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PA Bulletin, Doc. No. 09-374


Updating the List of Citations to ACIP Recommendations Prescribing Child Immunization Practices and Immunizing Agents and Doses

[39 Pa.B. 1167]
[Saturday, February 28, 2009]

   In accordance with 31 Pa. Code §§ 89.806(a) and 89.807(b) (relating to coverage of child immunizations; and immunizing agents, doses and AWPs), the Department of Health, Bureau of Communicable Diseases, Division of Immunization (Department) is updating 31 Pa. Code Chapter 89, Appendices G and H (relating to ACIP recommendations prescribing child immunization practices; and immunizing agents and doses). The Department has primary responsibility for the interpretation and the implementation of 31 Pa. Code §§ 89.806 and 89.807. See 31 Pa. Code § 89.801(b) (relating to authority and purpose; implementation).

   Health insurance policies are required by the Childhood Immunization Insurance Act (40 P. S. §§ 3501--3508) (act) and regulations promulgated thereunder, 31 Pa. Code Chapter 89, Subchapter L (relating to childhood immunization insurance) to include coverage for certain childhood immunizations, unless the policies are exempted by the act and 31 Pa. Code § 89.809 (relating to exempt policies). The childhood immunizations covered are those that meet Advisory Committee on Immunization Practices (ACIP) standards in effect on May 21, 1992. See 31 Pa. Code § 89.806(a). A list of the MMWR publications containing ACIP recommendations issued under the ACIP standards in effect on May 21, 1992, appears in 31 Pa. Code §§ 89.801--89.809, Appendix G.

   The Department is required to update the list of these MMWR publications appearing in 31 Pa. Code §§ 89.801--89.809, Appendix G. See 31 Pa. Code § 89.806(a). The additions to the list are as follows, the remainder of the list at Appendix G remains in full force and effect:

August 1, 2008, Vol. 57/No. 30

Newborn Hepatitis B Vaccination Coverage Among Children Born January 2003--June 2005--United States

   Hepatitis B vaccine was first recommended for administration to all infants in 1991 by the Advisory Committee on Immunization Practices (ACIP) as the primary focus of a strategy to eliminate hepatitis B virus (HBV) transmission in the United States. The recommended timing of administration of the first dose of hepatitis B vaccine to infants has evolved since then to optimize prevention of perinatal and early childhood HBV infections. In 1991, the first dose was recommended to be administered at birth before hospital discharge or at age 1--2 months. In 2002, ACIP indicated a preference for the first dose to be administered to newborns before hospital discharge. In December 2005, ACIP issued revised recommendations specifying that all medically stable newborns who weigh >=2,000 g (4.4 lbs) receive their first dose of hepatitis B vaccine before hospital discharge. To measure hepatitis B vaccination coverage during the neonatal period, CDC analyzed data from the 2006 National Immunization Survey (NIS). This report summarizes the results of this analysis and provides National, State and local data on vaccination coverage for infants who received the hepatitis B vaccine during the first days of life. The findings reveal that, during January 2003--June 2005, before implementation of the 2005 ACIP hepatitis B vaccine recommendation, the National newborn hepatitis B vaccination coverage estimate was 42.8% at age 1 day and 50.1% at age 3 days, with substantial variation by states and local areas. To comply with ACIP recommendations and increase coverage, delivery hospitals should provide hepatitis B vaccination of newborns as a standard of care.

