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Hep Express Issue 59

Issue Number 59, August 9, 2007
 
Contents of this Issue
1. VIS news: CDC releases interim VIS for hepatitis B vaccine
2. Merck notifies CDC of delays in production of its pediatric and adult hepatitis A vaccines
3. CDC reports on hepatitis A vaccination coverage of U.S. children ages 24-35 months during 2004-05
4. Official CDC Health Advisory: Hepatitis A infections linked to children adopted from Ethiopia and their family contacts
5. Updated: IAC revises three of its immunization education print materials
6. Support the National Viral Hepatitis Roundtable
7. 2007 Perinatal Hepatitis B and HIV Grantees' Meeting presentations available online
8. CDC website posts presentation slides from the June ACIP meeting
9. Asian Liver Center publishes 2007 edition of its Physician's Guide to Hepatitis B
10. National Viral Hepatitis Training Center offers training in San Diego
11. MedPage Today offers teaching brief about treating HBV and HIV co-infection
12. IAC website posts interim VIS for hepatitis B vaccine in Turkish
13. Asian Liver Center operates an information help line
14. National Task Force on Hepatitis B: Focus on Asian and Pacific Islander Americans works to eliminate hepatitis B-related mortality and morbidity
15. Hepatitis B Foundation's webcast on HIV and hepatitis B available online
16. Hepatitis Foundation International hosting Atlantic Regional Hepatitis Coordinators' Meeting on September 17-18
17. HEP DART meeting scheduled for December 9-13 in Maui

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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August 9, 2007
VIS NEWS: CDC RELEASES INTERIM VIS FOR HEPATITIS B VACCINE

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 7/30/07.]

On July 18, CDC released an interim edition of the VIS for the hepatitis B vaccine; it replaces the 7/11/01 edition. The primary reason for issuing the interim edition is to stress that the birth dose of the vaccine is now recommended for ALL newborns before hospital discharge. Other changes were made throughout the interim VIS.

Existing stocks of the previous (7/11/01) edition may be used, but use of the interim edition is encouraged. A final edition is expected in 2008.

To access the interim VIS for hepatitis B vaccine from the CDC website, go to:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hep-b.pdf

To access it from the IAC website, go to:
http://www.immunize.org/vis/hepb01.pdf

For information about the use of VISs, and for VISs in more than 30 languages, visit IAC's VIS web section at
http://www.immunize.org/vis

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(2 of 17)
August 9, 2007
MERCK NOTIFIES CDC OF DELAYS IN PRODUCTION OF ITS PEDIATRIC AND ADULT HEPATITIS A VACCINES

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 8/6/07.]

On August 2 the CDC website posted a footnote in its Chart of Vaccines in Delay or Shortage announcing that Merck's hepatitis A vaccines are on backorder owing to production delays. The production delays have NOT resulted in any change in routine recommendation for hepatitis A vaccine. The footnote is reprinted below in its entirety.

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

Merck & Co., Inc., is experiencing production delays for Pediatric and Adult hepatitis A vaccine (Pediatric & Adult VAQTA) resulting in backorders for these products. GSK production and supply of their Pediatric and Adult hepatitis A vaccine (Pediatric & Adult Havrix) and their Adult hepatitis A/hepatitis B combination vaccine (Twinrix) are currently in good supply to meet demand. GSK has initiated plans to increase production of Havrix and Twinrix, to help ensure uninterrupted supply for the U.S. market.

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

To access the information from the CDC website, go to:
http://www.cdc.gov/vaccines/vac-gen/shortages
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August 9, 2007
CDC REPORTS ON HEPATITIS A VACCINATION COVERAGE OF U.S. CHILDREN AGES 24-35 MONTHS DURING 2004-05

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 7/16/07.]

CDC published "Hepatitis A Vaccination Coverage Among Children Aged 24-35 Months--United States, 2004-2005" in the July 13 issue of MMWR. Portions of the article and Editorial Note are reprinted below.

