Issue 1210: October 20, 2015

Ask the Experts
Ask the Experts—Question of the Week: My state has an immunization recommendation for school and child care employees…read more


TOP STORIES


VACCINE INFORMATION STATEMENTS


OFFICIAL RELEASES AND ANNOUNCEMENTS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING

 


TOP STORIES


Familiar with immunize.org and its materials? Join IAC as a website content manager!

Our website at immunize.org has a vast collection of highly maintained educational materials and a wealth of other immunization information that we are dedicated to keeping up to date. We currently need an experienced professional with a background in immunization or public health to assist in maintaining the content and organization of immunize.org.
 
This long-term, contract consultant position is available immediately, and there is no need to reside in the Twin Cities. The number of hours per week is open to discussion.
 
A good background, but not a requirement, would be experience in nursing or public health. We seek someone who is excited by organizing immunization information for dissemination online to a mass audience. Inherent skills involve excellent writing and command of grammar, attention to detail and accuracy, being highly organized and a talented communicator, and being a person who enjoys working with a team.
 
If you or someone you know might be interested in working closely with Dr. Deborah Wexler, Dr. William Atkinson, and all the other IAC web content experts, please contact us today.
 
Send an email message to Julie Murphy at Julie@immunize.org with a summary description of your background and how your skills and experience can help us maintain the content of immunize.org.
 
Looking forward to hearing from you.
 
Deborah L. Wexler, MD
Executive Director
Immunization Action Coalition


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Join the IAC Web Team!

IAC is looking for an experienced web designer to help us maintain and expand our websites at immunize.org and vaccineinformation.org. This long-term position is for a contract consultant who can assist us in the technical maintenance of these sites. The number of hours per week is open to discussion, you can start immediately or when available, and there is no need to reside in the Twin Cities.
 
Here are some principal requirements and duties of the position: 

  • Formal design training as well as background in designing for websites
  • Competent in use of Adobe Photoshop and Illustrator
  • Continue and expand current designs of immunize.org and vaccineinformation.org
  • Create images, buttons, and other design elements appropriate for placement online
  • Create and modify existing web pages that use HTML tables for layout
  • Create and adjust existing HTML source code including styling with CSS
  • Skilled in using any HTML editor, such as Dreamweaver
  • No programming experience needed, although light familiarity with JavaScript a plus 

We believe you will find the creative and friendly people at IAC to be great to work with and will gain great satisfaction in serving health care professionals and others who visit immunize.org and vaccineinformation.org.
 
If you or someone you know might be interested in working for IAC, please send an email message to Julie Murphy at Julie@immunize.org with a summary description of your background and how your skills align with our needs.
 
We look forward to hearing from you.
 
IAC Web Team 


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Reminder! Register today for IAC’s "Take a Stand™” workshops; next up: Chicago on Friday, October 23 

The Immunization Action Coalition (IAC), with support from Pfizer, has launched Take a Stand™, a new national effort designed to improve adult immunization rates by increasing the use of standing orders in medical practices.*
 
The core of this project is a no-cost, interactive workshop led by national experts, including L.J Tan, MS, PhD, William Atkinson, MD, MPH, and Deborah Wexler, MD, from IAC, and Alexandra Stewart, JD, from George Washington University. These workshops will be presented in 22 cities across the United States beginning in October 2015 and continuing through June 2016. 

Seating is limited for the fast-approaching workshop in Chicago, Illinois, on October 23. If you are a medical staff member in a medical practice serving adults near Chicago, register today for this free educational workshop.

Physicians, practice managers, nurse practitioners, physician assistants, and nurses in medical offices that serve adults are encouraged to attend. 
 
Wondering if these workshops are coming to a city near you? You can find details about the workshop locations and schedule, a preliminary agenda, and online registration information on the Take a Stand website

About the Workshops

Adult vaccine-preventable diseases contribute to significant morbidity, mortality, and cost in the United States, but adult immunization rates remain low. Strong evidence supports the use of standing orders programs to improve these rates, and their use is recommended by numerous agencies and provider associations. However, adoption of this important intervention may be inhibited by poor understanding of the benefits of standing orders programs or the misperception that they are difficult to implement. The workshops are designed to help physicians and their practice staff easily obtain the information and training they need to overcome these perceived barriers. An additional unique feature of the training is the availability of one year of direct support for workshop attendees as they install or enhance a standing orders program in their practices.
 
Please “take a stand” with us and spread the word about this unique opportunity for medical clinics to improve their adult immunization rates while empowering staff and streamlining facility operations.
 
* Standing orders are written protocols approved by a physician or other authorized practitioner that allow qualified health care professionals (who are eligible to do so under state law, such as registered nurses or pharmacists) to assess the need for vaccination and to vaccinate patients meeting certain criteria. 
 
