Issue 1385: September 19, 2018
TOP STORIES
IAC HANDOUTS
WORLD NEWS
FEATURED RESOURCES
JOURNAL ARTICLES AND NEWSLETTERS
EDUCATION AND TRAINING
TOP STORIES
IAC updates two of its most popular Ask the Experts sections: one on influenza and the second on pneumococcal vaccines
IAC's Ask the Experts: Influenza and Ask the Experts: Pneumococcal web pages have been completely reviewed and updated by experts at CDC.
Ask the Experts: Influenza: Revisions include inclusion of information about the use of live attenuated influenza vaccine (LAIV); revised recommendations for vaccination of persons with egg allergy; updated data, statistics, and links; and a variety of editorial revisions.
Ask the Experts: Pneumococcal: The revision primarily involved updating website URLs and references and minor editorial changes.
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. William Atkinson, MD, MPH, IAC's associate director for immunization education, manages this web section, with answers provided by Andrew T. Kroger, MD, MPH; Candice L. Robinson, MD, MPH; Raymond A. Strikas, MD, MPH, FACP, FIDSA; Tina S. Objio, MSN, MHA, RN; and JoEllen Wolicki, BSN, RN, all from the National Center for Immunization and Respiratory Diseases, CDC.
IAC Express publishes five special editions each year of Ask the Experts Q&As answered by CDC experts. You can access the four most recent IAC Express Ask the Experts sets of Q&As from the main web page of Ask the Experts, in the right-hand column.
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Register now: Dr. Sharon G. Humiston, IAC's associate director for research, will present a webinar on adolescent immunization and the 16-year-old platform on September 26
Sharon G. Humiston, MD, MPH, FAAP, IAC's associate director for research, will present a one-hour webinar titled "Adolescent Immunization Update and the 16-Year-Old Platform" on September 26, at 1:00 p.m. (ET). During her presentation, Dr. Humiston will review the recommendations for adolescent vaccines, including those recommended at 11–12 years of age and those at age 16.
CDC's most recent National Immunization Survey, published on August 24, found that 51% of adolescents had not completed the HPV vaccine series, and 56% had not received both doses of MenACWY vaccine by their 18th birthday. In addition, fewer adolescents in rural areas, compared with those in urban areas, are getting these vaccines.
Register today for the webinar.
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IAC Spotlight! Easily find what you're looking for on immunize.org by using the new blue-gray tabs that run across the top of every web page
The Immunization Action Coalition (IAC) recently redesigned its website to make it easier to navigate. Each page includes the following six clickable tabs, now in a more visible font and blue-gray color.
- Favorites: Includes the most frequently requested pages, such as ACIP Recommendations, "Ask the Experts," Package Inserts, and 15 more
- Handouts & Staff Materials: Includes IAC's print resources for healthcare professionals and their patients, sortable in multiple ways
- Clinic Tools: Includes resources from IAC, CDC, and other organizations related to administering vaccines, adult vaccination, documenting vaccinations, scheduling vaccines, screening for contraindications, vaccine storage and handling, and vaccine recommendations
- Vaccine Information Statements: Includes all English VISs and translations in up to 50 languages, as well as information about using VISs
- Diseases & Vaccines: Includes the latest recommendations, information, and up-to-date resources from IAC, CDC, and other organizations for 22 vaccine-preventable diseases
- Talking about Vaccines: Includes the following sections: Adjuvants and Ingredients, Alternative Medicine, Autism, Countering Dr. Sears, Importance of Vaccines, MMR Vaccine, Religious Concerns, Responding to Parents, Thimerosal, Too Many Vaccines?, and Vaccine Safety
Explore these sections by clicking on the blue-gray tabs at the top of any web page of immunize.org.
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Voices for Vaccines releases new podcast episode titled "Anti-Vaccine Nurses"
Voices for Vaccines (VFV) has posted a new entry in its Vax Talk podcast series: Anti-Vaccine Nurses. In this podcast, Melody Butler, founder of Nurses Who Vaccinate, discusses ways to constructively engage with nurses who question the value or safety of vaccines.
