IAC Express 2010
Issue number 887: September 7, 2010
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Contents of this Issue
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  1. Reminder: August 2010 issues of Needle Tips and Vaccinate Adults available online
  2. New DVD for 2010! "Immunization Techniques: Best Practices with Infants, Children, and Adults"--from the California Department of Public Health, Immunization Branch
  3. MMWR publishes ACIP's updated recommendations for preventing invasive pneumococcal disease among adults using PPSV23
  4. Clarification: Tdap/DTaP chart from last week's IAC Express includes California-specific recommendations
  5. Mandatory influenza vaccination for healthcare workers called for by the American Academy of Pediatrics and the Society for Healthcare Epidemiology of America
  6. AAP releases policy statement on recommendations for influenza immunization of children
  7. IAC updates online "Ask the Experts" Q&A sections related to influenza, meningococcal, and rabies vaccines and diseases
  8. IAC's Video of the Week features Dr. Nancy Snyderman speaking about California's pertussis outbreak
  9. Society for Adolescent Health and Medicine encourages increased efforts in adolescent immunization
  10. NACCHO launches radio campaigns to promote Vaccines for Children program
  11. CDC website adds 2010-11 influenza vaccination print materials for a variety of audiences
  12. Almost 100 million children in China to receive measles vaccine
  13. VISs for influenza and Td/Tdap vaccines now available in additional languages
  14. Reminder: Vaccine Education Center to hold symposium in Philadelphia on September 25
  15. VICNetwork hosts September 23 webinar on communicating vaccine safety data to parents
  16. "CDC Features" educates about the development of influenza videos for deaf and hard-of-hearing people
  17. MMWR announces a Clinical Vaccinology Course scheduled for November 5-7 in Bethesda, MD
  18. PKIDs' September 23 webinar will discuss social media problems and solutions; September 30 webinar to focus on traditional media
 
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 887: September 7, 2010
1.  Reminder: August 2010 issues of Needle Tips and Vaccinate Adults available online

The August 2010 issues of Needle Tips and Vaccinate Adults are available online for viewing, downloading, and printing. Both issues emphasize the importance of vaccinating everyone age 6 months and older against influenza. Most of the content of Vaccinate Adults is identical to that of Needle Tips; only the pediatric information has been removed.

To download the entire issue of Needle Tips right now, go to: http://www.immunize.org/nslt.d/n46/n46.pdf

To download the entire issue of Vaccinate Adults right now, go to: http://www.immunize.org/va/va29.pdf

Complete information about the August 2010 issue of Needle Tips is available at http://www.immunize.org/nt

Complete information about the August 2010 issue of Vaccinate Adults is available at http://www.immunize.org/va

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2 New DVD for 2010! "Immunization Techniques: Best Practices with Infants, Children, and Adults"--from the California Department of Public Health, Immunization Branch

The California Department of Public Health (CDPH), Immunization Branch, recently updated its award-winning training video, "Immunization Techniques: Best Practices with Infants, Children, and Adults." The 25-minute program can be used to train new employees and to refresh the skills of experienced staff. The video demonstrates the skills and techniques needed to administer vaccines to patients of all ages. It includes instruction on the following:

  • Selecting, preparing, and administering injectable, oral, and nasal vaccines
  • Documenting immunizations
  • Making patients comfortable and educating them
  • Facilitating staff and patient communication

Prices start at $17 each for 1-9 copies and are greatly reduced for large orders, dropping to $4.25 each for 1,000-1,500 copies.

To learn more about the DVD, and find out how to order it, go to: http://www.immunize.org/shop/toolkit_iztechdvd.asp

For quotes on larger quantities, call (651) 647-9009 or email admininfo@immunize.org

The Immunization Action Coalition is the only nationwide vendor of this new DVD.

Note: For healthcare settings located in California, contact your local health department immunization program for a free copy.

