Issue 1319: August 9, 2017
Ask the Experts—Question of the Week: What is the schedule for hepatitis B vaccine administration for infants who . . . read more
TOP STORIES
VACCINE INFORMATION STATEMENTS
OFFICIAL RELEASES AND ANNOUNCEMENTS
WORLD NEWS
FEATURED RESOURCES
EDUCATION AND TRAINING
CONFERENCES AND MEETINGS
TOP STORIES
National Immunization Awareness Month is here, with the second week focusing on vaccinations for pregnant women
Every year in August, National Immunization Awareness Month (NIAM) provides an opportunity to raise awareness about the importance of immunization and the need for improving national vaccination coverage levels. NIAM is sponsored by the National Public Health Information Coalition (NPHIC). The second week, August 7–August 13, focuses on vaccinations for pregnant women.
From CDC:
The theme for the week is “Protect yourself and pass protection on to your baby.” The Centers for Disease Control and Prevention (CDC) encourages all partners to help observe NIAM and offers resources to help you highlight the importance of vaccination for people of all ages.
CDC has developed immunization tools you can use in your local outreach and education efforts. Below are the links to tools to use during NIAM and throughout the year:
The 2017 edition of the NIAM communications toolkit, put out by NPHIC in collaboration with CDC, contains key messages, vaccine information, sample news releases and articles, sample social media messages, links to web resources from CDC and other organizations, and logos, web banners, posters, and graphics to use with social media. The website also includes a place for you to share your NIAM activities and view what others are doing for NIAM, using the hashtag #NIAM17.
The first week of NIAM focused on babies and young children. The remaining weeks of August will focus on the following groups:
- August 14–20—Adults: Vaccines are not just for kids
- August 21–27—Preteens/teens: Ensure a healthy future with vaccines
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Hepatitis A outbreak claims eighth life in southern California
The recent hepatitis A outbreak in San Diego County has resulted in eight deaths, according to the County of San Diego communications office. A selection from the county's July 28 news release is reprinted below.
Eight people have now died as a result of the hepatitis A outbreak in San Diego the County Health and Human Services Agency announced today. All eight people had underlying medical conditions at the time of their death.
There have been 275 cases identified during the local outbreak, including 194 people who have been hospitalized. People who are either homeless or using illicit drugs account for at least seven in ten of the illnesses, and just over one in five also have hepatitis C.
“We continue to stress that people who are at risk should get vaccinated and people need to be vigilant about washing their hands after going to the bathroom,” said Wilma Wooten, M.D., M.P.H., County public health officer. “We are continuing to evaluate cases, but so far public health investigators have not identified any common food, drink or drug source as the contributing cause to this outbreak.”
County press release: More Hepatitis A Outbreak Deaths Reported
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Hilleman: A Perilous Quest to Save the World’s Children documentary now available to purchase
The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia has worked with Medical History Pictures to produce the documentary Hilleman: A Perilous Quest to Save the World’s Children. You can now order this film to view and/or share to help promote vaccination. A synopsis of the film is reprinted below.
The 20th century was a dangerous time to be young: a multitude of diseases too often kept children from reaching even their teenage years. Millions suffered and died. From that environment one man would emerge to lead a revolution in vaccine innovation that would save many millions of young lives every year; the greatest scientist of the 20th century, and no one knows his name.
Maurice Hilleman had a singular, unwavering focus: to eliminate the diseases of children. From his poverty-stricken youth on the plains of Montana, Hilleman came to prevent pandemic flu, invent the measles-mumps-rubella (MMR) vaccine, and develop the first-ever vaccine against human cancer.
Responsible for more than half of the vaccines children receive today, he is credited with saving more than eight million lives every year. Now through exclusive interviews with Dr. Hilleman and his peers, rare archival footage, and 3-D animation, this new documentary puts a human face to vaccine science, revealing the character that drove this bold, complex, and heroic man.
When parents began choosing not to vaccinate their children in the 1990s, a cruel irony became clear; Hilleman's unprecedented successes have allowed us to forget just how devastating childhood diseases can be.
The film is part of the Vaccine Makers Project which also includes free educational materials.
