Issue 1297: April 5, 2017

Ask the Experts
Ask the Experts—Question of the Week: A 7-year-old has a history of 3 doses of DTaP, appropriately spaced . . . read more


TOP STORIES


OFFICIAL RELEASES AND ANNOUNCEMENTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


New! April 2017 issue of Needle Tips is available online

The April 2017 issue of Needle Tips is now online.

This issue highlights the 16-year-old immunization visit platform in the 2017 U.S. child/teen immunization schedule, IAC’s popular summaries of immunization recommendations, and the 2017 U.S. immunization schedules for children/teens and for adults. You’ll also read about the new edition of The Vaccine Handbook: A Practical Guide for Clinicians (aka “The Purple Book”) and its newly updated app for iOS (Apple) devices available free from IAC via the iTunes store.

The April issue also features the always popular “Ask the Experts” column, with Q&As by experts from CDC’s National Center for Immunization and Respiratory Diseases.

Click on the image below to download the entire April issue of Needle Tips (30-page, 12.87 MB PDF).

Access the Table of Contents (HTML) to download individual sections or pages.

Download the November issue of Vaccinate Adults

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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 our Subscribe to IAC page to sign up.

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New edition of The Vaccine Handbook: A Practical Guide for Clinicians, a.k.a. "The Purple Book," by Dr. Gary Marshall available for purchase from IAC; free app for iPhones and iPads available from IAC

The 6th edition of The Vaccine Handbook: A Practical Guide for Clinicians ("The Purple Book") is considered a vital source of practical, up-to-date information for vaccine providers and educators. Now printed in color and updated with the latest vaccine information through early 2017, The Purple Book draws 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.

The sixth edition of this valuable guide (592 pages) is available on IAC's website at www.immunize.org/vaccine-handbook. The price of the handbook is $34.95 per copy, plus shipping charges. Order copies for your staff or for distribution at an upcoming conference.

Discount pricing is available for more than 10 copies. For quotes on larger quantities, email admininfo@immunize.org.

Order your copy today! Click on the image below to visit the "Shop IAC: The Vaccine Handbook" web page.
Order your copy of The Vaccine Handbook today!

The Vaccine Handbook App for Apple iPhones and iPads is available free from IAC. Sorry, the app is not available for android devices. Book purchase is not necessary but registration to obtain the app is required.

The app is fully searchable, allows for bookmarking, highlighting and annotation, and contains hyperlinks to valuable content from nonprofit and governmental sources.

Click on the image below to visit the The Vaccine Handbook App page in the iTunes store.

Download new app!

About the Author
Gary S. 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.

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Now available! IAC's sturdy laminated versions of the 2017 U.S. child/teen immunization schedule and the 2017 U.S. adult immunization schedule—order a supply for your healthcare setting today!

IAC's laminated versions of the 2017 U.S. child/teen immunization schedule and the 2017 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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IAC Spotlight! IAC enrolls nine new birthing institutions into its Hepatitis B Birth Dose Honor Roll; 13 previously honored institutions qualify for additional years' honors

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

  • Baylor, Scott & White Medical Center–Waxahachie, Waxahachie, TX (92%)
  • Cogdell Memorial Hospital, Snyder, TX (100%)
  • Coon Memorial Hospital, Dalhart, TX (95%)
  • McLaren Central Michigan, Mt. Pleasant, MI (91%)
  • MidMichigan Health–Midland, Midland, MI (92%)
  • OSF St. Francis Hospital and Medical Group, Escanaba, MI (90%)
  • Rolling Plains Memorial Hospital, Sweetwater, TX (90%)
  • Sparrow Carson Hospital, Carson City, MI (90%)
  • Unity Health–Harris Medical Center, Newport, AR (94%)

The following five institutions are being recognized for a second year:

  • Holland Hospital, Holland, MI (91%)
  • Mercy Health Muskegon, Muskegon, MI (93%)
  • MidMichigan Health–Midland, Midland, MI (91%)
  • Morton Hospital, Taunton, MA (95%)
  • Sparrow Carson Hospital, Carson City, MI (92%)

In addition, the following six institutions are being recognized for a third year:

  • Mercy Health Muskegon, Muskegon, MI (92%)
  • Beaumont Hospital–Wayne, Wayne, MI (92%)
  • MidMichigan Health–Gratiot, Alma, MI (94%)
  • MidMichigan Health–Midland, Midland, MI (93%)
  • Morton Hospital, Taunton, MA (94%)
  • Three Rivers Health, Three Rivers, MI (92%)

Finally, the following two institutions are being recognized for a fourth year:

  • Beaumont Hospital–Wayne, Wayne, MI (91%)
  • Sinai-Grace Hospital, Detroit Medical Center, Detroit, MI (94%)

Note: A number of these institutions qualified for multiple 12-month periods at one time.

