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Needle Tips Fall/Winter 1998-1999

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Needle Tips Fall/Winter 1998-1999 Volume 8 - Number 2 NEEDLE TIPS Fall/Winter 1998-1999 & the Hepatitis B Coalition News Published by the Immunization Action Coalition for individuals and organizations concerned about vaccine-preventable diseases. Holy contraindications, Robin! That person was coughing! WHAT'S ON THE INSIDE: Why did you vaccinate him? Ask the Experts CDC’s immunization expert Dr. William Atkinson answers your questions ......................... 1 CDC’s hepatitis experts, Harold Margolis, MD, and Linda Moyer, RN, answer hepatitis A and B questions .................................................................................................. 17 What’s New? Vaccinate, don’t vacillate! by Walter A. Orenstein, MD, Centers for Disease Control ........... 3 Vaccine highlights: new vaccines and new recommendations .............................................. 4 ? ? ? It’s federal law! by Neal Halsey, MD, Institute for Vaccine Safety ....................................... 6 What’s your state doing? hepatitis B laws, pneumococcal, influenza rates, etc. .................... 9 Unprotected people...five varicella-related deaths ................................................................ 13 Photocopy these materials! Holy missed opportunities, Batman! Polio Vaccine Information Statement (VIS) ......................................................................... 7 A mild illness is NOT a reason to NEW! Vaccinations for adults with hepatitis C virus infection ............................................. 10 withhold vaccinations. You’d know this, Revised! Summary of recommendations for adult immunization ....................................... 11 too, if you took THE TEST on page 14. Revised! Dosage schedule of hepatitis A and B vaccines ................................................... 19 National Resources Where to get videos, ACIP statements, and more ................................................................. 20 Coalition Catalog Immunization and hepatitis B videos, brochures, etc. Order one, make copies! ................... 24 Take A+ Join the Coalition! the The test! A $50 annual membership will help support the Coalition plus we’ll send you a huge Test packet of all our printed materials, too! ................................................................................ 28 General vaccine questions within 30 minutes of reconstitution, and MMR must be administered within 8 hours. Ask the by William L. Atkinson, MD, MPH If you decide to pre-draw syringes, I would When the expiration date of a vaccine strongly suggest that you draw up only inactivated Experts indicates a month and year, does the vaccine vaccines (hepatitis B, DTaP, IPV, Hib), and only expire on the first or last day of the month? enough for a single day’s use. Make sure the sy- Editors’ note: The Immunization Action Coalition Vaccine may be used through the last day of the ringes are clearly marked to avoid administration thanks William L. Atkinson, MD, MPH, Harold S. month indicated on the expiration date. errors. Pre-drawn doses should be kept refriger- Margolis, MD, and Linda A. Moyer, RN, of the ated. Live injected vaccines (MMR and varicella) Should multidose vials of vaccine (DTaP, Td, Centers for Disease Control and Prevention for should not be pre-drawn. Hib, etc.) be disposed of after they have been answering the following questions from our read- opened for 30 days? When giving two IM injections in the same ers. Dr. Atkinson, medical epidemiologist at the No. These vaccines contain a bacteriostatic agent limb, what is the minimum spacing between National Immunization Program, and Dr. and may be used until the expiration date unless the two injection sites? Margolis, chief of the Hepatitis Branch, serve as they become contaminated. The vaccines should be separated by at least one CDC liaisons to the Coalition. Ms. Moyer is an inch in the body of the muscle so that any local epidemiologist at the Hepatitis Branch. Is it “legal” to draw up vaccines at the begin- ning of the shift? If it isn’t, how much in reactions are unlikely to overlap. advance can this be done? (continued on page 14) Questions for the experts? The Advisory Committee on Immunization Prac- tices (ACIP) recommends against pre-drawing Sign up for IAC EXPRESS! • E-mail [email protected] vaccine into syringes, primarily because of the You will receive timely immunization and • Call your state health department increased possibility of administration and dosing hepatitis news from us via e-mail. (phone numbers on page 23) errors. Many vaccines look alike after drawing To subscribe, send an e-mail request to • Call CDC’s Immunization Information into a syringe. In addition, some vaccines have a [email protected] and