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3 MMWR publishes ACIP's updated recommendations for preventing invasive pneumococcal disease among adults using PPSV23

CDC published "Updated Recommendations for Prevention of Invasive Pneumococcal Disease Among Adults Using the 23-Valent Pneumococcal Polysaccharide Vaccine (PPSV23)" in the September 3 issue of MMWR. The first paragraph as well as the text from a box titled " Updated recommendations for administration of 23-valent pneumococcal polysaccharide vaccine (PPSV23) among adults aged >=19 years--Advisory Committee on Immunization Practices (ACIP), United States" are reprinted below.


Invasive disease from Streptococcus pneumoniae (pneumococcus) is a major cause of illness and death in the United States, with an estimated 43,500 cases and 5,000 deaths among persons of all ages in 2009. This report provides updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for prevention of invasive pneumococcal disease (IPD) (i.e., bacteremia, meningitis, or infection of other normally sterile sites) through use of the 23-valent pneumococcal polysaccharide vaccine (PPSV23) among all adults aged >=65 years and those adults aged 19-64 years with underlying medical conditions that put them at greater risk for serious pneumococcal infection. The new recommendations include the following changes from 1997 ACIP recommendations: (1) the indications for which PPSV23 vaccination is recommended now include smoking and asthma, and (2) routine use of PPSV23 is no longer recommended for Alaska Natives or American Indians aged <65 years unless they have medical or other indications for PPSV23. ACIP recommendations for revaccination with PPSV23 among the adult patient groups at greatest risk for IPD (i.e., persons with functional or anatomic asplenia and persons with immunocompromising conditions) remain unchanged. ACIP recommendations for prevention of pneumococcal disease among infants and youths aged <=18 years using the 13-valent pneumococcal conjugate vaccine (PCV13) and PPSV23 are published separately.

BOX CONTENT:
Updated recommendations for administration of 23-valent pneumococcal polysaccharide vaccine (PPSV23) among adults aged >=19 years--Advisory Committee on Immunization Practices (ACIP), United States
  • PPSV23 should be administered to adults aged 19-64 years with chronic or immunosuppressing medical conditions, including those who have asthma.
     
  • Adults aged 19-64 years who smoke cigarettes should receive PPSV23 and smoking cessation guidance.
     
  • Routine PPSV23 use is no longer recommended for Alaska Natives or American Indians aged <65 years unless they have medical indications for PPSV23. However, in certain situations, public health authorities may recommend PPSV23 for Alaska Natives and American Indians aged 50-64 years who are living in areas where the risk for invasive pneumococcal disease is increased.
     
  • All persons should be vaccinated with PPSV23 at age 65 years. Those who received PPSV23 before age 65 years for any indication should receive another dose of the vaccine at age 65 years or later if at least 5 years have passed since their previous dose. Those who receive PPSV23 at or after age 65 years should receive only a single dose.
     
  • ACIP does not recommend routine revaccination for most persons for whom PPSV23 is indicated. A second dose of PPSV23 is recommended 5 years after the first dose for persons aged 19-64 years with functional or anatomic asplenia and for persons with immunocompromising conditions. ACIP does not recommend multiple revaccinations because of uncertainty regarding clinical benefit and safety.

To download a PDF of the updated recommendations, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5934.pdf and see pages 1102-06.

To access the updated recommendations in web-text (HTML) format, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5934a3.htm

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4 Clarification: Tdap/DTaP chart from last week's IAC Express includes California-specific recommendations

A number of concerned readers contacted IAC about the Tdap/DTaP product chart written about in last week's IAC Express (dated August 30, 2010). The chart was developed by the California Department of Public Health and reflects recommendations specific to that state in light of the current pertussis outbreak. Specifically, the chart shows Tdap as being used in patients "7 Years of Age or Older," which could be misleading to our readers.

No pertussis-containing product is licensed for children age 7-9 years or for adults older than age 64 years. However, vaccines can be given off-label if the healthcare professional believes the benefit is greater than any possible risk. The state of California is currently recommending Tdap vaccine for children as young as age 7 and adults older than age 64 in an attempt to stop the pertussis outbreak that has killed eight infants.

