Issue Number
276 October
11, 2001
CONTENTS OF THIS ISSUE
- Second chance to improve your vaccine injection
techniques! New video shows best practices
- Nevada passes new law for hepatitis A, hepatitis B, and
varicella vaccinations
- New! Varicella Vaccine Information page on IAC's website
- Institute of Medicine Immunization Safety Review
Committee releases report on thimerosal
- CDC issues report on state-based immunization registries
- New! Anthrax and Smallpox Information page on IAC's
website
- VAERS data now available online
- CDC publishes news on vaccination among children in
Head Start, child care centers, and schools
- CDC issues public health dispatch on recent polio
outbreak in the Dominican Republic and Haiti
- Polio eradication priorities identified in Africa by
CDC
- CDC provides influenza activity update and vaccine
recommendations for 2001-2002
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October 11, 2001
SECOND CHANCE TO IMPROVE YOUR VACCINE INJECTION TECHNIQUES! NEW VIDEO SHOWS BEST PRACTICES
Since we first offered this video in IAC Express #273 in September, IAC has processed 356 orders for 445 videotapes!
We also have a pending order for 500 videotapes from one state. Because it was so popular, we are announcing
the offer once again as follows:
Every clinic in the United States that delivers vaccination services should have
a copy of this brand-new 35-minute video titled "Immunization Techniques: Safe, Effective, Caring"
available for clinic staff! Developed by the California Department of Health Services Immunization Branch in
collaboration with a team of national experts, this video teaches best practices about how to
administer intramuscular (IM) and subcutaneous (SC) vaccines to infants, children, and
adults. It is designed for use as a "hands-on" instructional program for new staff as well as a refresher course for
experienced health professionals.
The video provides discussion of all the following:
- Anatomic sites
- Choice of needle size
- Vaccines and routes of administration
- How to "draw up" doses of vaccine
Infants, toddlers, kindergartners, and adults are
vaccinated in the video to demonstrate these techniques.
The video comes with presenter's notes that include instructional objectives,
pre- and post-tests, photos showing vaccination sites appropriate for infants
and toddlers, and a skills checklist to help you document that your staff is well
trained.
IAC distributes the video and presenter's notes at $15 per set (to U.S. addresses). California Distance Learning
Health Network (CDLHN) offers it at $25 per set. The versions are the same except that IAC's video comes in a
plain cardboard sleeve and the presenter's notes are printed in black and white, while CDLHN's video box and
presenter's notes are printed in color. The videotape and text of presenter's notes are identical.
An IAC order form is available at: http://www.immunize.org/catg.d/2020a.pdf
If you'd like to place an order with IAC, send your order payment (check, credit card information, or purchase order
to Immunization Action Coalition, 1573 Selby Ave., Ste. 234, St. Paul, MN 55104 and include your complete
mailing information and phone number. You can fax your order with payment information to IAC at (651) 647-9131. If you are
placing an order from outside the United States, please call IAC at (651) 647-9009 for pricing
information.
Alternatively, you can order online (U.S. addresses only)
at: http://www.immunize.org/iztech
CDLHN also offers the following resources developed by the California Department of Health Services Immunization
Branch in addition to the video and presenter's notes:
Anatomic Sites for Immunization poster (33" x 13") sold in
quantities of 5 posters at $20 per set;
Comfort Measures poster (25" x 20") in English-language and Spanish-language versions, sold in quantities of 5 posters
at $20 per set.
If you have questions about CDLHN materials or wish to place an order, call
(619) 594-3348, email cdlhn@projects.sdsu.edu, or visit CDLHN online at
http://www.cdlhn.com/
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October 11, 2001
NEVADA PASSES NEW LAW FOR HEPATITIS A, HEPATITIS B, AND VARICELLA VACCINATIONS
On September 7, 2001, the Nevada Board of Health applied its existing administrative code for school-entry
vaccination to three new vaccines: hepatitis A, hepatitis B, and varicella. Hepatitis A and B vaccination will be
required for elementary-school entry beginning July 1, 2002, and varicella
vaccination will be required beginning July 1, 2003.
Catch-up vaccines for children already enrolled will not be required. Varicella
vaccination for children who have had chickenpox disease will not be required.
To view IAC's chart of state mandates for hepatitis B prevention and their implementation dates, go to:
http://www.immunize.org/laws/hepb.htm
To view IAC's chart of state mandates for varicella prevention and their implementation dates, go to:
http://www.immunize.org/laws/varicel.htm
We depend on our readers to help us stay informed and to
ensure we offer the most accurate and current information available on state vaccination
mandates. Please let us know when any changes occur in your state.
