Issue
Number 480
September 20, 2004
CONTENTS OF THIS ISSUE
- CDC reports that the shortage of pneumococcal conjugate vaccine (PCV7)
has been resolved
- Dear Abby to publish a letter on September 22 about the importance of
childhood influenza immunization
- Act now: Free bulk copies of the latest issue of "Vaccinate Adults"
(May 2004) will go fast
- New: NIP's web-based interactive "Vaccine Quiz" helps adolescents and
adults find out which vaccines they need
- Paul A. Offit, MD, responds to "Wall Street Journal" article about
thimerosal and autism
- Coming soon: Teleconference on Eliminating Disparities in Childhood
Immunization set for September 23
- Updated: IAC makes major revisions to its parent-education piece
"Vaccine Concerns"
- Updated: IAC revises its patient education brochure "Hepatitis A is a
Serious Liver Disease"
- The Society for Adolescent Medicine website offers valuable
information to professionals, teens, and parents
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ABBREVIATIONS: AAFP, American Academy of Family Physicians; AAP, American
Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices;
CDC, Centers for Disease Control and Prevention; FDA, Food and Drug
Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and
Mortality Weekly Report; NIP, National Immunization Program; VIS, Vaccine
Information Statement; VPD, vaccine-preventable disease; WHO, World Health
Organization.
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September 20, 2004
CDC REPORTS THAT THE SHORTAGE OF PNEUMOCOCCAL CONJUGATE VACCINE (PCV7) HAS
BEEN RESOLVED
CDC published "Notice to Readers: Pneumococcal Conjugate Vaccine Shortage
Resolved" in the September 17 issue of MMWR. The notice is reprinted below
in its entirety, with the exception of references and a table. (Titled
"Recommended 7-valent pneumococcal conjugate vaccination regimens among
children aged <5 years, by history and condition," the table provides
detailed scheduling, catch-up, and high-risk information for PCV7. To access
the table, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5336a8.htm#tab)
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Since February 2004, CDC has recommended that 7-valent pneumococcal
conjugate vaccine (PCV7), marketed as Prevnar and manufactured by Wyeth
Vaccines (Collegeville, Pennsylvania), be administered to healthy children
on an abbreviated schedule to conserve the limited supply. Production
capacity has been increased, and supply is now sufficient to meet the
national demand for vaccine on the routine, 4-dose schedule. Effective
immediately, CDC, in consultation with the Advisory Committee on
Immunization Practices, the American Academy of Family Physicians, and the
American Academy of Pediatrics, recommends that providers resume
administration of PCV7 according to the routine schedule.
A vaccination schedule is provided for children who are incompletely
vaccinated. The highest priority for catch-up vaccination is to ensure that
children aged <5 years at high risk for invasive pneumococcal disease
because of certain immunocompromising or chronic conditions (e.g., sickle
cell disease, asplenia, chronic heart or lung disease, diabetes,
cerebrospinal fluid leak, cochlear implant, or human immunodeficiency virus
infection) are fully vaccinated. Second priorities include vaccination of
healthy children aged <24 months who have not received any doses of PCV7 and
vaccination of healthy children aged <12 months who have not yet received 3
doses.
Because of the frequency of health-care provider visits by children during
their first 18 months, catch-up vaccination might occur at regularly
scheduled visits for most children who receive vaccines from their
primary-care providers. Programs that provide vaccinations but do not see
children routinely for other reasons should consider a notification process
to contact undervaccinated children.
Providers with questions about obtaining Prevnar should contact Wyeth's
customer service department, telephone (800) 666-7248. For public-purchased
vaccine, including vaccines used in the Vaccines for Children Program,
providers should contact their state/grantee immunization projects to obtain
vaccine. These projects should contact their project officers at the
National Immunization Program at CDC for information regarding vaccine
supply.
