Issue 1344: January 10, 2018
TOP STORIES
OFFICIAL RELEASES AND ANNOUNCEMENTS
FEATURED RESOURCES
EDUCATION AND TRAINING
CONFERENCES AND MEETINGS
TOP STORIES
IAC Spotlight! Using screening checklists for vaccine contraindications helps protect your patients
IAC’s Screening Checklists web page contains several checklists for vaccine contraindications that will help protect your patients. These checklists verify that a person is eligible for a particular vaccination on the day of the visit. The checklists can be downloaded for free from immunize.org and are available in other languages in addition to English.
Each checklist is two pages. The first page contains a form to be completed by the adult patient or by the parent or guardian if the patient is a teen or child. The form has several questions that can be answered by "yes," "no," and "not sure."
If a patient's answer is “yes” to any question, it does not necessarily mean the patient should not be vaccinated; rather, it means additional questions must be asked to determine the patient's eligibility for the vaccine.
The second page is a reference for the healthcare professional administering the vaccine. It explains why each of the questions in the patient's form was asked and how the patient’s response could affect the decision to vaccinate. This page also includes some relevant references with additional guidelines, recommendations, and resources for the healthcare provider.
The following are brief descriptions of four key screening checklists for vaccine contraindications on IAC’s Screening Checklists web page:
1. Screening Checklists for Contraindications to Inactivated Injectable Influenza Vaccination
This checklist, which applies to both children and adult patients, contains four questions to help the healthcare provider determine whether there is any reason the provider should not give the patient inactivated injectable influenza vaccination on that day. This checklist is also available in Spanish.
2. Screening Checklist for Contraindications to Vaccines for Children and Teens
This checklist asks the parent or guardian to respond to twelve questions to help determine which vaccines the child or teen can be given on that day. The accompanying page for the healthcare provider explains why each of the questions was asked and explains how that response might or might not be a contraindication for particular vaccines. This checklist is also available in Spanish, Arabic, Chinese, French, Korean, Russian, and Vietnamese.
3. Screening Checklist for Contraindications to Vaccines for Adults
This checklist asks the patient to respond to ten questions. The accompanying page for the healthcare provider explains why each of the questions was asked and explains how that response might or might not be a contraindication for vaccines. This checklist is also available in Spanish, Arabic, Chinese, French, Hmong, Korean, Russian, Turkish, and Vietnamese.
4. Screening Checklist for Contraindications to HPV, MenACWY, MenB, and Tdap Vaccines for Teens:
This checklist contains five questions to be completed by the parent or guardian. The responses will help determine if human papillomavirus (HPV), meningococcal conjugate (MenACWY), meningococcal serogroup B (MenB), and tetanus, diphtheria, and acellular pertussis (Tdap) vaccines may be given to the teen at that time. This checklist is also available in Spanish.
Other screening checklists are also available on this web page as well:
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AAP News article discusses why perinatal hepatitis B transmission occurs despite available post-exposure prophylaxis
AAP News recently published an article titled Why does perinatal HepB occur despite availability of post-exposure prophylaxis? by H.C. Meissner. The following is an excerpt from the article:
Data from the CDC suggest about 1,000 perinatal hepatitis B infections occur annually in the United States. These infections occur despite the availability of effective post-exposure prophylaxis. When properly administered, hepatitis B vaccine alone is 75% effective, and hepatitis B immune globulin (HBIG) alone is about 70% effective in preventing transmission from mother to her offspring. When both are administered as recommended, HBIG and hepatitis B vaccine have an efficacy close to 95%.
At least two reasons account for the estimated 1,000 hepatitis B perinatal infections. First, mothers with a chronic hepatitis B infection may not be identified because serology results regarding hepatitis B infection are misinterpreted, falsely reported as negative, not obtained or not communicated. In this setting, infants may not receive timely prophylaxis.
A small number of breakthrough perinatal infections occur despite appropriate prophylaxis with both hepatitis B vaccine and HBIG within 12 hours of birth to an infant born to an HBsAg-positive mother. The most likely explanation appears to be a high viral maternal load at the time of delivery that overwhelms the active and passive immunity provided by vaccine and HBIG. A high maternal viral load generally is associated with the presence of detectable hepatitis B e-antigen HBeAg in maternal serum.
Failure of HBIG and hepatitis B vaccine prophylaxis is most likely to occur in a mother with a viral load greater than 200,000 international units/milliliter (IU/mL). Administration of an antiviral agent (nucleoside analog) during gestation to mothers with a hepatitis B DNA load greater than 200,000 IU/mL has been reported to increase the effectiveness of HBIG and hepatitis B vaccine prophylaxis.
Since 2005, the Academy has recommended a birth dose of hepatitis B vaccine to all newborns. A policy statement issued in September 2017 modified the previously permissive language regarding the timing of the first vaccine dose to infants born to mothers reported to be HBsAg negative (Pediatrics.2017;140:20171870, http://pediatrics.aappublications.org/content/140/3/e20171870.full). Recommendations from the Academy and CDC now state that all medically stable infants with a birth weight of 2,000 grams or greater born to HBsAg-negative mothers receive the first of three vaccine doses within 24 hours of birth. This change serves as a safety net to prevent hepatitis B virus transmission to infants not identified due to errors in maternal testing.
