Immunization Action Coalition and the Hepatitis B Coalition

IAC EXPRESS

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Issue Number 404            August 11, 2003

CONTENTS OF THIS ISSUE

  1. CDC reports on vaccination coverage levels among U.S. children in 2002
  2. New edition of "Vaccines: What You Should Know" available for order
  3. IAC reorganizes Unprotected People reports and asks readers to send in influenza articles
  4. IOM report urges major changes in U.S. vaccination financing and delivery
  5. Three states enact legislation for a variety of educational institutions
  6. New translations: 2003-2004 inactivated influenza VIS now available in nine languages
  7. "American Journal of Preventive Medicine" article indicates lack of consistent evidence for autism-thimerosal connection
  8. Updated: IAC revises its patient education sheet on reliable sources of immunization information
  9. New: Superheroes poster is a colorful reminder of IAC's four websites
  10. CDC publishes updated pneumococcal vaccination recommendations for cochlear implant candidates and recipients
  11. CDC releases updated slide set on hepatitis A
  12. Immunization Registry Conference scheduled for October 27-29 in Atlanta
  13. CDC reports on vaccination services in postwar Iraq
  14. Latest Afghani measles immunization campaign reaches 5 million children

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August 11, 2003
CDC REPORTS ON VACCINATION COVERAGE LEVELS AMONG U.S. CHILDREN IN 2002

The Centers for Disease Control and Prevention (CDC) published "National, State, and Urban Area Vaccination Levels Among Children Aged 19-35 Months--United States, 2002" in the August 8 issue of  the "Morbidity and Mortality Weekly Report" (MMWR). The information in the article is based on data from the National Immunization Survey (NIS); 2002 data became available July 31. A link to tables  describing immunization coverage by region and ethnic and economic data will be given at the end of this article.

A summary made available to the press reports immunization of children age 19-35 months is at a near-record high. Varicella (VAR) vaccination coverage achieved a record high of 80.6 percent, and pneumococcal (PCV) vaccination coverage, reported for the first time, was 40.9 percent.

The article includes two tables. Table 1 shows nationwide coverage levels for individual vaccines from 1998 through 2002. Table 2 shows estimated coverage levels by state and selected urban areas.

A portion of the article's Editorial Note is reprinted below.

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Changes in national level coverage from 2001 to 2002 with all vaccines other than VAR and PCV were so small that they are unlikely to have a major public health impact. Although coverage with recommended vaccines for each new birth cohort remains high, vigilance is needed to maintain these high levels. Eliminating the coverage disparity between states and urban areas with the highest and lowest coverage remains a priority. If vaccine-preventable disease is introduced in an area with low coverage, groups of susceptible children might serve as a reservoir to transmit disease.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5231a2.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5231.pdf

To access NIP 2002 data tables from the CDC website, go to:
http://www.cdc.gov/nip/coverage/NIS/02/toc-02.htm

To access general information on U.S. vaccination coverage, go to: http://www.cdc.gov/nip/coverage/default.htm#chart and click on the topics listed under the subhead "On this page."

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 11, 2003
NEW EDITION OF "VACCINES: WHAT YOU SHOULD KNOW" AVAILABLE FOR ORDER

The new edition of "Vaccines: What You Should Know" (formerly titled "Vaccines: What Every Parent Should Know") gives parents straightforward answers to their questions about vaccines and vaccine safety. Written by pediatricians Paul A. Offit, MD, and Louis M. Bell, MD, of the Children's Hospital of Philadelphia (CHOP), the book helps parents make informed decisions about what is right for their children.

It answers the most common questions about how vaccines are made and when children should get vaccinated and also addresses parents' concerns about vaccine safety. Parents will find the book useful in understanding medical jargon and in clarifying misleading or incomplete information they may get from the Internet or other sources.

To order the book online, go to the website of the Vaccine Education Center of CHOP at
http://www.chop.edu/consumer/jsp/microsite/microsite.jsp?id=75918 Find the image of the book cover at the right of the page, and click on "view more."

