Issue
Number 371
March 17, 2003
CONTENTS OF THIS ISSUE
- Reader alert: CDC to clarify its notification about Pediarix
pediatric combination vaccine
- CDC makes corrections to recommendations on prevention and
control of hepatitis infections in correctional settings
- IOM Immunization Safety Review Committee's study indicates no
link between SIDS and childhood vaccines
- New translations: Updated smallpox VIS now available in nine
languages
- New: Learn the fine points of vaccine storage and handling
from IAC's latest education sheet
- New: IAC adds to its library of reliable immunization
resources
- New: Pro-vaccine experts and parents available for vaccine
safety interviews
- CDC notifies readers about the National Vaccine Advisory
Committee's report on strengthening the vaccine supply
- Updated: IAC revises its information sheet about vaccines
distributed in the United States
- CDC publishes update of smallpox vaccine adverse events
surveillance
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March 17, 2003
READER ALERT: CDC TO CLARIFY ITS NOTIFICATION ABOUT PEDIARIX PEDIATRIC
COMBINATION VACCINE
The Centers for Disease Control and Prevention (CDC) published a Notice to
Readers, "FDA Licensure of Diphtheria and Tetanus Toxoids and Acellular
Pertussis Adsorbed, Hepatitis B (Recombinant), and Poliovirus Vaccine
Combined, (PEDIARIX) for use in Infants," in the March 14 issue of the
"Morbidity and Mortality Weekly Report" (MMWR).
This Notice to Readers contains information that might be misinterpreted. "IAC
EXPRESS" has learned that MMWR will issue a clarification shortly, perhaps
as soon as its March 21 issue. As the clarification is expected soon, we
have decided not to reprint the March 14 Notice to Readers; instead, we will
reprint the Notice to Readers and the clarification simultaneously in a
future issue of "IAC EXPRESS."
To obtain the complete text of the notice online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5210a8.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5210.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 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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March 17, 2003
CDC MAKES CORRECTIONS TO RECOMMENDATIONS ON PREVENTION AND CONTROL OF
HEPATITIS INFECTIONS IN CORRECTIONAL SETTINGS
The Centers for Disease Control and Prevention (CDC) published "Errata: Vol.
52, No. RR-1" in the March 14 issue of the "Morbidity and Mortality Weekly
Report" (MMWR). It concerns the "MMWR Recommendations and Reports"
publication titled "Prevention and Control of Infections with Hepatitis
Viruses in Correctional Settings," published January 24.
A portion of the text follows.
****************************
. . . an error occurred on page 4 in the second sentence of the paragraph
under Occupational Exposures. The sentence should read, "Occupational
transmission of HBV infection among hospital-based workers has been linked
to percutaneous and mucous membrane exposures, and HCV infection has been
primarily associated with percutaneous exposure."
On page 12, in Box 6, the fourth item under Type of Exposure should read,
"Household (e.g., cell or dormitory) contact--to person with chronic HBV
infection."
On page 2, errors occurred in Table 1, and on page 20, errors occurred in
Table 5. ["IAC EXPRESS" Editor's Note: the tables mentioned are included in
the Errata but not in this "IAC EXPRESS" article.]
****************************
To obtain the complete text of the Errata online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5210a9.htm
To obtain a camera-ready (PDF format) copy of the "MMWR Recommendations and
Reports" publication "Prevention and Control of Infections with Hepatitis
Viruses in Correctional Settings, go to:
http://www.cdc.gov/mmwr/PDF/RR/RR5201.pdf
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March 17, 2003
IOM IMMUNIZATION SAFETY REVIEW COMMITTEE'S STUDY INDICATES NO LINK BETWEEN
SIDS AND CHILDHOOD VACCINES
On March 12, the National Academy of Science's Institute of Medicine (IOM)
released a study, "Immunization Safety Review: Vaccinations and Sudden
Unexpected Death in Infancy." The study concludes that sudden infant death
syndrome (SIDS) is not linked to the number or variety of childhood vaccines
currently recommended in the United States.
