Issue 1317: July 26, 2017
Ask the Experts—Question of the Week: In the past, CDC has recommended to only accept patient-reported history for . . . read more
TOP STORIES
IAC HANDOUTS
VACCINE INFORMATION STATEMENTS
WORLD NEWS
FEATURED RESOURCES
EDUCATION AND TRAINING
CONFERENCES AND MEETINGS
TOP STORIES
CDC reminds international travelers to protect themselves against measles
On July 19, CDC issued a press release reminding international travelers to protect themselves against measles amid outbreaks of the disease in Europe and elsewhere. The complete press release is reprinted below.
With the peak summer travel season under way, the Centers for Disease Control and Prevention (CDC) is reminding travelers to Europe and other global destinations to take steps to protect themselves against measles amid outbreaks of the disease.
More than 14,000 cases of measles have been reported in Europe since January 2016, according to the European Centre for Disease Prevention and Control. In the past year, 35 people across Europe have died from the disease, according to the World Health Organization.
“Most measles cases in the United States are the result of international travel,” said Gary Brunette, M.D., M.P.H., chief of CDC’s travelers’ health program. “Travelers get infected while abroad and bring the disease home. This can cause outbreaks here in the United States.”
Measles cases have been reported in 15 European countries in 2017: Austria, Belgium, Bulgaria, the Czech Republic, Denmark, France, Germany, Hungary, Iceland, Italy, Portugal, Slovakia, Spain, Sweden, and the United Kingdom, according to the European Centre for Disease Prevention and Control.
CDC has issued travel health notices for five European countries with measles outbreaks since November 2016; the most recent was France on July 7. The others are Belgium, Germany, Italy, and Romania.
How to protect yourself and others against measles
The CDC recommends that anyone who isn’t protected against measles, either through vaccination or past infection, should get vaccinated, including before international travel. This simple step protects both travelers and people back home. Travelers should see their health care professional at least 4–6 weeks before any international travel. You may need this much time to complete a vaccine series, and your body needs time to build up immunity.
Measles is one of the most contagious of all infectious diseases; approximately 9 out of 10 susceptible persons with close contact to a measles patient will develop measles. The virus spreads when an infected person coughs or sneezes. The virus can live for up to 2 hours in the air or on surfaces.
People with measles usually have a rash, high fever, cough, runny nose, and red, watery eyes. Some people also get an ear infection, diarrhea, or a serious lung infection such as pneumonia. Although severe cases are rare, measles can cause swelling of the brain and death.
Any international travelers coming to the United States who develop measles symptoms should contact a doctor immediately.
To learn more about measles vaccine recommendations, visit CDC’s Measles Vaccination page.
For more information about measles symptoms, prevention and travel precautions, visit CDC’s Measles for Travelers page .
Access the CDC press release online: CDC reminds travelers to Europe: Protect against measles.
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WHO and UNICEF report that nearly one in 10 infants worldwide didn’t receive any vaccinations in 2016
A July 17 joint press release from the World Health Organization (WHO) and UNICEF reported that nearly one in 10 infants worldwide, or about 12.9 million infants, did not receive any vaccinations in 2016. According to the press release, an additional 6.6 million infants did not complete the three-dose series of diphtheria-tetanus-pertussis (DTP) vaccine, and the percentage of children immunized worldwide has remained at 86% since 2010.
The director of Immunization, Vaccines, and Biologicals at WHO, Dr. Jean-Marie Okwo-Bele, stated:
Most of the children that remain un-immunized are the same ones missed by health systems. These children most likely have also not received any of the other basic health services. If we are to raise the bar on global immunization coverage, health services must reach the unreached. Every contact with the health system must be seen as an opportunity to immunize.
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Association of Immunization Managers issues press release commending ACIP for adding the 16-year-old immunization column to the child/teen immunization schedule
The Association of Immunization Managers (AIM) recently issued a press release commending ACIP for adding a 16-year-old immunization column to the 2017 child/teen immunization schedule. The first three paragraphs of the AIM statement are reprinted below.
