IAC Express 2011 |
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Issue number 935: June 13, 2011 |
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as well as other FREE IAC periodicals. |
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Contents
of this Issue
Select a title to jump to the article. |
- States,
major cities, and counties across the nation report recent increases in
measles cases
- Three
states expand immunization requirements for school attendance
- ASTHO
brief asserts that permissive state vaccine-exemption laws contribute to
increasing spread of VPDs
- Spotlight
on immunize.org: official releases from ACIP, CDC, FDA, WHO, and more
- IAC's
Video of the Week features five short clips that answer parents' basic
questions about immunization
- IAC makes
major updates to "It's federal law! You must give your patients current
Vaccine Information Statements (VISs)"
- IAC
updates its useful handout "Vaccines with Diluents: How to Use Them"
- Varicella
and shingles vaccines should not be transported or stored at temperatures
colder than -58 degrees F; do not use dry ice when transporting
- CDC
publishes interim results of state-specific U.S. influenza vaccination
coverage during August 2010-February 2011
- IAC's
popular laminated versions of the 2011 U.S. immunization schedules are
available. Order a supply for your workplace today!
-
Award-winning DVD! "Immunization Techniques: Best Practices with Infants,
Children, and Adults"--from the California Department of Public Health,
Immunization Branch
- May
issue of CDC's Immunization Works newsletter now available
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| Abbreviations |
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AAFP, American Academy of Family Physicians; AAP,
American Academy of Pediatrics; ACIP, Advisory Committee on Immunization
Practices; AMA, American Medical Association; CDC, Centers for Disease
Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization
Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NCIRD,
National Center for Immunization and Respiratory Diseases; NIVS, National
Influenza Vaccine Summit; VIS, Vaccine Information Statement; VPD,
vaccine-preventable disease; WHO, World Health Organization. |
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Issue 935: June 13, 2011 |
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1. |
States, major cities, and counties across the nation report recent increases
in measles cases
Many U.S. locations have recently experienced
increases in measles cases. Since mid-May, health departments in at least ten
states, major cities, or counties have issued press releases for broad
distribution to the general public and healthcare community. Following are
titles of and links to the ten press releases:
1. New York City (6/8/11): "Alert #9: Increase in Measles Cases and Hospital
Exposures"
http://www.nyc.gov/html/doh/downloads/pdf/cd/2011/11md09.pdf
2. Monterey County, CA (6/8/11): "Health Advisory--Increase in Measles Cases"
To read press release, click
here.
3. Maryland (6/8/11): "Maryland Health Officials Investigating Possible
Exposures to Measles"
http://www.dhmh.state.md.us/pressreleases/pdf/2011/measles%20060811.pdf
4. Vermont (6/7/11): No title given
http://healthvermont.gov/advisory/2011/060711_measles.aspx
5. Boston, MA (6/3/11): "Commission Reports New Case of Measles"
http://www.bphc.org/Newsroom/Pages/TopStoriesView.aspx?ID=223
6. Bear River Health Department (BRHD), UT (5/31/11): "BRHD Confirms Measles
Case in Cache County"
To read press release, click
here.
7. New York State (5/30/11): "State Health Department Confirms Measles Case
in Capital Region"
http://www.health.state.ny.us/press/releases/2011/2011-05-30_measles.htm
8. Nassau County, NY (5/27/11): "Advisory: Case of Measles in Nassau County"
http://www.nassaucountyny.gov/agencies/health/NewsRelease/2011/5272011.html
9. Iowa (5/24/11): "Measles Reported in Central Iowa"
To read press release, click
here.
10. Lawrence-Douglas County, KS (5/17/11): "Health Department Investigates
Measles Case in Elementary School"
http://www.ldchealth.org/pdf/Press%20releases/Measles%20case%205.17.11.pdf
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2. |
Three states expand immunization requirements for school attendance
Idaho, Texas, and Vermont have recently expanded
their
immunization requirements for pre-school, school, and/or
college attendance. Details follow.
BACKGROUND INFORMATION--ACTIONS TAKEN BY THE THREE STATES'
LEGISLATIVE OR EXECUTIVE BRANCHES:
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Idaho: On 4/7/11, the 2011 Idaho Legislature approved new
school immunization requirements for children enrolled in
child care facilities and schools. Exemptions to these
requirements are permissible for medical, religious, or
personal reasons.