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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New CDC data found that adolescents in rural areas are less likely to be vaccinated against HPV cancers and meningitis than adolescents in urban areas; learn about new related resources
On August 24, CDC published National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years—United States, 2017 in MMWR. One of the findings was that fewer adolescents in rural areas, compared with youth in urban areas, are getting the HPV and meningococcal conjugate vaccines. From CDC's website:
In 2017, the percentage of adolescents who received the first dose of the HPV vaccine was 11 percentage points lower in rural areas compared to urban areas. The percentage of adolescents receiving the first dose of the meningococcal conjugate vaccine was 7 percentage points lower in rural areas compared to urban areas.
This difference may be due in part to the fact that there are fewer pediatricians in rural areas compared to urban areas. Clinicians in rural areas serve a broader population base and may be less familiar with adolescent vaccination recommendations and/or may be less likely to stock all recommended adolescent vaccines.
CDC has a number of resources to assist clinicians in rural areas to improve adolescent vaccination rates, including information about how to make an effective vaccine recommendation and/or effective vaccine referral. Access these resources by clicking on the graphic below.
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IAC HANDOUTS
IAC updates "Screening Checklist for Contraindications to Inactivated Injectable Influenza Vaccination" and "Screening Checklist for Contraindications to Live Attenuated Intranasal Influenza Vaccination"
IAC recently revised "Screening Checklist for Contraindications to Inactivated Injectable Influenza Vaccination" and "Screening Checklist for Contraindications to Live Attenuated Intranasal Influenza Vaccination."
Access all of IAC's Screening Checklists.
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 posts updated Spanish-language version of "Should You Be Vaccinated Against Hepatitis A?"
IAC recently revised the Spanish-language version of its handout for adult patients titled "Should You Be Vaccinated Against Hepatitis A?" The piece has been revised to incorporate vaccination for infants 6 through 11 months who are travelling to a hepatitis A-endemic country.
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WORLD NEWS
WHO reports on transmission of circulating vaccine-derived poliovirus in the Horn of Africa
The World Health Organization (WHO) published Widespread transmission of circulating vaccine-derived poliovirus identified by environmental surveillance and immunization response, Horn of Africa, 2017–2018 in the September 14 issue of its Weekly Epidemiological Record. A section of the report is reprinted below.
After declaration of the eradication of wild poliovirus type 2 in 2015, all countries that were using oral poliovirus vaccine (OPV) switched from trivalent OPV (tOPV) (containing types 1, 2 and 3) to bivalent OPV (bOPV) (containing types 1 and 3) in April 2016. Vaccine-derived polioviruses (VDPVs)—strains that have diverged from the live vaccine virus during prolonged circulation—can sometimes emerge in areas with inadequate OPV coverage and can cause outbreaks of paralysis....
Ethiopia, Kenya, and Somalia comprise much of the Horn of Africa. Performance indicators for acute flaccid paralysis (AFP) surveillance, an indicator of the sensitivity of surveillance for detecting a case of polio, indicate some subnational gaps in these countries, including areas of Somalia that are inaccessible for polio vaccination activities....
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CDC reports on surveillance for congenital rubella syndrome in India
CDC published Sentinel Surveillance for Congenital Rubella Syndrome—India, 2016–2017 in the September 14 issue of MMWR (pages 1012–1016). A summary made available to the press is reprinted below.
Rubella infection during early pregnancy can result in serious consequences such as miscarriage, stillbirth, or a constellation of severe birth defects known as congenital rubella syndrome (CRS). The Government of India is committed to eliminate measles and control rubella and CRS by 2020. The Indian Council of Medical Research (ICMR) and the Indian Ministry of Health and Family Welfare (MoHFW) initiated laboratory-supported surveillance for CRS in five sentinel sites in November 2016. During the first eight months, surveillance identified more than 200 suspected CRS patients. About a third of the patients had laboratory-confirmed CRS. The experience gained during the first phase of surveillance will be useful in expanding the surveillance network; data generated will help monitor progress toward CRS control in India.