The Association of Immunization Managers (AIM), representing the 64 federally-funded state, local, and territorial public health immunization programs, commends the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention (CDC) for creating a specific 16-year-old immunization column in the recommended vaccination schedule.
CDC released the 2017 Children and Adolescent Immunization Schedule, adding the specific 16-year-old column to replace the previous 16–18-year-old column. The simplification allows providers and parents to more clearly understand the timing of vaccination and encourages a routine vaccination visit at age 16.
“We hope that a 16-year-old immunization platform visit will result in more routine vaccination of adolescents,” said Executive Director Claire Hannan. Currently, only one third (33%) of eligible adolescents receive the recommended second dose of meningococcal vaccine, less than 35% receive the recommended doses of HPV vaccine, and less than half received influenza vaccine during the 2015–16 flu season. Teens need the second dose of meningococcal vaccine to be fully protected against the deadly meningitis A, C, W, and Y strains. HPV vaccinations could prevent around 12,000 cases of cervical cancer and approximately 4,000 deaths. “Assessment and vaccination at age 16 will save lives,” said Hannan.
Access the complete press release: AIM Commends Establishment of 16-year-old Immunization Platform Visit.
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Reminder: August is National Immunization Awareness Month; 2017 communications toolkit available
Every year in 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. NIAM is sponsored by the National Public Health Information Coalition (NPHIC). The 2017 edition of the communications toolkit, put out by NPHIC in collaboration with CDC, contains key messages, vaccine information, sample news releases and articles, sample social media messages, links to web resources from CDC and other organizations, and logos, web banners, posters, and graphics to use with social media. The website also includes a place for you to share your NIAM activities and view what others are doing for NIAM, using the hashtag #NIAM17.
The observance features a different group each week of August:
- July 31–August 6—Babies and Young Children: A healthy start begins with on-time vaccinations
- August 7–13—Pregnant Women: Protect yourself and pass protection on to your baby
- August 14–20—Adults: Vaccines are not just for kids
- August 21–27—Preteens/teens: Ensure a healthy future with vaccines
CDC has provided the following suggestions to help providers promote vaccination during each week of NIAM.
- Update your materials with the latest information and key messages that are provided in the toolkit
- Place matte articles (i.e., formatted, ready-to-print articles that are free to use in any publication) in newsletters, on your website, or in local news outlets. The articles provided in the toolkit assist in educating and motivating consumers to talk to their healthcare professional and get vaccinated, and also encourage healthcare professionals to strongly recommend the vaccines patients need. You can tailor the articles to your particular audience(s) to maximize their impact.
- Place NIAM logos and banners on your website and/or social media platforms to highlight your participation in NIAM
- Create buzz for NIAM by using the social media messages in the toolkit. The messages are crafted in a way that enables you to use them as they are—or tailor them as you see fit for your audience(s).
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Yemen’s cholera epidemic, with 360,000 cases and rising, now considered to be worst in modern history
On July 20, OXFAM International reported that in the past three months, the number of cholera cases in Yemen, currently at 360,000, has already surpassed the largest number ever recorded in a single year. The report predicts that with the rainy season from July to September, the numbers could reach 600,000. The OXFAM report concludes with a call for an immediate cease-fire to enable a nationwide cholera campaign.
Read more about this devastating epidemic in the July 19 issue of IAC Express.
Recent news reports about the Yemen cholera epidemic:
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MMWR reports on hospital contact investigation after a patient developed a zoster vaccine–related rash
CDC published Notes from the Field: Hospital Contact Investigation for a Patient Who Developed a Zoster Vaccine–Related Rash—Maryland, February 2015 in the July 21 issue of MMWR (pages 763–4). Selections from the report are reprinted below.
