Issue
Number 381
April 28, 2003
CONTENTS OF THIS ISSUE
- CDC releases recommendations on prevention and
control of influenza
- CDC clarifies hepatitis B birth dose information
presented in its earlier notification about PEDIARIX combination vaccine
- American College of Obstetricians and
Gynecologists makes its guidelines on immunization during pregnancy
available on the Internet
- New on the Web: "Vaccines Across the Life Span,
2003"
- Maine adopts regulations requiring hepatitis B
vaccination for children attending licensed daycare facilities
- Act today: April 28 is early bird registration
deadline for the National Conference on Immunization Coalitions
- New vaccination website offers valuable vaccine
information plus an online childhood/adolescent immunization scheduler
- CDC presents progress report on global
eradication of poliomyelitis
- Angola launches campaign to immunize seven
million children against measles by May 19
- CDC reports on success of the 2002 Afghani
measles vaccination campaign
- CDC publishes an update of smallpox vaccine
adverse events surveillance
- CDC notifies readers about "M Guide Online
Knowledge Centers"
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April 28, 2003
CDC RELEASES RECOMMENDATIONS ON PREVENTION AND CONTROL OF INFLUENZA
The Centers for Disease Control and Prevention (CDC) published "Prevention
and Control of Influenza: Recommendations of the Advisory Committee on
Immunization Practices (ACIP)" in the April 25 issue of "MMWR
Recommendations and Reports" (MMWR). The summary is reprinted below in its
entirety.
************************
This report updates the 2002 recommendations by the Advisory Committee on
Immunization Practices (ACIP) on the use of influenza vaccine and antiviral
agents (CDC. Prevention and Control of Influenza: Recommendations of
the Advisory Committee on Immunization Practices [ACIP]. MMWR 2002;51[No.
RR-3]:1-31). The 2003 recommendations include new or updated information
regarding 1) the timing of influenza vaccination by age and risk group; 2)
influenza vaccine for children aged 6-23 months; 3) the 2003-2004
trivalent inactivated vaccine virus strains: A/Moscow/10/99 (H3N2)-like,
A/New Caledonia/20/99 (H1N1)-like, and B/Hong Kong/330/2001-like antigens
(for the A/Moscow/10/99 [H3N2]-like antigen, manufacturers will use the
antigenically equivalent A/Panama/2007/99 [H3N2] virus, and for the B/Hong
Kong/330/2001-like antigen, manufacturers will use either B/Hong
Kong/330/2001 or the antigenically equivalent B/Hong Kong/1434/2002); 4)
availability of certain influenza vaccine doses with reduced thimerosal
content, including single 0.25 mL-dose syringes; and 5) manufacturers of
influenza vaccine for the U.S. market. Although the optimal time to
vaccinate against influenza is October and November, vaccination in December
and later continues to be strongly recommended. A link to this report and
other information regarding influenza can be accessed at
http://www.cdc.gov/ncidod/diseases/flu/fluvirus.htm
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To obtain the complete text of the recommendation online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5208a1.htm
To obtain a camera-ready (PDF format) copy of the recommendation, go to:
http://www.cdc.gov/mmwr/PDF/rr/rr5208.pdf
The PDF version includes a free CDC-sponsored continuing education activity
that can be completed online or submitted via U.S. mail for CME, CEU, or CNE
credit. Simply read the MMWR recommendation, answer the questions at the
end, and follow the instructions for submitting your answers.
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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April 28, 2003
CDC CLARIFIES HEPATITIS B BIRTH DOSE INFORMATION PRESENTED IN ITS EARLIER
NOTIFICATION ABOUT PEDIARIX COMBINATION VACCINE
The Centers for Disease Control and Prevention (CDC) published
"Clarification: Vol. 52, No. 10" in the April 25 issue of the "Morbidity and
Mortality Weekly Report" (MMWR). It concerns the Notice to Readers titled
"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. The clarification is reprinted
below in its entirety.
*****************************
In the 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," there were two potentially
misleading statements in the paragraph following the heading "ACIP Approval
for DTaP-HepB-IPV for the Vaccines for Children Program." First, the
statement "3 doses of PEDIARIX can be administered to an infant who is born
to a woman who is hepatitis B surface antigen (HBsAg)-positive or whose
HBsAg status is unknown" is potentially misleading. A birth dose of
single-antigen vaccine is preferred for all infants but must be administered
to infants who are born to women who are HBsAg-positive or whose HBsAg
status is unknown. The birth dose can then be followed by 3 doses of
PEDIARIX at ages 2, 4, and 6 months. Second, the third dose of PEDIARIX
should be administered at least 16 weeks after the first dose and at least 8
weeks after the second dose but not before age 6 months.