The California Department of Public Health has kindly provided IAC with a copy of its earlier Tdap/DTaP product chart, which is more applicable to the rest of the nation.

To access it, go to: http://www.immunize.org/tdap_dtap_vial_chart.pdf NOTE: The VFC telephone number that appears at the bottom left of the chart applies ONLY TO HEALTHCARE SETTINGS IN CALIFORNIA.

We apologize for the confusion created in last week's IAC Express and thank our astute readers for their emails.

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5 Mandatory influenza vaccination for healthcare workers called for by the American Academy of Pediatrics and the Society for Healthcare Epidemiology of America

This past week, both the American Academy of Pediatrics (AAP) and the Society for Healthcare Epidemiology of America (SHEA) joined the Infectious Diseases Society of America (IDSA) and the National Patient Safety Foundation in calling for mandatory influenza vaccination for healthcare workers, with few exceptions allowed. In addition, IDSA endorsed the updated SHEA policy and similarly amended its organization's policy on influenza vaccination for healthcare workers.

AAP announced its new policy statement in an article titled "AAP Policy Calls for Mandatory Flu Shots for Health Care Workers," which was published in the September 2010 issue of the AAP News. According to the article, the academy will be issuing a new policy statement in mid-September that recommends the implementation of a mandatory influenza immunization policy for all healthcare personnel. To read the news story, go to: http://aapnews.aappublications.org/cgi/content/full/31/9/1-b

According to SHEA's position statement, which was electronically published on August 31, 2010, "SHEA views influenza vaccination of HCP [healthcare personnel] as a core patient and HCP safety practice with which noncompliance should not be tolerated. . . . Therefore, for the safety of both patients and HCP, SHEA endorses a policy in which annual influenza vaccination is a condition of both initial and continued HCP employment and/or professional privileges. . . .This recommendation applies to all HCP working in all healthcare settings, regardless of whether the HCP have direct patient contact or whether the HCP are directly employed by the facility. It also applies to all students, volunteers, and contract workers. SHEA recommends that only exemptions due to recognized medical contraindications to influenza vaccination be considered." To access the position statement in its entirety, go to: http://www.journals.uchicago.edu/doi/full/10.1086/656558

A press release accompanied the revised position statement by SHEA; to read it, go to: http://www.shea-online.org/Assets/files/policy/083110_Vaccination_Release.pdf

On July 28, 2010, IDSA endorsed SHEA's statement and updated its policy to disallow declination of influenza vaccination for personal reasons and to specify the steps that should be taken to protect patients from being infected by unimmunized healthcare workers. To read IDSA's updated position statement, go to: http://www.idsociety.org/hcwimmunization.htm

Related press releases, position statements, and the AAP news article were added to IAC's Honor Roll for Patient Safety. The honor roll recognizes hospitals, professional organizations, medical practices, and government entities that have taken a stand for patient safety by strengthening mandatory influenza vaccination policies for healthcare workers.

To be included in the honor roll, an organization's mandate must require influenza vaccination for employees and must include serious measures to prevent transmission of influenza from unvaccinated workers to patients. Such measures might include a mask requirement, reassignment to non-patient-care duties, or dismissal of the employee.

To find out specific information on the mandates of the enrolled organizations or to submit your organization's application for the honor roll, go to: http://www.immunize.org/honor-roll

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6 AAP releases policy statement on recommendations for influenza immunization of children

On August 30, the American Academy of Pediatrics (AAP) published a policy statement online (ahead of print) made by AAP's Committee on Infectious Diseases. Titled "Recommendations for Prevention and Control of Influenza in Children, 2010-2011," this statement updates the current recommendations for routine use of trivalent seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children.