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Texas: On 5/27/11, the governor signed an amendment to the
immunization mandates for new students enrolling in
institutions of higher education or private or independent
institutions of higher education in Texas. Further, the
definition of a "new student" now includes those who were
previously enrolled but took a break in enrollment of at
least one semester. Exemptions to the requirements may be
granted for medical reasons or "reasons of conscience."
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Vermont: On 1/27/11, the legislative committee on
administrative rules signed regulations for new vaccination
requirements for children enrolled in child care facilities.
The Vermont regulations continue to allow for exemptions
for medical or religious reasons, or based on the moral
convictions of the parents.
NEW REQUIREMENTS (listed in alphabetical order by vaccine):
HEPATITIS A
Idaho: Updates to the Idaho Administrative Code require that
children born since 9/1/05, who are enrolling in a child
care facility or school, have evidence of hepatitis A
vaccination as follows: one dose for children ages 16 months
to 2 years and two doses for children 2 years and older. The
requirements became effective 4/7/11.
IAC has compiled a chart of information about all states
that have hepatitis A prevention mandates for day care and
school attendance. To access the information, go to:
http://www.immunize.org/laws/hepa.asp
The information is also depicted visually on a map of the
United States. To access the map, go to:
http://www.immunize.org/pdfs/hepa.pdf
HEPATITIS B
Vermont: Updates to Vermont's Immunization Regulations
require that children age 2 months and older who are
enrolled in a licensed child care facility have
documentation of age-appropriate vaccination against
hepatitis B, effective 3/5/11.
IAC has compiled a chart of information about all states
that have hepatitis B prevention mandates for day care and
school attendance. To access the information, go to:
http://www.immunize.org/laws/hepb.asp
The information is also depicted visually on a map of the
United States. To access the map, go to:
http://www.immunize.org/pdfs/hepb.pdf
MENINGOCOCCAL
Idaho: Updates to the Idaho Administrative Code require
documentation (e.g., by a written certificate, electronic
medical health record) of receipt of one dose of
meningococcal vaccine for all students prior to admission to
the seventh grade, beginning with school year 2011-12. This
requirement will be extended to the subsequent grade
incrementally each year (e.g., grades 7-8 in school year
2012-13, etc.).
Texas: Revisions to Texas Education Code now require
evidence of meningococcal vaccination for all new incoming
students to institutions of higher education, including
students who were previously enrolled but took a break in
enrollment of at least one semester. (The previous
requirement applied only to students living in on-campus
housing.) Additionally, the date on which the most recent
meningococcal vaccination was given must be within 5 years
of the student's enrollment. The requirements go into effect
immediately.
IAC has compiled a chart of information about all states
that have meningococcal prevention mandates for elementary
and secondary school attendance. To access the information,
go to: http://www.immunize.org/laws/menin_sec.asp
The information is also depicted visually on a map of the
United States. To access the map, go to:
http://www.immunize.org/laws/menin_sec.pdf
IAC has compiled a chart of information about all states
that have meningococcal prevention mandates for college and
university attendance. To access the information, go to:
http://www.immunize.org/laws/menin.asp
The information is also depicted visually on a map of the
United States. To access the map, go to:
http://www.immunize.org/pdfs/menin.pdf
PNEUMOCOCCAL
Idaho: Updates to the Idaho Administrative Code require that
children ages 3 to 59 months who are enrolling in child care
facilities have evidence of age-appropriate pneumococcal
vaccination, effective 4/7/11.
Vermont: Updates to Vermont's Immunization Regulations
require that children age 2 months and older who are
enrolled in a licensed child care facility have
documentation of age-appropriate vaccination against
pneumococcal disease, effective 3/5/11.
IAC has compiled a chart of information about all states
that have pneumococcal prevention mandates for day care
attendance. To access the information, go to:
http://www.immunize.org/laws/pneuconj.asp
The information is also depicted visually on a map of the
United States. To access the map, go to:
http://www.immunize.org/pdfs/pcv7.pdf
ROTAVIRUS
Idaho: Updates to the Idaho Administrative Code require that
children ages 3 through 7 months who are enrolling in child
care facilities have evidence of age-appropriate rotavirus
vaccination, effective 4/7/11.
Note: Because Idaho is the only U.S. state to require
rotavirus vaccination for enrollment in child care
facilities, IAC has not developed a chart or map of
information. We hope many other states will soon join Idaho
in requiring vaccination to prevent the spread of this life-threatening, highly contagious disease in child care
facilities.