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

[From the article]
After the licensure of hepatitis A vaccine in 1995 for children aged >=24 months, the Advisory Committee on Immunization Practices (ACIP) incrementally expanded the proportion of children for whom it recommended the vaccine. In 1996, ACIP recommended vaccinating children in communities that had high rates of hepatitis A virus (HAV) infection, including American Indian/Alaska Native (AI/AN) communities and selected Hispanic and religious communities. In 1999, ACIP extended the recommendation to include routine vaccination for all children living in states, counties, and communities with incidence rates twice the 1987-1997 national average of 10 cases per 100,000 population (i.e., >=20 cases per 100,000 population); ACIP also recommended considering vaccination for children living in states, counties, and communities with incidence rates exceeding the 1987-1997 national average (i.e., >10 to <20 cases per 100,000 population). National estimates of hepatitis A vaccination coverage were first made available through the 2003 National Immunization Survey (NIS), which indicated an overall national 1-dose coverage level of 16.0% (range: 6.4%-72.7%) among children aged 24-35 months. The estimates in this report update those findings by including 2 additional years of data (2004 and 2005). National 1-dose vaccination-coverage levels among children aged 24-35 months increased from 17.6% in 2004 to 21.3% in 2005. Coverage in states where vaccination was recommended (overall in 2005: 56.5%; range: 12.9%-71.0%) was below those for other recommended childhood vaccinations, such as varicella (87.5% in 2004). Despite low hepatitis A vaccination-coverage levels compared with other recommended childhood vaccinations, incidence of acute HAV infections have declined to the lowest level ever recorded. The 2005 licensure of the hepatitis A vaccine for use in younger children (aged >=12 months) and the 2006 ACIP guideline for routine hepatitis A vaccination of all children aged >=12 months should result in improved vaccination coverage and further reductions in disease incidence. . . .

[From the Editorial Note]
Despite low levels of 1-dose hepatitis A vaccination coverage compared with other recommended vaccinations, the number of cases and rates of acute hepatitis A in the United States have declined substantially, especially among racial/ethnic groups disproportionately affected by hepatitis A. Before the 1995 introduction of hepatitis A vaccine for children aged >=24 months, rates of acute hepatitis A were five times greater than the national average among AI/ANs and three times greater among Hispanics. In 2005, acute hepatitis A rates among AI/ANs were comparable to other populations but remained greater for Hispanics compared with non-Hispanics. This trend demonstrates progress toward eliminating racial/ethnic disparities previously observed in rates of acute hepatitis A.

The overall number of cases and rates of acute hepatitis A in the United States have declined to historic lows since the last peak in 1995. In 1995, a total of 31,582 cases were reported (12 per 100,000 population), compared with 4,488 cases (1.5 per 100,000) in 2005, which was the lowest annual number ever recorded. In 2005, similar rates of acute hepatitis A were reported by states where vaccination was recommended (2.1 per 100,000), states where vaccination was to be considered (1.5 per 100,000), and states where no specific recommendation for vaccination was in effect (1.3 per 100,000). Even limited vaccination coverage might reduce disease incidence through herd effects because young children are thought to be a major reservoir of infection. In one communitywide outbreak, approximately 40% of adults with hepatitis A without an identifiable source lived with a child aged <6 years who had evidence of recent HAV infection. Declines also might be the result of cyclic increases and decreases in HAV infections. . . .

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

To access a web-text (HTML) version of the complete article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5627a2.htm

To access a ready-to-print (PDF) version of this issue of MMWR, go to:
http://www.cdc.gov/mmwr/PDF/wk/mm5627.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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August 9, 2007
OFFICIAL CDC HEALTH ADVISORY: HEPATITIS A INFECTIONS LINKED TO CHILDREN ADOPTED FROM ETHIOPIA AND THEIR FAMILY CONTACTS

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 7/23/07.]

On July 19, CDC's Health Alert Network issued an official CDC Health Advisory titled "Hepatitis A Infections Linked to Children Adopted from Ethiopia and Their Family Contacts." It is reprinted below in its entirety.

