Issue 1274: November 9, 2016
Ask the Experts—Question of the Week: An adolescent received the first
dose of hepatitis B vaccine at age 11 years but did not…read more
TOP STORIES
VACCINE INFORMATION STATEMENTS
- IAC posts Hmong-, Farsi-, Khmer-, and Korean-language translations of the HPV9 VIS
- IAC posts Hmong-, Farsi-, and Korean-language translations of the PCV13 VIS
- IAC posts Hmong-, Korean-, and Tagalog-language translations of the Tdap VIS
- IAC posts Farsi-language translation of the Haemophilus influenzae (Hib) VIS
- IAC posts Karen-language translations of the hepatitis A, hepatitis B, serogroup B meningococcal (MenB), and polio VISs
WORLD NEWS
FEATURED RESOURCES
JOURNAL ARTICLES AND NEWSLETTERS
TOP STORIES
Reminder: October issues of Needle Tips and Vaccinate Adults are available online
The October issues of Needle Tips and Vaccinate Adults are now available online. Vaccinate Adults is an abbreviated version of Needle Tips
with the pediatric content removed. Both publications feature important
information about the 2016–17 influenza recommendations, including related "Ask
the Experts" Q&As 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, CDC. In addition, they include many immunization
resources that healthcare professionals can use in their practice settings,
including IAC's standing orders templates for administering influenza and
pneumococcal vaccines (PCV13 and PPSV23).
Click on the images below to download the October 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 ACIP recommendations for use of meningococcal conjugate vaccines in HIV-infected persons
CDC published
Recommendations for Use of Meningococcal Conjugate Vaccines in HIV-Infected
Persons—Advisory Committee on Immunization Practices, 2016 in the November 4 issue of MMWR
(pages 1189–94). A summary made available to the press is reprinted below.
At its June 2016 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of meningococcal conjugate (serogroups A, C, W, and Y) vaccine for people age 2 months or older with human immunodeficiency virus (HIV) infection. ACIP has previously recommended routine vaccination of people age 2 months or older who have certain medical conditions that increase risk for meningococcal disease. Routine vaccination with meningococcal conjugate vaccine is also recommended for all healthy adolescents in the United States.
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Three cases of meningococcal serogroup B disease confirmed at the University of
Wisconsin–Madison; University Health Services recommends vaccination for all
undergraduates through age 25
The University of Wisconsin–Madison confirmed a third case of meningococcal
serogroup B disease recently. An excerpt from the university's press release is reprinted below.
Testing has identified meningococcal disease in a third UW–Madison student.
This student is currently being treated at a local hospital. University Health
Services (UHS) is working with Public Health Madison Dane County to notify
individuals who have been in close contact with the student so appropriate
preventive care can be provided...
UHS, in consultation with local and state health officials, continues to
strongly urge that all UW–Madison undergraduate students through age 25 get
vaccinated against meningococcal disease serogroup B...
To date, more than 12,000 students—about 41 percent of the undergraduate
population—have received first doses of the vaccine.
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Four healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination
Six hundred 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 healthcare personnel.
Since October 12, when IAC Express last reported on the Influenza Vaccination Honor Roll, four additional healthcare organizations have been enrolled.
IAC urges qualifying healthcare organizations to apply.
Newly added healthcare organizations, hospitals, government agencies, and medical practices
- Gallatin City-County Health Department, Bozeman, MT
- Hebrew Senior Life, Boston, MA
- North Oaks Health System, Hammond, LA
- Norton County Hospital and Medical Clinic, Norton, KS
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IAC issues a clarification for November 2 Question of the Week
In IAC Express issue #1273, the Question of the Week and answer read:
A 32-year-old patient with ulcerative colitis is taking high-dose immunosuppressive medications (6-mercaptopurine). Should he receive meningococcal vaccine?
There is no specific indication for meningococcal vaccine in this patient. He is
older than 21 years, and the risk–based recommendations are restricted to
specific forms of altered immunocompetence (persistent complement component
deficiency, functional or anatomic asplenia, use of eculizumab and HIV
infection) and are not inclusive of other forms of altered immunocompetence.
It should have been specified that the question relates to MenACWY (MCV4) and not MenB vaccine. The indications listed in the answer are for quadrivalent meningococcal vaccine. ACIP does not consider HIV infection to be an indication for MenB vaccine.
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VACCINE INFORMATION STATEMENTS
IAC posts Hmong-, Farsi-, Khmer-, and Korean-language translations of the HPV9 VIS
IAC recently posted Hmong-, Farsi-, Khmer-, and Korean-language translations of the HPV9 VIS. IAC thanks the California Department of Public Health for the translations.
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IAC posts Hmong-, Farsi-, and Korean-language translations of the PCV13 VIS
IAC recently posted Hmong-, Farsi-, and Korean-language translations of the PCV13 VIS. IAC thanks the California Department of Public Health for the translations.