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October 11, 2001
NEW! VARICELLA VACCINE INFORMATION PAGE ON IAC'S WEBSITE
See the new Varicella Vaccine Information page on the website of the Immunization Action Coalition (IAC) for helpful
varicella news. The page includes journal article references and links, links to recommendations from
AAP and ACIP, case histories, photos, and numerous resources.
To view IAC's Varicella Vaccine Information web page, go to: http://www.immunize.org/varicella
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October 11, 2001
INSTITUTE OF MEDICINE IMMUNIZATION SAFETY REVIEW COMMITTEE RELEASES REPORT ON THIMEROSAL
On October 1, 2001, the Institute of Medicine (IOM) Immunization Safety Review Committee published its findings
and recommendations on thimerosal-containing vaccines in a report titled "Thimerosal-Containing
Vaccines and Neurodevelopmental Disorders."
The Committee conducted two separate plausibility assessments: 1) biological
plausibility, and 2) causal-link plausibility. The Committee determined that "the
hypothesis that thimerosal exposure through the recommended childhood immunization schedule has caused neurodevelopmental
disorders is not supported by clinical or experimental evidence" and that "the evidence is
inadequate to accept or reject a causal relationship between exposure to thimerosal
from vaccines and the neurodevelopmental disorders of autism, ADHD, and speech or language delay."
Table ES-1 summarizes the Committee's recommendations and conclusions.
For the complete text of the IOM thimerosal report, go to: http://www.nap.edu/catalog/10208.html
For CDC's information on the report and thimerosal, go to: http://www.cdc.gov/nip/news/iom-thim10-1-01.htm
For IAC's Thimerosal Information web page, go to: http://www.immunize.org/thimerosal
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October 11, 2001
CDC ISSUES REPORT ON STATE-BASED IMMUNIZATION REGISTRIES
On October 5, 2001, the Centers for Disease Control (CDC) published "Development of Community- and State-Based
Immunization Registries: CDC Response to a Report from the National Vaccine Advisory Committee" as part
of its Morbidity and Mortality Weekly Report (MMWR) Recommendations and Reports series (Vol. 50, RR-17).
The Summary reads as follows:
*****************************
Immunization registries are confidential, population-based computerized systems that contain information regarding
children's vaccinations. Registries provide a critical tool for increasing and sustaining vaccination coverage. A
national health objective for 2010 is to increase to 95 percent the proportion of
children under 6 years who participate in fully operational population-based
immunization registries. According to 2000 data, 24 percent of U.S. children
are participating in population-based immunization registries. In 1998, to facilitate community-
and state-based immunization registry development in the United States, the National Vaccine Advisory Committee
(NVAC) launched the Initiative on Immunization Registries. Through public hearings and parent
focus groups, NVAC identified four concerns that needed to be addressed to increase registry participation: a) protecting each
person's privacy and the confidentiality of registry information; b) ensuring participation of vaccination
providers and recipients; c) overcoming technical and operational challenges;
and d)determining resources needed to develop and maintain immunization registries. In January
1999, NVAC approved the report Development of Community-and State-Based Immunization Registries (available at
<http://www.cdc.gov/nip/registry/nvac.htm>; accessed July
30, 2001). The following report summarizes NVAC's recommendations and describes CDC's
National Immunization Program activities in response to NVAC's recommendations.
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Note: The above-quoted URL may not work as a link; you may have to copy or retype it in your address line.
To view or print the full MMWR report, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5017a1.htm
To obtain a camera-ready (PDF format) copy of the report, go to: http://www.cdc.gov/mmwr/PDF/rr/rr5017.pdf
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October 11, 2001
NEW! ANTHRAX AND SMALLPOX INFORMATION PAGE ON IAC'S WEBSITE
Don't miss the new Anthrax and Smallpox Information page on the website of the Immunization Action Coalition (IAC). The
page includes links to ACIP recommendations, a link to the Department of Defense Anthrax Vaccine
Immunization Program (AVIP), and a link to CDC resources.
