Issue
Number 389
June 9, 2003
CONTENTS OF THIS ISSUE
- Vaccines For Children (VFC) program supports a universal
hepatitis B birth dose policy
- CDC reports on 2002-03 influenza activity in the U.S. and
worldwide and on composition of the 2003-04 influenza vaccine
- Information from the National Influenza Summit 2003 now posted
on the American Medical Association website
- CDC allows immunization providers to use VISs with old Vaccine
Injury Compensation Program Web address
- Reminder: June 26 is the date for CDC's "Adult Immunization
Update 2003" satellite broadcast
- Minnesota passes new immunization law for pharmacists
- California Distance Learning Health Network's broadcast on
eliminating immunization disparities set for July 10
- IAC makes minor correction to an attachment to its
"Vaccination Record for Adults" professional education sheet
- Institute of Medicine releases third letter report on CDC's
smallpox vaccination program implementation
- CDC reports on recent progress in eradicating polio in
Southern Africa
- MMWR issues a correction to the Recommendations and Reports
for Prevention and Control of Influenza
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June 9, 2003
VACCINES FOR CHILDREN (VFC) PROGRAM SUPPORTS A UNIVERSAL HEPATITIS B BIRTH
DOSE POLICY
[The following is cross posted from the Immunization Action Coalition's "HEP
EXPRESS" electronic newsletter, 6/6/03]
The Vaccines for Children (VFC) program recently agreed to support requests
from grantees for four doses of hepatitis B vaccine for routine vaccination
of infants. VFC based its decision on the Advisory Committee on Immunization
Practices' preference for giving all infants the birth dose of hepatitis B
vaccine before hospital discharge and on reports of numerous errors in
perinatal hepatitis B prevention.
In a memorandum dated June 2, Lance E. Rodewald, MD, Director, Immunization
Services Division, National Immunization Program at CDC, outlined the VFC
program's rationale for making the decision and listed eligibility criteria
for purchasing hepatitis B vaccine with VFC funds. The memorandum is
reprinted below in its entirety, excluding one table.
**********************
Date: June 2, 2003
From: Director, Immunization Services Division/NIP
Subject: VFC Support for a Universal Hepatitis B Birth Dose Policy
To: Immunization Program Managers
The Advisory Committee on Immunization Practices (ACIP) and the National
Immunization Program (NIP) support the implementation of a universal
hepatitis B birth dose policy for several reasons:
- Approximately 20,000 infants born to
hepatitis B surface antigen (HBsAg) positive women are born annually in
the United States. These infants require hepatitis B vaccine and hepatitis
B immune globulin (HBIG) within 12 hours of birth to prevent
perinatal hepatitis B transmission. However, because errors or delays in
documenting, testing, and reporting maternal HBsAg status can and do
occur, administering the first dose of hepatitis B vaccine soon after
birth to all infants acts as a safety net and reduces the risk for
perinatal infection in infants whose mothers' HBsAg status is either
unknown or incorrectly documented at the time of delivery.
- Childhood transmission of hepatitis B
virus does occur in infants whose mothers are HBsAg negative but who are
exposed to persons in the household with chronic hepatitis B virus (HBV)
infection. Two out of three cases of childhood transmission occur in this
manner and these children could be protected with a birth dose of
hepatitis B vaccine.
- Initiating the hepatitis B vaccine series
at birth has been shown to increase a child's likelihood of completing the
vaccine series according to the recommended childhood schedule.
As indicated in the 2003 Childhood and
Adolescent Immunization Schedule, the ACIP prefers the birth dose of
hepatitis B vaccine over vaccination after discharge from the hospital
recommending that "all infants should receive the first dose of hepatitis B
vaccine soon after birth and before hospital discharge; the first dose may
also be given by age two months if the infant's mother is HBsAg negative."
The VFC Resolution for hepatitis B (Resolution 02/03-1) also explicitly
indicates a preference for administering the first dose of hepatitis B
vaccine at birth, as outlined in the table on the following page. [The table
is available by clicking on the link at the end of this article.]
[TABLE]
Given the ACIP's preference for the birth dose of hepatitis B vaccine and
its preference for combination vaccines, the VFC Program will support
requests from grantees for four doses of hepatitis B vaccine for
routine vaccination of infants. Hospitals using VFC vaccine must enroll as
VFC providers and must screen for eligibility for the VFC program.
