Issue 1198: August 11, 2015 Ask the Experts—Question of the Week: The protective cap on a single-dose vial was removed but the vaccine was not needed…read more TOP STORIES
IAC HANDOUTS
WORLD NEWS FEATURED RESOURCES
JOURNAL ARTICLES AND NEWSLETTERS
EDUCATION AND TRAINING TOP STORIES CDC publishes 2015–16 influenza vaccination recommendations in MMWR CDC published Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2015–16 Influenza Season in the August 7 issue of MMWR (pages 818–825). The first paragraph is reprinted below. This report updates the 2014 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines. Updated information for the 2015–16 season includes 1) antigenic composition of U.S. seasonal influenza vaccines; 2) information on influenza vaccine products expected to be available for the 2015–16 season; 3) an updated algorithm for determining the appropriate number of doses for children aged 6 months through 8 years; and 4) recommendations for the use of live attenuated influenza vaccine (LAIV) and inactivated influenza vaccine (IIV) when either is available, including removal of the 2014–15 preferential recommendation for LAIV for healthy children aged 2 through 8 years. Information regarding topics related to influenza vaccination that are not addressed in this report is available in the 2013 ACIP seasonal influenza recommendations. Related Links
New! CDC issues VISs for the 2015–16 influenza vaccines—stay tuned for translations On August 7, CDC issued two new influenza vaccine Vaccine Information Statements (VISs) for use during the 2015–16 influenza season. The VIS for inactivated influenza vaccine (IIV) is intended for use with all injectable formulations—trivalent, quadrivalent, cell-culture, recombinant, intradermal, and high-dose. The VIS for live attenuated intranasal influenza vaccine (LAIV) is intended for use when administering nasal-spray vaccine. An important note from CDC: you won’t see the influenza season dates (i.e., 2015–16) at the top of these VISs. These VISs may be used not only for this year, but also for subsequent years, until there is a significant change in influenza recommendations that will require revising them. Translations of the 2015–16 influenza vaccine VISs will be available in additional languages in the weeks ahead. IAC Express will announce the availability of translations as soon as they are ready. Related Links
National Immunization Awareness Month's theme this week is maternal vaccination Every August, National Immunization Awareness Month (NIAM) provides an opportunity to raise awareness of the importance of immunization and the need for improving national vaccination coverage levels. Each week of NIAM focuses on the importance of immunization for a different audience. The week of August 9–15 will highlight maternal vaccinations, with the theme “Protect yourself and pass protection on to your baby.” To help you with your planning efforts, CDC has provided the following information about resources for pregnant women and their healthcare providers. CDC, in partnership with the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Nurse-Midwives (ACNM), and the American College of Obstetricians and Gynecologists (ACOG), recently launched a new campaign to educate pregnant women about the importance of Tdap vaccine during pregnancy. CDC has also developed a variety of materials about the importance of influenza vaccination during pregnancy. Resources for healthcare professionals from CDC Tdap
Tdap
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VICNetwork to offer August 19 webinar on what's new for the 2015–16 influenza season The VICNetwork has scheduled a webinar on August 19 titled What's New With The Flu? CDC's Recommendations and Communication Plans for the 2015–2016 Influenza Season. This webinar will focus on what's new with this year's influenza vaccine along with highlights for communication plans by CDC and partners. Speakers will highlight updated resources that will help with influenza vaccination promotion efforts. Speakers for this webinar are Alicia Fry, MD, MPH, medical officer, team lead for the Influenza Prevention and Control Team, Epidemiology and Prevention Branch, Influenza Division, CDC's National Center for Immunization and Respiratory Diseases (NCIRD), and Cindy Alvarez, a health communications specialist with NCIRD. The one-hour webinar begins at 2:00 p.m. (ET). The Virtual Immunization Communication (VIC) Network is a project of the National Public Health Information Coalition and the California Immunization Coalition. Registrations are being accepted. Back to top IAC Spotlight! "Like" IAC on Facebook and "follow" IAC on Twitter! IAC invites you to connect with us on Facebook and Twitter. IAC's Facebook page is designed to help parents and all interested Facebook users learn about vaccines and their importance. If you have a personal or organizational Facebook page, please take a minute to "like" IAC on Facebook. If you have an account on Twitter, please take a minute to "follow" @ImmunizeAction on Twitter. Also, you and your patients are invited to view and repost videos available from IAC's YouTube account. Related Links Back to top Reminder: Help get the word out about the benefits of vaccines by joining the #TeamVax Thunderclap on August 17 CDC's National Center for Immunization and Respiratory Diseases invites everyone to join in the #TeamVax Thunderclap campaign on August 17 to support vaccination during National Immunization Awareness Month (NIAM). Thunderclap is a platform that uses the power of crowds to amplify a single important message across supporter social media profiles, allowing supporters to sign up in advance to share a unified message at a specific time via their individual Facebook, Twitter, or Tumblr account. The collective action creates a wave of support—or “thunderclap”—across social media. On August 17 at 3:00 p.m. (ET), the #TeamVax message will be released, thus creating a thunderclap announcement that is heard far and wide. Please, sign up now and help CDC reach supporters. Show your support by going to