A summary of an IOM press release states the following: "The available
scientific evidence does not support a causal link between sudden infant
death syndrome and exposure to the diphtheria, tetanus, and whole-cell
pertussis [DTwP] vaccine or to multiple childhood vaccines . . . Only an
older diphtheria-[tetanus]-pertussis vaccine, no longer used in the United
States, is causally related to a rare and fatal inflammatory reaction in
infants. These and other findings about links between childhood vaccines and
SIDS or other types of sudden unexpected death in infancy do not warrant a
review of the childhood vaccination schedule."
To read the complete press release from the website of the National
Academies Press (NAP), go to:
http://www4.nationalacademies.org/news.nsf/isbn/0309088860?OpenDOcument
To access a text-only version of the study from the NAP website, go to:
http://www.nap.edu/books/0309088860/html
The study will be published later this year. For ordering information, call
NAP customer service at (800) 624-6242 or (202) 334-3313.
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March 17, 2003
NEW TRANSLATIONS: UPDATED SMALLPOX VIS NOW AVAILABLE IN NINE LANGUAGES
Updated on January 16, the current smallpox Vaccine Information Statement (VIS)
was initially available only in English. The Minnesota Department of Health
(MDH) recently translated the smallpox VIS into eight languages: Cambodian
(Khmer), Hmong, Laotian, Russian, Serbo-Croatian, Somali, Spanish, and
Vietnamese. The Immunization Action Coalition (IAC) gratefully acknowledges
MDH for making the translations available to us.
USING A TRANSLATED VIS WITH SUPPLEMENTS A THROUGH E
When updating the smallpox VIS in January, the Centers for Disease Control
and Prevention (CDC) made the VIS part of a Smallpox Information Packet,
which includes five supplements (A through E). The supplements and other
material in the Smallpox Information Packet are available from the CDC
website in English and Spanish.
Like the English smallpox VIS, the other smallpox VISs must be used with
supplements A through E. To access the Smallpox Information Packet in English
or Spanish from the CDC website, click on the links below.
For an English-language packet (including the VIS), go to:
http://www.bt.cdc.gov/agent/smallpox/vaccination/pdf/smallpox-vax-info-packet.pdf
For a Spanish-language packet (including the VIS), go to:
http://www.bt.cdc.gov/agent/smallpox/vaccination/espanol/pdf/viruela-paquete.pdf
IAC's smallpox web page also has a link to the English and Spanish packets.
To access it, go to:
http://www.immunize.org/vis/index.htm#smallpox
ACCESSING THE SMALLPOX VIS IN NINE LANGUAGES
To access a camera-ready (PDF) version of the smallpox VIS in Cambodian
(Khmer) from the IAC website, go to:
http://www.immunize.org/vis/casmal03.pdf
To access it in Hmong, go to:
http://www.immunize.org/vis/hmsmal03.pdf
To access it in Laotian, go to:
http://www.immunize.org/vis/lasmal03.pdf
To access it in Russian, go to:
http://www.immunize.org/vis/rusmal03.pdf
To access it in Serbo-Croatian, go to:
http://www.immunize.org/vis/scsmal03.pdf
To access it in Somali, go to:
http://www.immunize.org/vis/sosmal03.pdf
To access it in Spanish, go to:
http://www.immunize.org/vis/spsmal03.pdf
To access it in Vietnamese, go to:
http://www.immunize.org/vis/vnsmal03.pdf
To access it in English from the CDC website, go to:
http://www.bt.cdc.gov/agent/smallpox/vaccination/pdf/smallpox-vis.pdf
For extensive, up-to-date information about smallpox disease and vaccine,
visit the CDC's bioterrorism website at
http://www.bt.cdc.gov/agent/smallpox
For information about the use of VISs, as well as VISs for additional
vaccines (some in up to 28 languages), visit the IAC website at
http://www.immunize.org/vis
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March 17, 2003
NEW: LEARN THE FINE POINTS OF VACCINE STORAGE AND HANDLING FROM
IAC'S LATEST EDUCATION SHEET
Improper vaccine storage and handling can cause headaches for
immunization providers. For example, clinics and practices can
lose lots of money if they have to discard a box of varicella
vaccine because they inadvertently stored it at the wrong
temperature. Worse yet, improper storage can cause the vaccine
to lose potency and result in unprotected vaccinees.