On January 30, 2015, the public health department of a Maryland hospital was notified of a patient who developed a disseminated rash after receiving the live attenuated zoster vaccine, Zostavax (Merck). Zostavax is routinely provided to adults aged ≥50 years for the prevention of herpes zoster (shingles). The patient, a man aged 51 years, was evaluated in an outpatient clinic on postvaccination day 21, at which time physical exam revealed a nonpainful, nonpruritic, mixed maculopapular and vesicular rash (approximately 50 total lesions) involving the patient’s face, torso, groin, and arms....
Although zoster is less contagious than varicella (particularly if the rash is appropriately covered), the unusual presentation of the rash raised concerns for varicella. A contact investigation was initiated by the hospital's public health department to identify health care worker contacts as well as clinic waiting room patient contacts who might have been exposed to the patient during the outpatient clinic visit. Eight health care workers were identified as having had face-to-face contact with the patient; all had documented evidence of VZV immunity by antibody titer or documentation of receipt of 2 doses of varicella vaccine. The patient spent approximately 25 minutes in the clinic waiting room, resulting in potential exposure of 18 persons. Among these persons, 15 had evidence of VZV [varicella zoster virus] immunity and the three who did not were offered vaccination....No cases of varicella were identified in potentially exposed patients or health care workers after 21 days of surveillance...
Health care settings should ensure that health care workers are immune to VZV. Documentation of immunity includes: 1) written documentation of vaccination with 2 doses of varicella vaccine; 2) laboratory evidence of immunity or laboratory confirmation of disease; 3) diagnosis or verification of a history of varicella disease by a health care provider; or 4) diagnosis or verification of a history of herpes zoster by a health care provider. This case highlights the importance of maintaining vigilance for unusual events following the use of live vaccines in persons who receive immunosuppressant medications, the importance of vaccination for primary prevention of communicable diseases in hospital settings, and the value of a robust occupational health program as a critical component of hospital infection control efforts.
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CDC releases video about using new VAERS reporting system
On June 30, CDC and the Food and Drug Administration (FDA) announced a new Vaccine Adverse Event Reporting (VAERS) website and reporting form. Following that, CDC released a video about how to use the new reporting system. Access this video on YouTube: New Vaccine Adverse Event Reporting System (VAERS) Website and Ways to Report.
There are now two ways to report an adverse event following vaccination to VAERS:
- Use the online reporting tool.
- Complete a paper VAERS form (PDF format) and upload it to the new VAERS website.
As CDC and FDA will phase out the VAERS paper form by the end of 2017 and fully transition to the new VAERS 2.0 electronic submission process, it would behoove immunization providers to understand the new reporting system as soon as feasible. Accommodations will be made for persons unable to submit reports electronically. Additional assistance is available via email at info@vaers.org or by phone at (800) 822-7967.
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Reminder: July 10 webinar of Dr. William L. Atkinson presenting “Adolescent Immunization Update and the 16-Year-Old Platform” can be viewed on IAC website; slide set and presenter's notes also available for your use
On July 10, Dr. William L. Atkinson, MD, MPH, IAC’s associate director for immunization education, presented a webinar titled “Adolescent Immunization Update and the 16-Year-Old Platform.” The webinar provided a review of immunization platforms —healthcare visits where specific vaccines are indicated—specifically the 16-year-old immunization platform added to the Child and Adolescent Immunization Schedule in 2017. It also included a discussion of current immunization rates among adolescents and recommendations for Tdap, HPV, and meningococcal vaccines (both meningococcal conjugate and meningococcal serogroup B), with emphasis on the second dose of meningococcal conjugate vaccine recommended at the 16-year-old visit. Strategies to improve immunization rates among adolescents were also summarized.
This presentation is now available on the home page of IAC’s main website at www.immunize.org. To view it, scroll down to the middle of the page to Dr. Atkinson’s photo and click on the link.
In addition, the slide presentation and presenter's notes are available on IAC’s PowerPoint Slide Set web page. At this link, you can request the full PowerPoint slide set and presenter's notes to create your own adolescent immunization presentation.
