Issue Number
289 January
7, 2002
CONTENTS OF THIS ISSUE
- CDC publishes Notice to Readers on DTaP shortage
- CDC publishes article on drug-resistant Streptococcus
pneumoniae in a child care center in Georgia
- Important finding: Routine childhood hepatitis A
vaccination can lower disease in whole community
- Easy online video explains Medicare billing process
- DHHS offers two further treatment options for those
exposed to anthrax
- Reminder: Every Child By Two newsletter covers
immunization events on Capitol Hill
- New translation! 2001 Summary of Adult Recommendations
available in Turkish
----------------------------------------------------------
Back to Top
(1 of 7)
January 7, 2002
CDC PUBLISHES NOTICE TO READERS ON DTAP SHORTAGE
On January 4, 2002, CDC published "Notice to Readers: Update: Supply of diphtheria and tetanus toxoids and
acellular pertussis vaccine" in the Morbidity and Mortality Weekly Report (MMWR).
The complete text of the Notice, excluding references and one footnote, reads
as follows:
*****************************
Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) remains
in short supply, and the shortage will continue into mid-2002. Shortages are
greatest in the public sector. Despite high vaccination rates, pertussis continues to cause serious illness and death, particularly
among infants aged <6 months who are too young to have completed the 3-dose primary series of
DTaP. In 2000, a total of 1,873 pertussis cases (rate: 99 per 100,000 infants
aged <6 months) and 16 deaths were reported among infants aged <6 months. Vaccinating infants on time with
the 3-dose primary series of DTaP to protect them from serious disease remains a priority during this vaccine
shortage.
The shortage began in 2000 when two manufacturers (Wyeth Lederle, Pearl River, New York, and Baxter Hyland Immuno
Vaccines, Baltimore, Maryland) stopped production of DTaP. Aventis Pasteur (Swiftwater, Pennsylvania) and
GlaxoSmithKline (Philadelphia, Pennsylvania), producers of Tripedia* and Infanrix**, respectively, are the only two
U.S. suppliers.
DTaP is recommended as a 5-dose series: 3 doses administered to infants at ages 2, 4, and 6 months,
followed by 2 additional doses at age 15-18 months and at age 4-6 years. During the shortage of DTaP, the Advisory
Committee on Immunization Practices recommends that providers who do not have
enough DTaP to vaccinate all children with 5 doses give priority to vaccinating
infants with the first 3 doses. To ensure an adequate supply of DTaP to vaccinate infants, providers should first defer
vaccination of children aged 15-18 months with the fourth DTaP dose. If deferring the fourth dose does not
leave enough DTaP to vaccinate infants, then the fifth DTaP dose (given to children aged 4-6 years) also should be
deferred. In areas with severe DTaP shortages, local public health officials might elect to recommend
communitywide deferral of the fourth DTaP dose, and, if necessary, the fifth
DTaP dose.
When the DTaP shortage ends, providers should recall and
administer DTaP to all children who missed a dose. Vaccination of children aged 4-6 years is
needed to ensure immunity to pertussis, diphtheria, and tetanus during the elementary school years.
*****************************
* Registered trademark
** Trademark
To obtain the complete text of this Notice online, go to:
http://www.cdc.gov/mmwr//preview/mmwrhtml/mm5051a3.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to: http://www.cdc.gov/mmwr//PDF/wk/mm5051.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 email.
-----------------------------------------------------------
Back to Top
(2 of 7)
January 7, 2002
CDC PUBLISHES ARTICLE ON DRUG-RESISTANT STREPTOCOCCUS PNEUMONIAE IN A CHILD CARE CENTER IN GEORGIA
On January 4, 2002, CDC published "Multidrug-resistant Streptococcus pneumoniae in a child care center--Southwest
Georgia, December 2000" in the Morbidity and Mortality Weekly Report (MMWR).
The first paragraph of the article reads as follows:
*****************************
On December 18, 2000, public health officials in southwest Georgia contacted
the Georgia Division of Public Health (GDPH) about a child aged 11 months
hospitalized for refractory otitis media. Eight days before hospitalization, a
culture of drainage obtained from the child's middle ear revealed Streptococcus pneumoniae
resistant to penicillin, clindamycin, erythromycin, trimethoprim/sulfamethoxazole, and tetracycline (index
strain). The child attended a local child care center. GDPH and CDC conducted an
investigation to determine the rate of pneumococcal carriage among attendees of the child
care center, to identify risk factors for carriage of the index strain, and to characterize parental knowledge and
use of antibiotics and of pneumococcal conjugate vaccine (PCV7) (Prevnar*, Wyeth Lederle
Vaccine, Philadelphia, Pennsylvania). GDPH met with parents and physicians of
children attending the child care center to discuss the results of the investigation and the importance of
vaccination with PCV7. This report summarizes the results of the investigation, which suggest that
person-to-person transmission of the index strain had occurred at the child care center and indicate that most parents had been
unaware of the dangers of frequent antibiotic use and of the availability of PCV7. A multifaceted
intervention targeting parents and health-care providers might improve prescribing practices and vaccination in this community.
