Issue 1215: November 18, 2015
Ask the Experts—Question of the Week: Do you have any information on the use of aborted fetal cells in vaccine development?…read more
TOP STORIES
IAC HANDOUTS
VACCINE INFORMATION STATEMENTS
OFFICIAL RELEASES AND ANNOUNCEMENTS
WORLD NEWS
FEATURED RESOURCES
EDUCATION AND TRAINING
CONFERENCES AND MEETINGS
TOP STORIES
Reminder: November issues of Needle Tips and Vaccinate Adults available online
The November 2015 issues of Needle Tips and Vaccinate Adults are available online. Vaccinate Adults is an abbreviated version of Needle Tips with the pediatric content removed. Both publications focus on meningococcal vaccine recommendations for MenB and MenACWY, including many new related "Ask the Experts" Q&As from CDC medical officer Andrew T. Kroger, MD, MPH, and nurse educator Donna L. Weaver, RN, MN.
Click on the images below to download the entire November issues (PDF) of Needle Tips and/or Vaccinate Adults.
 
Needle Tips: View the table of contents, Ask the Experts section, magazine viewer, and back issues.
Vaccinate Adults: View the table of contents, Ask the Experts section, magazine viewer, and back issues.
If you would like to receive immediate email notification whenever new issues of Needle Tips or Vaccinate Adults are released, visit IAC's subscribe page to sign up.
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CDC releases final versions of PCV13 and pediatric multi-vaccine Vaccine Information Statements
On November 5, CDC released final versions of the PCV13 and the pediatric multi-vaccine Vaccine Information Statements (VISs). These VISs were updated from “interim” to “final” versions with minimal changes. The title of the pediatric multi-vaccine was changed from "Your Baby's First Vaccines" to "Your Child’s First Vaccines," and the pneumococcal conjugate vaccine VIS had "PCV13" added to the title. The formatting and some section titles also changed. CDC encourages providers to begin using these VISs immediately; however, stocks of the previous editions may be used until gone.
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Register for IAC's "Take a Stand™” workshops in 2016 to learn all about standing orders for adult vaccination
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.*
At the core of this project are free, interactive workshops 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.
Mark your calendar to attend one of these workshops in 2016:
- January 19: San Francisco, California
- January 20: Sacramento, California
- January 22: Los Angeles, California
- January 23: San Diego, California
- February 16: Fort Worth, Texas
- February 17, San Antonio, Texas
- February 19: Houston, Texas
- March 15: Seattle, Washington
- March 17: Phoenix, Arizona
- March 18: Tucson, Arizona
- April 12: Orlando/Daytona Beach, Florida
- April 13: Fort Lauderdale, Florida
- April 15: Atlanta, Georgia
- June 6: Boston, Massachusetts
- June 8: New York, New York
- June 9: Philadelphia, Pennsylvania
- June 11: Baltimore, Maryland
If you are a medical staff member in a medical practice serving adults, register today for one of these free educational workshops. Physicians, practice managers, nurse practitioners, physician assistants, and nurses in medical offices that serve adults are encouraged to attend.
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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Reminder: Call-to-action letter from national organizations emphasizes the importance of second dose of MCV4 vaccine
The American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American College Health Association (ACHA), Society for Adolescent Health and Medicine (SAHM), Centers for Disease Control and Prevention (CDC), and Immunization Action Coalition (IAC) have issued a joint “Dear Colleague” letter, urging health care professionals to strongly recommend and administer the second (booster) dose of meningococcal ACWY vaccine (MenACWY or MCV4) at age 16.
According to CDC, the meningococcal meningitis booster vaccination rate is an estimated 28.5% for eligible teens, compared to 79.3% for the primary dose. Despite CDC recommendations for a booster dose at age 16, after an initial vaccination at age 11 or 12, fewer than 30% of 17-year-olds have received the second vaccination needed to enhance protection against meningococcal meningitis caused by serogroups A, C, W, and Y. The “Dear Colleague” letter supports a national call-to-action for health care professionals to improve this alarming statistic.