To access a ready-to-print (PDF) version of this statement, go to: http://pediatrics.aappublications.org/cgi/reprint/peds.2010-2216v1

To access the abstract of the statement, go to: http://pediatrics.aappublications.org/cgi/content/abstract/peds.2010-2216v1

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7 IAC updates online "Ask the Experts" Q&A sections related to influenza, meningococcal, and rabies vaccines and diseases

IAC recently updated the online "Ask the Experts" Q&A sections related to these three vaccines/diseases: influenza, meningococcal, and rabies. IAC's online "Ask the Experts" Q&As are reviewed and updated annually with input from vaccination experts at CDC. The process is ongoing; IAC Express will inform readers as sections are reviewed and revised.

To access the revised influenza Q&As, go to: http://www.immunize.org/askexperts/experts_inf.asp

To access the revised meningococcal Q&As, go to: http://www.immunize.org/askexperts/experts_men.asp

To access the revised rabies Q&As, go to: http://www.immunize.org/askexperts/experts_rab.asp

To access the index page of "Ask the Experts" Q&As for all other vaccines, go to: http://www.immunize.org/askexperts

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8 IAC's Video of the Week features Dr. Nancy Snyderman speaking about California's pertussis outbreak

IAC encourages IAC Express readers to watch a 4-minute video featuring Dr. Nancy Snyderman, MSNBC's chief medical editor. Dr. Snyderman appeared on the Today Show to discuss the recent pertussis outbreak in California and the serious consequences of vaccine exemptions.

The video will be available on the home page of IAC's website through September 12. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week. After that date, the video will be available on MSNBC at http://today.msnbc.msn.com/id/38447752/ns/health-infectious_diseases

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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9 Society for Adolescent Health and Medicine encourages increased efforts in adolescent immunization

On August 19, in response to a National Immunization Survey report on U.S. adolescent vaccination coverage that was published in MMWR on August 20, the Society for Adolescent Health and Medicine issued a press release titled "The Society for Adolescent Health and Medicine (SAHM) Advocates for Ways to Improve Immunization Rates and Halt Disease Outbreaks." Portions of the press release are reprinted below.


In light of today's report of the National Immunization Survey results, the Society for Adolescent Health and Medicine (SAHM) encourages increased efforts in fully immunizing all adolescents.

The report issued by the National Immunization Survey (NIS) shows progress in increasing immunization rates among teens 13-17 years of age. However, rates remain unacceptably low for those vaccines that are targeted specifically to prevent disease in adolescents: meningococcal meningitis (53.6 %), human papillomavirus (44.3% received one dose, while only 26.7% received all three recommended doses), tetanus/diphtheria/pertussis (Tdap) (55.6 %). Low rates among adolescents may be responsible for the epidemic of pertussis (whooping cough) that is presently occurring in California. . . .

A variety of challenges face providers and public health authorities in vaccinating adolescents. SAHM recommends the following steps to help providers overcome these barriers: (1) Vaccinate adolescents at every opportunity possible, regardless of the reason for a medical visit; (2) Make sure vaccinations are a priority for comprehensive health visits, including sports physicals; (3) Utilize standing orders which instruct office staff to vaccinate adolescents when indicated, even if a provider forgets; (4) Utilize a vaccine reminder and recall system to get patients to return for additional vaccines when they need them; (5) Lobby for and utilize centralized statewide vaccine registries where all adolescents can have their vaccine status documented; (6) support the use of school-located programs and other alternative sites to provide immunization services for those with less access to comprehensive services, and (7) educate patients at every opportunity about the benefits of vaccines. SAHM urges patients and parents to talk to their providers about vaccines including the efficacy and safety of this most important primary prevention tool. . . .


To access the complete press release, go to: https://www.adolescenthealth.org/Press_Releases.htm Click on the link to the press release dated August 19, 2010.

