Issue Number 134            January 21, 2000

CONTENTS OF THIS ISSUE

  1. CDC releases "Recommended Childhood Immunization Schedule -- United States, 2000"
  2. CDC publishes press release on influenza questions and answers for the 1999-2000 flu season
  3. CDC publishes announcement on vaccine research conference
  4. Upcoming broadcast set to launch "Healthy People 2010" program objectives

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(1)
January 21, 2000
CDC RELEASES "RECOMMENDED CHILDHOOD IMMUNIZATION  SCHEDULE -- UNITED STATES, 2000"

The Centers for Disease Control and Prevention (CDC) published the revised childhood immunization schedule titled "Recommended Childhood Immunization Schedule -- United States, 2000" as a "Notice to Readers" in the January 21, 2000, issue of the MMWR. This new schedule reflects significant changes and new vaccine recommendations that were not presented in the 1999 schedule. 

The full text of the MMWR "Notice to Readers" is reprinted here as follows:

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RECOMMENDED CHILDHOOD IMMUNIZATION SCHEDULE -- UNITED STATES, 2000

Each year, CDC's Advisory Committee on Immunization Practices (ACIP) reviews the recommended childhood immunization schedule to ensure it remains current with changes in manufacturers' vaccine formulations,  revisions in recommendations for the use of licensed vaccines, and recommendations for newly licensed vaccines. This report presents the recommended childhood immunization schedule for 2000 and explains the changes that have occurred since January 1999.

Since the publication of the immunization schedule in January 1999, ACIP, the American Academy of Family Physicians, and the American Academy of Pediatrics have recommended removal of rotavirus vaccine from the schedule, endorsed an all-inactivated poliovirus vaccine (IPV) schedule for polio vaccination, recommended exclusive use of acellular pertussis vaccines for all doses of the pertussis vaccine series, and added hepatitis A vaccine (Hep A) to the schedule to reflect its recommended use in selected geographic areas. Detailed recommendations for using vaccines are available from the manufacturers' package inserts, ACIP statements on specific vaccines, and the 1997 Red Book. ACIP statements for each recommended childhood vaccine can be viewed, downloaded, and printed at CDC's National  Immunization Program World-Wide Web site: http://www.cdc.gov/nip/publications/acip-list.htm

REMOVAL OF ROTAVIRUS VACCINE FROM THE SCHEDULE:
On October 22, 1999, ACIP recommended that Rotashield (rhesus rotavirus vaccine-tetravalent [RRV-TV]) (Wyeth Laboratories, Inc., Marietta, Pennsylvania), the only U.S. licensed rotavirus vaccine, no longer be used in  the United States. The decision was based on the results of an expedited review of scientific data presented to ACIP by CDC. Data from the review indicated a strong association between RRV-TV and intussusception among  infants 1-2 weeks following vaccination. Vaccine use was suspended in July pending the ACIP data review. Parents should be reassured that children who received the rotavirus vaccine before July are not at increased risk for intussusception now. The manufacturer withdrew the vaccine from the market in October.

INACTIVATED POLIOVIRUS VACCINE FOR ALL FOUR DOSES:
As the global eradication of poliomyelitis continues, the risk for importation of wild-type poliovirus into the United States decreases dramatically. To eliminate the risk for vaccine-associated paralytic poliomyelitis (VAPP), an all-IPV schedule is recommended for routine childhood vaccination in the United States. All children should receive four doses of IPV: at age 2 months, age 4 months, between ages 6 and 18 months, and between ages 4 and 6 years. Oral poliovirus vaccine (OPV), if available, may be used only for the following special circumstances:

  1. Mass vaccination campaigns to control outbreaks of paralytic polio.
  2. Unvaccinated children who will be traveling within 4 weeks to areas where polio is endemic or epidemic.
  3. Children of parents who do not accept the recommended number of vaccine injections; these children may receive OPV only for the third or fourth dose or both. In this situation, health-care providers should administer OPV only after discussing the risk for VAPP with parents or caregivers.

OPV supplies are expected to be very limited in the United States after inventories are depleted. ACIP reaffirms its support for the global eradication  initiative and use of OPV as the vaccine of choice to eradicate polio where it is endemic.

ACELLULAR PERTUSSIS VACCINE:
ACIP recommends exclusive use of acellular pertussis vaccines for all doses of the pertussis vaccine series. The fourth dose may be administered as early as age 12 months, provided 6 months have elapsed since the third dose and the child is unlikely to return at 15-18 months.

HEPATITIS A:
Hepatitis A vaccine (Hep A) is listed on the schedule for the first time because it is recommended for routine use in some states and regions. Its appearance on the schedule alerts providers to consult with their local public health authority to learn the current recommendations for hepatitis A vaccination in their community. Additional information on the use of Hep A can be found in recently published guidelines.

HEPATITIS B:
Special considerations apply in the selection of hepatitis B vaccine products for the dose administered at birth.

VACCINE INFORMATION STATEMENTS:
The National Childhood Vaccine Injury Act requires that all health-care providers, whether public or private, give to parents or patients copies of  Vaccine Information Statements before administering each dose of the vaccines listed in this schedule (except Hep A). Vaccine Information Statements, developed by CDC, can be obtained from state health departments and CDC's World-Wide Web site,  http://www.cdc.gov/nip/publications/VIS. Instructions on use of the Vaccine Information Statements are available from CDC's website or the December 17, 1999, Federal Register (64 FR 70914).