Watch the trailer for Hilleman: A Perilous Quest to Save the World’s Children.
The film is being distributed by First Run Features (FRF), and can be ordered in three different formats—DVD, Blu-Ray, and streaming.
FRF will also work with organizations interested in hosting screenings. If you are interested in hosting a screening, email gonglewska@email.chop.edu.
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AAP publishes information about coding for influenza vaccination during 2017–18 season
On August 1, the American Academy of Pediatrics' AAP News published an article titled How to code for influenza vaccine in the 2017–18 season. Healthcare professionals who provide vaccination services may find this information helpful for the upcoming 2017–18 influenza season.
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Study of audio recordings of pediatrician-parent conversations reveals how providers' use of presumptive statements in recommending HPV vaccination can improve uptake of same-day vaccination for patients
The August issue of the Journal of Adolescent Health includes an article by L. Sturm et al. titled Pediatrician-Parent Conversations About Human Papillomavirus Vaccination: An Analysis of Audio Recordings. The article reports that presumptive communication, featuring a matter-of-fact statement that a child is due for an HPV vaccine, is critical for motivating same-day HPV vaccination. A selection of the abstract is reprinted below.
Purpose
We sought to establish which human papillomavirus (HPV) vaccine communication approaches by pediatricians were associated with same-day HPV vaccination of 11- to 12-year-olds by evaluating audio recordings of visits.
Results
Same-day agreement to HPV vaccination occurred in 29% of encounters. Pediatricians in the sample often provided parents with inconsistent, mixed messages and sometimes offered information about HPV or HPV vaccination that was inaccurate. Pediatricians used presumptive language in only 11 of 75 encounters; when used, presumptive language was associated with higher odds of accepting HPV vaccine (73% vs. 22%; odds ratio = 8.96; 95% confidence interval = 2.32–34.70). Pediatricians offered or recommended delay in most encounters (65%). HPV vaccine acceptance occurred far more often when pediatricians did not mention delaying vaccination (82% vs. 6%; odds ratio = 80.84; 95% confidence interval = 15.72–415.67). Same-day vaccination was not associated with strength of recommendation or pediatrician reference to vaccinating their own children.
Conclusions
Our findings highlight the need to develop and evaluate physician-focused trainings on using presumptive language for same-day HPV vaccination.
Access the abstract.
Access the complete article: Pediatrician-Parent Conversations About Human Papillomavirus Vaccination: An Analysis of Audio Recordings.
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Voices for Vaccines plans four new podcasts, one for each week of National Immunization Awareness Month
This month, instead of one podcast, Voices for Vaccines (VFV) is producing four podcasts—one for each week of National Immunization Awareness Month (NIAM). The first podcast— Baby!—discusses how anyone can advocate during the month of August, and the importance of infant immunizations. Check back each week of NIAM for additional releases.
Voices for Vaccines is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters. VFV invites everyone who values vaccines to become a member. Please spread the word to your friends and colleagues to join VFV!
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Chicago Tribune publishes article about new measures to limit vaccination exemptions in Illinois and across U.S.
On July 30, the Chicago Tribune published an article titled New measures add pressure to anti-vaccine parents in Illinois and across U.S. A summary of the newspaper article from the National Public Health Information Coalition is reprinted below.
Supporters of childhood vaccines are turning to an array of relatively restrained measures that create pressure—legal, medical, and even social—on parents who don't want to vaccinate their school-age children. While California vaccine advocates made headlines in 2015 when they helped pass a law wiping out the state's nonmedical exemption entirely, advocates have more commonly settled for modest gains in recent years: closing loopholes, limiting eligibility and adding requirements. Since 2011, nine states have limited exemptions or added new requirements, such as parent education and more frequent renewals, according to data from the pro-vaccine Immunization Action Coalition. The CDC is encouraging states to disclose school-level immunization rates online, a practice that puts pressure on schools with low vaccination rates, and, in turn, on parents who send their children to them. And pediatricians have upped their game, with the American Academy of Pediatrics recommending the elimination of all nonmedical exemptions, as well as softening its position on pediatricians who decline to see patients if parents refuse vaccines.
