Immunization Action Coalition and the Hepatitis B Coalition

IAC EXPRESS

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Issue Number 605            June 19, 2006

CONTENTS OF THIS ISSUE

  1. New: JCAHO establishes infection control standards that address influenza vaccination for healthcare staff
  2. VIS translations: Current VIS for hepatitis A vaccine translated into Spanish and 10 other languages
  3. Updated: IAC revises many immunization and hepatitis information pieces for parents, patients, and professionals
  4. Time magazine selects CDC's Dr. Nancy Cox as one of the Time 100: The People Who Shape Our World
  5. July 7 NIP net conference will cover human papillomavirus (HPV), cervical cancer, and HPV vaccine and recommendations
  6. July 20 NIP net conference to focus on vaccine preparation and delivery and on 2006 influenza recommendations
  7. August 10 broadcast to cover influenza, pertussis, rotavirus and zoster vaccines and hepatitis A recommendations
  8. CDC issues an update on U.S. and worldwide influenza activity in 2005-06 and on composition of 2006-07 influenza vaccine
  9. CDC issues "Summary of Notifiable Diseases—United States, 2004"
  10. HHS announces final rule for smallpox vaccine injury compensation

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ABBREVIATIONS: AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NIP, National Immunization Program; VIS, Vaccine Information Statement; VPD, vaccine-preventable disease; WHO, World Health Organization.
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June 19, 2006
NEW: JCAHO ESTABLISHES INFECTION CONTROL STANDARDS THAT ADDRESS INFLUENZA VACCINATION FOR HEALTHCARE STAFF

On June 13, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) issued a press release announcing that it has approved a standard requiring accredited healthcare organizations to offer influenza vaccinations to staff, volunteers, and independent practitioners, effective January 1, 2007. The press release is reprinted below in its entirety.

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June 13, 2006

JOINT COMMISSION ESTABLISHES INFECTION CONTROL STANDARD TO ADDRESS INFLUENZA VACCINES FOR STAFF

The Joint Commission on Accreditation of Healthcare Organizations today announced the approval of an infection control standard that requires accredited organizations to offer influenza vaccinations to staff, which includes volunteers and licensed independent practitioners with close patient contact. The standard will become an accreditation requirement beginning January 1, 2007, for the Critical Access Hospital, Hospital and Long-Term—Care accreditation programs.

"Preventing the spread of the flu protects patients and saves lives. Encouraging healthcare workers to be vaccinated can play a vital role in stopping the transmission of this potentially fatal infection," says Robert Wise, MD, vice president, Division of Standards and Survey Methods, Joint Commission.

The Joint Commission developed the standard in response to recommendations by the Centers for Disease Control and Prevention (CDC) making the reduction of influenza transmission from healthcare professionals to patients a top priority in the United States. While the CDC has urged annual influenza vaccination for healthcare workers since 1981, the CDC's Morbidity and Mortality Weekly Report published earlier this year calls for stronger steps to increase influenza vaccination of healthcare workers. Despite the recommendations, the vaccination rates as measured by the CDC remain low.

Studies show that influenza causes 36,000 deaths and [more than] 200,000 hospitalizations on average in the United States annually. Furthermore, healthcare-associated transmission of influenza has been documented among many patient populations in a variety of clinical settings, and infections have been linked epidemiologically to unvaccinated healthcare workers. Typically, fewer than 40 percent of healthcare workers are immunized each year.

The new Joint Commission standard requires organizations to

  • Establish an annual influenza vaccination program that includes at least staff and licensed independent practitioners;
  • Provide access to influenza vaccinations on site;
  • Educate staff and licensed independent practitioners about flu vaccination; non-vaccine control measures (such as the use of appropriate precautions); and diagnosis, transmission, and potential impact of influenza;
  • Annually evaluate vaccination rates and reasons for non-participation in the organization's immunization program; and
  • Implement enhancements to the program to increase participation.