To access the August 20 MMWR report titled "National, State, and Local Area Vaccination Coverage among Adolescents Aged 13-17 Years--United States, 2009," go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5932a3.htm

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10.  NACCHO launches radio campaigns to promote Vaccines for Children program

On September 1, the National Association of County and City Health Officials (NACCHO) held radio interviews in national and selected English- and Spanish-speaking regional radio markets across the country. The radio tour was intended to educate the public about the Vaccines for Children (VFC) program, which makes vaccines available at no- or low-cost to those qualifying for coverage. This is an attempt to reduce financial barriers to seeking necessary health care because of the current poor economy.

The radio tour is the beginning of a broader campaign that will be phased in over the next several weeks. Public service announcements will soon be available for download from NACCHO's website. In the coming weeks, information will also be available on how local health departments and private providers can order free posters and tear-pads promoting the VFC program to reach VFC-eligible families who may not know about the program.

To learn more about the campaign and when campaign materials will be available, visit www.naccho.org/VFC

If you have questions about the campaign, contact Paul Etkind at petkind@naccho.org

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11.  CDC website adds 2010-11 influenza vaccination print materials for a variety of audiences

Right on time for the beginning of the 2010-11 influenza vaccination season, CDC has posted an array of print materials that encourage influenza vaccination for various population groups including

  • General public
  • Families and children
  • Speakers of Spanish and other non-English languages
  • People with high-risk conditions
  • Pregnant women
  • Adults ages 19-24 years
  • Adults age 65 years and older
  • Businesses and employers
  • Healthcare workers
  • Minority populations

All materials can be downloaded at no charge and can be printed on standard office printers or at commercial printers. Materials are or will be available in Spanish, Arabic, Chinese, French, German, Korean, Russian, and Vietnamese.

To access the materials, go to: http://www.cdc.gov/flu/freeresources/print.htm Click on each image to see the different sizes and languages available. Search by audience or topic. Materials will be added throughout the month of September, so be sure to check back often.

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12.  Almost 100 million children in China to receive measles vaccine

On September 1, UNICEF and WHO issued a press release titled "UNICEF, WHO: Nearly 100 Million Children to Be Vaccinated against Measles in China." A portion of it is reprinted below.


Nearly 100 million children across China will be vaccinated against measles from 11-20 September in one of the world's biggest such public health undertakings to date. The nationwide campaign will protect millions of children against the disease and bring China closer to reaching the measles elimination goal by 2012 in line with the target set by the World Health Organization's Western Pacific region.

"China is a priority country in the global fight against measles and we commend the government for its leadership in this life-saving work," said Dr Michael O'Leary, the World Health Organization (WHO) Representative in China.

In 2009, more than 52,000 people in China were reported to have contracted measles, accounting for about 86 per cent of the measles cases in WHO's Western Pacific region. . . .

To access the complete press release, go to: http://www.unicef.org/media/media_55859.html

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13.  VISs for influenza and Td/Tdap vaccines now available in additional languages

The interim 2010-11 VISs for trivalent inactivated influenza vaccine (TIV; injectable) and live attenuated intranasal influenza vaccine (LAIV; nasal spray) are now available in Arabic, Armenian, Cambodian, Farsi, and Tagalog. The interim VIS for Td/Tdap vaccines is now available in Chinese, Tagalog, and Vietnamese. IAC gratefully acknowledges the California Department of Public Health, Immunization Branch, for the translations.

INFLUENZA VISs
To access the new translations of the interim VIS for injectable influenza vaccine, as well as the injectable influenza vaccine VIS in English and other translations, go to: http://www.immunize.org/vis/vis_flu_inactive.asp

To access the new translation of the interim VIS for nasal-spray influenza vaccine, as well as the nasal-spray influenza vaccine VIS in English and other translations, go to: http://www.immunize.org/vis/vis_flu_live.asp

Td/Tdap VIS
To access the new translations of the interim VIS for Td/Tdap vaccines, as well as the interim VIS for Td and Tdap vaccines in English and other translations, go to: http://www.immunize.org/vis/vis_td-tdap.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

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14.  Reminder: Vaccine Education Center to hold symposium in Philadelphia on September 25

The Vaccine Education Center at The Children's Hospital of Philadelphia will hold a Vaccine Education Symposium on September 25 in Philadelphia. The symposium is intended for physicians, allied health and public health professionals, nurses, and other healthcare professionals who work in the field of immunizations.

