IAC Express 2009
Issue number 839: December 7, 2009
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Contents of this Issue
Select a title to jump to the article.
  1. MMWR Early Release reports on H1N1 influenza vaccine safety
  2. ACIP posts provisional recommendations for use of HPV vaccine
  3. CDC warns about email phishing scam related to H1N1 influenza vaccination
  4. CDC provides new H1N1 influenza vaccination information for healthcare professionals
  5. Summary report of ACIP's October meeting is now online
  6. IAC's Video of the Week encourages kids to get vaccinated
  7. More translations available for seasonal and H1N1 influenza VISs
  8. Healthy Roads Media offers English-language H1N1 influenza VISs in alternative formats
  9. Important: While you're vaccinating against influenza, be sure to administer PPSV to all people with existing indications
  10. Laminated seasonal influenza vaccine pocket guides--FREE!--from the National Influenza Vaccine Summit
  11. Reminder: Abstracts for the 2010 National Immunization Conference due by December 11
  12. November issue of CDC's Immunization Works electronic newsletter recently released
  13. IAC updates "Quick Answers to Tough Questions" PowerPoint presentation
  14. MMWR reports on global measles mortality
  15. The Measles Initiative launches redesigned website
  16. November issue of the Global Immunization News available online
  17. MMWR publishes information about Conference on Vaccine Research
 
Abbreviations
AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; AMA, American Medical Association; CDC, Centers for Disease Control and Prevention; FDA, Food and Drug Administration; IAC, Immunization Action Coalition; MMWR, Morbidity and Mortality Weekly Report; NCIRD, National Center for Immunization and Respiratory Diseases; NIVS, National Influenza Vaccine Summit; VIS, Vaccine Information Statement; VPD, vaccine-preventable disease; WHO, World Health Organization.
  
Issue 839: December 7, 2009
1.  MMWR Early Release reports on H1N1 influenza vaccine safety

On December 4, CDC published an MMWR Early Release titled, "Safety of Influenza A (H1N1) 2009 Monovalent Vaccines--United States, October 1-November 24, 2009." The first paragraph is reprinted below.


The Food and Drug Administration (FDA) licensed the first 2009 influenza A (H1N1) monovalent vaccines ("H1N1 vaccines") on September 15, 2009. The H1N1 vaccines are available as a live, attenuated monovalent vaccine (LAMV) for intranasal administration and as monovalent, inactivated, split-virus or subunit vaccines for injection (MIV). The licensure and manufacturing processes for the monovalent H1N1 vaccines were the same as those used for seasonal trivalent inactivated (TIV) or trivalent live, attenuated influenza vaccine (LAIV); none of these vaccines contains an adjuvant. Vaccine safety monitoring is an important component of all vaccination programs. To assess the safety profile of H1N1 vaccines in the United States, CDC reviewed vaccine safety results for the H1N1 vaccines from 3,783 reports received through the U.S. Vaccine Adverse Event Reporting System (VAERS) and electronic data from 438,376 persons vaccinated in managed-care organizations in the Vaccine Safety Datalink (VSD), a large, population-based database with administrative and diagnostic data, in the first 2 months of reporting (as of November 24). VAERS data indicated 82 adverse event reports per 1 million H1N1 vaccine doses distributed, compared with 47 reports per 1 million seasonal influenza vaccine doses distributed. However, no substantial differences between H1N1 and seasonal influenza vaccines were noted in the proportion or types of serious adverse events reported. No increase in any adverse events under surveillance has been seen in VSD data. Many agencies are using multiple systems to monitor H1N1 vaccine safety. Healthcare providers and the public are encouraged to report adverse health events that occur after vaccination. . . .

To access the complete Early Release in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58e1204a1.htm?s_cid=mm58e1204a1_e

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2 ACIP posts provisional recommendations for use of HPV vaccine

On December 1, CDC posted provisional recommendations for use of HPV vaccine on the ACIP web section. Provisional recommendations are those ACIP has voted on but that are not yet approved by CDC or the Department of Health and Human Services and have not yet been published in MMWR. A portion of the HPV provisional recommendations is reprinted below.


