Issue
Number 333
August 26, 2002
CONTENTS OF THIS ISSUE
-
National Immunization Program issues
"Vaccine Supply Update"
-
New! Tattooing and Body Piercing Information
page on IAC's website
-
PEDIATRICS commentators call getting
reimbursement for pneumococcal conjugate vaccine a Herculean task
-
Letter from Surgeon General urges hepatitis
B immunization for Asian American and Pacific Islander high-schoolers
-
Safe Injection Global Network (SIGN) meeting
will take place October 24-26 in Cambodia
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August 26, 2002
NATIONAL IMMUNIZATION PROGRAM ISSUES "VACCINE SUPPLY UPDATE"
The National Immunization Program (NIP) has provided the following brief
update on the supply of vaccines in the United States, listing those
vaccines that are now in sufficient supply and those still in short supply.
*****************************
This is an update on the present availability of vaccines that are routinely
used in the pediatric schedule.
SUFFICIENT SUPPLY
The following vaccines are in sufficient supply to allow health care
providers to vaccinate in accordance with the full dosing schedule as
recommended by the Advisory Committee on Immunization Practices (ACIP), the
American Academy of Pediatrics (AAP) Red Book Committee, and the American
Academy of Family Physicians (AAFP).
- DTaP
- Hepatitis B
- Hib (Vaccine supply is sufficient at this
time only for Aventis Pasteur, brand name ActHIB. Please see below
regarding other Hib vaccines.)
- IPV
- MMR
- Td
- Varicella
- Hepatitis A (pediatric)
SHORTAGES AND/OR DELAYS REMAIN IN EFFECT
- Hepatitis B - Hib Vaccine - (HepB-Hib vaccine supply from Merck, brand
name COMVAX, is taking about 2 to 4 weeks to supply, from the time of order
placement. Expect delays into the Fall, 2002.)
- Hib Vaccine - (Hib vaccine supply from Wyeth, brand name HibTITER, is
taking 8 weeks between order placement and vaccine receipt. Expect delays
into Fall, 2002.)
- Pneumococcal Conjugate Vaccine (PCV) - (The supply of PCV remains
critically low. Expect delays at least into late 2002.)
OTHER VACCINES
Meningococcal Vaccine - (Supply is sufficient to meet demand.)
Pneumococcal Polysaccharide Vaccine (PPV) - (Wyeth is currently out of PPV
but will have supplies available in late fall/early winter. Merck has an
adequate supply of PPV.)
Influenza Vaccine - (All three vaccine manufacturers are reporting that
influenza vaccine production for the 2002-03 season is proceeding
satisfactorily. According to the latest data provided by the manufacturers,
the projected total production for the U.S. market should approximate 95
million doses.)
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For more information on the vaccine supply, go to:
http://www.cdc.gov/nip
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August 26, 2002
NEW! TATTOOING AND BODY PIERCING INFORMATION PAGE ON IAC'S WEBSITE
Because tattooing and body piercing have become popular even in mainstream
American culture, and because these procedures can be associated with
increased risk for blood-borne infectious diseases such as hepatitis B and
hepatitis C, the Immunization Action Coalition (IAC) has created a web page
containing links to relevant articles from medical journals and publications
from national sources such as the Centers for Disease Control and Prevention
(CDC).
Theoretically, tattooing and body piercing carry the risk of transmitting
blood-borne infections; however, in practice it has been difficult to
isolate the risk associated with tattooing and body piercing from other risk
factors. We hope this page will help you advise patients who are considering
one or both of these forms of body art.
To visit IAC's new Tattooing and Body Piercing Information web page, go to:
http://www.immunize.org/tattoos/index.htm
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August 26, 2002
PEDIATRICS COMMENTATORS CALL GETTING REIMBURSEMENT FOR PNEUMOCOCCAL
CONJUGATE VACCINE A HERCULEAN TASK
According to the five authors of a 2-page commentary in the August issue of
PEDIATRICS (vol. 110, no. 2), the tale of the year-plus struggle by
physicians to get adequate reimbursement for administering pneumococcal
conjugate vaccine to children contains important lessons for future vaccine
policy implementation.
