Issue
Number 305
April 8, 2002
CONTENTS OF THIS ISSUE
- New on the Web: Supplement on
vaccines across the life span
- Article on 17-year surveillance of
acute hepatitis B identifies significant gaps in
vaccination
- Revisions! Download the most
current versions of two IAC forms
- Summit to Eliminate Racial and
Ethnic Disparities in Health is set for July
10-12 in Washington
- CDC publishes influenza recap for
2001-2002 season so far
- CDC reports on suspected cutaneous
anthrax in Texas lab worker
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April 8, 2002
NEW ON THE WEB: SUPPLEMENT ON VACCINES ACROSS THE LIFE SPAN
"For years I have wished for a practical resource on
immunizations across the life span written by
family physicians for their colleagues,"
says Richard K. Zimmerman, M.D., M.P.H., in "A Red
Book of Our Own," his
introduction to a major project of the Group on
Immunization Education of the Society of Teachers
of Family Medicine (STFM). "In Vaccines Across the
Life Span, 2001, we now have the
comprehensive resource I've always wanted."
"Vaccines Across the Life Span, 2001," funded by a grant
from the Centers for Disease Control and
Prevention (CDC), is a five-article document that
first appeared as a supplement to the October 2001
issue of the Journal of Family Practice
(vol. 50, no. 10). This invaluable resource is now
available as a link on the website of
STFM's immunization education group.
The following excerpt from "A Red Book of Our Own"
(footnotes excluded) describes the supplement's
components:
****************************************
The first article, "Routine Vaccines Across the Life Span,
2001," addresses vaccines that have
indications based on age and covers the disease
burden, rationale for vaccination, vaccine
efficacy, adverse reactions, and
specific vaccine recommendations. Pictures of vaccine-preventable
diseases are included in the color centerfold
of the supplement. The second article, "Vaccines for
Persons at High Risk Because of
Medical Conditions, Occupation, Environment, or
Lifestyle, 2001," addresses indications based on
high-risk situations, including pregnancy and
health care workers. The third article,
"Vaccine Schedules and Procedures, 2001," addresses the
practical issues of vaccination including
catch-up schedules, contraindications,
administration routes, storage, and keeping
current with changing recommendations.
The fourth article, "Overcoming Barriers to Immunization,"
reviews barriers and strategies to overcome
them, and includes a summary of what is proven to
work. The fifth article, "Communicating the
Benefits and Risks of Vaccines," addresses the
important issue of vaccine safety and contains
tables comparing the risks of the disease with the benefits
and risks of vaccination; the reader will
find these tables useful in dealing with parents
who are concerned about vaccine safety.
****************************************
To obtain a copy of "Vaccines Across the Life Span, 2001"
or any of its articles, go to:
http://www.immunizationed.org
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April 8, 2002
ARTICLE ON 17-YEAR SURVEILLANCE OF ACUTE HEPATITIS B
IDENTIFIES SIGNIFICANT GAPS IN VACCINATION
On March 15, 2002, the Journal of Infectious Diseases
published "Incidence and Risk Factors for
Acute Hepatitis B in the United States, 1982-1998: Implications for
Vaccination Programs" (vol. 185, no. 6: 713-719). The
abstract states, "Over half of all patients (55%) reported
treatment for a sexually transmitted disease (STD) or
incarceration in a prison or jail prior to their illness,
suggesting that more than half of the acute hepatitis B
cases might have been prevented through routine hepatitis
B immunization in STD clinics and correctional health care
programs." According to the article, only 25%
of STD clinics currently offer hepatitis B vaccination.
The article was written by Susan T. Goldstein, Miriam J.
Alter, Ian T. Williams, Linda A. Moyer, all from
the Division of Viral Hepatitis, National Center for
Infectious Diseases, Centers for Disease Control and
Prevention (CDC), Atlanta, Georgia; Franklyn N. Judson,
Denver Department of Health and Hospitals, Denver,
Colorado; Karen Mottram, Tacoma-Pierce County Department
of Health, Tacoma, Washington; Michael Fleenor, Jefferson
County Department of Health, Birmingham, Alabama; Patricia
L. Ryder, Pinellas County Department of Health, St.
Petersburg, Florida; and Harold S. Margolis, Division of
Viral Hepatitis, CDC.
The authors wrote in the Discussion section, in part
(footnotes excluded):
*******************************
Of the patients in this study, 76.4% had risk behaviors or
characteristics, either during the incubation
period or over their lifetime, that placed them in a group for which
hepatitis B vaccination is recommended. . . .
There are longstanding recommendations to vaccinate adults
at increased risk for HBV infection. However, nationwide
programs do not exist that integrate hepatitis B
immunization into programs that serve high-risk adults in
STD clinics, correctional facilities, drug treatment
programs, or HIV/AIDS counseling and testing programs.
Over the past decade, studies have shown that, when cost
is not a barrier, 46% to >90% of persons in these settings
received the first hepatitis B vaccine dose and 31%-
9% of those who received the first dose completed the 3-dose
series. . . .
