Issue Number
279 October
29, 2001
CONTENTS OF THIS ISSUE
- ACIP votes on birth dose of hepatitis B vaccine
- Five new hepatitis prevention programs added to IAC's
Hepatitis Programs website
- HFI offers video as part of Partners in Liver Wellness
Program
- Slightly revised! "Community-Based Immunization Clinic
Supplies Checklist"
- CDC publishes update on bioterrorism-related anthrax
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October 29, 2001
ACIP VOTES ON BIRTH DOSE OF HEPATITIS B VACCINE
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: http://www.immunize.org/birthdose/
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: http://www.immunize.org/birthdose/survey.htm
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October 29, 2001
FIVE NEW HEPATITIS PREVENTION PROGRAMS ADDED TO IAC'S HEPATITIS PROGRAMS WEBSITE
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)
http://www.hepprograms.org/apia/apia1.htm
Take 3 Hep B (Hawaii school program)
http://www.hepprograms.org/school/school3.htm
San Francisco City Clinic (STD clinic)
http://www.hepprograms.org/std/std10.htm
Oakland City Children's Village (School program, STD clinics, Juvenile corrections)
http://www.hepprograms.org/school/school4.htm
Illinois Department of Public Health (STD clinics, MSM, IDU)
http://www.hepprograms.org/drug/drug7.htm
To see IAC's Hepatitis Programs website home page, go to:
http://www.hepprograms.org
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 evaluation@immunize.org
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October 29, 2001
HFI OFFERS VIDEO AS PART OF PARTNERS IN LIVER WELLNESS PROGRAM
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: http://www.hepfi.org
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October 29, 2001
SLIGHTLY REVISED! "COMMUNITY-BASED IMMUNIZATION CLINIC SUPPLIES CHECKLIST"
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: http://www.immunize.org/catg.d/p3046chk.pdf
To view or print an unformatted copy of the checklist, if you cannot download
PDF files, go to: http://www.immunize.org/catg.d/p3046chk.htm
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October 29, 2001
CDC PUBLISHES UPDATE ON BIOTERRORISM-RELATED ANTHRAX
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:
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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.
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To obtain the complete text of this article online, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5042a1.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5042.pdf
HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
To obtain a free electronic subscription to the "Morbidity and Mortality Weekly
Report" (MMWR), visit CDC's MMWR website at: http://www.cdc.gov/mmwr
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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