Immunization Action Coalition and the Hepatitis B Coalition

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Issue Number 428            December 1, 2003

CONTENTS OF THIS ISSUE

  1. CDC website posts a Q&A series about its Vaccine Safety Datalink Study on thimerosal-containing vaccines
  2. Latest edition of CDC's "Guide to Contraindications to Vaccinations" is available free of charge
  3. CDC issues print version of report on current hepatitis A outbreak in Pennsylvania and corrects electronic version
  4. Update: IAC revises two patient-education brochures
  5. Today is World AIDS Day
  6. Job opening: National Immunization Program seeks candidates for director of its Global Immunization Division
  7. Free: Bulk copies of the latest issue of "VACCINATE ADULTS" (November 2003) are available--place your order now
  8. January 15, 2004, is the deadline for abstracts for the 1st International Neonatal Vaccination Workshop
  9. Submit late-breaker abstracts for the International Conference on Emerging Infectious Diseases as early as December 10
  10. CDC reports on global progress toward certifying polio eradication and laboratory containment of wild polioviruses

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December 1, 2003
CDC WEBSITE POSTS A Q&A SERIES ABOUT ITS VACCINE SAFETY DATALINK STUDY ON THIMEROSAL-CONTAINING VACCINES

The Centers for Disease Control and Prevention (CDC) recently posted the following page on its website: "Vaccine Safety Datalink (VSD) Study: Safety of Thimerosal-Containing Vaccines: A Two-Phased Study of Computerized Health Maintenance Organization (HMO) Databases."

The web page, which contains a summary of findings and a 14-item Q&A series, was posted in reference to an article published November 5 in "Pediatrics," the journal of the American Academy of Pediatrics (AAP). Following are the first three Q&As as they appear on the CDC website.

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1. WHAT WERE THE MAJOR FINDINGS AND CONCLUSIONS FROM THE CDC'S VACCINE SAFETY DATALINK STUDY?

The final results of this study found no consistent statistically significant associations between exposure to vaccines that contained thimerosal as a preservative and a wide range of neurodevelopmental problems, including autism, attention deficit disorder (ADD), language delays, sleep disorders, emotional disorders, and tics. None of the results found any associations with autism or ADD. Since it is necessary to first establish there is an association between two things (often called "variables"), the results from this study suggest there is not a "cause and effect" relationship between thimerosal and autism or ADD.

In the first phase of the research, there were some statistically significant associations between exposure to thimerosal-containing vaccines and two categories of neurodevelopmental problems, "tics," and language delay. However, these results were not consistent--that is, the relationships were only found with one of the health maintenance organization (HMO) databases, rather than in all three that were used in the study. Such a pattern suggests that an association does not exist, but that further research should be done.

As a result of the inconsistent finding involving "tics" and language delay, one of the major conclusions was that additional research be done to further examine the issue of exposure to thimerosal in vaccines. The CDC is currently involved in this additional research.

2. WHAT DO THE STUDY'S RESULTS MEAN FOR PARENTS?

The study did not find consistent evidence to suggest that thimerosal might cause any of the conditions studied. In particular, the study found that thimerosal exposure was not associated with autism, which adds to the evidence from other studies that thimerosal does not increase the risk of autism.

Since 1999 thimerosal has been removed from the majority of recommended childhood vaccines for preschool children. In fact today, none of the routinely recommended childhood vaccines used in the U.S. to protect preschool children against 11 infectious diseases contain thimerosal as a preservative. These include vaccines for measles, mumps, rubella, chickenpox, hepatitis B, diphtheria, tetanus, pertussis (whooping cough), Haemophilus influenzae type b (Hib), polio, and pneumococcal disease. In some of the recommended childhood vaccines minute amounts of thimerosal can be found; this is an unavoidable byproduct of the production process and has nothing to do with thimerosal being used as a preservative in the vaccines. No harmful effects have ever been reported or found with these amounts of thimerosal in vaccine.

3. THIS STUDY LOOKED AT THIMEROSAL IN VACCINES. WHY IS THERE A CONCERN ABOUT THIS VACCINE PRESERVATIVE?

There was a concern because thimerosal contains a type of mercury called ethylmercury. Since exposure to small amounts of mercury can be harmful, concerns were raised about the very tiny amount of ethylmercury in thimerosal. However, the safety concerns related to thimerosal were not based on any evidence that connects thimerosal to harmful health outcomes. Rather, the concerns were related to federal government guidelines and theoretical estimates about how much mercury people can be safely exposed to without possible risk of serious health effects.