TETANUS-DIPHTHERIA AND ACELLULAR PERTUSSIS (Tdap)
Idaho: Updates to the Idaho Administrative Code require
documentation (e.g., by a written certificate, electronic
medical health record) of one dose of Tdap for all students
prior to admission to seventh grade, beginning with school
year 2011-12. This requirement will be extended to the
subsequent grade incrementally each year (e.g., grades 7-8
in school year 2012-13, etc.).
IAC has compiled a chart of information about all states
that have Tdap vaccination mandates for middle school and
high school attendance. To access the information, go to:
http://www.immunize.org/laws/tdap.asp
The information is also depicted visually on a map of the
United States. To access the map, go to:
http://www.immunize.org/laws/tdap.pdf
VARICELLA
Idaho: Updates to the Idaho Administrative Code require that
children age 16 months and older (and born after 9/1/05),
who are enrolling in child care facilities have evidence of
receipt of at least one dose of varicella vaccine, effective
4/7/11. Also, children born after 9/1/05 who are enrolling
in school must have evidence of receipt of two doses of
varicella vaccine, effective school year 2011-12. The
requirement may also be met if a physician or licensed
healthcare professional submits documentation of a personal
examination of a child's diagnosed varicella disease.
Vermont: Updates to Vermont's Immunization Regulations will
require that children age 15 months and older who are
enrolled in a licensed child care facility have
documentation of receipt of one dose of varicella vaccine,
effective 3/5/11.
IAC has compiled a chart of information about all states
that require varicella vaccination for child care or school
attendance. To access the information, go to:
http://www.immunize.org/laws/varicel.asp
The information is also depicted visually on a map of the
United States. To access the map, go to:
http://www.immunize.org/laws/varicella.pdf
IAC has compiled a chart of information about all states
that require two doses of varicella vaccine for school
attendance. To access the information, go to:
http://www.immunize.org/laws/varicel_sec.asp
The information is also depicted visually on a map of the
United States. To access the map, go to:
http://www.immunize.org/laws/vari_two.pdf
WANT MORE INFORMATION ON STATE IMMUNIZATION MANDATES?
To access more information about state mandates, visit our
State Mandates on Immunization and Vaccine-Preventable
Diseases web section at http://www.immunize.org/laws
IAC Express depends on readers to help us stay informed and
ensure our website contains the most current and accurate
information available. Please let us know when any changes
occur in your state by emailing us at admin@immunize.org
The CDC website has a section of resources on immunization
requirements for school attendance, healthcare workers,
patients in various healthcare settings, and residents of
various institutional settings. Among the resources is a
searchable database on state immunization laws. To access
CDC's web section of resources on immunization requirements,
go to: http://www.cdc.gov/vaccines/vac-gen/laws
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3. |
ASTHO brief asserts that permissive state vaccine-exemption laws contribute
to increasing spread of VPDs
The Association of State and Territorial Health
Officials
(ASTHO) recently issued a brief titled Permissive State
Exemption Laws Contribute to Increased Spread of Disease.
The brief provides information on types of nonmedical
exemptions, the increasing rates of nonmedical exemptions
being granted, and the possible impact of nonmedical
exemptions on the spread of vaccine-preventable diseases
(VPDs). It encourages the use of this strategy for granting
nonmedical exemptions:
"To address the risk of VPD, states should consider adopting
more rigorous standards for non-medical vaccine exemptions
that require parents to demonstrate that they have made a
conscious, concerted, and informed decision in requesting
these exemptions for their children. An example of such a
standard might include a requirement for parents to complete
a form that explicitly states the grounds for the exemption
and requires them to acknowledge awareness of the disease-specific risks associated with not vaccinating their
child(ren)."
To access the complete brief, go
here.
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4. |
Spotlight on immunize.org: official releases from ACIP, CDC, FDA, WHO, and
more
Looking for official publications and
authoritative news
releases pertaining to immunization? Look no further. IAC's
New Releases web section provides a chronological listing of
just-published ACIP and AAP vaccine recommendations, FDA
licensures, CDC news releases, and other resources. Updated
frequently, this section has subsections devoted to
information from AAP, ACIP, CDC, FDA, and WHO.
To access New Releases, visit http://www.immunize.org/newreleases
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5. |
IAC's Video of the Week features five short clips that answer parents' basic
questions about immunization
IAC encourages IAC Express readers to watch a
series of five
video clips that answer parents' most frequently asked
questions about immunization. The clips, which run less than
a minute each, were developed by the National Association of
Pediatric Nurse Practitioners.