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To access the press release from the JCAHO website, go to:
http://www.jointcommission.org/newsroom/newsreleases/nr_06_13_06.htm
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June 19, 2006
VIS TRANSLATIONS: CURRENT VIS FOR HEPATITIS A VACCINE TRANSLATED INTO SPANISH AND 10 OTHER LANGUAGES

Dated 3/21/06, the current version of the hepatitis A vaccine VIS is now available on the IAC website in Spanish and 10 additional languages: Arabic, Armenian, Cambodian, Chinese, Farsi, Hmong, Korean, Russian, Tagalog, and Vietnamese. IAC gratefully acknowledges the California Department of Health Services for the translations.

To obtain a ready-to-copy (PDF) version of the current VIS hepatitis A vaccine in Spanish, go to:
http://www.immunize.org/vis/sp_hpa06.pdf

To obtain it in Arabic, go to:
http://www.immunize.org/vis/ab_hpa06.pdf

To obtain it in Armenian, go to:
http://www.immunize.org/vis/ar_hpa06.pdf

To obtain it in Cambodian, go to:
http://www.immunize.org/vis/ca_hpa06.pdf

To obtain it in Chinese, go to:
http://www.immunize.org/vis/ch_hpa06.pdf

To obtain it in Farsi, go to:
http://www.immunize.org/vis/fa_hpa06.pdf

To obtain it in Hmong, go to:
http://www.immunize.org/vis/hm_hpa06.pdf

To obtain it in Korean, go to:
http://www.immunize.org/vis/ko_hpa06.pdf

To obtain it in Russian, go to:
http://www.immunize.org/vis/ru_hpa06.pdf

To obtain it in Tagalog, go to:
http://www.immunize.org/vis/ta_hpa06.pdf

To obtain it in Vietnamese, go to:
http://www.immunize.org/vis/vn_hpa06.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/v-hepa.pdf

For information about the use of VISs, and for VISs in more than 30 languages, visit IAC's VIS web section at http://www.immunize.org/vis
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June 19, 2006
UPDATED: IAC REVISES MANY IMMUNIZATION AND HEPATITIS INFORMATION PIECES FOR PARENTS, PATIENTS, AND PROFESSIONALS

IAC recently revised many of its immunization and hepatitis education materials for parents, patients, and healthcare professionals. Following is a list of the updated materials; it explains the changes made to each and provides links to each.

IMMUNIZATION EDUCATIONAL MATERIALS

For parents and patients:
1. The two-page brochure "Questions parents ask about baby shots" now includes rotavirus vaccine.

To access a ready-to-print (PDF) version of it, go to:
http://www.immunize.org/catg.d/p4025.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/nslt.d/n18/p4025.htm

2. The Spanish-language version of the one-page chart "When do children and teens need vaccinations?" was changed to add rotavirus vaccine and update the recommended age for influenza vaccination from 6–23 months to 6–59 months. IAC gratefully acknowledges the California Department of Health Services for the translation.

To access a ready-to-print (PDF) version of it, go to:
http://www.immunize.org/catg.d/p4050-01.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4050-01.htm

To access a ready-to-print (PDF) version of it in English, go
to: http://www.immunize.org/catg.d/when1.pdf

To access a web-text (HTML) version in English, go to: To access a web-text (HTML) version in English, go to:
http://www.immunize.org/nslt.d/n17/when1.htm

3. The English- and Spanish-language versions of the one-page chart "Immunizations for babies . . . a guide for parents: These are the vaccinations your baby needs!" were changed to add rotavirus vaccine and update the recommended age for influenza vaccination from 6–23 months to 6–59 months. IAC gratefully acknowledges the California Department of Health Services for the Spanish translation.

To access a ready-to-print (PDF) version of it in English, go to: http://www.immunize.org/catg.d/p4010imm.pdf

To access a web-text (HTML) version in English, go to:
http://www.immunize.org/catg.d/p4010.htm

To access a ready-to-print (PDF) version of it in Spanish, go
to: http://www.immunize.org/catg.d/p4010-01imm.pdf

To access a web-text (HTML) version in Spanish, go to:
http://www.immunize.org/catg.d/p4010-01.htm


For healthcare professionals:
1. The one-page document "Brief sex history questionnaire" was recently reviewed and minor changes were made.