In 1999, the Food and Drug Administration (FDA) conducted a review of the mercury content in drugs and medicines, including vaccines. As part of this review, the FDA concluded that the use of thimerosal as a preservative in some recommended childhood vaccines could result in a six-month-old infant being exposed to an amount of mercury that exceeded the Environmental Protection Agency (EPA) recommendations. However, this same amount would not exceed the FDA, the Agency for Toxic Substances and Disease Registry (ATSDR), or the World Health Organization (WHO) guidelines for methylmercury intake (Ball et al., 2001). Thimerosal contains ethylmercury. Methylmercury is a related compound and has been more thoroughly researched than ethylmercury. Thus federal safety standards are based on information we have about methylmercury.

The FDA's review found no evidence of harm caused by the small amounts of thimerosal in vaccines, except for minor local reactions (Ball et al., 2001). In July 1999, as a precautionary measure, the Public Health Service (including the CDC and FDA), the American Academy of Pediatrics, and vaccine manufacturers agreed that thimerosal levels in vaccines should be reduced or eliminated, and the FDA committed to expediting the review of new vaccines that do not contain thimerosal.

Although there is no evidence that any vaccine or vaccine additive increases the risk of neurodevelopment disorders, such as autism, CDC recognizes that this issue is of concern to parents and others. As a result, CDC is committed to investigating this issue to the fullest extent possible, using the best scientific methods available.

For more information on thimerosal in vaccines, visit:
http://www.cdc.gov/nip/vacsafe/concerns/thimerosal/faqs-thimerosal.htm#2

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To access the full Q&A series on the CDC website, go to:
http://www.cdc.gov/nip/vacsafe/vsd/VSDstudyQAs.htm

The complete "Pediatrics" article is available to subscribers only. To access the abstract, go to:
http://pediatrics.aappublications.org/cgi/content/abstract/112/5/1039
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December 1, 2003
LATEST EDITION OF CDC'S "GUIDE TO CONTRAINDICATIONS TO VACCINATIONS" IS AVAILABLE FREE OF CHARGE

Published by the Centers for Disease Control and Prevention (CDC) in September 2003, the latest edition of "Guide to Contraindications to Vaccinations" is now available for order online or by phone. The current edition contains information on all licensed U.S. vaccines; previous editions have focused on pediatric vaccines.

To order the guide from the CDC website, go to: https://www2.cdc.gov/nchstp_od/PIWeb/niporderform.asp Scroll down to the section titled "Health Care Providers Only," and go to item number 00-6562. NOTE: There is a limit of 10 copies per order; additional copies are available upon request (see the comments block at the end of the order form).

To order by phone, call the National Immunization Information Hotline at (800) 232-2522.
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December 1, 2003
CDC ISSUES PRINT VERSION OF REPORT ON CURRENT HEPATITIS A OUTBREAK IN PENNSYLVANIA AND CORRECTS ELECTRONIC VERSION

The Centers for Disease Control and Prevention (CDC) published "Hepatitis A Outbreak Associated with Green Onions at a Restaurant--Monaca, Pennsylvania, 2003" in the November 28 issue of "Morbidity and Mortality Weekly Report" (MMWR). Originally published in the web-based "MMWR Dispatch" on November 21, the report has not been available in hard-copy format until now.

In addition to making a hard-copy version available, CDC also issued a correction to the electronic version of the report. Please note that the hard-copy version made available on November 28 has been corrected. The information about the correction is reprinted below in its entirety.

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On November 21, 2003, this report was posted on the MMWR website
(http://www.cdc.gov/mmwr). However, two errors* were found.

* In the fourth sentence of the fifth paragraph, green onions were stated to have been stored for 5 or more days before processing rather than for 5 or fewer days. In the third sentence of the fifth paragraph of the Editorial Note, the word "of" appeared before "plant surfaces are particularly complex or adherent to viral or fecal particles."

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To access a web-text (HTML) version of the corrected and complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5247a5.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5247.pdf

Receive a FREE electronic subscription to MMWR (which includes new ACIP statements) by going to http://www.cdc.gov/mmwr/mmwrsubscribe.html
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December 1, 2003
UPDATE: IAC REVISES TWO PATIENT-EDUCATION BROCHURES

The Immunization Action Coalition (IAC) recently updated two of its patient-education brochures. Both brochures are designed to be copied, folded into thirds, and given to patients. In addition, the Centers for Disease Control and Prevention has reviewed both for technical accuracy.

(1) On the brochure "What If You Don't Immunize Your Child," statistical information was updated about the U.S. incidence of pertussis and the worldwide incidence of measles. Other small
changes were made as well.

