Issue Number 279            October 29, 2001


  1. ACIP votes on birth dose of hepatitis B vaccine
  2. Five new hepatitis prevention programs added to IAC's Hepatitis Programs website
  3. HFI offers video as part of Partners in Liver Wellness Program
  4. Slightly revised! "Community-Based Immunization Clinic Supplies Checklist"
  5. CDC publishes update on bioterrorism-related anthrax


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October 29, 2001

On October 16, 2001, the Advisory Committee on Immunization Practices (ACIP) voted to change its recommendation regarding the timing of the first dose of hepatitis B vaccination for infants of low-risk women. ACIP voted to recommend a birth dose of hepatitis B vaccine for all infants, which means that the first dose of hepatitis B vaccine should be administered between birth  and hospital discharge. Only for infants of mothers whose HBsAg test is assured to be negative does ACIP now consider allowing administration of the first dose as late as 2 months of age. 

Since 1991, ACIP has offered two recommended infant hepatitis B vaccination schedules and each had equal weight. In the first option, the first dose is given prior to hospital discharge; in the second option, the first dose is  given anytime up to 2 months of age. The new recommendation will formally favor the first option.

The ACIP recommendation will now agree with American Academy of Pediatrics (AAP) policy, which since 1992 has been to recommend a birth  dose for all infants and to refer to an alternative schedule beginning with a dose at 2 months as "acceptable." (See AAP's position as originally stated in "Universal Hepatitis B Immunization," Pediatrics, vol. 89, no. 4, April 1992 and as reiterated in "Updates on Timing of Hepatitis B Vaccination for Premature Infants and for Children with Lapsed Immunization," Pediatrics, vol. 94, no. 3, September 1994, as well as in the 1997 and 2000 Red Books.)

The ACIP has not changed its hepatitis B vaccination recommendation for infants of HBsAg-positive mothers and infants of mothers whose HBsAg status  at the time of delivery is unknown. These infants should be given HBIG and hepatitis B vaccine or just hepatitis B vaccine, respectively, within 12 hours of birth, not just anytime prior to hospital discharge.

The ACIP vote will become an official recommendation upon publication in the Recommended Childhood Immunization Schedule for 2002, which will appear in the Morbidity and Mortality Weekly Report and elsewhere in January.

IAC actively supports the birth dose of hepatitis B vaccine for all infants. Please see the Birth Dose page on our website at:

To see the results of IAC's recent survey of state and other CDC project hepatitis B coordinators, including statements describing experiences with  failures in the current system and cases of harm resulting from missed birth doses, go to:

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October 29, 2001

IAC's Hepatitis Programs website continues to expand! The website provides names and links to 55 innovative prevention programs from around the nation as well as links to many resources about viral hepatitis.

We have recently added the following five programs:

Illinois Health Education Consortium (APIA program)

Take 3 Hep B (Hawaii school program)

San Francisco City Clinic (STD clinic)

Oakland City Children's Village (School program, STD clinics, Juvenile corrections)

Illinois Department of Public Health (STD clinics, MSM, IDU)

To see IAC's Hepatitis Programs website home page, go to:

Remember: We rely on members and other readers for current, accurate information about new or already existing programs. Please inform us of any other programs that should be included on IAC's Hepatitis Programs website when visiting the website or email

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October 29, 2001

The Hepatitis Foundation International (HFI) now offers a new 3D video titled "The Invisible Threat," which promotes liver wellness and prevention of bloodborne pathogens. Cost is $50.

"The Invisible Threat" is one component of HFI's Partners in Liver Wellness Program. Partners in Wellness aims to heighten awareness of hepatitis issues by providing educational resources and ideas for implementing community programs.

For further information or to order HFI materials, call (800) 891-0707 or visit HFI's website:

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October 29, 2001

An astute reader alerted us to a very basic yet important omission in the "Emergency Kit" section of the "Community-Based Immunization Clinic Supplies Checklist": a sphygmomanometer. We have added this instrument to the checklist. 

Thanks to Cathy Schellhase, director of nursing with the Immunization Program in Los Angeles County, California, for catching this omission and contacting us about it in the spirit of professional camaraderie! We are always  happy to refine IAC materials and take the opportunity to re-announce them.

To obtain a camera-ready (PDF format) copy of "Community-Based Immunization Clinic Supplies Checklist," go to:

To view or print an unformatted copy of the checklist, if you cannot download PDF files, go to:

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October 29, 2001

CDC published "Update: Investigation of Bioterrorism-Related Anthrax and Interim Guidelines for Exposure Management and Antimicrobial Therapy, October 2001" in the October 26, 2001, issue of Morbidity and Mortality Weekly Report (MMWR). The opening statement reads as follows:

Since October 3, 2001, CDC and state and local public health authorities have been investigating cases of bioterrorism-related anthrax. This report updates previous findings, provides new information on case investigations in two additional areas, presents the susceptibility patterns of Bacillus anthracis isolates, and provides interim recommendations for managing potential threats and exposures and for treating anthrax.

As of October 24, investigations in the District of Columbia (DC), Florida, New Jersey, New York City (NYC), Maryland, Pennsylvania, and Virginia have identified 15 (11 confirmed and four suspected) cases of anthrax according to the CDC surveillance case definition. Seven of the 15 cases were inhalational  anthrax and eight were cutaneous. . . .Six cases were identified in employees of media companies; one was a 7-month-old infant who visited a media company; and eight cases are consistent with exposures along the postal route of letters known to be contaminated with B. anthracis spores in New Jersey and DC.

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

To obtain a camera-ready (PDF format) copy of this issue of MMWR, 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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Editorial Information

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