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Issue Number 247            May 21, 2001


  1. CDC publishes article on hepatitis B vaccination for injection drug users
  2. CDC reports on syringe exchange programs in the United States
  3. May is National Hepatitis Awareness Month
  4. IAC'S hepatitis prevention programs website expands


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May 21, 2001

The Centers for Disease Control and Prevention (CDC), published the article "Hepatitis B Vaccination for Injection Drug Users--Pierce County, Washington, 2000" in the May 18, 2001, issue of "Morbidity and Mortality Weekly Report" (MMWR), an issue that focuses on public health and injection drug use.

This article reports on an outbreak of hepatitis B among injection drug users (IDUs) in Pierce County, Washington, in April 2000, and describes the successful implementation of a hepatitis B vaccination program for people at high risk for hepatitis B.

The Editorial Note states: 


This report describes the successful implementation of a hepatitis B vaccination program for IDUs and other high-risk persons that involved public health departments and community-based organizations and provided hepatitis B vaccine to approximately 1900 persons. Assuming that half of the estimated 6000 IDUs residing in Pierce County are susceptible to HBV infection, at least 20% of this population received one or more doses of vaccine during the first 8 months of the program. . . .

Relatively high vaccination coverage levels can be achieved among IDUs participating in harm reduction services such as syringe exchange programs. For example, pneumococcal and influenza vaccination was accepted by 86% of IDUs at a syringe exchange program in New York City. Offering hepatitis B vaccine at nontraditional sites such as syringe exchange programs and jails and providing modest monetary incentives can increase hepatitis B vaccination coverage among IDUs. Although the outbreak may have increased concern among IDUs about the risks for HBV infection, approximately 75% of IDUs who attended the vaccination clinics reported reasons other than awareness of the outbreak as their motivation for getting vaccinated. This finding suggests that hepatitis B vaccination for IDUs also could be successfully incorporated into syringe exchange programs in nonoutbreak settings. . . .

This report illustrates how hepatitis B vaccination programs targeted at IDUs can be implemented through collaborations between departments of health and corrections and community organizations and demonstrates the feasibility of vaccinating IDUs in various community settings. National programs to provide hepatitis B vaccine to high-risk persons are needed to apply these findings widely.


To obtain the complete text of this article online, go to:

To obtain the complete issue of this MMWR issue on public health and injection drug use, go to:

For information on how to obtain a free electronic subscription to the MMWR, see the information following story three below.

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May 21, 2001

CDC published "Update: Syringe Exchange Programs--United States, 1998" in the May 18, 2001, issue of MMWR. The article reports on a survey of 131 syringe exchange programs. The findings indicated growth in the number of cities with syringe exchange programs (SEPs) as well as in the number of programs that provide prevention services for injection drug users. According to the article's Editorial Note: "Many SEPs, particularly the largest programs, serve as community-based HIV prevention and health promotion centers for IDUs, including IDUs at high risk for bloodborne infections. SEPs also provide additional services (e.g., influenza and pneumococcal vaccinations). Hepatitis B vaccination at a SEP was an important part of the public health response to a hepatitis B outbreak among IDUs in Pierce County, Washington."

To read the full text of this article online, go to:

For information on how to obtain a free electronic subscription to the MMWR, see the information following story three below.

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May 21, 2001

CDC published "Notice to Readers: National Hepatitis Awareness Month--May 2001" in the May 18, 2001, issue of MMWR.

The full text of the notice is reprinted in full below:


May is National Hepatitis Awareness Month. Hepatitis A, B, and C are the most common types of viral hepatitis in the United States. Hepatitis A, a disease transmitted through the fecal-oral route, occurs in epidemics both nationwide and in communities. Children are often the reservoir for infection, and during epidemic years, the number of reported cases has reached 35,000. Hepatitis A vaccine is the best protection against hepatitis A virus infection. During the late 1990s, when hepatitis A vaccine became more widely used, the number of cases reached historic lows.

Hepatitis B and C are both bloodborne diseases transmitted when blood or body fluids from an infected person enter the body of a susceptible person. Both hepatitis B and C can cause chronic infection that can lead to cirrhosis and hepatocellular carcinoma. The number of new hepatitis B virus (HBV) infections per year has declined from approximately 450,000 during the 1980s to approximately 80,000 in 1998. Hepatitis B vaccine is the best protection against infection with HBV. The greatest decline in HBV infections has occurred among children and adolescents as the result of routine hepatitis B vaccination. The number of hepatitis C virus (HCV) infections per year declined from approximately 240,000 during the 1980s to approximately 40,000 in 1998. No vaccine exists to prevent HCV infection. The infection is transmitted most often by injection drug use. Transfusion-associated cases occurred before blood donor screening, but currently HCV infection occurs in less than one per million transfused units of blood. Additional information about hepatitis A, B, and C is available from the CDC hepatitis hotline,  telephone (888) 443-7232 or from CDC's Division of Viral Hepatitis at:


To read the full text of this notice online, go to:

To obtain a free electronic subscription to the "Morbidity and Mortality Weekly Report" (MMWR), visit CDC's MMWR website at: 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 arrive automatically by e-mail.

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May 21, 2001

Hepatitis Prevention Programs-- a website of the Immunization Action Coalition (IAC) that showcases programs to prevent hepatitis A, B, and C in communities at risk. Recent updates to the site include new information on hepatitis prevention programs in Florida, Massachusetts, Minnesota, and Montana. To explore information on these programs, visit the following links:

Florida Department of Health:

Massachusetts Department of Public Health:

Minnesota Department of Health:

Montana Department of Public Health and Human Services:

Visit IAC's Hepatitis Prevention Programs website at to explore what 41 featured programs are doing to prevent viral hepatitis. Click on the "Tell us about your program" link on the left-hand navigation bar to provide information about your innovative hepatitis prevention program!  

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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