On October 21, 2009, ACIP voted on updated recommendations for use of human papillomavirus (HPV) vaccine, including recommendations for the bivalent HPV (types 16 and 18) vaccine (Cervarix) for females and the quadrivalent HPV (types 6, 11, 16 and 18) vaccine (Gardasil) for females and males.

These recommendations, when published in the MMWR, will replace recommendations published in the 2007 MMWR Recommendations and Reports document: Centers for Disease Control and Prevention. Quadrivalent Human Papillomavirus Vaccine: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 2007; 56(No. RR-02).

PROVISIONAL RECOMMENDATIONS FOR FEMALES

ACIP recommends routine vaccination of females aged 11 or 12 years with 3 doses of HPV vaccine. The vaccination series can be started as young as age 9 years.

HPV vaccination also is recommended for females aged 13 through 26 years who have not been previously vaccinated or who have not completed the full vaccination series. Ideally, vaccine should be administered before potential exposure to HPV through sexual contact.
  • ACIP recommends vaccination with either the bivalent HPV vaccine or the quadrivalent vaccine for prevention of cervical cancers and precancers.
     
  • ACIP recommends vaccination with the quadrivalent HPV vaccine for prevention of cervical cancers and precancers, and genital warts.* [FOOTNOTE] The quadrivalent vaccine has also been demonstrated to protect against vulvar and vaginal cancers and precancers.

PROVISIONAL RECOMMENDATIONS FOR MALES

The 3-dose series of quadrivalent HPV vaccine may be given to males aged 9 through 26 years to reduce their likelihood of acquiring genital warts. Ideally, vaccine should be administered before potential exposure to HPV through sexual contact.


These provisional recommendations also provide guidance related to HPV administration, precautions, and contraindications.

To access the complete HPV provisional recommendations, go to:
http://www.cdc.gov/vaccines/recs/provisional/downloads/hpv-vac-dec2009-508.pdf

All provisional ACIP recommendations can be found at http://www.cdc.gov/vaccines/recs/provisional

To access all final ACIP recommendations, go to: http://www.immunize.org/acip IAC's ACIP web section allows visitors to sort documents by date, vaccine, or topic. Bookmark this link for easy access to all provisional and final ACIP recommendations.

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3 CDC warns about email phishing scam related to H1N1 influenza vaccination

CDC has received reports of fraudulent emails asking users to register their vaccination profile with the government. A statement from CDC about this phishing scam follows.


CDC has received reports of fraudulent emails (phishing) referencing a CDC sponsored State Vaccination Program.

The messages request that users must create a personal H1N1 (swine flu) Vaccination Profile on the cdc.gov website. The message then states that anyone that has reached the age of 18 has to have his/her personal Vaccination Profile on the cdc.gov site.

The CDC has NOT implemented a state vaccination program requiring registration on www.cdc.gov Users that click on the email are at risk of having malicious code installed on their system. CDC reminds users to take the following steps to reduce the risk of being a victim of a phishing attack:
  • Do not follow unsolicited links and do not open or respond to unsolicited email messages.
     
  • Use caution when visiting un-trusted websites.
     
  • Use caution when entering personal information online.

CDC has published this warning with a replica of an actual phishing email at http://www.cdc.gov/hoaxes_rumors.html

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4 CDC provides new H1N1 influenza vaccination information for healthcare professionals

CDC continually updates information about H1N1 influenza vaccination on its website and through email notices. On December 2, CDC informed its partners that 70.2 million doses of 2009 H1N1 influenza vaccine had been made available, with approximately 24% of the doses being the live, nasal-spray vaccine.

CDC experts have also noted that although H1N1 influenza disease is declining, the virus is far from gone. Vaccination is the best prevention against the 2009 H1N1 virus, and the lull in disease activity provides a window of opportunity for vaccinating susceptible people.