The video clips will be available on the home page of IAC's
website through June 19. To access them, go to:
http://www.immunize.org and click on the image under the
words Video of the Week.
Remember to bookmark IAC's home page to view a new video
every Monday.
To access the archives of IAC's Videos of the Week, go to:
http://www.immunize.org/votw
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6. |
IAC makes major updates to "It's federal law! You must give your patients
current Vaccine Information Statements (VISs)"
IAC recently combined two of its handouts related
to vaccine
information statements (VIS). Information from the one-page
handout titled "The Facts about Using VISs" have been
combined with information included in "It's federal law! You
must give your patients current Vaccine Information
Statements (VISs)." "It's Federal Law!" is now a two-page
document; "The Facts about Using VISs" has been discontinued
as a stand-alone handout. Go to:
http://www.immunize.org/catg.d/p2027.pdf
IAC's Handouts for Patients and Staff web section offers
healthcare professionals and the public approximately 250
FREE English-language handouts (many also available in
translation), which we encourage website users to print out,
copy, and distribute widely. To access all of IAC's free
handouts, go to: http://www.immunize.org/handouts
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7. |
IAC updates its useful handout "Vaccines with Diluents: How to Use Them"
IAC recently revised information about yellow
fever vaccine
and removed information about Japanese encephalitis vaccine
on the handout titled "Vaccines with Diluents: How to Use
Them." Go to: http://www.immunize.org/catg.d/p3040.pdf
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8. |
Varicella and shingles vaccines should not be transported or stored at
temperatures colder than -58 degrees F; do not use dry ice when transporting
The Iowa Department of Public Health (IDPH) and
the Minnesota
Department of Health have alerted IAC that effective June 6,
2011, Merck is no longer transporting its varicella
(Varivax) and shingles (Zostavax) vaccines using dry ice--and neither should you. Following is the information IAC
received from IDPH.
In the past, Varivax and Zostavax have been shipped using
dry ice. Both of these vaccines will now be packed for
shipping with six frozen gel packs as refrigerant in the
shipping containers. The gel packs are for one-time use only
and should be discarded upon receipt of the vaccine. The
vaccine shipping containers are packed according to Merck
guidelines that take into account the maximum temperature to
which the container will be exposed, the time in transit,
and the need to keep the vaccine at the appropriate
temperature during shipping.
The shipping containers are designed to maintain proper
temperatures for three days from the shipment date, which is
located on the packing list. It is important to verify the
date vaccine was shipped on the packing list to assure the
vaccine arrived within the three-day window for delivery.
If the container is received after the three-day shipping
time period or you have questions about the condition of the
vaccine upon arrival, store the vaccine appropriately, mark
do not use, and contact the vaccine manufacturer, Merck, for
additional guidance.
To maintain potency of Varivax and Zostavax, the vaccine
must be stored frozen between -58 degrees F and +5 degrees F
(-50 degrees C to -15 degrees C). Diluent must be stored in
the refrigerator (2 degrees C to 8 degrees C or 35 degrees F
to 46 degrees F) or at room temperature (20 degrees C to 25
degrees C or 68 degrees F to 77 degrees F). The diluent is located in the top compartment of the shipping box underneath the cardboard cap.
The manufacturer recommends that the vaccine NOT be
transported on dry ice. Use of dry ice may subject the
product to temperatures colder than -58 degrees F (-50
degrees C).
On May 26, Merck posted information about this topic on its
website. To access it, go
here.
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9. |
CDC
publishes interim results of state-specific U.S. influenza vaccination coverage
during August 2010-February 2011
CDC published "Interim Results: State-Specific
Influenza
Vaccination Coverage--United States, August 2010-February
2011" in the June 10 issue of MMWR. A press summary of the
article is reprinted below
The CDC estimates that 2010-11 seasonal influenza (flu)
vaccination coverage among persons 6 months and older in 43
states and the District of Columbia was nearly 43 percent by
the end of February 2011. This preliminary finding suggests
that the record high national seasonal vaccination coverage
seen in 2009-10 was sustained during this non-pandemic
season. This season, national influenza vaccination coverage
increased among children (49 percent vs. 42.3 percent during
2009-10), and improved coverage among non-Hispanic black and
Hispanic children eliminated racial/ethnic disparities in
child vaccination coverage. There was wide variation in
influenza vaccination coverage between states, particularly
among children, and several states had overall coverage
levels for children that were above 60 percent. Coverage in
adults was similar to levels reported in the 2009-10 season,
and racial/ethnic disparities persisted among adults. The
2010-11 season marked the first post-pandemic vaccination
season and the first full season since the Advisory
Committee on Immunization Practices' (ACIP) universal
influenza vaccination recommendation went into effect.
