Issue 1244: May 4, 2016

Ask the Experts
Ask the Experts—Question of the Week: If a patient has a history of cerebrospinal fluid (CSF) leak but no current leak…read more


TOP STORIES


IAC HANDOUTS


VACCINE INFORMATION STATEMENTS


OFFICIAL RELEASES AND ANNOUNCEMENTS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


Six measles cases confirmed in Memphis area outbreak

Six cases of measles have been confirmed in Shelby County, the county encompassing the city of Memphis. Prior to this outbreak, Tennessee had reported just nine confirmed measles cases since 2004. Two paragraphs from a related New York Times article are reprinted below.

Dr. Tim Jones, the state epidemiologist for the Tennessee Department of Health, said in a telephone interview that none of the six patients had been immunized. They included infants who were too young to be immunized and at least one adult who chose to forgo immunization, all in Shelby County.

What concerns Dr. Jones is that the six people were divided into three unrelated clusters in different parts of town, and officials had been unable to piece together how their paths might have crossed.

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Download Dr. Gary Marshall's The Vaccine Handbook: A Practical Guide for Clinicians ("The Purple Book") as an app for iOS devices or purchase as a print book

The Vaccine Handbook: A Practical Guide for Clinicians  (“The Purple Book,” 2015) is a 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. This book is now available as an app for iOS devices. The Vaccine Handbook App contains the 5th edition of the book, updated with the latest immunization schedules and recommendations. The app enhances the utility of an already valuable print resource by including functions like keyword search, internal links, bookmarking, quick access to schedules and tables, hyperlinks to external sources, and the ability for real-time updates. A resources section provides ready access to authoritative immunization-related websites. Available through a collaboration between the publisher and Sanofi Pasteur, registration as well as reporting under Open Payments is required. (Offer void in Minnesota.) Click on the image below to visit the relevant App Store page to download this resource today.

Laminated Child and Teen Laminated Schedule

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CDC marks World Immunization Week by sharing historical highlights and future strategies

This year marks the 50th anniversary of World Immunization Week (April 24–30, 2016). CDC’s Center for Global Health, Global Immunization Division, marked the occasion by sharing key historical highlights, recognizing unsung global vaccination champions, and announcing CDC’s future global immunization strategies. CDC’s “Strategic Framework for Global Immunization” builds on 50 years of CDC’s public health leadership and global immunization expertise. The new plan uses vaccine strategies that protect all global citizens, including Americans, by providing an umbrella of protection against life-threatening disease.

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Visit CDC's "Keep the Momentum Going" web page for ideas to keep the NIIW energy alive 

National Infant Immunization Week (NIIW) is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and celebrate the achievements of immunization programs and their partners in promoting healthy communities. NIIW was held this year on April 16–23. CDC has published seven ways to keep the NIIW momentum going on its NIIW: Keep the Momentum Going web page. Visit this page to get great ideas for evaluating and celebrating your 2016 efforts and planning for NIIW 2017!

Related Link

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CDC reports on FDA approval for use of Hiberix as a 3-dose primary Hib vaccination series

CDC published Food and Drug Administration Approval for Use of Hiberix as a 3-Dose Primary Haemophilus influenzae Type b (Hib) Vaccination Series in the April 29 issue of MMWR (pages 418–419). The beginning of the article is reprinted below.

On January 14, 2016, GlaxoSmithKline Biologicals (Research Triangle Park, North Carolina) received approval from the Food and Drug Administration (FDA) to expand use of Hiberix (Haemophilus b Conjugate Vaccine [Tetanus Toxoid Conjugate]) for a 3-dose infant primary vaccination series at ages 2, 4, and 6 months. Hiberix was first licensed in the United States in August 2009 for use as a booster dose in children aged 15 months through 4 years under the Accelerated Approval Regulations, in response to a Haemophilus influenzae type b (Hib) vaccine shortage that lasted from December 2007 to July 2009. Expanding the age indication to include infants provides another vaccine option in addition to other currently licensed monovalent or combination Hib vaccines recommended for the primary vaccination series.