The Honor Roll now includes 333 birthing institutions from 38 states, Puerto Rico, and Guam. Seventy institutions have qualified for two years, 37 institutions have qualified three times, 8 institutions have qualified four times, and 3 institutions have qualified five 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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Reminder: CDC 6-part NetConference series about adult immunization scheduled for Wednesdays, April 12–May 31

CDC's 6-part NetConference series on vaccinating adults will start next week. A collaborative effort between CDC and Maryland’s adult immunization coalition and state immunization program, the "Vaccinating Adults" series will feature 6 presentations by experts in promoting, administering, and securing reimbursement for adult immunizations.

  • Wednesday, April 12—Burden of Vaccine-Preventable Diseases in Adults: Medical, Social, and Economic Costs
  • Wednesday, April 19—Provider Reimbursement for Adult Immunizations
  • Wednesday, April 26—Immunizing Adults: Immunization Schedule, Coverage, and Challenges
  • Wednesday, May 17—Immunizing Older Adults and the Chronically Ill
  • Wednesday, May 24—Immunizing Pregnant Women, Health Care Personnel, and in the Workplace
  • Wednesday, May 31—Clinic Logistics: Vaccine Administration, Storage, and Handling

Each session will start at 12:00 p.m. (ET).

Continuing education will be available for each event. The series will be archived later on CDC's website.

Advanced registration is required to participate.

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OFFICIAL RELEASES AND ANNOUNCEMENTS


National Academies publishes phase 2 of  "A National Strategy for the Elimination of Hepatitis B and C"; related webinar scheduled for April 10

On March 28, the National Academies of Science, Engineering, and Medicine (National Academies) published a consensus report, A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report. It is available to the public at nationalacademies.org/HepatitisElimination. This report provides a useful set of goals and recommendations, and identifies innovative concepts to resolve difficult issues. A summary is reprinted below.

Each year, hepatitis B virus and hepatitis C virus cause nearly 1.5 million deaths worldwide—more than HIV, tuberculosis, and malaria. Such loss of life comes at a cost to society through the direct expense of treatment as well as through the loss of adults in their prime. In an effort to describe a strategy for eliminating viral hepatitis as a U.S. public health problem by 2030, the National Academies, with support from the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services, the American Association for the Study of Liver Diseases, the Infectious Diseases Society of America, and the National Viral Hepatitis Roundtable, convened an expert committee to outline a national strategy. The committee produced two reports. The first report, Eliminating the Public Health Problem of Hepatitis B and C in the United States: Phase One Report, concluded that both hepatitis B and C could be eliminated as a public health problem in the United States, but that there are substantial obstacles to meeting this goal. This second report, A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report, recommends specific actions to hasten the end of these diseases and lays out five areas—information, interventions, service delivery, financing, and research—to consider in the national plan.

On April 10, Hep B United and the National Viral Hepatitis Roundtable will sponsor a community discussion on this consensus report from 2:00 p.m. to 3:00 p.m. (ET). Brian L. Strom, MD, MPH, chair, Committee on a National Strategy for the Elimination of Hepatitis B and C and chancellor, Rutgers University, the State University of New Jersey, will present the National Academies' recommendations.

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National Institutes of Health releases statement about World Tuberculosis Day

On March 24, the National Institutes of Health (NIH) released NIH Statement on World Tuberculosis Day. The first three paragraphs are reprinted below.

Tuberculosis (TB) is one of the world’s most devastating infectious diseases. March 24th marks the day in 1882 when German microbiologist Robert Koch announced he had discovered Mycobacterium tuberculosis, the bacterium that causes this ancient scourge. Today, in recognition of World TB Day, the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), reasserts its commitment to improving our understanding of TB and how to prevent, diagnose, and treat it. Around the globe, researchers and the public health community are united in working toward these goals.

TB is the world’s leading cause of death from an infectious disease, especially among women and children. The World Health Organization estimates that more than 1.8 million people worldwide died of TB in 2015. The symptoms of the disease, which is transmitted through the air and primarily affects the lungs, often begin with coughing, shortness of breath, or swollen lymph nodes—but can end in death if left untreated. People with HIV are especially vulnerable: of deaths among people co-infected with HIV and TB, about one quarter are due to TB. In addition, the World Health Organization estimates that about one-third of the world’s population is infected with “latent” TB, in which people carry the bacterium while exhibiting no symptoms. Five to 10 percent of these latent TB carriers risk developing active TB at some point in their lifetimes. For latent TB carriers who are infected with HIV, this risk is approximately 10 percent per year. Finally, it is important to note that smoking substantially increases TB disease occurrence and risk of death due to TB worldwide.

