Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 403            August 4, 2003

CONTENTS OF THIS ISSUE

  1. AAP issues an erratum about epinephrine information published in the "2003 Red Book"
  2. "Pediatrics" publishes a clinical report on immunization of preterm and low birth weight infants
  3. Menomune is once again available in single-dose vials
  4. CDC announces the number of children receiving vaccines is at an all time high
  5. Revised: National Immunization Program updates the meningococcal VIS
  6. CDC seeks information on provider-based quality improvement projects aimed at enhancing immunization delivery
  7. Revised: IAC updates "It's Federal Law!" health professional information sheet about VISs
  8. CDC updates pneumococcal vaccination recommendations for cochlear implant candidates and recipients
  9. CDC reports on vaccination coverage among Alaska Native children and on other American Indian and Alaska Native health issues
  10. September 29 is deadline for abstracts for the 2004 National STD Prevention Conference
  11. IAC adds new resources to its Hepatitis Prevention Programs website
  12. WHO reports Angola vaccinated almost 5 million children against polio

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August 4, 2003
AAP ISSUES AN ERRATUM ABOUT EPINEPHRINE INFORMATION PUBLISHED IN THE "2003 RED BOOK"

The American Academy of Pediatrics (AAP) recently issued an erratum concerning Table 1.11 of the "2003 Red Book," soft cover and hard cover editions. The table, titled "Epinephrine in the Treatment of  Anaphylaxis," appears on page 64. Previously the third sentence under the heading "Intravenous  administration" read "1 mg/kg or 0.01 mL/kg." It now reads "0.01 mg/kg or 0.1 mL/kg."

Links to the erratum (below) are open access, so "Red Book" users do not need a subscription to "Red  Book Online" to see them.

To access the complete text of the erratum from "Red Book Online," go to:
http://aapredbook.aappublications.org/cgi/content/full/2003/1/E1

To access a camera-ready (PDF) version of the erratum, go to:
http://aapredbook.aappublications.org/cgi/content/full/2003/1/DC1

For information about ordering the "Red Book," go to:
http://www.AAP.org/bst/showprod.cfm?&DID=15&CATID=132&ObjectGroup_ID=790 or phone (866) 843-2271.
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August 4, 2003
"PEDIATRICS" PUBLISHES A CLINICAL REPORT ON IMMUNIZATION OF PRETERM AND LOW BIRTH WEIGHT INFANTS

The American Academy of Pediatrics (AAP) published a clinical report, "Immunization of Preterm and Low Birth Weight Infants," in the July issue of the journal "Pediatrics." Written by Thomas N. Saari, MD, and the academy's Committee on Infectious Diseases, the report offers guidance to clinicians providing pediatric care. The report abstract is reprinted below in its entirety.

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ABSTRACT

Preterm (PT) infants are at increased risk of experiencing complications of vaccine-preventable diseases but are less likely to receive immunizations on time. Medically stable PT and low birth weight (LBW) infants should receive full doses of diphtheria, tetanus, acellular pertussis, Haemophilus influenzae type b, hepatitis B, poliovirus, and pneumococcal conjugate vaccines at a chronologic age  consistent with the schedule recommended for full-term infants. Infants with birth weight less than 2000  g may require modification of the timing of hepatitis B immunoprophylaxis depending on maternal hepatitis B surface antigen status. All PT and LBW infants benefit from receiving influenza vaccine  beginning at 6 months of age before the beginning of and during the influenza season. All vaccines routinely recommended during infancy are safe for use in PT and LBW infants. The occurrence of mild vaccine-attributable adverse events are similar in both full-term and PT vaccine recipients. Although the immunogenicity of some childhood vaccines may be decreased in the smallest PT infants, antibody concentrations achieved usually are protective.

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To access the abstract from the AAP website, go to:
http://pediatrics.aappublications.org/cgi/content/abstract/112/1/193

To access the complete article, go to:
http://pediatrics.aappublications.org/cgi/content/full/112/1/193

To access a camera-ready (PDF) version of the article, go to:
http://pediatrics.aappublications.org/cgi/reprint/112/1/193.pdf

To access a variety of immunization information from AAP's Childhood Immunization Support Program website, go to: http://www.cispimmunize.org
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August 4, 2003
MENOMUNE IS ONCE AGAIN AVAILABLE IN SINGLE-DOSE VIALS