In addition, CDC recently added or updated the following resources for healthcare professionals on its H1N1 web section:

2009 H1N1 Influenza: Resources for Pharmacists
http://www.cdc.gov/h1n1flu/pharmacist

Questions and Answers on 2009 H1N1 Vaccine Financing
http://www.cdc.gov/H1N1flu/vaccination/statelocal/vaccine_financing.htm

Interim Guidance for Management of Influenza-Like Illness aboard Commercial Aircraft during the 2009-10 Influenza Season
http://www.cdc.gov/h1n1flu/guidance/air-crew-dom-intl.htm

Preparing for the Flu: A Communication Toolkit for Schools (Grades K-12)
http://www.cdc.gov/h1n1flu/schools/toolkit

Opening and Mixing Tamiflu Capsules with Liquids if Child Cannot Swallow Capsules [for caregivers]
http://www.cdc.gov/h1n1flu/antivirals/mixing_tamiflu_qa.htm

Fraudulent Emails Referencing CDC-Sponsored State Vaccination Program
http://www.cdc.gov/hoaxes_rumors.html

CDC's H1N1 Flu web section contains hundreds of documents for healthcare professionals and the public. To access the  web section's home page, go to: http://www.cdc.gov/h1n1flu

To make it easy for you to keep up to date with developments, IAC has gathered important information related to H1N1 influenza into a single web section. To access this resource, go to: http://www.immunize.org/h1n1

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5 Summary report of ACIP's October meeting is now online

[The following is cross posted from CDC's Immunization Works electronic newsletter, November 2009.]

ACIP HIGHLIGHTS
The Advisory Committee on Immunization Practices (ACIP) held its final meeting for 2009 in Atlanta October 21 and 22. The meeting produced several new and updated recommendations. These recommendations are provisional until they are reviewed by the director of CDC and published in the MMWR. Full minutes of the meeting, including slides from presentations, will be available soon on the ACIP Meetings web page.

Topics addressed at this meeting were

HPV

  • The committee voted to update the human papillomavirus (HPV) vaccine recommendations to include the recently licensed bivalent vaccine for women.
     
  • They voted to harmonize the schedule and dosing recommendations for the two vaccines (for women) without expressing a preference for either vaccine, to update the precautions and contraindications to apply to both vaccines.
     
  • The committee also voted to add a permissive recommendation for males 9 through 26 years of age to receive the quadrivalent HPV vaccine to prevent genital warts.

SCHEDULES
The committee voted to approve the 2010 vaccine schedules both for children and adolescents and for adults. Each will contain minor changes and updates from the previous year's edition.

GENERAL RECOMMENDATIONS
After discussing the incorporation into the General Recommendations of previously free-standing, but non-vaccine specific, ACIP statements on Adolescent and Adult Vaccination Principles, the General Recommendations Work Group summarized revisions to the document. These include small changes to the sections on combination vaccines, timing and spacing, storage and handling, and syncope. The committee voted to accept the final document with the understanding that several outstanding issues, e.g., vaccination of persons with altered immunocompetence, will be resolved prior to publication.

YELLOW FEVER
The committee voted to approve an updated yellow fever statement in light of evolving epidemiologic and adverse event data. Changes will affect indications, contraindications and precautions, and the vaccine's adverse event profile.

PNEUMOCOCCAL
The committee reviewed epidemiologic data regarding invasive pneumococcal disease in children, heard immunogenicity and cost-effectiveness data on the forthcoming 13-valent pneumococcal conjugate vaccine, and discussed proposed recommendations for incorporating it into the routine and catch-up childhood schedules.

The committee discussed the use of meningococcal conjugate vaccines, including proposed combination vaccines, in infants; heard an update on rotavirus vaccine and post-licensure monitoring of intussusception; got the initial report from the new RSV work group; and heard updates on the vaccine supply and influenza and influenza vaccine. CDC, CMS, DoD, DVA, FDA, HRSA, HIS, NIH, NVAC and NVPO provided agency updates, and there were a number of public comments, mainly regarding HPV vaccine.

