Issue
Number 388
June 2, 2003
CONTENTS OF THIS ISSUE
- American Academy of Pediatrics paper rebuts article purporting
a connection between thimerosal and autism
- Article traces the American Academy of Pediatrics' history of
support for the hepatitis B vaccine birth dose
- National Immunization Program releases Influenza Vaccine
Bulletin #1 for influenza season 2003-04
- New: Updated editions of three significant immunization
resources available for order
- NFID report offers lots of ideas for boosting childhood
influenza immunization rates
- Know someone with chronic hepatitis B infection? If so, be
sure to tell them about the "B-Informed 2003" conference!
- New: English- and Spanish-language hepatitis B Vaccine
Information Statements available in audio format
- CDC publishes an update about cardiac-related events during
the smallpox vaccination program
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June 2, 2003
AMERICAN ACADEMY OF PEDIATRICS PAPER REBUTS ARTICLE PURPORTING A CONNECTION
BETWEEN THIMEROSAL AND AUTISM
In response to an article by Geier and Geier that has received media
attention, the American Academy of Pediatrics (AAP) recently issued a paper,
"Study Fails to Demonstrate a Connection Between Thimerosal and Autism."
The paper informs clinicians about numerous flaws in the article, which
claims to show a correlation between thimerosal and autism. The AAP advises
clinicians that the Geiers' article uses data from the Vaccine Adverse
Event Reporting System inappropriately and contains abundant conceptual and
scientific flaws, omissions of fact, inaccuracies, and misstatements.
Titled "Thimerosal in Childhood Vaccines, Neurodevelopment Disorders, and
Heart Disease in the United States," the Geiers' article was published in
the "Journal of American Physicians and Surgeons," Vol. 8, No. 1, Spring
2003.
To access a camera-ready (PDF) copy of the AAP paper, go to:
http://www.cispimmunize.org/pro/pdf/Geiersummary.pdf
To access a camera-ready (PDF) copy of the Geiers' article, go to:
http://www.jpands.org/vol8no1/geier.pdf
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June 2, 2003
ARTICLE TRACES THE AMERICAN ACADEMY OF PEDIATRICS' HISTORY OF SUPPORT FOR
THE HEPATITIS B VACCINE BIRTH DOSE
An article that appeared in a newsletter of the American Academy of
Pediatrics (AAP) summarizes the history of the professional organization's
long-standing preference for the birth dose of hepatitis B vaccine.
Written by AAP fellow Thomas N. Saari, MD, the article was published in the
"Section on Infectious Diseases Newsletter" (Vol.6, Issue 1, Spring 2003).
To access a camera-ready (PDF) copy of the article from the AAP website, go
to:
http://www.cispimmunize.org/pro/pdf/Hep%20B%20guidance.pdf
For a wealth of information about the importance of the birth dose, go to
the Immunization Action Coalition birth dose web page at
http://www.immunize.org/birthdose
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June 2, 2003
NATIONAL IMMUNIZATION PROGRAM RELEASES INFLUENZA VACCINE
BULLETIN #1 FOR INFLUENZA SEASON 2003-04
On May 22, the National Immunization Program of the Centers for
Disease Control and Prevention (CDC) issued "Influenza Vaccine
Bulletin #1." It is reprinted below in its entirety.
*****************************
INFLUENZA VACCINE BULLETIN #1
Influenza Season 2003-04
May 22, 2003
The National Immunization Program (NIP) of the Centers for
Disease Control and Prevention (CDC) publishes and distributes
periodic bulletins to update partners about recent developments
related to the production, distribution, and administration of
influenza vaccine. All recipients of this bulletin are
encouraged to distribute each issue widely to colleagues,
members, and constituents.
INFLUENZA VACCINE SUPPLY AND PRODUCTION
2003-2004 influenza vaccine strains
The 2003-2004 influenza vaccine formulation includes A/New
Caledonia/20/99-like (H1N1), A/Panama/2007/99 (H3N2), and
B/Hong Kong/330/2001-like virus strains, exactly the same
formulation as in the 2002-03 season.
The Food and Drug Administration (FDA) does not recommend
the use of any vaccine beyond its expiration date.
