Issue Number 572            January 3, 2006


  1. New: ACIP releases hepatitis B recommendations for infants, children, and adolescents
  2. Net conference on new hepatitis B recommendations is scheduled for February 2; register by January 31
  3. Registration opens January 19 for CDC's satellite broadcast on Epidemiology & Prevention of Vaccine-Preventable Diseases
  4. CDC reports on 2001-03 pertussis surveillance data
  5. World Health Organization reports on pandemic influenza now available online
  6. Updated: IAC revises "It's federal law! You must give your patients current Vaccine Information Statements (VISs)"
  7. Russian-language VISs for influenza and meningococcal vaccines are revised
  8. January 10 teleconference to offer a preview and update on the National Conference on Immunization Coalitions


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ABBREVIATIONS: AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NIP, National Immunization Program; VIS, Vaccine Information Statement; VPD, vaccine-preventable disease; WHO, World Health Organization.

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January 3, 2006

On December 23, 2005, CDC published "A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP) Part 1: Immunization of Infants, Children, and Adolescents" in the MMWR Recommendations and Reports. The new recommendations are the first major update of the immunization strategy to eliminate hepatitis B virus in the United States since 1991.

The summary to the recommendations is reprinted below.


This report is the first of a two-part statement from the Advisory Committee on Immunization Practices (ACIP) that updates the strategy to eliminate hepatitis B virus (HBV) transmission in the United States. The report provides updated recommendations to improve prevention of perinatal and early childhood HBV transmission, including implementation of universal infant vaccination beginning at birth, and to increase vaccine coverage among previously unvaccinated children and adolescents. Strategies to enhance implementation of the recommendations include (1) establishing standing orders for administration of hepatitis B vaccination beginning at birth; (2) instituting delivery hospital policies and procedures and case management programs to improve identification of and administration of immunoprophylaxis to infants born to mothers who are hepatitis B surface antigen (HBsAg) positive and to mothers with unknown HBsAg status at the time of delivery; and (3) implementing vaccination record reviews for all children aged 11-12 years and children and adolescents aged [younger than] 19 years who were born in countries with intermediate and high levels of HBV endemicity, adopting hepatitis B vaccine requirements for school entry, and integrating hepatitis B vaccination services into settings that serve adolescents. The second part of the ACIP statement, which will include updated recommendations and strategies to increase hepatitis B vaccination of adults, will be published separately.


To access a web-text (HTML) version of the recommendations, go to:

To access a ready-to-print (PDF) version them, go to:

NOTE: The PDF version includes a free CDC-sponsored education activity that can be submitted electronically or by fax or U.S. mail for CME, CEU, or CNE credit. Simply read the recommendations, answer the questions at the end, and follow instructions for submitting your answers.

To receive a FREE electronic subscription to MMWR (which includes new ACIP statements), go to:

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January 3, 2006

NIP and the Division of Viral Hepatitis have scheduled a one-hour net conference for 12 noon ET February 2. Titled New ACIP Recommendations: Prevention of Perinatal and Childhood Hepatitis B Infections, the conference is intended for hospital obstetrical and neonatal staff, prenatal care providers, professional organizations involved in perinatal care, and public health staff. For additional conference information, go to:

The conference requires pre-registration, as space is limited. Registration will close when the course is full or on January 31 (midnight ET). To register for the conference, go to:

The program will combine a telephone audio conference and simultaneous online visual content. Participants can join the Q&A session by telephone or Internet. For instructions and system requirements, go to:

For additional information, go to:

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January 3, 2006

The CDC website now has updated information on the satellite broadcast of Epidemiology & Prevention of Vaccine-Preventable Diseases, a live interactive program offered by NIP. Online registration for continuing education credit will open on January 19 (details are at the end of this article).

Presented in four sessions, the course will be held on consecutive Thursdays: February 9, 16, and 23, and March 2. All sessions will be broadcast from 12 noon ET to 3:30PM ET.

