677 Update of the list of citations to ACIP recommendations prescribing child immunization practices and immunizing agents and doses

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

[36 Pa.B. 1949]

   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 (act) (40 P. S. §§ 3501--3508) and regulations promulgated thereunder, 31 Pa. Code Chapter 809, 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 Morbidity and Mortality Weekly Report (MMWR) publications containing ACIP recommendations issued under the ACIP standards in effect on May 21, 1992 appears in 31 Pa. Code Chapter 89, Appendix G.

   The Department is required to update the list of these MMWR publications in 31 Pa. Code Chapter 89, Appendix G. See 31 Pa. Code § 89.806(a). The additions to the list are as follows. The remainder of the list in 31 Pa. Code Chapter 89, Appendix G remains in full force and effect:

   The Department is required to update the list of these MMWR publications in 31 Pa. Code Chapter 89, Appendix G. See 31 Pa. Code § 89.806(a). The additions to the list are as follows. The remainder of the list in 31 Pa. Code Chapter 89, Appendix G remains in full force and effect:

September 2, 2005/Vol. 54/No. 34

   *  Update:  Influenza Vaccine Supply and Recommendations for Prioritization During the 2005-06 Influenza Season

September 16, 2005/Vol. 54/No. 36

   *  Direct and Indirect Effects of Routine Vaccination of Children with 7-Valent Pneumococcal Conjugate Vaccine on Incidence of Invasive Pneumococcal Disease--United States, 1998-2003

   *  Update: Influenza Activity--United States and Worldwide, May 22--September 3, 2005, and 2005-06 Season Vaccination Recommendations

October 14, 2005/Vol. 54/No. 40

   *  Guillain-Barre Syndrome Among Recipients of Menactra® Meningococcal Conjugate Vaccine--United States, June--July 2005

   *  Notice To Readers: FDA Approval of VAQTA® (Hepatitis A Vaccine, Inactivated) for Children Aged > 1 Year

   *  QuickStats: Rate of Hospitalizations for Pertussis Among Infants Aged < 6 Months--United States, 1994-1998 and 1999-2003

December 2, 2005/Vol. 54/No. 47

   *  Notice to Readers: Licensure of a Combined Live Attenuated Measles, Mumps, Rubella, and Varicella Vaccine

February 3, 2006/Vol. 55/No. 4

   *  Childhood Influenza Vaccination Coverage--United States, 2003-04 Influenza Season

January 6, 2006/Vol. 54/Nos. 51 and 52

   *  MMWR QuickGuide Recommended Childhood and Adolescent Immunization Schedule--United States, 2006

   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 Chapter 89, Appendix H. The updated information is as follows:

