Subject: CDC CALLS FOR UNIVERSAL HEP B VACCINE FOR 0-18 YEAR OLDS >Vaccination (HBV); CDC Calls for Universal Immunization for Those Aged >0-18 >February 23, 1999 > >Hepatitis Weekly: The U.S. Centers for Disease Control and Prevention >(CDC) wants physicians to help identify children and adolescents who >have not been vaccinated against hepatitis B virus. The Advisory >Committee on Immunization Practices (ACIP) recently expanded its >hepatitis B vaccination recommendations to include those aged 0-18 >years. "To increase access to hepatitis B vaccine, the new >recommendations encourage >vaccination of previously unvaccinated children and adolescents aged >0-18 years >whenever they are seen for routine medical visits," according to a >report in the CDC's >MMWR ("Update: Recommendations to Prevent Hepatitis B Virus Transmission >- United States," MMWR, January 22, 1999;48(2):3-4). > >"This expansion of the recommended age group for vaccination and for >Vaccines for >Children (VFC) program eligibility simplifies previous recommendations >and the eligibility criteria for VFC vaccine. Providers should ensure >that vaccination records of children and adolescents presenting for >vaccination are checked for receipt of previous doses." The report >noted that ACIP priorities for hepatitis B vaccination of children >remain unchanged and include all infants; children in populations at >high risk for HBV infection (e.g., Alaska Natives, Pacific Islanders, >and children who reside in households of first-generation immigrants >from countries where HBV infection is moderately or highly endemic); >previously unvaccinated children aged 11-12 years; and older adolescents >and adults in defined risk groups. > >In 1991, the ACIP recommended a comprehensive hepatitis B vaccination >strategy to eliminate HBV transmission in the United States. Critical >elements of this strategy include preventing perinatal HBV transmission >by identifying and providing >immunoprophylaxis to infants of hepatitis B surface antigen-positive >mothers and >universal hepatitis B vaccination of infants to interrupt transmission. > >In 1994, the ACIP expanded the recommendations to include previously >unvaccinated children aged 11-12 years. "The percentage of children >aged 19-35 months who have received three doses of hepatitis B vaccine >has increased substantially from less than 10 percent in 1991 to 84 >percent in 1997," the report noted. No nationwide vaccine coverage data >are available to assess vaccine coverage among children aged 11-12 >years; however, vaccine coverage in this group is expected to increase >in states that have implemented middle school entry requirements for >hepatitis B vaccination." > >The report found that universal vaccination of infants and children aged >11- 12 years will result in a highly immune population and is expected >to eliminate HBV transmission in the United States. High rates of HBV >infection continue to occur among Alaska Native and Pacific Islander >children and among children residing in households of first-generation >immigrants from countries where HBV infection is endemic. > >"As a result, targeted programs are needed to achieve high vaccination >coverage among >these children," the report stated. "In addition, because most HBV >infections in the >United States occur among adults, vaccinating infants and adolescents >aged 11-12 years alone will not substantially lower disease incidence >for several years." The majority of HBV infections in adults occur >among persons who have defined risk factors for HBV infection, including >those with multiple sex partners (more than one partner during the >preceding six months); men who have sex with men; and injecting-drug >users. > >"The primary means to prevent these infections is to identify settings >where adolescents and adults with high-risk drug and sexual practices >can be routinely accessed and vaccinated (e.g., sexually transmitted >disease clinics, family-planning clinics, drug-treatment clinics, >community-based HIV prevention sites, and correctional facilities)," the >report concluded. - by Salynn Boyles, Senior Editor > > >*************************************************************** >Karin Schumacher >Vaccine Information & Awareness (VIA) >12799 La Tortola >San Diego, CA 92129 >619-484-3197 (phone/voicemail) >619-484-1187 (fax) >via@access1.net (email) >http://www.909shot.com (NVIC website) >http://www.access1.net/via (VIA website) >*************************************************************** >We Must Have The Freedom To Choose & Respect Everyone's Choice >*************************************************************** >Any information obtained here is not to be construed as medical >OR legal advice. The decision to vaccinate and how you >implement that decision is yours and yours alone.