To help immunization providers avoid costly mistakes, the
Immunization Action Coalition (IAC) recently developed a
professional education sheet, "Don't Be Guilty of These Errors
in Vaccine Storage and Handling." It is based on the Vaccine
Storage and Handling section of the Centers for Disease Control
and Prevention's satellite training course "The Immunization
Encounter: Critical Issues," which was broadcast June 27, 2002.
The one-page education sheet gives immunization providers an
easy way to evaluate their vaccine storage and handling
procedures. It succinctly explains the ten most commonly
reported errors in vaccine storage and handling and presents a
plan for correcting each.
To access the new piece in camera-ready (PDF) format, go to:
http://www.immunize.org/catg.d/p3036.pdf
To access it in HTML format, go to:
http://www.immunize.org/catg.d/p3036.htm
For further information on vaccine storage and handling, check
out two other IAC resources for health professionals:
- "Checklist for Safe Vaccine Handling and Storage" is a
one-page sheet of the 20 most important things to do to
safeguard your vaccine supply.
To access it in camera-ready (PDF) format, go to:
http://www.immunize.org/catg.d/p3035chk.pdf
To access it in HTML format, go to:
http://www.immunize.org/catg.d/p3035chk.htm
- "Protect Your Vaccines: Check Temperatures Twice a Day!"
is a two-page vaccine temperature log with space for
recording a month's worth of temperatures in your vaccine-storage refrigerator and freezer. IAC is grateful to the
Michigan Department of Community Health for giving us
permission to adapt the log.
To access the Fahrenheit version of the log in camera-ready (PDF) format, go to:
http://www.immunize.org/catg.d/p3039.pdf
To access the Celsius version of the log in camera-ready
(PDF) format, go to:
http://www.immunize.org/news.d/celsius.pdf
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March 17, 2003
NEW: IAC ADDS TO ITS LIBRARY OF RELIABLE IMMUNIZATION RESOURCES
In keeping with its goal to provide the public and health
professionals with a virtual library of high-quality, reliable
immunization resources, the Immunization Action Coalition (IAC)
has recently collected immunization material from the Institute
of Medicine and the Children's Vaccine Program at PATH (Program
for Appropriate Technology in Health) and posted it on the IAC
website.
The material in the IAC virtual library is constantly updated;
plan to visit it often.
INSTITUTE OF MEDICINE (IOM) MATERIALS
To date, IAC has culled thirty immunization publications from
IOM. Some publications are based on presentations made at
national immunization workshops organized by IOM. Others are
reports from the Immunization Safety Review Committee, an IOM
project that addresses vaccine-safety concerns and provides
independent, non-biased advice to vaccine policy makers, health
practitioners, and the public.
Created in 1970, IOM is part of the National Academy of Sciences
(NAS). IOM's mission is to advance and disseminate scientific
knowledge to improve human health. As a part of NAS, IOM is
private; the studies it undertakes for the federal government
are usually funded from appropriations made available to federal
agencies.
To access IOM materials from the IAC website, go to:
http://www.immunize.org/iom
To access IOM directly, go to: http://www.iom.edu
CHILDREN'S VACCINE PROGRAM (CVP) MATERIALS
IAC's collection of CVP immunization resources currently
comprises nine training modules for providers; all were
published between 2000-2003. Some are available in French,
Russian, and/or Spanish, as well as English, which is in keeping
with CVP's focus on global immunization.
PATH launched CVP in 1998 with funds from the Bill and Melinda
Gates Foundation. CVP works with such international partners as
the World Health Organization (WHO) and the United Nations
Children's Fund to leverage the resources of the global health
community to build equitable, sustainable, safe, and efficient
immunization systems.