*****************************
To obtain the complete text of the clarification online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a7.htm
To obtain the March 14 Notice to Readers, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5210a8.htm
The Immunization Action Coalition (IAC) wants to make sure you have the
information you need about the importance of the hepatitis B birth dose.
Following are links to a variety of resources from the IAC website.
To visit all the IAC birth dose web pages, go to:
http://www.immunize.org/birthdose
To obtain a camera-ready (PDF) copy of a professional education sheet about
medical errors in perinatal hepatitis B prevention, go to:
http://www.immunize.org/catg.d/p2062.pdf
To obtain an HTML version of it, go to:
http://www.immunize.org/catg.d/p2062.htm
To obtain a camera-ready (PDF) copy of an open letter to health
professionals written by Deborah L. Wexler, MD, IAC's executive director,
about the importance of the hepatitis B birth dose, go to:
http://www.immunize.org/catg.d/p2125.pdf
To obtain an HTML version of it, go to:
http://www.immunize.org/catg.d/p2125.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5216.pdf
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Please note: A correction has been published
for this article. To view the correction, click
here.
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April 28, 2003
AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS
MAKES ITS GUIDELINES ON IMMUNIZATION DURING PREGNANCY AVAILABLE ON THE
INTERNET
The American College of Obstetricians and Gynecologists (ACOG) Committee
Opinion No. 282, "Immunization During Pregnancy," is now available
on the ACOG website. Originally published in January in ACOG's journal,
"Obstetrics & Gynecology," the document reflects emerging clinical and
scientific advances and is subject to change because the effects of many
diseases and vaccines on the pregnant woman or the fetus may be rare and
infrequently reported.
The substance of the opinion document is a five-page table that presents the
following information about each immunobiologic agent: Risk from disease to
a pregnant woman and her fetus or newborn; type of immunizing agent and its
risk to the fetus; indications for immunization during pregnancy; dose
schedule; and other comments.
To access a ready-to-print (PDF) version of the complete opinion from the ACOG
website, go to:
http://www.acog.org/from_home/publications/misc/bco282.pdf
To access a web-text (HTML) version, go to:
http://www.acog.org/from_home/publications/misc/bco282.cfm
To access the ACOG home page, go to:
http://www.acog.org
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April 28, 2003
NEW ON THE WEB: "VACCINES ACROSS THE LIFE SPAN, 2003"
A five-article document, "Vaccines Across the Life Span, 2003," first
appeared as a supplement to the January 2003 issue of the "Journal of Family
Practice" (vol.52, no. 1). Produced by the Group on Immunization Education
of the Society of Teachers of Family Medicine and the Department of Family
Medicine at the University of Pittsburgh School of Medicine, it is now
available on the website of the Journal of Family Practice.
The document, which was edited by Richard K. Zimmerman, MD, MPH, and funded
by a grant from the Centers for Disease Control and Prevention, is a
practical resource on immunization written by family physicians for their
colleagues. Following is a synopsis of each article.
The first article, "Routine Vaccines Across the Life Span, 2003," discusses
age-based indications for vaccination and other topics including disease
burden, rationale for vaccination, vaccine efficacy, adverse reactions, and
specific vaccine recommendations. A color centerfold with photographs of
vaccine-preventable diseases and the current immunization schedules
amplifies the material in this article.
The second article, "Vaccines for Persons at High Risk Due to Medical
Conditions, Occupation, Environment, or Lifestyle, 2003," reviews the safety
and efficacy of current vaccines for high-risk populations, such as pregnant
women, health care workers, and those with underlying medical conditions.
"Vaccine Schedules and Procedures, 2003," the third article, reviews current
age-based recommendations for vaccination as well as the contraindications,
precautions, administration techniques, and storage procedures for routinely
administered vaccines.
The fourth article, "Addressing Immunization Barriers, Benefits, and Risks,"
presents suggestions for explaining vaccine benefits and risks and a summary
of practical, proven strategies for increasing immunization rates.
"Vaccines and Bioterrorism: Smallpox and Anthrax," the fifth article,
discusses pre- and post-exposure management and containment strategies for
smallpox and anthrax.