To access a ready-to-print (PDF) version of it, go to:
http://www.immunize.org/catg.d/p4401.pdf

HEPATITIS EDUCATIONAL MATERIALS
For patients:
1. The two-page brochure "Every day, teens are infected with hepatitis B virus: Be sure you're vaccinated against this disease" was recently reviewed and minor changes were made.

To access a ready-to-print (PDF) version of it, go to:
http://www.immunize.org/catg.d/p4100tee.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4100tee.htm

2. The two-page brochure "Every week hundreds of sexually active people get hepatitis B: Get protected! Get vaccinated!" was recently reviewed and minor changes were made.

To access a ready-to-print (PDF) version of it, 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

3. The two-page brochure "If you, your parents, or your children were born in any of these places . . . give this brochure to your healthcare provider and ask to find out your hepatitis B status" was recently translated into Spanish. IAC gratefully acknowledges the California Department of Health Services for the translation.

To access a ready-to-print (PDF) version of it, go to:
http://www.immunize.org/catg.d/p4170sp.pdf

To access a ready-to-print (PDF) version of it in English, go to: http://www.immunize.org/catg.d/p4170ref.pdf

4. Dated 9/03, the four-page document "Questions frequently asked about hepatitis B" was recently translated into Spanish. IAC gratefully acknowledges the Perinatal Hepatitis B Prevention Program of the Montgomery County (Maryland) Department of Health and Human Services for the translation.

To access a ready-to-print (PDF) version of it, go to:
http://www.immunize.org/catg.d/4090-01q.pdf

To access a ready-to-print (PDF) version of it in English, go to: http://www.immunize.org/catg.d/p4090.pdf

For healthcare professionals:
1. The one-page document "Give the birth dose . . . hepatitis B vaccine at birth saves lives" was modified to be consistent with the new birth dose recommendations made by CDC, AAP, AAFP, and American College of Obstetricians/Gynecologists (ACOG).

To access a ready-to-print (PDF) version of it, go to:
http://www.immunize.org/catg.d/p2125.pdf

To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p2125.htm
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June 19, 2006
TIME MAGAZINE SELECTS CDC'S DR. NANCY COX AS ONE OF THE TIME 100: THE PEOPLE WHO SHAPE OUR WORLD

CDC recently announced that scientist Nancy Cox, PhD, has been selected to be included in the Time 100: The People Who Shape Our World. Dr. Cox, director of CDC's Influenza Division, is widely respected for her knowledge of and understanding of influenza viruses, as well as her insights into important influenza prevention and control strategies.

To read the CDC announcement, go to:
http://www.cdc.gov/flu/nancycox_article.htm
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June 19, 2006
JULY 7 NIP NET CONFERENCE WILL COVER HUMAN PAPILLOMAVIRUS (HPV), CERVICAL CANCER, AND HPV VACCINE AND RECOMMENDATIONS

A supplemental Current Issues in Immunization net conference is scheduled for July 7, from noon to 1PM ET. It will focus on the newly emerging immunization topic of HPV disease, vaccine, and recommendations.

PLEASE NOTE: Based on decisions made at the June 29–30 ACIP meeting this supplemental session on HPV may be rescheduled. If so, the net conference's new dates and times will be posted at http://www.cdc.gov/nip/ed/ciinc/hpv.htm

The net conference will cover three primary topics:

  • Epidemiology of human papillomavirus, presented by Eileen Dunne, MD, MPH
  • Cervical cancer in the United States, presented by Herschel Lawson, MD
  • HPV vaccine efficacy and recommendations, presented by Lauri Markowitz, MD

The conference requires pre-registration, as space is limited. Registration will close when the course is full or on July 5 (midnight ET). To register for the conference, go to: http://www2a.cdc.gov/nip/isd/ciinc_hpv