Workshop Information

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American Academy of Family Physicians adopts new policy that supports ending non-medical vaccination exemptions

On October 5, the American Academy of Family Physicians released a new policy that supports ending non-medical vaccination exemptions. The policy is reprinted below.

Immunization Exemptions
The American Academy of Family Physicians (AAFP) supports immunization of infants, children, adolescents, and adults as defined by recommendations set forth in the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices and approved by the AAFP. With the exception of policies which allow for refusal due to a documented allergy or medical contraindication, the AAFP does not support immunization exemption policies.


AAFP joins the American Medical Association (AMA), which adopted a similar policy at its annual meeting in June.


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California governor signs bill into law that will require day care workers to be immunized against pertussis, measles, and influenza and joins Rhode Island in having such requirements

On October 11, California Governor Edmund (Jerry) Brown signed a bill into law (SB 792) that will require day care workers in the state to be immunized against pertussis, measles, and influenza. The new law was sponsored by the Health Officers Association of California (HOAC), and goes into effect September 1, 2016. 

HOAC has developed a fact sheet to help day care centers prepare for implementation of the new law.


IAC is aware of one other state that has such a requirement for child care workers. Rhode Island passed public health regulations July 2014, with implementation starting on August 1, 2015. If you are aware of other states that require day care/child care workers to be immune to certain vaccine-preventable diseases, please contact Diane Peterson, IAC's associate director for immunization projects.

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HHS shares information from technical consultation about eliminating perinatal hepatitis B transmission in the United States

On September 29, the U.S. Health and Human Services (HHS) Office of HIV/AIDS and Infectious Disease Policy convened a technical consultation focused on the goal of eliminating perinatal hepatitis B virus (HBV) transmission in the United States. The multidisciplinary group of experts met to share best practices, identify and better understand challenges, and strategize collectively about how to move forward. The consultation participants included representatives of professional medical societies, health departments, nonprofits, and advocacy networks, as well as colleagues from numerous federal agencies whose work touches on this issue.

Perinatal transmission of HBV is especially serious because approximately 90 percent of HBV-infected newborns develop chronic infection; and up to 25 percent of these children will die prematurely from cirrhosis, liver failure, or liver cancer later in life. With fewer than 1,000 estimated cases of perinatal HBV infection occurring each year in the U.S., many see elimination as an achievable goal.

Read more about this technical consultation.

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IAC Spotlight! Check out the recently updated "Ask the Experts" archive of online Q&As for meningococcal vaccines

IAC recently updated the following section of its online "Ask the Experts" feature:

IAC’s Ask the Experts web section is a compilation of common as well as challenging questions and answers (Q&As) about vaccines and their administration. The experts are Andrew T. Kroger, MD, MPH, medical officer, and Donna L. Weaver, RN, MN, nurse educator. Both are at CDC's National Center for Immunization and Respiratory Diseases. The Q&As have been featured in previous issues of IAC Express, Needle Tips, and Vaccinate Adults.

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Subscribe to IAC Express and receive a new "Ask the Experts" Q&A every week, as well as several special editions of "Ask the Experts" throughout the year.

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IAC enrolls one new birthing institution into its Hepatitis B Birth Dose Honor Roll; four previously honored institutions qualify for additional years

The Immunization Action Coalition (IAC) is pleased to announce that the following new institution has been accepted into its Hepatitis B Birth Dose Honor Roll. The reported hepatitis B birth dose coverage rate is included in parentheses.

  • University of Virginia Health System, Charlottesville, VA (92%)

In addition, the following four institutions are being recognized for a second year.

  • Georgetown Community Hospital, Georgetown, KY (97%)
  • Mercy Hospital St. Louis, St. Louis, MO (92%)
  • Oconee Memorial Hospital, Seneca, SC (96%)
  • Rumford Hospital, Rumford, ME (97%)

The Honor Roll now includes 210 birthing institutions from 34 states and Puerto Rico. Fifty-five institutions have qualified for a second year and two institutions have qualified three times.

The Honor Roll is a key part of IAC’s major initiative urging the nation’s hospitals to Give birth to the end of Hep B. Hospitals and birthing centers are recognized for attaining high coverage rates for administering hepatitis B vaccine at birth and meeting specific additional criteria. The initiative urges qualifying health care organizations to apply for the Hepatitis B Birth Dose Honor Roll online.

To be included in the Hepatitis B Birth Dose Honor Roll, a birthing institution must have: (1) reported a coverage rate of 90% or greater, over a 12-month period, for administering hepatitis B vaccine before hospital discharge to all newborns, including those whose parents refuse vaccination, and (2) implemented specific written policies, procedures, and protocols to protect all newborns from hepatitis B virus infection prior to hospital discharge.