To access CVP materials from the IAC website, go to:
http://www.immunize.org/cvp
To access CVP directly, go to: http://www.childrensvaccine.org
MATERIALS FROM OTHER SOURCES
For the past several years, IAC has collected and posted
immunization materials from a variety of sources: statements
from the Advisory Committee on Immunization Practices (ACIP),
policy statements from the American Academy of Pediatrics (AAP),
and immunization information from WHO. Many materials are
available in both HTML and PDF formats. To access these
collections from the IAC website, go to the following links:
ACIP statements,
http://www.immunize.org/acip
AAP policy statements, http://www.immunize.org/aap
WHO immunization information, http://www.immunize.org/who
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March 17, 2003
NEW: PRO-VACCINE EXPERTS AND PARENTS AVAILABLE FOR VACCINE
SAFETY INTERVIEWS
In the interest of helping the press and the public understand
the pro-vaccine viewpoint, the Sabin Vaccine Institute and PKIDS
(Parents of Kids with Infectious Diseases) issued a joint press
release introducing a panel of medical experts and parents
available for vaccine safety interviews. The experts will
comment on the science and safety of vaccines; the parents will
discuss their experience in caring for or losing an unimmunized
child who contracted a vaccine-preventable illness.
The press release is reprinted below.
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EXPERTS
Peter Hotez, MD, PhD, is Professor and Chair of the Department
of Microbiology at George Washington University and a Senior
Fellow and Chair of the Sabin Vaccine Institute's Scientific
Advisory Council. The father of an autistic child, Dr. Hotez
offers a unique perspective on the current debate about
vaccines. He can be reached at (202) 994-3532 or
mtmpjh@gwumc.edu
Samuel Katz, MD, was co-developer of the measles vaccine in
conjunction with Nobel Prize winner Dr. John Enders. Chairman of
Pediatrics at Duke University for 22 years, Dr. Katz is
currently the Wilburt C. Davison Professor of Pediatrics
Emeritus at the University. Dr. Katz can be reached at (919)
684-3734 or katz0004@mc.duke.edu
Sharon Humiston, MD, MPH, works in the Pediatric Emergency
Department of the University of Rochester Medical Center,
Rochester, N.Y., and is the author of "Vaccinating Your Child;
Questions and Answers for the Concerned Parent." In addition to
her public health and immunization expertise, Dr. Humiston is
the mother of an autistic child. Dr. Humiston can be reached at
(585) 275-6657 or at sharon_humiston@urmc.rochester.edu
Paul Offit, MD, is Chief of Infectious Diseases at the
Children's Hospital of Philadelphia and a Professor of
Pediatrics at the University of Pennsylvania School of Medicine.
A scientist and co-author of "Vaccines: What Every Parent Should
Know," Dr. Offit educates the public about vaccines as Director
of the Vaccine Education Center. He can be reached at (215) 590-2020 or
offit@email.chop.edu
PARENTS [To arrange to interview a parent, call PKIDs at (360)
695-0293 or email ckukka@pkids.org]
Suzanne and Leonard Walther of Murfreesboro, Tennessee,
postponed their daughter's immunizations based on misinformation
they found on the Internet. She subsequently contracted
Haemophilus influenzae type b (Hib), a vaccine-preventable
disease, and spent her first birthday in a hospital emergency
room. Their daughter survived, and today Suzanne Walther urges
parents to trust their pediatrician and science--not unfounded
allegations--when deciding whether to protect their children
against infectious diseases.
Mary-Clayton Enderlein contracted whooping cough (pertussis)
from her son's unimmunized friend during her ninth month of
pregnancy. She consequently infected her newborn son, who became
very ill and required hospitalization. Pertussis, or whooping
cough, is a highly contagious bacterial disease that causes
severe coughing and gasping for breath. Enderlein, who lives
outside of Seattle, comments, "I've always felt that
immunizations are our social responsibility. Vaccinating
children is part of our social contract to help protect the
health of everyone who lives in our communities."