The program will combine a telephone audio conference and simultaneous online visual content. Participants can join the Q&A session by telephone or Internet. For instructions and system requirements, go to: http://www.cdc.gov/nip/ed/ciinc/instructions.htm

For additional information, go to: http://www.cdc.gov/nip/ed/ciinc/hpv.htm or call (800) 232-4636.
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June 19, 2006
JULY 20 NIP NET CONFERENCE TO FOCUS ON VACCINE PREPARATION AND DELIVERY AND ON 2006 INFLUENZA RECOMMENDATIONS

Scheduled for July 20, from noon to 1PM ET, the Current Issues in Immunization net conference is designed to provide clinicians with up-to-date information on immunization. The program has two primary topics: (1) vaccine administration and current recommendations (presented by Donna Weaver, RN, MN) and (2) the 2006 influenza recommendations (presented by David Shay, MD, MPH).

The conference requires pre-registration, as space is limited. Registration will close when the course is full or on July 17 (midnight ET). To register for the conference, go to: http://www2a.cdc.gov/nip/isd/ciinc

The program will combine a telephone audio conference and simultaneous online visual content. Participants can join the Q&A session by telephone or Internet. For instructions and system requirements, go to: http://www.cdc.gov/nip/ed/ciinc/instructions.htm

For additional information, go to: http://www.cdc.gov/nip/ed/ciinc or email nipinfo@cdc.org or call (800) 232-4636.
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June 19, 2006
AUGUST 10 BROADCAST TO COVER INFLUENZA, PERTUSSIS, ROTAVIRUS, AND ZOSTER VACCINES AND HEPATITIS A RECOMMENDATIONS

The live satellite broadcast and webcast Immunization Update 2006 will provide up-to-date information on the rapidly changing field of immunization. Sponsored by CDC, the live broadcast is scheduled for August 10, from 9AM to 11:30AM ET. It will be rebroadcast later in the day from noon to 2:30PM ET. Both broadcasts will feature a live Q&A session in which participants nationwide can interact with the course instructors by toll-free telephone lines.

Following is the anticipated course content: influenza vaccine, pertussis vaccine for adolescents and adults, revised recommendations for childhood hepatitis A vaccination, the new vaccines for rotavirus and herpes zoster, and possibly information about human papillomavirus (HPV) vaccine.

The course instructors are William L. Atkinson, MD, MPH; Donna Weaver, RN, MN; and Andrew Kroger, MD, MPH. All are with the CDC's National Immunization Program.

Site registration begins on June 22; individual registration, on July 13. Registration is not required for the webcast. For further registration information, email ce@cdc.gov or call (800) 418-7246.

For comprehensive program information, go to: http://www.phppo.cdc.gov/PHTN/immup-2006 or email nipinfo@cdc.gov
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June 19, 2006
CDC ISSUES AN UPDATE ON U.S. AND WORLDWIDE INFLUENZA ACTIVITY IN 2005–06 AND ON COMPOSITION OF 2006-07 INFLUENZA VACCINE

CDC published "Update: Influenza activity—United States and worldwide, 2005–06 season, and composition of the 2006–07 influenza vaccine" in the June 16 issue of MMWR. Portions of the article and editorial note are reprinted below.

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During the 2005-06 influenza season, influenza A (H1N1), A (H3N2), and B viruses co-circulated worldwide. In the United States, influenza A (H3N2) viruses predominated overall, but influenza B viruses were isolated more frequently than influenza A viruses late in the season. Influenza activity in the United States peaked in early March, and the number of pneumonia and influenza deaths did not exceed the epidemic threshold. Worldwide, influenza B viruses were the most commonly reported influenza type in Europe; influenza A (H1N1) and influenza B viruses predominated in Asia. Through June 13, 2006, outbreaks of influenza A (H5N1) viruses (avian influenza) among migratory birds and poultry flocks were associated with severe human illness or death in 10 countries (Azerbaijan, Cambodia, China, Djibouti, Egypt, Indonesia, Iraq, Thailand, Turkey, and Vietnam). This report summarizes influenza activity in the United States and worldwide during the 2005-06 influenza season and describes composition of the 2006-07 influenza vaccine.

