Issue 1413: February 27, 2019
TOP STORIES
IAC HANDOUTS
OFFICIAL RELEASES AND ANNOUNCEMENTS
FEATURED RESOURCES
JOURNAL ARTICLES AND NEWSLETTERS
EDUCATION AND TRAINING
CONFERENCES AND MEETINGS
TOP STORIES
Measles outbreak continues in five states; 64 cases confirmed in Washington State
Five measles outbreaks (defined as 3 or more cases) have been reported in the U.S. in 2019 in Rockland County, NY; Monroe County, NY; New York City; Washington State; and Texas. These outbreaks are linked to travelers who brought measles back from other countries such as Israel and Ukraine, where large measles outbreaks are occurring.
The measles outbreak in Clark County, WA, is continuing. As of February 20, Clark County Public Health reported 63 confirmed cases and one case in King County, WA. Clark County Public Health also reported that as of December 31, 2018, only 78% of Clark County 6- to 18-year-olds and only 81% of 1- to 5-year-olds had received the age-appropriate number of doses of measles vaccine.
According to CDC's Measles Cases and Outbreaks web page, 127 individual cases of measles have been confirmed in ten states between January 1 to February 14. The states that have reported cases to CDC are California, Colorado, Connecticut, Georgia, Illinois, Kentucky, New York, Oregon, Texas, and Washington.
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Influenza remains widespread across the nation; CDC reports 19,100 deaths so far this season so keep vaccinating your patients
Influenza remains widespread, and CDC has reported 7 additional pediatric deaths from influenza in the U.S. this season, for a total of 41. Last season, there was a record-setting number of pediatric deaths in the U.S. (185).
CDC stated in its Weekly U.S. Influenza Surveillance Report, FluView, that during the week ending February 16, the geographic spread of influenza in Puerto Rico and 48 states was reported as widespread; one state reported regional activity; the District of Columbia reported local activity; the U.S. Virgin Islands and one state reported sporadic activity; and Guam did not report.
According to CDC's Preliminary Burden Estimates, from October 1, 2018 through February 16, 2019, there have been 17.7 million to 20.4 million flu illnesses, 8.2 million to 9.6 million flu medical visits, 214,000 to 256,000 flu hospitalizations, and 13,600 to 22,300 flu deaths.
Pediatrician, mom, and CDC flu fighter Dr. Wendy Sue Swanson will take over CDC's twitter channel to talk about children and flu. Tune in on Wednesday, February 27 at 10:30 a.m. ET to join the conversation.
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:
IAC Spotlight! IAC's “Clinic Tools: Vaccine Storage and Handling" web page provides resources from IAC and CDC to help ensure you're doing everything you can to safeguard your vaccine supply
On IAC's Clinic Tools: Vaccine Storage and Handling web page on immunize.org, you will find a comprehensive collection of resources from IAC and CDC related to vaccine storage and handling. This web page can be found by selecting the "Clinic Tools" tab (third from the left) in the blue banner across the top of every immunize.org web page and then selecting "Vaccine Storage and Handling" in the drop-down menu.
In the left-hand column of the page, you will find IAC's educational materials related to vaccine storage and handling. From here, you can access IAC's checklist for safe vaccine storage and handling, vaccine temperature logs for refrigerators and freezers, as well as links to other related resources available on immunize.org. The right-hand column of the page includes resources from CDC, AAP, the Alliance for Immunization in Michigan, the California Department of Public Health, and the Office of the Inspector General.
Accessible from IAC's web page, CDC's Vaccine Storage & Handling web section has several new and updated resources, including the 2019 edition of the Vaccine Storage and Handling Toolkit, fact sheets on best practices for temperature monitoring and storage, You Call the Shots: Vaccine Storage and Handling Module, and vaccine label examples to help organize vaccines within a storage unit.
The 16 Vaccine campaign from the National Meningitis Association highlights the importance of the second dose of MenACWY at the 16-year-old checkup
The 16 Vaccine is a national campaign to highlight the importance of the second dose of the MenACWY vaccine at the 16-year-old checkup. Launched by the National Meningitis Association (NMA), in collaboration with Sanofi Pasteur, the campaign includes a website, social media posts, and a series of videos presenting NMA advocates discussing how meningitis affected their lives.
Many parents are aware of the first dose of MenACWY at ages 11-12, but they don’t know the CDC recommends a second dose at age 16. The campaign encourages parents to talk to their teen's doctor about the second dose of MenACWY, along with other important vaccinations given at the 16-year-old visit.
Access additional campaign content on Facebook and Twitter.
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CDC issues clinical guidance for providers during the Recombivax HB vaccine shortage
In light of the current shortage of Recombivax HB pediatric hepatitis B vaccine (Merck), CDC has updated its Current Vaccine Shortages and Delays web page. Note 2 of the footnotes regarding the limited supply is reprinted below.