Frankie Milley of Conroe, Texas, lost her only child to
meningococcal meningitis, which could have been prevented by a
vaccine. "I am motivated by the loss of my only child to make
sure all children everywhere are protected against infectious
diseases," she said. "Vaccines are safe, they work, and they
save lives. Our children deserve the best protection we can give
them."
Maureen Kane and her husband wanted nothing more than to provide a happy, healthy home for their newly adopted daughter. When
they brought her to their small town in Maryland, they soon
found that they could provide happiness, but they would have to
fight for her health. Like more than 1.2 million Americans,
their daughter was infected with chronic hepatitis B, which can
lead to cirrhosis and liver cancer. After months of grueling
medical treatment, their daughter is healthy, but her struggle
has motivated Maureen to advocate for critical childhood
immunizations worldwide.
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March 17, 2003
CDC NOTIFIES READERS ABOUT THE NATIONAL VACCINE ADVISORY
COMMITTEE'S REPORT ON STRENGTHENING THE VACCINE SUPPLY
The Centers for Disease Control and Prevention (CDC) published a
Notice to Readers, "National Vaccine Advisory Committee Report
on Strengthening the Vaccine Supply," in the March 14 issue of
the "Morbidity and Mortality Weekly Report" (MMWR). The entire
notice follows.
******************************
The National Vaccine Advisory Committee has released a report
entitled "Strengthening the Supply of Routinely Recommended
Vaccines in the United States: A Report of the National Vaccine
Advisory Committee." The report describes the immediate and
contributing factors leading to the 2001-2002 vaccine supply
shortages and outlines 12 recommendations to prevent future
shortages. The report is available at
http://www.cdc.gov/od/nvpo/nvac-vsr.htm.
***************************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5210a6.htm
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March 17, 2003
UPDATED: IAC REVISES ITS INFORMATION SHEET ABOUT VACCINES
DISTRIBUTED IN THE UNITED STATES
If you're interested in phoning a vaccine manufacturer's
customer service line or accessing a manufacturer's website,
you'll want a copy of "Vaccines and Related Products Distributed
in the United States, 2003," which was recently revised by the
Immunization Action Coalition (IAC).
This one-page information sheet lists all the vaccines and
related biologic products licensed for U.S. distribution as of
March 2003. It shows the disease(s) each vaccine and biologic
protects against, as well as the brand name, manufacturer, type
(e.g., inactivated or live attenuated), and supply size (e.g.,
single- or multi-dose vial) of each.
One notable addition since the sheet was last revised in
November 2001 is information about Pediarix, GlaxoSmithKline's
pediatric combination vaccine for diphtheria, tetanus,
pertussis, hepatitis B, and polio.
To access the revised sheet in camera-ready (PDF) format, go to:
http://www.immunize.org/catg.d/2019prod.pdf
To access it in HTML format, go to:
http://www.immunize.org/catg.d/2019prod.htm
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March 17, 2003
CDC PUBLISHES UPDATE OF SMALLPOX VACCINE ADVERSE EVENTS
SURVEILLANCE
The Centers for Disease Control and Prevention (CDC) published
"Smallpox Vaccine Adverse Events Among Civilians--United States,
March 4-10, 2003" in the March 14 issue of the "Morbidity and
Mortality Weekly Report" (MMWR). The article updates information
published in the March 7 MMWR. Surveillance for adverse events
during the civilian smallpox vaccination program is ongoing;
regular surveillance reports will be published in MMWR.
Portions of the article are reprinted below.
*************************
During January 24-March 7, smallpox vaccine was administered to
16,919 civilian health-care and public health workers in 50
jurisdictions. No potentially life-threatening adverse events of
a type known previously to be caused by smallpox vaccination
have been reported as of March 10.
During March 4-10, three moderate-to-severe adverse events were
reported. All were cases of inadvertent inoculation and were
traced to contact with military personnel who received smallpox
vaccine. . . .
Four other serious adverse events were reported during
March 4-10. None of these events was of a type known to be
associated causally with vaccination.
*************************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5210a5.htm
To obtain a camera-ready (PDF format) copy of this issue of
MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5210.pdf
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