To access a camera-ready (PDF) copy of the articles from the "Journal of
Family Practice" website, go to:
http://www.jfponline.com/supplements/jan_03_supplement.asp
For an array of practical immunization information from the website of the
Group on Immunization Education, go to:
http://www.immunizationed.org
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April 28, 2003
MAINE ADOPTS REGULATIONS REQUIRING HEPATITIS B VACCINATION FOR CHILDREN
ATTENDING LICENSED DAYCARE FACILITIES
Effective November 2002, Maine adopted regulations to require hepatitis B
vaccination for children attending licensed daycare facilities. This
information was recently added to the table of state mandates for hepatitis
B prevention maintained by the Immunization Action Coalition (IAC).
To access the table on the IAC website, go to:
http://www.immunize.org/laws/hepb.htm
To access additional information about state immunization mandates, go to:
http://www.immunize.org/laws
We depend on our readers to help us stay informed and to ensure this is the
most current and accurate information available. Please let us know when any
changes occur in your state.
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April 28, 2003
ACT TODAY: APRIL 28 IS EARLY BIRD REGISTRATION DEADLINE FOR THE NATIONAL
CONFERENCE ON IMMUNIZATION COALITIONS
Register today and get $100 off the regular conference fee for the Fifth
National Conference on Immunization Coalitions. Scheduled for May 28-30, the
conference will take place at the Westin Kierland Resort and Spa in
Phoenix-Scottsdale, AZ. The conference will provide information, resources,
and skills-building sessions to energize and strengthen immunization
coalitions at every stage of development.
For a copy of the conference brochure and registration form, go to:
http://www.publichealth.usf.edu/conted/pdf/ImmBroch03.pdf
April 28 is also the cut-off date for the special hotel conference rate of
$119. To receive the special rate, call the Westin Kierland Resort and Spa
directly at (480) 624-1000 and reference the National Conference on
Immunization Coalitions.
For more information, call (888) 873-2674 or email
conted@hsc.usf.edu
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April 28, 2003
NEW VACCINATION WEBSITE OFFERS VALUABLE VACCINE INFORMATION PLUS AN ONLINE
CHILDHOOD/ADOLESCENT IMMUNIZATION SCHEDULER
The new website VaccineCheck gives patients, parents, and health
professionals an excellent source of credible, comprehensive vaccine
information. Written and reviewed by board-certified pediatricians, the
website provides users with extensive information about vaccines across the
life span and an exhaustive array of links to other immunization websites.
A unique feature of VaccineCheck is an interactive program that lets health
professionals and parents create an instant, printable immunization schedule
for any child or adolescent up to age 21. The goal of the program is to make
vaccine scheduling an easier, more exact process.
To learn about the program from the VaccineCheck website, go to:
http://www.vaccinecheck.com/aboutprogram.jsp
To access the abundance of information the website offers, visit the
VaccineCheck homepage at
http://www.vaccinecheck.com
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April 28, 2003
CDC PRESENTS PROGRESS REPORT ON GLOBAL ERADICATION OF POLIOMYELITIS
The Centers for Disease Control and Prevention (CDC) published "Progress
Toward Global Eradication of Poliomyelitis, 2002" in the April 25 issue of
the "Morbidity and Mortality Weekly Report" (MMWR). A summary made available
to the press is reprinted below in its entirety.
***********************
Progress made toward global polio eradication has been tremendous, however
important challenges still remain.
Since the 1988 World Health Assembly resolution to eradicate poliomyelitis
globally, the number of countries where polio is endemic declined from 125
to 7, and the estimated incidence of polio decreased more than 99%. Three
World Health Organization Regions (American, Western Pacific, and European)
have been certified polio-free. Despite these achievements, a provisional
total of 1,920 polio cases were reported during 2002, a substantial increase
from 483 in 2001, reflecting primarily the large polio epidemic in India.
Efforts must be focused on India and the other polio-endemic countries to
ensure global polio eradication as quickly as possible.
***********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a4.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5216.pdf
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April 28, 2003
ANGOLA LAUNCHES MASSIVE CAMPAIGN TO IMMUNIZE SEVEN MILLION CHILDREN AGAINST
MEASLES BY MAY 19
On April 21, Angola began the biggest health campaign in the nation's
history, aiming to inoculate seven million children against measles by May
19. The campaign goal is to reduce by 75 percent the number of deaths caused
by measles, which claims the lives of more than 7,000 Angolan children
annually.
Spearheaded by the country's Ministry of Health, with key financial,
logistical, and training support from the United Nations Children's Fund
(UNICEF), the campaign seeks to vaccinate every child from age nine months
to 15 years. In planning for the campaign the health ministry and UNICEF
have trained 24,000 vaccinators nationwide; 35,000 teachers have been
recruited as campaign advocates and educators.