CDC strongly recommends a booster dose at age 16 because protection wanes in most teens within five years after the primary vaccination. By vaccinating fewer than 1 in 3 eligible teens, we are leaving millions of young adults without the protection they need against potentially deadly and crippling meningococcal disease. Meningococcal meningitis has a 10–15% fatality rate and cases have occurred in which an otherwise healthy young person contracts the illness, becomes severely sick, and dies in as few as 24 hours after the first symptoms appear.
The “Dear Colleague” letter includes a statement from Anne Schuchat, MD, principal deputy director of CDC, who notes, “A clinician’s endorsement of immunization has long been recognized as a key factor in improving immunization rates.”
To help health care professionals in their efforts to recommend meningococcal meningitis vaccine and improve immunization rates, IAC has developed several resources that are available on its website at www.immunize.org/meningococcal. In addition, health care professionals can visit www.Give2MCV4.org to download free educational materials and tools, including fact sheets, talking points, an overview of adolescent immunization recommendations, Q&As, and other useful resources.
The joint “Dear Colleague” letter serves as a rallying cry for all health care providers to assure your adolescent patients are adequately protected. Remember—You’re not done if you give just one! Give 2 doses to strengthen protection.
Related Links
“Dear Colleague” letter
Meningococcal resources from Give2MCV4 project
Meningococcal Resources from IAC
Meningococcal Resources from CDC
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CDC reports on cases of meningococcal disease among men who have sex with men
CDC published Notes from the Field: Meningococcal Disease Among Men Who Have Sex with Men—United States, January 2012–June 2015 in the November 13 issue of MMWR (pages 1256–1257). The first four sentences and last two paragraphs are reprinted below.
Since 2012, three clusters of serogroup C meningococcal disease among men who have sex with men (MSM) have been reported in the United States. During 2012, 13 cases of meningococcal disease among MSM were reported by the New York City Department of Health and Mental Hygiene; over a 5-month period during 2012–2013, the Los Angeles County Department of Public Health reported four cases among MSM; and during May–June 2015, the Chicago Department of Public Health reported seven cases of meningococcal disease among MSM in the greater Chicago area. MSM have not previously been considered at increased risk for meningococcal disease. Determining outbreak thresholds for special populations of unknown size (such as MSM) can be difficult.
Information on MSM and HIV status of men reported with meningococcal disease is not currently noted on most meningococcal case report forms. However, representative and complete data on MSM and HIV status are needed to better understand the epidemiology of and potential risk factors for meningococcal disease among MSM in the United States and to inform prevention and control recommendations.
Health departments are encouraged to attempt to determine MSM and HIV status during investigations of meningococcal disease cases caused by any serogroup occurring among males aged ≥16 years. If permitted by state law, state health departments are asked to complete a supplemental case report form (available at http://www.cdc.gov/meningococcal/surveillance/index.html) for all cases of meningococcal disease occurring among MSM and submit the forms to CDC via e-mail (meningnet@cdc.gov) or via fax (404-315-4681).
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IAC Spotlight! Five health care organizations join IAC's Influenza Vaccination Honor Roll for mandatory health care worker vaccination
More than 580 organizations are now enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, medical practices, professional organizations, health departments, and government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for health care personnel.
Since October 27, when IAC Express last reported on the Influenza Vaccination Honor Roll, five additional health care organizations have been enrolled.
IAC urges qualifying health care organizations to apply.
Newly added health care organizations, hospitals, government agencies, and medical practices
- Community Hospital, Anderson, IN
- Endwell Family Physicians, Endwell, NY
- Haywood Pediatrics, Clyde, NC
- Pediatric Care North, Kansas City, MO
- Wayne Memorial Community Health Centers, Honesdale, PA
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IAC enrolls five more birthing institutions into its Hepatitis B Birth Dose Honor Roll; five previously honored institutions qualify for a second year
The Immunization Action Coalition (IAC) is pleased to announce that five new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.