Chicago Tribune: New measures add pressure to anti-vaccine parents in Illinois and across U.S.
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IAC Spotlight: Check out the "Ask the Experts" online archive for answers to immunization questions
IAC’s Ask the Experts web section is a compilation of common as well as challenging questions and answers (Q&As) about vaccines and their administration. The experts are Andrew T. Kroger, MD, MPH; Candice L. Robinson, MD, MPH; Raymond A. Strikas, MD, MPH, FACP, FIDSA; Donna L. Weaver, RN, MN; and Jessie Wing, MD, MPH, all from the National Center for Immunization and Respiratory Diseases, CDC. The Q&As archived here have been featured in previous issues of IAC Express, Needle Tips, or Vaccinate Adults.
The main "Ask the Experts" index page can be found at www.immunize.org/askexperts.
Sub-sections of "Ask the Experts" include:
- Vaccine Index where you can view Q&As organized by vaccine
- Topic Index, which includes such topics as administering vaccines, billing and reimbursement, documenting vaccination, precautions and contraindications, scheduling vaccines, storage and handling, travel vaccines, vaccine recommendations, and vaccine safety
- View All
- What's New
- Question of the Week (Q&As featured each week in IAC Express)
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VACCINE INFORMATION STATEMENTS
IAC posts Hepatitis B, HPV, and MenB VIS translations in Hindi, Punjabi, and Thai
IAC recently posted Hindi, Punjabi, and Thai translations of the Hepatitis B, HPV (human papillomavirus), and Meningococcal Serogroup B (MenB) VISs. IAC thanks the California Department of Public Health for the translations.
Hepatitis B VIS
HPV VIS
MenB VIS
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IAC posts Multi-vaccine VIS in Farsi
IAC recently posted a Farsi translation of the Multi-vaccine VIS. IAC thanks the Minnesota Department of Public Health for the translation.
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IAC posts Adenovirus VIS translation in Turkish
IAC recently posted a Turkish translation of the Adenovirus VIS. IAC thanks Betül Polatdemir, MD, Lokman Hekim Hospital Group, Ankara, and Sibel Bostancıoğlu, MD, Ankara Occupational and Environmental Diseases Hospital, Ankara, Turkey for the translation.
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OFFICIAL RELEASES AND ANNOUNCEMENTS
NACCHO releases statement about the President's proposed budget
On July 19, the National Association of County and City Health Officials (NACCHO) posted a press release on their website titled NACCHO Expresses Concern Over House Committee Cuts to Immunization Funding and Other Critical Public Health Services. The beginning of this statement is reprinted below.
The National Association of County and City Health Officials (NACCHO) representing the nation’s nearly 3,000 local governmental health departments, today expressed concern that the House Appropriations Committee is proposing to cut discretionary funding for immunization and other programs that are key to preventing disease outbreaks. It is the role of local health departments to monitor, prevent, and control disease to reduce health risks through vaccine awareness and immunization programs. The funding levels for the bill are drastically low because of artificial budget caps. The FY2018 House Labor-HHS-Education bill cuts $50 million in funding to the Centers for Disease Control and Prevention’s (CDC) immunization program. The program supports the purchase of vaccines, as well as immunization operations, at the local, state, and national levels.
Read the complete press release: NACCHO Expresses Concern Over House Committee Cuts to Immunization Funding and Other Critical Public Health Services.
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WHO issues updated position paper on diphtheria vaccination
WHO published Diphtheria vaccine: WHO position paper—August 2017 in the August 4 issue of its Weekly Epidemiological Record. This is the most recent addition to a WHO-issued series of regularly updated position papers on vaccines that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programs.
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WORLD NEWS
CDC reports on meningitis outbreak caused by vaccine-preventable bacteria in Ghana
CDC published Meningitis Outbreak Caused by Vaccine-Preventable Bacterial Pathogens—Northern Ghana, 2016 in the August 4 issue of MMWR (pages 806–10). A summary made available to the press is reprinted below.
