Issue Number
177
July 25,
2000
CONTENTS OF THIS ISSUE
- CDC'S pneumococcal conjugate VIS now available online!
- CDC issues press release on ACIP vote regarding
pneumococcal conjugate vaccine
- CDC publishes update notice on the expanded availability
of thimerosal preservative-free hepatitis B vaccine
- IOM reports on immunization finance policies and
practices
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July 25, 2000
CDC'S PNEUMOCOCCAL CONJUGATE VIS NOW AVAILABLE ONLINE!
The Centers for Disease Control and Prevention (CDC) has issued an interim Vaccine Information Statement (VIS) for
pneumococcal conjugate vaccine, to be used when administering this vaccine to infants and young children.
This VIS (dated 7/18/00) is now available on CDC's website and the website of the
Immunization Action Coalition (IAC). Foreign-language translations of this document are not
currently available.
Note: This new pneumococcal conjugate VIS should not be confused with the
pneumococcal polysaccharide VIS (dated 7/29/97), which is used for persons 65 years of age and
older as well as other high-risk individuals.
To obtain a camera-ready copy (PDF format) of the pneumococcal conjugate VIS, visit one of the following
web pages:
CDC: http://www.cdc.gov/nip/publications/vis/vis-pneumoConjugateInterim.pdf
IAC:
http://www.immunize.org/vis/pnPCV7.pdf
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June 26, 2000
CDC ISSUES PRESS RELEASE ON ACIP VOTE REGARDING PNEUMOCOCCAL CONJUGATE VACCINE
The Centers for Disease Control (CDC) issued a press release on June 26, 2000, regarding the Advisory Committee
on Immunization Practices (ACIP) vote on pneumococcal conjugate vaccine. The press release is reprinted
below in its entirety:
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On June 21, 2000, the CDC Advisory Committee on Immunization Practices (ACIP) voted to recommend the
pneumococcal conjugate vaccine for all children 23 months of age and younger, and for children 24 to 59 months of
age who are at high risk of serious pneumococcal disease, which includes children with sickle cell disease, HIV infection,
chronic illness or weakened immune systems.
The vaccine is highly effective in preventing invasive pneumococcal disease in
young children. Pneumococcal infections cause approximately 700 cases of
meningitis, 17,000 cases of bacteremia (blood stream infections) and 200 deaths each year in children under age 5 in the United
States. Streptococcus pneumoniae is the most common cause of community-acquired pneumonia in
young children. Meningitis is the most severe type of pneumococcal disease. Of children under 5 years old with pneumococcal meningitis,
about 5% will die of their infection. Many children with pneumococcal pneumonia or blood
stream infection will be hospitalized and about 1% of children with blood stream
infections or pneumonia with a blood stream infection will die of their illness.
The committee voted that the vaccine be given to all infants at 2, 4, and 6 months of age, followed by a booster
dose at 12-15 months of age. Children who are unvaccinated and are 7 to 11 months of age should be given a total of
3 doses and children who are unvaccinated and are 12 to 23 months of age should be given a total of 2 doses. Healthy
children who are unvaccinated at 24 months of age or older only need one dose of the vaccine.
The ACIP also recommended that the vaccine should be considered for all children age 24 to 59 months, with
priority given to children at moderate risk of invasive pneumococcal disease. This includes all children aged 24 to
35 months, children of American Indian, Alaskan Native or African American descent, and children who attend out-of-home group child care.
The vote will become a final recommendation when it is published in the Morbidity and Mortality Weekly Report
(MMWR).
The committee also voted to include this vaccine in the Vaccines For Children
program, which provides free vaccines to children who are enrolled in Medicare, are not insured,
underinsured or are American Indian or Alaskan Native.