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The Centers for Disease Control and Prevention (CDC) has recently received reports of hepatitis A in children and adults linked to adoptees from Ethiopia. Hepatitis A is a liver disease caused by the hepatitis A virus. Symptoms usually occur abruptly and include fatigue, abdominal pain, loss of appetite, nausea, jaundice (yellowing of the skin or eyes), and diarrhea. Jaundice is common in adults but rare in children. Most children under the age of 6 years do not get sick from the infection, but can spread it to older children and adults, who often become ill. Older persons and persons with chronic liver disease can have more serious illness. The overall mortality rate from hepatitis A is 0.3%, but it is 1.8% among persons aged >=50 years. Symptoms generally last up to 2 months; there is no chronic (long-term) form of the disease.

The virus is found in the stool (feces) of persons with hepatitis A. It is usually spread from person to person by putting something in the mouth that has been contaminated with stool. Frequent hand washing with soap and water, particularly after using the bathroom, changing a diaper, and before preparing or eating food, is very important in preventing the spread of hepatitis A.

To prevent hepatitis A virus infections, CDC recommends that travelers to areas with high rates of hepatitis A, including Ethiopia, receive hepatitis A vaccine as soon as travel is considered. CDC also recommends that all children >=1 year of age receive the hepatitis A vaccine. Other household members and caregivers of children adopted from Ethiopia should consider being vaccinated before adopted children are brought to the United States.

Adopted children, household members, or other persons experiencing symptoms of hepatitis A should contact a healthcare provider for an evaluation. Persons exposed to hepatitis A who have not been previously immunized should contact their healthcare provider or local health department to determine if they should receive an immunization or immunoglobulin that might prevent the illness. More information about hepatitis A is available at http://www.cdc.gov/ncidod/diseases/hepatitis

CDC recommends that all international travelers consult a travel healthcare provider 4-6 weeks prior to travel to determine if any other measures, such as immunizations or medications, are indicated for the planned itinerary. Vaccine-preventable diseases, such as measles and mumps, are still common in many parts of the world, including developed countries. The CDC website (http://www.cdc.gov/travel) has a specific section for Traveling with Children, which includes general health advice for international adoptees and their adoptive parents, and Travel Notices, which describe current disease information of interest to travelers.

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

To access the health advisory, go to:
http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00263
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(5 of 17)
August 9, 2007
UPDATED: IAC REVISES THREE OF ITS IMMUNIZATION EDUCATION PRINT MATERIALS

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 7/23/07.]

IAC recently updated three of its immunization education print materials. Details follow:

1. "Vaccines Work! CDC statistics demonstrate dramatic declines in vaccine-preventable diseases when compared with the pre-vaccine era" (formerly titled "What would happen if we stopped vaccinations?"). This was updated with 2005 statistics, based on recently published information from CDC.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p4037.pdf

2. "Vaccinations for Adults: You're NEVER too old to get immunized!" Minor changes were made to the influenza section.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p4030.pdf

3. "If you have hepatitis C, which vaccinations do you need?" Minor changes were made to the influenza section.

To access a ready-to-print (PDF) version, go to:
http://www.immunize.org/catg.d/p4042.pdf
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August 9, 2007
SUPPORT THE NATIONAL VIRAL HEPATITIS ROUNDTABLE

The National Viral Hepatitis Roundtable (NVHR) is a coalition of public, private, and voluntary organizations dedicated to reducing the incidence of infection, morbidity, and mortality from viral hepatitis in the United States through strategic planning, leadership, coordination, advocacy, and research.

You can support NVHR in its mission by listing your organization as supporting its hepatitis elimination strategy as detailed in the publication "Eliminating Hepatitis: A Call To Action."

To read this document, go to:
http://www.nvhr.org/pdf/NVHR_CalltoAction.pdf

For sign up as an organizational supporter of this plan, go to:
http://www.nvhr.org/calltoaction.htm

In addition, NVHR is creating a web-based toolkit to aid in its collective lobbying and advocacy efforts. This new resource will communicate the National Hepatitis Elimination Strategy in a consistent and powerful way to policymakers. If your organization has any fact sheets, testimonials, success stories, talking points, model legislation, or other information that you think would be helpful, please share these resources with NVHR by August 15.