Influenza vaccine produced in 2002 outdates June 30, 2003.
The FDA has issued a statement, posted on its web site at
http://www.fda.gov/cber/flu/flu.htm to address issues
concerning use of last season's influenza vaccine.
Place orders now for influenza vaccine!
Healthcare providers who have not yet placed orders should
do so as soon as possible. Additional information about
sources of vaccine can be found at
http://www.hida.org/link_frame.asp?URL=http://www.hida.org/govtrelations/flulinks.asp
a service provided by the Health Industry Distributors
Association.
Projection for this year's influenza vaccine supply
Vaccine manufacturers Aventis Pasteur and Powderject
Vaccines (Powderject produces the Evans vaccines brand)
project an aggregate total of 80-85 million doses of
influenza vaccine for the U.S. market this year. This is
10-15 million doses below last year's total, yet greater
than the estimated 79 million doses sold to individuals
in 2002.
INFLUENZA VACCINE DISTRIBUTION
The Advisory Committee on Immunization Practices (ACIP) has
released its influenza vaccine recommendations for the 2003-04
flu season, published in the April 25 CDC Morbidity and
Mortality Weekly Report (MMWR). The recommendations refer
specifically to the timing of vaccinations for at-risk and
target groups.
The best time to be vaccinated against influenza continues
to be October and November. Because of vaccine
distribution delays during the period 2000-2002, ACIP
recommends that the following persons should be vaccinated
in October:
- Adults aged 50 or older
- Infants and children aged 6 through 23 months
- Anyone aged 2-49 years who is at increased risk for
influenza-related complications
- Children aged less than 9 years who are receiving their
first influenza vaccination
- Healthcare workers
- All household contacts of persons at high risk for
influenza
All other groups can be vaccinated in November. To see
this issue of MMWR (MMWR 2003; 52(RR-8)), go to
http://www.cdc.gov/mmwr/PDF/rr/rr5208.pdf
New Medicare payment rates for influenza, pneumococcal, and
hepatitis B vaccine administration became effective
March 1, 2003.
Medicare's 2003 vaccine administration rate allowances
average $7.72 for 2003, a 94% increase over 2002. The
rates range from $5.34 to $10.98, depending on geographic
location. To determine the rate for a specific locale, go
to http://www.cms.hhs.gov/preventiveservices/2.asp
To download an Excel table for rates, look for the link 03
Pay Rates in the yellow "News" box on the right side of
the page. Please note, the payment rate for the 2003
influenza vaccine has not yet been determined.
Amendment to Medicare Standing Orders Rule Eliminates Physician
Signature Requirement
The Centers for Medicare and Medicaid published a rule on
October 2, 2002, that eliminates the physician signature
requirement for the administration of influenza and
pneumococcal vaccinations from the Conditions of
Participation for Medicare and Medicaid participating
hospitals, long-term care facilities, and home health
agencies. Influenza and pneumococcal vaccines can now be
administered per physician-approved facility or agency
following assessment of contraindications.
To review the details of this and other recommendations,
see MMWR article in the January 31, 2003 issue
"Facilitating Influenza and Pneumococcal Vaccination
Through Standing Orders Programs" (MMWR 2003;52(04):
68-69). The entire issue is available at
http://www.cdc.gov/mmwr/PDF/wk/mm5204.pdf
INFLUENZA VACCINE COMMUNICATIONS
2003 Influenza Vaccine Summit
The 2003 Influenza Vaccine Summit was held May 20-21 in
Chicago, Illinois. Additional information about the summit
can be found on the American Medical Association web site,
http://www.ama-assn.org, at
http://www.ama-assn.org/ama/pub/article/1826-7688.html
Watch the AMA site and this Flu Bulletin for additional
information from the 2003 Flu Summit.