Aventis Pasteur recently informed the Immunization Action Coalition that as of June 16 the company began shipping single-dose vials of Menomune (meningococcal vaccine) to its customers once again. Since October 2002, only 10-dose vials have been available. For more information, contact Aventis Pasteur at http://www.vaccineshoppe.com or call (800) 822-2463.
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August 4, 2003
CDC ANNOUNCES THE NUMBER OF CHILDREN RECEIVING VACCINES IS AT AN ALL TIME HIGH

On July 31, the Centers for Disease Control and Prevention (CDC) issued a press release titled "More U.S. Children Are Getting Their Shots." It is reprinted below in its entirety:

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Press Release
More U.S. Children Are Getting Their Shots
July 31, 2003

The number of children in the nation receiving immunizations remains at an all time high, with significant increases in the coverage rates for varicella (chickenpox) and pnuemococcal conjugate  vaccine, two of the most recent additions to the childhood immunization schedule. However, wide variations exist among states and among some urban areas.

The findings were reported today by the Centers for Disease Control and Prevention (CDC), an agency within the U.S. Department of Health and Human Services (HHS). The news conference,  sponsored by the National Partnership for Immunization (NPI), served to kick off August as National Immunization Awareness Month.

"Vaccines are one of the most important tools we have to protect the health of our nation's most vulnerable citizens, our children," said HHS Secretary Tommy G. Thompson. "These results demonstrate our nation's ability to reach high immunization coverage rates. The President and HHS remain committed to ensuring that our children continue to get the vaccines they need for a healthy start in life."

CDC reports that coverage for three or more doses of pnuemococcal conjugate vaccine, being reported for the first time, was 40.9 percent. Pnuemococcal conjugate vaccine can help prevent serious pnuemococcal disease. Invasive pnuemococcal disease is responsible for about 200 deaths each year among children under 5-years old. Vaccines are among the most successful and cost-effective public health tools for preventing disease and death. Because of nationwide immunization efforts, the number of most vaccine-preventable diseases has been reduced by more than 99 percent since the implementation of immunization programs.

"We are pleased with the progress we're making in regards to immunization rates in the United States," said CDC Director Dr. Julie Gerberding. "However, we have more work to do to make sure our nation's children are protected. The consequences from vaccine-preventable disease to even one child is an unnecessary human tragedy."

National vaccination coverage with chickenpox vaccine increased from 76.3 percent in 2001 to 80.6 percent in 2002. For all other vaccines, coverage remained steady compared to 2001.

This year, coverage also is reported for the first time for the immunization series that includes four doses of DTaP, three doses of polio vaccine, one dose of measles containing vaccine, three doses of Hib vaccine, three doses of hepatitis B vaccine and one dose of varicella vaccine (known as the 4:3:1:3:3:1 series). Coverage in 2002 for the series increased to  65.5 percent compared to 54.1 percent in 2000 and 61.3 percent in 2001.

The estimated coverage with the same series, minus the one dose of varicella vaccine, ranged from 86.2 percent in Massachusetts to 62.7 percent in Colorado, a difference of 23.5 percentage points. Variations among urban areas was slightly less than among the states. Among the 28 identified urban areas, the highest estimated coverage for the series that did not include the chicken pox vaccine was 79.3 percent in Santa Clara County, California, with the lowest rate at 57.5 percent in Newark, New Jersey, a difference of 21.8 percentage points.

"Unfortunately, immunization coverage is not uniformly high across the country," said Dr. Walter A. Orenstein, director of the CDC National Immunization Program (NIP). "There is a substantial variation in coverage levels between various states and cities. Eliminating the disparity between those with the highest and lowest coverage remains a priority. We need the public health community and private providers in areas of low coverage rates to intensify their efforts."

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To access the press release from the CDC website, go to:
http://www.cdc.gov/od/oc/media/pressrel/r030731.htm
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August 4, 2003
REVISED: NATIONAL IMMUNIZATION PROGRAM UPDATES THE MENINGOCOCCAL VIS

On July 28, the National Immunization Program, Centers for Disease Control and Prevention (CDC), published a revised Vaccine Information Statement (VIS) for meningococcal vaccine. One change, which occurs in the fourth paragraph of Part 1, makes the description of the serotypes included in the vaccine less open to interpretation and more relevant for travelers. Another change was the addition of the CDC Travelers Health website address to the second page.

To access a camera-ready (PDF) version of the new meningococcal VIS from the CDC website, go to:
http://www.cdc.gov/nip/publications/VIS/vis-mening.pdf

For information about the use of VISs, as well as VISs for additional vaccines (some in up to 28 languages), visit the Immunization Action Coalition website at: http://www.immunize.org/vis
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August 4, 2003
CDC SEEKS INFORMATION ON PROVIDER-BASED QUALITY IMPROVEMENT PROJECTS AIMED AT ENHANCING IMMUNIZATION DELIVERY

Recently the National Immunization Program, Centers for Disease Control and Prevention (CDC), requested that the Immunization Action Coalition publicize the following message.

