Issue
Number 428
December 1, 2003
CONTENTS OF THIS ISSUE
- CDC website posts a Q&A series about its Vaccine Safety
Datalink Study on thimerosal-containing vaccines
- Latest edition of CDC's "Guide to Contraindications to
Vaccinations" is available free of charge
- CDC issues print version of report on current hepatitis A
outbreak in Pennsylvania and corrects electronic version
- Update: IAC revises two patient-education brochures
- Today is World AIDS Day
- Job opening: National Immunization Program seeks candidates
for director of its Global Immunization Division
- Free: Bulk copies of the latest issue of "VACCINATE ADULTS"
(November 2003) are available--place your order now
- January 15, 2004, is the deadline for abstracts for the 1st
International Neonatal Vaccination Workshop
- Submit late-breaker abstracts for the International Conference
on Emerging Infectious Diseases as early as December 10
- CDC reports on global progress toward certifying polio
eradication and laboratory containment of wild polioviruses
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December 1, 2003
CDC WEBSITE POSTS A Q&A SERIES ABOUT ITS VACCINE SAFETY DATALINK STUDY ON
THIMEROSAL-CONTAINING VACCINES
The Centers for Disease Control and Prevention (CDC) recently posted the
following page on its website: "Vaccine Safety Datalink (VSD) Study: Safety
of Thimerosal-Containing Vaccines: A Two-Phased Study of Computerized Health
Maintenance Organization (HMO) Databases."
The web page, which contains a summary of findings and a 14-item Q&A series,
was posted in reference to an article published November 5 in "Pediatrics,"
the journal of the American Academy of Pediatrics (AAP). Following are the
first three Q&As as they appear on the CDC website.
**************************
1. WHAT WERE THE MAJOR FINDINGS AND CONCLUSIONS FROM THE CDC'S VACCINE
SAFETY DATALINK STUDY?
The final results of this study found no consistent statistically
significant associations between exposure to vaccines that contained
thimerosal as a preservative and a wide range of neurodevelopmental
problems, including autism, attention deficit disorder (ADD), language
delays, sleep disorders, emotional disorders, and tics. None of the results
found any associations with autism or ADD. Since it is necessary to first
establish there is an association between two things (often called
"variables"), the results from this study suggest there is not a "cause and
effect" relationship between thimerosal and autism or ADD.
In the first phase of the research, there were some statistically
significant associations between exposure to thimerosal-containing vaccines
and two categories of neurodevelopmental problems, "tics," and language
delay. However, these results were not consistent--that is, the
relationships were only found with one of the health maintenance
organization (HMO) databases, rather than in all three that were used in the
study. Such a pattern suggests that an association does not exist, but that
further research should be done.
As a result of the inconsistent finding involving "tics" and language delay,
one of the major conclusions was that additional research be done to further
examine the issue of exposure to thimerosal in vaccines. The CDC is
currently involved in this additional research.
2. WHAT DO THE STUDY'S RESULTS MEAN FOR PARENTS?
The study did not find consistent evidence to suggest that thimerosal might
cause any of the conditions studied. In particular, the study found that
thimerosal exposure was not associated with autism, which adds to the
evidence from other studies that thimerosal does not increase the risk of
autism.
Since 1999 thimerosal has been removed from the majority of recommended
childhood vaccines for preschool children. In fact today, none of the
routinely recommended childhood vaccines used in the U.S. to protect
preschool children against 11 infectious diseases contain thimerosal as a
preservative. These include vaccines for measles, mumps, rubella,
chickenpox, hepatitis B, diphtheria, tetanus, pertussis (whooping cough),
Haemophilus influenzae type b (Hib), polio, and pneumococcal disease. In
some of the recommended childhood vaccines minute amounts of thimerosal can
be found; this is an unavoidable byproduct of the production process and has
nothing to do with thimerosal being used as a preservative in the vaccines.
No harmful effects have ever been reported or found with these amounts of
thimerosal in vaccine.
3. THIS STUDY LOOKED AT THIMEROSAL IN VACCINES. WHY IS THERE A CONCERN ABOUT
THIS VACCINE PRESERVATIVE?
There was a concern because thimerosal contains a type of mercury called
ethylmercury. Since exposure to small amounts of mercury can be harmful,
concerns were raised about the very tiny amount of ethylmercury in
thimerosal. However, the safety concerns related to thimerosal were not
based on any evidence that connects thimerosal to harmful health outcomes.
Rather, the concerns were related to federal government guidelines and
theoretical estimates about how much mercury people can be safely exposed to
without possible risk of serious health effects.
