Issue 1221: December 23, 2015
Ask the Experts—Question of the Week: A dose of live attenuated influenza vaccine (LAIV, Flumist) was inadvertently given…read more
TOP STORIES
VACCINE INFORMATION STATEMENTS
WORLD NEWS
FEATURED RESOURCES
EDUCATION AND TRAINING
TOP STORIES
Happy holidays from all of us at IAC!
All of us at the Immunization Action Coalition (IAC) wish you, our readers, a safe, happy, and relaxing holiday season. Because of the holiday schedule, we will not publish another issue of IAC Express until January 6.
In observance of the upcoming holidays, the IAC office will be closed on Thursday, December 24 (Christmas Eve), Friday, December 25 (Christmas), and Friday, January 1 (New Year’s Day).
Happy holidays!
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New! December issue of Vaccinate Adults available online
The December 2015 issue of Vaccinate Adults is now online.
Click on the image below to download the entire December issue of Vaccinate Adults (16-page, 5.0 MB PDF).
Access the Table of Contents to download individual sections or pages.
This issue features information on influenza and pneumococcal vaccination, and showcases professional societies that support mandatory influenza vaccination of healthcare personnel. You’ll find new and updated vaccination resources for patients and staff, including standing orders templates, screening checklists, administration guides, and other ready-to-copy educational materials.
Also featured is the ever-popular column "Ask the Experts" from CDC medical officer Andrew T. Kroger, MD, MPH, and nurse educator Donna L. Weaver, RN, MN, both with the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention.
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If you would like to receive immediate email notification whenever new issues of Vaccinate Adults or Needle Tips are released, visit IAC's subscribe page to sign up.
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Reminder! December issue of Needle Tips available online
The December 2015 issue of Needle Tips is now online.
Click on the image below to download the entire December issue of Needle Tips (18-page, 9.0 MB PDF).
Access the Table of Contents to download individual sections or pages.
This issue features information on both influenza and pneumococcal vaccination, as well as the American Academy of Pediatrics’ reaffirmation of its policy for mandatory influenza vaccination of healthcare personnel.
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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 reports on injection safety and vaccine administration errors at an employee influenza vaccination clinic
CDC published Notes from the Field: Injection Safety and Vaccine Administration Errors at an Employee Influenza Vaccination Clinic—New Jersey, 2015 in the December 18 issue of MMWR (pages 1363–1364). This article details the vaccine administration and vaccine storage and handling errors committed by a health services company contracted to hold an onsite employee influenza vaccination clinic, and how the state immunization program responded to the situation. The first two paragraphs are reprinted below.
On September 30, 2015, the New Jersey Department of Health (NJDOH) was notified by an out-of-state health services company that an experienced nurse had reused syringes for multiple persons earlier that day. This occurred at an employee influenza vaccination clinic on the premises of a New Jersey business that had contracted with the health services company to provide influenza vaccinations to its employees. The employees were to receive vaccine from manufacturer-prefilled, single-dose syringes. However, the nurse contracted by the health services company brought three multiple-dose vials of vaccine that were intended for another event. The nurse reported using two syringes she found among her supplies to administer vaccine to 67 employees of the New Jersey business. She reported wiping the syringes with alcohol and using a new needle for each of the 67 persons. One of the vaccine recipients witnessed and questioned the syringe reuse, and brought it to the attention of managers at the business who, in turn, reported the practice to the health services company contracted to provide the influenza vaccinations.
Reuse of syringes for multiple patients, with or without reuse of needles, is recognized as a serious infection control breach that poses risks for bloodborne pathogen transmission. Upon investigation, additional concerns regarding vaccine administration and storage and handling were identified for this event. The nurse used only two multiple dose vials of vaccine (10 doses/vial) to administer vaccines to 67 adult participants; thus, participants did not receive the recommended dose of influenza vaccine. The health services company had shipped the vaccine to the nurse's home, where it was stored in her home refrigerator without temperature monitoring until the event. Vaccine doses were then transported from the nurse's home to the vaccination site using a styrofoam container and cold packs. After the event, unused vaccine doses were transported back to the nurse's home and stored in her refrigerator before being shipped back to the health services company in a container with cold packs.
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FDA expands Gardasil 9 licensure to include males age 16–26 years
On December 14, FDA expanded its approval of Merck’s 9-valent HPV vaccine, Gardasil 9 (9vHPV) vaccine to include use in males age 16–26 years. Gardasil 9 already was licensed for males ages 9–15 and females ages 9–26. The 9vHPV vaccine contains the four HPV types in 4vHPV (Gardasil; 16, 18, 6, and 11) and 5 additional "high risk" types (31, 33, 45, 52, and 58).
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FDA approves new injectable influenza vaccine, Fluad, for use in people age 65 years and older
On November 24, FDA approved a new injectable influenza vaccine, Fluad (Novartis), for people age 65 years and older. The first three paragraphs of the FDA press release are reprinted below.
