Issue 1295: March 22, 2017
Ask the Experts—Question of the Week: If a patient receives hepatitis B vaccine while undergoing hemodialysis, . . . read more
TOP STORIES
IAC HANDOUTS
OFFICIAL RELEASES AND ANNOUNCEMENTS
FEATURED RESOURCES
JOURNAL ARTICLES AND NEWSLETTERS
EDUCATION AND TRAINING
CONFERENCES AND MEETINGS
TOP STORIES
CDC clarifies footnote in 2017 schedule about birth dose of hepatitis B vaccine given within 24 hours of birth
Each February, the U.S. Recommended Immunization Schedule for Children and Adolescents is published by the Advisory Committee on Immunization Practices (ACIP), American Academy of Family Physicians, American Academy of Pediatrics, and American College of Obstetricians and Gynecologists to reflect current recommendations for licensed vaccines.
This year, an "easy-to-miss" but significant change was made to the timing of the first dose of hepatitis B vaccine (HepB birth dose) when administered to infants born to women who are not infected with the hepatitis B virus (HBV), i.e., women who are hepatitis B surface antigen (HBsAg)-negative.
In the 2016 schedule, the first bullet in the footnote for hepatitis B vaccine read: "At birth: Administer monovalent HepB vaccine to all newborns before hospital discharge." In the 2017 schedule, the first bullet in the same footnote section reads: "At birth: Administer monovalent HepB vaccine to all newborns within 24 hours of birth."
This change reemphasizes the importance of the timeliness of this dose as a safety net to protect newborns from becoming infected with hepatitis B at birth and developing chronic HBV disease later in life.
On March 6, CDC posted clarification about this guidance on its Child and Teen Immunization Schedule
web page (see “Changes to the Schedule" section). The additional text clarifies
the recommendations for infants whose mothers' HBsAg status is unknown or
positive and for low birth weight infants, as follows:
- Monovalent hepatitis B vaccine should be administered within 24
hours of birth for medically stable infants weighing ≥2,000 grams born to
hepatitis B surface antigen (HBsAg)-negative mothers. The recommendations
for vaccination of infants <2,000 grams (as well as infants born to HBsAg-positive
mothers or mothers whose hepatitis B status is unknown) remain unchanged.
- Preterm infants weighing <2,000 g born to HBsAg-negative mothers should receive the first dose of vaccine 1 month after birth or at hospital discharge.
The clarification concludes by noting that “Additional detail regarding hepatitis B vaccination of infants born to HBsAg-positive mothers or mothers whose hepatitis B status is unknown can be found in the ACIP hepatitis B recommendations.”
[dated December 23, 2005]
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CDC NetConference about the 2017 immunization schedules to be held on March 29
CDC will present a one-hour Current Issues in Immunization NetConference on March 29 at 12:00 p.m. (ET). The speakers and topics will be:
- "Update on 2017 Child/Adolescent Immunization Schedule," Candice L. Robinson, MD, MPH, Communications and Education Branch, Immunization Services Division, National Center for Immunization and Respiratory Diseases (NCIRD), CDC
- "Update on 2017 Adult Immunization Schedule," David Kim, MD, deputy associate director for adult immunization, Immunization Services Division, CDC
The NetConference will be moderated by Andrew Kroger, MD, MPH, medical officer, CDC, NCIRD.
This is a limited registration event. Registration is required.
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CDC announces NetConference series about adult immunization; sessions scheduled
for Wednesdays, April 12–May 31
CDC has announced a new 6-part NetConference series on vaccinating adults, that
will address key issues related to protecting adults from vaccine-preventable
diseases. A collaborative effort between CDC and Maryland’s adult immunization
coalition and state immunization program, the "Vaccinating Adults" series will
feature 6 presentations by experts in promoting, administering, and securing
reimbursement for adult immunizations.
- Wednesday, April 12—Burden of Vaccine-Preventable Diseases in Adults:
Medical, Social, and Economic Costs
- Wednesday, April 19—Provider Reimbursement for Adult Immunizations
- Wednesday, April 26—Immunizing Adults: Immunization Schedule, Coverage,
and Challenges
- Wednesday, May 17—Immunizing Older Adults and the Chronically Ill
- Wednesday, May 24—Immunizing Pregnant Women, Health Care Personnel, and
in the Workplace
- Wednesday, May 31—Clinic Logistics: Vaccine Administration, Storage, and
Handling
Each session will start at 12:00 p.m. (ET).
Continuing education will be available for each event. The series will be archived later on CDC's website.
Advanced registration is required to participate.
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IAC Spotlight! IAC’s ACIP recommendations web section makes guidance available
in chronological order as well as alphabetically by vaccine type
IAC maintains a listing of links to vaccine recommendations from the Advisory Committee on Immunization Practices (ACIP) at www.immunize.org/acip. The web page is searchable chronologically by publication date or alphabetically by vaccine name. It includes a historical archive of recommendations dating back to 1991.