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CDC's National Immunization Program (NIP) is collecting information on provider-based quality improvement projects that have been implemented in provider offices to improve immunization delivery. The projects identified will be considered for inclusion in a Symposium on Education and Quality Improvement Programs to be held in Atlanta on October 22-23, 2003. The symposium will provide an opportunity to learn more about practice-based interventions that may improve immunization and other prevention services in all age groups. The proceedings of the meeting will be published and successful strategies will be promoted to our immunization grantees.

We need your help to identify individuals or organizations who are actively involved in providing or coordinating provider intervention activities. Please disseminate the attached Information Questionnaire to your membership and others who may be involved in practice-based quality improvement efforts. Interested parties should complete the questionnaire and return it to CDC by August 15, 2003 (instructions are provided on the form).

Please address questions to Ken Anderson at 404-639-8550 or kna1@cdc.gov We appreciate your assistance in this important public health matter.

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To access a camera-ready (PDF) copy of the questionnaire, go to:
http://www.immunize.org/cdc/imcollectionform.pdf
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August 4, 2003
REVISED: IAC UPDATES "IT'S FEDERAL LAW!" HEALTH PROFESSIONAL INFORMATION SHEET ABOUT VISs

The Immunization Action Coalition (IAC) recently revised the one-page health professional education sheet "It's Federal Law! You Must Give Your Patients Current Vaccine Information Statements (VISs)." The piece was originally written by Neal A. Halsey, MD, Director, Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health. IAC updates it periodically.

IAC made five revisions--two were additions, and three were changes. In the section headed "Most current versions of VISs," information about the smallpox and yellow fever VISs was added. In the same section, the date for the influenza VIS was changed to 5/6/03, the date for the anthrax VIS was changed to 4/24/03 and the date for the meningococcal VIS was changed to 7/28/03.

To access the revised piece in camera-ready (PDF) format, go to:
http://www.immunize.org/catg.d/2027law.pdf

To access it in HTML, go to:
http://www.immunize.org/catg.d/2027law.htm

To access VIS information and VISs from the website of the Centers for Disease Control and  Prevention, go to: http://www.cdc.gov/nip/publications/VIS/default.htm

For information about the use of VISs and for VISs in up to 28 languages, visit the IAC website at http://www.immunize.org/vis
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August 4, 2003
CDC UPDATES PNEUMOCOCCAL VACCINATION RECOMMENDATIONS FOR COCHLEAR IMPLANT CANDIDATES AND RECIPIENTS

On July 31, the Centers for Disease Control and Prevention (CDC) published "Pneumococcal Vaccination for Cochlear Implant Candidates and Recipients: Updated Recommendations of the Advisory Committee on Immunization Practices" as an "MMWR Early Release." The current recommendations update those last made by CDC in October 2002.

The CDC publishes "MMWR Early Release" electronically for the immediate release of important public health information. It will be available in hard-copy format in the future.

To access the recommendations from the CDC website, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/m2e731a1.htm

To access a camera-ready (PDF) version of the recommendations, go to: http://www.cdc.gov/mmwr/pdf/wk/m2e731.pdf

To access a press release on the cochlear implant recommendations from the CDC website, go to:
http://www.cdc.gov/od/oc/media/pressrel/r030730.htm
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August 4, 2003
CDC REPORTS ON VACCINATION COVERAGE AMONG ALASKA NATIVE CHILDREN AND ON OTHER AMERICAN INDIAN AND ALASKA NATIVE HEALTH ISSUES

The Centers for Disease Control and Prevention (CDC) published "Vaccination Coverage Levels Among Alaska Native Children Aged 19-35 Months--National Immunization Survey, United States, 2000-2001" in the August 1 issue of the "Morbidity and Mortality Weekly Report" (MMWR).

The majority of the August 1 issue focuses on describing health disparities for four preventable health conditions--injuries, diabetes, cancer, and bronchiolitis--among American Indians and Alaska Natives. In addition, CDC issued a surveillance summary, "Surveillance for Health Behaviors of American Indians and Alaska Natives: Findings from the Behavioral Risk Factor Surveillance System, 1997-2000," on August 1. Links to the entire MMWR issue and to the CDC surveillance summary appear at the end of this article.

A summary of the vaccination article made available to the press is reprinted below in its entirety.