To access a ready-to-copy (PDF) version of the updated brochure, go to: http://www.immunize.org/catg.d/p4017.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4017.htm

(2) On the brochure "Every Week, Hundreds of Sexually Active People Get Hepatitis B," several disease incidence rates were modified. Please note that the Spanish-language version has not yet been revised.

To access a ready-to-copy (PDF) version of the updated brochure, go to: http://www.immunize.org/catg.d/4112std.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/4112std.htm
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December 1, 2003
TODAY IS WORLD AIDS DAY

The Centers for Disease Control and Prevention (CDC) published "World AIDS Day, December 1, 2003" in the November 28 issue of "Morbidity and Mortality Weekly Report" (MMWR). The article is reprinted below in its entirety, excluding references.

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"Live and Let Live" is the theme for this year's World AIDS Day, December 1, 2003. This theme highlights the obstacles that stigma and discrimination pose to the success of prevention and care programs for persons living with human immunodeficiency virus (HIV). Discrimination against persons with infectious diseases is not new, and acquired immunodeficiency syndrome (AIDS) continues to be a stigmatizing health issue for those living with the disease.

Stigma and discrimination might pose barriers that keep persons at risk for HIV infection from getting tested. In the United States, approximately one fourth of the estimated 850,000-950,000 persons living with HIV are unaware of their infection and thus are not receiving needed treatment and prevention services.

Worldwide, an estimated 42 million persons were living with HIV/AIDS at the end of 2002. As in the United States, stigma and discrimination associated with HIV/AIDS remain key challenges to effective public health prevention programs. Information about HIV/AIDS is available from CDC at http://www.cdcnpin.org and http://www.cdc.gov/nchstp/od/nchstp.html or by telephone, (800) 342-2437.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5247a1.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5247.pdf
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December 1, 2003
JOB OPENING: NATIONAL IMMUNIZATION PROGRAM SEEKS CANDIDATES FOR DIRECTOR OF ITS GLOBAL IMMUNIZATION DIVISION

The Immunization Action Coalition (IAC) recently received the following announcement from the Centers for Disease Control and Prevention (CDC). It is reprinted below in its entirety.

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The National Immunization Program (NIP), CDC, is seeking exceptional candidates for the position of Director, Global Immunization Division (GID). The Director provides leadership; technical, programmatic, and financial support; policy development; and coordinates with other federal, national, and international organizations and institutions to plan, direct, conduct, and evaluate programs that control, eliminate, or eradicate vaccine preventable diseases worldwide.

The Global Immunization Division is responsible for leading NIP activities in support of global polio eradication, measles mortality reduction, regional measles elimination, and other global immunization activities. The Division works closely with the World Health Organization (WHO), Pan American Health Organization, UNICEF, Rotary International, United Nations Foundation, World Bank, American Red Cross, and the International Federation of Red Cross and Red Crescent Societies.

Qualifications required: Applicants must possess an M.D. degree and demonstrate: (1) a high degree of prominence and expertise, and a distinguished record of accomplishments in their fields, such that the individual can readily command the respect of the national and international public health communities and stimulate their interest in CDC global immunization-related activities; (2) experience in applying the practices and methods of effective disease control, eradication, and prevention programs in developing country settings; (3) the ability to lead, manage, and direct scientific and technical staff engaged in activities which impact directly on immunization and global vaccine-preventable disease programs and public health; and (4) experience that indicates the ability to deal effectively with high-level government officials, the scientific and academic communities, national and international medical and health-related organizations, diverse community and non-governmental groups, and the public at large.

How to apply: Please respond to announcement No: AD-10-04-006 which should open on or about November 26, 2003, for two weeks. (Applications before that date will not be accepted.) Applicants may visit the CDC home page at http://www.cdc.gov and the NIP home page at http://www.cdc.gov/nip

More information: Interested applicants should contact Bob Keegan, Acting Director, Global Immunization Division, at rak1@cdc.gov or (404) 639-8724, or Kim Lane, Associate Director for Management and Operations, National Immunization Program, at ksb1@cdc.gov or (404) 639-8200.

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December 1, 2003
FREE: BULK COPIES OF THE LATEST ISSUE OF "VACCINATE ADULTS" (NOVEMBER 2003) ARE AVAILABLE--PLACE YOUR ORDER NOW

The Immunization Action Coalition (IAC) is giving away bulk copies (up to 225 per request) of the November 2003 issue of "VACCINATE ADULTS" to make room for our January 2004 issue.

If you have an immunization conference or an educational program coming up for health professionals, this 12-page publication is an excellent item to distribute. It's packed with information that can make many aspects of adult immunization go more smoothly. The November issue includes the most current version of the popular "Summary of Recommendations for Adult Immunization," as well as information on influenza vaccination and updated professional-education material about hepatitis B.