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Society of Teachers of Family Medicine updates its "Shots Immunization" app for 2017 as well as its "Shots Online" version
The Group on Immunization Education of the Society of Teachers of Family Medicine (STFM) has released 2017 versions of its "Shots Immunizations" mobile app for iPhone and Android devices and its "Shots Online" resource for computers.
The "Shots Immunizations" mobile app is a downloadable application (app) for iPhones and Android devices that was developed to serve as a point-of-care tool. To download the free app, search "STFM" on your iPhone or Android app store and select the "Shots Immunizations" app.
"Shots Online" is a free, personal computer-based program covering every aspect of the current CDC immunization schedules. "Shots Online" can be used by computers, tablets, and smart phones by going to http://shotsonline.immunizationed.org.
Both versions cover the following topics:
- Basics
- High-Risk Indications
- Adverse Reactions
- Contraindications
- Catch-Up
- Administration
- Risk Communication
- Epidemiology
- Brand Names/Coding
- Additives
- Resident Education
- Pictures of vaccine-Preventable Diseases
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Autism Science Foundation's chief science officer writes article for STAT refuting claims regarding a connection between vaccines and autism
Alycia Halladay, chief scientific officer at the Autism Science Foundation, has written a piece for STAT
that strongly refutes the claims about a connection between vaccines and
autism. She explains the science on this issue, lists the environmental
factors that—combined with genetics— are likely causes of autism, and makes a
respectful plea to legislators and others for funding to follow scientifically
sound leads for the causes and treatments for autism.
Access Let’s
focus on the real environmental factors linked to autism. Please share this article with legislators, concerned parents, and the media.
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IAC HANDOUTS
IAC revises two of its most popular staff education materials, "Summary of Recommendations for Child/Teen Immunization" and "Summary of Recommendations for Adult Immunization"
IAC recently updated its Summary of Recommendations for Child/Teen Immunization and Summary of Recommendations for Adult Immunization to incorporate all of the revised recommendations of ACIP that have recently been published in the 2017 child/adolescent and adults schedules. These summaries include the indications, schedule (including minimum intervals), and contraindications and precautions for all routinely recommended vaccines. The child/teen piece covers age birth through age 18 years, while the adult piece covers age 19 years and older.
Related Link
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.
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IAC updates "Guide to Contraindications and Precautions to Commonly Used Vaccines" and "Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults"
IAC has updated the Guide to Contraindications and Precautions to Commonly Used Vaccines and Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults to incorporate all the recent ACIP recommendations.
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OFFICIAL RELEASES AND ANNOUNCEMENTS
WHO and FDA select 2017–2018 influenza vaccine strains for the northern
hemisphere
On March 2, the World Health Organization (WHO) published information about
the influenza vaccine strains selected for the 2017–2018 influenza vaccines. A
news release from WHO is reprinted below.
Recommended composition of influenza virus vaccines for use in the
2017–2018 northern hemisphere influenza season
It is recommended that trivalent vaccines for use in the 2017–2018 northern
hemisphere influenza season contain the following:
- an A/Michigan/45/2015 (H1N1)pdm09-like virus;
- an A/Hong Kong/4801/2014 (H3N2)-like virus; and
- a B/Brisbane/60/2008-like virus.
It is recommended that quadrivalent vaccines containing two influenza B viruses contain the above three viruses and a B/Phuket/3073/2013-like virus.
Access the complete WHO report: Recommended composition of influenza virus vaccines for use in the 2017- 2018 northern hemisphere influenza season
The Vaccines and Related Biological Products Advisory Committee of the U.S. Food and Drug Administration (FDA) voted to back WHO's March 2 recommendations for influenza vaccine composition in the northern hemisphere for the upcoming influenza season. Three of the four recommended strains are unchanged from last season.
Access Medscape news article:
FDA Committee Selects 2017–2018 Influenza Vaccine Strains (log-in required)
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American Cancer Society offers resource for healthcare professionals titled "HPV: Just the Facts"
As part of a cooperative agreement with CDC, the American Cancer Society has developed a 6-page handout for healthcare professionals to help in discussing human papillomavirus (HPV) vaccination with parents. Titled HPV: Just the Facts, this resource includes 8 facts with detailed supporting references. The facts are:
- The HPV vaccine is safe.
- The HPV vaccine does NOT cause fertility issues.
- The HPV vaccine does NOT contain harmful ingredients.
- The HPV vaccine is necessary, regardless of sexual activity.
- The HPV vaccine is for boys and girls.
- The HPV vaccine is effective and prevents cancer.
- Many parents do not know about the HPV vaccine and benefit from a quality provider recommendation.
- The effectiveness of the HPV vaccine does not decrease over time.
Access HPV: Just the Facts.
Related Links
- American Cancer Society HPV web section
- “Dear Colleague” letter from AAFP, AAP, ACOG, ACP, CDC, and IAC: Give a strong recommendation for HPV vaccine to increase uptake!