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6 IAC's Video of the Week encourages kids to get vaccinated

This week, IAC's Video of the Week section includes a 28-minute episode from the PBS animated series "Sid the Science Kid" that deals with getting an influenza vaccine, as well as a 2-minute song from the show. The episode is titled, "Getting a Shot: You can do it!"

The video will be available on the home page of IAC's website through December 13. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week. It may take a few moments for the video to begin playing; please be patient!

Remember to bookmark IAC's home page to view a new video every Monday. To view an IAC Video of the Week from the past, go to the video archive at http://www.immunize.org/votw

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7 More translations available for seasonal and H1N1 influenza VISs

The VISs for 2009 H1N1 inactivated influenza vaccine (injectable) and 2009 H1N1 live attenuated influenza vaccine (nasal spray) are now available in Dinka (spoken in Sudan), Kirundi (spoken in Burundi), Kunama (spoken in Eritrea), Punjabi (spoken in India and Pakistan), and Tigrigna (spoken in Ethiopia). IAC gratefully acknowledges the California Department of Public Health, Immunization Branch, for the translations.

The VIS for the seasonal inactivated influenza vaccine (injectable) is now available in Amharic (spoken in Ethiopia). IAC gratefully acknowledges the Minnesota Department of Health and the DSMA Ethiopian Orthodox Tewahedo Church Parish Nursing Program, Minneapolis, MN, for the translation.

To access the new translations (Dinka, Kirundi, Kunama, Punjabi, and Tigrigna) of the VIS for the injectable 2009 H1N1 influenza vaccine, as well as this VIS in English and other translations, go to: http://www.immunize.org/vis/vis_h1n1_inactive.asp Click on the pertinent languages.

To access the new translations (Dinka, Kirundi, Kunama, Punjabi, and Tigrigna) of the VIS for the nasal-spray 2009 H1N1 influenza vaccine, as well as this VIS in English and other translations, go to: http://www.immunize.org/vis/vis_h1n1_live.asp Click on the pertinent languages.

To access the new Amharic translation of the VIS for the seasonal inactivated influenza vaccine, as well as the VIS in English and other translations, go to:
http://www.immunize.org/vis/vis_flu_inactive.asp

For information about the use of VISs, and for VISs in more than 35 languages, visit IAC's VIS web section at
http://www.immunize.org/vis

For general information about VISs from CDC's website go to:
http://www.cdc.gov/vaccines/pubs/vis

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8 Healthy Roads Media offers English-language H1N1 influenza VISs in alternative formats

Healthy Roads Media has posted the English-language H1N1 influenza VISs in alternative formats, including one (MPEG video format) that can be used in closed-circuit television or video-on-demand systems.

To access the free MPEG video versions of the H1N1 influenza VISs, go to:
http://www.healthyroadsmedia.org/videos/agree.htm

To access the H1N1 influenza VIS in other alternative formats (audio, mobile video, multimedia), as well as Healthy Roads Media's other immunization resources, go to:
http://www.healthyroadsmedia.org/topics/immunization.htm

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9 Important: While you're vaccinating against influenza, be sure to administer PPSV to all people with existing indications

CDC advises healthcare professionals that during seasonal and H1N1 influenza outbreaks, all people who have existing indications for pneumococcal polysaccharide vaccine (PPSV) should be vaccinated according to current ACIP recommendations. This is important because people with existing indications are not only at increased risk for pneumococcal disease, but are also at increased risk for serious complications from influenza.

CDC has issued related guidance titled "Prevention of Pneumococcal Infections Secondary to Seasonal and 2009 H1N1 Influenza Virus Infection." To access it, go to: http://www.cdc.gov/h1n1flu/vaccination/provider/provider_pneumococcal.htm

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10.  Laminated seasonal influenza vaccine pocket guides--FREE!--from the National Influenza Vaccine Summit

With vaccination against 2009 H1N1 influenza now underway, it is important to remember that seasonal influenza vaccination efforts must continue. To aid in these efforts, the Immunization Action Coalition is inviting IAC Express readers to place orders now for the National Influenza Vaccine Summit's laminated 2009-10 Seasonal Influenza Vaccination Pocket Information Guides. The pocket guides are the perfect size to fit in a lab coat pocket. And best of all--they're free!

