Issue Number 305            April 8, 2002


  1. New on the Web: Supplement on vaccines across the life span
  2. Article on 17-year surveillance of acute hepatitis B identifies significant gaps in vaccination
  3. Revisions! Download the most current versions of two IAC forms
  4. Summit to Eliminate Racial and Ethnic Disparities in Health is set for July 10-12 in Washington
  5. CDC publishes influenza recap for 2001-2002 season so far
  6. CDC reports on suspected cutaneous anthrax in Texas lab worker


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April 8, 2002

"For years I have wished for a practical resource on immunizations across the life span written by family physicians for their colleagues," says Richard K. Zimmerman, M.D., M.P.H., in "A Red Book of Our Own," his introduction to a major project of the Group on Immunization Education of the Society of Teachers of Family Medicine (STFM). "In Vaccines Across the Life Span, 2001, we now have the comprehensive resource I've always wanted."

"Vaccines Across the Life Span, 2001," funded by a grant from the Centers for Disease Control and Prevention (CDC), is a five-article document that first appeared as a supplement to the October 2001 issue of the Journal of Family Practice (vol. 50, no. 10). This invaluable resource is now available as a link on the website of STFM's immunization education group.

The following excerpt from "A Red Book of Our Own" (footnotes excluded) describes the supplement's components:


The first article, "Routine Vaccines Across the Life Span, 2001," addresses vaccines that have indications based on age and covers the disease burden, rationale for vaccination, vaccine efficacy, adverse reactions, and specific vaccine recommendations. Pictures of vaccine-preventable diseases are included in the color centerfold of the supplement. The second article, "Vaccines for Persons at  High Risk Because of Medical Conditions, Occupation, Environment, or Lifestyle, 2001," addresses indications based on high-risk situations, including pregnancy and health care workers. The third article, "Vaccine Schedules and Procedures, 2001," addresses the practical issues of vaccination including catch-up schedules, contraindications, administration routes, storage, and keeping current with changing recommendations. The fourth article, "Overcoming Barriers to Immunization," reviews barriers and strategies to overcome them, and includes a summary of what is proven to work. The fifth article, "Communicating the Benefits and Risks of Vaccines," addresses the important issue of vaccine safety and contains tables comparing the risks of the disease with the benefits and risks of vaccination; the reader will find these tables useful in dealing with parents who are concerned about vaccine safety.


To obtain a copy of "Vaccines Across the Life Span, 2001" or any of its articles, go to:

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April 8, 2002

On March 15, 2002, the Journal of Infectious Diseases published "Incidence and Risk Factors for Acute Hepatitis B in the United States, 1982-1998: Implications for Vaccination Programs" (vol. 185, no. 6: 713-719). The abstract states, "Over half of all patients (55%) reported treatment for a sexually transmitted disease (STD) or incarceration in a prison or jail prior to their illness, suggesting that more than half of the acute hepatitis B cases might have been prevented through routine hepatitis B immunization in STD clinics and correctional health care programs." According to the article, only 25% of STD clinics currently offer hepatitis B vaccination.

The article was written by Susan T. Goldstein, Miriam J. Alter, Ian T. Williams, Linda A. Moyer, all from the Division of Viral Hepatitis, National Center for Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; Franklyn N. Judson, Denver Department of Health and Hospitals, Denver, Colorado; Karen Mottram, Tacoma-Pierce County Department of Health, Tacoma, Washington; Michael Fleenor, Jefferson County Department of Health, Birmingham, Alabama; Patricia L. Ryder, Pinellas County Department of Health, St. Petersburg, Florida; and Harold S. Margolis, Division of Viral Hepatitis, CDC.

The authors wrote in the Discussion section, in part (footnotes excluded):


Of the patients in this study, 76.4% had risk behaviors or characteristics, either during the incubation period or over their lifetime, that placed them in a group for which hepatitis B vaccination is recommended. . . .

