) 594-2111.
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June 9, 2003
IAC MAKES MINOR CORRECTION TO AN ATTACHMENT TO ITS "VACCINATION RECORD FOR ADULTS" PROFESSIONAL EDUCATION SHEET

The Immunization Action Coalition (IAC) made an error on an attachment to the professional education sheet "Vaccination Record for Adults."

The error appeared on an attachment containing examples for recording combination vaccines (the attachment has "Example #4" superimposed on it). The column titled "Site Given" had an error for Hepatitis A and Hepatitis B combination vaccine. The error has been corrected; the date of the corrected version is 5/03. If you printed the "Example #4" attachment, please discard your printed copies and print new ones from the following URL: http://www.immunize.org/catg.d/p2023b.pdf

We apologize for any inconvenience this error may have caused readers of "IAC EXPRESS."
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June 9, 2003
INSTITUTE OF MEDICINE RELEASES THIRD LETTER REPORT ON CDC'S SMALLPOX VACCINATION PROGRAM IMPLEMENTATION

On May 27, the Institute of Medicine (IOM) of the National Academies released its third letter report advising the Centers for Disease Control and Prevention (CDC) on the implementation of the national smallpox vaccination program. CDC sponsored the report. A private, nonprofit institution, IOM provides health policy advice under a Congressional charter granted to the National Academy of Sciences.

Titled "Review of the Centers for Disease Control and Prevention's Smallpox Vaccination Program Implementation: Letter Report #3," the 16-page report reaffirms the need for a pause in the smallpox vaccination program and provides commentary about the CDC's smallpox program activities to date, including next steps in the pre-event vaccination program.

To access the report from the IOM website, go to:
http://www.nap.edu/books/NI000508/html
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June 9, 2003
CDC REPORTS ON RECENT PROGRESS IN ERADICATING POLIO IN SOUTHERN AFRICA

The Centers for Disease Control and Prevention (CDC) published "Progress Toward Poliomyelitis Eradication--Southern Africa 2001-March 2003" in the June 6 issue of the "Morbidity and Mortality Weekly Report" (MMWR). A summary made available to the press is reprinted below.

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Although wild poliovirus circulation appears to have been interrupted in the southern part of Africa, polio eradication activities should be sustained until global eradication is certified.

The estimated global occurrence of poliomyelitis has decreased more than 99% since 1988, when the World Health Assembly resolved to eradicate polio worldwide. The last cases of poliomyelitis in the Southern African Block were observed in Zambia in February 2002. While it is possible that polio transmission has been interrupted, the quality of surveillance in several important countries does not yet allow [the reliable exclusion of] the ongoing transmission of polio. External surveillance reviews are planned for 2003 in Madagascar, Mozambique, and South Africa, and a Technical Advisory Group for Angola will convene for the first time in June. Additional funding will be required to sustain polio eradication activities in those countries and prevent importation and circulation of polioviruses until global polio eradication is certified.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5222a3.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5222.pdf
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June 9, 2003
MMWR ISSUES A CORRECTION TO THE RECOMMENDATIONS AND REPORTS FOR PREVENTION AND CONTROL OF INFLUENZA

The Centers for Disease Control and Prevention (CDC) published "Erratum: Vol. 52, No. RR-8" in the June 6 issue of the "Morbidity and Mortality Weekly Report" (MMWR). It is reprinted below in its entirety.

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In the MMWR Recommendations and Reports, "Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)," published April 25, 2003, on page 12, an error occurred in the title for Table 3. The title should read, "Influenza vaccine* dosage by age group--United States, 2003-04 season."

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5222a5.htm

 

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 9, 2003