Issue 1290: February 15, 2017

Ask the Experts
Ask the Experts—Question of the Week: A patient recently exposed to a bat received the rabies vaccine series. . . . read more


TOP STORIES


OFFICIAL RELEASES AND ANNOUNCEMENTS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


Following the release of the 2017 immunization schedules, CDC issues easy-to-read versions of the child, teen, and adult immunization schedules in English and Spanish

On February 7, CDC released the 2017 national immunization schedules for children/adolescents and adults in an MMWR Early Release; this news was covered in IAC Express on February 8. The same two articles were published in the February 10 issue of MMWR.

In addition, easy-to-read versions of the 2017 schedules in English and Spanish are now posted on the CDC website. Please share with the patients and parents in your sphere of influence.

Each of these pages includes a choice of the English-language schedule in color and black and white, the Spanish-language version in color, and a version formatted for displaying on a website.

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New survey from Pew Research Center shows that the majority of Americans believe benefits of vaccines outweigh risks, but concerns remain

A Pew Research Center survey conducted prior to the election found that the vaccine-hesitant views expressed by President Trump and other public figures were not held by most Americans, but some groups had more concerns than the average. The first 4 paragraphs of the report are reprinted below.

Most Americans support requiring the measles, mumps and rubella vaccine for public school children in order to protect public health. They see high preventive health benefits of such vaccines, and low risk of side effects, and they consider the benefits of the vaccine to outweigh the risks.

Yet, public concerns about childhood vaccines linger in the public discourse, often linked to a now discredited and retracted research study published nearly two decades ago that raised questions about a possible link between the measles, mumps and rubella vaccine and autism. Despite assurances of vaccine safety from the Centers for Disease Control and Prevention, the American Academy of Pediatrics, and a host of other scientific bodies that the measles, mumps, and rubella (MMR) vaccine does not cause autism, a number of prominent figures have expressed concerns about the safety of childhood vaccines. President Donald Trump raised questions about the safety of childhood vaccines on the campaign trail and during the transition period met with Robert Kennedy Jr. reportedly about the possibility of leading a commission on vaccine safety and scientific integrity. Kennedy edited a book that argues that a preservative used in some vaccines causes neurological disorders, including autism.

An overwhelming majority of Americans (82%) support requiring all healthy schoolchildren to be vaccinated for measles, mumps, and rubella. Some 73% of Americans see high preventive health benefits from use of the MMR vaccine, and 66% believe there is a low risk of side effects from the vaccine. Overall, 88% believe that the benefits of these inoculations outweigh the risks.

But there are several groups with comparatively more concern about the safety of the measles, mumps, and rubella vaccine. Foremost among them are parents of children ages 0 to 4 who have recently faced or will soon face a decision about whether to follow the recommended immunization schedule for measles, mumps, and rubella starting when their children are between 12 and 15 months old. Six-in-ten (60%) parents with children ages 0 to 4 see the preventive health benefits of the MMR vaccine as high, compared with 75% of parents with school-age children (ages 5–17) and 76% of people with no children under age 18. About half (52%) of parents with children ages 0 to 4 say the risk of side effects from the MMR vaccine is low, 43% of this group says the risk is medium or high. By comparison, 70% of those with no minor age children say the risk of side effects is low, and 29% say the risk is medium or worse.


Read the complete article: Vast Majority of Americans Say Benefits of Childhood Vaccines Outweigh Risks (HTML format)
Vast Majority of Americans Say Benefits of Childhood Vaccines Outweigh Risks (PDF format)

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More than 350 organizations write to President Trump to endorse vaccine safety

More than 350 medical, professional, and nonprofit advocacy organizations signed on to a 28-page letter drafted by the American Academy of Pediatrics (AAP) to President Trump expressing “unequivocal support” for the safety of vaccines. The letter cites more than 40 studies on vaccine safety and effectiveness, and concludes: "Put simply: Vaccines are safe. Vaccines are effective. Vaccines save lives. Our organizations welcome the opportunity to meet with you to share the robust, extensive scientific evidence supporting vaccine safety and effectiveness."

Read the complete letter to President Donald Trump, dated February 7.