August 8, 2008, Vol. 57/No. RR07

Prevention and Control of Influenza

   This report updates the 2007 recommendations by CDC's Advisory Committee on Immunization Practices ACIP regarding the use of influenza vaccine and antiviral agents (CDC. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2007;56 [No. RR-6]). The 2008 recommendations include new and updated information. Principal updates and changes include: 1) a new recommendation that annual vaccination be administered to all children aged 5--18 years, beginning in the 2008-09 influenza season, if feasible, but no later than the 2009-10 influenza season; 2) a recommendation that annual vaccination of all children aged 6 months through 4 years (59 months) continue to be a primary focus of vaccination efforts because these children are at higher risk for influenza complications compared with older children; 3) a new recommendation that either trivalent inactivated influenza vaccine or live, attenuated influenza vaccine (LAIV) be used when vaccinating healthy persons aged 2 through 49 years (the previous recommendation was to administer LAIV to person aged 5--49 years); 4) a recommendation that vaccines containing the 2008-09 trivalent vaccine virus strains A/Brisbane/59/2007 (H1N1)-like, A/Brisbane/10/2007 (H3N2)-like and B/Florida/4/2006-like antigens be used; and 5) new information on antiviral resistance among influenza viruses in the United States. Persons for whom vaccination is recommended are listed in boxes 1 and 2. These recommendations also include a summary of safety data for United States. licensed influenza vaccines. This report and other information are available at CDC's influenza web site (, including any updates or supplements to these recommendations that might be required during the 2008-09 influenza season. Vaccination and health-care providers should be alert to announcements of recommendation updates and should check the CDC influenza website periodically for additional information.

August 22, 2008, Vol. 57/No. 33

Update: Measles--United States, January--July 2008

   Sporadic importations of measles into the United States have occurred since the disease was declared eliminated from the United States in 2000. During January--July 2008, 131 measles cases were reported to CDC, compared with an average of 63 cases per year during 2000--2007. This report updates an earlier report on measles in the United States during 2008 and summarizes two recent United States outbreaks among unvaccinated school-aged children. Among those measles cases reported during the first 7 months of 2008, 76% were in persons aged < 20 years, and 91% were in persons who were unvaccinated or of unknown vaccination status. Of the 131 cases, 89% were imported from or associated with importations from other countries, particularly countries in Europe, where several outbreaks are ongoing. The findings demonstrate that measles outbreaks can occur in communities with a high number of unvaccinated persons and that maintaining high overall measles, mumps and rubella (MMR) vaccination coverage rates in the United States is needed to continue to limit the spread of measles.

September 5, 2008, Vol. 57/No. 35

National, State and Local Area Vaccination Coverage Among Children Aged 19--35 Months

   The National Immunization Survey (NIS) provides vaccination coverage estimates among children aged 19--35 months for each of the 50 states and selected urban areas. This report describes the results of the 2007 NIS, which provided coverage estimates among children born during January 2004--July 2006. Healthy People 2010 established vaccination coverage targets of 90% for each of the vaccines included in the combined 4:3:1:3:3:1 vaccine series and a target of 80% for the combined series. Findings from the 2007 NIS indicated that >= 90% coverage was achieved for most of the routinely recommended vaccines. The majority of parents were vaccinating their children, with less than 1% of children receiving no vaccines by age 19--35 months. The coverage level for the 4:3:1:3:3:1 series remained steady at 77.4%, compared with 76.9% in 2006. Among states and local areas, substantial variability continued, with estimated vaccination coverage ranging from 63.1% to 91.3%. Coverage remained high across all racial/ethnic groups and was not significantly different among racial/ethnic groups after adjusting for poverty status. However, for some vaccines, coverage remained lower among children living below the poverty level compared with children living at or above the poverty level. Maintaining high vaccination coverage and continued attention to reducing current poverty disparities is needed to limit the spread-preventable diseases and ensure that children are protected.

September 26, 2008, Vol. 57/No. 38

Influenza Vaccination Coverage Among Children Aged 6--59 Months--Eight Immunization Information System Sentinel Sites, United States, 2007-08 Influenza Season

   Vaccination is the most effective way to prevent influenza-associated morbidity and mortality. However, influenza vaccination coverage among children historically has been low. The Advisory Committee on Immunization Practices (ACIP) recommends annual vaccination with influenza vaccine for all children aged 6--59 months. Previously unvaccinated children and children who received only one vaccine dose for the first time in the previous influenza season are recommended to receivet two influenza vaccine doses. To assess vaccination coverage among children aged 6--59 months during the 2007-08 influenza season, CDC analyzed data from the eight immunization information system (IIS) sentinel sites. For the eight sites, an average (unweighted) of 40.8% of children aged 6--23 months received one or more influenza vaccine doses, and an average of 22.1% were fully vaccinated. Among children aged 24--59 months, an average of 22.2% received 1 or more doses, and an average of 16.5% were fully vaccinated. These results indicate that influenza vaccination coverage among children remains low and highlight the need to identify additional barriers to influenza vaccination and to develop more effective interventions to promote vaccination of children aged 6--59 months who are at high risk for influenza-related morbidity and mortality.