To reach children across the nation, the campaign is scheduled to be
conducted in three phases: first, children in schools and institutions will
be vaccinated, followed by children in urban areas, and concluding with
children in rural areas.
To access a press release about the campaign from the UNICEF website, go to:
http://www.unicef.org/newsline/2003/03ma05measles.htm
To access several pertinent press releases from the Angola web pages of the
AllAfrica.com website, go to:
http://allafrica.com/angola
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April 28, 2003
CDC REPORTS ON SUCCESS OF THE 2002 AFGHANI MEASLES VACCINATION CAMPAIGN
The Centers for Disease Control and Prevention (CDC) published "Nationwide
Measles Vaccination Campaign for Children Aged 6 Months-12
Years--Afghanistan, 2002" in the April 25 issue of the "Morbidity and
Mortality Weekly Report" (MMWR). A summary made available to the press is
reprinted below in its entirety.
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A measles campaign for children below 12 years of age prevented between
20,000 to 25,000 children's deaths in Afghanistan in 2002.
Measles accounts for an estimated 30,000 to 35,000 deaths every year in
Afghanistan. To reduce measles-related mortality, the Ministry of Health of
the Interim Government of Afghanistan, with the support of international
organizations, organized a nationwide measles vaccination campaign for
children aged 6 months to 12 years in 2002. As of December 31, 2002,
10,299,878 children were reported to have been vaccinated representing 82%
of the national target population. The number of reported measles cases
decreased from 8,762 in 2001 to 2,574 in 2002. The cost of the campaign was
approximately $0.78 per child vaccinated.
***********************
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a3.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5216.pdf
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April 28, 2003
CDC PUBLISHES AN UPDATE OF SMALLPOX VACCINE ADVERSE EVENTS SURVEILLANCE
The Centers for Disease Control and Prevention (CDC) published "Update:
Adverse Events Following Civilian Smallpox Vaccination--United States, 2003"
in the April 25 issue of the "Morbidity and Mortality Weekly Report" (MMWR).
It includes reports on one new case each of myopericarditis, myocardial
infarction, atypical chest pain, and anoxic encephalopathy. One inadvertent
contamination of a vaccine vial was also observed. Excerpts from the article
are reprinted below.
*****************************
During January 24-April 18, 2003, smallpox vaccine was administered to
33,444 civilian health-care and public health workers in 54 jurisdictions to
prepare the United States for a possible terrorist attack using smallpox
virus. This report updates information on vaccine-associated adverse events
among civilians vaccinated since the beginning of the program and among
contacts of vaccinees, received by CDC from the Vaccine Adverse Event
Reporting System (VAERS) as of April 18. . . .
As of April 18, a total of 10 cases of myopericarditis have been reported;
one new report was received during April 14-18. During the same period, one
new case of acute myocardial infarction (MI) was reported. . . .
During April 14-18, in addition to the MI, nine other serious adverse events
were reported, including one case of atypical chest pain and one case of
anoxic encaphalopathy. . .
During the current reporting period, information was received about one
inadvertent contamination of a vaccine vial when a vaccinator was observed
placing a needle from a vaccinee back into the vial, then removing the
needle from the vial and discarding it. The vial was then used to vaccinate
additional persons, but new needles were used. The initial vaccinee was
tested for hepatitis B virus, hepatitis C virus, and human immunodeficiency
virus; all tests were negative. Investigation is ongoing for evidence of any
complications from this event.
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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a2.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5216.pdf
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April 28, 2003
CDC NOTIFIES READERS ABOUT "M GUIDE ONLINE KNOWLEDGE CENTERS"
The Centers for Disease Control and Prevention (CDC) published a Notice to
Readers, "Introduction of 'M Guide'" in the April 25 issue of the "Morbidity
and Mortality Weekly Report" (MMWR). It is reprinted below in its entirety.
*******************************
To ensure that MMWR publications are both useful and easy to access, MMWR
has introduced "M Guide Online Knowledge Centers." Available through MMWR
Online (http://www.cdc.gov/mmwr),
each "M Guide" provides an online grouping of MMWR reports related to a
single health topic. Features of the "M Guide" include a chronological list
of MMWR reports relevant to the topic, summaries of the reports, links
to the full reports, and links to other resources.
The first "M Guide" was introduced on April 23, 2003, and focused on severe
acute respiratory syndrome (SARS). The SARS "M Guide" is available at
http://www.cdc.gov/mmwr/mguide_sars.html
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To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5216a6.htm
To obtain a camera-ready (PDF format) copy of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5216.pdf
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