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Issue 1022
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IAC Express: Weekly immunization news and information
Issue 1022: October 30, 2012






Reminder: October 2012 issues of Needle Tips and Vaccinate Adults available online
The October 2012 issues of Needle Tips and Vaccinate Adults are available online. Vaccinate Adults is an abbreviated version of Needle Tips with the pediatric content removed.

Click on the images below to download the entire October 2012 issues (PDF) of Needle Tips and/or Vaccinate Adults.
Download October issue of Needle TipsDownload October issue of Vaccinate Adults
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ACIP votes to recommend that pregnant women receive Tdap vaccination during each pregnancy
On October 24, at its regularly scheduled October meeting, CDC's Advisory Committee on Immunization Practices (ACIP) voted to recommend that pregnant women receive Tdap vaccine during each pregnancy even if a woman has received the vaccine previously. A related CDC media advisory issued on the same date is reprinted below.

CDC Advisory Committee for Immunization Practices Recommends Tdap Immunization for Pregnant Women
The Advisory Committee on Immunization Practices voted today 14 to 0, with one abstention, to recommend that providers of prenatal care implement a Tdap immunization program for all pregnant women. Health-care personnel should administer a dose of Tdap during each pregnancy irrespective of the patient’s prior history of receiving Tdap. If not administered during pregnancy, Tdap should be administered immediately postpartum.

This builds upon a previous recommendation made by ACIP in June 2011 to administer Tdap during pregnancy only to women who have not previously received Tdap. By getting Tdap during pregnancy, maternal pertussis antibodies transfer to the newborn, likely providing protection against pertussis in early life, before the baby starts getting DTaP vaccines. Tdap will also protect the mother at time of delivery, making her less likely to transmit pertussis to her infant. If not vaccinated during pregnancy, Tdap should be given immediately postpartum, before leaving the hospital or birthing center.

The U.S. remains on track to have the most reported pertussis cases since 1959, with more than 32,000 cases already reported along with 16 deaths, the majority of which are in infants.

Note: ACIP’s recommendations will be forwarded to CDC’s director for approval. If the ACIP recommendations are approved by the CDC director, they will be published in CDC’s Morbidity and Mortality Weekly Report (MMWR) and represent the official CDC recommendations for immunizations in the U.S.; until then, they are considered provisional.

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ACIP votes to recommend meningococcal vaccination for high-risk infants starting at age 2 months
On October 24, CDC's Advisory Committee on Immunization Practices (ACIP) voted to recommend that high-risk infants be vaccinated with HibMenCY vaccine (MenHibrix; GSK) starting at age 2 months. A related CDC media advisory issued on the same date is reprinted below.

CDC Advisory Committee on Immunization Practices Recommends HibMenCY for Infants at Increased Risk for Meningococcal Disease
The Advisory Committee on Immunization Practices voted today 13 to 1, with 1 abstention, to recommend that infants at increased risk for meningococcal disease should be vaccinated with 4 doses of HibMenCY at 2, 4, 6, and 12 through 15 months. These include infants with recognized persistent complement pathway deficiencies and infants who have anatomic or functional asplenia including sickle cell disease. HibMenCY can be used in infants ages 2 through 18 months who are in communities with serogroup C and Y meningococcal disease outbreaks.

Meningococcal disease is a serious, vaccine-preventable bacterial infection caused by Neisseria meningitidis bacteria. The two most severe common illnesses caused by these bacteria include meningitis and bloodstream infections. Infants with certain medical conditions, such as sickle cell disease or complement component deficiency, are at increased risk for meningococcal disease.

Meningococcal disease incidence has declined to historically low levels since the last peak in disease in the late 1990s. About 50 of infant cases are potentially preventable by available vaccines. The majority of infant cases are caused by a type of the bacteria that are not prevented by meningococcal vaccines. Also, the majority of infant cases occur within the first 6 months of life, before a vaccine would likely be able to protect since 3 doses are needed (at 2, 4 and 6 months) to maximize the immune response.

Note: ACIP’s recommendations will be forwarded to CDC’s director for approval. If the ACIP recommendations are approved by the CDC director, they will be published in CDC’s
Morbidity and Mortality Weekly Report (MMWR) and represent the official CDC recommendations for immunizations in the U.S.; until then, they are considered provisional.