In 1999, the Food and Drug Administration (FDA) conducted a review of the
mercury content in drugs and medicines, including vaccines. As part of this
review, the FDA concluded that the use of thimerosal as a preservative in
some recommended childhood vaccines could result in a six-month-old infant
being exposed to an amount of mercury that exceeded the Environmental
Protection Agency (EPA) recommendations. However, this same amount would not
exceed the FDA, the Agency for Toxic Substances and Disease Registry (ATSDR),
or the World Health Organization (WHO) guidelines for methylmercury intake
(Ball et al., 2001). Thimerosal contains ethylmercury. Methylmercury is a
related compound and has been more thoroughly researched than ethylmercury.
Thus federal safety standards are based on information we have about
methylmercury.
The FDA's review found no evidence of harm caused by the small amounts of
thimerosal in vaccines, except for minor local reactions (Ball et al.,
2001). In July 1999, as a precautionary measure, the Public Health Service
(including the CDC and FDA), the American Academy of Pediatrics, and vaccine
manufacturers agreed that thimerosal levels in vaccines should be reduced or
eliminated, and the FDA committed to expediting the review of new vaccines
that do not contain thimerosal.
Although there is no evidence that any vaccine or vaccine additive increases
the risk of neurodevelopment disorders, such as autism, CDC recognizes that
this issue is of concern to parents and others. As a result, CDC is
committed to investigating this issue to the fullest extent possible, using
the best scientific methods available.
For more information on thimerosal in vaccines, visit:
http://www.cdc.gov/nip/vacsafe/concerns/thimerosal/faqs-thimerosal.htm#2
**************************
To access the full Q&A series on the CDC website, go to:
http://www.cdc.gov/nip/vacsafe/vsd/VSDstudyQAs.htm
The complete "Pediatrics" article is available to subscribers only. To
access the abstract, go to:
http://pediatrics.aappublications.org/cgi/content/abstract/112/5/1039
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December 1, 2003
LATEST EDITION OF CDC'S "GUIDE TO CONTRAINDICATIONS TO VACCINATIONS" IS
AVAILABLE FREE OF CHARGE
Published by the Centers for Disease Control and Prevention (CDC) in
September 2003, the latest edition of "Guide to Contraindications to
Vaccinations" is now available for order online or by phone. The current
edition contains information on all licensed U.S. vaccines; previous
editions have focused on pediatric vaccines.
To order the guide from the CDC website, go to:
https://www2.cdc.gov/nchstp_od/PIWeb/niporderform.asp Scroll down to
the section titled "Health Care Providers Only," and go to item number
00-6562. NOTE: There is a limit of 10 copies per order; additional copies
are available upon request (see the comments block at the end of the order
form).
To order by phone, call the National Immunization Information Hotline at
(800) 232-2522.
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December 1, 2003
CDC ISSUES PRINT VERSION OF REPORT ON CURRENT HEPATITIS A OUTBREAK IN
PENNSYLVANIA AND CORRECTS ELECTRONIC VERSION
The Centers for Disease Control and Prevention (CDC) published "Hepatitis A
Outbreak Associated with Green Onions at a Restaurant--Monaca, Pennsylvania,
2003" in the November 28 issue of "Morbidity and Mortality Weekly Report" (MMWR).
Originally published in the web-based "MMWR Dispatch" on November 21, the
report has not been available in hard-copy format until now.
In addition to making a hard-copy version available, CDC also issued a
correction to the electronic version of the report. Please note that the
hard-copy version made available on November 28 has been corrected. The
information about the correction is reprinted below in its entirety.
***********************
On November 21, 2003, this report was posted on the MMWR website
(http://www.cdc.gov/mmwr).
However, two errors* were found.
* In the fourth sentence of the fifth paragraph, green onions were stated to
have been stored for 5 or more days before processing rather than for 5 or
fewer days. In the third sentence of the fifth paragraph of the Editorial
Note, the word "of" appeared before "plant surfaces are particularly complex
or adherent to viral or fecal particles."
***********************
To access a web-text (HTML) version of the corrected and complete article,
go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5247a5.htm
To access a ready-to-copy (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5247.pdf
Receive a FREE electronic subscription to MMWR (which includes new ACIP
statements) by going to
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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December 1, 2003
UPDATE: IAC REVISES TWO PATIENT-EDUCATION BROCHURES
The Immunization Action Coalition (IAC) recently updated two of its
patient-education brochures. Both brochures are designed to be copied,
folded into thirds, and given to patients. In addition, the Centers for
Disease Control and Prevention has reviewed both for technical accuracy.
(1) On the brochure "What If You Don't Immunize Your Child," statistical
information was updated about the U.S. incidence of pertussis and the
worldwide incidence of measles. Other small
changes were made as well.
To access a ready-to-copy (PDF) version of the updated brochure, go to:
http://www.immunize.org/catg.d/p4017.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4017.htm
(2) On the brochure "Every Week, Hundreds of Sexually Active People Get
Hepatitis B," several disease incidence rates were modified. Please note
that the Spanish-language version has not yet been revised.