A safe and highly effective vaccine against TB will be a critical tool in ultimately controlling the infection. Currently, the only available vaccine against TB is bacille Calmette-Guerin (BCG), developed in 1921. While this vaccine offers protection against disseminated disease and death in children, it is much less effective against the transmissible pulmonary form of the disease in adults. NIAID supports research across the spectrum of basic, preclinical, and clinical development to arrive at innovative new approaches toward the development of vaccines to prevent this disease.


Access the complete NIH Statement on World Tuberculosis Day.

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WORLD NEWS


Africa unites to confront threat of polio; over 116 million children to be immunized

On March 24, UNICEF and the Global Polio Eradication Initiative posted a joint press release titled From coast to coast: Africa unites to tackle threat of polio. The first two paragraphs are reprinted below.

More than 190,000 polio vaccinators in 13 countries across west and central Africa will immunize more than 116 million children over the next week, to tackle the last remaining stronghold of polio on the continent.
 
The synchronized vaccination campaign, one of the largest of its kind ever implemented in Africa, is part of urgent measures to permanently stop polio on the continent. All children under five years of age in the 13 countries—Benin, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of Congo, Guinea, Liberia, Mali, Mauritania, Niger, Nigeria, and Sierra Leone—will be simultaneously immunized in a coordinated effort to raise childhood immunity to polio across the continent. In August 2016, four children were paralysed by the disease in security-compromised areas in Borno state, north-eastern Nigeria, widely considered to be the only place on the continent where the virus maintains its grip. 


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WHO publishes update on yellow fever vaccination recommendations for travelers to Brazil

On March 20, the World Health Organization (WHO) published an update on yellow fever vaccination recommendations for international travelers related to the current situation in Brazil. Selections from the update are reprinted below.

As of 16 March 2017, yellow fever virus transmission continues to expand towards the Atlantic coast of Brazil in areas not deemed to be at risk for yellow fever transmission prior to the revised risk assessment...

The WHO Secretariat has determined that the State of Rio de Janeiro, with the exception of the urban areas of Rio de Janeiro City and Niterói, and the State of São Paulo, with the exception of the urban areas of São Paulo City and Campinas, should also be considered at risk for yellow fever transmission.

Consequently, vaccination against yellow fever is recommended for international travellers visiting those areas in the States of Rio de Janeiro and São Paulo. The typology of activities that international travellers anticipate to undertake while visiting areas determined to be at risk for yellow fever transmission should be weighted in the risk-benefit analysis informing the individual decision to be immunized against yellow fever.


Access the complete update: Updates on yellow fever vaccination recommendations for international travellers related to the current situation in Brazil.

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CDC publishes two articles about a yellow fever outbreak in Democratic Republic of the Congo

CDC published the following related articles in the March 31 issue of MMWR

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WHO publishes report on epidemic meningitis control in countries of the African meningitis belt

The World Health Organization (WHO) published Epidemic meningitis control in countries of the African meningitis belt, 2016 in the March 31 issue of its Weekly Epidemiological Record. The first two paragraphs are reprinted below.
 
Meningococcal meningitis is a bacterial disease caused by
Neisseria meningitidis (N.m). Of the 13 subtypes or serogroups of N.m. identified, 4 (N.m. A, B, C and W) are recognized to be the main causes of epidemics, while occasional outbreaks are also caused by N.m. X and Y. Meningococcal meningitis cases occur throughout the world. However, large, recurring epidemics affect an extensive region of sub-Saharan Africa known as the “meningitis belt” which comprises 26 countries from Senegal in the west to Ethiopia in the east. In this area, outbreaks occur during the dry “epidemic” season, usually covering the first half of the year. Before 2010, serogroup A was responsible for the large majority of epidemics in this area.

Starting in 2010, the progressive introduction of a meningococcal A conjugate vaccine (MACV) in the epidemic-prone areas of 19 countries of the African meningitis belt through preventive mass vaccination campaigns has dramatically reduced N.m. A cases and eliminated N.m. A epidemics in these areas. To sustain this success, the campaign strategy should be followed by the introduction of the vaccine into the routine childhood immunization programme within 1–5 years following campaign completion, along with a one-time catch up campaign for birth cohorts born since the mass campaign and not targeted by the routine immunization programme.