*****************************
To access the bulletin from the CDC website, go to:
http://www.cdc.gov/nip/Flu/bulletins-flu/2003-04/bulletin1_052203.htm
To access a camera-ready (PDF) version of the bulletin from the
Immunization Action Coalition website, go to:
http://www.immunize.org/news.d/flubul1-03.pdf
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June 2, 2003
NEW: UPDATED EDITIONS OF THREE SIGNIFICANT IMMUNIZATION
RESOURCES AVAILABLE FOR ORDER
The Centers for Disease Control and Prevention (CDC), American
Academy of Pediatrics (AAP), and Lippincott Williams and Wilkins
recently made newly revised editions of important immunization
resources available for order. The three are "Health Information
for International Travel, 2003-2004 (the Yellow Book); "2003
Report of the Committee on Infectious Diseases" (the Red Book);
and "Vaccine Handbook: A Practical Guide for Clinicians." A
brief synopsis of each book and ordering information follows:
- "Health Information for International Travel, 2003-2004"
(CDC, 2003; softbound, $29). Described as the preeminent
reference for health care providers who administer pre- and
post-travel counseling and care, the new edition includes
changes in vaccine recommendations, a new chapter focusing on
recommendations for children and infants, and updated text on
injury during travel and travelers with disabilities. Available
now.
To order the Yellow Book from the website of the Public Health
Foundation, go to: http://bookstore.phf.org/prod159.htm
Available in the summer, the Yellow Book in combination with a
CD-ROM can be ordered for $40 at
http://bookstore.phf.org/prod281.htm
To place an order by phone, call (877) 252-1200.
- "2003 Report of the Committee on Infectious Diseases" (AAP,
2003; softbound, $95 or $90 [AAP members]). Described as the
most reliable and clinically useful information on the
manifestations, etiology, epidemiology, diagnosis and treatment
of 200 childhood infectious diseases. The 26th edition has
expanded information on passive and active immunizations,
vaccine shortages, and immunization of pre-term infants, among a
wealth of other information. Available in July.
To preorder the Softbound Red Book from the AAP website, go to:
http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=755&CatID=132
The Red Book comes in six additional formats. Following is
ordering information for all (see A-F below).
-
The Hardbound Red Book ($115 or $110 [AAP members])
includes a 32-page full-color atlas of new photos. To
preorder go to:
http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=1927&CatID=132
-
The Visual Red Book on CD-ROM ($170 or $165 [AAP members])
has the complete Red Book text (including PDA download),
more than 1,300 images; and a Red Book Online subscription
(see entry C below for information). To preorder go to:
http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=757&CatID=132
-
The Red Book Online ($145 or $140 [AAP members]) has the
complete Red Book text (including PDA download), all images
from the CD-ROM, and an online life-of-the edition
subscription to updated news and resources. To preorder go
to:
http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=3828&CatID=132
-
The Red Book for PDA ($95 or $90 [AAP members]) has the
complete Red Book text formatted for the user's PDA; it's
compatible with Palm OS and Pocket PC. To preorder go to:
http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=3829&CatID=132
-
The Softbound Red Book with Multimedia Set ($195 or $190
[AAP members]) has both the softbound book and the Red Book
Online (see entry C above). To preorder go to:
http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=1267
-
The Hardbound Red Book with Multimedia Set ($215 or $210
[AAP members]) has both the hardbound book and the Red Book
Online (see entry C above). To preorder go to:
http://www.aap.org/bst/showdetl.cfm?&DID=15&Product_ID=2294
To place an order by phone, call (866) 843-2271.
- "The Vaccine Handbook: A Practical Guide for Clinicians"
(Lippincott Williams & Wilkins, softbound, $40). The handbook
discusses a spectrum of vaccines, each separately, and presents
information about the disease the vaccine prevents and its
epidemiology, the vaccine's efficacy and safety, and the
practical questions most frequently asked about the vaccine's
use. A chapter addresses specific parental concerns about
vaccines and their safety. Available in September.
To preorder the handbook from the publisher's website, go to:
http://www.lww.com/productPrint.html?intProductID=540917826
To place an order by phone, call (800) 638-3030.
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June 2, 2003
NFID REPORT OFFERS LOTS OF IDEAS FOR BOOSTING CHILDHOOD
INFLUENZA IMMUNIZATION RATES
The National Foundation for Infectious Diseases (NFID) recently
issued a consensus report, "Increasing Influenza Immunization
Rates in Infants and Children: Putting Recommendations into
Practice." The 34-age report is based on the work of a panel of
15 experts NFID convened to address the changes the Advisory
Committee on Immunization Practices and the American Academy of
Pediatrics made in their pediatric influenza vaccination
recommendations for the 2002-03 influenza season.
