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Issue Number 138            February 14, 2000


  1. CDC publishes article on vaccination coverage among adolescents in San Diego
  2. National Medical Association launches physician education program, "Immunization: A Family Affair"


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February 11, 2000

The Centers for Disease Control and Prevention (CDC) published an article titled "Vaccination Coverage Among Adolescents 1 Year Before the Institution of a Seventh Grade School Entry Vaccination Requirement -- San Diego, California, 1998" in the February 11, 2000, issue of the MMWR. This report summarizes the findings from a San Diego County Health Department survey, which indicate that most fifth and sixth graders lacked required and recommended vaccinations.

The article begins: "In 1996, the Advisory Committee on Immunization Practices, the American Academy of Pediatrics, the American Association of Family Physicians, and the American Medical Association recommended routine health-care visits for children aged 11-12 years, emphasizing vaccination with hepatitis B vaccine; measles, mumps, and rubella vaccine (MMR); tetanus and diphtheria toxoids (Td); and varicella vaccine. Because no national data exist regarding vaccination coverage among adolescents, the impact of these recommendations is unknown..."

The "Editorial Note" reads in part: "This is the first study that has assessed population-based vaccination coverage of adolescents. The findings suggest that in the absence of a school requirement, most adolescents lack documentation of recommended vaccinations. Reliable estimates of vaccination coverage among adolescents are difficult to obtain... New methods to accurately measure adolescent vaccination coverage are needed so that coverage levels can be assessed reliably, the impact of vaccination programs for adolescents measured, and overvaccination of adolescents resulting from incomplete documentation avoided.

"School vaccination requirements are an effective means of increasing vaccination coverage and preventing disease among children and adolescents. Emphasis has been placed on hepatitis B vaccination requirements because of the substantial disease burden of hepatitis B among adolescents and young adults. Hepatitis B vaccination requirements for middle school entry have been implemented in 14 states and the District of Columbia.  In California, 477,584 seventh graders were subject to the 1999 seventh grade vaccination requirement of receipt of three doses of hepatitis B vaccine. An estimated 20,059 hepatitis B virus (HBV) infections and 168 HBV-related chronic liver disease deaths expected during the lifetime of this cohort may be averted if each seventh grader received the required three doses of hepatitis B vaccine."

To obtain the full text version (HTML format) of this MMWR article, go to:

For more information about recommended immunizations for adolescents, see "Are you 11-19 years old? Then you need to be vaccinated against these serious diseases!" from the Immunization Action Coalition.

For web text format (HTML), visit:
For a camera-ready copy (PDF format), visit:

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:

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February 14, 2000

The National Medical Association (NMA) has been awarded an educational grant from the Health Care Financing Administration to provide adult immunization education and information to providers and address key immunization issues among African Americans and other underserved  populations. The first educational program will be held in Houston, Texas, on February 17, 2000. A total of eleven adult immunization symposia will be held throughout the United States in 2000. NMA is a professional association that represents the interests of 25,000 Black physicians in the United States, Puerto Rico, and the Caribbean.

For more information on registration for the February 17th meeting or for future meetings, contact Yvonne Fuller, Director, Maternal and Child Health Division at NMA at (202) 347-1895, ext. 263 or ext. 264.

About IZ Express

IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of and do not necessarily represent the official views of CDC.

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Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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