To order by phone, call the publisher, John Wiley & Sons, at (800) 567-4797, or shop for it at your favorite local or online bookstore.
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August 11, 2003
IAC REORGANIZES UNPROTECTED PEOPLE REPORTS AND ASKS READERS TO SEND IN INFLUENZA ARTICLES

The Immunization Action Coalition recently reorganized its Unprotected People reports, grouping them by disease. The reports recount the experiences of people who have suffered from vaccine-preventable diseases. Published since 1997, the reports now number 56 and cover 14 diseases.

Reports about people who have suffered complications from influenza are conspicuously absent, however. To fill this gap, we are asking readers of "IAC EXPRESS" to send us well-developed articles that relate an individual's or group's (e.g., a nursing home's) experience with influenza. Because of our small staff size, we cannot write these reports ourselves or edit an article extensively. If you have or know of a suitable article, please email it to us at admin@immunize.org or fax it to (651) 647-9131.

HOW TO USE UNPROTECTED PEOPLE REPORTS
In addition to organizing the reports by disease, we have also modified our Unprotected People reports index page to include a brief summary of each report and the age of the person(s) featured in each. This allows readers to select reports that mesh with a particular audience's informational needs. Following are examples of audiences that you can educate with Unprotected People reports:

Legislators. A health professional scheduled to testify before a legislative committee about implementing a school entry law for varicella vaccine (or for any other vaccine-preventable disease), can easily find a few compelling Unprotected People reports to bolster his or her position.

Vaccine-hesitant parents. A pediatrician, pediatric nurse practitioner, family physician, or other health professional who routinely deals with vaccine-hesitant parents, can print out numerous Unprotected  People reports documenting that unvaccinated children suffer and die from vaccine-preventable diseases.

Adult medical specialists who don't routinely vaccinate. Some specialists (e.g., gynecologists and cardiologists) may not ask their patients about their vaccination history and may not administer needed vaccines. Yet these specialists are often the only doctors adults see. Unprotected People reports about adults who have suffered or died from pneumococcal disease or tetanus, for example, allow adult  medical specialists to become actively involved in educating their patients about the seriousness of vaccine-preventable diseases.

To access the index of the newly formatted Unprotected People web page, go to: http://www.immunize.org/stories Click on the diseases that interest you, or read through all 56 summaries. We hope you'll find this page and the Unprotected People reports educational, interesting, and an aid to your work as an immunization professional.

Reminder: If you have or know of an influenza article suitable for publication as an Unprotected People report, please email it to us at admin@immunize.org or fax it to (651) 647-9131.
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August 11, 2003
IOM REPORT URGES MAJOR CHANGES IN U.S. VACCINE FINANCING AND DELIVERY

On August 4, the Institute of Medicine (IOM) of the National Academies issued a press release on its report "Financing Vaccines in the 21st Century: Assuring Access and Availability." According to the press release, the report recommends changes in vaccine financing and delivery that "would effectively change the government's role from buying vaccines to assuring immunization."

While acknowledging the current U.S. immunization system has achieved high levels of immunization, the press release points out two significant problems: (1) disparities in access to vaccines across geographic and demographic populations, which leave certain populations of adults and children unvaccinated, and (2) the recent shortage of certain vaccines, which points to an outmoded financing system that discourages pharmaceutical manufacturers from producing current vaccines and developing new ones.

To correct the situation, the report recommends "a three-part plan made up of a federal government mandate, subsidy, and voucher," the press release states. Conceding the proposed plan will increase  federal expenditures for vaccines, the press release notes the increase will likely be offset by a reduction in vaccine-preventable disease and an increase in future vaccine development.

Sponsored by the Centers for Disease Control and Prevention, the report was produced by IOM's Committee on Evaluation of Vaccine Purchase Financing in the United States, an 11-member panel of physicians, economists, and health policy experts. A private, nonprofit institution, IOM provides health policy advice under a Congressional charter granted to the National Academy of Sciences.

