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Hep Express Issue 5

(1 of 5)
July 2, 2003
ARTICLE ABOUT HEPATITIS B VACCINATION OF HIGH-RISK ADULTS MAKES CASE FOR FEDERAL FUNDING

"A Review of the Case for Hepatitis B Vaccination of High-Risk Adults" examines the history of providing hepatitis B vaccine to high-risk adults in the United States, and illustrates the need for a clear national objective and federal funding in this area.

The article describes how the hepatitis B vaccine continues to be underutilized in high-risk adults. For example, a survey of 65 federally funded STD projects in 1997 found that only 24 percent offered the hepatitis B vaccine in some or all of their clinics. In another national survey, only three of 36 responding state and federal correctional systems reported offering the vaccine to all inmates. In another study, only 13 to 25 percent of injection drug users reported being offered vaccination.

Although targeting high-risk adults for hepatitis B vaccination is likely to be cost-effective, most programs providing services to such clients--such as STD clinics, drug treatment centers, mental health facilities, prisons, and homeless shelters--will not be able to add hepatitis B vaccination without additional funding.

The article concludes, "Beyond the issue of feasibility and cost-effectiveness, however, lies the reality of politics and public consciousness. Hepatitis B is prevalent in prisoners, injection drug users, commercial sex workers, and men who have sex with men, and current political agendas are not likely to increase funding to these marginalized groups for  preventative health. What is needed is a clear national objective and federal funding for vaccinating high-risk adults."

The full citation for this article follows:

"A Review of the Case for Hepatitis B Vaccination of High-Risk Adults"
Authors: Rich JD, Ching CG, Lally MA, Gaitanis MM,
Schwartzapfel B, Charuvastra A, Beckwith CG, Flanigan TP
Source: The American Journal of Medicine, March 2003, Vol. 114(4):316-8
http://www.ncbi.nlm.nih.gov/entrez/
query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12681460&dopt=
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(2 of 5)
July 2, 2003
NEW WEBSITE FOR MSM LISTS CLINICS PROVIDING FREE OR LOW-COST HEPATITIS A AND B VACCINATION

Men who have sex with men (MSM) should be vaccinated against both hepatitis A and hepatitis B, yet many remain unprotected. GayHealth.com recently compiled a list of clinics nationwide providing free or low-cost hepatitis A and hepatitis B vaccines to MSM.

The list of clinics is available as part of GayHealth.com's new website, HepClinics.com, which also provides links to other viral hepatitis information of interest to persons at high risk of infection; not only MSM, but also persons with multiple sex partners, users of intravenous drugs, travelers to endemic areas, and others.

Visit this new website at http://www.hepclinics.com The editors are always looking for more clinics to add, so if you work for a clinic offering free or low-cost hepatitis A and hepatitis B vaccines to high-risk adolescents and adults, and your clinic isn't listed, please inform GayHealth.com by writing to editor@hepclinics.com
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(3 of 5)
July 2, 2003
RECENT HEPATITIS-RELATED ARTICLES YOU MAY HAVE MISSED

As a convenience to our readers, each month "HEP EXPRESS" provides links to recent journal article abstracts related to hepatitis A, B, and C. While we realize that not all these topics may be of interest to every reader, we hope most subscribers find this service helpful.

"Hepatitis A Vaccine: Immunogenicity Following Administration of a Delayed Immunization Schedule in Infants, Children and Adults"
Authors: Williams JL, Bruden DA, Cagle HH, et al
Source: Vaccine, July 4, 2003, Vol. 21(23):3208-3211
http://www.ncbi.nlm.nih.gov/entrez/
query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12804849&dopt=

"Foodborne Transmission of Hepatitis A--Massachusetts, 2001"
Source: MMWR, June 20, 2003, Vol. 52(24):565-7
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5224a2.htm

"Economic Analysis of Promotion of Hepatitis B Vaccinations Among Vietnamese-American Children and Adolescents in Houston and Dallas"
Authors: Zhou F, Euler GL, McPhee SJ, et al
Source: Pediatrics, June 2003, Vol. 111(6):1289-1296
http://pediatrics.aappublications.org/cgi/content/abstract/111/6/1289
(This is a companion piece to "Successful Promotion of Hepatitis B Vaccinations Among Vietnamese-American Children Ages 3 to 18: Results of a Controlled Trial," which was mentioned in "HEP EXPRESS #4." The abstract is available at http://pediatrics.aappublications.org/cgi/content/abstract/111/6/1278)

"Hepatitis B Virus Infection Among Young Injection Drug Users in San Francisco, Calif: The UFO Study"
Authors: Lum PJ, Ochoa KC, Hahn JA, Shafer KP, Evans JL, Moss AR
Source: American Journal of Public Health. June 2003,
Vol. 93(6):919-923
http://www.ncbi.nlm.nih.gov/entrez/
query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12773355&dopt=

