Issue
Number 349
November 18, 2002
CONTENTS OF THIS ISSUE
- Danish study finds no connection between MMR
vaccine and autism
- Dr. Neal Halsey reaffirms vaccines do not cause
autism
- CDC study finds seniors' current influenza and
pneumococcal vaccination rates are drastically below goals for 2010
- IAC website adds information on state hepatitis
A mandates and also provides newest CDC information on state childhood
vaccination requirements
- IAC updates "Vaccine Administration Record for
Adults" for medical charts
- IAC updates "Reliable Sources of Immunization
Information" educational sheet
- MMWR notifies readers about ACIP's supplemental
recommendations for the use of anthrax vaccine
- First annual edition! "ImmunoFacts" is now
available as a bound volume
- NIAID releases 20th anniversary edition of "The
Jordan Report" on vaccine research
- Hepatitis Foundation International launches the
California Hepatitis Resource Center website
- CDC reports hundreds died in July-August
influenza outbreak in Madagascar
----------------------------------------------------------
Back to Top
(1 of 11)
November 18, 2002
DANISH STUDY FINDS NO CONNECTION BETWEEN MMR VACCINE AND AUTISM
On November 7, the "New England Journal of Medicine" published an article
titled "A Population-Based Study of Measles, Mumps, and Rubella Vaccination
and Autism," which refutes the hypothesis that the vaccination causes
autism. The article is part of an established body of evidence that
disproves a connection between vaccines and autism. The complete abstract of
the article follows.
*************************
Background
It has been suggested that vaccination against measles, mumps, and rubella (MMR)
is a cause of autism.
Methods
We conducted a retrospective cohort study of all children born in Denmark
from January 1991 through December 1998. The cohort was selected on the
basis of data from the Danish Civil Registration System, which assigns
a unique identification number to every live-born infant and new resident in
Denmark. MMR-vaccination status was obtained from the Danish National Board
of Health. Information on the children's autism status was obtained from the
Danish Psychiatric Central Register, which contains information on all
diagnoses received by patients in psychiatric hospitals and outpatient
clinics in Denmark. We obtained information on potential confounders from
the Danish Medical Birth Registry, the National Hospital Registry, and
Statistics Denmark.
Results
Of the 537,303 children in the cohort (representing 2,129,864 person-years),
440,655 (82.0 percent) had received the MMR vaccine. We identified 316
children with a diagnosis of autistic disorder and 422 with a
diagnosis of other autistic-spectrum disorders. After adjustment for
potential confounders, the relative risk of autistic disorder in the
group of vaccinated children, as compared with the unvaccinated group,
was 0.92 (95 percent confidence interval, 0.68 to 1.24), and the relative
risk of another autistic-spectrum disorder was 0.83 (95 percent
confidence interval, 0.65 to 1.07). There was no association between the age
at the time of vaccination, the time since vaccination, or the date of
vaccination and the development of autistic disorder.
Conclusions
This study provides strong evidence against the hypothesis that MMR
vaccination causes autism.
*************************
To access the abstract, go to:
http://content.nejm.org/cgi/content/abstract/347/19/1477
For additional articles on vaccines and autism, go to: the Immunization
Action Coalition web page "Autism Information" at
http://www.immunize.org/safety/autism.htm
----------------------------------------------------------
Back to Top
(2 of 11)
November 18, 2002
DR. NEAL HALSEY REAFFIRMS VACCINES DO NOT CAUSE AUTISM
On November 14, the Johns Hopkins Bloomberg School of Public Health
distributed a press release in response to public concern over an
article titled "The Not-So-Crackpot Autism Theory," which appeared in the
"New York Times Magazine" on November 10. The opening paragraph of the press
release is reprinted below.
************************
Recently, there has been some confusion surrounding a hypothesis that the
vaccine preservative thimerosal is linked to an increase in autism among
children. Neal Halsey, MD, professor of international health and director of
the Institute for Vaccine Safety at the Johns Hopkins Bloomberg School of
Public Health, does not and has not supported the belief that thimerosal or
vaccines themselves cause autism in children, saying scientific evidence
does not suggest any causal association between any vaccine and autism. Data
published in the November 7, 2002, issue of the "New England Journal
of Medicine" conclusively showed that there was no difference in the rate of
autism or related disorders in children who received measles, mumps, and
rubella (MMR) vaccines than those who did not. Studies from other countries
have determined the hypothetical association between vaccines and
autism was not supported by the available evidence.