2006 List of Immunizing Agents and Average Wholesale Prices

Product Name, Company	Brand/Product Name	NDC Number	Unit	Dose	AWP/ Dose*
Diphtheria Tetanus acellular Pertussis Vaccine (DTaP):
sanofi pasteur	Tripedia	49281-0298-10	10 × 1	0.5 ml	$26.18
sanofi pasteur	Daptacel	49281-0286-10	10 × 1	0.5 ml	$26.00
GlaxoSmithKline	Infanrix	58160-0840-11	10 × 1	0.5 ml	$24.70
GlaxoSmithKline	Infanrix	58160-0840-46	5 × 0.5	0.5 ml	$25.28
Tetanus Diphtheria acellular Pertussis Vaccine (TdaP):
sanofi pasteur	Adacel	49261-0400-10	10 × 1	0.5 ml	$42.45
GlaxoSmithKline	Boosterix	58160-0842-11	10 × 1	0.5 ml	$41.85
GlaxoSmithKline	Boosterix	58160-0842-46	5 × 1	0.5 ml	$41.85
Diphtheria Tetanus pediatric Vaccine (DT pediatric):
sanofi pasteur	DT Pediatric	49281-0275-10	5.0 ml	0.5 ml	$21.96
Diphtheria Tetanus acellular Pertussis/Haemophilus Influenzae B (DTaP-HIB)
sanofi pasteur	TriHIBit	49281-0597-05	5 × 1	0.5 ml	$51.40
Tetanus Diphtheria adult Vaccine (Td adult):
sanofi pasteur	(1) Td Adult	49281-0271-83	5.0 ml	0.5 ml	$22.70
sanofi pasteur	(2) Decavac	49281-0291-10	10 × 1	0.5 ml	$21.66
Diphtheria, Tetanus, acellular Pertussis, Hepatitis B, Polio (DTaP, Hep B, OPV)
GlaxoSmithKline	Pediarix	58160-0841-11	10 × 1	0.5 ml	$84.11
GlaxoSmithKline	Pediarix	58160-0841-46	5 × 1	0.5 ml	$84.12
Tetanus Toxoid
sanofi pasteur	Tetanus toxoid	49281-0820-10	10 × 5	0.5 ml	$22.17
Haemophilus Influenzae B Vaccine (HIB):
Wyeth Pharmaceuticals	HibTITER	0005-0104-32	5 × 0.5	0.5 ml	$25.54
Wyeth Pharmaceuticals	HibTITER	0005-0104-10	10 × 1	100 mcg	$25.68
sanofi pasteur	ActHIB	49281-0545-05	5 × 1	0.5 ml	$27.04
Merck & Co.	Pedvax HIB	0006-4897-00	10 × 0.5	0.5 ml	$27.17
Injectable Polio Vaccine Inactivated (Salk Enhanced IPV):
sanofi pasteur	IPOL	49281-0860-10	10 × 5	0.5 ml	$27.35
sanofi pasteur	IPOL	49281-0860-55	10 × 5	0.5 ml	$31.45
Measles Mumps Rubella Vaccine (MMR):
Merck & Co.	MMR II	0006-4749-00	0.5 ml	0.5 ml	$44.72
Merck & Co.	MMR II	0006-4681-00	10 × 0.5	0.5 ml	$48.00
Measles Vaccine (Rubeola):
Merck & Co.	Atenuvax	0006-4709-00	0.5 ml	0.5 ml	$17.73
Merck & Co.	Atenuvax	0006-4589-00	10 × 0.5	0.5 ml	$17.73
Meninigococcal Vaccine (MCV4):
sanofi pasteur	Menactra	49281-0589-01	0.5 ml	0.5 ml	$98.40
sanofi pasteur	Menactra	49281-0589-05	5 × 1	0.5 ml	$98.40
Mumps Vaccine (Mumps):
Merck & Co.	Mumpsvax	0006-4753-00	0.5 ml	0.5 ml	$20.45
Merck & Co.	Mumpsvax	0006-4584-00	10 × 0.5	0.5 ml	$22.95
Rubella (German Measles):
Merck & Co.	Meruvax II	0006-4747-00	0.5 ml	0.5 ml	$18.57
Merck & Co.	Meruvax II	0006-4673-00	10 × 0.5	0.5 ml	$19.76
Hepatitis A Vaccine Pediatric (HEP-A):
Merck & Co.	VAQTA	0006-4831-00	0.5 ml	0.5 ml	$34.56
Merck & Co.	VAQTA	0006-4831-41	10 × 0.5	0.5 ml	$32.66
Merck & Co.	VAQTA syringe	0006-4845-00	0.5 ml	0.5 ml	$35.30
Merck & Co.	VAQTA syringe	0006-4845-38	5 × 0.5	0.5 ml	$33.31
GlaxoSmithKline	Havrix	58160-0837-01	0.5 ml	0.5 ml	$30.11
GlaxoSmithKline	Havrix	58160-0837-11	10 × 0.5	0.5 ml	$28.79
GlaxoSmithKline	Havrix syringe	58160-0837-50	25 × 0.5	0.5 ml	$28.79
GlaxoSmithKline	Havrix syringe	58160-0837-46	5 × 0.5	0.5 ml	$28.79
Hepatitis A Vaccine Adult (HEP-A):
Merck & Co.	VAQTA	0006-4841-00	1.0 ml	1.0 ml	$76.06
Merck & Co.	VAQTA	0006-4841-38	5 × 1.0	1.0 ml	$66.64
Merck & Co.	VAQTA	0006-4841-41	10 × 1.0	1.0 ml	$71.93
Merck & Co.	VAQTA syringe	0006-4844-00	1.0 ml	1.0 ml	$70.60
Merck & Co.	VAQTA syringe	0006-4844-38	5 × 1.0	1.0 ml	$66.64
Merck & Co.	VAQTA pediatric	0006-4831-00	1 × 5	0.5 ml	$38.41
Merck & Co.	VAQTA pediatric	0006-4831-41	10 × 5	0.5 ml	$36.29
GlaxoSmithKline	Havrix	58160-0835-01	1.0 ml	1.0 ml	$66.50