To access a ready-to-copy (PDF) version of the updated brochure, go to:
http://www.immunize.org/catg.d/4112std.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/4112std.htm
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December 1, 2003
TODAY IS WORLD AIDS DAY
The Centers for Disease Control and Prevention (CDC) published "World AIDS
Day, December 1, 2003" in the November 28 issue of "Morbidity and Mortality
Weekly Report" (MMWR). The article is reprinted below in its entirety,
excluding references.
***********************
"Live and Let Live" is the theme for this year's World AIDS Day, December 1,
2003. This theme highlights the obstacles that stigma and discrimination
pose to the success of prevention and care programs for persons living with
human immunodeficiency virus (HIV). Discrimination against persons with
infectious diseases is not new, and acquired immunodeficiency syndrome
(AIDS) continues to be a stigmatizing health issue for those living with the
disease.
Stigma and discrimination might pose barriers that keep persons at risk for
HIV infection from getting tested. In the United States, approximately one
fourth of the estimated 850,000-950,000 persons living with HIV are unaware
of their infection and thus are not receiving needed treatment and
prevention services.
Worldwide, an estimated 42 million persons were living with HIV/AIDS at the
end of 2002. As in the United States, stigma and discrimination associated
with HIV/AIDS remain key challenges to effective public health prevention
programs. Information about HIV/AIDS is available from CDC at
http://www.cdcnpin.org and
http://www.cdc.gov/nchstp/od/nchstp.html or by telephone, (800)
342-2437.
***********************
To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5247a1.htm
To access a ready-to-copy (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5247.pdf
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December 1, 2003
JOB OPENING: NATIONAL IMMUNIZATION PROGRAM SEEKS CANDIDATES FOR DIRECTOR OF
ITS GLOBAL IMMUNIZATION DIVISION
The Immunization Action Coalition (IAC) recently received the following
announcement from the Centers for Disease Control and Prevention (CDC). It
is reprinted below in its entirety.
**************************
The National Immunization Program (NIP), CDC, is seeking exceptional
candidates for the position of Director, Global Immunization Division (GID).
The Director provides leadership; technical, programmatic, and financial
support; policy development; and coordinates with other federal, national,
and international organizations and institutions to plan, direct, conduct,
and evaluate programs that control, eliminate, or eradicate vaccine
preventable diseases worldwide.
The Global Immunization Division is responsible for leading NIP activities
in support of global polio eradication, measles mortality reduction,
regional measles elimination, and other global immunization activities. The
Division works closely with the World Health Organization (WHO), Pan
American Health Organization, UNICEF, Rotary International, United Nations
Foundation, World Bank, American Red Cross, and the International Federation
of Red Cross and Red Crescent Societies.
Qualifications required: Applicants must possess an M.D. degree and
demonstrate: (1) a high degree of prominence and expertise, and a
distinguished record of accomplishments in their fields, such that the
individual can readily command the respect of the national and international
public health communities and stimulate their interest in CDC global
immunization-related activities; (2) experience in applying the practices
and methods of effective disease control, eradication, and prevention
programs in developing country settings; (3) the ability to lead, manage,
and direct scientific and technical staff engaged in activities which impact
directly on immunization and global vaccine-preventable disease programs and
public health; and (4) experience that indicates the ability to deal
effectively with high-level government officials, the scientific and
academic communities, national and international medical and health-related
organizations, diverse community and non-governmental groups, and the public
at large.
How to apply: Please respond to announcement No: AD-10-04-006 which should
open on or about November 26, 2003, for two weeks. (Applications before that
date will not be accepted.) Applicants may visit the CDC home page at
http://www.cdc.gov and the NIP home
page at http://www.cdc.gov/nip
More information: Interested applicants should contact Bob Keegan, Acting
Director, Global Immunization Division, at
rak1@cdc.gov or (404) 639-8724, or Kim Lane, Associate Director for
Management and Operations, National Immunization Program, at
ksb1@cdc.gov or (404) 639-8200.
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December 1, 2003
FREE: BULK COPIES OF THE LATEST ISSUE OF "VACCINATE ADULTS" (NOVEMBER 2003)
ARE AVAILABLE--PLACE YOUR ORDER NOW
The Immunization Action Coalition (IAC) is giving away bulk copies (up to
225 per request) of the November 2003 issue of "VACCINATE ADULTS" to make
room for our January 2004 issue.
If you have an immunization conference or an educational program coming up
for health professionals, this 12-page publication is an excellent item to
distribute. It's packed with information that can make many aspects of adult
immunization go more smoothly. The November issue includes the most current
version of the popular "Summary of Recommendations for Adult Immunization,"
as well as information on influenza vaccination and updated
professional-education material about hepatitis B.
Because supplies are limited, it's best to make your request right away. The
free copies go quickly. Sorry, we can only mail orders to addresses within
the United States.