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To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5336a8.htm
To access a ready-to-copy (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5336.pdf
To receive a FREE electronic subscription to MMWR (which includes new ACIP
statements), go to:
http://www.cdc.gov/mmwr/mmwrsubscribe.html
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September 20, 2004
DEAR ABBY TO PUBLISH A LETTER ON SEPTEMBER 22 ABOUT THE IMPORTANCE OF
CHILDHOOD INFLUENZA IMMUNIZATION
Be sure to turn the pages of your newspaper to Dear Abby's column on
September 22. The column is scheduled to publish a letter that makes the
case for giving influenza vaccine to children 6-23 months of age (and their
household contacts and out-of-home caregivers) this fall. Representing the
views of AAFP, AAP, and the American Medical Association, the letter is
signed by leaders from all three professional associations.
From IAC's past experience being published in Dear Abby's column, we want to
alert immunization providers that they may get a number of phone calls from
people seeking appointments for influenza vaccination after the column is
published. The column's reach is broad: the Dear Abby staff estimates 110
million people read it each day.
If possible, we would appreciate your clipping the September 22 column
(including the headline) from your newspaper and faxing or mailing it to us.
We'd like to see the headlines various papers generate for the column.
Our fax number is (651) 647-9131; our mailing address is Immunization Action
Coalition, 1573 Selby Ave., Ste. 234, St. Paul, MN 55104. Thank you for your
help with this.
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September 20, 2004
ACT NOW: FREE BULK COPIES OF THE LATEST ISSUE OF "VACCINATE ADULTS" (MAY
2004) WILL GO FAST
The Immunization Action Coalition (IAC) is giving away bulk copies (up to 50
per request) of the May 2004 issue of "VACCINATE ADULTS."
If you have an immunization conference or an educational program coming up
for adult medical specialists, this 12-page publication is an excellent item
to distribute. The May issue includes a timely professional-education piece
that encourages health professionals to protect their patients by getting
immunized against influenza. It also has a patient-education piece advising
adults of the need for vaccination throughout the lifespan. PLEASE NOTE: One
of the patient-education pieces, "Protect Yourself Against Hepatitis A and
Hepatitis B: A Guide for Gay and Bisexual Men," is intended for a gay
audience in settings such as STD clinics and clinics for men who have sex
with men. It is not intended for routine use in all clinic settings.
Because supplies are limited, it's best to make your request right away. The
free copies go quickly. Sorry, we can mail orders only to addresses within
the United States.
To request copies, fill out the online form on IAC's website:
http://www.immunize.org/freeoffer
You will be asked to supply the following information:
- The number of copies you want (maximum 50)
- 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 email
admin@immunize.org
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September 20, 2004
NEW: NIP'S WEB-BASED INTERACTIVE "VACCINE QUIZ" HELPS ADOLESCENTS AND
ADULTS FIND OUT WHICH VACCINES THEY NEED
NIP recently launched a web-based interactive "Vaccine Quiz" to help
adolescents and adults understand which vaccines they need and to drive
home the point that vaccination is a lifelong, life-saving intervention.
Health care providers can reduce the time they spend on patient education
by referring patients to the quiz.
It takes a patient only five seconds to answer general questions about
their age, lifestyle, and medical conditions. When they finish, the
website immediately displays a short list of vaccines that may be
appropriate for the patient and encourages her/him to ask about these
vaccines during their next medical visit.
Quiz questions and results are based on the latest ACIP recommendations;
the quiz is updated whenever the recommendations change. To access the
quiz, go to:
http://www2a.cdc.gov/nip/adultimmsched
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September 20, 2004
PAUL A. OFFIT, MD, RESPONDS TO "WALL STREET JOURNAL" ARTICLE ABOUT
THIMEROSAL AND AUTISM
On September 14, the "Wall Street Journal" (WSJ) published a letter to the
editor from Paul A. Offit, MD, chief, Division of Infectious Diseases,
Children's Hospital of Philadelphia (CHOP), and professor of pediatrics,
University of Pennsylvania School of Medicine. The letter is a response to
an article written by WSJ reporter Tara Parker-Pope, which was published
September 7.
