SIGNIFICANCE ASSESSMENT

The committee concludes that concerns about the hepatitis B vaccine remain significant in the minds of some parents and workers who are required to take the vaccine because of occupational risk.

PUBLIC HEALTH RESPONSE RECOMMENDATIONS

Policy Review

The committee does not recommend a policy review of the hepatitis B vaccine by any of the national and federal vaccine advisory bodies on the basis of concerns about demyelinating neurological disorders.

The committee recommends continued surveillance of hepatitis B disease and increased surveillance of secondary diseases such as cirrhosis and hepatocellular carcinoma.

Basic and Clinical Science

The committee recommends continued research in animal and in vitro models, as well as in humans, on the mechanisms of immune-mediated neurological disease possibly associated with exposure to vaccines.

Communication

The committee again recommends that government agencies and professional organizations responsible for immunizations critically evaluate their communication services with increased understanding of, and input from, the intended users.

REFERENCES

Alter MJ, Hadler SC, Margolis HS, Alexander WJ, Hu PY, Judson FN, Mares A, Miller JK, Moyer LA. 1990. The changing epidemiology of hepatitis B in the United States. Need for alternative vaccination strategies. JAMA 263(9):1218–22.

Armstrong GL, Mast EE, Wojczynski M, Margolis H. 2001. Childhood hepatitis B virus infections in the United States before hepatitis B immunization. Pediatrics 108(5):1123–1128.


CDC (Centers for Disease Control and Prevention). 1990. Protection against viral hepatitis. Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 39(RR-2):1– 26.

CDC. 1991. Hepatitis B virus: A comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR; 40((RR-13)):1–19 .

CDC. 2001a. Viral hepatitis B: Fact sheet.

CDC. 2001b. Influenza Vaccine 2001–2002. Vaccine Information Sheet.

CDC. 2001c. National, state, and urban area vaccination coverage levels among children aged 19–35 months—United States, 2000. MMWR Morb Mortal Wkly Rep 50(30):637–41.



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