Getting a flu vaccination remains the first and most
important step to prevent influenza and its complications.
To access the full article, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6022a3.htm
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10. |
IAC's popular laminated versions of the 2011 U.S. immunization schedules are
available. Order a supply for your workplace today!
IAC's laminated versions of the 2011 U.S.
child/teen and
adult immunization schedules are covered with a tough,
washable coating that lets them stand up to a year's worth
of use in every area of your workplace where immunizations
are given. Each has six pages (i.e., three double-sided
pages) and is folded to measure 8.5" by 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
To view images of the laminated schedules, or to order
online or download an order form, go to:
http://www.immunize.org/shop/laminated-schedules.asp
For quotes on customizing or placing orders in excess of 999
schedules, call (651) 647-9009 or email
admininfo@immunize.org
To learn about other essential immunization resources
available for purchase from IAC, go to:
http://www.immunize.org/shop
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11. |
Award-winning DVD! "Immunization Techniques: Best Practices with Infants,
Children, and Adults"--from the California Department of Public Health,
Immunization Branch
The California Department of Public Health (CDPH),
Immunization Branch, has updated its award-winning training
video, "Immunization Techniques: Best Practices with
Infants, Children, and Adults." The 25-minute program can be
used to train new employees and to refresh the skills of
experienced staff. The video demonstrates the skills and
techniques needed to administer vaccines to patients of all
ages.
Prices start at $17 each for 1-9 copies and are greatly
reduced for large orders, dropping to $3 each for 1,000-1,499 copies.
To learn more about the DVD, and find out how to order it,
go to: http://www.immunize.org/shop/toolkit_iztechdvd.asp
For quotes on larger quantities, call (651) 647-9009 or
email admininfo@immunize.org
The Immunization Action Coalition is the only nationwide
vendor of this new DVD.
Note for healthcare settings located in California: Contact
your local health department immunization program for a free
copy.
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12. |
May issue of CDC's Immunization Works newsletter now available
CDC recently released the May 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.
Most articles in the May Immunization Works newsletter have
been covered in this or previous issues of IAC Express. Here
is information about two topics we haven't covered.
1. Global Immunizations
- Applications for the STOP program: CDC's Stop Transmission
of Polio (STOP) program is in need of experienced mid-career
epidemiologists as global polio eradication efforts are at a
critical juncture. If you are interested in being a STOP
team member, visit the STOP application web page at
http://www.cdc.gov/vaccines/programs/stop/application.htm
- Polio in Pakistan: Pakistan is the only one of the four
polio-endemic countries that experienced an increase of
polio cases in 2011.
- Polio and Measles in DRC: In the Democratic Republic of
Congo (DRC), the political, economic, and health crises of
the early 1990s has resulted in epidemics of polio, measles,
and other diseases throughout the country. The total number
of polio cases for 2011 is 46 (through May 4, 2011). A
measles outbreak has resulted in more than 36,591 measles
cases and 288 deaths through April 24, 2011. CDC has
deployed epidemiologists to support the response to these
outbreaks. During these short term assignments Global
Immunization Division (GID) staff will collaborate with WHO
and the DRC Ministry of Health to develop vaccination
initiatives.
2. An App to Train Clinicians on Pertussis Testing:
NCIRD's Division of Bacterial Diseases (DBD) and CDC's
Electronic Media Branch, working in collaboration with
Epocrates.com (http://www.epocrates.com), have launched CDC:
Pertussis Testing, an Essential Points mobile learning
activity that is now available to healthcare professionals
and students who use Epocrates on iPhone. The activity will
be accessible for one year. DBD provided content and video
for this project. Epocrates will track participant responses
to the activity and share aggregated statistics such as open
rates, completion rates, responses to pre- and post-test
questions, and responses to the built-in survey questions
about the perceived value of the video components. Learn
more about pertussis at http://www.cdc.gov/pertussis
To access the complete May issue of Immunization Works, go
to:
http://www.cdc.gov/vaccines/news/newsltrs/imwrks/2011/201105.htm
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