See an image of the laminated seasonal influenza vaccine pocket guide at
http://www.preventinfluenza.org/fluguide/pocketguide_flu.pdf

For description of the content of the pocket guides and information on their background, go to:
http://www.immunize.org/express/issue833.asp#n16

The Summit is also pleased to be able to offer a companion piece to the laminated influenza pocket guides--free laminated pocket guides for the administration of pneumococcal polysaccharide vaccine (PPSV). See an image of the PPSV pocket guide at
http://www.immunize.org/ppvguide/pocketguide.pdf

HOW TO ORDER
Each order must be for a minimum of 100 pocket guides. Place your order at http://www.preventinfluenza.org/pocketguides There is no cost for the pocket guides, shipping, or handling within the U.S.

If you have questions, email admininfo@immunize.org

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11.  Reminder: Abstracts for the 2010 National Immunization Conference due by December 11rticle 11.

If you plan on submitting an abstract for CDC's 2010 National Immunization Conference, be aware that the deadline is December 11. The conference will take place April 19-22, in Atlanta, GA.

On December 3, CDC published a special edition of Immunization Works, encouraging people to submit abstracts appropriate for the health and risk communication track of the conference. The text of this communication follows.


Call for Health and Risk Communication Abstracts

Deadline for submission is December 11, 2009

The Centers for Disease Control and Prevention is pleased to announce the 44th Annual National Immunization Conference. The goals of this conference are to disseminate information and to explore innovative strategies for developing programs, policy, and research to promote comprehensive immunization coverage for all age groups.

We invite you to submit an abstract for the Health and Risk Communication Track. This track includes presentations focusing on risk communication strategies, addressing vaccine hesitancy, and building effective media campaigns and collaborations. Abstracts may describe communication programs or pilot projects, innovative research methods and risk communication practices, methods for evaluating communication effectiveness, and media engagement.

Abstract submissions may be related to, but are not limited to the following areas:
  • Social/new media
  • Audience research and segmentation
  • Web communication strategies
  • Innovations in immunization communication
  • Evaluating communication campaigns and evaluation metrics
  • Health literacy/plain language communication
  • Best practices in working with the media
  • Message development
  • Partnerships for vaccine communication
  • Communication channel selection (i.e. traditional media vs. social media)
  • Modeling and modifying behaviors

For more information about abstract submissions, please visit http://cdc.confex.com/cdc/nic2010/cfp.cgi

For more information about the conference, please visit:
http://www.cdc.gov/vaccines/events/nic


Remember to register for the conference before February 19 to get the early-bird rate. To register online, go to:
http://conferences.taskforce.org/nic10

For additional information, contact the conference planning team at (404) 639-8225 or nipnic@cdc.gov

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12.  November issue of CDC's Immunization Works electronic newsletter recently released

CDC recently released the November issue of its monthly newsletter Immunization Works; it is posted on the website of the National Center for Immunization and Respiratory Diseases (NCIRD). The newsletter offers the immunization community information about current topics. The information is in the public domain and can be reproduced and circulated widely.

Most of the information in the November issue has already appeared in previous issues, or the current issue, of IAC Express. Here are two articles not covered elsewhere:

STAY INFORMED
Stay Informed! Information on 2009 pandemic influenza A (H1N1) is updated frequently. Please visit the following websites for the latest updates:

CDC PODCASTS
CDC has released several podcasts this month including "H1N1 Flu Vaccine--Why the Delay," "Influenza Round Table: Warning Signs," and "Influenza Round Table: Don't Get, Don't Spread." Each podcast is approximately 2 to 4 minutes long and there are more than 300 different podcasts in 20 different series covering a wide range of health topics. Access CDC podcasts on your computer or download them for reliable health and safety information. (http://www2c.cdc.gov/podcasts)