Honorees are also awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IAC Express’s approximately 50,000 readers.

Please visit the Hepatitis B Birth Dose Honor Roll web page that lists these institutions and their exceptional efforts to protect infants from perinatal hepatitis B transmission.

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VACCINE INFORMATION STATEMENTS


IAC posts five new translations of the 2015–16 VIS for live, attenuated influenza vaccine

IAC recently posted Armenian, Farsi, Hmong, Korean, and Tagalog translations of the Vaccine Information Statement (VIS) for use with the 2015–16 live, intranasal influenza vaccine (LAIV) on its website. IAC thanks the California Department of Public Health for these translations.

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Spanish translations of the influenza and meningococcal serogroup B vaccine VISs are now available in rich text format (RTF)

If your organization utilizes an electronic medical records system such as GE Centricity or Epic, you may need Vaccine Information Statements (VISs) in a format other than a PDF file. To accommodate the need for electronic record-friendly formats, IAC has added VIS Spanish translations in rich text format (otherwise known as RTF) for the following recently updated VISs—inactivated influenza vaccine (IIV), live, attenuated influenza vaccine (LAIV), and meningococcal Serogroup B vaccine.

Providing Spanish translations of VISs in RTF is possible because of IAC's five-year cooperative agreement with CDC to support IAC’s role as the official clearinghouse of VIS translations. Shoo the Flu provided the Spanish-language translations of the IIV and LAIV VISs. CDC provides English VISs in RTF on their website. 

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OFFICIAL RELEASES AND ANNOUNCEMENTS


World Pneumonia Day to be held on November 12

The 7th annual World Pneumonia Day will be held on November 12. World Pneumonia Day was established in 2009 to:

  • Raise awareness about pneumonia, the world’s leading killer of children under the age of five
  • Promote interventions to protect against, prevent, and treat pneumonia
  • Generate action to combat pneumonia

Pneumonia is one of the most solvable problems in global health, yet a child dies from pneumonia every 20 seconds. Visit the World Pneumonia Day website to see how you can help in the effort to end child pneumonia worldwide.

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FEATURED RESOURCES


Vaccine Education Center's Parents PACK offers resources and support; try its "Just the Vax" trivia quiz

Parents PACK—Possessing, Accessing and Communicating Knowledge about vaccines—was established by the Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia to:
  • Develop a dialogue with parents about vaccines
  • Provide parents with vaccine information more regularly than family doctor visits
  • Establish a place where parents can easily get up-to-date information and answers to their vaccine questions

Parents PACK offers a newsletter, a free mobile app for Apple and android devices, personal stories, a contact form for questions or comments, and more. Try the challenging "Just the Vax" trivia game and see how well you score!

Be sure to recommend Parents PACK to the parents in your practice who have questions about the safety and efficacy of vaccines.

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Influenza is serious; many resources are available to help health care professionals in vaccinating

Vaccination remains the single most effective means of preventing influenza, and is recommended for everyone age six months and older. If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to a clinic or pharmacy that provides vaccines or to the HealthMap Vaccine Finder to locate sites near their workplaces or homes that offer influenza vaccination services.

Following is a list of resources related to influenza disease and vaccination for health care professionals and the public:

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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.
Order your 

copy of The Vaccine Handbook today!
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:

  • Information on every licensed vaccine in the United States
  • Rationale behind authoritative vaccine recommendations
  • Contingencies encountered in everyday practice
  • A chapter dedicated to addressing vaccine concerns
  • Background on how vaccine policy is made
  • Standards and regulations
  • Office logistics, including billing procedures, and much more

About the Author
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

  • 1–10 books: no discount + shipping
  • 11–50 books: 5% + shipping
  • 51–100 books: 10% + shipping
  • 101–500 books: 15% + shipping
  • 501–1000 books: 20% + shipping

For quotes on larger quantities, email admininfo@immunize.org.

Order your copy today!

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JOURNAL ARTICLES AND NEWSLETTERS


Study shows influenza vaccination reduces hospitalizations for pneumonia

On October 13, the Journal of the American Medical Association published an article titled Association Between Hospitalization With Community-Acquired Laboratory-Confirmed Influenza Pneumonia and Prior Receipt of Influenza Vaccination. Two sections of the abstract are reprinted below.

Objective
To assess the association between influenza vaccination status and hospitalization for community-acquired laboratory-confirmed influenza pneumonia.

Conclusions and Relevance  
Among children and adults hospitalized with community-acquired pneumonia, those with laboratory-confirmed influenza-associated pneumonia, compared with those with pneumonia not associated with influenza, had lower odds of having received influenza vaccination.