The content of the four sessions is outlined below:

  • Session One: principles of vaccination; general recommendations on immunization; and vaccine storage, handling, and administration
  • Session Two: pertussis, pneumococcal disease (childhood), polio, and Hib
  • Session Three: measles, rubella, varicella, and meningococcal disease
  • Session Four: hepatitis B, hepatitis A, influenza, and pneumococcal disease (adult)

The faculty: Donna Weaver, RN, MN; Judy Schmidt, RN, EdD; Andrew Kroger, MD, MPH; and William Atkinson, MD, MPH. All are with NIP; additional presenters will include other CDC experts.

For comprehensive course information, including online registration information, go to:

If you have registration questions, email or phone (800) 418-7246. For other questions, email

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January 3, 2006

On December 23, 2005, MMWR published "Pertussis--United States, 2001-2003." Portions of the article are reprinted below.


[From the article text]
Pertussis is a highly contagious, vaccine-preventable bacterial illness characterized by paroxysmal cough, posttussive vomiting, and inspiratory whoop. Pertussis also can occur as a mild or moderate cough illness in persons who are partially immune. In the United States, most hospitalizations and nearly all deaths from pertussis are reported in infants aged [younger than] 6 months, but substantial morbidity does occur in other age groups. Infant/childhood vaccination has contributed to a reduction of more than 90% in pertussis-related morbidity and mortality since the early 1940s in the United States. Estimates of childhood vaccination coverage with 3 [or more] doses of pertussis-containing vaccine have exceeded 90% since 1994; however, reported pertussis cases increased from a historic low of 1,010 in 1976 to 11,647 cases in 2003. A substantial increase in reported cases has occurred among adolescents, who become susceptible to pertussis approximately 6-10 years after childhood vaccination. Recently, booster vaccines for adolescents and adults combining pertussis antigens with tetanus and diphtheria toxoids (Tdap) were approved by the Food and Drug Administration (FDA). On June 30, 2005, the Advisory Committee on Immunization Practices (ACIP) recommended Tdap for all persons aged 11-18 years. This report summarizes national surveillance data on pertussis reported to CDC during 2001-2003 and focuses on pertussis reported among persons aged 10-19 years before implementation of national recommendations for adolescent pertussis vaccination. . . .

Of 9,609 persons aged 10-19 years with reported pertussis, 116 (1%) of 8,286 for whom information was provided were hospitalized, 148 (2%) of 7,560 had radiographically confirmed pneumonia, and 20 (0.2%) of 8,543 reported seizures as a complication of pertussis. Hospitalization and complications of pertussis were most common among infants aged [younger than] 6 months. Of the total 5,872 infants aged [younger than] 6 months, 3,255 (69%) of 4,748 for whom information was provided were hospitalized, 532 (13%) of 4,096 had radiographically confirmed pneumonia, and 79 (2%) of 4,802 had seizures. Among persons of all ages with pertussis, 33 cases of encephalopathy and 56 pertussis-related deaths were reported during 2001-2003. Fifty-one (91%) of the deaths were among infants aged [younger than] 6 months, and 42 (75%) of the deaths were among infants aged [younger than] 2 months.

Compared with other age groups, the greatest number of reported cases was among persons aged 10-19 years. Among the 6,090 (63%) of 9,609 persons in this age group reported as having confirmed pertussis, 1,570 cases (26%) were confirmed by an epidemiologic link to a confirmed case, 1,356 (22%) by culture, 1,562 (26%) by PCR [polymerase chain reaction], and 1,511 (25%) by the Massachusetts serologic test. . . .

[From the Editorial Note]
Reported cases of pertussis in the United States have increased since 1976, with a substantial increase among persons aged 10-19 years. Compared with the increase observed in reported cases among adolescents, the increases in cases reported in age groups that contain recently vaccinated children have been small. Compared with older age groups, infants aged [younger than] 6 months continued to have the highest reported incidence of pertussis, and Hispanic infants were overrepresented in this group, as also demonstrated in a previous study. Among all age groups, the reported pertussis incidence in whites was higher than the incidence in blacks. However, passive surveillance probably does not equally reflect the relative burden of pertussis in all racial and ethnic groups; even among reported cases, race and ethnicity data were complete in only 74% of cases. . . .