This FDA expanded age indication for Hiberix was covered in the January 20 issue of IAC Express.

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FDA provides updated information about yellow fever vaccine shortage

FDA has published an update on distribution of yellow fever vaccine during the current shortage. A paragraph from FDA's "CBER-Regulated Products: Current Shortages" website is reprinted below.

Health care providers may no longer place orders for Yellow Fever Vaccine online. Health care providers must call Sanofi Pasteur at 1-800-VACCINE (1-800-822-2463), and speak to a customer service representative. Yellow Fever Vaccine doses will be prioritized to patients who are traveling within 30 days to an area where Yellow Fever Vaccine is required or recommended.

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National Meningitis Association to host an inaugural panel discussion in New York City on May 9

The National Meningitis Association (NMA) is hosting an inaugural panel discussion, Achieving Childhood Vaccine Successes in the U.S., on May 9 from 4:30 p.m. to 6:00 p.m. (ET) at the Pierre Hotel in New York. This expert panel is open to the public and will address critical issues that hinder childhood vaccine success in the U.S. Topics covered include parents who opt out of vaccine requirements, physicians who stray from the recommended vaccine schedule, and the defining role of the media.  

Panelists will include:

  • Arthur Caplan, PhD, professor of Medical Ethics at NYU Langone Medical Center
  • Carol Baker, MD, professor of Pediatrics, Molecular Virology and Microbiology at Baylor College of Medicine in Houston
  • Paul Offit, MD, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia
  • Dorit Rubinstein Reiss, PhD, professor of Law at UC Hastings College of Law
  • William Schaffner, MD, professor of Preventive Medicine and Infectious Diseases, Vanderbilt University School of Medicine
  • Alison Singer, president of Autism Science Foundation
  • Paul Lee, MD, director of the International Adoption Program and Pediatric Travel Center at Winthrop-University Hospital in Mineola, New York (moderator)

To access an invitation, click here. NMA hopes that you will be able to join the event and/or extend this invitation to your colleagues. Please note that although this event is open to the public, an RSVP is required. To RSVP, please email Sandra Salviejo or call 212-886-2219.

There will be an accompanying Twitter chat that can be joined by following the hashtag #YesVax. Audiences will be encouraged to join the discussion and pose question for the experts.

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CDC publishes MMWR Surveillance Summary about certain health behaviors, chronic diseases, and conditions; includes information on influenza and pneumococcal vaccination rates

On April 29, CDC published an issue of MMWR Surveillance Summaries titled Surveillance for Certain Health Behaviors, Chronic Diseases, and Conditions, Access to Health Care, and Use of Preventive Health Services Among States and Selected Local Areas—Behavioral Risk Factor Surveillance System, United States, 2012. This document includes information about influenza and pneumococcal vaccination rates. The "Problem" section of the abstract is reprinted below.

Problem
Chronic diseases (e.g., heart diseases, cancer, chronic lower respiratory disease, stroke, diabetes, and arthritis) and unintentional injuries are the leading causes of morbidity and mortality in the United States. Behavioral risk factors (e.g., tobacco use, poor diet, physical inactivity, excessive alcohol consumption, failure to use seat belts, and insufficient sleep) are linked to the leading causes of death. Modifying these behavioral risk factors and using preventive health services (e.g., cancer screenings and influenza and pneumococcal vaccination of adults aged ≥65 years) can substantially reduce morbidity and mortality in the U.S. population. Continuous monitoring of these health-risk behaviors, chronic conditions, and use of preventive services are essential to the development of health promotion strategies, intervention programs, and health policies at the state, city, and county level.

Related Links

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IAC enrolls seven new birthing institutions into its Hepatitis B Birth Dose Honor Roll; two previously honored institutions qualify for second year 

The Immunization Action Coalition (IAC) is pleased to announce that seven 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.