"Investigation of Infection Control Practices and Knowledge of Hepatitis C Among Body-Piercing Practitioners"
Authors: Hellard M, Aitken C, Mackintosh A, Ridge A, Bowden S
Source: American Journal of Infection Control, June 2003, Vol. 31(4):215-220
http://www.ncbi.nlm.nih.gov/entrez/
query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12806358&dopt=

"Hepatitis A Vaccination Among Young African American Men Who Have Sex with Men in the Deep South: Psychosocial Predictors"
Source: Journal of the National Medical Association, April 2003, Vol. 95(4 Suppl):31S-36S
http://www.ncbi.nlm.nih.gov/entrez/
query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12749607&dopt=

"Validity of Injecting Drug Users' Report of Hepatitis A, B, and C"
Authors: Schlicting EG, Johnson ME, Brems C, Wells RS,
Fisher DG, Reynolds G
Source: Clinical Laboratory Science, Spring 2003, Vol. 16(2): 99-106
http://www.ncbi.nlm.nih.gov/entrez/
query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12757189&dopt=

For links to more hepatitis-related journal abstracts, go to:
http://www.immunize.org/hepb for articles about hepatitis B
http://www.immunize.org/hepa for articles about hepatitis A.
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(4 of 5)
July 2, 2003
STATE HEPATITIS COORDINATORS PROVIDE ASSISTANCE NATIONWIDE

State hepatitis coordinators are a vital resource for health professionals and the public. The Centers for Disease Control and Prevention (CDC) describes their role:

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Coordinators, the designated hepatitis program experts for their state, work with organizations and individuals on all levels of viral hepatitis prevention. They provide the bridge between CDC and the states, ensuring that funding and programs  get to the states as needed. Their work reaches out locally to hospitals, physicians, STD clinics, and drug treatment centers. They ensure that education and counseling of viral hepatitis prevention is provided to communities and individuals.

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Every state and territory has a hepatitis B coordinator who works primarily with physicians and hospitals to ensure that pregnant women infected with the hepatitis B virus are identified and that appropriate prophylactic medical care is given to their babies. Most states also have a hepatitis C coordinator who works with public health professionals in areas such as HIV/AIDS, immunizations, sexually transmitted diseases, and corrections. One state also has a hepatitis A coordinator.

The Immunization Action Coalition (IAC) continually updates the contact information for these hepatitis coordinators (as well as for state immunization and VFC coordinators) on a web page titled "Need Help? Call your immunization, hepatitis, and VFC coordinators." To access this information, go to: http://www.immunize.org/coordinators

Please contact IAC with any additions or corrections to this page.

CDC provides additional information about the role of viral hepatitis coordinators at
http://www.cdc.gov/ncidod/diseases/hepatitis/spotlights/coordinators.htm
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(5 of 5)
July 2, 2003
IAC OFFERS VACCINE INFORMATION STATEMENTS IN UP TO 28 LANGUAGES

Federal law mandates that all patients be provided with a Vaccine Information Statement (VIS) before receiving hepatitis B vaccine. The Centers for Disease Control and Prevention (CDC) recommends providing a Hepatitis A VIS before vaccination, and such use is required if the vaccine being administered was purchased under a contract with CDC (e.g., VFC).

The law requires that providers ensure all patients receive such information, regardless of their ability to read English. The Immunization Action Coalition (IAC) offers the Hepatitis B VIS in 28 languages and the Hepatitis A VIS in 27 languages on its website for health professionals.

The Hepatitis B VIS is available in English, Arabic, Armenian, Cambodian, Chinese, Croatian, Farsi, French, German, Haitian, Hmong, Ilokano, Japanese, Korean, Laotian, Polish, Portuguese, Punjabi, Romanian, Russian, Samoan, Serbo-Croatian, Somali, Spanish, Tagalog, Thai, Turkish, and Vietnamese. The Hepatitis A VIS is available in the same translations with the exception of Ilokano. The Hepatitis B VIS is also offered in audio format in English and Spanish.

These VIS translations are courtesy of the Minnesota Department of Health, the California Department of Health Services, the Massachusetts Department of Public Health, the Hawaii Department of Health, Asian Pacific Health Care Venture, Inc., Danusia Filipowski, M.D., Mustafa Kozanoglu, M.D., and Murat Serbest, M.D.

All the VISs are camera-ready and copyright-free. Feel free to download and use them for your patients and clients! To access the VIS page, go to: http://www.immunize.org/vis

The following educational pieces provide detailed information on the proper use of VISs:

"Instructions for the Use of Vaccine Information Statements"
Source: Centers for Disease Control and Prevention
http://www.cdc.gov/nip/publications/VIS/vis-instructions.pdf

"It's Federal Law!! You Must Give Your Patients Current Vaccine Information Statements (VISs)"
Author: Neal Halsey, M.D.
Source: Immunization Action Coalition
http://www.immunize.org/catg.d/2027law.pdf

"The Truth about Using VISs"
Source: Immunization Action Coalition
http://www.immunize.org/catg.d/p2028.pdf


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