Issue 1357: March 28, 2018
TOP STORIES
OFFICIAL RELEASES AND ANNOUNCEMENTS
WORLD NEWS
FEATURED RESOURCES
JOURNAL ARTICLES AND NEWSLETTERS
CONFERENCES AND MEETINGS
TOP STORIES
HHS secretary Alex Azar will name Robert R. Redfield, MD, new director of CDC
On Wednesday, March 21 the Department of Health and Human Services (HHS) announced that HHS Secretary Alex Azar will name Robert R. Redfield, MD, as the new director of CDC.
Read the HHS press release.
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CDC publishes report on tuberculosis in the U.S. in 2017 in this week’s MMWR
CDC published Tuberculosis—United States, 2017 in the March 23 issue of MMWR (pages 317–323). The first paragraph is reprinted below.
In 2017, a total of 9,093 new cases of tuberculosis (TB) were provisionally reported in the United States, representing an incidence rate of 2.8 cases per 100,000 population. The case count decreased by 1.8% from 2016 to 2017, and the rate declined by 2.5% over the same period. These decreases are consistent with the slight decline in TB seen over the past several years. This report summarizes provisional TB surveillance data reported to CDC’s National Tuberculosis Surveillance System for 2017 and in the last decade. The rate of TB among non-U.S.-born persons in 2017 was 15 times the rate among U.S.-born persons. Among non-U.S.-born persons, the highest TB rate among all racial/ethnic groups was among Asians (27.0 per 100,000 persons), followed by non-Hispanic blacks (blacks; 22.0). Among U.S.-born persons, most TB cases were reported among blacks (37.1%), followed by non-Hispanic whites (whites; 29.5%). Previous studies have shown that the majority of TB cases in the United States are attributed to reactivation of latent TB infection (LTBI). Ongoing efforts to prevent TB transmission and disease in the United States remain important to continued progress toward TB elimination. Testing and treatment of populations most at risk for TB disease and LTBI, including persons born in countries with high TB prevalence and persons in high-risk congregate settings, are major components of this effort.
Read the entire article.
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Following the MMWR Early Release last week of an article on the yellow fever outbreak in Brazil, CDC published the same article in the current issue of MMWR
On March 23, CDC published Fatal Yellow Fever in Travelers to Brazil, 2018 (pages 340–341). The same article was published as an MMWR Early Release on March 16; this was covered in IAC Express on March 21.
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CDC's Digital Media Toolkit now available for National Infant Immunization Week, April 21–28
CDC's 2018 NIIW Digital Media Toolkit is now available for planning and implementing your activities for National Infant Immunization Week (NIIW), occurring April 21–28 this year. NIIW is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and to celebrate the achievements of immunization programs and their partners in promoting healthy communities. The media toolkit contains a range of suggested social media activities, including digital graphics and messaging, as well as tools for planning and developing promotional materials for the press and public service announcements.
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IAC Spotlight! IAC’s Adult Vaccination Handouts web page contains many free ready-to-print materials you can use to make sure your adult patients are vaccinated
IAC's Adult Vaccination Handouts web page on immunize.org contains many free, CDC-reviewed print materials you can use to make sure your adult patients are vaccinated. This web page can be found by selecting the "Handouts & Staff Materials" tab (second from the left) in the light gray banner across the top of every immunize.org web page and then selecting "Adult Vaccination" in the drop-down menu.
The Adult Vaccination Handouts web page contains a wide range of ready-to-print resources for both healthcare professionals and for patients. Each item is accompanied by a brief description. When you hover over or click on the handout's title, a preview of its image appears. Most of the handouts for patients are available in Spanish as well as English, and a few are available in six other languages as well.
The following are the categories of print materials available on the Adult Vaccination Handouts web page.
Visit the Adult Vaccination Handouts web page to access materials that will support and enhance your immunization of the adults in your practice.
IAC's Handouts for Patients & Staff web section offers healthcare professionals and the public more than 250 FREE English-language handouts (many also available in translation), which we encourage website users to print out, copy, and distribute widely.
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IAC corrects three slides on its PowerPoint slide set "The Importance of Minimum Ages and Intervals in the Vaccine Schedule"; the entire set can be requested from IAC’s PowerPoint web page
IAC has corrected three slides on its 46-slide set titled The Importance of Minimum Ages and Intervals in the Vaccine Schedule.
Slide 25 was corrected by adding the word "healthy" to clarify that it is a minimum age error to give the second dose of MenACWY vaccine before age 16 to a healthy adolescent.
The third bullet in Slide 27 was corrected to state that a common minimum interval error is giving the second dose of a HPV vaccine series without at least 5 months between the two doses.
Slide 39 was corrected to state that in a 3-dose HPV schedule, the third dose of HPV can be considered to be valid if it was separated from the first dose by at least 5 months (instead of 6 months) and from the second dose by at least 12 weeks.