Parker-Pope's article, "Controversial Study Reignites Debate on Autism and
Childhood Vaccines," suggests that parents "politely ask to see the label"
on vials of influenza vaccine to be sure their child receives a thimerosal-free
version of the vaccine this year. Parker-Pope's article received media
attention. Offit's response, reprinted below from the listserv of CHOP's
Vaccine Education Center, may help physicians and other health
professionals answer questions raised by the article.
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This year, for the first time, the Centers for Disease Control and
Prevention (CDC) recommended that all children between six and 23 months
of age receive an influenza vaccine. Some of the influenza vaccine used
this year will contain a preservative (thimerosal) and some will not. In
her article ("Controversial Study Reignites Debate Over Autism and
Childhood Vaccines," Wall Street Journal, September 7, 2004), Tara
Parker-Pope recommends that, because thimerosal might cause autism,
parents should "politely ask to see the label." Because supplies of
thimerosal-free influenza vaccine are limited, many parents will be faced
with the choice of getting thimerosal-containing influenza vaccine or not
getting a vaccine; Parker-Pope leads her readers to believe that no
vaccine is the better choice. But a choice not to get an influenza vaccine
will unnecessarily put children in harm's way.
Parker-Pope's article is misleading for several reasons. First, thimerosal
contained in vaccines doesn't cause autism. Two large epidemiologic
studies performed in the United States and Denmark found that children who
received thimerosal-containing vaccines were not at greater risk of
autism. Because epidemiologic studies are capable of detecting even very
rare side effects, the importance of these findings cannot be overlooked.
For example, large epidemiologic studies easily found that the swine flu
vaccine used in the mid-1970s caused a serious side effect in 1 of every
100,000 people that got it. Parker-Pope can't argue that rates of autism
are "as high as 1 in 150" and that epidemiologic studies aren't sensitive
enough to find that vaccines are the cause. Second, the article states
that after the Institute of Medicine (IOM) "rejected a link between
vaccines and autism, a mouse study has reignited the debate." The mouse
study to which Parker-Pope refers is not new; it was evaluated by the IOM
at the time of their review and found to be critically flawed. The authors
of the mouse study found that mice uniquely susceptible to autoimmune
diseases developed autism after receiving thimerosal. But mice aren't men,
autism is not an autoimmune disease, and the extrapolation from autism in
children (a disorder of speech, language, and social behavior) to autism
in mice is fanciful. Third, the article states that Congressman Dan
Burton's grandson "developed autism five years ago after receiving shots
containing thimerosal." This statement would lead the reader to believe
that autism was caused by vaccines; something clearly at variance with
epidemiologic studies. Fourth, the article states that "[a]nother option
is to ask for Flu-Mist, a nasal mist vaccine that doesn't contain
thimerosal." The article fails to mention that Flu-Mist is not licensed
for children less than five years old and, therefore, cannot be used in 6-
to 23-month-olds.
Every year in the United States, influenza causes about 115,000 people to
be hospitalized--about 40 percent are young children. Children with
influenza are hospitalized because they suffer high fever, croup,
wheezing, or severe pneumonia. Last year about 150 children in the United
States died from influenza; most were previously healthy and many were
less than two years old. A choice not to get an influenza vaccine
containing thimerosal will not lessen the risk of autism; it will only
increase the risk of getting a potentially fatal infectious disease.
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September 20, 2004
COMING SOON: TELECONFERENCE ON ELIMINATING DISPARITIES IN CHILDHOOD
IMMUNIZATION SET FOR SEPTEMBER 23
Each month, the National Association of City and County Health Officials (NACCHO)
and CityMatCH present a teleconference in a series on Emerging Issues in
Maternal and Child Health. Scheduled for September 23 from 3PM to 4:30PM
(ET), the next teleconference will focus on the topic Eliminating
Disparities in Childhood Immunization.
Presenters will highlight current initiatives addressing the provision of
childhood immunization and the improvement of immunization rates among
racial and ethnic minorities and individuals of lower socioeconomic
status.
Among the presenters are Susan Y. Chu, PhD, MSPH, associate director for
science, NIP/CDC; and Anne Bailowitz, MD, MPH, chief, Bureau of Child
Health and Immunization, Baltimore City Health Department.