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FEATURED RESOURCES


Boost Oregon offers new downloadable booklet, Parents’ Guide to Children’s Vaccines

Boost Oregon, a parent-led community that educates Oregonians about the safety and benefits of childhood vaccinations, has developed a booklet for parents that can be downloaded from their website. Parents’ Guide to Children’s Vaccines is a 32-page booklet that answers such questions as:
  • How to Sort through the Noise
  • Can I Space Out My Child’s Shots?
  • Aren’t Vaccines Just Moneymakers for Pharmaceutical Companies?
  • How Do Vaccines Fit into a Natural Lifestyle?
Download Parents’ Guide to Children’s Vaccines and refer your vaccine-questioning parents to this great new resource.

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JOURNAL ARTICLES AND NEWSLETTERS


New study in Vaccine shows that parental perceptions about influenza vaccine have a strong influence on vaccine acceptance

On April 4, the journal Vaccine published Psychological factors associated with uptake of the childhood influenza vaccine and perception of post-vaccination side-effects: A cross-sectional survey in England. Three sections of the abstract are reprinted below.

OBJECTIVES
To identify predictors of uptake of the childhood influenza vaccine in the 2015–2016 influenza season, parental perceptions of side-effects from the influenza vaccine and intention to vaccinate one's child for influenza in the 2016–2017 influenza season.

RESULTS
Self-reported uptake of the childhood influenza vaccine was 52.8%. Factors strongly positively associated with uptake included the child having previously been vaccinated against influenza, perceiving the vaccine to be effective, and perceiving the child to be susceptible to flu. Factors strongly negatively associated with uptake included perceiving the vaccine to be unsafe, to cause short-term side-effects or long-term health problems, and believing that yearly vaccination may overload the immune system. Predictors of intended vaccine uptake in 2016 2017 were similar. Participants who perceived side-effects after the 2015–2016 vaccination reported being less likely to vaccinate their child next year. Side-effects were more likely to be reported in first-born children, by participants who knew another child who had side-effects, those who thought that the vaccine would interact with medication that the child was currently taking, and those who believed the vaccine causes short-term side-effects.

CONCLUSIONS
Perceptions about the childhood influenza vaccine show strong associations with uptake, intended uptake, and perception of side-effects. Attempts to improve uptake rates from their current low levels must address these perceptions.


Access the complete article.

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Study finds HPV vaccine inadvertently administered during pregnancy to be safe 

On March 30, the New England Journal of Medicine published Quadrivalent HPV Vaccination and the Risk of Adverse Pregnancy Outcomes. The abstract is reprinted below.

BACKGROUND
The quadrivalent human papillomavirus (HPV) vaccine is recommended for all girls and women 9 to 26 years of age. Some women will have inadvertent exposure to vaccination during early pregnancy, but few data exist regarding the safety of the quadrivalent HPV vaccine in this context.

METHODS
We assessed a cohort that included all the women in Denmark who had a pregnancy ending between October 1, 2006, and November 30, 2013. Using nationwide registers, we linked information on vaccination, adverse pregnancy outcomes, and potential confounders among women in the cohort. Women who had vaccine exposure during the prespecified time windows were matched for propensity score in a 1:4 ratio with women who did not have vaccine exposure during the same time windows. Outcomes included spontaneous abortion, stillbirth, major birth defect, small size for gestational age, low birth weight, and preterm birth.

RESULTS
In matched analyses, exposure to the quadrivalent HPV vaccine was not associated with significantly higher risks than no exposure for major birth defect (65 cases among 1665 exposed pregnancies and 220 cases among 6660 unexposed pregnancies; prevalence odds ratio, 1.19; 95% confidence interval [CI], 0.90 to 1.58), spontaneous abortion (20 cases among 463 exposed pregnancies and 131 cases among 1852 unexposed pregnancies; hazard ratio, 0.71; 95% CI, 0.45 to 1.14), preterm birth (116 cases among 1774 exposed pregnancies and 407 cases among 7096 unexposed pregnancies; prevalence odds ratio, 1.15; 95% CI, 0.93 to 1.42), low birth weight (76 cases among 1768 exposed pregnancies and 277 cases among 7072 unexposed pregnancies; prevalence odds ratio, 1.10; 95% CI, 0.85 to 1.43), small size for gestational age (171 cases among 1768 exposed pregnancies and 783 cases among 7072 unexposed pregnancies; prevalence odds ratio, 0.86; 95% CI, 0.72 to 1.02), or stillbirth (2 cases among 501 exposed pregnancies and 4 cases among 2004 unexposed pregnancies; hazard ratio, 2.43; 95% CI, 0.45 to 13.21).