Although a number of US states and counties provide
hepatitis B vaccine to limited groups of high-risk
adults, transmission of HBV cannot be eliminated until there is a
nationwide program to vaccinate adults at increased risk
for HBV infection, and hepatitis B-related liver cancer
and chronic liver disease will remain elevated for
decades.
*******************************
To read the abstract of this article, go to:
http://www.journals.uchicago.edu/JID/journal/issues/v185n6/011066/brief/011066.abstract.html
The entire article is currently available online only to
registered subscribers of the Journal of Infectious
Diseases Electronic Edition. To learn about becoming a
registered subscriber, go to:
http://www.journals.uchicago.edu/JID/
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April 8, 2002
REVISIONS! DOWNLOAD THE MOST CURRENT VERSIONS OF TWO IAC
FORMS
The Immunization Action Coalition (IAC) has revised its
"Vaccine Administration Record for Adults," a
one-page form intended to be kept in patient medical charts. Three
lines were added for doses of the hepatitis A and B
combination vaccine, while Lyme disease vaccine was
removed.
On our "Patient Notification Letter Regarding Hepatitis B
Test Results," we have added a new result
category to communicate to patients: "resolving hepatitis B virus
infection." The description reads: "Your
results show that you were recently infected with hepatitis B virus,
but that your infection is resolving. You are no longer
infectious to others."
The other result categories are "susceptible," "immune due
to past infection," "immune due to
vaccination," "acutely infected with hepatitis B," "chronically infected with
hepatitis B virus," and "indeterminate results."
In addition to the new result category, we've made a
functional change to the letter. Because the content
of this notification letter is fairly standard, we have
removed text at the top about adapting the letter for
your clinic's use. Of course, you can still create your own
version if necessary, but now you also can, if
you prefer, simply print and fill out a hard copy of IAC's model
letter.
To obtain a copy of "Vaccine Administration Record for
Adults," go to:
HTML: http://www.immunize.org/catg.d/p2023b.htm
PDF: http://www.immunize.org/catg.d/p2023b.pdf
To obtain a copy of "Patient Notification Letter Regarding
Hepatitis B Test Results," go to:
http://www.immunize.org/catg.d/p4140.htm
http://www.immunize.org/catg.d/p4140.pdf
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April 8, 2002
SUMMIT TO ELIMINATE RACIAL AND ETHNIC DISPARITIES IN
HEALTH IS SET FOR JULY 10-12 IN WASHINGTON
The U.S. Department of Health and Human Services Office of
Minority Health and Office of Public Health and Science
will sponsor the National Leadership Summit to Eliminate
Racial and Ethnic Disparities in Health July 10-12 at the
Hilton Hotel and Towers in Washington, D.C.
The Summit's theme is "Closing the Health Gap," which will
be explored via three cross-cutting issues: access to
care, health providers, and the role of data. The purpose
of the Summit is "to draw national attention to the
existence of health disparities and to innovative
approaches being implemented in our communities at the
local, state, national, federal, and tribal levels to
address these disparities."
The registration fee for the Summit is $150.00. On-site
registration will not be available.
For more information on the Summit, go to:
http://www.summit.omhrc.gov
To register for the Summit online, go to:
http://www.betah.com/betah/conferences/form01.html
Hilton room rates are $119 for a single and $139 for a
double. For reservations, call (888) 324-4586.
You may also contact Matthew Murguia, Division of Information and Education, Office of Minority
Health, by email at
mmurguia@osophs.dhhs.gov or phone at (301) 443-3325.
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April 8, 2002
CDC PUBLISHES INFLUENZA RECAP FOR 2001-2002 SEASON SO FAR
On April 5, 2002, the Centers for Disease Control and
Prevention (CDC) published "Update: Influenza
Activity--United States, 2001-02 Season" in the Morbidity and
Mortality Weekly Report (MMWR). According to the editorial
note, "Influenza activity in the United States during the
current season increased steadily during December-January,
peaked in February, and is declining nationwide. . . . In
recent weeks, influenza B virus activity has increased in
certain areas of the country, and both influenza A and B
viruses might continue to circulate during April."
To obtain the complete text of the update online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5113a3.htm
To obtain a camera-ready (PDF format) copy of this issue
of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5113.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.
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April 8, 2002
CDC REPORTS ON SUSPECTED CUTANEOUS ANTHRAX IN TEXAS LAB
WORKER
On April 5, 2002, the Centers for Disease Control and
Prevention (CDC) published "Suspected Cutaneous Anthrax in
a Laboratory Worker--Texas, 2002" in the Morbidity and
Mortality Weekly Report (MMWR). The male laboratory worker
became ill in early March and spent four days in the
hospital after becoming infected from B. anthracis
isolates (most likely on the surface of laboratory vials)
that entered a shaving cut on his jaw. Neither this worker
nor any of his colleagues (approximately 40 in all) had
received anthrax vaccine.
According to the editorial note, "This suspected case of
laboratory-acquired cutaneous anthrax highlights the need
for anthrax vaccination, in addition to standard
laboratory safety procedures, for laboratorians who work
routinely with B. anthracis specimens."
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5113a4.htm
To obtain a camera-ready (PDF format) copy of this issue
of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5113.pdf
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