***************************
To view the complete press release online, go to:
http://www.jhsph.edu/Press_Room/Press_Releases/Halsey_autism.html
----------------------------------------------------------
Back to Top
(3 of 11)
November 18, 2002
CDC SURVEY FINDS SENIORS' CURRENT INFLUENZA AND PNEUMOCOCCAL VACCINATION
RATES ARE DRASTICALLY BELOW GOALS FOR 2010
The Centers for Disease Control and Prevention (CDC) published "Influenza
and Pneumococcal Vaccination Levels Among Persons Aged 65 Years and
Older--United States, 2001" in the November 15 issue of "Morbidity and
Mortality Weekly Report" (MMWR).
Based on data collected from CDC's 2001 Behavioral Risk Factor Surveillance
System, the article states that overall, influenza vaccine reaches 64.9
percent of people 65 and older and pneumococcal vaccine only 60.0
percent. Coverage of both vaccines is lower among African Americans and
Hispanics than among non-Hispanic whites.
The article noted that 90 percent of the 20,000 people influenza kills
annually in the United States are people age 65 and older. National
health objectives for 2010 include increasing influenza and pneumococcal
immunization rates to 90 percent or higher in this population.
The Editorial Note addresses strategies for increasing influenza and
pneumococcal immunization rates among the 65-years-and-older population in
general, and among African Americans and Hispanics in particular. It
reads in part:
********************
Strategies for addressing [racial/ethnic disparities in adult vaccine
coverage] will be investigated by CDC's Racial and Ethnic Adult Disparities
Immunization Initiative (READII) through 2-year demonstration projects in
Chicago, Illinois; Milwaukee, Wisconsin; a rural area of Mississippi;
Rochester, New York; and San Antonio, Texas. Local and state health
departments in these areas will work with community partners, CDC, and other
federal agencies to identify and implement effective ways to improve
influenza and pneumococcal vaccination levels among older non-Hispanic
blacks and Hispanics.
Health-care providers should assess the vaccination status of their patients
and offer indicated vaccines. Annual influenza vaccination provides such an
opportunity; persons reporting recent influenza vaccination were 2.5
times more likely to report having received pneumococcal vaccine than
were persons who did not report recent influenza vaccination. Administration
of influenza and pneumococcal vaccine simultaneously does not increase the
incidence or severity of adverse reactions. Nevertheless, approximately one
fourth of persons reporting recent influenza vaccination did not report
having ever received pneumococcal vaccine. . . .
The optimal time to administer influenza vaccination is during
October-November. However, influenza vaccination should continue into
December and later because many persons at high risk for influenza-related
complications, household members of these persons, health-care workers, and
other persons who want to decrease their risk for influenza remain
unvaccinated by the end of November. Current projections indicate that 93
million doses of influenza vaccine will be available during the 2002-03
influenza season, and several million doses remain available for purchase.
To maximize coverage among target groups and overall use, physicians should
offer influenza vaccine throughout the influenza season. Influenza activity
peaked in January or later in 21 of the preceding 25 influenza seasons.
During influenza season and all year, pneumococcal vaccination also should
be offered to persons aged 65 years and older and others at high risk who
have not been vaccinated or whose vaccination status is unknown. Physicians
can improve coverage by using strategies such as improved record keeping,
standing orders, reminder/recall systems, and offering vaccinations to
hospitalized patients before discharge. Additional information about
influenza and pneumococcal vaccination is available at
http://www.cdc.gov/nip.
********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5145a3.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5145.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.
----------------------------------------------------------
Back to Top
(4 of 11)
November 18, 2002
IAC WEBSITE ADDS INFORMATION ON STATE HEPATITIS A MANDATES AND ALSO PROVIDES
NEWEST CDC INFORMATION ON STATE CHILDHOOD VACCINATION REQUIREMENTS
The Immunization Action Coalition (IAC) has updated its "State Mandates on
Immunization and Vaccine-Preventable Disease" web pages. These pages now
include a page describing hepatitis A vaccine mandates and also incorporate
some of the pages found in the booklet "State Immunization Requirements
2001-2002," recently published by the Centers for Disease Control and
Prevention (CDC).
Hepatitis A Information
In developing the "Hepatitis A Vaccination Recommendations and Policies" web
page, IAC compiled information on hepatitis A vaccine mandates surveying all
50 states. To access the new web page, go to:
http://www.immunize.org/laws/hepa.htm
CDC Information
The updated information from CDC on state childhood vaccination requirements
is for the following vaccine-preventable diseases that IAC has selected to
include: diphtheria, tetanus, and pertussis (DTP); measles, mumps, and
rubella (MMR); polio; and Haemophilus influenzae type b (Hib). The
last time CDC published requirements for these diseases was for the 1998-99
school year.