To access the press release from the National Academies website, go to:
http://www4.nationalacademies.org/news.nsf/isbn/0309089794?OpenDocument

To access the 8-page executive summary of the report in camera-ready (PDF) format, go to:
http://www.iom.edu/includes/DBFile.asp?id=14454

To access the 200-page report in HTML format, go to:
http://books.nap.edu/books/0309089794/html/index.html

Print copies of the report will be available this fall from the National Academies Press at (800) 624-6242 or http://www.nap.edu/catalog/10782.html
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August 11, 2003
THREE STATES ENACT IMMUNIZATION LEGISLATION FOR A VARIETY OF EDUCATIONAL INSTITUTIONS

New Jersey, New York, and Iowa enacted legislation requiring immunization against various diseases. New Jersey now requires immunization against hepatitis B virus, New York against meningococcal disease, and Iowa against varicella disease.

HEPATITIS B IMMUNIZATION
New Jersey: The New Jersey State Legislature passed legislation requiring hepatitis B vaccination for public and private school students in grades 9 through 12. A signed waiver is required to exempt a student from hepatitis B immunization for medical or religious reasons. The governor signed the legislation August 3, 2002; it went into effect immediately for the 2003-04 school year.

The Immunization Action Coalition (IAC) has compiled information about all states that have hepatitis B prevention mandates for prenatal screening and school attendance for day care, elementary, and middle school students. To access this information, go to: http://www.immunize.org/laws/hepb.htm

MENINGOCOCCAL IMMUNIZATION
New York: The New York State Assembly passed legislation requiring private and public colleges to provide information about meningococcal disease and vaccine to students and their parents or  guardians. The law also requires students to be vaccinated or submit a waiver. The vaccination requirements also apply to children attending overnight camps for seven nights or more, as well as students in grades 7 through 12 in residential schools. The governor signed the legislation July 22; it goes into effect on August 15 for the school year beginning in fall 2003.

IAC has compiled information about all states that have meningitis prevention mandates for colleges and universities. To access this information, go to: http://www.immunize.org/laws/menin.htm

VARICELLA IMMUNIZATION
Iowa: The Iowa General Assembly passed legislation that added varicella requirements to the state's day care and school immunization laws. A signed waiver is required to exempt a student from varicella immunization for medical or religious reasons. The governor signed the legislation on April 28. The Iowa Board of Health subsequently adopted rules on July 9 that specify the applicability of the new requirements for children attending day care, preschool or kindergarten who were born on or after September 15, 1997. The new requirements become effective on January 1, 2004.

IAC has compiled information about all states that have varicella prevention mandates for school attendance. To access this information, go to: http://www.immunize.org/laws/varicel.htm

For complete and current information about state mandates for a variety of immunizations, go to: http://www.immunize.org/laws

We depend on our readers to help us stay informed and to ensure our website contains the most current and accurate information available. Please let us know when any changes occur in your state.
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August 11, 2003
NEW TRANSLATIONS: 2003-2004 INACTIVATED INFLUENZA VIS NOW AVAILABLE IN NINE LANGUAGES

Updated on 5/06/03, the 2003-2004 inactivated influenza Vaccine Information Statement (VIS) is now available in Armenian, Chinese, Portuguese, Russian, Serbo-Croatian, Somali, Spanish, Turkish, and Vietnamese on the website of the Immunization Action Coalition (IAC). Following are links to the VIS in each language.

Armenian. IAC gratefully acknowledges the Los Angeles County Health Department for the Armenian translation of the inactivated influenza VIS. To access a camera-ready (PDF) version of it, go to:
http://www.immunize.org/vis/ar_flu03.pdf

Chinese. IAC gratefully acknowledges the California Department of Health Services for the Chinese translation of the inactivated influenza VIS. To access a camera-ready (PDF) version of it, go to:
http://www.immunize.org/vis/ch_flu03.pdf

Portuguese. IAC gratefully acknowledges the Massachusetts Department of Public Health for the Portuguese translation of the inactivated influenza VIS. To access a camera-ready (PDF) version of it, go to:
http://www.immunize.org/vis/pr_flu03.pdf