To request copies, fill out the online form on IAC's website:
http://www.immunize.org/oldva
You will be asked to supply the following information:
- The number of copies you want (maximum 225)
- A description of how you plan to use the copies
- Your name and complete contact information, including mailing
address, telephone number, and email address
For further information, please contact Pat Storti, office
administrator, by email at pat@immunize.org
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December 1, 2003
JANUARY 15, 2004, IS THE DEADLINE FOR ABSTRACTS FOR THE
1ST INTERNATIONAL NEONATAL VACCINATION WORKSHOP
The 1st International Neonatal Vaccination Workshop will be held
on March 2-4, 2004, at the Hilton McLean Tysons Corner Hotel in
McLean, VA. The workshop will explore the feasibility and safety
of strategies to expand protection of young infants against
vaccine-preventable diseases. Abstracts to be submitted for
poster presentations must be received by January 15, 2004. The
pre-registration deadline is February 13, 2004.
For information, go to:
http://www.cdc.gov/nip/events/neonatal_wkshop/default.htm
For additional information, contact the workshop planning team
by email at neonatal@cdc.gov or by phone at (404) 639-8695 or
(404) 639-8845.
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December 1, 2003
SUBMIT LATE-BREAKER ABSTRACTS FOR THE INTERNATIONAL CONFERENCE
ON EMERGING INFECTIOUS DISEASES AS EARLY AS DECEMBER 10
The Centers for Disease Control and Prevention (CDC) published
"Notice to Readers: Call for Abstracts: International Conference
on Emerging Infectious Diseases 2004" in the November 28 issue
of "Morbidity and Mortality Weekly Report" (MMWR). The article
is reprinted below in its entirety.
PLEASE NOTE: The text of the report reprinted below has been
corrected and does not correspond to the official electronic PDF
version. An erratum will be published in a subsequent issue of
MMWR.
IAC EXPRESS EDITOR'S NOTE: The official electronic PDF version
mistakenly lists the conference title as the International
Conference on Emerging Infectious Diseases 2000. Aside from the
mistaken date in the conference title, the text of the official
electronic PDF version is the same as the text reprinted below.
***********************
The International Conference on Emerging Infectious Diseases
2004 (ICEID 2004) is calling for late-breaker abstracts.
Abstracts should address new, reemerging, or drug-resistant
infectious diseases that affect human health. The late-breaker
abstract submission website will open on December 10, 2003, and
close promptly on January 16, 2004, at 5 p.m., Eastern Standard
Time. Information about submitting a late-breaker abstract is
available at http://www.iceid.org/abssub.asp
ICEID 2004 will be held February 29-March 3, 2004, at the
Marriott Marquis Hotel in Atlanta, Georgia. Cosponsors include
CDC, Council of State and Territorial Epidemiologists, American
Society for Microbiology, Association of Public Health
Laboratories, CDC Foundation, and World Health Organization.
Registration information is available at http://www.iceid.org
and at http://www.cdc.gov/ncidod and by e-mail at
meetinginfo@asmusa.org or at
dsy1@cdc.gov
***********************
To access a web-text (HTML) version of the complete and
corrected article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5247a8.htm
To access a ready-to-copy (PDF) version of this issue of MMWR,
go to: http://www.cdc.gov/mmwr/PDF/wk/mm5247.pdf
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December 1, 2003
CDC REPORTS ON GLOBAL PROGRESS TOWARD CERTIFYING POLIO
ERADICATION AND LABORATORY CONTAINMENT OF WILD POLIOVIRUSES
The Centers for Disease Control and Prevention (CDC) published
"Global Progress Toward Certifying Polio Eradication and
Laboratory Containment of Wild Polioviruses--August 2002-August
2003" in the November 28 issue of "Morbidity and Mortality
Weekly Report" (MMWR). A summary made available to the press is
reprinted below in its entirety.
***********************
Significant progress is being made in the process of certifying
the world as polio-free and in the process of containing
laboratory stores of poliovirus-containing samples.
At the end of the campaign to eradicate polio, the world will be
certified as polio-free by a global certification commission.
This will take place after each of the six WHO regions has been
declared polio-free by regional certification commissions. To
date, the Americas, Western Pacific, and European regions have
been certified. As part of the global certification process,
each country must identify laboratories that might have stored
poliovirus-containing samples and survey those labs to determine
whether such samples have been found. 90% of the identified labs
in the Americas have been surveyed, 72% of those in the Western
Pacific Region, and 91% of the labs in the European region.
Significant progress toward laboratory containment of poliovirus
is also being made in the remaining three regions.
***********************
To access a web-text (HTML) version of the complete article, go
to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5247a6.htm
To access a ready-to-copy (PDF) version of this issue of MMWR,
go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5247.pdf |