  • Cortland Regional Medical Center, Cortland, NY (95%)
  • Holland Hospital, Holland, MI (93%)
  • Lamb Healthcare Center, Littlefield, TX (94%)
  • Moore County Hospital District, Dumas, TX (95%)
  • Oaklawn Hospital, Marshall, MI (90%)
  • St. David's Georgetown Hospital, Georgetown, TX (93%)
  • The Hospitals of Providence–Sierra Campus, El Paso, TX (100%)

In addition, the following two institutions are being recognized for a second year:

  • Auburn Community Hospital, Auburn, NY (93%)
  • ProMedica Monroe Regional Hospital (formerly Mercy Memorial Hospital System), Monroe, MI (91%)

The Honor Roll now includes 242 birthing institutions from 34 states and Puerto Rico. Seventy-one institutions have qualified for two years, twelve institutions have qualified three times, and one institution has qualified four 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 healthcare 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 percent 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 Spotlight! IAC's 84-page HepB birth dose guidebook Hepatitis B: What Hospitals Need to Do to Protect Newborns is available free online or as a hard copy for purchase

In July 2013, the Immunization Action Coalition (IAC) launched a major initiative urging the nation’s hospitals to Give birth to the end of Hep B. As part of this project, IAC developed a comprehensive guidebook for helping hospitals and birthing centers establish, implement, and optimize their birth dose policies. Hepatitis B: What Hospitals Need to Do to Protect Newborns was reviewed by the American Academy of Family Physicians, American Academy of Pediatrics, American College of Obstetricians and Gynecologists, and CDC, and is a complete policy and best practices guide for newborn hepatitis B immunization.

The guide has always been available for downloading from IAC's website, but now you can order a beautiful hard copy of this 84-page resource for $20 plus shipping. Discounts are available for those ordering in bulk.

Check out the Shop IAC: Hepatitis B: What Hospitals Need to Do to Protect Newborns page on IAC's website for more information on ordering this valuable resource.

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Reminder: IAC and Med-IQ developed two free CME courses on adult immunization

A reminder that IAC partnered with one of the nation’s premiere continuing medical education (CME) providers, Med-IQ, to develop two online courses: Vaccinating Adults With Chronic Disorders: The Specialist’s Role and Vaccinating Adults With Chronic Disorders: Insights for the Primary Care Clinician.
 
IAC’s Dr. L.J Tan recruited stellar faculty members for a guided roundtable discussion on which course audio clips are based. You will hear from experts in immunization, a cardiologist, an endocrinologist, a pharmacist, and a nurse practitioner.
 
The trainings focus on the challenges of vaccinating adults with chronic disease, from either a specialist’s perspective or from that of primary care physicians and pharmacists. The frontline perspectives and practical strategies offered will educate and empower you to be a more effective vaccinator.
 
The 30-minute specialist’s course offers 0.5 AMA PRA Category 1 credit.
 
The one-hour primary care clinician course offers 1.0 AMA PRA Category 1 credit and 1.0 Accreditation Council for Pharmacy Education (ACPE) credit.

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IAC’s “Take a Stand™” workshops are highly successful across the nation: Register NOW for a session in Boston, New York, Philadelphia, or Baltimore in June 

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, PhDWilliam 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; Little Rock, AR; San Francisco, Sacramento, Los Angeles and San Diego, CA; Fort Worth, San Antonio, and Houston, TX; Seattle, WA; Phoenix and Tucson, AZ; Orlando and Fort Lauderdale, FL; and Atlanta, GA. To illustrate how these have been going, here is a small sampling of comments received from attendees:
 
"The workshop was over and beyond what I expected...I recommend these workshops to anyone involved in immunizations." H.A.C.H., RN (California)
 
"Our workshop was…led by a deep field of nationally ranked authorities who literally wrote the book on vaccine-preventable diseases. Everyone was very knowledgeable, down to earth, and friendly. A well-paced, informal workshop with great audience participation. This is everything you need if starting from square one to implement standing orders for vaccines." 
S.P., MD (Pasadena, CA)
 
"As a new manager and nursing supervisor, this workshop was instrumental in helping me understand setting up standing orders and implementation."
T.B., BSN, MSN, APN, CNS, nursing supervisor (San Diego, CA)
 
