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Hep Express Issue

Issue Number 39, January 6, 2006
 
Contents of this Issue
1. New: ACIP issues hepatitis B recommendations for infants, children, and adolescents
2. CDC provides online information about the new hepatitis B recommendations
3. Net conference on new hepatitis B recommendations is scheduled for February 2; register by January 31
4. Continuing education credits available for national hepatitis conference attendees
5. Current Issues in Immunization Net Conference to focus on new hepatitis A vaccine recommendations
6. Hepatitis B bill introduced in Congress
7. NIP website posts provisional ACIP recommendations for use of Tdap, hepatitis A, and hepatitis B vaccines
8. CDC issues press release about the appointment of three new center directors
9. MMWR notifies readers that FDA approved lowering the age limit for Havrix hepatitis A vaccine to 12 months
10. Management of hepatitis conference set for April 6-8 in Bethesda
11. Access AASLD conference presentations online
12. Viral Hepatitis Prevention Board adds two resources to its website

ABBREVIATIONS: ACIP, Advisory Committee on Immunization Practices; CDC, Centers for Disease Control and Prevention; DVH, Division of Viral Hepatitis; HAV, hepatitis A virus; HBV, hepatitis B virus; HCV, hepatitis C virus; IAC, Immunization Action Coalition; IDU, injection drug user; MMWR, Morbidity and Mortality Weekly Report; MSM, men who have sex with men; STD, sexually transmitted disease; VIS, Vaccine Information Statement; WHO, World Health Organization.
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January 6, 2006
NEW: ACIP ISSUES HEPATITIS B RECOMMENDATIONS FOR INFANTS, CHILDREN, AND ADOLESCENTS

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 1/3/06.]

On December 23, 2005, CDC published "A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP) Part 1: Immunization of Infants, Children, and Adolescents" in the MMWR Recommendations and Reports. The new recommendations are the first major update of the immunization strategy to eliminate hepatitis B virus in the United States since 1991.

The summary to the recommendations is reprinted below.

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This report is the first of a two-part statement from the Advisory Committee on Immunization Practices (ACIP) that updates the strategy to eliminate hepatitis B virus (HBV) transmission in the United States. The report provides updated recommendations to improve prevention of perinatal and early childhood HBV transmission, including implementation of universal infant vaccination beginning at birth, and to increase vaccine coverage among previously unvaccinated children and adolescents. Strategies to enhance implementation of the recommendations include (1) establishing standing orders for administration of hepatitis B vaccination beginning at birth; (2) instituting delivery hospital policies and procedures and case management programs to improve identification of and administration of immunoprophylaxis to infants born to mothers who are hepatitis B surface antigen (HBsAg) positive and to mothers with unknown HBsAg status at the time of delivery; and (3) implementing vaccination record reviews for all children aged 11-12 years and children and adolescents aged [younger than] 19 years who were born in countries with intermediate and high levels of HBV endemicity, adopting hepatitis B vaccine requirements for school entry, and integrating hepatitis B vaccination services into settings that serve adolescents. The second part of the ACIP statement, which will include updated recommendations and strategies to increase hepatitis B vaccination of adults, will be published separately.

**********************

To access a web-text (HTML) version of the recommendations, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5416a1.htm

To access a ready-to-print (PDF) version them, go to: http://www.cdc.gov/mmwr/PDF/rr/rr5416.pdf

NOTE: The PDF version includes a free CDC-sponsored education activity that can be submitted electronically or by fax or U.S. mail for CME, CEU, or CNE credit. Simply read the recommendations, answer the questions at the end, and follow instructions for submitting your answers.

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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January 6, 2006
CDC PROVIDES ONLINE INFORMATION ABOUT THE NEW HEPATITIS B RECOMMENDATIONS

CDC's Division of Viral Hepatitis has created a web section featuring resources related to the new ACIP hepatitis B recommendations. The page includes links to the following:

  • frequently asked questions about the new recommendations
  • frequently asked questions about foreign-born persons and hepatitis B
  • state perinatal hepatitis B prevention program coordinators
  • the Vaccines for Children program
  • "Progress Towards Elimination of Perinatal and Childhood Hepatitis B Virus Infections," a PowerPoint presentation from the National Viral Hepatitis Prevention Conference, December 7, 2005

To access this information, and more, go to: http://www.cdc.gov/ncidod/diseases/hepatitis/b/acip.htm
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January 6, 2006
NET CONFERENCE ON NEW HEPATITIS B RECOMMENDATIONS IS SCHEDULED FOR FEBRUARY 2; REGISTER BY JANUARY 31

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 1/3/06.]