To obtain this PowerPoint slide set, go to IAC's PowerPoint Slide Sets web page, and just below the presentation's tile and description, click on "Request the PowerPoint slide set" and IAC will email the PowerPoint presentation to you. Once you have received the presentation, you can edit and use it as you see fit.
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Five healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination
There are now 664 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 February 28, when IAC Express last reported on the Influenza Vaccination Honor Roll, five additional healthcare organizations have been enrolled.
IAC urges qualifying healthcare organizations to apply.
Newly added healthcare organizations, hospitals, government agencies, and medical practices
- Kaiser Permanente, Riverside, CA
- Coastal Pediatric Medical Group, Oxnard, CA
- Jackson County Medical Care Facility, Jackson, MI
- CHI St. Alexis Health-Williston, Williston, ND
- Cody Regional Health (West Park Hospital), Cody, WY
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Nominations for AIM's Natalie J. Smith, MD Award and AIM Rising Star Award can be submitted until April 6
The Association of Immunization Managers (AIM) is soliciting nominations for the Natalie J. Smith, MD Award and the AIM Rising Star Award from among the 64 federally-funded state, local, and territorial immunization program managers. Nominations must be submitted by April 6.
The Natalie J. Smith, MD Award is presented in recognition of outstanding management and leadership skills in the area of state and national vaccine-preventable disease programs. This award is the highest form of recognition for immunization program managers.
The AIM Rising Star Award recognizes a new program manager who demonstrates effective leadership and potential for growth within AIM.
AIM presents several awards each year to its members in recognition of their outstanding initiatives, service, dedication, and leadership. These awards will be presented at the 2018 AIM Leadership in Action conference in San Diego this June.
Access additional information and the submissions form for the Natalie J. Smith, MD Award.
Access additional information and the submissions form for the AIM Rising Star Award.
AIM was founded in 1999 with the purpose of enabling collaboration among immunization managers to prevent vaccine-preventable diseases and improve immunization coverage in the United States. Its membership includes representatives from all 64 state, territorial, and local National Center for Immunization and Respiratory Diseases awardees.
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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
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.
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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OFFICIAL RELEASES AND ANNOUNCEMENTS
WHO publishes "Recommended composition of influenza virus vaccines for use in the 2018–2019 northern hemisphere influenza season" in this week's Weekly Epidemiological Record
WHO published Recommended composition of influenza virus vaccines for use in the 2018–2019 northern hemisphere influenza season in the March 23 issue of the Weekly Epidemiological Record (pages 133–141). Below is a summary of the recommendations presented in a text box on page 139 of the article.
It is recommended that quadrivalent vaccines for use in the 2018–2019 northern hemisphere influenza season contain the following:
– an A/Michigan/45/2015 (H1N1)pdm09-like virus;
– an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus;
– a B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage); and
– a B/Phuket/3073/2013-like virus (B/Yamagata/16/88 lineage).
It is recommended that the influenza B virus component of trivalent vaccines for use in the 2018–2019 northern hemisphere influenza season be a B/Colorado/06/2017-like virus of the B/Victoria/2/87-lineage.
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WORLD NEWS
WHO reports over 1,300 people in Yemen contracted diphtheria and 70 died; campaign to vaccinate 2.7 million children has been completed
The World Health Organization (WHO) has reported that over 1,300 people in Yemen have contracted diphtheria and 70 have died since October 2017. WHO also reported that it has completed its campaign to vaccinate 2.7 million children between six weeks and 15 years old in the 11 governorates at highest risk for the disease. Eighty percent of those infected with diphtheria have been children and young adults under 25 years old. More than 6,000 health workers participated in the effort to engage communities in the immunization effort and to administer the vaccine in a country where only 50% of its health system is functioning and the sanitation systems have been seriously compromised after three years of war.
Read the complete WHO report.
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Two polio workers killed and others injured in ambush by militants in tribal region of Pakistan
Two polio workers were killed recently and two others were seriously injured in an ambush by gunmen in a remote tribal region of Pakistan. A paramilitary officer defending the workers was also killed.
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Flu vaccination still recommended as long as influenza viruses are circulating
CDC has reported in its Weekly U.S. Influenza Surveillance Report, FluView, that as of the week ending March 17, influenza activity decreased in the United States, although it was still widespread, with 5 additional pediatric deaths. The total number of pediatric deaths since October 1, 2017 is 128. The proportion of outpatient visits for influenza-like illness (ILI) was 2.7%, which is above the national baseline of 2.2%. Nine of 10 regions reported ILI at or above region-specific baseline levels. The geographic spread of influenza in 17 states was reported as widespread.
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
Pediatrics publishes study showing a bundled communication intervention may improve HPV vaccination rates
In its March issue, Pediatrics published Provider Communication, Prompts, and Feedback to Improve HPV Vaccination Rates in Resident Clinics, by C.M. Rand, et al., showing that a bundled communication intervention may improve vaccination rates. The abstract is reprinted below.