If your state is considering providing the hepatitis B vaccine birth dose to
all hospitals, please be aware of the following:
- If you are supplying the birth dose of
hepatitis B vaccine to hospitals, those hospitals must be registered VFC
providers.
- You may only supply VFC vaccine to a
hospital to cover children that are VFC-eligible. If you are supplying
vaccine for the hospital to cover all births, you must use vaccine
purchased from 317 or state funds to cover non-VFC-eligible children.
- Please work with your hospitals to make
provider profiles as accurate as possible. Hospitals screen everyone for
insurance status and can easily tell you how many of their births are
covered by Medicaid, private insurance, or self-pay. This information can
be used for required VFC-eligibility screening in hospitals.
- We are very concerned that hospitals may
bill for vaccine being supplied by the state. Please work with your
hospitals to assure that they are not billing insurance plans for vaccine
supplied by the state.
If you have any questions about implementing
a universal hepatitis B birth dose policy in your state, please do not
hesitate to contact Tasneem Malik at (404) 639-4213 or your VFC Consultant
at (404) 639-8222.
Original Signed By
Lance E. Rodewald, M.D.
Director
Immunization Services Division
National Immunization Program
**********************
To access the CDC memorandum (including the table showing the routine
recommended schedule for hepatitis B vaccination for infants born to
hepatitis B surface antigen negative mothers), from the website of the
Immunization Action Coalition, go to:
http://www.immunize.org/cdc/hepbmemo.pdf
For a wealth of information about the importance of the birth dose, go to
the Immunization Action Coalition birth dose web page at
http://www.immunize.org/birthdose
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June 9, 2003
CDC REPORTS ON 2002-03 INFLUENZA ACTIVITY IN THE U.S. AND
WORLDWIDE AND ON COMPOSITION OF THE 2003-04 INFLUENZA VACCINE
The Centers for Disease Control and Prevention (CDC) published
"Update: Influenza Activity--United States and Worldwide,
2002-03 Season, and Composition of the 2003-04 Influenza
Vaccine" in the June 6 issue of the "Morbidity and Mortality
Weekly Report" (MMWR). A portion of a summary made available to
the press is reprinted below.
********************
Influenza A (H1N1), A (H1N2), A (H3N2), and B viruses co-circulated worldwide during the 2002–03 influenza season in the
Northern Hemisphere. Human infections with avian influenza A
(H5N1) and A (H7N7) viruses were reported in Hong Kong and the
Netherlands, respectively. In the United States, the 2002–03
influenza season was mild; influenza A (H1) and B viruses
circulated widely but the predominant virus varied by region and
time of season. The Food and Drug Administration's Vaccines and
Related Biological Products Advisory Committee (VRBPAC)
recommended A/New Caledonia/20/99-like (H1N1), A/Moscow/10/99-like (H3N2), and B/Beijing/330/01-like viruses for the 2003–04
trivalent influenza vaccine for the United States. This
recommendation was based on antigenic analyses of recently
isolated influenza viruses, epidemiologic data, and post-vaccination serologic studies in humans.
********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5222a2.htm
To obtain a camera-ready (PDF format) copy of this issue of
MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5222.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 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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June 9, 2003
INFORMATION FROM THE NATIONAL INFLUENZA SUMMIT 2003 NOW POSTED
ON THE AMERICAN MEDICAL ASSOCIATION WEBSITE
Sponsored by the Centers for Disease Control and Prevention and
the American Medical Association (AMA), the 2003 National
Influenza Summit was held in Chicago on May 20-21. Attendance
was by invitation only.
Participants considered two major topics: future developments in
vaccine production and challenges to improving influenza uptake.
To access the summit's list of participants, final agenda, and
speakers' PowerPoint presentations from the AMA website, go to:
http://www.ama-assn.org/ama/pub/article/1826-7688.html As
additional news and materials become available, they will be
posted on this site.