- Inland Hospital, Waterville, ME (90%)
- Maine General Medical Center, Augusta, ME (91%)
- North Kansas City Hospital, North Kansas City, MO (93%)
- Weatherford Regional Hospital, Weatherford, OK (98%)
- York Hospital, York, ME (90%)
In addition, the following five institutions are being recognized for a second year:
- Community Hospital Anderson, Anderson, IN (99%)
- Mercy Hospital Lebanon, Lebanon, MO (95%)
- Mercy Hospital NWA, Rogers, AR (91%)
- Mercy Hospital Washington, Washington, MO (95%)
- Spectrum Health Grand Rapids Hospital, Grand Rapids, MI (98%)
The Honor Roll now includes 215 birthing institutions from 34 states and Puerto Rico. Sixty 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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IAC HANDOUTS
IAC updates "Administering Vaccines: Dose, Route, Site, and Needle Size"
IAC recently updated its resource for health care professionals titled Administering Vaccines: Dose, Route, Site, and Needle Size. Information was added about administering meningococcal serotype B vaccines and some abbreviations were changed.
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IAC's Handouts for Patients & Staff web section offers health care 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 revises "How to Administer Intramuscular and Subcutaneous Vaccine Injections to Adults"
IAC recently revised How to Administer Intramuscular and Subcutaneous Vaccine Injections to Adults. The sentence "To avoid causing an injury, do not inject too high (near the acromion process)" was revised to read, "To avoid causing an injury, do not inject too high (near the acromion process) or too low."
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IAC revises "How to Administer Intradermal, Intranasal, and Oral Vaccinations"
IAC recently revised How to Administer Intradermal, Intranasal, and Oral Vaccinations. The abbreviation "IN" (intranasal) was changed to "NAS."
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VACCINE INFORMATION STATEMENTS
IAC posts Haitian Creole translations of the 2015–16 influenza VISs
IAC recently posted Haitian Creole translations of the VISs for the 2015–16 inactivated influenza vaccine (IIV) and 2015–16 live attenuated influenza vaccine (LAIV). IAC thanks the Massachusetts Department of Public Health for the translations.
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IAC posts corrected Portuguese translation of the DTaP VIS
IAC recently posted a revised Portuguese translation of the DTaP VIS. An astute reader noticed that in Section 3 the original translation read "HPV" in one place instead of "DTaP."
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OFFICIAL RELEASES AND ANNOUNCEMENTS
WHO Strategic Advisory Group of Experts on Immunization requests nominations for new members
The World Health Organization (WHO) is soliciting proposals for nominations for current and future vacancies on its Strategic Advisory Group of Experts (SAGE) on Immunization. Nominations are solicited from all regions and are required to be submitted no later than January 15, 2016.
SAGE is the principal advisory group to WHO for vaccines and immunization. All members are acknowledged experts with an outstanding record of achievement in their own field and an understanding of the immunization issues covered by SAGE.
For more information, access WHO Strategic Advisory Group of Experts (SAGE) on Immunization: Request for nominations.
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WORLD NEWS
CDC and WHO report on global routine vaccination coverage in this week's MMWR and Weekly Epidemiological Report, respectively
CDC published Global Routine Vaccination Coverage, 2014 in the November 13 issue of MMWR (pages 1252–1255). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Global routine vaccination coverage, 2014. A media summary of the MMWR article is reprinted below.
The year 2014 marks the 40th anniversary of the World Health Organization’s (WHO) Expanded Program on Immunization, which was established to ensure equitable access to routine immunization services. Since 1974, global coverage with the four core vaccines (Bacille Calmette-Guérin vaccine [BCG; for protection against tuberculosis], diphtheria-tetanus-pertussis [DTP] vaccine, poliovirus vaccine, and measles vaccine) has increased from <5 percent to ≥85 percent, and additional vaccines have been added to the recommended schedule. However, global DTP3 coverage has remained unchanged at 86 percent since 2013, with 65 (34 percent) countries having not yet met the GVAP target of 90 percent national coverage. To reach and sustain global goals of vaccination coverage >90 percent in every country, adequate vaccine stock management and additional opportunities for immunization, such as through routine visits in the second year of life, are integral components to strengthening immunization programs and reducing morbidity and mortality from vaccine preventable diseases.