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To view this press release online, visit: http://www.cdc.gov/od/oc/media/pressrel/r2k0626.htm
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July 21, 2000
CDC PUBLISHES UPDATE NOTICE ON THE EXPANDED AVAILABILITY OF THIMEROSAL PRESERVATIVE-FREE HEPATITIS B VACCINE
The Centers for Disease Control and Prevention (CDC) announced in the July 21, 2000, issue of the MMWR that "an
adequate supply of preservative-free hepatitis B vaccine is available for all infant and childhood vaccinations." The
complete notice is reprinted below:
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NOTICE TO READERS: UPDATE: EXPANDED AVAILABILITY OF THIMEROSAL PRESERVATIVE-FREE HEPATITIS B VACCINE
Thimerosal, a mercury-based compound, is no longer used as a preservative in any of the pediatric hepatitis B vaccines
licensed in the United States. On March 28, 2000, SmithKline Beecham Biologicals (Rixensart, Belgium)
received approval from the Food and Drug Administration of a supplement to its hepatitis B license to include the
manufacture of single-antigen, preservative-free hepatitis B vaccine (Engerix-B, pediatric/adolescent);
distribution of this product has begun. A single-antigen, preservative-free hepatitis B vaccine (Recombivax HB, pediatric) from
Merck Vaccine Division (West Point, Pennsylvania) had earlier received similar approval. A
preservative-free Haemophilus influenzae type b (Hib)/hepatitis B combination
vaccine (Comvax) from Merck Vaccine Division also is available. An adequate supply of preservative-free
hepatitis B vaccine is available for all infant and childhood vaccinations. Thimerosal preservative-containing
hepatitis B vaccines may continue to be used for vaccination of adolescents and adults as recommended.
Some vaccines that do not use thimerosal as a preservative may have trace amounts of thimerosal introduced during the
manufacturing process. The amount of thimerosal in the new pediatric/adolescent formulation of Engerix-B
(less than 1 mcg of thimerosal/0.5 mL dose of vaccine) has been reduced by more than 96%.
Universal vaccination of infants is the central focus of hepatitis B prevention
efforts, and initiation of the hepatitis B vaccine series at birth is safe and
effective. Many hospitals that had provided routine hepatitis B vaccination to all
infants at birth before the July 1999 joint American Academy of Physicians/Public Health Service
statement on thimerosal in vaccines discontinued this practice because of concerns about thimerosal. Some of
these hospitals did not resume routine vaccination at birth even after hepatitis
B vaccines that do not contain thimerosal as a preservative became available (CDC,
unpublished data, 2000). Preservative-free hepatitis B vaccines are now widely available, and efforts should be
made to reintroduce routine hepatitis B vaccination policies for all newborn infants in hospitals in which
these policies and practices have been discontinued.
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To access the full text of this notice online, go to: http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4928a4.htm
For a more complete listing of thimerosal-related information, visit CDC's website at:
http://www.cdc.gov/nip/vacsafe/concerns/thimerosal/
or visit the website of the Immunization Action Coalition at: http://www.immunize.org/genr.d/thimer.htm
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://www2.cdc.gov/mmwr Select "Free MMWR Subscription" from themenu 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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July 25, 2000
IOM REPORTS ON IMMUNIZATION FINANCE POLICIES AND PRACTICES
On June 15, 2000, the Institute of Medicine (IOM) released a report raising a
public health warning about the weakening U.S. immunization system. The report titled
"Calling the Shots" recommends federal and state partnerships to provide increased investment and long-term
strategies for funding the nation's immunization infrastructure. It also calls for better integration
between public and private vaccination efforts to reduce disparities in immunization coverage.
The report is based on an 18-month, 50-state study sponsored by CDC to look at
the nation's immunization system.
Portions of the discussion can be accessed at
http://www4.nas.edu/onpi/webextra.nsf/web/web_extra_immunizations?OpenDocument
The forthcoming book to be published this year by National Academy Press, also titled "Calling the Shots," is
currently available for purchase in a prepublication (manuscript) form for $50 plus shipping. To order, call
(888) 624-8373, or visit the online catalog at: http://books.nap.edu/catalog/9836.html
to order it at a 20 percent discount.
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