In addition to posting these four updated childhood vaccination mandates and
the new hepatitis A mandates, IAC also compiles and continually updates
information on state vaccination requirements for hepatitis B, varicella,
and meningococcal disease.
To access IAC's updated state mandates web pages, go to:
http://www.immunize.org/laws/
----------------------------------------------------------
Back to Top
(5 of 11)
November 18, 2002
IAC UPDATES "VACCINE ADMINISTRATION RECORD FOR ADULTS" FOR MEDICAL CHARTS
The Immunization Action Coalition (IAC) has revised its "Vaccine
Administration Record for Adults," a one-page chart designed to help health
professionals keep track of an adult patient's immunization history.
The revised sheet has an added space to record information about the second
dose of pneumococcal polysaccharide vaccine (PPV23), which is recommended
for some high-risk patients. In addition, the columns for route of vaccine
administration and Vaccine Information Statements have been modified.
For an HTML version of the revised sheet, go to:
http://www.immunize.org/catg.d/p2023b.htm
For a camera-ready (PDF) copy of the sheet, go to:
http://www.immunize.org/catg.d/p2023b.pdf
----------------------------------------------------------
Back to Top
(6 of 11)
November 18, 2002
IAC UPDATES ITS "RELIABLE SOURCES OF IMMUNIZATION INFORMATION" EDUCATIONAL
SHEET
The Immunization Action Coalition (IAC) has added the address of its newest
website to the one-page educational sheet "Reliable Sources of Immunization
Information: Where To Go To Find Answers!"
The sheet describes several sources of valuable information that the public
and health professionals can access on the Web and by phone. Four book
titles are also provided.
For an HTML version of the revised educational sheet, go to:
http://www.immunize.org/catg.d/p4012.htm
For a camera-ready (PDF) copy of the sheet,
go to:
http://www.immunize.org/catg.d/p4012.pdf
To access IAC's newest website, "Vaccine Information for the Public and
Health Professionals," go to:
http://www.vaccineinformation.org/
----------------------------------------------------------
Back to Top
(7 of 11)
November 18, 2002
MMWR NOTIFIES READERS ABOUT ACIP'S SUPPLEMENTAL RECOMMENDATIONS FOR THE USE
OF ANTHRAX VACCINE
The Centers for Disease Control and Prevention (CDC) published a Notice to
Readers, "Use of Anthrax Vaccine in Response to Terrorism: Supplemental
Recommendations of the Advisory Committee on Immunization Practices," in the
November 15 issue of "Morbidity and Mortality Weekly Report" (MMWR). The
first paragraph of the notice follows, with the exception of one note.
**********************
In December 2000, the Advisory Committee on Immunization Practices (ACIP)
released its recommendations for using anthrax vaccine in the United States.
Because of recent terrorist attacks involving the intentional exposure of
U.S. civilians to Bacillus anthracis spores and concerns that the current
anthrax vaccine supply is limited, ACIP developed supplemental
recommendations on using anthrax vaccine in response to terrorism. These
recommendations supplement the previous ACIP statement in three areas: use
of anthrax vaccine for pre-exposure vaccination in the U.S. civilian
population, the prevention of anthrax by postexposure prophylaxis (PEP), and
recommendations for additional research related to using antimicrobial
agents and anthrax vaccine for preventing anthrax.
*******************************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5145a4.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5145.pdf
----------------------------------------------------------
Back to Top
(8 of 11)
November 18, 2002
FIRST ANNUAL EDITION! "IMMUNOFACTS" IS NOW AVAILABLE AS A BOUND VOLUME
The first annual, bound version of "ImmunoFacts: Vaccines & Immunologic
Drugs" by LTC John D. Grabenstein, RPh, PhD, is now available from the
publisher, Facts & Comparisons. Intended for hospitals, public health
programs, and institutions that handle frequent and diverse immunologics,
the bound version replaces the blue 3-ring, loose-leaf version. Annual
updated editions will be published each spring, beginning in 2003.
Following is a brief description of the book's content and format, excerpted
from the preface.
*************************
The goal of "ImmunoFacts: Vaccines & Immunologic Drugs" is to provide
comprehensive drug information about this specific category of drugs. The
format is intended to allow quick, reliable access to discrete pieces of
information, while also helping readers compare and contrast information for
similar products or uses.