Related Links

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New: Sixth edition of Vaccines, the definitive  vaccine textbook, now available for order
Just published by Elsevier, the sixth edition of Vaccines is described in the foreword, written by Bill Gates, as "an indispensable guide to the enhancement of the well-being of our world."

Edited by esteemed vaccine scientists Stanley A. Plotkin, MD; Walter A. Orenstein, MD; and Paul A. Offit, MD, the sixth edition contains key features that, according to Elsevier, will enable readers to
  • Gain a complete understanding of each disease, including clinical characteristics, microbiology, pathogenesis, diagnosis, and treatment, as well as epidemiology and public health and regulatory issues
  • Update their knowledge of existing vaccines and vaccines currently in the research and development stage
  • Get complete answers on each vaccine, including its stability, immunogenicity, efficacy, duration of immunity, adverse events, indications, contraindications, precautions, administration with other vaccines, and disease-control strategies
  • Analyze the cost-benefit and cost-effectiveness of different vaccine options
  • Clearly visualize concepts and objective data through an abundance of tables and figures
Website features will let readers
  • Consult the book from any computer at home, in the office, or at any practice location
  • Instantly locate the answers to clinical questions via a simple search query
  • Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract
A comprehensive preview of Vaccines is available, as is access to a one-day free-trial offer (click on the hyperlinked text "List of free titles available" to access the free-trial offer). 

Priced at $287.20, Vaccines contains 1,392 pages. Order online, or access information for ordering by phone or mail by scrolling down to the subhead titled "Books Customer Service Department."

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Spotlight on immunize.org: subscribe to immunization-related email news services from CDC, AAP, VEC, and more

The Email News Services web section on immunize.org includes descriptions and subscription information for more than 25 immunization-related e-newsletters and email updates published by governmental and non-governmental agencies, professional societies, academic centers, and nonprofit organizations.

IAC's listing of email news offerings includes CDC's Email Subscription service, AAP's Immunization Initiative Newsletter, Vaccine Education Center's (VEC) Parent PACK Newsletter, EZIZ.org email news updates, and many more. Browse IAC's selection of e-newsletters and email updates for healthcare professionals, and subscribe to one or more of these helpful resources.

If you have additional email news services to recommend for inclusion on immunize.org, please send your suggestion(s) by email to maryq@immunize.org.

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CDC publishes information about two-dimensional vaccine barcoding
CDC recently published Two-Dimensional (2D) Vaccine Barcoding on its Immunization Information Systems (IIS) web section. The report includes results from a study assessing the potential impact of 2D barcodes for vaccine production, clinical development, and public health reporting and tracking, and a pilot project to test 2D barcode implementation.

Currently, vaccine product identification and vaccine lot numbers are either handwritten or typed into an electronic medical record and/or IIS system, and are frequently missing or incorrect. Implementation of a 2D barcode on vaccines could allow for rapid and accurate entry of these data (and more) by a handheld imaging device or scanner.

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IAC updates its healthcare professional Q&A "Hepatitis B and Healthcare Personnel"
IAC recently revised its three-page Q&A resource from CDC immunization experts titled Hepatitis B and Healthcare Personnel: CDC answers frequently asked questions about how to protect healthcare personnel. Revisions were made throughout the document, including the table.

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 six standing orders templates for vaccine administration
IAC made revisions to the following six standing orders templates for vaccine administration. The revisions reflect changes CDC recently made to its vaccine recommendations.

  1. Standing Orders for Administering DTaP to Children Younger than Age 7 Years
  2. Standing Orders for Administering Tdap/Td to Children Ages 7 Years and Older
  3. Standing Orders for Administering Tdap/Td to Adults
  4. Standing Orders for Administering Hepatitis B Vaccine to Children & Teens
  5. Standing Orders for Administering Hepatitis B Vaccine to Adults
  6. Standing Orders for Administering Haemophilus influenzae Type B Vaccine to Children
Related Link
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California's new interactive training on conducting a vaccine inventory available to all
The Immunization Branch of the California Department of Public Health (CDPH) recently posted a 19-minute interactive training module on its EZIZ website. Developed by EZIZ for the use of medical assistants who work for California's Vaccines for Children (VFC) providers, the Conducting a Vaccine Inventory module is accessible to anyone who clicks on the hyperlinked text above, then clicks on the text by the same name on the EZIZ website, and logs in (log in is free). 