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IAC Spotlight! Dr. Wexler's Technically Speaking columns on practical vaccination topics now featured on the home page of Immunize.org 

Technically Speaking, a monthly column written by IAC’s executive director Deborah Wexler, MD, covers practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules. You can now access this feature from a box in the middle of the Immunize.org home page, or by going directly to www.immunize.org/technically-speaking. The most recent column reviewed the new 2-dose HPV vaccination schedule.

The column is featured in The Children's Hospital of Philadelphia Vaccine Education Center’s (VEC's) monthly e-newsletter for healthcare professionals. Check out a recent issue of VEC's Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events. To subscribe to this newsletter, go to the sign-up form.

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A Call to Action for eliminating mother-to-child transmission of HBV in the U.S.

Representatives from the Hepatitis B Foundation, Hawaii Department of Health, Association of Asian Pacific Community Health Organizations, and the National Viral Hepatitis Roundtable have authored a document titled Eliminating Mother-to-Child Transmission of HBV in the US: A Call to Action. The first 3 paragraphs are reprinted below.

Every year, an estimated 800 to 1,200 infants in the U.S. become infected with hepatitis B virus (HBV) at birth. While this might not seem like a large number, one in four of these babies will die prematurely (in adulthood) of HBV-related complications, such as cirrhosis, liver failure, and/or liver cancer. This is unacceptable, given that we have the tools necessary to eliminate mother-to-child (perinatal) transmission of hepatitis B. However, these tools are only effective if they are used widely and consistently. Current reports show that there are gaps and lost opportunities that need to be addressed in order to eliminate perinatal transmission of HBV.

The U.S. has built a strong foundation for the prevention of hepatitis B through its Perinatal Hepatitis B Prevention Program, administered by the Centers for Disease Control and Prevention (CDC) and implemented in state and local jurisdictions across the country. The program includes routine screening of all pregnant women for HBV infection and post-exposure prophylaxis for infants born to HBV-infected mothers. Program success hinges on effective collaboration between clinical providers, birthing hospitals, and local health departments. Perinatal prevention coordinators housed at local, city, and state health departments around the U.S. serve as the critical link, ensuring that infected mothers and their babies receive necessary services.

About 25,000 births each year in the U.S. are to women who are infected with HBV. The CDC Advisory Committee on Immunization Practices (ACIP) recommends that all infants born to HBV-infected mothers receive their first dose of HBV vaccine, and a dose of hepatitis B immune globulin (HBIG), within 12 hours of birth. This regimen has been shown to be 95 percent effective in preventing perinatal infection. In 2016, ACIP took further steps to emphasize the importance of vaccinating newborns as soon as possible after birth and issued a new recommendation that newborns receive their first dose of HBV vaccine (the “birth dose”) within 24 hours of birth, replacing their previous recommendation “at hospital discharge.”


Access Eliminating Mother-to-Child Transmission of HBV in the US: A Call to Action on the National Association of County & City Health Officials website.

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Reminder: Nominations being accepted for the National Adult and Influenza Immunization Summit Excellence Awards until February 24

The National Adult and Influenza Immunization Summit (NAIIS) is still soliciting nominations for the 2017 Immunization Excellence Awards. These prestigious awards recognize individuals and organizations that have made extraordinary contributions towards improving vaccination rates within their communities during 2016. The awards focus on individuals and organizations that exemplify the meaning of the "immunization neighborhood" (collaboration, coordination, and communication among immunization stakeholders dedicated to meeting the immunization needs of the patient and protecting the community from vaccine-preventable diseases).

The national winner in each category will be invited to present their program at the 2017 NAIIS meeting, to be held May 9–11 in Atlanta, Georgia. The deadline for receipt of nominations is February 24.

Nominations are being accepted for the following six award categories:     

  • NEW: Non-Healthcare Employer Campaign
  • Laura Scott NAIIS Immunization Excellence Award for Outstanding Influenza Season Activities Campaign
  • “Immunization Neighborhood” Champion
  • Adult Immunization Champion
  • Corporate Campaign
  • Adult Immunization Publication Award

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OFFICIAL RELEASES AND ANNOUNCEMENTS


WHO publishes new position paper on tetanus vaccines

On February 10, the World Health Organization (WHO) published Tetanus vaccines: WHO position paper—2017 in its Weekly Epidemiological Record. According to WHO, these position papers are intended for use by national public health officials and managers of immunization programs, and may also be of interest to international funding agencies, vaccine advisory groups, vaccine manufacturers, the medical community, the scientific media, and the general public.
 