Implementing the ACIP recommendation to vaccinate persons aged 11-18 years with Tdap should substantially reduce morbidity associated with pertussis among adolescents. In addition, the cost of case investigations and outbreak-control measures by local and state health departments likely will be reduced by an effective vaccination program targeting persons aged 11-18 years. Ensuring high coverage with Tdap in adolescents is an important step to better control pertussis in the United States.


To access a web-text (HTML) version of the complete article, go to:

To access a ready-to-print (PDF) version of this issue of MMWR, go to:

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January 3, 2006

Recently, the World Health Organization produced three excellent reports on pandemic influenza. Information follows.

(1) A succinct overview of pandemic influenza, the first report appeared December 9, 2005, in the WHO publication Weekly Epidemiological Record.

To access the report, titled "Ten things you need to know about pandemic influenza," go to: and scroll down to the report.

(2) The second is a two-part report on pandemic influenza preparations at the international, national, and community levels. It appears in the January 2006 issue of the CDC journal Emerging Infectious Diseases (EID).

To access a ready-to-print (PDF) version of Part I ("Nonpharmaceutical interventions for pandemic flu, international measures"), go to:

To access a web-text (HTML) version of it, go to:

To access a ready-to-print (PDF) version of Part II ("Nonpharmaceutical interventions for pandemic influenza, national and community measures"), go to:

To access a web-text (HTML) version of it, go to:

The January issue of EID is devoted to a discussion of various aspects of epidemic influenza, including history, pathogenesis, prevention, policy, and research.

To access a ready-to-print (PDF) version of the complete issue, go to:

To access a web-text (HTML) version of it, go to:

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January 3, 2006

IAC recently made a minor change to its one-page professional-education piece "It's federal law! You must give your patients current Vaccine Information Statements (VISs)." In the section titled "Most current versions of VISs," the issue dates were updated for the VISs for trivalent inactivated influenza vaccine (TIV; injectable) and live attenuated intranasal influenza vaccine (LAIV; nasal spray). The current VIS issue date for both vaccines is 10/20/05.

To access a ready-to-print (PDF) version of the revised "It's federal law!" go to:

To access a web-text (HTML) version of it, go to:

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January 3, 2006

Changes were recently made to the Russian-language versions of the VIS for trivalent inactivated influenza vaccine (TIV; injectable) and the interim VIS for meningococcal vaccine. IAC gratefully acknowledges the Minnesota Department of Health for changing the translations.

VIS for injectable influenza vaccine (dated 10/20/05)
To obtain a ready-to-print (PDF) version of the VIS for TIV in Russian (revised), go to:

To obtain it in English, go to:

Interim VIS for meningococcal vaccine (dated 10/7/05)
To obtain a ready-to-print (PDF) version of the interim VIS for meningococcal vaccine in Russian (revised), go to:

To obtain it in English, go to:

For information about the use of VISs, and for VISs in a total of 33 languages, visit IAC's VIS web section at

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January 3, 2006

The National Immunization Coalition TA [technical assistance] Network has scheduled a teleconference that will present a preview and update on the National Conference on Immunization Coalitions (NCIC). It will be held at 1:00PM, ET, January 10.

NOTE: CDC will give updates on the current influenza vaccine supply at the beginning of this teleconference and at the beginning of future teleconferences throughout the influenza season.

During the course of the teleconference, participants will (1) become familiar with the history and past evaluations of NCIC, (2) learn the date and location of the 2006 NCIC, as well as registration options, (3) learn about the conference agenda and options for submitting an abstract, and (4) learn how their organization can help support NCIC.

The presenters are Sarah Nasca, MPH, CHES, and Roberta Smith, MSPH. Nasca, a member of the NCIC program committee, holds the position of instructor, Department of Pediatrics, Center for Pediatric Research, Eastern Virginia Medical Center. She is also the coordinator for Project Immunize Virginia. Smith, the 2006 NCIC conference coordinator, is adult immunization coordinator, Colorado Department of Public Health and Environment. She is also the coordinator of the Colorado Influenza and Pneumococcal Alert Coalition.

To register for the teleconference, send an email to Include this message: "Sign me up for the NCIC update."

For additional information, or to access earlier programs, go to:

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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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