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Issue Number 281            November 12, 2001


  1. CDC revises official booklet on Vaccine Information Statements (VISs)
  2. CDC publishes update on bioterrorism-related anthrax and notice to readers on symptoms
  3. Healthy People 2010 documents now available on CD-ROM
  4. CDC reports on campaign to vaccinate against rubella and measles in Costa Rica
  5. Free! Copies of Needle Tips (Spring 2001 issue) available


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November 12, 2001

On October 1, 2001, the Centers for Disease Control (CDC) released the latest edition of its official VIS booklet for providers, "Vaccine Information Statements: What You Need to Know."

The booklet covers VIS fundamentals (what, who, why, when which); practical guidelines; questions and answers; legal issues; VIS instructions (also revised, see IAC Express #280); and camera-ready copies of current VISs in English.

FYI: The PDF format of the entire publication described below is a very large file and some printers are unable to print a file of this size. For some helpful tips on downloading and printing PDF files, go to:

To obtain a complete copy of "Vaccine Information Statements: What You Need to Know," call CDC at (800) 232-2522 or go to the VIS page on IAC's website for a camera-ready (PDF format) copy:

To obtain just the guidelines and instructions but not the VISs, go to:

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November 12, 2001

CDC published two anthrax articles in the November 9, 2001, issue of Morbidity and Mortality Weekly Report: "Update: Investigation of Bioterrorism-related Anthrax" and "Notice to Readers: Considerations for Distinguishing Influenza-like Illness from Inhalational Anthrax."

The Editorial Note to "Update: Investigation of Bioterrorism-related Anthrax" reads in part as follows:

Since the last report, one new case of confirmed cutaneous anthrax has been identified in a media company employee resulting from exposure to a  previously known contaminated letter. The probable source of exposure for two cases reported last week (one cutaneous and one inhalational) has yet to be determined. Although these two cases ultimately might be attributed to letter  handling, the lack of a discernable link to previous cases or workplaces raises the possibility of new routes of exposure or new target populations.

Since October 8, approximately 32,000 persons with potential exposure to B. anthracis in FL, NJ, NYC, and DC have initiated antimicrobial prophylaxis to prevent anthrax infection, and for approximately 5,000 persons, a 60-day course of antibiotics has been recommended. . . .CDC and state and local public health agencies are continuing epidemiologic and laboratory  investigations of bioterrorism-related anthrax. Even without confirmed cases of anthrax, state and local health departments have responded to public concerns and have applied substantial personnel and laboratory resources to address anthrax issues in recent weeks. . . . Because new cases of anthrax may occur, public health authorities and clinicians should remain vigilant.

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

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

The Notice to Readers, "Considerations for Distinguishing Influenza-like  Illness from Inhalational Anthrax," reads in part as follows:

CDC has issued guidelines on the evaluation of persons with a history of exposure to Bacillus anthracis spores or who have an occupational or environmental risk for anthrax exposure. This notice describes the clinical  evaluation of persons who are not known to be at increased risk for anthrax  but who have symptoms of influenza-like illness (ILI). Clinicians evaluating  persons with ILI should consider a combination of epidemiologic, clinical, and, if indicated, laboratory and radiographic test results to evaluate the likelihood that inhalational anthrax is the basis for ILI symptoms.

ILI is a nonspecific respiratory illness characterized by fever, fatigue, cough, and other symptoms. The majority of ILI cases [are] not caused by influenza but by other viruses. . . . Yearly, adults and children can average one to three  and three to six ILI, respectively. . . .Nasal congestion and rhinorrhea are features of most ILI cases not associated with anthrax.

To obtain the complete text of this Notice 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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November 12, 2001

The Healthy People documents released in November 2000 have been compiled on a CD-ROM that has been tested in six web browsers and found to be virtually crash-free, according to the CD-ROM liner notes.

Healthy People is a national initiative of the U.S. Department of Health and Human Services that brings together national, state, and local organizations; businesses; communities; and individuals to improve the health of all  Americans, eliminate disparities in health, and increase both years and quality of life. The initiative includes immunization and infectious disease objectives, which have been expanded since Healthy People 2000.

"Healthy People 2010 CD-ROM" includes electronic files (HTML, PDF, MS Word, RTF) of Understanding and Improving Health, Healthy People 2010, and Tracking Healthy People 2010. When ordering the CD-ROM, reference GPO stock no. 017-001-00549-5. Cost is $19. 

To purchase a copy of the CD-ROM, contact the U.S. Government Printing Office by phone at (202) 512-1800 or mail at:

U.S. Government Printing Office
Superintendent of Documents
P.O. Box 371954
Pittsburgh, PA 15250-7954

To access all of the CD-ROM files online and to learn more about Healthy People 2010, go to:

To view just the Healthy People 2010 text on immunization under "Leading Health Indicators," go to:

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November 12, 2001

On November 9, 2001, the Centers for Disease Control (CDC) published "Nationwide Campaign for Vaccination of Adults against Rubella and Measles--Costa Rica, 2001" in Morbidity and Mortality Weekly Report (MMWR).

A large rubella outbreak occurred in Costa Rica in 1999, and in 2001, a nationwide vaccination campaign commenced, reaching approximately 1.6 million people. The report highlights "successful aspects of the campaign," including house-to-house vaccination teams.

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:

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November 12, 2001

The Immunization Action Coalition (IAC) is giving away bulk copies (up to 200 per request) of the Spring issue of Needle Tips to make room for our new Fall 2001 issue.

If you have an immunization conference or an educational program coming up for health professionals, this is an excellent item to distribute.

Because supplies are limited, it's best to make your request right away. The free copies go quickly.

To request copies, fill out the online form on IAC's website:

You will be asked to supply the following information:

  1. the number of copies you want (maximum 200)
  2. a description of how you plan to use the copies
  3. your name and complete contact information, including mailing address, telephone number, and email address 

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.

IZ Express Disclaimer
ISSN 2771-8085

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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