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IAC posts Hmong-, Korean-, and Tagalog-language translations of the Tdap VIS
IAC recently posted Hmong-, Korean-, and Tagalog-language translations of the Tdap VIS. IAC thanks the California Department of Public Health for the translations.
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IAC posts Farsi-language translation of the Haemophilus influenzae (Hib) VIS
IAC recently posted a Farsi-language translation of the Haemophilus influenzae (Hib) VIS. IAC thanks the California Department of Public Health for the translation.
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IAC posts Karen-language translations of the hepatitis A, hepatitis B, serogroup B meningococcal (MenB), and polio VISs
IAC recently posted Karen-language translations of the hepatitis A, hepatitis B, serogroup B meningococcal (MenB), and polio VISs. IAC thanks St. Peter's Health Partners for the translations.
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WORLD NEWS
CDC and WHO report on progress toward polio eradication in Afghanistan in this week's MMWR and Weekly Epidemiological Report, respectively
CDC published
Progress Toward Poliomyelitis Eradication—Afghanistan, January 2015?August 2016 in the November 4 issue of MMWR
(pages 1195–99). On the same day, WHO's Weekly Epidemiological Record published a similar article titled
Progress towards poliomyelitis eradication: Afghanistan, January 2015–August
2016. A media summary of the MMWR article is reprinted below.
During 2015, the number of wild poliovirus cases reported in Afghanistan declined by 29% compared with 2014. Trends observed so far in 2016 suggest that poliovirus circulation in the country is limited to a few areas. The drop in the number of polio cases in Afghanistan mirrors global trends, which were at a historic low in 2015. Despite this progress, Afghanistan faces significant constraints in its quest to interrupt poliovirus circulation by the end of the year. The deteriorating security situation in the Eastern and Northeastern regions of the country considerably limits the ability to reach and vaccinate children in these regions, and substantial numbers of children are still being missed in areas that are accessible during polio immunization activities.
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Influenza is serious; many resources are available to help healthcare professionals vaccinate patients
Influenza vaccination is recommended for everyone six months of age 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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JOURNAL ARTICLES AND NEWSLETTERS
New research finds fatal measles complication to be more common than previously thought
New research presented at IDWeek found that subacute sclerosing panencephalitis (SSPE), a fatal complication of measles infection, is more common than previously thought. An excerpt from Fatal measles complication more common than previously understood, published in Helio: Infectious Disease News, is reprinted below.
Subacute sclerosing panencephalitis [SSPE]—a 100% fatal complication of
measles—occurs much more often than previously thought, according to data
presented at IDWeek 2016. The recent finding underscores the importance of herd
immunity with the measles-mumps-rubella vaccine to protect infants and those who
are immunocompromised...
Previous research estimated that the risk of SSPE was one in 100,000. However, a more recent analysis in Germany established that the rate of SSPE was one in 1,700 among children infected with measles before 5 years of age. The current study suggests the prevalence may be even higher.
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Study finds no link between Tdap vaccination during pregnancy and microcephaly and other birth defects
JAMA recently published a research letter titled Tdap Vaccination During Pregnancy and Microcephaly and Other Structural Birth Defects in Offspring. The first two paragraphs are reprinted below.
In 2012, the US Advisory Committee on Immunization Practices recommended
tetanus, diphtheria, and acellular pertussis (Tdap) vaccine be administered
during every pregnancy, ideally between 27 and 36 weeks’ gestation. Previously,
Tdap was recommended for unvaccinated pregnant women since 2010 in California
and since 2011 across the United States.
Cases of microcephaly in Brazil increased substantially during 2015, likely
associated with maternal Zika virus infections. However, these cases overlapped
with the November 2014 initiation of Brazil’s maternal Tdap program. Previous
small observational studies reported no increased risks for birth defects
following maternal Tdap vaccination; none focused on microcephaly. This large
study examined associations between maternal Tdap vaccination and structural
birth defects, including microcephaly, in offspring.
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ASK THE EXPERTS
Question of the Week
An adolescent received the first dose of hepatitis B vaccine at age 11 years but did not return for subsequent doses. If the patient comes back at age 16 years, is it necessary to repeat the first dose of the series?
It is not necessary to restart or add doses to the hepatitis B series (or any other routine vaccine series) because of a prolonged interval between doses. Just continue the series from the point where it was interrupted.
About IAC's Question of the Week
Each week, IAC Express highlights a new, topical, or
important-to-reiterate Q&A. This feature is a cooperative venture between IAC
and CDC. William L. Atkinson, MD, MPH, IAC's associate director for immunization
education, chooses a new Q&A to feature every week from a set of Q&As prepared
by experts at CDC’s National Center for Immunization and Respiratory Diseases.
We hope you enjoy this feature and find it helpful when dealing with difficult real-life scenarios in your vaccination practice. Please encourage your healthcare professional colleagues to sign up to receive IAC Express at www.immunize.org/subscribe.
If you have a question for the CDC immunization experts, you can email them directly at nipinfo@cdc.gov. There is no charge for this service.
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