- IAC's HPV handouts for healthcare professionals, parents, and patients
- Human Papillomavirus (HPV) web page on immunize.org
- CDC's You Are the Key to HPV Cancer Prevention campaign web section
- Vaccine Education Center's Questions and Answers About HPV and the Vaccine
- Human Papillomavirus (HPV) web section on AAP's website for parents, www.healthychildren.org
- ACOG's Toolkit: Human Papillomavirus Vaccination 2016
- Watch "Someone You Love: the HPV Epidemic," a documentary that presents the struggles and triumphs of five women whose lives were changed forever by this deadly virus. Access the trailer on YouTube. Physicians, nurses, and pharmacists can earn free continuing credit for viewing the complete film. Others can view the film for free, courtesy of PKIDs (not for continuing education credit).
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Influenza is spreading and serious; please keep vaccinating your patients
Influenza vaccination is recommended for everyone six months of age 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 healthcare professionals and the public:
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JOURNAL ARTICLES AND NEWSLETTERS
CDC publishes report about patients testing positive for yellow fever viral RNA after mass yellow fever vaccination campaign in Angola
CDC published Notes from the Field:
Investigation of Patients Testing Positive for Yellow Fever Viral RNA After
Vaccination During a Mass Yellow Fever Vaccination Campaign—Angola, 2016 in the March 17 issue of MMWR
(pages 282–3). The first paragraph is reprinted below.
The yellow fever outbreak declared in Angola in January 2016 soon became the
largest recorded yellow fever outbreak in the country’s history. In response,
the Angola Ministry of Health, supported by the World Health Organization (WHO),
conducted mass yellow fever vaccination campaigns beginning in February 2016 for
all persons aged ≥6 months. By June 2016, a total of 11.6 million yellow fever
vaccine doses had been distributed among a national population of 25 million.
Because of the urgency of distributing vaccine to stop the outbreak,
surveillance for cases of yellow fever after vaccination and serious adverse
events after immunization (AEFIs) was not implemented. However, CDC and the
Angola Field Epidemiology and Laboratory Training Program conducted an
investigation of patients with a history of yellow fever vaccination and
symptoms of yellow fever disease whose specimens tested positive for yellow
fever viral RNA by reverse transcription–polymerase chain reaction (RT-PCR) to
assess whether such cases could represent vaccine failure or AEFIs.
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EDUCATION AND TRAINING
Webinar on engaging with HPV vaccine-hesitant parents scheduled for April 13
The Scenic River Area Health Education Center is sponsoring a webinar titled "What is the C.A.S.E. method & how can we apply it to HPV?" on April 13 at 12:00 p.m. CT. The C.A.S.E. (Corroborate, About Me, Science, Explain/Advise) approach provides guidance to engage effectively and positively with others, and can be used when discussing the importance of vaccination with parents and patients.
The featured speaker will be Robert M. Jacobson, MD, medical director for the Population Health Science Program at Mayo Clinic's Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. He also leads Mayo's Employee and Community Health (ECH) Research Initiative.
Upon completion of this webinar, participants will be able to:
- Articulate a strong recommendation for the HPV vaccine
- Describe the four components of the C.A.S.E. approach
- Demonstrate how to apply the C.A.S.E. approach in three scenarios of vaccine hesitancy
Registration (required) is open now.
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CONFERENCES AND MEETINGS
Iowa Immunization Summit scheduled for June 14–15; includes CDC's "Pink Book"
course
The 2017 Iowa Immunization Summit will be held June 14–15 in Des Moines. The
first day will feature CDC's Epidemiology and Prevention of Vaccine-Preventable
Diseases ("Pink Book") course.
Access the summit's brochure for more information on the agenda and the scheduled nationally known speakers. Register online at trainingresources.org—scroll
down to the Iowa Immunization Summit entry.
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Massachusetts Adult Immunization Conference to be held April 25 in Marlborough
The 22nd Annual Massachusetts Adult Immunization Conference, "Building Networks to Vaccinate the Village," is scheduled for April 25 in Marlborough. The two plenary speakers will be David Kim, MD, MA, associate director for adult immunization, CDC, who will provide a national immunization update, and Litjen (L.J) Tan, MS, PhD, chief strategy officer, IAC, who will review the benefits of implementing standing orders in your practice.
Access more information.
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ASK THE EXPERTS
Question of the Week
If a patient receives hepatitis B vaccine while undergoing hemodialysis, will the vaccine be effective? Will the dose need to be repeated?
Neither the Advisory Committee on Immunization Practices (ACIP) nor the
manufacturers address the timing of vaccination and dialysis. Persons with
end-stage renal disease including predialysis, hemodialysis, peritoneal
dialysis, and home dialysis should be tested for hepatitis B surface antibody
(anti-HBs) 1–2 months after vaccination, and annually. If the anti-HBs level is
below 10mIU/mL, they should be revaccinated. See www.cdc.gov/mmwr/PDF/rr/rr5516.pdf, page 27, for more information.
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 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.
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