place the word Hotline at 800/232-2522 very limited shelf life after reconstitution. In par- SUBSCRIBE in the "Subject:" field. It’s free! ticular, varicella vaccine must be administered NEEDLE TIPS Letters to the Editor ● ● ● "To keep at your fingertips" Immunization Action Coalition Editors' note: IAC welcomes letters of interest to "The ACIP now recommends that pregnant women Hepatitis B Coalition readers. Please send your letters by mail, fax, or who will be beyond the first trimester of pregnancy 1573 Selby Avenue, Suite 234 e-mail to the address in the box at the left. (14 weeks) during influenza season should receive St. Paul, MN 55104 influenza vaccine. The recommendation also states 651/647-9009 Senator Wellstone wishes IAC well that pregnant women who have medical conditions fax: 651/647-9131 that increase their risk of complications from influ- e-mail: [email protected] I want to take this opportunity to let you know that I e-mail: [email protected] think the Immunization Action Coalition is doing a enza should be vaccinated before the influenza sea- website: www.immunize.org wonderful job. NEEDLE TIPS is such a great publi- son regardless of their stage of pregnancy. "Children with asthma also need to be vaccinated NEEDLE TIPS is a semi-annual publi- cation. I think it is a valuable resource for those who cation of the Immunization Action Coa- care about vaccine-preventable diseases. I especially against influenza and are often overlooked. Respira- lition. Everything herein is reviewed by enjoy the artwork. You have very talented artists. tory illnesses in asthmatic children can trigger pro- the Centers for Disease Control and Pre- I wish the Immunization Action Coalition contin- longed asthmatic illnesses, steroid use, hospital stays, vention for technical accuracy (unless it ued success. You should be very proud of your loss of the parents’ time from work, and loss of the is an opinion piece written by a non- child’s school time. Please remind parents to bring CDC author). NEEDLE TIPS is written accomplishments. My best to everyone at the Immu- for physicians, nurses, and other health nization Action Coalition. children in for vaccination, and, as recommended, professionals in the public and private —Paul Wellstone vaccinate all of the child’s family members as well." sectors. Circulation is now 200,000. United States Senator, Minnesota —W. Paul Glezen, MD Co-editors: Professor and Head, Preventive Medicine Section Deborah L. Wexler, MD Doctor discusses deadly diseases Baylor College of Medicine Margaret Vaillancourt The new vaccine against varicella is an important Writer says website wonderful Publication Assistants: adjunct to our preventive medicine armamentarium Just a quick note to let you know how terrific your Lynn Bahta, RN and merits complete implementation. However, a Linda Boerger-Johnson website is! Your site provides a tremendous amount statement in the MMWR (5/15/98) – "Varicella is the Kim Klose of information, and is very well laid out. For your Mary Borck leading cause of vaccine-preventable deaths in chil- information, I heard about your website at a CDC dren in the United States" – needs qualification. I am Artwork: satellite broadcast on immunization. I have spread sure that the authors of that statement were referring Leo, Izzy, and Sarah Wexler-Mann the good word about your site to our public health to "routinely recommended childhood vaccinations" Layout & Design: clients, as I am sure that they will find it a wonder- and were not considering vaccines which are rou- Creative Training & Consulting ful resource. Thanks so much for your hard work. tinely recommended for high-risk children. In fact, Website Design: Lantern Web™ —Susan Cumming more children die of influenza and/or pneumococcal Provincial Laboratory of Public Health The Immunization Action Coalition disease each year than varicella disease. Edmonton, Alberta, Canada (IAC), a 501(c)3 nonprofit organization, This fact reveals a disconnect in programs for “rou- works to boost immunization rates. IAC tine childhood” immunization and “adult” immuniza- Ed. note: Visit IAC's website at www.immunize.org promotes physician, community, and tion that I hope will disappear. I think that these are family awareness of, and responsibility artificial distinctions that do not enhance coverage for, appropriate immunization of all overall. Both influenza and pneumococcal vaccines people of all ages against all vaccine-pre- Welcome new board member! ventable diseases. are presently covered by the Vaccines For Children Stanley A. Gall, MD, obstetrician-gynecologist, is program for use in eligible high-risk children; how- Donald E. Baxter Professor and Chairman, Depart- The Hepatitis B Coalition, a program of ever, immunization rates are low as they also are for ment of Obstetrics/Gynecology,
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