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Immunization coverage among Alaska Native children is high.

This report indicates that Alaska Native (AN) children aged 1935 months have a high level of vaccination coverage that exceeds the national goal for 2010 of 90% for all vaccines except varicella and the fourth dose of DTP. This achievement, despite the presence of barriers to vaccination, demonstrates the commitment of AN communities, tribal corporations, and state public health to address health concerns and exemplifies the effectiveness of using multiple strategies (e.g., reducing financial and access barriers, making vaccination a priority, using collaborative efforts, tracking and recall, assessment, and registries).

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Links to the August 1 MMWR:
To obtain the complete text of the vaccination article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5230a6.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5230.pdf

Links to the August 1 CDC surveillance summary:
To obtain the complete text of the surveillance summary, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5207a1.htm

To obtain a camera-ready (PDF format) copy of the surveillance summary, go to:
http://www.cdc.gov/mmwr/PDF/ss/ss5207.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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August 4, 2003
SEPTEMBER 29 IS DEADLINE FOR ABSTRACTS FOR THE 2004 NATIONAL STD PREVENTION CONFERENCE

[The following is cross posted from the Immunization Action Coalition's "HEP EXPRESS" electronic newsletter, 7/30/03.]

The 2004 National STD Prevention Conference will be held March 8-11, 2004, in Philadelphia, Pennsylvania. The Planning Committee welcomes submission of abstracts for oral presentations, poster sessions, pre-organized symposia, and skills-building workshops that focus on the broad spectrum of critical issues in the field of STD prevention and related fields. The abstract submission deadline is September 29, 2003.

The conference's title, "Sharing Successes and Strategies During an Era of Uncertainty," succinctly describes the goal of the meeting: to identify practical strategies for countering an STD epidemic in a time of shrinking resources and political challenge. The conference is co-sponsored by the Centers for Disease Control and Prevention, the American STD Association, the National Coalition of STD Directors, and the American Social Health Association.

For more information about the conference, please visit http://www.stdconference.org Persons interested in submitting an abstract can do so online by clicking on the "Call for Abstracts" button.
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August 4, 2003
IAC ADDS NEW RESOURCES TO ITS HEPATITIS PREVENTION PROGRAMS WEBSITE

[The following is cross posted from the Immunization Action Coalition's "HEP EXPRESS" electronic newsletter, 7/30/03.]

The Immunization Action Coalition (IAC) recently made several improvements to its Hepatitis Prevention Programs website.

First, two new projects were added to the Model Programs section:

Indiana State Department of Health
Hepatitis Education in a Juvenile Correctional Setting
http://www.hepprograms.org/juven/juven8.asp

Springfield Department of Public Health Confidential Clinic
http://www.hepprograms.org/std/std11.asp

Second, links were added to the home page to aid visitors searching online for basic information about viral hepatitis. These links direct visitors to the following topic pages on IAC's main website: Hepatitis B Information, Hepatitis A Information, Health Care Workers, Birth Dose of Hepatitis B Vaccine, Tattooing and Body Piercing, Needle Safety, International Adoption, Travel Vaccines, and Dialysis.

Third, the title of the "Drug treatment/needle exchange" category was changed to "Harm reduction" to better reflect the focus of these programs.

In addition, every week more relevant journal articles and abstracts are added to the site. Please visit http:///www.hepprograms.org often to read the latest news and check out all the great work your colleagues are doing!
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August 4, 2003
WHO REPORTS ANGOLA VACCINATED ALMOST 5 MILLION CHILDREN AGAINST POLIO

On July 29, the World Health Organization (WHO) issued a press release announcing plans to step up the global effort to eradicate polio and praised Angola's three-day (July 25-27) polio immunization campaign, during which almost 5 million children were vaccinated. The campaign was the first to reach the entire nation; in the past, armed conflict impeded nationwide immunization efforts. The second stage of the national vaccination campaign will take place August 29-31.

Looking to global eradication of the disease, WHO reported that from the end of August to December, key endemic countries will conduct mass immunization campaigns aimed at reaching 175 million children. Ridding the world of polio depends on conducting successful campaigns in India, Nigeria, Pakistan, and Egypt, which together account for 99 percent of new cases. Other countries with indigenous wild poliovirus include Afghanistan, Niger, and Somalia.

To access the press release from the WHO website, go to:
http://www.who.int/mediacentre/releases/2003/pr60/en

To access a related press release from the website of the electronic news service AllAfrica.com, go to:
http://allafrica.com/stories/200307280999.html

 

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 August 4, 2003