For more information on the teleconference, go to:
http://www.naccho.org/general1209.cfm
To register for the teleconference, click
here. For information about
this and upcoming teleconferences in the series, contact Angela
Ablorh-Odjidja, MPH, at
aablorh@naccho.org
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September 20, 2004
UPDATED: IAC MAKES MAJOR REVISIONS TO ITS PARENT-EDUCATION PIECE "VACCINE
CONCERNS"
IAC recently revised its 10-page parent-education piece, "Vaccine
Concerns." The revised piece is entirely reprinted from "Common Concerns
about Vaccines," a chapter in the most recent (third) edition of the book
"Vaccines: What You Should Know." Paul A. Offit, MD, and Louis M. Bell,
MD, wrote the book; the third edition was published in 2003.
"Vaccine Concerns" presents comprehensive information about vaccine
efficacy, safety, and side effects; autism; thimerosal; and other current
concerns related to childhood immunization. It replaces an earlier IAC
parent-education piece, "Vaccine Myths," which was reprinted from an
earlier edition of Offit and Bell's book.
To access a ready-to-copy (PDF) version of the revised piece, go to:
http://www.immunize.org/catg.d/4038myth.pdf
To access a web-text (HTML) version of it, go to:
http://www.immunize.org/catg.d/4038myth.htm
To purchase a copy of the third edition of the book, visit your local
bookstore or go to the publisher's website at
www.wiley.com
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September 20, 2004
UPDATED: IAC REVISES ITS PATIENT-EDUCATION BROCHURE "HEPATITIS A IS A
SERIOUS LIVER DISEASE"
IAC recently made significant revisions to its two-page patient-education
brochure "Hepatitis A Is a Serious Liver Disease." Written in Q&A format,
the brochure was expanded to include more questions. In addition, new
graphics give the brochure a fresh, contemporary look.
To access a ready-to-copy (PDF) version the updated brochure, go to:
http://www.immunize.org/catg.d/p4080a.pdf
To access a web-text (HTML) version, go to:
http://www.immunize.org/catg.d/p4080a.htm
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September 20, 2004
THE SOCIETY FOR ADOLESCENT MEDICINE WEBSITE OFFERS VALUABLE INFORMATION TO
PROFESSIONALS, TEENS, AND PARENTS
Intended primarily for professionals involved in improving the physical
and psychological health of adolescents, the website of the Society for
Adolescent Medicine (SAM) also provides resources for teens and parents.
Resources for professionals
The "Journal of Adolescent Health" is SAM's main resource for
professionals. In addition, SAM holds an annual meeting for its members,
publishes a member newsletter, and offers a variety of opportunities for
continuing education, professional education, and training in various
subjects related to adolescent health.
For complete information on SAM's resources for professionals, go to:
http://www.adolescenthealth.org
To access the "Journal of Adolescent Health," go to:
http://journals.elsevierhealth.com/periodicals/jah
Resources for teens
In 2003, SAM published a pamphlet, "Health Guide for America's Teens,"
full of information about issues pertinent to maintaining good physical
and psychological health during adolescence. The pamphlet covers topics
such as friends and relationships, health habits (including immunization),
food and fitness, smoking, sex and safety, and drinking and drugs. Its
purpose is to give teens the information they need to make sound health
decisions.
To download a copy of the pamphlet, go to:
http://www.adolescenthealth.org/html/Health_Guide_for_Americas_Teens.pdf
Resources for parents
Published in 2003, "The Healthy Student: A Parent's Guide to Preparing
Teens for the College Years" is intended to remind parents to review
important physical and mental health topics with their college-bound child
before the start of college. Available in English and Spanish, the 12-page
pamphlet discusses communication, independence and confidentiality,
immunizations, health insurance, medical records and prescriptions, and
more.
To download an English-language copy of the pamphlet, go to:
http://www.adolescenthealth.org/html/The_Healthy_Student.pdf
To download a Spanish-language copy, go to:
http://www.adolescenthealth.org/html/El_Estudiante_Saludable.pdf |