UNITED STATES
The national percentage of respiratory specimens testing positive for influenza and the proportion of outpatient visits to sentinel providers for influenza-like illness (ILI) peaked in early March 2006. Influenza A (H3N2) viruses were most commonly isolated overall, but influenza B viruses were more frequently identified than influenza A viruses during late April and May. A small number of influenza A (H1N1) viruses also were identified. . . .

COMPOSITION OF THE INFLUENZA VACCINE FOR THE 2006-07 SEASON
The Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee has recommended that the 2006-07 trivalent influenza vaccine for the United States contain A/New Caledonia/20/99-like (H1N1), A/Wisconsin/67/2005-like (H3N2), and B/Malaysia/2506/2004-like viruses. This represents a change in the influenza A (H3N2) and influenza B components. For the A/Wisconsin/67/2005-like (H3N2) virus, U.S. vaccine manufacturers can use A/Wisconsin/67/2005 or the antigenically equivalent A/Hiroshima/52/2005 strain. For the influenza B component, either the B/Malaysia/2506/2004 or B/Ohio/1/2005 strain can be used. This recommendation is based on antigenic analyses of recently isolated influenza viruses, epidemiologic data, and postvaccination serologic studies in humans. . . .

PNEUMONIA- AND INFLUENZA-RELATED MORTALITY
During the 2005-06 influenza season, the percentage of deaths attributed to pneumonia and influenza (P&I) as reported by the 122 Cities Mortality Reporting System did not exceed the epidemic threshold. The percentage of P&I deaths peaked twice at 7.8%, once during the week ending January 14, 2006 (week 2), and again during the week ending March 18, 2006 (week 11). During the preceding five influenza seasons, the peak percentage of P&I deaths ranged from 8.1% to 10.4%, and the total number of weeks above the epidemic threshold ranged from 4 to 16 (CDC, unpublished data, 2006). . . .

HUMAN INFECTIONS WITH AVIAN INFLUENZA A (H5N1) VIRUSES
During December 1, 2003-June 13, 2006, a total of 225 human cases of avian influenza A (H5N1) infection were reported to WHO from 10 countries. Of these, 128 (57%) were fatal. All cases were reported from Asia (Azerbaijan, Cambodia, China, Indonesia, Iraq, Thailand, Turkey, and Vietnam) or Africa (Djibouti and Egypt). To date, no human case of avian influenza A (H5N1) virus infection has been identified in the United States. . . .

EDITORIAL NOTE:

During the 2005-06 influenza season, influenza activity in the United States peaked in early March and excess mortality was not detected. In the United States, influenza A (H3N2) viruses predominated during most of the season, but influenza B viruses were more frequently identified than influenza A viruses during late April through May. Worldwide, influenza B viruses were reported most commonly in many European countries, and influenza A (H1N1) and influenza B viruses predominated in Asia. . . .

As a supplement to influenza vaccination, antiviral drugs have aided in the control and prevention of influenza. However, the 2005-06 influenza season was notable because of the emergence of a high level of resistance among circulating influenza A (H3N2) viruses to the antiviral adamantanes (i.e., amantadine and rimantadine). Of 209 influenza A (H3N2) virus isolates collected from 26 states and sent to CDC during October 1-December 31, 2005, a total of 193 (92.3%) were resistant to adamantanes. On the basis of these findings, in January 2006, CDC recommended against use of the adamantane class of antivirals for the treatment and prophylaxis of influenza in the United States until susceptibility to adamantanes has been reestablished among circulating influenza A isolates. A high level of resistance to adamantanes ([greater than] 90%) by influenza A (H3N2) viruses continued to be observed among specimens tested through May 2006.

