Issue Number
268 August
28, 2001
CONTENTS OF THIS ISSUE
- Employment opportunity! The Immunization Action
Coalition is looking for a Nurse Immunization Specialist
- CDC publishes report on outbreak of pneumococcal
pneumonia among unvaccinated residents of a nursing home
in New Jersey
- Updated! New varicella and hepatitis B state
immunization mandates on IAC's website
- National Immunization Program seeks applicants for the
position of Epidemiologist for Vaccine Safety and Development Activity
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(1)
August 28, 2001
EMPLOYMENT OPPORTUNITY! THE IMMUNIZATION ACTION COALITION IS LOOKING FOR A NURSE IMMUNIZATION SPECIALIST
If you or anyone you know might be interested in the position of Nurse Immunization Specialist, please contact
the Immunization Action Coalition (IAC). Job description and application instructions are listed on IAC's website
at http://www.immunize.org/admin/jobopp12.htm
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(2)
August 24, 2001
CDC PUBLISHES REPORT ON OUTBREAK OF PNEUMOCOCCAL PNEUMONIA AMONG UNVACCINATED RESIDENTS OF A NURSING HOME
IN NEW JERSEY
The Centers for Disease Control and Prevention (CDC) published an article
titled "Outbreak of Pneumococcal Pneumonia Among Unvaccinated Residents of a Nursing Home--New Jersey, April 2001," in the August 24, 2001, issue of
Morbidity and Mortality Weekly Report (MMWR).
The article's introductory paragraph reads: "On April 24, 2001, seven cases of
pneumococcal pneumonia with bacteremia among residents of a nursing home were reported to the
Hamilton Township Department of Health, New Jersey; all seven diagnoses were confirmed with blood cultures positive
for Streptococcus pneumoniae. Illness onset among the residents occurred during April 3-24; four
residents died. The New Jersey Department of Health and Senior Services (NJDHSS) was notified on April 24 and initiated an
investigation to identify additional cases and implement control efforts. This
report summarizes results of the investigation, which underscore the importance of providing
pneumococcal polysaccharide vaccine (PPV) to elderly residents of long-term care facilities
(LTCFs)."
The Editorial Note begins: "The findings in this report suggest that lack of
pneumococcal vaccine may contribute to invasive pneumococcal disease in adults in LTCFs. Adults in
LTCFs are especially vulnerable to pneumococcal disease and death because of their advanced age, the frequent presence
of chronic illnesses, and residence in a setting that might increase the risk for
bacterial transmission.
"PPV is considered safe and is cost-effective and potentially cost-saving among persons aged greater than or
equal to 65 years for prevention of bacteremia. Pneumococcal vaccinations are covered by Medicare, and
virtually all state Medicaid plans cover vaccinations for high-risk groups (e.g.,
residents of nursing facilities). However, PPV coverage among elderly adults
in LTCFs remains low, and outbreaks of pneumococcal pneumonia still occur in
LTCFs with low vaccine coverage. In 1999, PPV coverage among a sample of nursing home residents in the United
States was 38%. The low rate of PPV vaccination among institutionalized elderly has been attributed, in part, to
a lack of physician emphasis on PPV administration. In addition, incomplete documentation of vaccination history
of nursing home residents and misconceptions about adverse reactions after unintended revaccination with
PPV may discourage health-care providers from vaccinating those with unknown vaccination history; however, the incidence of
serious adverse events following revaccination is low. A study of Medicare inpatients indicated
that opportunities to provide pneumococcal vaccines were missed for up to 80%
of eligible elderly persons hospitalized with pneumonia."
The Editorial Note concludes: "This outbreak underscores the importance of providing pneumococcal vaccines to LTCF
[long-term care facilities] residents. The outbreak occurred in a setting of low vaccination coverage
despite state regulations designed to improve vaccine delivery. A multifaceted
approach that both facilitates delivery through standing orders programs and increases awareness of
the importance of preventing pneumococcal disease may be needed to ensure optimal vaccine delivery to LTCF
residents."
To obtain the full text of this article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5033a3.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5033.pdf
HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
To obtain a free electronic subscription to 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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(3)
August 28, 2001
UPDATED! NEW VARICELLA AND HEPATITIS B STATE IMMUNIZATION MANDATES ON IAC'S WEBSITE
Check out the website of the Immunization Action Coalition (IAC) for newly updated tables of varicella and hepatitis B
state immunization mandates. These tables offer a brief overview of which states currently mandate varicella or
hepatitis B vaccination for what ages, and the implementation dates for those
mandates.
MISSISSIPPI
In Mississippi, new state regulations that require varicella vaccination for
students entering daycare or kindergarten will go into effect, beginning with
the 2002-2003 school year.
PENNSYLVANIA
In Pennsylvania, new state regulations that require hepatitis B vaccine for students entering seventh grade
will go into effect, beginning with the 2002-2003 school year. IAC announced the new Pennsylvania varicella
mandate in IAC EXPRESS #257 on July 2, 2001.
It's not too soon to begin vaccinating your patients for the school year 2002-2003! Varicella vaccine can be given
to children 1 year of age and older. Hepatitis B vaccine can be given at any age. The sooner children are
vaccinated, the sooner they are protected.
To view IAC's table of state mandates for varicella prevention and their implementation dates, go to:
http://www.immunize.org/laws/varicel.htm
To view IAC's table of state mandates for hepatitis B prevention and their implementation dates, go to:
http://www.immunize.org/laws/hepb.htm
We depend on our readers to help us stay informed and to ensure this is the most accurate and current information
available. Please let us know when any changes occur in your state.
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(4)
August 28, 2001
NATIONAL IMMUNIZATION PROGRAM SEEKS APPLICANTS FOR THE POSITION OF EPIDEMIOLOGIST FOR VACCINE SAFETY AND
DEVELOPMENT ACTIVITY
CDC's National Immunization Program (NIP) is seeking a person to fill the position of Epidemiologist, Vaccine
Safety and Development Activity, within the Epidemiology and Surveillance Division. Applications will be accepted
until September 14, 2001.
For more information about the position, call (770) 488-1750 or go to: http://www2.cdc.gov/hrmo/viewdetail.asp?AnnouncementNumber=1-01-825
or go to: http://www.cdc.gov/hrmo/hrmo.htm
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