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To read the text version (HTML format) of this "Notice to Readers" which includes the schedule table,go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4902a4.htm

To obtain a camera-ready copy (PDF format) of the "Recommended Childhood Immunization Schedule -- United States, 2000," go to CDC's National Immunization Program website: http://www.cdc.gov/nip/pdf/child-schedule.pdf

PLEASE NOTE: IF YOU FIND THAT ANY PORTION OF THIS DOCUMENT DOES NOT PRINT TO THE APPROPRIATE SIZE, PLEASE SELECT "FIT TO PAGE" OR "SHRINK TO FIT" IN THE "PRINT" DIALOG BOX ON YOUR COMPUTER. (The "print" dialog box appears on the screen when you have selected the "print" command under the "file" menu.)

If you receive either "Pediatrics" or "American Family Physician," the journals of the American Academy of Pediatrics and the American Academy of Family  Physicians respectively, you may already have a camera-ready copy of the schedule. See page 148 of "Pediatrics," Vol. 105, No. 1, January 2000, or in "American Family Physician," Vol. 61, No. 1, January 2000, see pages 232-239.

If you do not receive either of these publications and/or are unable to download the schedule from the Internet, call CDC's National Immunization Information Hotline at (800) 232-2522 to request that a copy be mailed to you.

For information on how to obtain a free electronic subscription to the MMWR, see the instructions that follow article three below.
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(2)
January 21, 2000
CDC PUBLISHES PRESS RELEASE ON INFLUENZA QUESTIONS AND ANSWERS FOR THE 1999-2000 FLU SEASON

The Centers for Disease Control and Prevention (CDC) has published a press release of 20 questions and answers which provide important information on various aspects of influenza for the 1999-2000 flu season. Topics included in this document range from the formal definition of "influenza" to issues of adverse effects and shortage of flu vaccine nationwide. 

Intended to provide people with the most accurate and up-to-date information on influenza recommendations for the 1999-2000 season, these Q&As are ideal for distribution to the media, as well as appropriate for distribution to the general public.

To obtain the text version (HTML format) of this document, go to CDC's website at: http://www.cdc.gov/od/oc/media/pressrel/r2k0107.htm

If you are unable to download this document online, call CDC's "Public Inquiries" telephone line M-F, 8:00am to 4:30pm, ET, at (800) 311-3435 to request that these Q&As be sent to you by fax or mail.
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(3)
January 21, 2000
CDC PUBLISHES ANNOUNCEMENT ON VACCINE RESEARCH CONFERENCE 

The Centers for Disease Control and Prevention (CDC) published the announcement titled "Conference on Vaccine Research" as a "Notice to Readers" in the January 21, 2000, issue of the MMWR. The full text of the "Notice" reads as follows:

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The "Third Annual Conference on Vaccine Research:  Basic Science--Product Development--Clinical and Field Studies" will be held April 30-May 2, 2000, in Washington, D.C. This conference is sponsored by the National Foundation for Infectious Diseases (NFID) in collaboration with CDC, the National Institute of Allergy and Infectious Diseases, the International Society for Vaccines, the Center for Biologics Evaluation and Research of the Food and Drug Administration, the World Health Organization, the Albert B. Sabin Vaccine Institute at Georgetown University, and the U.S. Department of Agriculture. The meeting covers scientific data and issues from the disciplines involved in the research and development of vaccines and associated technologies for the control of human and veterinary diseases through vaccination.

The deadline for submitting abstracts for oral and poster presentations is January 28, 2000. Program announcements and forms for abstract submission, registration, and hotel reservations are available from Kip Kantelo, NFID, Suite 750, 4733 Bethesda Ave., Bethesda, MD 20814-5228; telephone (301) 656-0003, ext. 19; fax (301) 907-0878; e-mail kkantelo@nfid.org; World-Wide Web site http://www.nfid.org/conferences/

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To obtain the text version (HTML format) of this notice online, go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4902a5.htm

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 listed below. Select "Free MMWR 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 automatically arrive in your e-mail box. To go to the MMWR website, visit: http://www2.cdc.gov/mmwr
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(4)
January 21, 2000
UPCOMING BROADCAST SET TO LAUNCH "HEALTHY PEOPLE 2010" PROGRAM OBJECTIVES

Join Secretary Donna Shalala, U.S. Department of Health and Human Services, and David Satcher, MD, U.S. Surgeon General, as they launch the nation's public health goals for the upcoming decade in a satellite broadcast titled "Partnerships for Health in the New Millennium: Launching Healthy People 2010." Set for January 25 to January 28, 2000, the broadcast will cover a number of sessions of the joint meeting of the Healthy People Consortium and Partnerships for Networked Consumer Health Information  which will be held in Washington, DC, during those dates.

Topics covered in the broadcast include approaches to eliminating health disparities, as well as the utilization of information technology and how it can be used to improve health and health-related information in the United States. Goals for this program are to:

  1. Announce the third decade's set of national health objectives, Healthy People 2010.
  2. Promote partnerships to meet the vision of Healthy People 2010, Healthy People in Healthy Communities, Health for All.
  3. Explore the effective uses of technology to improve health care and public health.

This satellite broadcast is intended to reach elected officials, leaders of public health organizations and programs at the federal, state, and local community levels. Sponsors of the broadcast include the Health and Human Services (HHS) Office of Public Health and Science, and many other HHS agencies.

Scheduled at various times from January 25 - January 28, 2000, sessions will air both by satellite and by webcast on the Internet. For the most up-to-date schedule and session descriptions, go to: http://health.gov/partnerships/Program/castprog.htm

For further information about this broadcast and/or technical viewing information, visit: http://health.gov/partnerships

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
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    Taryn Chapman, MS
    Courtnay Londo, MA
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    Marian Deegan, JD
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