http://thndr.it/1IguVz3 and clicking on the red button. You can choose to have the message post on your Twitter, Facebook, or Tumblr account—or on all three. If you have questions about Thunderclap or #TeamVax, please email ibranam@cdc.gov. Back to top IAC HANDOUTS IAC revises "Meningococcal Vaccine Recommendations by Age and Risk Factor for Serogroups A, C, W, or Y Protection" Due to the recent licensing of two vaccines that protect against meningococcal serogroup B, IAC recently reformatted and made minor changes to "Meningococcal Vaccine Recommendations by Age and Risk Factor." The piece is retitled Meningococcal Vaccine Recommendations by Age and Risk Factor for Serogroups A, C, W, or Y Protection and a box at the top states, "A separate vaccine is needed for protection against meningococcal serogroup B disease." IAC's Handouts for Patients & Staff web section offers healthcare professionals and the public more than 250 FREE English-language handouts (many also available in translation), which we encourage website users to print out, copy, and distribute widely. Back to top IAC revises "Standing Orders for Administering Meningococcal ACWY Vaccine to Children and Teens" IAC recently updated and completely redesigned "Standing Orders for Administering Meningococcal Vaccine to Children & Teens," now titled Meningococcal Vaccine Recommendations by Age and Risk Factor for Serogroups A, C, W, or Y Protection. The new title makes clear that these sample standing orders are for meningococcal vaccines that protect against serotypes A, C, W, or Y only. Watch for additional redesigned standing orders in the months ahead from IAC. Related Links
IAC revises its resource for healthcare professionals, "Before you vaccinate adults, consider their 'H-A-L-O'!" IAC has redesigned and made one edit to Before you vaccinate adults, consider their “H-A-L-O”! This resource is an easy-to-use chart that can help healthcare professionals make an initial decision about vaccinating an adult patient based on four factors—the patient’s Health condition, Age, Lifestyle, and Occupation. Related Link
WORLD NEWS WHO publishes plans for containment of poliovirus following type-specific polio eradication worldwide The August 7 issue of the WHO periodical Weekly Epidemiological Record features an article titled Plans for containment of poliovirus following type-specific polio eradication worldwide, 2015. Related Links Back to top FEATURED RESOURCES IAC's laminated versions of the 2015 U.S. child/teen immunization schedule and the 2015 U.S. adult immunization schedule are covered with a tough, washable coating; they will stand up to a year's worth of use in every area of your healthcare setting where immunizations are given. The child and adolescent schedule has eight pages (i.e., four double-sided pages) and is folded to measure 8.5" x 11". The adult immunization schedule has six pages (i.e., three double-sided pages) and is folded to measure 8.5" x 11". 
 Laminated schedules are printed in color for easy reading, come complete with essential tables and footnotes, and include contraindications and precautions—a feature that will help you make an on-the-spot determination about the safety of vaccinating patients of any age. PRICING 1–4 copies: $7.50 each 5–19 copies: $5.50 each 20–99 copies: $4.50 each 100–499 copies: $4.00 each 500–999 copies: $3.50 each For quotes on customizing or placing orders for 1,000 copies or more, call (651) 647-9009 or email admininfo@immunize.org. You can access specific information on both schedules, view images of both, order online, or download an order form at the Shop IAC: Laminated Schedules web page. Back to top IAC makes available The Vaccine Handbook: A Practical Guide for Clinicians, a.k.a. "The Purple Book," by Dr. Gary Marshall The Vaccine Handbook: A Practical Guide for Clinicians (“The Purple Book,” 2015, 560 pages) is a uniquely comprehensive source of practical, up-to-date information for vaccine providers and educators. Its author, Gary S. Marshall, MD, has drawn together the latest vaccine science and guidance into a concise, user-friendly, practical resource for the private office, public health clinic, academic medical center, and hospital.  IAC Executive Director Deborah Wexler, MD, is enthusiastic about helping get this book circulated as widely as possible. “During more than 20 years in the field of immunization education, I have not seen a book that is so brimming with state-of-the-science vaccine information,” she states. "This book belongs in the hands of every medical student, physician-in-training, doctor, nursing student, and nurse who provides vaccines to patients.” The Vaccine Handbook provides:
Gary Marshall, MD, is professor of pediatrics at the University of Louisville School of Medicine in Kentucky, where he serves as chief of the division of pediatric infectious diseases and director of the Pediatric Clinical Trials Unit. In addition to being a busy clinician, he is nationally known for his work in the areas of vaccine research, advocacy, and education. The newly released fifth edition of this invaluable guide is now available on IAC’s website at www.immunize.org/vaccine-handbook. The price of the handbook is $29.95 each, plus shipping charges. Discount pricing is available for more than 10 copies. Order copies for your staff or for distribution at an upcoming conference. Quantity Discount Pricing