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FEATURED RESOURCES


Two new AAP clinical reports about adolescent immunization published online

The American Academy of Pediatrics (AAP) recently published the following two new clinical reports:
  1. The Need to Optimize Adolescent Immunization reviews the current epidemiology of meningococcus, pertussis, HPV and influenza in adolescents; and covers immunization rates and barriers to adhering to the adolescent immunization schedule.
  2. Practical Approaches to Optimize Adolescent Immunization discusses ways to improve immunization rates, including strategies to enhance parental confidence in immunization.

A summary from the AAP lists the key points highlighted in these two clinical reports.

  • Adolescent immunization rates are lower than those for younger children
  • Every healthcare visit is an opportunity to review and update immunization status
  • A strong recommendation from the healthcare provider is the most important reason why parents choose to have their children vaccinated
  • Substantial provider time may be necessary for counselling patients and families who are vaccine hesitant or wish to refuse vaccines
  • HPV vaccination presents a distinctive set of challenges
  • Healthcare technology can be useful and effective in decreasing missed opportunities for vaccination
  • Extending care into school-based settings is an alternative strategy that may help improve adolescent immunization rates

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AAP's social media toolkit can assist in developing social media accounts and crafting immunization messages

The American Academy of Pediatrics (AAP) has developed a toolkit to help pediatricians develop social media accounts and sample messages to share. Anyone can access the Immunization Social Media Toolkit from the AAP website. For example, one section allows healthcare professionals to copy and paste pre-written posts and tweets into their preferred media platform and link to immunization resources from various organizations. Another option involves parents being able to customize videos with their own pro-vaccination messages.

Access AAP's Immunization Social Media Toolkit.

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Influenza is spreading and serious; please keep vaccinating your 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


Vaccine Education Center's Parents PACK newsletter includes answers to four common vaccine safety questions

Parents PACK (Possessing, Accessing, and Communicating Knowledge about vaccines) from the Children's Hospital of Philadelphia offers an electronic newsletter for parents. The February issue includes an article titled "Four Common Vaccine Safety Questions." The questions answered are:

  • What about vaccines and autism?
  • What about vaccine ingredients?
  • Do babies get too many vaccines?
  • Why are so many vaccines given in a single visit?

Healthcare providers should check out the issue and encourage parents to subscribe to the free Parents PACK newsletter.

To find more information about their resources and subscribe to their newsletter, visit the Parents PACK web page.

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EDUCATION AND TRAINING


AAP to offer webinar on HPV vaccination on March 6
 
The American Academy of Pediatrics (AAP) will present a webinar on March 6 at 1:00 p.m. (ET) titled 2017 HPV Vaccination Update. The description is reprinted below.

Interested in learning what the new HPV vaccination series recommendations means for your practice? Unsure of how to best address commonly asked questions about HPV vaccinations from parents? Want to know more about how to increase HPV vaccination rates among your patient population? Join a panel of experts in pediatric primary care, infectious diseases, obstetrics and gynecology and ear, nose and throat for an HPV vaccination update webinar. Experts will cover a range of topics related to HPV vaccination, including the latest trends in HPV disease prevalence and prevention. 

Registration (required) is open now.

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CONFERENCES AND MEETINGS


ACIP meeting to be held on February 22–23; watch the webcast online or dial in

ACIP will hold its next meeting on February 22–23 in Atlanta. Registration is not required to watch the meeting via webcast or listen to the proceedings via phone. See the first link below for options for attending the meeting virtually.

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ASK THE EXPERTS

Question of the Week

A patient recently exposed to a bat received the rabies vaccine series. One of the doses was given in the gluteus. Does this dose count?   

No. Doses of rabies vaccine given in the gluteus should not be counted as valid and should be repeated. If repeating the invalid dose results in an interval between doses more than 3 days longer than the recommended interval, then you should perform a rabies serology 7–14 days after administration of the final dose in the series to ensure an adequate immune response to the series. For more information, see www.cdc.gov/mmwr/pdf/rr/rr5902.pdf.


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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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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