Bacterial meningitis can lead to death and serious disabilities such as deafness, nervous system problems, and brain damage. Countries in the meningitis belt of sub-Saharan Africa, including Ghana, have the highest incidence of bacterial meningitis and experience seasonal epidemics. During 2015–2016, Ghana experienced an increase in pneumococcal meningitis followed by a large outbreak of N. meningitidis serogroup W meningitis. Based on laboratory and epidemiologic data, more than 130,000 doses of meningococcal serogroup W containing vaccine were administered to the most affected districts. Rapid identification of the bacterium causing meningitis outbreaks is critical for directing targeted public health interventions, including vaccination.
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Hepatitis B Foundation and the ShotByShot project release new video about raising adopted daughters who are chronically infected with hepatitis B
The Hepatitis B Foundation and the ShotByShot project have jointly released a video titled Maureen K's Story: #justB Assertive. Maureen K, the American mother of two Chinese adopted daughters, shares her experience of the stigma associated with having children who are chronically infected with the hepatitis B virus.
When Maureen learned that her young daughter had hepatitis B, she knew she would need to fight for her daughter's health. What she did not anticipate was the reaction from family and others who learned of the diagnosis. In this video, Maureen talks about navigating issues of disclosure and stigma with her daughter.
This video is part of the storytelling campaign: #justB: Real People Sharing their Stories of Hepatitis B. The volunteers sharing their stories do so to put a human face on this serious disease, decrease stigma and discrimination, and promote the importance of testing and treatment for hepatitis B.
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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.
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.
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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Still 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 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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EDUCATION AND TRAINING
NFID to offer webinar on maternal immunization Thursday, August 10 (tomorrow)
The National Foundation for Infectious Diseases (NFID) will present a webinar titled "Maternal Immunization: Protecting Mother and Baby" on August 10 at 12:00 p.m. (ET). Maternal immunization is recommended to protect both mothers and young infants from vaccine-preventable diseases. C. Mary Healy, MD, associate professor of pediatrics, Baylor College of Medicine, will discuss the rationale and evidence for maternal vaccination recommendations, and strategies to improve vaccination rates in pregnant women.
Access registration information.
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ACOG to present webinar about communicating with adult patients about vaccination on August 17
The American College of Obstetricians and Gynecologists (ACOG) will present a webinar titled "Don’t Wait, Vaccinate! Tips and Resources for Communicating with Adult Patients about Vaccination" on August 17 at 12:00 p.m. (ET). Upon completion of the webinar, participants will be able to:
- Understand and describe the research on how adults make vaccination decisions.
- Incorporate a strong recommendation for vaccination into routine practice.
- Utilize effective strategies to address common questions about adult vaccines.
- Identify and locate immunization resources for patient education and implementation of practice standards.
This session is free and open to all; ACOG membership not required. CME credit is available.
Access registration information.
Following the live presentation, the webinar will be archived on ACOG’s Immunization for Women website for convenient viewing, but the recording will not provide CME credit.
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CDC to offer webinar about proven practices for increasing immunization rates in adults on August 24
CDC is offering a webinar on August 24 at 12:30 p.m. (ET) titled "Peer to Peer: Proven Practices for Increasing Vaccination Rates in Adults and Pregnant Women." During this session, nurse practitioner Maria Lanzi will moderate a panel with primary care physician Dr. Marie Brown and nurse-midwife Ginny Wurttemberg, who will share their top tips for having positive and productive vaccine conversations with adult patients.
Access registration information.
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CDC webinar on positive vaccine conversations with parents set for August 25
CDC will be sponsoring a webinar on August 25 at 12:00 p.m. (ET) titled "Getting Parents to Yes! Vaccine Conversations That Work for Providers & Parents." With parents consuming so much conflicting health information about their babies and children, providing an effective vaccination recommendation can be harder than ever. Fortunately, there are strategies for discussing immunization with parents that can help them feel comfortable protecting their their babies and children with on-time immunization.
During this session, pediatrician Dr. Sharon Humiston will moderate a panel with pediatrician Dr. Nathan Boonstra and family physician Dr. Margot Savoy, who will share suggestions for having positive and productive vaccine conversations with parents.
Access registration information.