Related Link
- MMWR main page provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements
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Refugee children in Germany found to be at greater risk of contracting invasive pneumococcal disease
CDC published Invasive Pneumococcal Disease in Refugee Children, Germany in the October issue of Emerging Infectious Diseases (Stephanie Perniciaro, et al.) A summary and first two paragraphs are reprinted below.
Refugee children in Germany are not routinely given a pneumococcal conjugate vaccine. Cases of invasive pneumococcal disease (IPD) in 21 refugee children were compared with those in 405 Germany-born children for 3 pneumococcal seasons. Refugee children had significantly higher odds of vaccine-type IPD and multidrug-resistant IPD than did Germany-born children.
Germany has taken in >1 million refugees since 2015, more than one third of whom were children <18 years of age. Invasive pneumococcal disease (IPD) is a major cause of childhood death, especially in resource-poor environments. Conflict settings are associated with outbreaks of vaccine-preventable diseases for reasons ranging from poor sanitation in refugee holding areas to the rapid movement of refugees, which, in turn, allows for a similarly rapid spread of disease and the interruption of immunization services because of the lack of personnel.
Of the 10 most frequent countries of origin for refugees arriving in Germany in 2017 (Syria, Iraq, Afghanistan, Turkey, Iran, Nigeria, Eritrea, Russia, Somalia, and Albania), 6 have a national vaccination program that includes pneumococcal conjugate vaccines (PCVs); however, because of the crisis conditions facing those who fled, timely infant vaccination is unlikely. Vaccine-preventable disease outbreaks have been reported in refugee housing facilities in Germany, and most of these cases have originated after arrival in Germany. The vaccination program for newly arrived refugees does not include PCVs....
Read the complete article: Invasive Pneumococcal Disease in Refugee Children, Germany.
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ACOG posts new resource online: "Seasonal Influenza Vaccination Programs: Tips for Optimizing Practice Management"
The American College of Obstetricians and Gynecologists (ACOG) has developed a new immunization resource for healthcare professionals titled Seasonal Influenza Vaccination Programs: Tips for Optimizing Practice Management. This resource includes practical tips on ordering and handling and storing vaccines, as well as advice on reimbursement.
For additional resources on vaccine administration, storage and handling, patient education, supply pricing, group purchasing options, reimbursement and coding, and more, visit www.immunizationforwomen.org/fluprogramresources.php.
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CDC develops new online resource to share with parents about why it's important to vaccinate babies on time
CDC has developed a new online resource titled On-time Vaccination: The Ultimate Babyproofing Plan. This web page features six talking points with accompanying graphics that explain to parents why it's important to vaccinate babies on time. For example, #3 is "It’s best to vaccinate before your child is exposed to dangerous diseases." The text for this reason follows:
You wouldn’t wait until you’re already driving down the road to put your baby in a car seat. You buckle him in every time, long before there is any chance he could be in a crash. Vaccines work the same way—your baby needs them long before he is exposed to a disease.
It can take weeks for a vaccine to help your baby make protective disease-fighting antibodies, and some vaccines require multiple doses to provide best protection. If you wait until you think your child could be exposed to a serious illness – like when he starts daycare or during a disease outbreak—there may not be enough time for the vaccine to work. That’s why the experts who set the schedule pay such careful attention to timing. They have designed it to provide immunity early in life, before children are likely to be exposed to life-threatening diseases.
Access "On-time Vaccination: The Ultimate Babyproofing Plan" by clicking on any of the graphics below.
 
 
 
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Still available! IAC's sturdy laminated version of the 2018 U.S. adult immunization schedule—order a supply for your healthcare setting today! Child/teen schedules sold out.