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Six healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination
There are now 650 organizations 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 November 29, 2017, when IAC Express last reported on the Influenza Vaccination Honor Roll, six additional healthcare organizations have been enrolled.
IAC urges qualifying healthcare organizations to apply.
Newly added healthcare organizations, hospitals, government agencies, and medical practices
- Bartlett Regional Hospital, Juneau, AK
- University of Arkansas for Medical Sciences, Little Rock, AR
- American Red Cross Nurse Assistant Training, Santa Rosa, DE
- Tippah County Nursing Home, Ripley, MS
- Texas Health Presbyterian Hospital Denton, Denton, TX
- Virginia Hospital Center, Arlington, VA
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IAC's new 142-page book, Vaccinating Adults: A Step-by-Step Guide, describes how to implement adult vaccination services in your healthcare setting and provides a review for staff who already vaccinate adults; IAC Guide available for free download or purchase
The Immunization Action Coalition (IAC) recently announced the publication of its new book, Vaccinating Adults: A Step-by-Step Guide (Guide).
This completely updated guide on adult immunization (originally published in 2004) provides easy-to-use, practical information covering important “how-to” activities to help providers enhance their existing adult immunization services or introduce them into any clinical setting, including:
- setting up for vaccination services,
- storing and handling vaccines,
- deciding which people should receive which vaccines,
- administering vaccines,
- documenting vaccinations (including legal issues), and
- understanding financial considerations and billing information.
In addition, the Guide is filled with hundreds of web addresses and references to help providers stay up to date on the latest immunization information, both now and in the future.
Two options are available to obtain a copy of the updated Guide:
- Purchase a copy
A limited number of printed editions of this 142-page book are available for purchase at www.immunize.org/shop. The Guide’s lie-flat binding and 10 tabbed sections make it easy to locate the information being sought. Purchased copies are delivered in a box that includes Immunization Techniques: Best Practices with Infants, Children, and Adults, a 25-minute training DVD developed by the California Department of Public Health. Also included are several selected IAC print materials, such as the "Skills Checklist for Vaccine Administration," an assessment tool to assist in evaluating the skill level of staff who administer vaccines.
- Download for free and print it yourself
The entire Guide is available to download/print free of charge at www.immunize.org/guide. The downloaded version is suitable for double-sided printing. Options are available online to download the entire book or selected chapters.
The development of the Guide was supported by the National Vaccine Program Office (NVPO) and the Centers for Disease Control and Prevention (CDC). Expert staff from both agencies also provided early technical review of the content.
The Guide is a uniquely valuable resource to assist providers in increasing adult immunization rates. Be sure to get a copy today!
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CDC provides updated information on Merck hepatitis B vaccine shortage
CDC recently issued an update on the Merck hepatitis B vaccine shortage to account for a further delay in the availability of pediatric hepatitis B vaccine until April 1, 2018, rather than mid-January 2018, as reported in August. This notice appears on CDC's Current Vaccine Shortages & Delays web page:
Merck is not currently distributing its adult Hepatitis B vaccine and does not expect to be distributing adult Hepatitis B vaccine between now and the end of 2018. Additionally, Merck anticipates that its pediatric Hepatitis B vaccine will be unavailable until April 1, 2018. Merck’s supply of the dialysis formulation of Hepatitis B vaccine, however, is not affected and is expected to remain available. GSK has sufficient supplies of adult and pediatric Hepatitis B vaccines to address these anticipated gaps in Merck’s supply of adult and pediatric Hepatitis B vaccines during these time periods; however, preferences for a specific presentation (i.e., vial versus syringe) may not be met consistently during this time.
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OFFICIAL RELEASES AND ANNOUNCEMENTS
WHO publishes summary and conclusions of research and recommendations by the Immunization and Vaccine-related Implementation Research Advisory Committee in this week's Weekly Epidemiological Record
WHO published Immunization and Vaccine-related Implementation Research Advisory Committee (IVIR-AC): summary of conclusions and recommendations, 20–22 September 2017 in the January 5 issue of its Weekly Epidemiological Record. The meeting's eight sessions focused overall on the following three themes, excerpted from the report:
- Research to minimize barriers and improve coverage of vaccines currently in use
- Research to conduct impact evaluation of vaccines in use
- Research to improve development and monitoring of immunization programmes
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Influenza is spreading and serious; please keep vaccinating your patients
During the week of December 24–30, influenza activity sharply increased in the United States. CDC reported that New York City and 26 states reported high influenza-like illness (ILI) activity; Puerto Rico and nine states reported moderate activity; the District of Columbia and six states reported low activity; and nine states experienced minimal ILI activity. One influenza-associated pediatric death was reported.
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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EDUCATION AND TRAINING
Registration is open for the Epidemiology & Prevention of Vaccine-Preventable Diseases ("The Pink Book") course in Colorado, September 11–13
CDC faculty from its National Center for Immunization and Respiratory Diseases will present a comprehensive review of immunization principles and recommendations for vaccines for vaccine-preventable diseases in a 2.5-day Epidemiology and Prevention of Vaccine Preventable Diseases (The Pink Book) course. Co-hosted by the Colorado Children's Immunization Coalition and the Colorado Department of Public Health and Environment Immunization Branch, the course will take place in Greenwood Village, Colorado, on September 11–13.
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