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CDC reports on HPV vaccination coverage among girls in a demonstration project in Botswana

CDC published Human Papillomavirus Vaccination Coverage Among School Girls in a Demonstration Project—Botswana, 2013 in the October 16 issue of MMWR (pages 1147–1149). A summary made available to the press is reprinted below.

Girls and women in Botswana face a dual epidemic of HIV and cervical cancer. HIV prevalence among women aged 15–49 years is 28 percent; and cervical cancer is the most common cancer among women of this age and the leading cause of cancer mortality among Botswanan women. HPV infection is common and aggressive in persons infected with HIV. Primary prevention of HPV infection and cervical cancer through introduction of HPV vaccination of 9- to 13-year-old girls is therefore a critical life-saving intervention for the girls and women of Botswana. Sustainably and routinely delivering a multi-dose vaccine to all girls who should be vaccinated is a new and challenging public health activity but it is one that deserves to be solved. The 2013 HPV vaccine demonstration project was the initial step in problem solving towards a national HPV vaccination program.


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WHO publishes article on development of candidate vaccine viruses for pandemic preparedness

The October 16 issue of the WHO periodical Weekly Epidemiological Record includes an article titled Antigenic and genetic characteristics of zoonotic influenza viruses and development of candidate vaccine viruses for pandemic preparedness.

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CDC reports on Ebola screening, monitoring, and movement policy statements from U.S. states and territories

CDC published State and Territorial Ebola Screening, Monitoring, and Movement Policy Statements–United States, August 31, 2015 in the October 16 issue of MMWR (pages 1145–1146). A summary made available to the press is reprinted below.

Shortly after CDC provided updated guidance on the monitoring and movement of people who might have been exposed to Ebola last fall, states began announcing state-specific policies. Because of concerns about the potential impact of inconsistencies between state policies and federal guidance, CDC’s Public Health Law Program (PHLP) evaluated publicly available Ebola policies for each state and territory. PHLP found that as of August 31, 2015, 17 states and the District of Columbia had policies that were more restrictive than CDC guidance, 35 states and territories were equivalent to CDC guidance, none were less restrictive, 1 territory had an unclear policy, and 2 territories did not have publicly available monitoring and movement policies.

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EDUCATION AND TRAINING


Register now for the CDC webinar series on "The Pink Book" chapter topics or listen to any archived sessions soon; opportunity to earn continuing education credit ends 30 days after posting

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. However, please note that continuing education will only be available for 30 days after each session is posted, so if you are interested in obtaining credit, plan accordingly.

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 14 sessions are now archived and can be viewed online; a transcript of each broadcast is also available.

Download Epidemiology and Prevention of Vaccine-Preventable Diseases

Order Epidemiology and Prevention of Vaccine-Preventable Diseases

Email CDC with comments, questions, or suggestions about the contents of this book.

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CDC NetConference scheduled for October 28; topics will be vaccination in adults with altered immunocompetence and intervals between PCV13 and PPSV23 vaccines

CDC will present a "Current Issues in Immunization NetConference" on October 28 from 12:00 to 1:00 p.m. (ET).

Topics and Speakers:

  • "Vaccination in Adults with Altered Immunocompetence," presented by Andrew Kroger, MD, MPH, medical officer, National Center for Immunization and Respiratory Diseases (NCIRD), CDC
  • "Updates on Intervals between PCV13 and PPSV23 Vaccines," presented by Miwako Kobayashi, MD, MPH, epidemic intelligence service officer, CDC

Candice L. Robinson, MD, MPH, Communications and Education Branch, Immunization Services Division, NCIRD, CDC, will moderate the conference.

This is a limited registration event. Registration is required.

Information about continuing education credits will be provided during the session.

Related Links

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ASK THE EXPERTS

Question of the Week

My state has an immunization recommendation for school and child care employees, which states that prior to employment, all full- and part-time employees show proof of vaccination against measles, mumps, rubella, hepatitis B, tetanus, diphtheria, pertussis, influenza, varicella, and hepatitis A. It states that this recommendation is in accordance with the recommendations of CDC. I have not found anything from CDC that makes recommendations for employees in schools and child care centers. Is there any information that you can offer on vaccine recommendations for these populations other than the standard adult vaccine recommendations for the general population? 

There is no specific ACIP document that addresses school and day care employees. High-risk persons are outlined in each vaccine’s published recommendations. You may access these at www.cdc.gov/vaccines/hcp/acip-recs.
  

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 health care 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.

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About IZ Express

IZ Express is supported in part by Grant No. 1NH23IP922654 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.

IZ Express Disclaimer
ISSN 2771-8085

Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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