Likening the reimbursement process through different insurance carriers and
the federal government to one of the 12 labors of the Greek hero
Hercules--slaying a multi-headed monster named Hydra--the authors write
about this modern medical saga:
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Our story begins back in October 1999, when the Advisory Committee on
Immunization Practices first voted to recommend the conjugate pneumococcal
vaccine (contingent on licensure) for administration to children (the king's
order). . . . [A letter from the manufacturer of the vaccine] stated that
the average wholesale price was set at $72.50 per dose and the Current
Procedural Terminology (CPT) code had been established as 90669 as opposed
to 90732, the code for the already existing 23-valent pneumococcal
polysaccharide vaccines for older children and adults. . . . This important
distinction would later prove confusing for health plans and problematic for
our hero because the reimbursement for Pneumovax is less than $10. . . .
Although appropriate reimbursement for future Prevnar use was won in the
battle, our hero's initial financial investment was never fully regained.
Over the course of the ordeal, the primary care physician had to contend not
only with the aggravation of the mistakes related to the CPT code and other
financial issues, but also with the de facto establishment of a 2-tier
system of care for those patients with private insurance and those covered
by public sources. . . .
Epilogue: In the story above, our "hero" is actually the medical director of
a group practice on which this tale is based, chair of the state advisory
committee on immunizations, board chair of insurer C, and a long-time
consultant to insurer B on immunization issues. The group practice has
dedicated staff assigned to resolve insurance issues like these. The above
experiences were not a result of information deficit or naivete. As such,
other practices may have experienced even greater difficulties.
******************************
This commentary is currently available for free online only to current
PEDIATRICS subscribers. If you are unable to obtain a hard copy of the
commentary through your medical library, online access is available to
non-subscribers on a Pay Per Article basis ($10) at:
http://www.pediatrics.org/cgi/content/full/110/2/399
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August 26, 2002
LETTER FROM SURGEON GENERAL URGES HEPATITIS B IMMUNIZATION FOR ASIAN
AMERICAN AND PACIFIC ISLANDER HIGH-SCHOOLERS
In recognition of both Asian/Pacific American Heritage Month and Hepatitis
Awareness Month, which coincide in May, the Office of the Surgeon General
issued a letter this year "to strongly encourage" hepatitis B immunization
in high schools, particularly in high schools with a high proportion of
Asian students. The letter, originally distributed by mail to health-care
colleagues, is now available online.
The letter is signed by Kenneth Moritsugu, M.D., M.P.H., Acting Surgeon
General; John B. Tsu, Ph.D., Chair of the President's Advisory Committee on
AAPIs; and Moon S. Chen, Jr., Ph.D., M.P.H., Executive Director of the
National Task Force on Hepatitis B Immunization, Focus on Asians and Pacific
Islanders.
"Currently in the United States," the letter informs, "there are 1.25
million people with chronic Hepatitis B virus (HBV) infection. Each year,
5,000 of these die from liver failure resulting from chronic HBV infection.
Fifty percent of the 1.25 million and of the 5,000 are Asian American and
Pacific Islanders (AAPI), even though only 4.5% of the U.S. population is
AAPI."
In the fourth and last paragraph of the letter, Drs. Moritsugu, Tsu, and
Chen say: "Please continue efforts to educate, motivate, and vaccinate for
Hepatitis B prevention in high schools where 30% are AAPI."
To read the letter on the Surgeon General's website, go to:
http://www.surgeongeneral.gov/topics/hepatitisb/hepbletter.htm
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August 26, 2002
SAFE INJECTION GLOBAL NETWORK (SIGN) MEETING WILL TAKE PLACE OCTOBER 24-26
IN CAMBODIA
A tentative agenda has been drafted for the annual SIGN meeting to be held
Thursday, October 24 through Saturday, October 26 in Cambodia.
SIGN meeting topics will include "Assessing Injection Practices," "Biologicals
in 2000-2002," and "Planning for Safe and Appropriate Use of Injections." A
major objective will be the presentation of the World Health Organization
(WHO) injection safety planner.
Details will be announced in IAC EXPRESS as they become available.
For more information immediately, contact SIGN by email at
sign@who.int
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