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CDC and WHO report on worldwide measles elimination
CDC published Progress Toward Regional Measles Elimination—Worldwide, 2000–2014 in the November 13 issue of MMWR (pages 1246–1251). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Progress towards regional measles elimination, worldwide, 2000–2014. A media summary of the MMWR article is reprinted below.
During 2000–2014, measles vaccination prevented an estimated 17.1 million deaths. During this period, annual reported measles incidence declined 73 percent worldwide, from 146 to 40 cases per million population, and annual estimated measles deaths declined 79 percent from 546,800 to 114,900. However, progress toward the elimination goals has slowed markedly since 2010. In countries with a high measles burden and low vaccine coverage, long-standing policy and practice gaps need to be addressed to increase routine immunization coverage. High-quality supplementary immunization activities should be used to improve routine services. As coverage improves, establishing a second-year-of-life visit integrating measles vaccination and other child-health interventions should further reduce measles cases and deaths.
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London School of Hygiene & Tropical Medicine and PATH report on HPV vaccine delivery in 37 low- and middle-income countries
During 2014–2015, the London School of Hygiene & Tropical Medicine and PATH conducted the first comprehensive review of HPV vaccine delivery experiences across 37 low- and middle-income countries. A recently released report's highlights include key findings and lessons from HPV vaccination experience across the following five themes: preparation, communications, delivery, achievements, and sustainability. Also addressed are the value of demonstration projects and potential HPV vaccination pitfalls.
Access HPV Vaccine Lessons Learnt. This web section includes links to a project overview, maps, videos, slides, and thematic briefs.
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The One & Only campaign offers resources to raise awareness about safe injection practices
The One & Only Campaign is a public health campaign, led by CDC and the Safe Injection Practices Coalition (SIPC), to raise awareness among patients and health care professionals about safe injection practices. A selection of background information from the campaign's website is reprinted below.
Since 2001, more than 150,000 patients in the United States have been notified of potential exposure to hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV due to lapses in basic infection control practices. Many of these lapses involved health care providers reusing syringes, resulting in contamination of medication vials or containers which were used then on subsequent patients.
The goal of the One & Only Campaign is to ensure patients are protected each and every time they receive a medical injection. This will be attained by empowering patients and re-educating health care providers regarding safe injection practices. Targeted education and awareness campaigns focus on influencing the culture of patient safety. Patients and providers must both insist on nothing less than One Needle, One Syringe, Only One Time for each and every injection.
Order print publications related to injection safety from CDC-INFO on Demand or download them from the campaign website.
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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.
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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EDUCATION AND TRAINING
Listen to any of the archived sessions of CDC's webinar series on "The Pink Book" chapter topics
CDC has just completed a 15-part webinar series that provided a chapter-by-chapter overview of the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). At this time, continuing education credit is no longer available, but all the sessions are archived and can still 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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CONFERENCES AND MEETINGS
First Institute of Medicine committee meeting on eliminating hepatitis B and C from the United States to be held November 30–December 1; meeting will include open sessions
The first meeting of the Institute of Medicine (IOM) committee on "A National Strategy for the Elimination of Hepatitis B and C" will be about the social, logistical, and scientific feasibility of eliminating hepatitis B from the United States. Speakers at the public workshop discuss the science of elimination and the challenges of reaching the hepatitis B patient and managing their condition, as well as the advances in virology and immunology that underlie the elimination goal.
During the open sessions of this meeting, there will be an opportunity for attendees to ask questions or to offer suggestions.
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ASK THE EXPERTS
Question of the Week
Do you have any information on the use of aborted fetal cells in vaccine development?
Please see this article which summarizes the use of cells which produced the MRC5 and WI138 cell lines for certain vaccines used in humans:
http://www.historyofvaccines.org/content/articles/human-cell-strains-vaccine-development.
The cells were taken from infants aborted for other reasons, and no new cells have been harvested since the 1960s. Rubella vaccine is one of those developed with such cells. Other commonly used vaccines from these cell lines include hepatitis A vaccines, varicella vaccine, and zoster (shingles) vaccine.
The National Council of Catholic Bishops has deemed use of such vaccines acceptable, if no other alternatives exist.
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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