There are longstanding recommendations to vaccinate adults at increased risk for HBV infection. However, nationwide programs do not exist that integrate hepatitis B immunization into programs that serve high-risk adults in STD clinics, correctional facilities, drug treatment programs, or HIV/AIDS counseling and testing programs. Over the past decade, studies have shown that, when cost is not a barrier, 46% to >90% of persons in these settings received the first hepatitis B vaccine dose and 31%- 9% of those who received the first dose completed the 3-dose series. . . .

Although a number of US states and counties provide hepatitis B vaccine to limited groups of high-risk adults, transmission of HBV cannot be eliminated until there is a nationwide program to vaccinate adults at increased risk for HBV infection, and hepatitis B-related liver cancer and chronic liver disease will remain elevated for decades.


To read the abstract of this article, go to:

The entire article is currently available online only to registered subscribers of the Journal of Infectious Diseases Electronic Edition. To learn about becoming a registered subscriber, go to:

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April 8, 2002

The Immunization Action Coalition (IAC) has revised its "Vaccine Administration Record for Adults," a one-page form intended to be kept in patient medical charts. Three lines were added for doses of the hepatitis A and B combination vaccine, while Lyme disease vaccine was removed.

On our "Patient Notification Letter Regarding Hepatitis B Test Results," we have added a new result category to communicate to patients: "resolving hepatitis B virus infection." The description reads: "Your results show that you were recently infected with hepatitis B virus, but that your infection is resolving. You are no longer infectious to others."

The other result categories are "susceptible," "immune due to past infection," "immune due to vaccination," "acutely infected with hepatitis B," "chronically infected with hepatitis B virus," and "indeterminate results."

In addition to the new result category, we've made a functional change to the letter. Because the content of this notification letter is fairly standard, we have removed text at the top about adapting the letter for  your clinic's use. Of course, you can still create your own version if necessary, but now you also can, if you prefer, simply print and fill out a hard copy of IAC's model letter.

To obtain a copy of "Vaccine Administration Record for Adults," go to:

To obtain a copy of "Patient Notification Letter Regarding Hepatitis B Test Results," go to:

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April 8, 2002

The U.S. Department of Health and Human Services Office of Minority Health and Office of Public Health and Science will sponsor the National Leadership Summit to Eliminate Racial and Ethnic Disparities in Health July 10-12 at the Hilton Hotel and Towers in Washington, D.C.

The Summit's theme is "Closing the Health Gap," which will be explored via three cross-cutting issues: access to care, health providers, and the role of data. The purpose of the Summit is "to draw national attention to the existence of health disparities and to innovative approaches being implemented in our communities at the local, state, national, federal, and tribal levels to address these disparities."

The registration fee for the Summit is $150.00. On-site registration will not be available.

For more information on the Summit, go to:

To register for the Summit online, go to:

Hilton room rates are $119 for a single and $139 for a double. For reservations, call (888) 324-4586.

You may also contact Matthew Murguia, Division of Information and Education, Office of Minority Health, by email at or phone at (301) 443-3325.

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April 8, 2002

On April 5, 2002, the Centers for Disease Control and Prevention (CDC) published "Update: Influenza Activity--United States, 2001-02 Season" in the Morbidity and Mortality Weekly Report (MMWR). According to the editorial note, "Influenza activity in the United States during the current season increased steadily during December-January, peaked in February, and is declining nationwide. . . . In recent weeks, influenza B virus activity has increased in certain areas of the country, and both influenza A and B viruses might continue to circulate during April."

To obtain the complete text of the update 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 email.

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April 8, 2002

On April 5, 2002, the Centers for Disease Control and Prevention (CDC) published "Suspected Cutaneous Anthrax in a Laboratory Worker--Texas, 2002" in the Morbidity and Mortality Weekly Report (MMWR). The male laboratory worker became ill in early March and spent four days in the hospital after becoming infected from B. anthracis isolates (most likely on the surface of laboratory vials) that entered a shaving cut on his jaw. Neither this worker nor any of his colleagues (approximately 40 in all) had received anthrax vaccine.

According to the editorial note, "This suspected case of laboratory-acquired cutaneous anthrax highlights the need for anthrax vaccination, in addition to standard laboratory safety procedures, for laboratorians who work routinely with B. anthracis specimens."

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

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

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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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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