For more information about the NVHR lobbying and advocacy toolkit, including information on submitting resources, go to:
http://www.nvhr.org/e_toolkit.htm

For more information about NVHR, go to http://www.nvhr.org

If your organization is interested in becoming a member of NVHR, please contact Dick Conlon at rconlon@nvhr.org
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(7 of 17)
August 9, 2007
2007 PERINATAL HEPATITIS B AND HIV GRANTEES' MEETING PRESENATIONS AVAILABLE ONLINE

CDC has posted many of the presentations from the 2007 Perinatal Hepatitis B and HIV Grantees' Meeting, which took place April 30-May 2, in Atlanta.

To access these presentations, click here.
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(8 of 17)
August 9, 2007
CDC WEBSITE POSTS PRESENTATION SLIDES FROM THE JUNE ACIP MEETING

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 7/30/07.]

The CDC website recently posted the PowerPoint slides presented at the June 27-28 ACIP meeting. Slides are available on the following topics:

  • Hepatitis A vaccine
  • Vaccine financing
  • Adult Immunization Schedule
  • Childhood/Adolescent Immunization Schedule
  • Immunization Safety Office
  • Herpes zoster vaccine
  • Combination vaccines
  • Meningococcal conjugate vaccine (MCV4)
  • Economic analyses of vaccine
  • Vaccines supply
  • Pneumococcal vaccines
  • Vaccines during pregnancy
  • Influenza
  • Vaccines in persons with HIV/AIDS
  • Rotavirus vaccines
  • Human papillomavirus (HPV) vaccines
  • Varicella
  • Agency update

To access the slides, go to:
http://www.cdc.gov/vaccines/recs/acip/slides-jun07.htm
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(9 of 17)
August 9, 2007
ASIAN LIVER CENTER PUBLISHES 2007 EDITION OF ITS PHYSICIAN'S GUIDE TO HEPATITIS B

The Asian Liver Center at Stanford University recently published its 2007 Physician's Guide to Hepatitis B. This 20-page document provides an excellent summary of HBV infection and liver cancer with a special emphasis on the Asian Pacific Islander communities.

Of all the people with chronic HBV infection in the world, approximately two-thirds live in Asia. In the United States, the incidence of hepatitis B and liver cancer constitutes the greatest health disparity that exists between Asians and Pacific Islanders (APIs) and the general U.S. population. As many as one in 10 APIs is chronically infected with HBV compared with one in 1,000 in the general population.

The guide provides straightforward information on preventing, diagnosing, and managing chronic HBV infection; monitoring for liver damage; and screening for liver cancer.

To download this valuable resource, go to:
http://liver.stanford.edu/files/2007Handbook.pdf
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(10 of 17)
August 9, 2007
NATIONAL VIRAL HEPATITIS TRAINING CENTER OFFERS TRAINING IN SAN DIEGO

The National Viral Hepatitis Training Center at the New York State Department of Health (NYSDOH) is offering "It's Time: Integrate viral hepatitis into your work" in San Diego, California, in September. NYSDOH will be delivering both its "It's Time! Training" and its "It's Time! Training of Trainers" courses.

"It's Time! Training" prepares staff working in settings that serve people at high risk for viral hepatitis, including substance use programs, HIV/AIDS programs, correctional settings, and public health/STD clinics to address viral hepatitis in their work with clients. These sessions will take place on September 25-26.

"It's Time! Training of Trainers" prepares individuals to deliver the "It's Time! Training" to health and human services providers. These sessions will take place on September 27-28.

For more information on registering for a training or becoming an authorized training agency, please contact mag20@health.state.ny.us or visit the NYSDOH website at http://www.health.state.ny.us/diseases/aids/training/viralhepatitis.htm
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(11 of 17)
August 9, 2007
MEDPAGE TODAY OFFERS TEACHING BRIEF ABOUT TREATING HBV AND HIV CO-INFECTION

On June 20, MedPage Today published a teaching brief titled "Hepatitis Drug May Generate HIV Resistance." To read this article, go to:
http://www.medpagetoday.com/HIVAIDS/HIVAIDS/dh/5977

Healthcare professionals can earn unlimited, free CME/CE credits by registering with the MedPage Today news service. To sign up, go to:
https://www.medpagetoday.com/register.cfm?testpage=5977
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(12 of 18)
August 9, 2007
IAC WEBSITE POSTS INTERIM VIS FOR HEPATITIS B VACCINE IN TURKISH

[The following is cross posted from the Immunization Action Coalition's "IAC EXPRESS" electronic newsletter, 8/6/07.]