"ImmunoFacts" brings together, for the first time in one volume, detailed
information about the pharmaceutic and pharmacologic characteristics of
immunologic drugs, along with authoritative recommendations for their use.
*************************
The 1,200-page book is available from the publisher for $69.95. To order
online, go to:
http://www.factsandcomparisons.com/ProdPage.asp?ID=129
For additional information, call (800) 223-0554.
To access the publisher's "ImmunoFacts" web page, go to:
http://www.immunofacts.com/
----------------------------------------------------------
Back to Top
(9 of 11)
November 18, 2002
NIAID RELEASES 20TH ANNIVERSARY EDITION OF "THE JORDAN REPORT" ON VACCINE
RESEARCH
Earlier this month, the National Institute of Allergy and Infectious
Diseases (NIAID) released "The Jordan Report 20th Anniversary: Accelerated
Development of Vaccines 2002." The report was prepared under the supervision
of NIAID, the Division of Microbiology and Infectious Diseases, and the
National Institutes of Health.
Forty-five vaccine experts and NIAID scientists produced this year's
300-page report with contributions from outside researchers. Two articles of
special interest include one written by William Jordan, MD, on the history
of vaccinology, and the other by Stanley A. Plotkin, MD, on the ten most
important discoveries in vaccinology in the past twenty years.
Other key topics in the report include the following: vaccines against
drug-resistant, emerging and re- merging diseases; public-private vaccine
research partnerships; and new vaccine technologies.
A NIAID press release dated November 6 announcing the publication of the
report reads in part:
***************************
Vaccines have become an increasingly important medical tool against a
variety of public health problems, both in the United States and abroad. To
inform policy-makers, researchers and the public about recent
accomplishments and future trends in vaccine research, the National
Institute of Allergy and Infectious Diseases (NIAID) today released a new
edition of its comprehensive vaccine report, "The Jordan Report 20th
Anniversary. . . ."
Besides describing the state of the science, this edition of The Jordan
Report reviews the last two decades and highlights important achievements in
the field of vaccinology. . . .
The report also includes expert perspectives on a variety of vaccine
research-related topics such as vaccine regulations, safety evaluations,
economic considerations and vaccine risk communication.
***************************
To access the report online, go to:
http://www.niaid.nih.gov/dmid/vaccines/jordan20/
To download a camera-ready (PDF) copy of the report, go to:
http://www.niaid.nih.gov/dmid/vaccines/jordan20/jordan20_2002.pdf
For further information or to order a free print copy of the report, call
(301) 496-5717.
----------------------------------------------------------
Back to Top
(10 of 11)
November 18, 2002
HEPATITIS FOUNDATION INTERNATIONAL LAUNCHES THE CALIFORNIA HEPATITIS
RESOURCE CENTER WEBSITE
On November 3, the Hepatitis Foundation International (HFI) announced the
launch of its new website--the California Hepatitis Resource Center. Funded
by the Centers for Disease Control and Prevention, the new site provides
health professionals, patients, caregivers, educators, legislators, and
members of the media with comprehensive information on all forms of viral
hepatitis.
According to Thelma King Thiel, HFI's Chairman and CEO, the point of
organizing a site specifically for California was to create a demonstration
project that other states can use as a template for developing their own
state-specific hepatitis sites.
To access the new site, go to:
http://www.hepatitisrcca.info/
For additional information, call (800) 891-0707.
----------------------------------------------------------
Back to Top
(11 of 11)
November 18, 2002
CDC REPORTS HUNDREDS DIED IN JULY-AUGUST INFLUENZA OUTBREAK IN MADAGASCAR
The Centers for Disease Control and Prevention (CDC) published "Influenza
Outbreak--Madagascar, July-August 2002" in the November 15 issue of
"Morbidity and Mortality Weekly Report" (MMWR).
Part of the press summary made available by CDC is reprinted below.
***********************
A large influenza outbreak occurred in southeastern Madagascar during July
and August with thousands of respiratory illnesses and hundreds of deaths
reported. The most affected persons were those living in remote highland
villages. Nearly all deaths occurred far away from healthcare facilities.
Madagascar is the world's 4th largest island country and one of the poorest
countries in the world. An investigation by a team from the World Health
Organization and CDC concluded that the outbreak was attributed to influenza
A (H3N2) viruses. The influenza virus strain associated with this outbreak
is similar to strains that have been circulating worldwide for several
years. This season's 2002-03 U.S. influenza vaccine includes a similar
strain to the one that caused this outbreak.
***********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5145a2.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5145.pdf
|