Merck anticipates having a limited supply of pediatric monovalent hepatitis B vaccine through 2019. GSK has confirmed its ability to continue to address supply gaps for pediatric hepatitis B vaccine during this period, using a combination of monovalent pediatric hepatitis B vaccine and its DTaP-HepB-IPV pediatric combination vaccine (Pediarix). The expected monovalent supply continues to provide sufficient vaccine to cover the hepatitis B birth dose for all children as well as additional pediatric hepatitis B vaccine for second and third doses. However, some adjustments will be needed from providers because of the decrease in monovalent vaccine (see attached guidance in the table above). To ensure an equitable distribution of monovalent hepatitis B vaccine and direct vaccine doses according to CDC’s clinical guidance, CDC has implemented controlled vaccine ordering in the public sector using both Merck’s and GSK’s monovalent pediatric hepatitis B vaccines. In addition, GSK is providing monovalent doses to the private sector market directly and through their channels consistent with CDC’s clinical guidance. GSK’s DTaP-HepB-IPV pediatric combination vaccine (Pediarix) continues to be available in both the public and private sectors.
Timely series completion is key to the success of any vaccination program and critical to ensuring patients receive the full benefit of their vaccinations.
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February is American Heart Month; patients with heart disease are at high risk of influenza complications
February has been designated American Heart Month by the American Heart Association. CDC is taking the opportunity to remind healthcare professionals that patients with heart disease are at high risk of influenza complications. Some information from CDC's Flu and Heart Disease & Stroke web page is reprinted below.
People with heart disease and those who have had a stroke are at high risk for developing serious complications from flu. Among adults hospitalized with flu during the 2017–2018 influenza season, heart disease was among the most commonly-occurring chronic conditions; about half of adults hospitalized with flu during the 2017–2018 flu season had heart disease. Studies have shown that influenza is associated with an increase of heart attacks and stroke.
Healthcare professionals should make sure their patients with heart disease are appropriately vaccinated against influenza and pneumococcal disease. In addition, CDC urges rapid antiviral treatment of very ill and high-risk suspect influenza patients without waiting for testing.
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Six healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination
There are now 822 organizations enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, long-term care facilities (LTCFs), medical practices, pharmacies, 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 January 23, 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 by visiting the Application page.
Newly added healthcare organizations, hospitals, government agencies, and medical practices
- Carilion Clinic, Roanoke, VA
- Community Healthcare System, Onaga, KS
- Genesis Healthcare, Kennett Square, PA
- Grand Forks Public Health Department, Grand Forks, ND
- Health Department of Northwest Michigan, Charlevoix, MI
- River Valley Family Health Centers, Olathe, CO
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National Adult and Influenza Immunization Summit soliciting nominations for its 2019 Immunization Excellence Awards; deadline extended to March 1
The National Adult and Influenza Immunization Summit (NAIIS) is soliciting nominations for the 2019 NAIIS Immunization Excellence Awards. The 2019 awards recognize individuals and organizations that have made extraordinary contributions towards improving vaccination rates within their communities during 2018. There are five award categories.
A National Winner will be selected for each award category, and where appropriate, an Honorable Mention recipient. The winners will be presented with their awards at the NAIIS meeting to be held May 14–16 in Atlanta; the awards ceremony will be May 15. The national winner in each category will be invited to present their programs at the meeting.
The deadline for nominations has been extended to March 1. Access information on the award categories and the nomination form.
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IAC HANDOUTS
IAC updates “After the Shots…What to Do if Your Child Has Discomfort”
IAC updated its handout for parents titled After the Shots…What to Do if Your Child Has Discomfort in January and has updated it further during February. In this new version, all references to using a teaspoon as a measuring device have been removed.
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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 updates its Spanish translation of "Keep Your Kids Safe—Get Them Vaccinated Every Fall or Winter!"
In October, IAC revised its easy-to-read handout for parents titled Keep Your Kids Safe—Get Them Vaccinated Every Fall or Winter! The Spanish-language version has now been updated to match the revised English-language version. Changes were made to include nasal spray flu vaccine as an available type of influenza vaccine.
Access the revised Spanish translation: Mantenga a salvo a sus hijos: ¡Vacúnelos cada otoño o invierno!
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 updates its Spanish translation of "Should You Be Vaccinated Against Hepatitis A?"
In January, IAC revised its handout for adults titled Should You Be Vaccinated Against Hepatitis A? The Spanish-language version has now been updated to match the revised English-language version. Changes were made to add homelessness as a risk factor for the receipt of hepatitis A vaccine.
Access the revised Spanish translation: ¿Se debe vacunar contra la hepatitis A?
Access all IAC's ready-to-print Screening Checklists about vaccines for all ages of patients.