Russian. IAC gratefully acknowledges the Minnesota Department of Health for the Russian translation of the inactivated influenza VIS. To access a camera-ready (PDF) version of it, go to:
http://www.immunize.org/vis/ru_flu03.pdf

Serbo-Croatian. IAC gratefully acknowledges the Minnesota Department of Health for the Serbo- Croatian translation of the inactivated influenza VIS. To access a camera-ready (PDF) version of it, go to:
http://www.immunize.org/vis/sc_flu03.pdf

Somali. IAC gratefully acknowledges the Minnesota Department of Health for the Somali translation of the inactivated influenza VIS. To access a camera-ready (PDF) version of it, go to:
http://www.immunize.org/vis/so_flu03.pdf

Spanish. IAC gratefully acknowledges the California Department of Health Services for the Spanish  translation of the inactivated influenza VIS. To access a camera-ready (PDF) version of it, go to:
http://www.immunize.org/vis/spflu03.pdf

Turkish. IAC gratefully acknowledges Mustafa Kozanoglu, MD, and Murat Serbest, MD, for the Turkish translation of the inactivated influenza VIS. To access a camera-ready (PDF) version of it, go to:
http://www.immunize.org/vis/tu_flu03.pdf

Vietnamese. IAC gratefully acknowledges the California Department of Health Services for the Vietnamese translation of the inactivated influenza VIS. To access a camera-ready (PDF) version of it, go to:
http://www.immunize.org/vis/vn_flu03.pdf

To access a camera-ready (PDF) version of the inactivated influenza VIS in English, go to:
http://www.immunize.org/vis/2flu.pdf

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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August 11, 2003
"AMERICAN JOURNAL OF PREVENTIVE MEDICINE" ARTICLE INDICATES LACK OF CONSISTENT EVIDENCE FOR AUTISM-THIMEROSAL CONNECTION

"Autism and Thimerosal-Containing Vaccines: Lack of Consistent Evidence for an Association" was published in the August issue of the "American Journal of Preventive Medicine." After analyzing population-based data collected in the United States, Denmark, and Sweden, the article authors conclude that the body of existing data is not consistent with the hypothesis that increased exposure to thimerosal-containing vaccines is responsible for the apparent worldwide increase in the rates of autism in young children.

The full text of the article is available only to subscribers; the abstract is available to all. To access the full text or abstract, go to: http://www.medicinedirect.com/journal/journal/current?sdid=6075 Scroll down to the article title, and click on the version available to you.
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August 11, 2003
UPDATED: IAC REVISES ITS PATIENT EDUCATION SHEET ON RELIABLE SOURCES OF IMMUNIZATION INFORMATION

The Immunization Action Coalition (IAC) recently made minor revisions to its patient education sheet "Reliable Sources of Immunization Information: Where To Go To Find Answers!" The sheet presents parents with the web addresses, phone numbers, and book titles of trustworthy resources.

Under the section subtitled "Books for Parents," ordering information for the new edition of the book "Vaccines: What You Should Know," was updated. In addition, a web address was added to the ordering information for the book "Vaccinating Your Child: Questions and Answers for the Concerned Parent."

To access a camera-ready (PDF) version the newly revised sheet, go to:
http://www.immunize.org/catg.d/p4012.pdf

To access an HTML version, go to:
http://www.immunize.org/catg.d/p4012.htm
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August 11, 2003
NEW: SUPERHEROES POSTER IS A COLORFUL REMINDER OF IAC'S FOUR WEBSITES

The Immunization Action Coalition (IAC) has grown a lot in the past few years, particularly in terms of its Internet presence, which now features four websites.

To make it easy for IAC's audience of private and public health professionals, patients, and parents to remember how to access our websites, we've developed a colorful 8-1/2" x 11" poster. Emblazoned  with two of IAC's favorite superheroes, the poster displays our four website addresses.