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IAC Spotlight! IAC offers many vaccine storage and handling resources for healthcare professionals
IAC offers many educational tools for healthcare professionals related to proper vaccine storage and handling on its website at www.immunize.org/handouts/vaccine-storage-handling.asp. Pieces include temperature logs for refrigerators and freezers in Celsius and Fahrenheit, a checklist for safe vaccine storage and handling, an emergency response worksheet, and other resources. Check out these materials to help keep your valuable vaccines viable and your patients safe from vaccine-preventable diseases!
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IAC HANDOUTS
IAC updates its staff education materials: "Current Dates of Vaccine Information Statements" and "It's Federal Law! You must give your patients current Vaccine Information Statements"
IAC recently revised Current Dates of Vaccine Information Statements as well as It's Federal Law! You must give your patients current Vaccine Information Statements to reflect the 7/6/2017 date of the recently published cholera VIS.
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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 and ACOG collaborate to update "Vaccinations for Pregnant Women"—a one-page immunization schedule to give to your pregnant patients
IAC recently posted a revised version of Vaccinations for Pregnant Women, a one-page handout for pregnant women. This resource is the result of a collaboration between IAC and the American College of Obstetricians and Gynecologists (ACOG).
Changes were made to create a separate section for MenB vaccine, clarify the timing of the Tdap booster (during the "early part" of the third trimester), improve readability, and standardize the text to match IAC's suite of handouts targeted to adults.
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IAC revises "Standing Orders for Administering MMR Vaccine to Children and Teens" and "Standing Orders for Administering Varicella Vaccine to Children and Teens"
IAC recently revised the following two standing orders templates:
The changes to the standing orders for MMR vaccination were 1) a small correction in the assessment section (age 4 [not 6] years and older ...), 2) the addition of the anterolateral thigh as an alternate injection site for young children, and 3) clarification that children should have received dose #1 at or after age 12 months in order for dose #2 to be considered valid (previously no age criterion for dose #1 was specified).
The changes to the standing orders for varicella vaccine were 1) the addition of the anterolateral thigh as an alternate injection site for young children, and 2) clarification that children should have received dose #1 at or after age 12 months in order for dose #2 to be considered valid (previously no age criterion for dose #1 was specified).
IAC thanks the users of these pieces who wrote with suggestions for improvements.
Related Link
- IAC's Standing Orders web section with standing orders templates for administering all routinely recommended vaccines and for the medical management of vaccine reactions
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IAC updates patient education piece titled "Vaccines Work!," which provides statistics on the pre-vaccination era compared to the present day
IAC recently updated its handout for the public titled Vaccines Work! In this piece, CDC statistics demonstrate dramatic declines in vaccine-preventable diseases when compared with the pre-vaccine era. Changes were made to include current information of the most recent reports of U.S. cases of vaccine-preventable diseases, and also to update the percent decrease from the pre-vaccine era.
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VACCINE INFORMATION STATEMENTS
IAC posts new translations of the Hepatitis A VIS in Amharic, Dari, Kinyarwanda, Kiswahili, Nepali, Oromo, and Tigrinya
IAC recently posted Amharic, Dari, Kinyarwanda, Kiswahili, Nepali, Oromo, and Tigrinya translations of the Hepatitis A VIS. IAC thanks the Minnesota Department of Health for these translations.
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IAC posts new translations of the DTaP VIS in Oromo and Tigrinya
IAC recently posted Oromo and Tigrinya translations of the DTaP VIS. IAC thanks the Minnesota Department of Health for the translations.
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IAC posts new translations of the Hepatitis B VIS in Nepali and Oromo
IAC recently posted Nepali and Oromo translations of the Hepatitis B VIS. IAC thanks the Minnesota Department of Health for the translations.