Dated 7/18/07, the interim VIS for hepatitis B vaccine is now available on the IAC website in Turkish. IAC gratefully acknowledges Mustafa Kozanoglu, MD, and Murat Serbest, MD, Adana, Turkey, for the translation.

To obtain a ready-to-print (PDF) version of the interim VIS for hepatitis B vaccine in Turkish, go to:
http://www.immunize.org/vis/tu_hpb01.pdf

To obtain it in English, go to:
http://www.immunize.org/vis/hepb01.pdf

For information about the use of VISs, and for VISs in more than 30 languages, visit IAC's VIS web section at http://www.immunize.org/vis
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(13 of 17)
August 9, 2007
ASIAN LIVER CENTER OPERATES AN INFORMATION HELP LINE

The Asian Liver Center (ALC) at Stanford University offers many services for Asian and Pacific Islander communities and individuals. One such service is an information help line in English, Mandarin, and Cantonese. To call toll free, dial (888) 311-3331.

To visit the ALC website, which features hepatitis B educational materials in multiple languages, go to: http://liver.stanford.edu
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August 9, 2007
NATIONAL TASK FORCE ON HEPATITIS B: FOCUS ON ASIAN AND PACIFIC ISLANDER AMERICANS WORKS TO ELIMINATE HEPATITIS B-RELATED MORTALITY AND MORBIDITY

The National Task Force on Hepatitis B: Focus on Asian and Pacific Islander Americans brings together scientists, health professionals, not-for-profit organizations, and concerned citizens in a concerted effort to eliminate hepatitis B-related mortality and morbidity over the next generation.

The group's mission is to support national, state, and local efforts to prevent new hepatitis B virus infections through vaccination, to identify chronically infected individuals, and to offer appropriate treatment and cancer screening.

Please visit the group's website at http://www.hepbtaskforce.org to learn more about the task force or to be added to their listserv or monthly conference call. The task force has collected useful resources for those working with Asian Pacific Islander Americans and made them available on their website at http://www.hepbtaskforce.org/resources.htm
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(15 of 17)
August 9, 2007
HEPATITIS B FOUNDATION'S WEBCAST ON HIV AND HEPATITIS B AVAILABLE ONLINE

On May 10, the Library of Congress and the Hepatitis B Foundation hosted a special symposium on the challenges of developing an HIV vaccine and ensuring the eradication of HBV infection. The event was held to coincide with National Hepatitis B Awareness Week (May 7-11) and World AIDS Vaccine Day (May 18).

This event was recorded and is now available online. To view the webcast, go to:
http://www.loc.gov/today/cyberlc/feature_wdesc.php?rec=4054
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(16 of 17)
August 9, 2007
HEPATITIS FOUNDATION INTERNATIONAL HOSTING ATLANTIC REGIONAL HEPATITIS COORDINATORS' MEETING ON SEPTEMBER 17-18

Hepatitis Foundation International is hosting an Atlantic Regional Hepatitis Coordinators' Meeting on September 17-18, in Washington, DC. The goals of the meeting are to establish a Mid-Atlantic Regional Hepatitis C Coordinators Group, increase collaborative opportunities for hepatitis activities, support hepatitis coordinators, share information and resources, and create a community of partners concerned about hepatitis.

For more information, contact Corinna Dan, RN, MPH, by phone (301) 622-4200, or email CorinnaDan@comcast.net
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August 9, 2007
HEP DART MEETING SCHEDULED FOR DECEMBER 9-13 IN MAUI

HEP DART 2007, a bi-annual international conference focusing on the current and future challenges in therapeutics for viral hepatitis, will be held December 9-13, in Maui, Hawaii.

The focus of HEP DART 2007 is to assemble clinicians, researchers, and basic scientists together to advance knowledge of the ongoing drug development processes in the treatment of hepatitis B and hepatitis C and other viruses affecting the liver, including co-infections with HIV.

The deadline for abstract submission is October 29, 2007.

For more information about the conference, go to:
http://www.informedhorizons.com/hepdart2007/welcome.html 


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