CONCLUSIONS
Quadrivalent HPV vaccination during pregnancy was not associated with a significantly higher risk of adverse pregnancy outcomes than no such exposure. 


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EDUCATION AND TRAINING


2017 AAP HPV Vaccination Update webinar now archived and available for viewing at your convenience
 
The American Academy of Pediatrics' (AAP) "HPV Vaccination Update" webinar originally presented on March 6 is now archived on YouTube for viewing at your convenience.

This webinar will help office teams:
  • Optimize HPV vaccine timing and scheduling
  • Increase HPV vaccination rates
  • Answers parents’ FAQs on HPV

Speakers include experts in pediatrics, infectious disease, obstetrics and gynecology, and ear, nose, and throat medicine.

The slides can be downloaded from www.aap.org/hpvtoolkit. Go to “Toolkit Resources” under “What’s new with HPV Vaccine.”

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Area Health Education Center Network and the Postgraduate Institute for Medicine to present HPV webinar on April 6

The Area Health Education Center (AHEC) Network and Postgraduate Institute for Medicine will present a webinar on April 6 at 2:00 p.m. (ET) titled "HPV Vaccination: A Pinch of Prevention is Worth a Pound of Cure."

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National Influenza Vaccination Disparities Partnership to host April 20 webinar about strategies to protect underserved populations against influenza

The National Influenza Vaccination Disparities Partnership (NIVDP) will host the webinar, "Lessons from the Field: Immunization Leaders Sharing Strategies to Protect Underserved Populations" on April 20 at 2:00 p.m. (ET). Coinciding with National Minority Health Month, this is the perfect time to raise awareness about flu vaccination disparities and take action to close the gap. Webinar panelists will include:

  • Dr. Arlene Lester, Region IV regional minority health consultant, Office of Minority Health, U.S. Department of Health and Human Services
  • Claire Hannon, executive director, Association of Immunization Managers
  • Josana Tonda, national coordinator, Ventanillas de Salud Program
  • Catherine Flores-Martin, executive director, California Immunization Coalition

Registration information

The National Influenza Vaccination Disparities Partnership is a national multi-sector campaign, spearheaded by local influential partners who commit to promote the importance of flu vaccination among underserved populations. The partnership is supported by CDC.

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CONFERENCES AND MEETINGS


Opportunity to see new documentary, Hilleman: A Perilous Quest to Save the World’s Children, on April 25 at the NFID Annual Conference on Vaccine Research in Bethesda

A new documentary, Hilleman: A Perilous Quest to Save the World’s Children, will be screened at 5:30 p.m. (ET) on April 25 as part of the National Foundation for Infectious Diseases (NFID) Annual Conference on Vaccine Research at the Bethesda North Marriott Hotel & Conference Center. This event is free and open to the public. A description of the film follows.

The greatest scientist of the 20th century, and no one knows his name. This documentary tells the inspiring story of Dr. Maurice Hilleman, a man with a singular, unwavering focus: to eliminate the diseases of children. From his poverty-stricken youth on the plains of Montana, he came to prevent pandemic flu, develop the measles-mumps-rubella (MMR) vaccine, and invent the first-ever vaccine against human cancer. Now through exclusive interviews with Dr. Hilleman and his peers, rare archival footage, and 3-D animation, this film puts a human face to vaccine science, revealing the character that drove this bold, complex, and heroic man. 

After the film, there will be a Q&A with Paul A. Offit, MD, Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia as well as the Maurice R. Hilleman Professor of Vaccinology and a Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. 


Registration information

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ASK THE EXPERTS

Question of the Week

A 7-year-old has a history of 3 doses of DTaP, appropriately spaced, between 4 years and 6 years of age. Is her DTaP series complete?  

Although the child would be considered complete for tetanus and diphtheria toxoids, she is not complete for pertussis vaccine. ACIP recommends that children age 7 through 10 years who are not fully vaccinated against pertussis (defined as 5 doses of DTaP or 4 doses of DTaP if the fourth dose was administered on or after the fourth birthday) and who do not have a contraindication to pertussis vaccine should receive a single dose of Tdap to provide protection against pertussis. The child may also receive an additional dose of Tdap at 11 or 12 years of age. See MMWR 2011;60(No.1):13–15 and footnote 12 of the 2017 child and adolescent immunization schedule, available at www.cdc.gov/vaccines/schedules/hcp/child-adolescent.html.


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.

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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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