NIP and the Division of Viral Hepatitis have scheduled a one-hour net conference for 12 noon ET February 2. Titled New ACIP Recommendations: Prevention of Perinatal and Childhood Hepatitis B Infections, the conference is intended for hospital obstetrical and neonatal staff, prenatal care providers, professional organizations involved in perinatal care, and public health staff. For additional conference information, go to: http://www.cdc.gov/nip/ed/ciinc/hepatitisb.htm

The conference requires pre-registration, as space is limited. Registration will close when the course is full or on January 31 (midnight ET). To register for the conference, go to: http://www2.cdc.gov/nip/isd/hepbconference

The program will combine a telephone audio conference and simultaneous online visual content. Participants can join the Q&A session by telephone or Internet. For instructions and system requirements, go to: http://www.cdc.gov/nip/ed/ciinc/instructions.htm

For additional information, go to: nipinfo@cdc.gov
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January 6, 2006
CONTINUING EDUCATION CREDITS AVAILABLE FOR NATIONAL HEPATITIS CONFERENCE ATTENDEES

The National Viral Hepatitis Prevention Conference chairs wish to remind people who attended the conference that continuing education credit is available through the CDC Training and Continuing Education Online system only. Individuals must complete the online evaluation by January 9, 2006 to receive continuing education credits or a certificate of completion.

To complete the online evaluation go to CDC Training and Continuing Education Online at http://www.cdc.gov/phtnonline. If you have not registered as a participant, click on New Participant to create a user ID and password; otherwise click on Participant Login and login. Directions for completing the evaluation can be found in your conference program book. The code for this training is NVHPC2005. Once you have completed the evaluation, a record of your course completion will be located in the Transcript and Certificate section of your record.

If you have any questions or problems, contact CDC/ATSDR Training and Continuing Education Online at (800) 418-7246 or (404) 639-1292, or email mailto:ce@cdc.gov
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January 6, 2006
CURRENT ISSUES IN IMMUNIZATION NET CONFERENCE TO FOCUS ON NEW HEPATITIS A VACCINE RECOMMENDATIONS

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 12/12/05.]

Scheduled for January 19, 2006, from noon to 1PM ET, the net conference Current Issues in Immunization is designed to provide clinicians with up-to-date information on immunization. The program has two primary topics: (1) new hepatitis A vaccine recommendations and (2) overview of vaccine information statements (VISs).

The conference requires pre-registration, as space is limited. Registration will close when the course is full or on January 17, 2006 (midnight ET). To register for the conference, go to: http://www2.cdc.gov/nip/isd/ciinc

The program will combine a telephone audio conference and simultaneous online visual content. Participants can join the Q&A session by telephone or Internet. For instructions and system requirements, go to: http://www.cdc.gov/nip/ed/ciinc/instructions.htm

For additional information, go to: nipinfo@cdc.gov
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January 6, 2006
HEPATITIS B BILL INTRODUCED IN CONGRESS

On December 15, 2005, Representatives Charles Dent (R-PA) and Mike Honda (D-CA) introduced HR 4550 in the House of Representatives. Titled the National Hepatitis B Act, the bill's purpose is "To amend the Public Health Service Act to direct the Secretary of Health and Human Services to establish, promote, and support a comprehensive prevention, education, research, and medical management program that will lead to a marked reduction in liver cirrhosis and a reduction in the cases of, and improved survival of, liver cancer caused by chronic hepatitis B infection."

This bill could be a useful vehicle to educate members of Congress about hepatitis B and the need for an enhanced federal response. Individuals are encouraged to let their congressional representatives know about this bill and encourage them to sign on as co-sponsors.

To view the bill online, go to http://thomas.loc.gov and enter HR 4550 in the search box.

Persons interested receiving ongoing information about national viral hepatitis policy should sign up for the National Alliance of State & Territorial AIDS Directors' listserv. Subscribe by emailing viralhepadvocacy@nastad.org
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January 6, 2006
NIP WEBSITE POSTS PROVISIONAL ACIP RECOMMENDATIONS FOR USE OF Tdap, HEPATITIS A, AND HEPATITIS B VACCINES

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 12/19/05.]