"The information in this workshop was very timely. Increasing access to adult vaccination is challenging. These standing orders greatly simplify the process for clinicians."
J.D., PharmD, pharmacist (Sacramento, CA)
 
"The workshop was informative and made me feel motivated and ready to implement strategies to improve on our delivery service."
M.M.G., clinic supervisor (San Antonio, TX)
 
"The Take A Stand workshop will prepare you with everything you need to implement standing orders for vaccination and overcome any barriers that previously stood in your way."
G.B.K., RN, (Houston, TX)
 
Don’t miss your chance to join these satisfied attendees. The next workshops are scheduled in the following four 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.
 
sample agenda and online registration information are available on the Take a Stand™ website at www.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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IAC HANDOUTS


IAC revises its medical chart vaccine administration record forms for documenting child, teen, and adult vaccine administration

IAC recently revised its healthcare professional resources Vaccine Administration Record for Children and Teens as well as Vaccine Administration Record for Adults. These forms are for tracking patients' vaccination record in medical charts. Updates were made to take into account new ACIP recommendations and vaccine licensures regarding meningococcal serogroup B vaccination. The forms include full instructions about how to fill the record out. In addition, examples of completed forms are provided for your reference. 

Related Links

IAC's Handouts for Patients & Staff web section offers healthcare professionals and the public more than 250 FREE English-language handouts (many also available in translation), which we encourage website users to print out, copy, and distribute widely.

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IAC updates healthcare professional resource "Hepatitis B Facts: Testing and Vaccination"

IAC recently redesigned and made minor edits to Hepatitis B Facts: Testing and Vaccination. This one-page resource summarizes hepatitis B vaccination indications, testing nomenclature, and result interpretation for healthcare professionals.

Related Link

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IAC updates three educational handouts about chronic hepatitis B virus infection for parents and patients

IAC recently made minor updates to the following three handouts about chronic hepatitis B virus infection for parents and patients:

Related Link

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IAC posts updated Spanish-language translations of "Top Ten Reasons to Protect Your Child by Vaccinating" and "Human Papillomavirus (HPV): A parent's guide to preteen and teen HPV vaccination"

IAC has posted updated Spanish-language translations of the following two handouts for parents:

These translations now match the English-language versions.

Related Link

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VACCINE INFORMATION STATEMENTS


IAC posts Thai-language translation of the Tdap Vaccine VIS

IAC recently posted a Thai-language translation of the Tdap Vaccine VIS. IAC thanks Asian Pacific Health Care Venture for this translation.

Related Links

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OFFICIAL RELEASES AND ANNOUNCEMENTS


It's Hepatitis Awareness Month; fifth annual national Hepatitis Testing Day scheduled for May 19

The month of May is designated as Hepatitis Awareness Month in the U.S., and May 19 is designated Hepatitis Testing Day. During May, CDC and its public health partners work to shed light on this hidden epidemic by raising awareness of viral hepatitis and encouraging priority populations to get tested. CDC has posted many related resources on its Hepatitis Awareness Month and Hepatitis Testing Day resource center, including:

  • Digital tools, including a quiz widget and buttons, badges, and banners in different shapes and sizes that are ready to download and use on websites and in emails
  • Radio PSA scripts
  • An online risk assessment that provides a personalized report on hepatitis testing and vaccination recommendations
  • A factsheet, proclamation, posters, and more

Follow @cdchep on Twitter to receive information from CDC about hepatitis resources, tools, publications, campaign updates, and events. Use the hashtags #HepAware, #HepTestingDay, and #hepatitis to join the conversation and help CDC share information on viral hepatitis.

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FEATURED RESOURCES


Now available! IAC's sturdy laminated versions of the 2016 U.S. child/teen immunization schedule and the 2016 U.S. adult immunization schedule—order a supply for your healthcare setting today!