The symposium will examine vaccines in light of these and other topics:

  • Vaccine safety concerns
  • Current challenges in vaccine financing
  • Parents refusal to vaccinate

For more information, download the symposium brochure at http://www.chop.edu/system/galleries/download/pdfs/articles/cme/vaccine-2010.pdf

To register online, go to: https://www.chop.edu/professionals/educational-resources/continuing-medical-education/registration.cfm/vaccine-2010

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15.  VICNetwork hosts September 23 webinar on communicating vaccine safety data to parents

The Virtual Immunization Communication Network (VICNetwork) is hosting a free webinar on September 23 at 11AM Pacific time/2PM Eastern time. "Making the CASE for Vaccines: Communicating about Vaccine Safety" features Alison Tepper Singer, the co-founder and president of the Autism Science Foundation, a nonprofit organization dedicated to supporting autism research. Ms. Singer will describe strategies for communicating vaccine safety information to parents and discuss new developments in the search for the causes of autism.

There is no fee to participate in the webinar, but pre-registration is required. To pre-register, send an email to VICNetwork at info@vicnetwork.org

For more information, go to http://vicnetwork.org

VICNetwork is a project of the National Public Health Information Coalition (NPHIC) in collaboration with the California Immunization Coalition (CIC).

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16.  "CDC Features" educates about the development of influenza videos for deaf and hard-of-hearing people

The "CDC Features" web section now includes information about the development of two videos that use American Sign Language (ASL) to communicate influenza information to people in the deaf and hard-of-hearing community. One video contains influenza prevention information; the other informs deaf parents about how to care for their children during influenza season.

To access the CDC Feature titled "Seasonal Flu Videos in American Sign Language," go to: http://www.cdc.gov/Features/FluVideos

To access the influenza videos in ASL directly, go to http://www.cdc.gov/flu/freeresources/media.htm Click on the pertinent links under the title Videos.

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17.  MMWR announces a Clinical Vaccinology Course scheduled for November 5-7 in Bethesda, MD

CDC published "Announcements: Clinical Vaccinology Course--November 5-7, 2010" in the September 3 issue of MMWR. Portions of the announcement are reprinted below.


CDC and six other national organizations are collaborating with the National Foundation for Infectious Diseases (NFID), Emory University School of Medicine, and the Emory Vaccine Center to sponsor a Clinical Vaccinology Course November 5-7, 2010, at the Hyatt Regency Bethesda in Bethesda, Maryland. . . .

Continuing education credits will be offered. Information regarding the preliminary program, registration, and hotel accommodations is available online (http://www.nfid.org). . . .

To access the announcement in web-text (HTML) format, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5934a4.htm

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18.  PKIDs' September 23 webinar will discuss social media problems and solutions; September 30 webinar to focus on traditional media

PKIDs (Parents of Kids with Infectious Diseases) has scheduled a 90-minute webinar for September 23. It will be a roundtable discussion of participants' social media problems and solutions. A 90-minute webinar scheduled for September 30 will focus on traditional media outreach. The webinars are part of Communications Made Easy, a PKIDs' program intended to help immunization educators learn the ropes of social marketing and traditional and social media.

The roundtable discussion social media problems/solutions is scheduled for September 23 at 9AM Pacific time/noon Eastern time. Space is limited and pre-registration is recommended. For additional information and to register, go to: https://cc.readytalk.com/cc/schedule/display.do?udc=67sr1csslru9

The webinar on traditional media is scheduled for September 30 at 9AM Pacific time/noon Eastern time. Space is limited and pre-registration is recommended. For additional information and to register, go to: https://cc.readytalk.com/cc/schedule/display.do?udc=ohvot83uhwsq

For more information on the Communications Made Easy program, go to: http://www.pkids.org/cme

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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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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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