BACKGROUND AND OBJECTIVES: Human papillomavirus (HPV) vaccination rates lag behind vaccination rates for other adolescent vaccines; a bundled intervention may improve HPV vaccination rates. Our objective is to evaluate the impact of quality improvement (QI) training plus a bundled practice-based intervention (provider prompts plus communication skills training plus performance feedback) on improving HPV vaccinations in pediatric resident continuity clinics.
METHODS: Staff and providers in 8 resident clinics participated in a 12-month QI study. The intervention included training to strengthen provider communication about the HPV vaccine. Clinics also implemented provider prompts, received monthly performance feedback, and participated in learning collaborative calls. The primary outcome measure was eligible visits with vaccination divided by vaccine-eligible visits (captured HPV vaccination opportunities). Practices performed chart audits that were fed into monthly performance feedback on captured HPV vaccination opportunities. We used conditional logistic regression (conditioning on practice) to assess captured vaccination opportunities, with the time period of the study (before and after the QI intervention) as the independent variable.
RESULTS: Overall, captured opportunities for HPV vaccination increased by 16.4 percentage points, from 46.9% to 63.3%. Special cause was demonstrated by centerline shift, with 8 consecutive points above the preintervention mean. On adjusted analyses, patients were more likely to receive a vaccine during, versus before, the intervention (odds ratio: 1.87; 95% confidence interval: 1.54–2.28). Captured HPV vaccination rates improved at both well-child and other visits (by 11.7 and 13.0 percentage points, respectively).
CONCLUSIONS: A bundled intervention of provider prompts and training in communication skills plus performance feedback increased captured opportunities for HPV vaccination.
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WHO publishes "Antigenic and genetic characteristics of zoonotic influenza viruses and development of candidate vaccine viruses for pandemic preparedness" in this week's Weekly Epidemiological Record
WHO published Antigenic and genetic characteristics of zoonotic influenza viruses and development of candidate vaccine viruses for pandemic preparedness in the March 23 issue of its Weekly Epidemiological Record (pages 142–152). The first two paragraphs are reprinted below.
The development of influenza candidate vaccine viruses (CVVs), coordinated by WHO, remains an essential component of the overall global strategy for pandemic preparedness. Selection and development of CVVs are the first steps towards timely vaccine production and do not imply a recommendation for initiating manufacture. National authorities may consider the use of one or more of these CVVs for pilot lot vaccine production, clinical trials and other pandemic preparedness purposes based on their assessment of public health risk and need.
Zoonotic influenza viruses continue to be identified and evolve both genetically and antigenically, leading to the need for additional CVVs for pandemic preparedness purposes. Changes in the genetic and antigenic characteristics of these viruses relative to existing CVVs, and their potential risks to public health, justify the need to select and develop new CVVs.
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CDC publishes “Notes from the Field: Typhoid Fever Outbreak—Harare, Zimbabwe, October 2016–March 2017" in this week’s MMWR
CDC published Notes from the Field: Typhoid Fever Outbreak—Harare, Zimbabwe, October 2016–March 2017 in the March 23 issue MMWR (pages 342–343). The first two paragraphs are reprinted below.
In October 2016, the Harare City Health Department (HCHD) surveillance system recorded the beginning of an upward trend in typhoid cases. On December 27, 2016, after the typhoid fever–associated death of a student, the Ministry of Health and Child Care (MOHCC) in Zimbabwe declared an outbreak of typhoid fever. HCHD defined a suspected case in a resident of Harare City as an illness that began on or after October 6, 2016, with fever ≥100.4°F (38°C), body pains, headache, and abdominal pain. Patients with confirmed cases had blood or stool specimens positive for Salmonella Typhi.
HCHD reported 860 cases with illness onset from October 6, 2016, through March 8, 2017, including 780 suspected cases, 80 confirmed cases, and four deaths (case fatality rate = 0.5%). A spike in suspected cases on January 1 followed widespread media reports of the death of the student, but none of these cases were confirmed by lab testing. A total of 665 (77%) cases occurred in the high-density suburbs of Budiriro, Glen View, and Mbare; 24 (3%) patients were from outside Harare. Patients ranged in age from 1 month to 78 years (median age = 18 years); 48% were female.
Read the full article: Typhoid Fever Outbreak—Harare, Zimbabwe, October 2016–March 2017.
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Registration open for ACIP meeting, June 20–21
ACIP will hold its next meeting on June 20–21 in Atlanta. To attend the meeting, ACIP attendees (participants and visitors) must register online. The registration deadline for non-U.S. citizens is May 16; for U.S. citizens, it's June 11. Registration is not required to watch the meeting via webcast or listen to the proceedings via phone.
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15th Annual Immunize Nebraska Conference to be held May 25 in Omaha
The 15th Annual Immunize Nebraska Conference will take place in Omaha on May 25.
For more information, including the agenda and list of speakers, view the conference brochure.
Access the registration information and form.
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