Tack the poster up near your computer for easy reference and hand it out to your colleagues. To access a camera-ready (PDF) version of the poster, go to:
http://www.immunize.org/news.d/u6022.pdf
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August 11, 2003
CDC PUBLISHES UPDATED PNEUMOCOCCAL VACCINATION RECOMMENDATIONS FOR COCHLEAR IMPLANT CANDIDATES AND RECIPIENTS

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" in the August 8 issue of the "Morbidity and Mortality Weekly Report" (MMWR). Published July 31 in the web-based "MMWR Early Release," the updated recommendations were not available in hard-copy format until now. The newly published recommendations update those last made by CDC in October 2002.

To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5231a5.htm

To obtain a camera-ready (PDF) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5231.pdf
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August 11, 2003
CDC RELEASES UPDATED SLIDE SET ON HEPATITIS A

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

The Centers for Disease Control and Prevention (CDC) has released an updated hepatitis A slide set for health care professionals. This 55-slide resource is available in three formats: PowerPoint, camera-ready (PDF), and text (HTML).

The hepatitis A slide set is part of a series titled "Epidemiology and Prevention of Viral Hepatitis A to E: An Overview." Slide sets on hepatitis A, B, C, D, and E are all available at no charge from CDC's Division of Viral Hepatitis. To view or download the new hepatitis A slide set, or any of the viral hepatitis slide sets, go to: http://www.cdc.gov/ncidod/diseases/hepatitis/slideset/index.htm

Many more resources, including brochures, posters, and recommendations, are available from CDC's Division of Viral Hepatitis. Visit the "Viral Hepatitis Resource Center" at http://www.cdc.gov/ncidod/diseases/hepatitis/resource/index.htm
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August 11, 2003
IMMUNIZATION REGISTRY CONFERENCE SCHEDULED FOR OCTOBER 27-29 IN ATLANTA

Sponsored by the Centers for Disease Control and Prevention (CDC), the 4th Immunization Registry Conference will be held October 27-29 in Atlanta. The conference will provide a forum to build support for immunization registries, enhance collaboration, promote multiple and innovative uses of registry data, explore alternative funding strategies, and demonstrate registry success.

For information about the conference program, registration, continuing education credits, and much more, visit the CDC website at http://www.cdc.gov/nip/registry/irc or contact the conference  planning team at (404) 639-8225 or NIPIRC@cdc.gov
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August 11, 2003
CDC REPORTS ON VACCINATION SERVICES IN POSTWAR IRAQ

The Centers for Disease Control and Prevention (CDC) published "Vaccination Services in Postwar Iraq, May 2003" in the August 8 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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The restoration of important public health programs in Iraq, such as routine childhood immunizations, is underway and significant achievements have been made.

The breakdown of civil order in Iraq, after the recent war, disrupted many public health programs including routine childhood vaccinations. In May, the Iraqi Ministry of Health (IMoH) sent teams around the country to assess refrigerated storage sites (cold chain) and the ability of the public health system to provide routine immunizations. At that time, 61% of primary healthcare centers had the equipment and staff to offer daily routine immunizations. The extent of the damage to cold chain equipment varied between the Iraqi governorates and ranged from 12% (Kerbala) to 64% (Missan). The Coalition Provisional Authority and the Iraqi Ministry of Health are working closely with international organizations and non-governmental organizations to re-establish secure public health programs throughout Iraq.

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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5231a3.htm

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5231.pdf
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August 11, 2003
LATEST AFGHANI MEASLES IMMUNIZATION CAMPAIGN REACHES 5 MILLION CHILDREN

On August 3, UNICEF issued a press release publicizing the success of recent measles immunization campaigns in Afghanistan. Held in June, the most recent nationwide operation reached more than 5 million children from 9 months to 5 years of age. In 2002, more than 11 million Afghani children were immunized against the disease. Prior to these campaigns, measles was estimated to contribute to up to 15 to 20 percent of deaths among children under five in the nation.

To access the press release from the UNICEF website, go to:
http://www.unicef.org/media/media_13108.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 12, 2003