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Issue Number 264            August 3, 2001


  1. CDC publishes National Immunization Survey data from the year 2000
  2. CDC reports on fever, jaundice, and multiple organ system failure associated with yellow fever vaccination
  3. CDC'S Immunization Update 2001 satellite broadcast set for September 20
  4. FDA Consumer and Consumer Reports examine vaccine safety
  5. CDC publishes article on progress toward laboratory containment of wild polioviruses


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August 3, 2001

The Centers for Disease Control and Prevention (CDC) published "National, State, and Urban Area Vaccination Coverage Levels Among Children Aged 19-35 Months--United States, 2000" in the August 3, 2001, issue of Morbidity and Mortality Weekly Report (MMWR). This article reported the results of the National Immunization Survey, which analyzes vaccination levels among young children in the 50 states and 28 selected urban areas. 

According to the article: "findings indicate that, during 2000, significant increases were reported on the national level of vaccination coverage with varicella and hepatitis B, and small but statistically significant decreases were reported in coverage with diphtheria, and tetanus toxoid, and pertussis vaccine. Coverage with poliovirus vaccine, Haemophilus influenzae type b vaccine, and measles-mumps-rubella vaccine [was] not significantly different from 1999." CDC stressed that to maximize immunization coverage among preschoolers, vaccine providers should continue to use strategies such as reminders and recalls.

During 2000, national vaccination coverage changed as follows:

  • Coverage with three doses of any diphtheria and tetanus toxoids and pertussis vaccine declined from 95.9 percent in 1999 to 94.1 percent.
  • Coverage with four doses of any diphtheria and tetanus toxoids and pertussis vaccine declined from 83.3 percent in 1999 to 81.7 percent.
  • Coverage changes were not significantly different from 1999 to 2000 for three doses of oral poliovirus vaccine (from 89.6 percent to 89.5 percent), three doses of Haemophilus influenzae type b vaccine (from 93.5 percent to 93.4 percent), and one dose of measles-mumps-rubella vaccine (from 91.5 percent to 90.5 percent).
  • Coverage with one dose of varicella vaccine increased from 57.5 percent in 1999 to 67.8 percent.
  • Coverage with three doses of hepatitis B vaccine increased from 88.1 percent in 1999 to 90.3 percent.
  • Coverage with combined vaccination series 4:3:1 (DTaP4, OPV3, and one dose of measles-containing vaccine) fell slightly from 79.9 percent to 77.6 percent.
  • Coverage with combined vaccination series 4:3:1:3 (4:3:1 series and three or more doses of Hib) fell slightly from 78.4 percent to 76.2 percent.
  • Coverage with combined vaccination series 4:3:1:3:3 (4:3:1:3 series and three or more doses of HepB) decreased from 73.2 percent to 72.8 percent.

As in previous years, vaccination coverage fluctuated significantly between states. North Carolina had the highest vaccination rate for the 4:3:1 series (87.6 percent), while Texas had the lowest (69.5 percent).

The Editorial Note emphasizes that vigilance is needed to maintain high levels of vaccination. It says: "State and local vaccination programs and public and private vaccination providers should continue to use reminders and recalls, vaccinate at every opportunity, and administer multiple vaccinations when indicated to ensure the highest possible coverage among preschool-aged children."

To obtain a copy of this article, go to:

To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:

To find out how to obtain a free electronic subscription to the MMWR, see the information following story five below.

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August 3, 2001

CDC published a Notice to Readers titled "Fever, Jaundice, and Multiple Organ System Failure Associated With 17D-Derived Yellow Fever Vaccination, 1996--2001" in the August 3, 2001, issue of the MMWR.

This notice reports on seven cases of multiple organ system failure (MOSF) in recipients of 17D-derived yellow fever vaccine that were reported at the most recent meeting of the Advisory Committee on Immunization Practices (ACIP). In response, ACIP formed a working group to review the cases, assess the potential risks involved, and consider revising the 1990 yellow fever vaccination recommendations. The notice also describes an enhanced  surveillance program designed to refine risk estimates and improve documentation of MOSF potentially associated with yellow fever vaccination.

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

To find out how to obtain a free electronic subscription to the MMWR, see the information following story five below.

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August 2, 2001

The Centers for Disease Control and Prevention (CDC) has scheduled Immunization Update 2001, an interactive satellite videoconference, for September 20, 2001. The broadcast will air twice, from 9 to 11:30 a.m. and again from 12 to 2:30 p.m., Eastern Time.

The program will offer the latest immunization recommendations and will also feature a question-and-answer session via toll-free telephone with medical epidemiologists William Atkinson, MD, MPH, and Raymond Strikas, MD, and nurse educator Donna Weaver, MN, RN, all from CDC's National Immunization Program. Anticipated topics include pneumococcal conjugate vaccine, influenza vaccine, the national shortage of tetanus and diphtheria toxoids, meningococcal vaccine, hepatitis B vaccine for adolescents, globa  polio eradication, and recent vaccine safety issues.

The target audience includes health professionals such as physicians, nurses, physician assistants, nurse practitioners, pharmacists, medical students, and others who provide vaccination and vaccine information. Continuing education credit will be offered.

For more information on registration and the technical specifications for the broadcast, go to CDC's website at: or contact your state or county immunization program. A list of state immunization program satellite broadcast distance learning coordinators is available on the website of CDC's National Immunization Program at:

For questions about registration, call (800) 418-7246 (800-41-TRAIN).

For questions about the program content of this broadcast, contact Craig Wilkins at (404) 639-8799 or email

For a detailed list of additional upcoming immunization and hepatitis conferences and events, visit IAC's "Calendar of Events" at:

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August 3, 2001

New articles in the current issues of FDA Consumer and Consumer Reports examine vaccine safety issues and encourage the public to arm themselves with facts about the benefits and risks of vaccination.

The July/August 2001 issue of FDA Consumer, a publication of the Food and Drug Administration aimed at the public, offers the article "Understanding Vaccine Safety: Immunization Remains Our Best Defense Against Deadly Diseases," which describes in plain language how vaccines work and explains the roles of the FDA's Center for Biologics Evaluation and Research (CBER), CDC, and the National Institutes of Health in ensuring vaccine safety. The article also discusses the Vaccine Adverse Event Reporting System (VAERS), which is jointly operated by FDA and CDC, as well as the National Vaccine Injury Compensation Program.

To obtain the article online, go to:

The August 2001 issue of Consumer Reports includes "Vaccines: An Issue of Trust," Part One of a two-part report that examines anti-vaccination arguments and offers recommendations on how consumers can best benefit from immunizations while minimizing any risks. The article recommends that parents become informed and ask for the safest vaccines, tell the doctor if their child has significant medical symptoms at the time of vaccination, and find out what post-vaccination symptoms are normal and which require medical attention.

Consumer Reports recommends the following sources of credible vaccine information:

To obtain the article online, go to: and under the blue bar titled "Current Issue," click on "Feature Report: Vaccine safety."

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August 3, 2001

The Centers for Disease Control and Prevention published an article titled "Progress Toward Laboratory Containment of Wild Polioviruses, June 2001" in the July 27, 2001, issue of the MMWR. The report describes the World Health Organization's global plan for containing laboratory wild polioviruses and summarizes the steps being taken toward its implementation.

To obtain the full text of this article, go to:

To obtain a free electronic subscription to 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.

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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