To access the complete November issue from CDC's Vaccines & Immunizations website, go to:
http://www.cdc.gov/vaccines/news/newsltrs/imwrks/2009/200911.htm

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13.  IAC updates "Quick Answers to Tough Questions" PowerPoint presentation

In 2005, IAC consultant Teresa Anderson, DDS, MPH, presented a workshop talk titled "Quick Answers to Tough Questions" at the National Immunization Conference. The presentation provided healthcare professionals with basic talking points and resources to use with vaccine-hesitant parents and patients. The presentation has been updated to include discussion of current controversies such as alternative schedules and vaccine adjuvants.

Feel free to use this information as needed. The Immunization Action Coalition is pleased when others reprint or adapt our materials. If you adapt our material for your organization or personal use, please acknowledge the Immunization Action Coalition as the source.

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14.  MMWR reports on global measles mortality

CDC published "Global Measles Mortality, 2000-2008" in the December 4 issue of MMWR. The first paragraph of the Editorial Note follows.


After a period of rapid progress in reducing global measles mortality during 2000-2006, the reduction in measles mortality has begun to level off, raising the possibility that the 2010 goal might not be reached. Approximately 77% of the estimated global measles mortality in 2008 was concentrated in one region (SEAR [South-East Asia Region]). Further progress toward the 90% mortality reduction goal is impeded by two factors: (1) India has not fully implemented the measles mortality strategies recommended by WHO and UNICEF in 2001, and (2) political and financial commitment to sustaining measles control in many of the other 46 priority countries has declined. . . .

To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5847a2.htm

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15.  The Measles Initiative launches redesigned website

[The following is cross posted from CDC's Immunization Works electronic newsletter, November 2009.]

RELAUNCH OF THE MEASLES INITIATIVE

The Measles Initiative is a partnership committed to reducing measles deaths globally. Launched in 2001, the Measles Initiative--led by the American Red Cross, the United Nations Foundation, the U.S. Centers for Disease Control and Prevention, UNICEF and the World Health Organization--provides technical and financial support to governments and communities conducting mass vaccination campaigns, improving routine immunization services, and establishing effective disease surveillance. After more than a year's worth of work, the Measles Initiative has re-launched a new website design that features improved navigation, enhanced internal search engine capabilities, a comprehensive multimedia library and interactive map. A substantial amount of updated content has also been added to better showcase this public health partnership's work around the world. Visit the Measles Initiative website (http://www.measlesinitiative.org) to learn how the Measles Initiative is helping reduce global measles deaths as well as to access journal articles, presentations and campaign reports.

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16.  November issue of the Global Immunization News available online

The November 30, 2009, issue of WHO's Global Immunization News can be accessed online at http://www.who.int/immunization/GIN_November_2009.pdf

Older issues of the Global Immunization News are archived at http://www.who.int/immunization/gin/en

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17.  MMWR publishes information about Conference on Vaccine Research

CDC published "Announcement: 13th Annual Conference on Vaccine Research" in the December 4 issue of MMWR. The first paragraph follows.


The Thirteenth Annual Conference on Vaccine Research, the largest scientific forum devoted exclusively to the research and development of vaccines and related technologies for prevention and treatment of disease through immunization, will be held April 26-28, 2010, at the Bethesda North Marriott & Conference Center Hotel in Bethesda, Maryland. The conference brings together the diverse fields of human and veterinary vaccinology to encourage collaboration and multidisciplinary approaches among disease-specific and methodologic experts.


For more details about the conference, including information about abstract submission, travel grants, and the Maurice R. Hilleman Early-State Career Investigator Award, go to: http://www.nfid.org/conferences/vaccine10 or contact the conference planners at (301) 656-0003 or vaccine@nfid.org

To access the full article in web-text (HTML) format, go to:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5847a4.htm

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About IZ Express

IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.

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ISSN 2771-8085

Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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