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June 9, 2003
CDC ALLOWS IMMUNIZATION PROVIDERS TO USE VISs WITH OLD VACCINE
INJURY COMPENSATION PROGRAM WEB ADDRESS
The Centers for Disease Control and Prevention (CDC) recently
updated the Web address for the Vaccine Injury Compensation
Program (VICP) on Vaccine Information Statements (VISs) for
routine childhood vaccines. The address changed last year.
CDC advises immunization providers that it did not change the
VIS issue date or anything else on these VISs. Providers may use
VISs with the old VICP Web address (as long as the VIS is
otherwise current) with the understanding that the VICP Web
address is nonfunctional. The new Web address is
www.hrsa.gov/osp/vicp
The address was changed on VISs for the following vaccines:
diphtheria, tetanus, and pertussis (DTaP), pneumococcal
conjugate (PCV7), inactivated polio (IPV), Haemophilus
influenzae type b (Hib), hepatitis B, and varicella. Updated
versions of these VISs are posted on the National Immunization
program website at
http://www.cdc.gov/nip/publications/VIS/default.htm
To access copies of the newly revised VISs for routine childhood
vaccines from the VIS web page of the Immunization Action
Coalition, go to: http://www.immunize.org/vis The VIS web page
has information about the use of VISs and also has VISs in up
to 28 languages.
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June 9, 2003
REMINDER: JUNE 26 IS THE DATE FOR CDC'S "ADULT IMMUNIZATION
UPDATE 2003" SATELLITE BROADCAST
"Adult Immunization Update 2003" is a live satellite broadcast
for health care providers on current adult immunization practice
and improving adult immunization coverage levels. Sponsored by
the Centers for Disease Control and Prevention (CDC), the
broadcast is scheduled for June 26 from noon to 2:30 pm ET. It
will feature a Q&A session in which participants nationwide can
interact with the course instructors via toll-free telephone
lines.
The course instructors are William L. Atkinson, MD, MPH, medical
epidemiologist, and Donna L. Weaver, RN, MN, nurse educator.
Both are with the CDC's National Immunization Program. For
information about program content, email
nipinfo@cdc.gov
Only online registration is available. To register on the Public
Health Training Network website, go to:
http://www.phppo.cdc.gov/phtnonline
For registration information, call (800) 418-7246 or email
ce@cdc.gov
The program will have a live webcast at
http://www.phppo.cdc.gov/phtn/webcast/adult-imm03
For technical support and to prepare for the webcast ahead of
time, go to:
http://www.phppo.cdc.gov/phtn/webcast/techsupport.asp
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June 9, 2003
MINNESOTA PASSES NEW IMMUNIZATION LAW FOR PHARMACISTS
On May 27, Minnesota's governor signed a law allowing pharmacists
who have had special training to administer influenza and
pneumococcal vaccine to adult patients using a physician's
standing orders or by written protocol with a physician. This makes
Minnesota the 37th state to allow pharmacists to administer
vaccinations. The law goes into effect July 1.
To access information about laws, rules, and regulations regarding
pharmacists' providing vaccinations from the website of the
Immunization Action Coalition (IAC), go to:
http://www.immunize.org/laws/pharm.htm
IAC thanks the American Pharmacists Association (APhA) for
providing us with this information. To access information about APhA,
go to: http://www.aphanet.org
To access information about state immunization mandates, go to:
http://www.immunize.org/laws
We depend on our readers to help us stay informed and to ensure
this is the most current and accurate information available.
Please let us know when any changes occur in your state.
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June 9, 2003
CALIFORNIA DISTANCE LEARNING HEALTH NETWORK'S BROADCAST ON
ELIMINATING IMMUNIZATION DISPARITIES SET FOR JULY 10
"Eliminating Health Disparities: A Satellite Broadcast for
Outreach Workers" will be broadcast July 10 from noon to
2 pm ET. Produced by California Distance Learning Health Network
(CDLHN), the program will offer insights into working with
diverse communities and present the latest immunization outreach
strategies. It will focus particularly on California but has
information applicable to outreach workers across the nation.