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IAC posts new translations of the MenACWY VIS translations in Amharic, Kinyarwanda, Kiswahili, Nepali, and Oromo
IAC recently posted Amharic, Kinyarwanda, Kiswahili, Nepali, and Oromo translations of the MenACWY VIS. IAC thanks the Minnesota Department of Health for the translations.
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WORLD NEWS
CDC and WHO report on progress toward measles elimination in Bangladesh in this week's MMWR and Weekly Epidemiological Report, respectively
CDC published Progress Toward Measles Elimination—Bangladesh, 2000–2016 in the July 21 issue of MMWR (pages 753–4). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Progress towards measles elimination in Bangladesh, 2000–2016. A media summary of the MMWR article is reprinted below.
This report summarizes progress toward measles elimination in Bangladesh during 2000–2016. During 2000–2016, estimated coverage with the first dose of measles-containing vaccine (MCV1) increased from 74 percent to 94 percent. Supplementary immunization activities vaccinated approximately 36 million children in 2005–06, 18.1 million children in 2010, and 53.6 million children in 2014. Reported suspected measles incidence declined by 82 percent during 2000–2016, from 34.2 to 6.1 cases per million population.
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WHO reports on acute flaccid paralysis surveillance and incidence of poliomyelitis
The World Health Organization (WHO) published Performance of acute flaccid paralysis (AFP) surveillance and incidence of poliomyelitis, 2017 in the July 21 issue of its Weekly Epidemiological Record.
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AAFP Foundation launches program to help address teen undervaccination
American Academy of Family Physicians (AAFP) Foundation has begun a program, Highlight on VACCINATIONS 4 TEENS, to help address the problem of teen undervaccination. The first two paragraphs of the AAFP Foundation press release are reprinted below.
The American Academy of Family Physicians Foundation today announced the launch of Highlight on VACCINATIONS 4 TEENS , a new program that will help family physicians educate teen patients and their families about the importance of vaccination at a time when millions of teens remain vulnerable to serious infectious disease. With support from Sanofi Pasteur, 15 American Academy of Family Physicians Chapters each received a $5,000 grant to bring this program to members to help increase teen vaccination rates in their states.
The Centers for Disease Control and Prevention recommends adolescents receive four immunizations—two of which are administered as multi-dose series—to help protect against meningococcal meningitis; human papillomavirus (HPV); tetanus, diphtheria, and pertussis (whooping cough) (Tdap); and influenza (flu). Despite these recommendations, only 33 percent of adolescents who received the first dose of meningococcal meningitis vaccine (MenACWY) received the recommended second dose, only 42 percent of girls and 28 percent of boys completed the HPV vaccine series, and less than half of teens 13 through 17 years of age were vaccinated against the flu. While the majority (86 percent) of teens received the Tdap booster, there is still room for improvement.
To access the materials in the Highlight on VACCINATIONS 4 TEENS's Resource Library, including videos, Q&As, fact sheets, and personal testimonials, visit www.aafpfoundation.org/vaccinations4teens.
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CDC presents latest podcast in its “Defining Moments in MMWR History” series; subject is 2009 H1N1 influenza pandemic
CDC recently started releasing a series of MMWR podcasts that highlight the leading role MMWR has played in reporting on health-related issues through the years, The most recent podcast in this series (7/17/17) looks back on the H1H1 influenza outbreak: Swine Influenza A (H1N1) Infection in Two Children, Southern California, March–April 2009.
Access all MMWR podcasts.
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New edition of The Vaccine Handbook: A Practical Guide for Clinicians, a.k.a. "The Purple Book," by Dr. Gary Marshall available for purchase from IAC; free app for iPhones and iPads available from IAC
The 6th edition of The Vaccine Handbook: A Practical Guide for Clinicians ("The Purple Book") is considered a vital source of practical, up-to-date information for vaccine providers and educators. Now printed in color and updated with the latest vaccine information through early 2017, "The Purple Book" draws 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.