GlaxoSmithKline	Havrix	58160-0835-41	1.0 ml	1.0 ml	$65.08
GlaxoSmithKline	Havrix syringe	58160-0835-46	5 × 1	1.0 ml	$65.08
Hepatitis B Vaccine (HEP-B):
Merck & Co.	(1) Recombivax HB	00006-4980-00	0.5 ml	0.5 ml	$27.26
Merck & Co.	(1) Recombivax HB	00006-4981-00	10 × 0.5 ml	0.5 ml	$25.93
Merck & Co.	(3a,b) Recombivax HB	00006-4995-00	1.0 ml	1.0 ml	$33.49
Merck & Co.	(3a,b) Recombivax HB	00006-4995-41	10 × 1.0	1.0 ml	$33.15
Merck & Co.	(3c) Recombivax HB	00006-4992-00	1.0 ml	1.0 ml	$93.31
GlaxoSmithKline	(4) Engerix-B pediatric	58160-0856-01	0.5 ml	0.5 ml	$25.64
GlaxoSmithKline	(4) Engerix-B	58160-0856-11	10 × 0.5	0.5 ml	$25.64
GlaxoSmithKline	(4) Engerix-B syringe	58160-0856-46	5 × 0.5	0.5 ml	$25.64
GlaxoSmithKline	(4) Engerix-B syringe	58160-0856-35	5 × 0.5	0.5 ml	$25.64
GlaxoSmithKline	(4) Engerix-B syringe	58160-0856-50	25 × 0.5	0.5 ml	$23.07
GlaxoSmithKline	(4) Engerix-B syringe	58160-0856-57	25 × 0.5	0.5 ml	$23.07
GlaxoSmithKline	(5) Engerix-B	58160-0857-01	1.0 ml	1.0 ml	$61.51
GlaxoSmithKline	(5) Engerix-B syringe	58160-0857-46	5 × 1.0	1.0 ml	$60.27
GlaxoSmithKline	Engerix-B syringe	58160-0857-16	25 × 1	1.0 ml	$99.92
GlaxoSmithKline	(5) Engerix-B syringe	58160-0857-50	25 × 1.0	1.0 ml	$54.24
(1) Pediatric/Adolescent formulation (preservative-free) 5mcg/.5ml
(3a) Adult formulation (preservative free) 10 mcg/1 ml
(3b) Two dose regimen for 11 through 15 years of age (preservative free)
(3c) Dialysis formulation (preservative free) 40mcg/1ml
Hepatitis B / HIB
Merck & Co.	COMVAX	0006-4898-00	10 × 0.5	0.5 ml	$54.07
Hepatitis A & Hepatitis B Vaccine:
GlaxoSmithKline	Twinrix	58160-0850-01	1.0 ml	1.0 ml	$84.96
GlaxoSmithKline	Twinrix	58160-0850-11	10 × 1.0	1.0 ml	$92.89
GlaxoSmithKline	Twinrix syringe	58160-0850-46	5 × 1.0	1.0 ml	$93.20
Influenza Vaccine:
sanofi pasteur	Fluzone PF	49281-0373-25	10 × 0.5	0.25 ml	$25.92
sanofi pasteur	Fluzone	49281-0374-11	10 × 1	0.5 ml	$12.27
sanofi pasteur	Fluzone	49281-0374-15	10 × 1	0.5 ml	$9.18
MedImmune	Flumist	66019-0101-01	10 × 1	0.5 ml	$16.20
sanofi pasteur	Fluzone	49281-0005-10	10 × 0.5	0.5 ml	$16.50
sanofi pasteur	Fluzone	49281-0005-50	10 × 0.5	0.5 ml	$16.50
sanofi pasteur	Fluzone	49281-0376-15	10 × 0.5	0.5 ml	$16.50
Pneumococcal Vaccine:
Wyeth Pharmaceuticals	Prevnar	0005-1970-67	5 × 0.5	0.5 ml	$82.95
Wyeth Pharmaceuticals	Prevnar	0005-1970-00	10 × 1	0.5 ml	$170.00
Merck & Co.	Pneumovax 23	0006-4739-00	2.5 ml	0.5 ml	$142.25
Merck & Co.	Pneumovax 23	0006-4739-50	10 × 2.5 ml	0.5 ml	$159.65
Merck & Co.	Pneumovax 23	0006-4943-00	10 × 0.5	0.5 ml	$31.93
Merck & Co.	Pneumovax 23 syringe	0006-4894-00	5 × 0.5	0.5 ml	$19.30
Varicella Virus Vaccine Live (Chickenpox):
Merck & Co.	Varivax**	00006-4827-00	10 × 0.5	0.5 ml	$80.02
Merck & Co.	Varivax**	00006-4826-00	0.5 ml	0.5 ml	$83.93
**Comes with a box of 10 vials of diluent (package B: 00006-4309-00)
Measles, Mumps Rubella and Varicella Vaccine
Merck & Co.	ProQuad***	00006-4999-00	10 × 0.5	0.5 ml	$140.52
Merck & Co.	ProQuad***	00006-4984-00	0.5 ml	0.5 ml	$147.30
***Comes with a box of 10 vials of diluent (package B: 00006-4309-00)

   * 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 Alice Gray, Director, Department of Health, Division of Immunizations, Room 1026, Health and Welfare Building, Harrisburg, PA 17120, [phone] or for speech and/or hearing impaired persons, V/TT [phone] or the Pennsylvania AT&T Relay Service at [phone] (TT).

CALVIN B. JOHNSON, M. D., M.P.H.,   
Secretary

[Pa.B. Doc. No. 06-677. Filed for public inspection April 21, 2006, 9:00 a.m.]