September 26, 2008, Vol. 57/No. 38

State-Specific Influenza Vaccination Coverage Among Adults United States, 2006-07 Influenza Season

   Adult groups included in the 2008 Advisory Committee on Immunization Practices (ACIP) recommendation for annual influenza vaccination include all persons aged >= 50 years, women who will be pregnant during the influenza season, persons aged 18--49 years with high-risk conditions, and other persons at increased risk for complications from influenza. Health-care personnel and household contacts and caregivers of persons at high risk also should receive annual influenza vaccination, as should adults who want to reduce their risk for becoming ill with influenza or for transmitting it to others. Healthy People 2010 influenza vaccination coverage targets are 90% among all persons aged >= 65 years and 60% among persons aged 18--64 years who have one or more high-risk conditions. Data from the 2006 and 2007 Behavioral Risk Factor Surveillance System (BRFSS) surveys indicate that influenza vaccination coverage among adults for the 2006-07 season increased significantly compared with the 2005-06 season, reaching 35.1% among persons aged 18--49 years with high-risk conditions, 42.0% among all persons aged 50--64 years, and 72.1% among all persons aged >= 65 years. However, vaccination coverage remained well below Healthy People 2010 targets. Increasing influenza vaccination coverage among adults in the United States will require more cooperation among health-care providers, professional organizations, vaccine manufacturers, and public health departments to raise public awareness about influenza vaccination and to ensure continued distribution and administration of available vaccine throughout the vaccination season.

October 3, 2008, Vol. 57/No. 39

Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Inactivated Poliovirus, and Haemophilus b Conjugate Vaccine and Guidance for Use in Infants and Children

   On June 20, 2008, the Food and Drug Administration (FDA) licensed a combined diphtheria and tetanus toxoids and acellular pertussis adsorbed (DTaP), inactivated poliovirus vaccine (IPV), and Haemophilus influenzae type b conjugate (tetanus toxoid [TT] conjugate) vaccine, DTaP-IPV/Hib (Pentacel, Sanofi Pasteur, Swiftwater, Pennsylvania), for use as a four-dose series in infants and children at ages 2, 4, 6 and 15--18 months. This report summarizes the indications for Pentacel and provides guidance from the Advisory Committee on Immunization Practices (ACIP) for its use.

October 3, 2008, Vol. 57/No. 39

Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus Vaccine and Guidance for Use as a Booster Dose

   On June 24, 2008, the Food and Drug Administration licensed a combined diphtheria and tetanus toxoids and acellular pertussis adsorbed (DTaP) and inactivated poliovirus (IPV) vaccine, DTaP-IPV (Kinrix, GlaxoSmith- Kline Biologicals, Rixensart, Belgium). Kinrix is licensed for use as the fifth dose of the DTaP vaccine series and the fourth dose of the IPV series in children aged 4--6 years whose previous DTaP vaccine doses were DTaP (Infanrix, GlaxoSmithKline) and/or DTaP-Hepatitis B-IPV (Pediarix, GlaxoSmithKline) for the first 3 doses and DTaP (Infanrix) for the fourth dose. DTaP-IPV administered to children aged 4--6 years would reduce by one the number of injections needed to complete DTaP and IPV immunization. This report summarizes the indications for Kinrix and provides guidance from the Advisory Committee on Immunization Practices (ACIP) for its use.