CDC's Medscape Expert Commentary series now includes guidance from Dr. Nancy Messonnier about working with vaccine-hesitant parents
CDC has posted a new "Expert Commentary" column on Medscape titled Vaccine Communication With Parents: Best Practices. This commentary features Dr. Nancy Messonnier, director of CDC’s National Center for Immunization and Respiratory Disease, discussing five research-based strategies that can help providers have positive vaccine conversations with parents.
There is no cost to view this commentary on Medscape, but you must register and log in first.
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AAP's archived 1-hour webinar on HPV vaccination now offers free CME/CNE credit
In March, the American Academy of Pediatrics (AAP) sponsored "2017 HPV Vaccination Update," a 1-hour webinar that featured discussion of the diseases and cancers caused by HPV, the safety and effectiveness of HPV vaccination, rationale for the 2-dose schedule, and effectiveness of early vaccination, as well as evidence-based recommendations for improving HPV vaccination rates. The overall goal was to improve knowledge about HPV and HPV vaccination and to give providers tools and motivation to make effective recommendations to their patients.
Free continuing education credit for watching this archived webinar is now available through the Boston University School of Medicine.
Access the webinar: HPV Vaccination is Cancer Prevention.
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AHEC to offer HPV quality improvement webinar on August 24
The National AHEC Organization will present a webinar titled "HPV Quality Improvement: Small-Scale Efforts for Practice Transformation" on August 24 at 3:00 p.m. (ET).
Access registration information.
The National AHEC Organization supports and advances the Area Health Education Center (AHEC) Network to improve health by leading the nation in recruitment, training, and retention of a diverse health work force for underserved communities.
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Reminder: Weekly CDC webinar series on "The Pink Book" chapter topics runs through October 11; register now
CDC is presenting a 15-part webinar series to provide a chapter-by-chapter overview of the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). This is a live series of weekly 1-hour webinars that started June 14 and will run through October 11. Recordings of sessions will be available online within 2 weeks after each webinar. All sessions begin at 12:00 p.m. (ET). Continuing education will be available for each event.
The webinar series will provide an overview of vaccines and the diseases they prevent, general recommendations for vaccines, vaccination principles, and immunization strategies for providers.
Registration and more information is available on CDC's Pink Book Webinar Series web page.
All the sections of "The Pink Book" (i.e., chapters, appendices, 2017 supplement) are available to download at no charge at www.cdc.gov/vaccines/pubs/pinkbook/index.html.
You can also order this resource from the Public Health Foundation for $40 plus shipping and handling. This print version does not include the 2017 supplement.
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CONFERENCES AND MEETINGS
Video presentations from the June 2017 ACIP meeting are now available online
ACIP recently posted the video presentations from the ACIP meeting held June 20–21. The presentation slides from the meeting were previously posted.
ACIP will hold its next meeting on October 25–26 in Atlanta. To attend the meeting, ACIP attendees (participants and visitors) must register online. The registration deadline for non-U.S. citizens is September 25; for U.S. citizens, it's October 5. Registration is not required to watch the meeting via webcast or listen to the proceedings via phone.
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ASK THE EXPERTS
Question of the Week
What is the schedule for hepatitis B vaccine administration for infants who weigh less than 2000 grams? I read that the birth dose should still be given in the hospital, but what would the schedule be after that?
Decreased seroconversion rates might occur among certain preterm infants (i.e., with low birth weights [less than 2,000 grams]) after administration of hepatitis B vaccine at birth. However, by the chronological age of 1 month, all preterm infants, regardless of initial birth weight, are likely to respond as adequately as larger infants. Preterm infants born to HBsAg-positive women and women with unknown HBsAg status must receive immunoprophylaxis with hepatitis B vaccine and hepatitis B immune globulin (HBIG) within 12 hours of birth. The initial vaccine dose should not be counted toward completion of the hepatitis B series, and 3 additional doses of hepatitis B vaccine should be administered, beginning when the infant is age 1 month. Infants weighing less than 2,000 g born to HBsAg-negative mothers should receive the first dose of the hepatitis B series at chronological age 1 month or at hospital discharge, whichever comes first.
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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