The U.S. Food and Drug Administration today approved Fluad, the first seasonal influenza vaccine containing an adjuvant. Fluad, a trivalent vaccine produced from three influenza virus strains (two subtype A and one type B), is approved for the prevention of seasonal influenza in people 65 years of age and older.
Fluad, which is manufactured using an egg-based process, is formulated with the adjuvant MF59, an oil-in-water emulsion of squalene oil. Squalene, a naturally occurring substance found in humans, animals, and plants, is highly purified for the vaccine manufacturing process. Adjuvants are incorporated into some vaccine formulations to enhance or direct the immune response of the vaccinated individual.
According to the Centers for Disease Control and Prevention, in recent years, it is estimated that 80 to 90 percent of seasonal influenza-related deaths and 50 to 70 percent of seasonal influenza-related hospitalizations have occurred among people 65 years of age and older.
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IAC’s “Take a Stand™” workshops proving highly successful around the country: Register NOW for the next sessions in California (January 19–23, 2016)
The Immunization Action Coalition (IAC), with support from Pfizer, has implemented Take a Stand™, a 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 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 already have been conducted in Louisville, KY; Chicago, IL; Portsmouth, VA; Nashville, TN; and Little Rock, AR. To illustrate how these have been going, here is a small sampling of comments received from attendees:
“Not only does this workshop provide great education, but it provides you with the tools and resources you need to implement this within your practice.” J.M., APN, MPH (Chicago, IL)
“This workshop gave us great ideas and information. Can’t wait to go back and start this process to get our Standing Orders going.” T.S., clinical manager (Fredericksburg, VA)
“Fantastic—great expertise, resources, tools and advice.” D.S. (Nashville, TN)
“This workshop is excellent for nursing directors/managers in the ambulatory setting. Excellent resources for preventive services.” L.R., primary care service line nursing director (Little Rock, AR)
Don’t miss your chance to join these satisfied attendees. The next workshops are scheduled for 2016 in four California cities.
Be sure to note that these are one-time only events in each city.
Who should attend? Clinicians, nurses, and practice managers in medical offices that serve adults, as well as pharmacists and quality improvement managers, will benefit from the workshops.
In addition to the California sessions, other workshop locations and schedules, a sample agenda, and online registration are available on the Take a Stand™ website atwww.standingorders.org.
Please “take a stand” with us and spread the word about this unique opportunity for medical practices 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 healthcare 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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Every Child By Two expands mission to include timely vaccination of people of all ages
On December 14, in anticipation of its 25-year anniversary, Every Child By Two (ECBT) announced the expansion of the organization's original mission of ensuring timely vaccination of all children by the age of two, to include the importance of ensuring timely vaccination of people of all ages. A statement from ECBT executive director Amy Pisani is reprinted below.
Studies now show that young children can be further protected against diseases through the vaccination of pregnant women, adolescents, and adults. As a result, ECBT's Board of Directors recognized the need to expand the official mission of the organization. We simply could not reach our goal of protecting our nation's young children unless we also focused on protecting their families, caregivers, and other close contacts.
As part of its expanded mission, ECBT also announced that their Vaccinate Your Baby website and Facebook page, which reach nearly seven million followers annually, has been replaced with a new Vaccinate Your Family website and Vaccinate Your Family Facebook page. With the introduction of the new Vaccinate Your Family program, families can now go to ECBT's social media platforms or the new website (VaccinateYourFamily.org) to obtain information about vaccines needed for pregnant women, children, adolescents, and adults.
ECBT is asking partners to replace the www.vaccinateyourbaby.org links that have been so kindly placed on many websites with the new URL: www.VaccinateYourFamily.org. For those who have included a description along with the link, you may wish to replace the wording with, “Every Child By Two’s www.VaccinateYourFamily.org website, aimed at educating the public about the critical importance of timely vaccination of people of all ages.”
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VACCINE INFORMATION STATEMENTS
IAC posts Armenian, Hmong, Korean, and Tagalog translations of the pediatric multi-vaccine VIS
IAC recently posted Armenian, Hmong, Korean, and Tagalog translations of the pediatric multi-vaccine VIS. IAC thanks the California Department of Public Health for the translations.
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IAC posts Amharic and Tigrigna translations of the 2015–16 inactivated influenza VIS
IAC recently posted Amharic and Tigrigna translations of the 2015–16 inactivated influenza VIS. IAC thanks the Swedish Medical Center, Seattle, WA, for the translations.
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IAC posts Marshallese translation of the hepatitis B VIS
IAC recently posted a Marshallese translation of the hepatitis B VIS. IAC thanks the University of Arkansas Medical Sciences for the translation.