October 10, 2008, Vol. 57/No. 40

Updated Recommendations for Isolation of Persons with Mumps

   Mumps, an acute vaccine-preventable viral illness transmitted by respiratory droplets and saliva, has an incubation period most commonly of 16--18 days. The classic clinical presentation of mumps is parotitis, which can be preceded by several days of nonspecific prodromal symptoms; however, mumps also can be asymptomatic, especially in young children. Mumps transmission can occur from persons with subclinical or clinical infections and during the prodromal or symptomatic phases of illness. In 2006, during a mumps resurgence in the United States, the latest National recommendations from CDC and the American Academy of Pediatrics (AAP) stipulated that persons with mumps be maintained in isolation with standard precautions and droplet precautions for 9 days after onset of parotitis. However, the existence of conflicting guidance (that is, that the infectious period of mumps extended through the 4th day after parotitis onset) led to confusion regarding the appropriate length of isolation. In addition, during the 2006 resurgence, compliance with recommendations for isolation in university settings was substantially lower for 9 days (65%) compared with 45 days (86%). In 2007, after a review of the evidence supporting the 9-day isolation guidance by AAP and CDC, AAP changed its isolation guidance for health-care workers in ambulatory settings from 9 days to 5 days. In February 2008, after review of data on mumps in health-care settings, mumps viral load, and mumps virus isolation, the Healthcare Infection Control Practices Advisory Committee (HICPAC) approved changes in its recommendations related to mumps in in-patient settings. As a result, CDC, AAP and HICPAC all now recommend a 5-day period after onset of parotitis, both for isolation of persons with mumps in either community or health-care settings and for use of standard precautions and droplet precautions. This report summarizes the scientific basis for these changes in mumps isolation guidance.

October 10, 2008, Vol. 57/No. 40

Vaccination Coverage Among Adolescents Aged 13--17 Years--United States, 2007

   Three new vaccines have been recommended for adolescents by the Advisory Committee for Immunization Practices (ACIP) since 2005: meningococcal conjugate vaccine (MCV4; 1 dose), tetanus, diphtheria, acellular pertussis vaccine (Tdap; 1 dose) and quadrivalent human papillomavirus vaccine (HPV4; 3 doses). ACIP also recommends that adolescents should receive recommended vaccinations that were missed during childhood. Since 2006, CDC has conducted the National Immunization Survey--Teen (NIS--Teen) to estimate vaccination coverage from a National sample of adolescents aged 13--17 years. This report describes the findings from NIS--Teen 2007, which indicated substantial increases in receipt of new adolescent vaccinations compared with 2006, including Tdap (from 10.8% to 30.4%) and MCV4 (from 11.7% to 32.4%), and increases in coverage with childhood vaccinations, including measles, mumps, and rubella (MMR), hepatitis B (HepB) and varicella (VAR) (among those without disease history). An assessment of HPV4 coverage, which is reported for the first time, showed that 25.1% of adolescent females initiated the vaccine series (>= 1 dose) in 2007. To improve vaccination coverage among adolescents, health-care providers should take advantage of every health-care visit as an opportunity to evaluate vaccination status and administer vaccines when needed.

November 21, 2008, Vol. 57/No. 46

Rotavirus Surveillance--Worldwide, 2001--2008

   Rotavirus infection is the leading cause of severe acute diarrhea among young children worldwide. An estimated 527,000 children aged < 5 years die from rotavirus diarrhea each year, with > 85% of these deaths occurring in low-income countries of Africa and Asia. Two licensed rotavirus vaccines have shown efficacy of 85%--98% against severe rotavirus diarrhea in trials conducted in the Americas and Europe, and they have been introduced into routine immunization programs in 11 countries in these regions and in Australia. Additional trials of these vaccines are ongoing to assess efficacy in low-income countries of Asia and Africa, where vaccine performance might be affected by factors such as concurrent enteric infections, greater prevalence of malnutrition, and a greater prevalence of unusual rotavirus strains. Results of these additional trials are expected within the next 1--2 years. To collect epidemiologic and burden-of-disease data that could form the basis of vaccination policy worldwide, beginning in 2001, the World Health Organization (WHO), in collaboration with partners, established networks of hospital-based sentinel surveillance sites for detection of rotavirus diarrhea and characterization of rotavirus strains. This report presents an analysis of results from the WHO surveillance networks for 2001--2008, which indicated that approximately 40% of diarrhea hospitalizations among children aged < 5 years worldwide were attributed to rotavirus infection. The most common rotavirus strains found were G1, G2, G3, G4 and G9, and the distribution of strains varied markedly across regions. These data demonstrate the substantial burden of rotavirus diarrhea worldwide and highlight the potential health impact of vaccination.