The sixth edition of this valuable guide (592 pages) is available on IAC's website at www.immunize.org/vaccine-handbook. The price of the handbook is $34.95 per copy, plus shipping charges. Order copies for your staff or for distribution at an upcoming conference.
Discount pricing is available for more than 10 copies. For quotes on larger quantities, email admininfo@immunize.org.
Order your copy today! Click on the image below to visit the "Shop IAC: The Vaccine Handbook" web page.
The Vaccine Handbook App for Apple iPhones and iPads is available free from IAC. Sorry, the app is not available for android devices. Book purchase is not necessary but registration to obtain the app is required.
The app is fully searchable, allows for bookmarking, highlighting and annotation, and contains hyperlinks to valuable content from nonprofit and governmental sources.
Click on the image below to visit the The Vaccine Handbook App page in the iTunes store.
About the Author
Gary S. 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.
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Still available! IAC's sturdy laminated versions of the 2017 U.S. child/teen immunization schedule and the 2017 U.S. adult immunization schedule—order a supply for your healthcare setting today!
IAC's laminated versions of the 2017 U.S. child/teen immunization schedule and the 2017 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. Both schedules are eight pages (i.e., four double-sided pages) and are 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.
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EDUCATION AND TRAINING
Reminder: ACOG to present "Best Practices to Improve Maternal Immunization" webinar on August 7
The American College of Obstetricians and Gynecologists (ACOG) will be hosting a webinar titled "Best Practices to Improve Maternal Immunization" on August 7, at 12:00 p.m. (ET). This session is free and open to all; ACOG membership is not required. CME credit is available.
Upon completion of the webinar, participants will be able to
- Emphasize the importance of maternal immunizations
- Update on current recommendations for maternal immunization and the future of maternal immunization
- Discuss practical tips to incorporate immunizations into your practice
- Identify and locate resources for providers and patients regarding immunizations
Registration information
Following the live presentation, the webinar will be archived on ACOG’s archived webinar web page, for convenient viewing. The recording will not provide CME credit.
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Reminder: Weekly CDC webinar series on "The Pink Book" chapter topics runs through October 11; register now
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 weekly 1-hour webinars that started June 14 and will run through October 11. Recordings of sessions will be available online within 2 weeks after each webinar. All sessions begin at 12:00 p.m. (ET). Continuing education will be available for each event.
The webinar series will provide an overview of vaccines and the diseases they prevent, general recommendations for vaccines, vaccination principles, and immunization strategies for providers.
Registration and more information is available on CDC's Pink Book Webinar Series web page.
All the sections of "The Pink Book" (i.e., chapters, appendices, 2017 supplement) are available to download at no charge at www.cdc.gov/vaccines/pubs/pinkbook/index.html.
You can also order this resource from the Public Health Foundation for $40 plus shipping and handling. This print version does not include the 2017 supplement.
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CONFERENCES AND MEETINGS
Presentation slides from June ACIP meeting now available; next meeting scheduled for October 25–26
ACIP recently posted the ;presentation slides from the ACIP meeting held on June 21–22.
ACIP will hold its next meeting on October 25–26 in Atlanta. To attend the meeting, ACIP attendees (participants and visitors) must register online. The registration deadline for non-U.S. citizens is September 25; for U.S. citizens, it's October 5. Registration is not required to watch the meeting via webcast or listen to the proceedings via phone.
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ASK THE EXPERTS
Question of the Week
In the past, CDC has recommended to only accept patient-reported history for influenza and pneumococcal polysaccharide vaccines. Is the recommendation to not accept a patient-reported history of pneumococcal conjugate vaccine?
ACIP's recently published "General Best Practice Guidelines for Immunization" still states that a patient’s undocumented history can be accepted as proof of vaccination only for influenza and pneumococcal polysaccharide vaccines. See https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/programs.html. CDC intends to collect data to determine if patients can distinguish between the two pneumococcal vaccines, or if records should be sought for all pneumococcal vaccines.
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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