IAC's laminated versions of the 2018 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. The schedule is eight pages (i.e., four double-sided pages) and is folded to measure 8.5" x 11".
The child/teen immunization schedules are sold out. If you wish to order a quantity of 500 or more, you can email admininfo@immunize.org to request a quote.
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's 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
In late 2017, the Immunization Action Coalition (IAC) 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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JOURNAL ARTICLES AND NEWSLETTERS
CDC publishes information about a mumps outbreak associated with a cheerleading competition in Texas
CDC published Notes from the Field: Mumps Outbreak Associated with Cheerleading Competitions — North Texas, December 2016–February 2017 in the September 14 issue of MMWR (pages 1019–1020). The first and last paragraphs are reprinted below.
On December 6, 2016, Collin County (Texas) Health Care Services (CCHCS) was notified of a suspected mumps case in a woman aged 41 years (patient A), who developed parotitis on December 5. Patient A had attended a cheerleading competition (event 2) 16 days before parotitis onset (Figure). On December 7, CCHCS was notified of a second suspected mumps case in a woman aged 24 years (patient B), with parotitis onset on November 29. Patient B had attended a different cheerleading competition (event 1) 23 days before parotitis onset and worked as a gymnastics instructor at a cheerleading facility (facility A) 2 days before parotitis onset. On December 9, real-time reverse transcription–polymerase chain reaction of buccal swabs performed by the Texas Department of State Health Services (Texas DSHS) confirmed mumps in both patients. After more cases were reported, a call for cases was issued by Texas DSHS. In all, 12 mumps cases (five confirmed and seven probable) in five counties were identified in persons who were nonathlete participants or attendees at three cheerleading competitions or were household contacts of mumps patients....
Although mumps outbreaks associated with athletic events have been reported, this outbreak is the first documented report of mumps transmission during a sporting event with the majority of cases occurring in nonathlete participants or attendees. Receipt of 2 appropriately spaced MMR vaccine doses offers the best protection against mumps; however, transmission can occur at athletic events among athletes, parents, guardians, coaches, and staff members, including appropriately vaccinated persons, underscoring the importance of receiving recommended vaccines to reduce transmission risk or disease severity. Because mumps outbreaks can occur in persons who have received mumps-containing vaccine, contact tracing should include vaccinated persons, and in some outbreak settings, a third dose of MMR vaccine is recommended.
Related Link
- MMWR main page provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements
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EDUCATION AND TRAINING
CDC Current Issues in Immunization NetConference about DTaP/Tdap and hepatitis vaccine recommendations scheduled for September 25
CDC will present a "Current Issues in Immunization NetConference" on September 25 at 12:00 p.m. (ET). Immunization NetConferences are live, 1-hour presentations combining an online visual presentation with simultaneous audio via telephone conference call, plus a live question and answer session. On-demand replays and presentations will be available shortly after each event.
Topics and speakers for the September 25 session:
- 2018 DTaP/Tdap Recommendations: Fiona Havers, MD, MHS, medical officer, Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases (NCIRD), CDC
- 2018 Hepatitis Vaccine Recommendations: Noele Nelson, MD, PhD, MPH, branch chief (acting), Prevention Branch, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
The NetConference will be moderated by Andrew Kroger, MD, MPH, medical officer, NCIRD, CDC.
This is a limited registration event. Registration is required.
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Weekly CDC webinar series on "The Pink Book" chapter topics will conclude on September 26; register now for the "Influenza" session
On September 26, CDC will conclude its 15-part webinar series on the chapters of the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). The webinar series has provided an overview of vaccines and the diseases they prevent, general recommendations for vaccines, vaccination principles, and immunization strategies for providers.
The September 26 webinar will cover "Influenza" and include a live Q&A session. Recordings of sessions will be available online within 2 weeks after each webinar. All sessions begin at 12:00 p.m. (ET). Free continuing education is available for healthcare personnel including physicians, nurses, nurse practitioners, pharmacists, physician’s assistants, and others.
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.
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