November 21, 2008, Vol. 57/No. 46

Continued Shortage of Haemophilus influenzae Type b (Hib) Conjugate Vaccines and Potential Implications for Hib Surveillance--United States, 2008

   In December 2007, Merck & Co., Inc. (West Point, Pennsylvania) announced a voluntary recall of certain lots of two Haemophilus influenzae type b (Hib) conjugate vaccines, PedvaxHIB® (monovalent Hib vaccine) and Comvax® (Hib-HepB vaccine) and suspended production of both vaccines, disrupting the U. S. supply of Hib vaccine. When the recall was announced, Merck projected restoration of these vaccines to the U. S. market in late 2008. To ensure that enough vaccine would be available for all U. S. children to complete the primary Hib vaccination series, on December 18, 2007, CDC recommended that providers defer the booster dose of Hib vaccine (scheduled for administration at age 12--15 months) for all children except those at increased risk for invasive Hib disease. On October 17, 2008, Merck announced that restoration of the two vaccines to the market would be delayed until mid-2009. Because the continued delay might result in an increase in Hib disease, National surveillance for invasive Hib disease has become particularly important. To assess the current status of surveillance for Hib Nationally, CDC reviewed 4,657 cases of invasive H. influenzae infection reported during January 2007--October 2008, including 748 cases among children aged < 5 years. Of those 748 cases, 45 (6.0%) were Hib (serotype b) and 278 (37.2%) were missing serotype information. The continued vaccine shortage heightens the need for timely reporting and investigation of H. influenzae cases and accurate serotyping of all invasive H. influenzae isolates in children aged < 5 years.

November 21, 2008, Vol. 57/No. 46

Implementation of Newborn Hepatitis B Vaccination--Worldwide, 2006

   Globally, hepatitis B virus (HBV) infections are a major cause of cirrhosis and liver cancer and result in an estimated 620,000 deaths annually. In 1992, the World Health Organization (WHO) set a goal for all countries to introduce hepatitis B (HepB) vaccine into national routine infant immunization programs by 1997. In countries where a high percentage of HBV infections are acquired perinatally (where general population prevalence of chronic HBV infection is >= 8%), WHO recommends administering the first HepB vaccine dose < 24 hours after birth to prevent perinatal HBV transmission (3). To assess implementation of newborn HepB vaccination, the most recently available data were examined from the Joint Reporting Form used by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) to track worldwide vaccine coverage for WHO-recommended infant immunizations. In 2006, a total of 162 (84%) of 193 countries had introduced HepB vaccine into their National infant immunization schedules. Among the 193 countries, 81 (42%) reported using a schedule with a HepB vaccine birth dose (defined as a dose administered within 24 hours of birth). Worldwide, 27% of newborns received a HepB vaccine birth dose in 2006. In the 87 countries with >= 8% chronic HBV infection prevalence, HepB vaccine birth dose coverage was 36%. These findings highlight the global need to implement this key hepatitis B prevention strategy more widely.