Because supplies are limited, it's best to make your request right away. The free copies go quickly. Sorry, we can only mail orders to addresses within the United States.

To request copies, fill out the online form on IAC's website:
http://www.immunize.org/oldva

You will be asked to supply the following information:

  • The number of copies you want (maximum 225)
  • A description of how you plan to use the copies
  • Your name and complete contact information, including mailing address, telephone number, and email address

For further information, please contact Pat Storti, office administrator, by email at pat@immunize.org
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December 1, 2003
JANUARY 15, 2004, IS THE DEADLINE FOR ABSTRACTS FOR THE 1ST INTERNATIONAL NEONATAL VACCINATION WORKSHOP

The 1st International Neonatal Vaccination Workshop will be held on March 2-4, 2004, at the Hilton McLean Tysons Corner Hotel in McLean, VA. The workshop will explore the feasibility and safety of strategies to expand protection of young infants against vaccine-preventable diseases. Abstracts to be submitted for poster presentations must be received by January 15, 2004. The pre-registration deadline is February 13, 2004.

For information, go to:
http://www.cdc.gov/nip/events/neonatal_wkshop/default.htm

For additional information, contact the workshop planning team by email at neonatal@cdc.gov or by phone at (404) 639-8695 or (404) 639-8845.
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December 1, 2003
SUBMIT LATE-BREAKER ABSTRACTS FOR THE INTERNATIONAL CONFERENCE ON EMERGING INFECTIOUS DISEASES AS EARLY AS DECEMBER 10

The Centers for Disease Control and Prevention (CDC) published "Notice to Readers: Call for Abstracts: International Conference on Emerging Infectious Diseases 2004" in the November 28 issue of "Morbidity and Mortality Weekly Report" (MMWR). The article is reprinted below in its entirety.

PLEASE NOTE: The text of the report reprinted below has been corrected and does not correspond to the official electronic PDF version. An erratum will be published in a subsequent issue of MMWR.

IAC EXPRESS EDITOR'S NOTE: The official electronic PDF version mistakenly lists the conference title as the International Conference on Emerging Infectious Diseases 2000. Aside from the mistaken date in the conference title, the text of the official electronic PDF version is the same as the text reprinted below.

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The International Conference on Emerging Infectious Diseases 2004 (ICEID 2004) is calling for late-breaker abstracts. Abstracts should address new, reemerging, or drug-resistant infectious diseases that affect human health. The late-breaker abstract submission website will open on December 10, 2003, and close promptly on January 16, 2004, at 5 p.m., Eastern Standard Time. Information about submitting a late-breaker abstract is available at http://www.iceid.org/abssub.asp

ICEID 2004 will be held February 29-March 3, 2004, at the Marriott Marquis Hotel in Atlanta, Georgia. Cosponsors include CDC, Council of State and Territorial Epidemiologists, American Society for Microbiology, Association of Public Health Laboratories, CDC Foundation, and World Health Organization. Registration information is available at http://www.iceid.org and at http://www.cdc.gov/ncidod and by e-mail at meetinginfo@asmusa.org or at dsy1@cdc.gov

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To access a web-text (HTML) version of the complete and corrected article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5247a8.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5247.pdf
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December 1, 2003
CDC REPORTS ON GLOBAL PROGRESS TOWARD CERTIFYING POLIO ERADICATION AND LABORATORY CONTAINMENT OF WILD POLIOVIRUSES

The Centers for Disease Control and Prevention (CDC) published "Global Progress Toward Certifying Polio Eradication and Laboratory Containment of Wild Polioviruses--August 2002-August 2003" in the November 28 issue of "Morbidity and Mortality Weekly Report" (MMWR). A summary made available to the press is reprinted below in its entirety.

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Significant progress is being made in the process of certifying the world as polio-free and in the process of containing laboratory stores of poliovirus-containing samples.

At the end of the campaign to eradicate polio, the world will be certified as polio-free by a global certification commission. This will take place after each of the six WHO regions has been declared polio-free by regional certification commissions. To date, the Americas, Western Pacific, and European regions have been certified. As part of the global certification process, each country must identify laboratories that might have stored poliovirus-containing samples and survey those labs to determine whether such samples have been found. 90% of the identified labs in the Americas have been surveyed, 72% of those in the Western Pacific Region, and 91% of the labs in the European region. Significant progress toward laboratory containment of poliovirus is also being made in the remaining three regions.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5247a6.htm

To access a ready-to-copy (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5247.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 December 1, 2003