Order your copy today! Back to top JOURNAL ARTICLES AND NEWSLETTERS July issue of CDC's Immunization Works newsletter now available CDC recently released the July issue of its monthly newsletter Immunization Works and posted it on the website of the National Center for Immunization and Respiratory Diseases (NCIRD). The newsletter offers the immunization community information about current topics. The information is in the public domain and can be reproduced and circulated widely. Related Links Back to top CDC reports on lack of measles transmission from a healthcare employee to susceptible contacts CDC published Lack of Measles Transmission to Susceptible Contacts from a Health Care Worker with Probable Secondary Vaccine Failure—Maricopa County, Arizona, 2015 in the August 7 issue of MMWR (pages 832–833). Selected sections from the report are reprinted below. On January 23, 2015, the Maricopa County Department of Public Health (MCDPH) was notified of a suspected measles case in a nurse, a woman aged 48 years. On January 11, the nurse had contact with a patient with laboratory-confirmed measles associated with the Disneyland theme park–related outbreak in California. On January 21, she developed a fever (103°F [39.4°C]), on January 23 she experienced cough and coryza, and on January 24, she developed a rash. The patient was instructed to isolate herself at home...Because of her symptoms and laboratory results, the patient was considered to be infectious. The case patient had documentation of receipt of 2 doses of measles-mumps-rubella (MMR) vaccine in 1991 and 1992. In 2006, the patient had received negative measles IgG serology test results; however, according to recommendations of the Advisory Committee on Immunization Practices, she was presumed to be immune because she had received two MMR doses. The patient worked at a tertiary pediatric outpatient health care facility during January 20–21, a period which coincided with her infectious period. In cooperation with the health care facility, an investigation was conducted to prevent further transmission by identifying contacts, providing postexposure prophylaxis, recommending quarantine for unvaccinated contacts, and providing education for rapid isolation and diagnosis of symptomatic contacts. After 21 days had elapsed from the last measles exposure, calls to families of the 195 patients were attempted; 106 (54%) families responded and reported that no exposed family members had developed a febrile rash illness. No measles cases were reported in Maricopa County. These findings are consistent with previous reports demonstrating limited transmission from persons with secondary measles vaccine failure. In addition, the risk for transmission was reduced because all exposed HCWs had been vaccinated for measles. HCWs born after 1956 should have documentation of receipt of 2 doses of MMR vaccine or laboratory evidence of measles immunity. Secondary vaccine failure occurs rarely, but transmission of measles to susceptible persons in these situations appears to be unlikely. If a patient is suspected of having measles, HCWs should implement airborne precautions. Case investigation and contact tracing should be conducted for all U.S. measles cases, regardless of vaccination history or occupation, and a history of travel should be solicited for any patient with a febrile rash illness. Two doses of MMR vaccine, administered ≥28 days apart, are recommended for children aged ≥12 months and adults born after 1956, for prevention of measles. Related Links
EDUCATION AND TRAINING Reminder: Register now for the CDC webinar series on "The Pink Book" chapter topics or listen to any of four archived sessions CDC is presenting a 15-part webinar series to provide a chapter-by-chapter overview of the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). This is a live series of one-hour webinars that started on July 8. All sessions begin at 12:00 p.m. (ET). Continuing education credit will be available for each session. Read more about the series. Participation in this series requires advance registration. Virtual seats are available for the first 500 registrants, but each session will also be archived and available within two weeks after each event. The following four sessions are now archived and can be viewed online; a transcript of each broadcast is also available.
Back to top ASK THE EXPERTS Question of the Week The protective cap on a single-dose vial was removed but the vaccine was not needed. No needle punctured the rubber seal. According to CDC's Vaccine Storage & Handling Toolkit, the vial without the cap should be discarded at the end of workday. If no needle punctured the seal, what is the reasoning for discarding the vaccine? Removing the protective cap increases the likelihood the septum or stopper could be punctured. The puncture may not be visible. Once the protective cap has been removed, the vaccine should be discarded at the end of the workday because it may not be possible to determine if the rubber seal has been punctured. About IAC's Question of the Week Each week, IAC Express highlights a new, topical, or important-to-reiterate Q&A. This feature is a cooperative venture between IAC and CDC. William L. Atkinson, MD, MPH, IAC's associate director for immunization education, chooses a new Q&A to feature every week from a set of Q&As prepared by experts at CDC’s National Center for Immunization and Respiratory Diseases. We hope you enjoy this new feature and find it helpful when dealing with difficult real-life scenarios in your vaccination practice. Please encourage your healthcare professional colleagues to sign up to receive IAC Express at www.immunize.org/subscribe. If you have a question for the CDC immunization experts, you can email them directly at nipinfo@cdc.gov. There is no charge for this service. Related Links
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About IZ Express
IZ Express is supported in part by Grant No. NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.
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ISSN 2771-8085
IZ Express Disclaimer
ISSN 2771-8085
Editorial Information
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Editor-in-ChiefKelly L. Moore, MD, MPH
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Managing EditorJohn D. Grabenstein, RPh, PhD
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Associate EditorSharon G. Humiston, MD, MPH
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Writer/Publication CoordinatorTaryn Chapman, MS
Courtnay Londo, MA -
Style and Copy EditorMarian Deegan, JD
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Web Edition ManagersArkady Shakhnovich
Jermaine Royes -
Contributing WriterLaurel H. Wood, MPA
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Technical ReviewerKayla Ohlde