December 5, 2008, Vol. 57/No. 48

Progress in Global Measles Control and Mortality Reduction, 2000--2007

   Despite the availability of a safe and effective vaccine since 1963, measles has been a major killer of children in developing countries (causing an estimated 750,000 deaths as recently as 2000), primarily because of underutilization of the vaccine. At the World Health Assembly in 2008, all World Health Organization (WHO) member states reaffirmed their commitment to achieving a 90% reduction in measles mortality by 2010 compared with 2000, a goal that was established in 2005 as part of the Global Immunization Vision and Strategy. This WHO-UNICEF comprehensive strategy for measles mortality reduction focuses on 47 priority countries. The strategy's components include: 1) achieving and maintaining high coverage (> 90%) with the routinely scheduled first dose of measles-containing vaccine (MCV1) among children aged 1 year; 2) ensuring that all children receive a second opportunity for measles immunization (either through a second routine dose or through periodic supplementary immunization activities [SIAs]); 3) implementing effective laboratory-supported disease surveillance; and 4) providing appropriate clinical management for measles cases. This report updates previously published reports and describes immunization and surveillance activities implemented during 2007. Increased routine measles vaccine coverage and SIAs implemented during 2000--2007 resulted in a 74% decrease in the estimated number of measles deaths globally. An estimated 197,000 deaths from measles occurred in 2007; of these, 136,000 (69%) occurred in the WHO South-East Asian Region. Achievement of the 2010 goal will require full implementation of measles mortality reduction strategies, especially in the WHO South-East Asian Region.

   The Department is also required to update information relating to immunizing agents and doses that the Department has extracted from ACIP recommendations issued under the standards in 31 Pa. Code § 89.806(a). See 31 Pa. Code § 89.807(b). The Department is also to periodically list the average wholesale price (AWP) for immunizing agents. Id. This information currently appears in 31 Pa. Code §§ 89.801--89.809, Appendix H (relating to immunizing agents and doses). The updated information is as follows:

2009 List of Immunizing Agents and Average Wholesale Prices

Product Name, Company Brand/Product Name NDC Number Unit Dose AWP/
Diphtheria Tetanus acellular Pertussis Vaccine (DTaP):
sanofi pasteur Tripedia 49281-0298-10 10 × 1 0.5 ml $26.37
sanofi pasteur Daptacel 49281-0286-10 10 × 1 0.5 ml $27.19
GlaxoSmithKline Infanrix 58160-0810-46 5 × 1 0.5 ml $23.02
GlaxoSmithKline Infanrix 58160-0810-11 10 × 1 0.5 ml $24.70
Tetanus Diphtheria acellular Pertussis Vaccine (TdaP):
sanofi pasteur Adacel 49281-0400-10 10 × 1 0.5 ml $44.46
sanofi pasteur Adacel 49281-0400-15 5 × 1 0.5 ml $44.46
GlaxoSmithKline Boostrix 58160-0842-11 10 × 1 0.5 ml $44.61
GlaxoSmithKline Boostrix 58160-0842-46 5 × 1 0.5 ml $44.61
Diphtheria Tetanus pediatric Vaccine (DT pediatric):
sanofi pasteur DT Pediatric 49281-0278-10 10 × 1 0.5 ml $34.57
Diphtheria Tetanus acellular Pertussis/Haemophilus Influenzae B (DTaP-HIB):
sanofi pasteur TriHIBit 49281-0597-05 5 × 1 0.5 ml $53.26
Tetanus Diphtheria adult Vaccine (Td adult):
sanofi pasteur Decavac 49281-0291-83 10 × 1 0.5 ml $23.09
sanofi pasteur Decavac 49281-0291-10 10 × 1 0.5 ml $23.09
Diphtheria, Tetanus, acellular Pertussis, Haemophilus Influenzae B, Polio (DTaP, HIB, IPV):
sanofi pasteur Pentacel 49281-0510-05 5 × 1 0.5 ml $86.74
Diphtheria, Tetanus, acellular Pertussis, Polio (DTap, IPV):
GlaxoSmithKline Kinrix 58160-0812-46 5 × 1 $57.00
GlaxoSmithKline Kinrix 58160-0812-11 10 × 1 $57.00
Diphtheria, Tetanus, acellular Pertussis, Hepatitis B, Polio (DTaP, Hep B, IPV):
GlaxoSmithKline Pediarix 58160-0811-11 10 × 1 0.5 ml $84.12
GlaxoSmithKline Pediarix 58160-0811-46 5 × 1 0.5 ml $84.12
Tetanus Toxoid:
sanofi pasteur Tetanus toxoid 49281-0820-10 10 × 1 0.5 ml $25.99
MassBiologics (Akorn, Inc) Tetanus toxoid
Haemophilus Influenzae Type B Vaccine (HIB):
sanofi pasteur ActHIB 49281-0545-05 5 × 1 10 mcg $27.25
Merck & Co. Pedvax HIB 00006-4897-00 10 × 1 7.5 mcg $27.32
Merck & Co. Recombivax HB Hepatitis B vaccine (Recombinant) Dialysis Formulation 4992-00-4992 each 1.0 ml $165.29
Injectable Polio Vaccine Inactivated (Salk Enhanced IPV):
sanofi pasteur IPOL 49281-0860-55 5.0 ml 0.5 ml $32.99
sanofi pasteur IPOL 49281-0860-10 5.0 ml 0.5 ml $28.53
Measles Mumps Rubella Vaccine (MMR):
Merck & Co. MMR II 00006-4681-00 10 × 0.5 0.5 ml $55.40
Measles Vaccine (Rubeola):
Merck & Co. Attenuvax 0006-4589-00 10 × 0.5 0.5 ml $20.48
Meningococcal Conjugate Vaccine (MCV4):
sanofi pasteur Menactra 49281-0589-05 5 × 1 0.5 ml $118.08
sanofi pasteur Menactra 49281-0589-15 5 × 1 0.5 ml $118.08
Meningococcal Polysaccharide Vaccine:
sanofi pasteur Menomune-A/C/Y/W-135 49281-0489-91 10 × 1 0.5 ml $118.08
sanofi pasteur Menomune-A/C/Y/W-135 49281-0489-01 each 0.05 mg $120.37
Mumps Vaccine:
Merck & Co. Mumpsvax 00006-4584-00 10 × 0.5 0.5 ml $26.54
Rubella Vaccine:
Merck & Co. Meruvax II 00006-4673-00 10 × 0.5 0.5 ml $22.83
Hepatitis A Vaccine (HEP-A):
Merck & Co. VAQTA syringe 00006-4096-31 1.0 ml 1.0 ml $77.89
Merck & Co. VAQTA syringe 00006-4096-06 6 × 1 1.0 ml $77.87
Merck & Co. VAQTA 00006-4841-00 1.0 ml 1.0 ml $76.21
Merck & Co. VAQTA 00006-4841-41 10 × 1 1.0 ml $71.99
Merck & Co. VAQTA Pediatric 00006-4831-41 10 × 0.5 0.5 ml $36.44
GlaxoSmithKline Havrix Pediatric 58160-0825-46 5 × 1 0.5 ml $34.34
GlaxoSmithKline Havrix Pediatric 58160-0825-11 10 × 1 0.5 ml $34.34
GlaxoSmithKline Havrix 58160-0826-46 5 × 1 1 ml $72.68
GlaxoSmithKline Havrix 58160-0826-11 10 × 1 1 ml $72.68