The program has three main objectives:
- Define the scope of immunization disparities in California
- Identify key community resources, groups, and services
- Describe effective entry points for working with key
communities, and review the skills needed to build effective
long-term relationships with them
It will cover four subjects:
- How to do outreach with minimal resources
- Outreach support for media campaigns
- How to present your program to a community
- Community partnerships and maximizing
resources
Registration, which is required, is through CDLHN. Contact CDLHN
online at http://www.cdlhn.com, by email at
cdlhn@projects.sdsu.edu, by phone at (619) 594-3348, or by fax at
(619) 594-2111.
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June 9, 2003
IAC MAKES MINOR CORRECTION TO AN ATTACHMENT TO ITS "VACCINATION
RECORD FOR ADULTS" PROFESSIONAL EDUCATION SHEET
The Immunization Action Coalition (IAC) made an error on an
attachment to the professional education sheet "Vaccination
Record for Adults."
The error appeared on an attachment containing examples for
recording combination vaccines (the attachment has "Example #4"
superimposed on it). The column titled "Site Given" had an error
for Hepatitis A and Hepatitis B combination vaccine. The error
has been corrected; the date of the corrected version is 5/03.
If you printed the "Example #4" attachment, please discard your
printed copies and print new ones from the following URL:
http://www.immunize.org/catg.d/p2023b.pdf
We apologize for any inconvenience this error may have caused
readers of "IAC EXPRESS."
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June 9, 2003
INSTITUTE OF MEDICINE RELEASES THIRD LETTER REPORT ON CDC'S
SMALLPOX VACCINATION PROGRAM IMPLEMENTATION
On May 27, the Institute of Medicine (IOM) of the National
Academies released its third letter report advising the Centers
for Disease Control and Prevention (CDC) on the implementation
of the national smallpox vaccination program. CDC sponsored the
report. A private, nonprofit institution, IOM provides health
policy advice under a Congressional charter granted to the
National Academy of Sciences.
Titled "Review of the Centers for Disease Control and
Prevention's Smallpox Vaccination Program Implementation: Letter
Report #3," the 16-page report reaffirms the need for a pause in
the smallpox vaccination program and provides commentary about
the CDC's smallpox program activities to date, including next
steps in the pre-event vaccination program.
To access the report from the IOM website, go to:
http://www.nap.edu/books/NI000508/html
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June 9, 2003
CDC REPORTS ON RECENT PROGRESS IN ERADICATING POLIO IN SOUTHERN
AFRICA
The Centers for Disease Control and Prevention (CDC) published
"Progress Toward Poliomyelitis Eradication--Southern Africa
2001-March 2003" in the June 6 issue of the "Morbidity and
Mortality Weekly Report" (MMWR). A summary made available to the
press is reprinted below.
********************
Although wild poliovirus circulation appears to have been
interrupted in the southern part of Africa, polio eradication
activities should be sustained until global eradication is
certified.
The estimated global occurrence of poliomyelitis has decreased
more than 99% since 1988, when the World Health Assembly
resolved to eradicate polio worldwide. The last cases of
poliomyelitis in the Southern African Block were observed in
Zambia in February 2002. While it is possible that polio
transmission has been interrupted, the quality of surveillance
in several important countries does not yet allow [the reliable
exclusion of] the ongoing transmission of polio. External
surveillance reviews are planned for 2003 in Madagascar,
Mozambique, and South Africa, and a Technical Advisory Group for
Angola will convene for the first time in June. Additional
funding will be required to sustain polio eradication activities
in those countries and prevent importation and circulation of
polioviruses until global polio eradication is certified.
********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5222a3.htm
To obtain a camera-ready (PDF format) copy of this issue of
MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5222.pdf
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June 9, 2003
MMWR ISSUES A CORRECTION TO THE RECOMMENDATIONS AND REPORTS FOR
PREVENTION AND CONTROL OF INFLUENZA
The Centers for Disease Control and Prevention (CDC) published
"Erratum: Vol. 52, No. RR-8" in the June 6 issue of the
"Morbidity and Mortality Weekly Report" (MMWR). It is reprinted
below in its entirety.
**********************
In the MMWR Recommendations and Reports, "Prevention and Control
of Influenza: Recommendations of the Advisory Committee on
Immunization Practices (ACIP)," published April 25, 2003, on
page 12, an error occurred in the title for Table 3. The title
should read, "Influenza vaccine* dosage by age group--United
States, 2003-04 season."
**********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5222a5.htm
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