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 updates its Spanish translation of "Protect Yourself from Whooping Cough...Get Vaccinated!"
In January, IAC revised its handout for teens and adults titled Protect Yourself from Whooping Cough...Get Vaccinated! The Spanish-language version has now been updated to match the revised English-language version. Changes were made to add information about the need for pregnant women to receive a Tdap booster during the third trimester of each pregnancy.
Access IAC's 21 Easy-to-Read Q&A's about Diseases and Vaccines for people of all ages, all ready to print and CDC-reviewed.
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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OFFICIAL RELEASES AND ANNOUNCEMENTS
WHO publishes "Recommended Composition of Influenza Virus Vaccines for Use in the 2019–2020 Northern Hemisphere Influenza Season"
WHO published Recommended Composition of Influenza Virus Vaccines for Use in the 2019–2020 Northern Hemisphere Influenza Season on February 21. The recommendations are reprinted below.
It is recommended that quadrivalent vaccines for use in the 2019–2020 northern hemisphere influenza season contain the following:
- an A/Brisbane/02/2018 (H1N1)pdm09-like virus; - an A(H3N2) virus to be announced on 21 March 2019*;
- 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 2019–2020 northern hemisphere influenza season be a B/Colorado/06/2017-like virus of the B/Victoria/2/87-lineage.
*In light of recent changes in the proportions of genetically and antigenically diverse A(H3N2) viruses, the recommendation for the A(H3N2) component has been postponed.
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WHO publishes position paper on pneumococcal conjugate vaccines in infants and children in this week's Weekly Epidemiological Record
WHO published a position paper in the February 22 issue of its Weekly Epidemiological Record. The report is titled Pneumococcal Conjugate Vaccines in Infants and Children Under 5 Years of Age: WHO Position Paper–February 2019. A portion of the report is reprinted below.
Currently available pneumococcal conjugate vaccines (PCVs) are safe and effective, and the increase in the number of serotypes in these vaccines as compared with the first licensed PCV7 represents significant progress in the fight against pneumococcal disease-related morbidity and mortality, particularly for developing countries. WHO recommends the inclusion of PCVs in childhood immunization programmes worldwide.
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National Academies of Sciences, Engineering, and Medicine creates new web page titled “Vaccines Are Safe”
The National Academies of Sciences, Engineering, and Medicine has created a new web page titled Vaccines Are Safe. Targeted to parents, the web page outlines several of the reasons describing why vaccines are safe, including the fact that vaccines go through a lot of testing and there are many health benefits and few side effects to vaccination. The web page states, "Unless your doctor tells you otherwise, the risks of not getting a recommended vaccine are worse than the small risk associated with the vaccine itself."
Visit the National Academies of Sciences, Engineering, and Medicine: Vaccines Are Safe web page.
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CDC launches second video in its new animated video series for parents, “How Vaccines Work”
CDC's National Center for Immunization and Respiratory Diseases recently launched the second video in a new, animated video series for parents titled How Vaccines Work: How Do Vaccines Help Babies Fight Infections?
In these short videos, viewers follow baby Jack and his parents as they get answers to common vaccine-related questions and learn more about the importance of vaccinating on schedule. The second video helps parents learn about their baby’s immune system and how vaccines support their overall health.
Watch and share How Vaccines Work: How Do Vaccines Help Babies Fight Infections?
The first video, How Vaccines Work: How Do Germs Make Your Baby Sick?, which was launched in January, describes how vaccines fight germs and provide long-lasting protection against 14 serious diseases. CDC will be launching an additional video in March on the following topic: “What to Expect When Your Child is Vaccinated.”
CDC encourages healthcare professionals to share this new educational resource for parents.
Learn more at www.cdc.gov/vaccines/parents/childhood-vaccines.
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Vaxopedia website releases new post titled "A Legislative Guide to Advocating for Stronger Vaccine Laws"
Vaxopedia, a website created by pediatrician Vincent Iannelli, MD, provides a wealth of immunization information with the goal of helping parents and healthcare professionals stay up to date about vaccines. Portions of a recent post titled A Legislative Guide to Advocating for Stronger Vaccine Laws are reprinted below.
Not surprisingly, as vaccines did their job and rates of vaccine-preventable diseases dropped, politicians were able to weaken our vaccine laws....
Legislators who want to combat vaccine exemption abuse should enact laws that make it clear that:
- medical exemptions are based on ACIP guidelines, current accepted medical practice, and evidence-based medicine – not anecdotes
- medical exemptions should be reviewed and approved by the State Epidemiologist, Deputy State Epidemiologist, or other designated professionals at the health department
- religious exemptions, if included at all, should specifically exclude philosophical exemptions and must reflect a sincere religious belief
- philosophical exemptions, if included at all, should require some degree of education against the myths and misinformation that scares parents away from vaccinating their kids
- exempted students will be excluded from school during outbreaks
- exemptions should include a signed affidavit that is notarized
- exemptions should be recertified each year
- most exemptions are temporary
- a separate exemption application should be required for each vaccine
- exemption rates should be tracked at the school level and should be posted on school websites
Getting an exemption shouldn’t be easier than getting vaccinated!