Varicella Virus Vaccine:
Merck & Co. Varivax 00006-4826-00 each 1350 pfu $97.41
Merck & Co. Varivax 00006-4827-00 10 × 1 1350 pfu $92.86
Merck & Co. Zostavax 00006-4963-00 each 19400 pfu $193.80
Merck & Co. Zostavax 00006-4963-41 10 × 1 19400 pfu $184.72
Human Papilloma Virus Vaccine:
Merck & Co. Gardasil 00006-4045-00 each 0.5 ml $150.51
Merck & Co. Gardasil 00006-4045-41 10 × 1 0.5 ml $150.18
Merck & Co. Gardasil syringe 00006-4109-06 6 × 1 0.5 ml $152.54
Merck & Co Gardasil syringe w/o needle 00006-4109-09 6 × 1 0.5 ml $152.54
Rotavirus Vaccine:
Merck & Co. Rotateq 00006-4047-41 10 × 1 2 ml $83.35
GlaxoSmithKline Rotarix 58160-0805-11 10 × 1 1.0 ml $122.85
Influenza Virus Vaccine:
Novartis Fluvirin 66521-0109-01 10 × 1 0.5 ml $18.24
Novartis Fluvirin 66521-0109-10 10 × 1 0.5 ml $14.81
Sanofi pasteur Fluzone 49281-0008-10 10 × 1 0.5 ml $19.16
Sanofi pasteur Fluzone 49281-0008-50 10 × 1 0.5 ml $19.16
Sanofi pasteur Fluzone 49281-0382-15 10 × 1 0.5 ml $13.91
Sanofi pasteur Fluzone Pediatric 49281-0008-25 10 × 1 0.25 ml $17.77
GlaxoSmithKline Fluarix 58160-0873-46 5 × 1 0.5 ml $15.75
MedImmune Flumist 66019-0106-01 10 × 1 0.2 ml $24.44
CSL Biotherapies Afluria 33332-0108-10 Multidose 0.5 ml $13.20
CSL Biotherapies Afluria 33332-0008-01 10 × 1 0.5 ml $17.40
Hepatitis B Vaccine (HEP-B):
Merck & Co. Recombivax HB Pediatric 00006-4981-00 10 × 0.5 ml 0.5 ml $27.85
Merck & Co. Recombivax HB 00006-4995-00 1.0 ml 1.0 ml $71.64
Merck & Co. Recombivax HB 00006-4995-41 10 × 1.0 ml 1.0 ml $70.81
Merck & Co. Recombivax HB syringe 00006-4094-31 1.0 ml 1.0 ml $73.31
Merck & Co. Recombivax HB syringe 00006-4094-06 6 × 1.0 ml 1.0 ml $73.31
Merck & Co Recombivax HB syringe w/o needle 00006-4094-09 6 × 1.0 ml 1.0 ml $73.31
GlaxoSmithKline Engerix-B Pediatric 58160-0820-11 10 × 1 0.5 ml $25.49
GlaxoSmithKline Engerix-B Pediatric 58160-0820-46 5 × 1 0.5 ml $25.49
GlaxoSmithKline Engerix-B Pediatric 58160-0856-35 5 × 1 0.5 ml $25.49
GlaxoSmithKline Engerix-B 58160-0821-46 5 × 1 1.0 ml $62.85
GlaxoSmithKline Engerix-B syringe 58160-0821-11 10 × 1 1.0 ml $62.85
Hepatitis B / HIB:
Merck & Co. COMVAX 00006-4898-00 10 × 0.5 ml 0.5 ml $52.27
Hepatitis A & Hepatitis B Vaccine:
GlaxoSmithKline Twinrix 58160-0815-11 10 × 1.0 1.0 ml $103.43
GlaxoSmithKline Twinrix 58160-0815-46 5 × 1.0 1.0 ml $103.43
Pneumococcal Vaccine:
Wyeth Pharmaceuticals Prevnar 00005-1970-50 10 × 1 0.5 ml $100.51
Merck & Co. Pneumovax 23 00006-4739-00 2.5 ml 2.5 ml $197.93
Merck & Co. Pneumovax 23 00006-4943-00 10 × 1 0.5 ml $44.43
Measles, Mumps, Rubella and Varicella Vaccine
Merck & Co. ProQuad 00006-4999-00 10 × 0.5 0.5 ml $149.24

   *  Indicates the Estimated Acquisition Cost (EAC) as stated in the Department of Public Welfare, Office of Medical Assistance Programs, Medical Assistance Regulations at 55 Pa. Code § 1121.55 (relating to method of payment).

   Persons with disability who require an alternative format of this notice (for example, large print, audiotape, Braille), should contact Heather Stafford, Director, Division of Immunizations, Department of Health, Room 1026, Health and Welfare Building, 7th and Forster Streets, Harrisburg, PA 17120-0001, (717) 787-5681 or for speech and/or hearing impaired persons, V/TT the Pennsylvania AT&T Relay Service at (800) 654-5984 (TT).


[Pa.B. Doc. No. 09-374. Filed for public inspection February 27, 2009, 9:00 a.m.]

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