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WORLD NEWS
Gavi approves an additional $220 million to fight measles and rubella
The board of Gavi, the Vaccine Alliance ((formerly named the Global Alliance for Vaccines and Immunization), recently approved an additional $220 million to work on fighting measles and rubella in Gavi-eligible countries. Two paragraphs from a related press release are reprinted below.
Despite progress over the past decade, global targets to eliminate measles are significantly off-track. The disease still claims the lives of more than 100,000 people worldwide every year, most of them children under 5 years of age. The disease is so infectious that an unvaccinated person could catch measles in a doctor’s waiting room hours after an infected person has left the building. Communities with measles vaccination coverage rates lower than 90–95% are at risk of fast-spreading outbreaks, leading to numerous fatalities.
Under the new package, the Vaccine Alliance’s support for measles and rubella vaccination between 2016 and 2020 will rise from US$ 600 million to around US$ 820 million. Countries will begin to pay a co-financing share for routine measles-rubella vaccines or second dose of measles—a crucial step in ensuring long-term financial sustainability of their programmes. Long-term planning and budgeting will be a crucial part of countries’ rolling five-year measles and rubella plans.
Read the complete press release: New support for measles vaccine to help save more than one million lives
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Influenza is serious; many resources are available to help healthcare 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 healthcare 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
NFID to offer webinar on healthcare personnel vaccination on January 13
The National Foundation for Infectious Diseases (NFID) will offer a webinar titled "Vaccination for Healthcare Professionals" on January 13, at 12:00 p.m. (ET). William L. Atkinson, MD, MPH, associate director for immunization education, Immunization Action Coalition, and Patricia (Patsy) A. Stinchfield, MS, CPNP, CIC, director of Infection Prevention & Control, Children’s Hospitals and Clinics of Minnesota, will discuss vaccination for healthcare professionals. The presentation will focus on the importance of vaccines for healthcare professionals (HCPs) as well as communication strategies and tips.
At the conclusion of the webinar, participants will be able to:
- Identify vaccines recommended for HCPs by the Advisory Committee on Immunization Practices (ACIP)
- Outline factors that influence acceptance of vaccines by HCPs and apply methods and strategies to approach HCPs with differing views on vaccines to improve uptake
- Describe the effectiveness of strategies to improve HCP uptake of vaccines in healthcare settings
Access registration information.
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Register for CDC's #PreteenVaxScene webinar miniseries in January
CDC will be sponsoring a #PreteenVaxScene webinar miniseries in January. Each weekly webinar will offer perspectives on “Taming Conversations Around HPV Vaccine and Other Immunizations in Social Media” from experts in immunization, vaccine safety, vaccine acceptance, and social media. The webinar dates, times, titles, and presenters are listed below.
- January 8, 11:00 a.m. (ET): “Vaccine Hesitancy, Public Health, and Evidence-Based Research.” Presented by Seth Mnookin. Register here.
- January 14, 4:00 p.m. (ET): “To Engage or Not to Engage: That is the question for social media comments.” Presented by Julie Leask, PhD, MPH. Register here.
- January 22, 11:00 a.m. (ET): “But I saw it on the internet! Addressing safety concerns that have gone viral.” Presented by Cindy Weinbaum, MD, MPH and Melinda Wharton, MD, MPH. Register here.
- January 29, 11:00 a.m. (ET): “Harnessing Enthusiasm: Real world examples of engaging partners in social media discussions.” Presented by Karen Ernst and Christine Vara. Register here.
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Webinar on tracking, scheduling, and recommending HPV vaccine to take place on January 21
The Scenic Rivers Area Health Education Center (AHEC) is sponsoring a webinar on HPV vaccination on January 21, at 1:00 p.m. (CT). The session will focus on best practices in tracking, scheduling, and recommending the HPV vaccine with Rajiv Naik, MD. Dr. Rajiv provides pediatric care at Gundersen Health System in Onalaska, WI.
The Scenic Rivers Area Health Education Center received funding from CDC to provide education to healthcare professionals regarding the human papillomavirus (HPV) vaccine. Selected AHEC entities in all 50 states are working to increase awareness as well as train healthcare professionals about the HPV vaccine.
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ASK THE EXPERTS
Question of the Week
A dose of live attenuated influenza vaccine (LAIV, Flumist) was inadvertently given to a 20-month-old. It was the first time the child had received influenza vaccine. Does the LAIV dose need to be repeated? We plan to give pediatric inactivated vaccine as dose #2 in one month.
The minimum approved age for LAIV is age 2 years. However, you can count the dose of LAIV because this vaccine has been demonstrated to be effective in children 1–2 years of age. You are correct that the second dose should be a pediatric dose of inactivated influenza vaccine. You should take steps to avoid this sort of vaccine administration error in the future. Even if no adverse reaction occurs, we request that vaccine administration errors like this be reported to the Vaccine Adverse Events Reporting System at www.vaers.hhs.gov.
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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