NIP recently posted links to provisional ACIP recommendations for the use of Tdap, hepatitis A, and hepatitis B vaccines to its web page of Provisional ACIP Recommendations. Provisional recommendations are those that ACIP has voted on but that CDC and the Department of Health and Human Services have not yet approved and that MMWR has not yet published. Links to newly posted provisional recommendations follow:

To access the web page of provisional recommendations, go to: http://www.cdc.gov/nip/recs/provisional_recs

To access a complete list of ACIP recommendations already published in MMWR, go to: http://www.cdc.gov/nip/publications/acip-list.htm
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January 6, 2006
CDC ISSUES PRESS RELEASE ABOUT THE APPOINTMENT OF THREE NEW CENTER DIRECTORS

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 12/5/05.]

On November 23, [2005], CDC published a press release announcing the appointment of three new directors, including the director of the National Immunization Program. Portions of the press release are reprinted below.

Following the reprinted material from the press release is a link to an article, "CDC Announces Restructuring Details," from the November 2005 issue of the newsletter published by Every Child by Two (ECBT). The article includes an organizational chart depicting the future structure of CDC's Coordinating Center for Infectious Diseases, which includes the current National Immunization Program, National Center for Infectious Diseases, and National Center for HIV, STD, and TB Prevention.

This IAC Express article concludes with IAC's expression of thanks for the leadership provided by Stephen L. Cochi, MD, MPH, acting director of NIP.

*********************

For immediate release
November 23, 2005

CDC DIRECTOR ANNOUNCES NEW CENTER DIRECTORS

Centers for Disease Control and Prevention (CDC) Director Dr. Julie Gerberding announced today the appointment of new directors for three key organizational components of the federal agency responsible for protecting the nation's health. . . .

The appointments include Anne Schuchat, MD, as director of the National Immunization Program. Dr. Schuchat began her career at CDC as an Epidemic Intelligence Service (EIS) Officer in 1988 and most recently served as the acting director of the National Center for Infectious Diseases (NCID). She has made critically important contributions to prevention of infectious diseases in children, including her role in group B streptococcal disease prevention, where she spearheaded the development of CDC's guidelines, which have led to an 80 percent reduction in newborn infections and a 75 percent narrowing of racial disparity in this infectious disease. She has also been instrumental in pre- and post-licensure evaluations of conjugate vaccines for bacterial meningitis and pneumonia and in accelerating availability of these new vaccines in resource-poor countries through WHO and the Global Alliance for Vaccine and Immunization.

In a second appointment, Rima Khabbaz, MD, was named as the director of the National Center for Infectious Diseases (NCID). Dr. Khabbaz began her career at CDC as an EIS Officer in 1980 and most recently served as acting deputy director of NCID. She has worked in research and epidemiology of hospital-acquired infections [and] viral diseases and played a leading role in coordinating CDC's programs around blood safety [and] food safety, as well as emerging infectious diseases. She has played critical roles in CDC's responses to bioterrorism, outbreaks of new diseases, and infectious disease responses to natural disasters.

In addition, Kevin Fenton, MD, PhD, was named director of the National Center for HIV, STD, and TB Prevention (NCHSTP). Dr. Fenton has served as chief of CDC's National Syphilis Elimination Effort since January 2005. He has worked in research, epidemiology, and the prevention of HIV and other STDs since 1995 and was previously the director of the HIV and STI Department at the United Kingdom's Health Protection Agency. Dr. Fenton has spearheaded the development of a number of national HIV, STD, and behavioral surveillance and research programs in the U.K. and Western Europe including the National Chlamydia Screening Programme in England, the 2nd British National Survey of Sexual Attitudes and Lifestyles, and the European Surveillance of STI (ESSTI) Network. . . .

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To access the press release from the CDC website, go to: http://www.cdc.gov/od/oc/media/pressrel/r051123.htm

IAC staff look forward to working with Dr. Schuchat, Dr. Khabbaz, and Dr. Fenton in their new roles as CDC center directors to meet the challenging public health issues that lie ahead.

LINK TO ECBT ARTICLE
For more information on CDC's restructuring, see "CDC Announces Restructuring Details" in the November 2005 issue of the Every Child by Two newsletter at http://www.ecbt.org/cdcrstrc.html

IAC THANKS DR. STEPHEN COCHI FOR HIS LEADERSHIP IAC staff express our great appreciation to Stephen L. Cochi, MD, MPH, for his outstanding leadership as acting director at CDC's National Immunization Program for the past 22 months. We also thank him for his services as NIP liaison to IAC's Advisory Board for the past two years and his personal commitment to IAC's mission and work.
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January 6, 2006
MMWR NOTIFIES READERS THAT FDA APPROVED LOWERING THE AGE LIMIT FOR HAVRIX HEPATITIS A VACCINE TO 12 MONTHS

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 12/12/05.]