To view IAC's Anthrax and Smallpox Information web page, go to: http://www.immunize.org/anthrax
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October 11, 2001
VAERS DATA NOW AVAILABLE ONLINE
The Vaccine Adverse Event Reporting System (VAERS) data set is available online. Data in compressed "self extracting
zip files" can be downloaded into spreadsheet applications using Windows. Sponsored by the CDC and the
FDA, VAERS receives reports of events that occur after immunization. Some of these events may occur coincidentally following
vaccination while others may truly be caused by vaccination.
For further background information regarding the VAERS data sets, go to: http://www.vaers.org/data.htm, which directs
you to the README file for definitions of terms, caveats to interpretation, and more.
For FAQs about VAERS, go to: http://www.vaers.org/vaers.htm
For more information about the VAERS program in general, visit http://www.vaers.org, call (800)822-7967, or send an
email to info@vaers.org
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October 11, 2001
CDC PUBLISHES NEWS ON VACCINATION AMONG CHILDREN IN HEAD START, CHILD CARE CENTERS, AND SCHOOLS
CDC published the article "Vaccination Coverage Among Children Enrolled in Head Start Programs and Licensed Child
Care Centers and Entering School--United States and Selected Reporting Areas, 1999-2000 School
Year" in the October 5, 2001, issue of Morbidity and Mortality Weekly Report
(MMWR). The 9-page article includes 3 tables.
The Editorial Note at the end of the article states in
part:
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Since 1980, national coverage for recommended childhood vaccines among children entering school has been over 90
percent. Although the incidence of vaccine-preventable disease is at an all-time low, coverage from over 90
percent to over 95 percent is considered necessary to prevent transmission of
measles in secondary schools. . . .The implementation and enforcement of state vaccination
requirements have resulted in high levels of coverage among the U.S. school-aged and licensed child care population
attending these facilities. State requirements constitute an important component of the effort to
meet 2010 objectives and ensure vaccination of children aged 5 and 6 years who had not been vaccinated during early childhood.
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To obtain the complete text of this article online, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5039a2.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5039.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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October 11, 2001
CDC ISSUES PUBLIC HEALTH DISPATCH ON RECENT POLIO OUTBREAK IN THE DOMINICAN REPUBLIC AND HAITI
CDC issued "Update: Outbreak of Poliomyelitis--Dominican Republic and Haiti, 2001-2001" in the October 5, 2001,
issue of Morbidity and Mortality Weekly Report (MMWR). According to the update, "From July 12, 2000,
through September 18, 2001, a total of 21 cases of poliomyelitis (including two
fatal cases) were reported from the Caribbean island of Hispaniola, divided between Haiti and
the Dominican Republic." The update concludes by stating that travelers to this location who are not vaccinated
adequately are at risk for polio.
To obtain the complete text of this article online, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5039a3.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5039.pdf
HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
see story #8.
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October 11, 2001
POLIO ERADICATION PRIORITIES IDENTIFIED IN AFRICA BY CDC
There has been substantial progress in poliomyelitis eradication in Africa, but
Angola, Democratic Republic of Congo (DR Congo), Ethiopia, and Nigeria remain priorities,
according to a report published in the September 28, 2001, issue of Morbidity and Mortality Weekly Report (MMWR).
To obtain the full text of this article online, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5038a3.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5038.pdf
HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
see story #8.
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October 11, 2001
CDC PROVIDES INFLUENZA ACTIVITY UPDATE AND VACCINE RECOMMENDATIONS FOR 2001-2002
CDC published a report titled "Update: Influenza Activity--United States and
Worldwide, May-September 2001" in the September 28, 2001, issue of Morbidity and Mortality Weekly
Report (MMWR). According to the report, from May through September 2001, influenza A (H1N1), A (H3N2), and B
viruses have continued to circulate worldwide. The majority of viruses are well
matched to the components of the 2001-2002 influenza vaccine.
The following ACIP recommendations, included in the report, address an anticipated delay in influenza vaccine delivery.
Providers should: 1) target vaccine available in September and October to persons at increased risk for
influenza complications and to healthcare workers; 2) beginning in November,
also offer vaccine to contacts of high-risk persons, healthy persons aged 50-64 years, and any others
who want to reduce their risk for influenza; and 3) continue vaccinating patients in December and throughout
the flu season as long as vaccine is available.
To obtain the full text of the report online, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5038a2.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5038.pdf
The latest information regarding influenza vaccine is available on CDC's website:
http://www.cdc.gov/nip/flu
HOW TO OBTAIN A FREE ELECTRONIC SUBSCRIPTION TO THE MMWR:
see story #8.
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