*****************************
* Trademark
To obtain the complete text of this article online, go to:
http://www.cdc.gov/mmwr//preview/mmwrhtml/mm5051a2.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr//PDF/wk/mm5051.pdf
-----------------------------------------------------------
Back to Top
(3 of 7)
January 7, 2002
IMPORTANT FINDING: ROUTINE CHILDHOOD HEPATITIS A VACCINATION CAN LOWER DISEASE IN WHOLE COMMUNITY
According to an article in the December 19, 2001, issue of JAMA, the Journal
of the American Medical Association (vol. 286, no. 23), a 6-year community-based project in
Butte County, California, confirmed that vaccinating children against hepatitis A can reduce the incidence of
hepatitis A disease in the community at large. As noted in the Introduction to the
article, "Available data suggest that young children, frequently asymptomatic
when infected, play an important role in hepatitis A virus (HAV) transmission."
"Control of Hepatitis A Through Routine Vaccination of Children" was written
by Francisco Averhoff, M.D., M.P.H., National Immunization Program, Centers for Disease Control
and Prevention; Craig N. Shapiro, M.D., and Beth P. Bell, M.D., M.P.H., Division of Viral Hepatitis, National Center
for Infectious Diseases; Insu Hyams, B.S.R.N., Butte County Department of Health; and nine other authors. These
researchers reported that 66.2 percent of the eligible children in Butte County received one dose of hepatitis A
vaccine and 39.3 percent received a second dose. The total number of cases of hepatitis A declined from 57 in 1995 to
only 4 in 2000, which was the lowest number reported in the county since hepatitis A surveillance began in 1966.
The Conclusion states: "In this population, hepatitis A vaccine was highly effective in preventing disease among
recipients. Childhood vaccination appears to have decreased hepatitis A incidence among children and adults
and controlled the disease in a community with recurrent epidemics."
To see the Abstract of this article, go to:
http://jama.ama-assn.org/issues/v286n23/abs/joc10974.html
The entire article is available online at no charge only to registered users or
subscribers of JAMA. To order the article online on a Pay Per View basis
($9.00 fee), go to: https://secure.edoc.com/PPV2AMA.html
To order individual reprints, call the JAMA reprint department at (312) 464-4594 or contact one of the
independent reprint vendors listed at: http://pubs.ama-assn.org/docdelivery.html
-----------------------------------------------------------
Back to Top
(4 of 7)
January 7, 2002
EASY ONLINE VIDEO EXPLAINS MEDICARE BILLING PROCESS
A 22-minute video shows you how to bill Medicare for influenza and pneumococcal vaccinations. Produced and
newly updated by the Centers for Medicare and Medicaid Services (CMS; formerly the Health Care Financing
Administration, HCFA), the video covers both carrier and intermediary roster
billing. IAC's reviewer described the video as "smoothly paced, an enjoyable
way to learn about this important material through sight and sound."
The CMS video is available online through the Missouri Patient Care Review Foundation. You will need to have a
56K modem and Real Player 8, which can be downloaded from Real.com for free.
To watch the video online, go to:
http://www.mpcrf.org/MU/
For the text guide that accompanies the video, go to:
http://www.hcfa.gov/quality/3g8.htm
To order a free copy of the video on tape, contact Linda Horsch at CMS by email at
lhorsch@cms.hhs.gov or by phone
at (214) 767-4467
-----------------------------------------------------------
Back to Top
(5 of 7)
January 7, 2002
DHHS OFFERS TWO FURTHER TREATMENT OPTIONS FOR THOSE EXPOSED TO ANTHRAX
On December 18, 2001, the Department of Health and Human Services (DHHS) issued a statement titled "Regarding
Additional Options for Preventive Treatment for Those Exposed to Inhalational Anthrax."
The statement pertains to people who were exposed to inhalational anthrax in
the recent mail incidents and who are concluding their 60-day course of preventive
antibiotic treatment. DHHS is providing two options for those who want to pursue them: "an extended course of
antibiotics, and investigational post-exposure treatment with anthrax vaccine."
To read the statement on the Department of Health and Human Services website, go to:
http://www.hhs.gov/news/press/2001pres/20011218.html
-----------------------------------------------------------
Back to Top
(6 of 7)
January 7, 2002
REMINDER: EVERY CHILD BY TWO NEWSLETTER COVERS EVENTS ON CAPITOL HILL
As we enter a new legislative session, don't forget to keep informed about new
vaccination legislation by reading the Every Child By Two (ECBT) bimonthly newsletter and the
less-frequent supplement "On the Hill," which covers pertinent committee hearings and other events as they
occur.
The December 18, 2001, issue of "On the Hill" includes a discussion of the 2002 funding increase for the National
Immunization Program.
To read the ECBT newsletter and the "On the Hill" supplement online, go to: http://www.ecbt.org/allnews.html
To subscribe to the newsletter by email, send a request to info@ecbt.org
-----------------------------------------------------------
Back to Top
(7 of 7)
January 7, 2002
NEW TRANSLATION! 2001 SUMMARY OF ADULT RECOMMENDATIONS AVAILABLE IN TURKISH
IAC now offers the current "Summary of Recommendations for Adult Immunization" in Turkish.
To view or print a camera-ready (PDF format) copy of the summary of adult immunization recommendations in Turkish,
go to:
http://www.immunize.org/catg.d/p2011tu.pdf
For the English version, go to:
http://www.immunize.org/catg.d/p2011b.pdf
IAC thanks Dr. Mustafa Kozanoglu, pediatrician, and Dr. Murat Serbest, pediatric hematologist, both from Adana,
Turkey, for providing this translation.
|