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Hepatitis B Foundation releases new #justB video titled "Heng’s Story" to empower people affected by hepatitis B, raise awareness, and end stigma
The Hepatitis B Foundation continues its storytelling campaign: #justB: Real People Sharing their Stories of Hepatitis B.
Watch the February video, Heng’s Story, about a young man who fell in love with Wendy during his college years. When Wendy told him she has hepatitis B, he got tested and found out he was already protected from the virus. They later married and had children whom they protected from hepatitis B. When Wendy’s mom passed away from liver cancer, Heng and Wendy realized the virus can have serious consequences and began learning about the importance of monitoring and medical care for people living with chronic hepatitis B.
Watch any of the following new videos by going to the web section: #justB: Real People Sharing their Stories of Hepatitis B.
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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
Vaccine publishes study about Medicare fee-for-service beneficiaries and predictors of vaccine receipt
On February 21, the journal Vaccine published a study titled Vaccination Among Medicare Fee-for-Service Beneficiaries: Characteristics and Predictors of Vaccine Receipt, 2014–2017 (Shen AK, et al.). The conclusion of the abstract is reprinted below.
Conclusion
Medicare beneficiaries of certain demographic with selected comorbid conditions are less likely to receive routinely recommended vaccines. Strategies and interventions can target such sub-populations of Medicare beneficiaries by optimizing the utilization of preventive services.
Access the full abstract: Vaccination Among Medicare Fee-for-Service Beneficiaries: Characteristics and Predictors of Vaccine Receipt, 2014–2017.
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Vaccine publishes study about provider time and costs to vaccinate adult patients
On February 4, the journal Vaccine published a study titled Provider Time and Costs to Vaccinate Adult Patients: Impact of Time Counseling Without Vaccination (Shen AK, et al.).
A portion of the abstract is reprinted below.
Abstract
Amid provider reports of financial barriers as an impediment to adult immunization, this study explores the time and costs of vaccination in adult provider practices....Counseling patients who ultimately do not go on to receive a vaccine may be an important cost factor. Lower costs of vaccination services may be achieved by increasing efficiencies in workflow or the volume of vaccinations.
Access the full abstract: Provider Time and Costs to Vaccinate Adult Patients: Impact of Time Counseling Without Vaccination.
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EDUCATION AND TRAINING
NFID offers webinar on March 19 at noon on updates from the February ACIP meeting
On March 19, the National Foundation for Infectious Diseases (NFID) will present a webinar titled Updates from February 2019 ACIP Meeting at 12:00 p.m. (ET). NFID medical director William Schaffner, MD, and liaison to the Advisory Committee on Immunization Practices (ACIP), and Amanda C. Cohn, MD, MPH, ACIP executive secretary, will discuss updates from the February 2019 ACIP meeting, including current U.S. vaccination recommendations for children, adolescents, and adults. There is no fee to participate in this activity, but pre-registration is required.
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AAP hosts webinar titled "Spring 2019 HPV Vaccination Update: Supporting Your Office Efforts" scheduled for March 26
The American Academy of Pediatrics (AAP) will host a one-hour webinar titled Spring 2019 HPV Vaccination Update: Supporting Your Office Efforts on March 26 at 1:00 p.m. (ET). A panel of experts in pediatric primary care, health communication, and obstetrics and gynecology will cover a range of topics including the latest trends in HPV disease prevalence and prevention, effective HPV vaccination communication strategies all office staff can use, evidence-based techniques for increasing HPV vaccination rates, and answers to commonly asked questions from parents.
Register for the webinar.
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Wyoming Immunization Conference to be held May 21–22 in Casper
The Wyoming Immunization Conference will be held May 21–22 in Casper, Wyoming. This year’s theme is Bringing Immunity to Every Community! Exhibitors and sponsors will be on hand to provide education and information to the more than 150 participants expected to be in attendance this year.
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2019 Iowa Immunization Summit to be held June 19–20 in Altoona; "Pink Book" training scheduled for the first day
The 2019 Iowa Immunization Summit will be held June 19–20 in Altoona, Iowa. This year’s theme is Promote, Protect, Prevent.
On the first day, CDC faculty from its National Center for Immunization and Respiratory Diseases will present a comprehensive review of immunization principles and recommendations for vaccines and vaccine-preventable diseases in the Epidemiology and Prevention of Vaccine Preventable Diseases ("The Pink Book") course.
Day two will feature renowned speakers who will share the latest information on immunizations and vaccine-preventable diseases, including vaccine issues impacting health care provider practices.
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