The first part of the report discusses the feasibility of
universal pediatric influenza immunization given concerns about
the following: vaccine safety, efficacy, and supply; parental
acceptance of universal immunization; and provider reimbursement
and liability. Based on reports from providers in different
practice settings who achieve high pediatric influenza
immunization rates, the second part presents proven strategies
to increase rates in various populations and health care
settings.
To access a camera-ready (PDF) copy of the report from the NFID
website, go to:
http://www.nfid.org/publications/pediatricflu.pdf
For information about NFID, go to: http://www.nfid.org
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June 2, 2003
KNOW SOMEONE WITH CHRONIC HEPATITIS B INFECTION? IF SO, BE SURE
TO TELL THEM ABOUT THE "B-INFORMED 2003" CONFERENCE!
Sponsored by the Hepatitis B Foundation (HBF), "B-Informed 2003:
A Gathering of Friends" will be held July 20-22 at Delaware
Valley College, Doylestown, PA. Intended for patients, parents,
and families of persons affected by chronic hepatitis B, the
conference will give participants the opportunity to meet others
who understand what it's like to live with the disease and share
their personal experiences.
Samuel So, MD, Director, Asian Liver Center, Stanford, CA, will
give the keynote address, "Eliminating the Voodoo from Hepatitis
B." The conference program includes the latest updates on
research, drug treatments, and management of hepatitis B given
by scientific, medical, and pharmaceutical experts.
For information from the HBF website, go to:
http://www.hepb.org/2-00-02-416.hepb
To access the registration form, go to:
http://hepb.org/pdf/BInformed_registration.pdf
For additional information, email Sarah, the conference
coordinator, at sarah@hepb.org or call her at (215) 489-4900.
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June 2, 2003
NEW: ENGLISH- AND SPANISH-LANGUAGE HEPATITIS B VACCINE
INFORMATION STATEMENTS AVAILABLE IN AUDIO FORMAT
The hepatitis B Vaccine Information Statements (VISs) in English
and Spanish are available in audio format for the first time as
links on the Immunization Action Coalition (IAC) website. IAC
gratefully acknowledges Healthy Roads Media, National Library of
Medicine Multilingual Health Education Resource Project for
providing the audio versions.
To access the VISs in audio format from the IAC website, go to:
http://www.immunize.org/vis/index.htm#hepatitisb and click on
either English Audio VIS or Spanish Audio VIS.
To obtain a camera-ready (PDF) copy of the hepatitis B VIS in
English, go to: http://www.immunize.org/vis/hepb01.pdf
To obtain a camera-ready (PDF) copy of the hepatitis B VIS in
Spanish, go to: http://www.immunize.org/vis/sphepb01.pdf
For information on the use of VISs, and for VISs in a total of
28 languages, visit IAC's VIS web page at
http://www.immunize.org/vis
For information about Healthy Roads Media, go to:
http://www.healthyroadsmedia.org
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June 2, 2003
CDC PUBLISHES AN UPDATE ABOUT CARDIAC-RELATED EVENTS DURING THE
SMALLPOX VACCINATION PROGRAM
The Centers for Disease Control and Prevention (CDC) published
"Update: Cardiac-Related Events During the Civilian Smallpox
Vaccination Program--United States, 2003" in the May 30 issue of
the "Morbidity and Mortality Weekly Report" (MMWR).
The report includes the case definition of myo/pericarditis and
updates information on all reports of cardiac adverse events
among 36,217 civilian vaccinees since the beginning of the
civilian smallpox vaccination program reported through May 9 to
CDC from the Vaccine Adverse Event Reporting System (VAERS).
Through May 9, a total of 21 cases of myo/pericarditis were
ascertained; all have been reported previously. In addition,
nine cases of ischemic cardiac events (i.e., myocardial
infarction [MI] or angina) among civilian vaccinees have been
reported previously.
To obtain the complete text of the article online, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5221a2.htm
To obtain a camera-ready (PDF format) copy of this issue of
MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5221.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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