CDC published "Notice to Readers: FDA Approval of Havrix (Hepatitis A Vaccine, Inactivated) for Persons Aged 1-18 Years" in the December 9, [2005], issue of MMWR. The notice is reprinted below in its entirety, with the exception of footnotes.

***********************

On October 17, 2005, the Food and Drug Administration approved an application to allow use of the pediatric/adolescent formulation of Havrix (hepatitis A vaccine, inactivated) (GlaxoSmithKline Biologicals, Rixensart, Belgium) for persons aged 1-18 years. Previously, pediatric use of Havrix was approved for use in persons aged 2-18 years.

Vaccine Description
The formulation, dosage, and schedule for Havrix were not changed. Each 0.5-mL dose of pediatric/adolescent Havrix contains 720 enzyme-linked immunosorbent assay units of formalin-inactivated hepatitis A viral antigen adsorbed onto aluminum hydroxide. The formulation contains 0.5% 2-phenoxyethanol as a preservative.

The pediatric/adolescent formulation of Havrix is indicated for vaccination of persons aged 1-18 years against disease caused by hepatitis A virus. Recommendations for hepatitis A vaccination have been published previously and are periodically updated. The primary vaccination schedule is unchanged and consists of 2  doses, administered on a 0, 6-12-month schedule.

In a study presented as part of the labeling change application, 99% of 218 children aged 11-13 months and 100% of 200 children aged 15-18 months who received 2 doses of Havrix developed a vaccine response. The approval included concomitant use of Havrix with Haemophilus influenzae type b conjugate vaccine (PRP-T Hib). Data regarding concomitant use with other routinely recommended childhood vaccines are limited. According to general recommendations of the Advisory Committee on Immunization Practices, inactivated vaccines usually do not interfere with the immune response to other inactivated or live vaccines.

Among the 723 healthy children who received 1 or more dose of Havrix, the most common adverse events were similar among children aged 11-18 months and children aged 23-25 months. Havrix is contraindicated in persons with known hypersensitivity to any component of the vaccine. Additional information is available from the manufacturer's package insert and GlaxoSmithKline Biologicals at telephone (888) 825-5249.

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To access a web-text (HTML) version of the complete article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5448a4.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5448.pdf
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January 6, 2006
MANAGEMENT OF HEPATITIS CONFERENCE SET FOR APRIL 6-8 IN BETHESDA

The National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, the American Association for the Study of Liver Diseases, and the Hepatitis B Foundation are sponsoring a meeting on April 6-8, 2006, in Bethesda, Maryland.

The goals of "Management of Hepatitis B Virus" are to assess current understanding of HBV, the disease that it causes, and its optimal management; and to make recommendations for directions for future research, both basic and clinical.

For more information, go to: http://www.niddk.nih.gov/fund/other/hbv2006
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January 6, 2006
ACCESS AASLD CONFERENCE PRESENTATIONS ONLINE

On November 11-15, 2005, the American Association for the Study of Liver Diseases (AASLD) hosted the 56th Annual Liver Meeting in San Francisco. You can now access presentations from this conference online.

HIVandHepatitis.com has posted independent coverage of the AASLD conference at http://www.hivandhepatitis.com/2005icr/aasld/main.html

Clinical Care Options has posted independent coverage of the conference at http://clinicaloptions.com/Hepatitis/Conference%20Coverage/
San%20Francisco%202005.aspx
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January 6, 2006
VIRAL HEPATITIS PREVENTION BOARD ADDS TWO RESOURCES TO ITS WEBSITE

The Viral Hepatitis Prevention Board (VHPB) website has been updated to include two new resources.

The program, pre-meeting document, and all the presentations from the November 2005 meeting, "Can the United Kingdom Control Viral Hepatitis?" are available online by going to the homepage at http://www.vhpb.org

The latest issue of Viral Hepatitis, "Hepatitis B, Hepatitis C, and Other Blood-Borne Infections in Healthcare Workers," can be accessed as a PDF document by going to http://www.vhpb.org/files/html/Meetings_and_publications/
Viral_Hepatitis_Newsletters/vhv14n1.pdf


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