Synopsis for November 5, 2004

The MMWR is embargoed until Thursday, 12 PM EDT.

1. Influenza and Pnuemococcal Vaccination Coverage Among Persons Aged >65 Years and Adults Aged 18-64 Years with Diabetes or Asthma ― United States, 2003
2. Influenza Vaccination and Self-Reported Reasons for Not Receiving Influenza Vaccination Among Non-Institutionalized Medicare Beneficiaries Aged >65 Years ― United States, 1991-2002
3. Acute Hepatitis B Among Children and Adolescents ― United States, 1990-2002
4. Blood Mercury Levels in Young Children and Childbearing-Aged Women ― United States, 1999-2002
5. Outbreak of Histoplasmosis Among Industrial Plant Workers ― Nebraska, 2004
6. West Nile Virus Activity ― United States, October 27- November 02, 2004

Synopsis for November 5, 2004

Influenza and Pnuemococcal Vaccination Coverage Among Persons Aged >65 Years and Adults Aged 18-64 Years with Diabetes or Asthma ― United States, 2003

Influenza and pneumococcal vaccination coverage for high-risk populations increased in the past couple years yet remains below the national 2010 objectives.

From 2002 to 2003 influenza and pneumococcal vaccination coverage increased among adults aged >65 years; however, coverage among persons indicated for these vaccinations remains below the national health objectives for 2010. In addition, the median coverage level of influenza vaccination among participants with asthma and the median coverage level of pneumococcal vaccines among participants with diabetes were below the 2010 target of 60% for noninstitutionalized adults at high risk. Innovative strategies to increase immunization coverage among high risk populations need to be implemented. Because of the 2004 influenza vaccine shortage, vaccine providers have been asked to direct available inactivated influenza vaccine to persons with chronic conditions, such as diabetes and asthma, and other priority groups.

Influenza Vaccination and Self-Reported Reasons for Not Receiving Influenza Vaccination Among Non-Institutionalized Medicare Beneficiaries Aged >65 Years ― United States, 1991-2002

Annual influenza vaccination coverage among Medicare beneficiaries has been increasing since 1991, but increases are threatened by a lack of knowledge among the elderly about the benefits of the vaccine, as well as the potential for disruption in vaccine supplies.

From 1991-2002, the Medicare Current Beneficiaries Survey (MCBS) shows a steady upward trend in influenza vaccination coverage among Medicare beneficiaries 65 years of age and older. The exception to this upward trend occurred during the 2000-2001 influenza season, in which vaccine distribution was delayed. Vaccine unavailability was reported as a reason for nonvaccination by respondents for the first time in 2000-2001. However, the most frequently cited survey reasons for not receiving influenza vaccine were not knowing that influenza vaccination was needed and concerns that vaccination might cause influenza or side effects, indicating that further efforts are needed to educate the elderly regarding the benefits of influenza vaccination.

Acute Hepatitis B Among Children and Adolescents ― United States, 1990-2002

The incidence of acute hepatitis B in US children and adolescents has decreased during the era of universal childhood vaccination.

The rate of acute hepatitis B in children and adolescents has decreased by 89% since the 1991 adoption of a comprehensive strategy to eliminate hepatitis B virus (HBV) transmission in the United States, and previous racial disparities in hepatitis B incidence have narrowed. Declines are greatest among children who were born after the 1991 recommendations for universal infant hepatitis B vaccination were implemented. Many recent confirmed cases of acute hepatitis B in children born after 1990 occur in international adoptees and other children born outside of the United States.

Blood Mercury Levels in Young Children and Childbearing-Aged Women ― United States, 1999-2002

These findings confirm that blood mercury levels in the vast majority of young children and women of childbearing age fall below levels of concern for exposure to mercury in the U.S.

However, approximately 6% of child-bearing age women have levels at or above an EPA reference dose (a level of exposure not likely to cause harmful effects). Blood mercury levels of young children and women of childbearing age in the U.S. during the 1999 – 2002 time period are below levels known to produce health effects. However, approximately 6% of childbearing-age women have levels at or above the EPA reference dose (a level of exposure not likely to cause harmful effects). Women who are pregnant or who intend to become pregnant should follow federal and state advisories on consumption of fish.

Outbreak of Histoplasmosis Among Industrial Plant Workers ― Nebraska, 2004

This histoplasmosis outbreak among workers from an agricultural industry plant emphasizes the highly infectious nature of Histoplasma spores, and the need to protect workers engaged in activities involving exposure to Histoplasma.

In particular, the results of our investigation suggest that manipulation of soil known to be contaminated with Histoplasma may pose a risk to persons who are not directly involved in the activity, but may be hundreds of feet away. Additional measures to minimize risk of histoplasmosis among agricultural industry workers in areas where histoplasmosis is endemic, may be necessary.

West Nile Virus Activity ― United States, October 27- November 02, 2004

No summary available.

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