IAC's laminated versions of the 2016 U.S. child/teen immunization schedule and the 2016 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 Child and Teen Laminated Schedule

Adult Laminated Immunization Schedules

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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The Vaccine Handbook: A Practical Guide for Clinicians, a.k.a. "The Purple Book," by Dr. Gary Marshall available for purchase from IAC 

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.
Order your copy of The Vaccine Handbook today!
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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JOURNAL ARTICLES AND NEWSLETTERS


CDC publishes article about healthcare-associated hepatitis A outbreak in Texas

CDC published Notes from the Field: Health Care–Associated Hepatitis A Outbreak—Texas, 2015 in the April 29 issue of MMWR (pages 425–426). The first paragraph is reprinted below.

On August 27–28, 2015, the Texas Department of State Health Services received calls from Fort Bend County and Harris County health departments requesting postexposure prophylaxis (PEP) recommendations for contacts of two nurses (patients A and B) with confirmed hepatitis A virus (HAV) infection. Both nurses had symptom onset during August 15–19 and worked for the same pediatric home health care agency in another jurisdiction. Because of the proximity of the onset dates, a common source exposure was suspected. The state and local health departments began an investigation to identify potentially exposed patients, their families, and other agency personnel; offer PEP; and identify the source of exposure.


Related Links

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March and April issues of CDC's Immunization Works newsletter now available online

CDC recently released the March and April issues of its monthly newsletter Immunization Works and posted them 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.

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EDUCATION AND TRAINING


University of Pittsburgh develops training module on maximizing adult vaccination rates; continuing education credit available for physicians

The PittVax Research Team at the University of Pittsburgh Department of Family Medicine has developed a Performance in Practice Module titled Maximizing Adult Vaccinations with the 4 Pillars™ Immunization Toolkit: ABFM Maintenance of Certification Part IV–Performance in Practice Module. This module is designed for physicians who wish to maximize adult vaccination rates, and meets the requirements for the American Board of Family Medicine MOC Part IV credit.

Requirements: 
  • Read and reflect upon one case study
  • Test your knowledge regarding vaccination systems & science
  • Conduct a minimum of 10 chart audits
  • Read a self-learning module
  • Conduct a post-audit
  • Complete a short evaluation survey

The toolkit’s evidence-based "4 Pillars" incorporated in this module:

  1. Convenient vaccination services
  2. Messaging to patients
  3. Enhanced office systems
  4. Motivation

Access the registration information for Maximizing Adult Vaccinations with the 4 Pillars™ Immunization Toolkit: ABFM Maintenance of Certification Part IV–Performance in Practice Module.

Related Link


CDC Learning Connection offers public health training developed by CDC, CDC partners, and other federal agencies

The CDC Learning Connection is a new source for information about public health training developed by CDC, CDC partners, and other federal agencies. Through website features, social media, and an e-newsletter, CDC Learning Connection provides information about training opportunities, including many that offer free continuing education.

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CONFERENCES AND MEETINGS


Reminder: Registration open for CDC’s 47th National Immunization Conference on September 13–15

Registration is still open for the 47th National Immunization Conference (NIC), scheduled for September 13–15 at the Hilton Hotel in Atlanta, Georgia. The theme of the conference is Immunization: It Takes a Community. This three-day conference will include three plenary sessions, 12 breakout sessions, workshops, two immunization Q&A sessions, posters, exhibits, and the Hilleman Lecture. The meeting will highlight the following major topics:

  • Adult Immunization
  • Immunization Information Systems
  • Programmatic Issues
  • Health and Risk Communications
  • Epidemiology and Surveillance
  • Childhood and Adolescent Immunization 

There is no charge to attend the conference, but space is limited. The organizers recommend registering well in advance of the registration deadline of August 22, 2016, to guarantee availability.

Access the conference web page.

For questions related to the 47th NIC, email NIPNIC@cdc.gov.

Related Link

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ASK THE EXPERTS

Question of the Week

If a patient has a history of cerebrospinal fluid (CSF) leak but no current leak, is this a risk factor and a reason to administer PCV13 and PPSV23 to an adult?  

No. If there is no longer a CSF leak, neither vaccine is recommended, unless there is another risk factor for invasive pneumococcal disease or an age-based indication.


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 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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About IZ Express

IZ Express is supported in part by Grant No. NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.

IZ Express Disclaimer
ISSN 2771-8085

Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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