As of June 13, 2006, influenza A (H5N1) had been reported in migratory birds or poultry flocks in Africa (Burkina Faso, Cameroon, Cote d'Ivoire, Djibouti, Egypt, Niger, Nigeria, and Sudan), Asia (Afghanistan, Azerbaijan, Cambodia, China, Georgia, Hong Kong, Kazakhstan, India, Indonesia, Iraq, Iran, Israel, Jordan, Malaysia, Mongolia, Myanmar, Palestinian Autonomous Territories, Pakistan, Thailand, Turkey, and Vietnam), and Europe (Albania, Austria, Bosnia-Herzegovina, Bulgaria, Croatia, Czech Republic, Denmark, France, Germany, Greece, Hungary, Italy, Poland, Romania, Russia, Serbia-Montenegro, Slovakia, Slovenia, Sweden, Switzerland, Ukraine, and the United Kingdom). The spread of the virus can be associated, in part, with the movement of wild migratory birds from Asia, suggesting that apparently healthy birds can carry the virus over long distances. No evidence of sustained person-to-person transmission of influenza A (H5N1) viruses has been reported to date, but rare cases of person-to-person transmission likely have occurred.

In collaboration with local and state health departments, CDC continues to recommend enhanced surveillance for possible influenza A (H5N1) infection among travelers with severe unexplained respiratory illness returning from influenza A (H5N1)-affected countries. Additional information on influenza, including avian influenza, is available at http://www.cdc.gov/flu Updates on the worldwide avian influenza situation are available from WHO at http://www.who.int/csr/disease/avian_influenza/en

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5523a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5523.pdf

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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June 19, 2006
CDC ISSUES "SUMMARY OF NOTIFIABLE DISEASES—UNITED STATES, 2004"

CDC published "Summary of Notifiable Diseases—United States, 2004" in the June 16 issue of MMWR Summary of Notifiable Diseases.

The summary has two primary sections. They are Part 1: Summaries of Notifiable Diseases in the United States, 2004; and Part 2: Graphs and Maps for Selected Notifiable Diseases in the United States, 2004. The opening paragraph of the preface is reprinted below.

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The "Summary of Notifiable Diseases—United States, 2004" contains the official statistics, in tabular and graphic form, for the reported occurrence of nationally notifiable infectious diseases in the United States for 2004. Unless otherwise noted, the data are final totals for 2004 reported as of December 2, 2005. These statistics are collected and compiled from reports sent by state health departments to the National Notifiable Diseases Surveillance System (NNDSS), which is operated by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE). The summary is available at http://www.cdc.gov/mmwr/summary.html This site also includes publications from past years.

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To access a web-text (HTML) version of the summary online, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5353a1.htm

Because the summary is a large file (1.7 MB), printing problems may occur because of printer memory size. One solution is to print a few pages at a time. To access more tips on downloading and printing large PDF files, go to:
http://www.immunize.org/nslt.d/tips.htm

To access a ready-to-print (PDF) version, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5353.pdf
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June 19, 2006
HHS ANNOUNCES FINAL RULE FOR SMALLPOX VACCINATION INJURY COMPENSATION

On June 16, HHS issued a press release announcing the final rules for the Smallpox Vaccine Injury Compensation Program. Portions of the press release are reprinted below

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For immediate release
Friday, June 16, 2006

HHS ISSUES FINAL RULE FOR SMALLPOX VACCINE INJURY COMPENSATION PROGRAM

HHS Secretary Mike Leavitt today announced final rules for the Smallpox Vaccine Injury Compensation Program. The rules strengthen the smallpox vaccination compensation program, which provides benefits to public health and medical response team members and others who are injured as a result of receiving the smallpox vaccine.

The final rules supersede and update the Smallpox Vaccine Injury Table and the Administrative Implementation interim final rules that were published in the Dec. 16, 2003, Federal Register. . . .

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To access the complete press release, go to:
http://www.hhs.gov/news/press/2006pres/20060616.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 June 19, 2006