Related Links
About EZIZ

The CDPH immunization skills training portal, EZIZ, provides interactive immunization lessons, job aids, and updated vaccine news and information of interest to California's VFC providers and others involved in immunization in other parts of the nation. 

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MMWR iPad app available for free download
CDC published Announcement: MMWR iPad App Now Available in the October 26 issue of MMWR (page 864). The first paragraph is reprinted below.

A new MMWR iPad application is now available for free download in the Apple store. This application provides access to the complete array of publications in the MMWR series, which includes the MMWR Weekly, plus Recommendations and Reports, Surveillance Summaries, Supplements, and the annual Summary of Notifiable Diseases.

Related Link

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CDC publishes report on recent progress Chad made toward eradicating polio
CDC published Progress Toward Poliomyelitis Eradication—Chad, January 2011–August 2012 in the October 26 issue of MMWR (pages 858–862). The first paragraph is reprinted below.

In 1988, the World Health Assembly launched the Global Polio Eradication Initiative (GPEI) to interrupt transmission of wild poliovirus (WPV). By January 2012, indigenous WPV transmission had been interrupted in all countries except Afghanistan, Pakistan, and Nigeria. However, importation of WPV caused outbreaks in 29 and reestablished transmission in four, previously polio-free African countries during 2003–2011. Transmission after WPV importation is considered reestablished when it continues for ≥12 months; in Chad, transmissions of WPV type 3 (WPV3) and WPV type 1 (WPV1) were reestablished. WPV3 was imported from Nigeria in 2007 and continued to circulate; the latest reported WPV3 case occurred on March 10, 2011. Transmission of WPV1 continued after a WPV1 case was imported from Nigeria in September 2010; the latest reported WPV1 occurred on June 14, 2012. This report updates previous reports and describes polio eradication activities and progress in Chad during January 2011–August 2012, as of October 2, 2012. Five WPV1 cases were reported during January–August 2012, compared with 111 WPV1 cases and three WPV3 cases reported during the same period in 2011. Five circulating type 2 vaccine-derived poliovirus (cVDPV2) cases occurred during July–August 2012. Current progress suggests that Chad could interrupt reestablished WPV transmission in 2012, although limitations in surveillance hamper the ability to detect ongoing transmission. Furthermore, with ongoing endemic WPV transmission in Nigeria, Chad remains at risk for new WPV importations. Efforts to strengthen surveillance and enhance routine and campaign immunization performance will need to continue in Chad to ensure interruption of reestablished WPV transmission, limit circulation after any WPV importation, and interrupt transmission of cVDPV.

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Medscape features CDC expert explaining new ACIP recommendations to give PCV13 to high-risk adults 
In a new Medscape video, CDC expert Tamara Pilishvili, MPH, talks about the new ACIP recommendations to give PCV13 (Prevnar 13) to high-risk adults and reviews existing PPSV23 (Pneumovax) recommendations for adults. This free overview is a must-see for every doctor, nurse, and healthcare provider who provides medical care to adults. Use of Medscape is free, but you must register to gain access to the resources.

Related Links

ACIP recommendations Back to top

About IAC Express 
The Immunization Action Coalition welcomes redistribution of this issue of IAC Express or selected articles. When you do so, please add a note that the Immunization Action Coalition is the source of the material and provide a link to this issue.
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IAC Express is supported in part by Grant No. U38IP000589 from the National Center for Immunization and Respiratory Diseases, CDC. Its contents are solely the responsibility of IAC and do not necessarily represent the official views of CDC. IAC Express is also supported by educational grants from the following companies: Baxter Healthcare Corp.; CSL Biotherapies; GlaxoSmithKline; MedImmune, Inc.; Merck Sharp & Dohme Corp.; Novartis Vaccines; Ortho Clinical Diagnostics, Inc.; Pfizer, Inc.; and sanofi pasteur.
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Issue 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.
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Editor: Deborah L. Wexler, MD
Managing Editor: Dale Thompson, MA
Associate Editor: Teresa Anderson, DDS, MPH
Editorial Assistant: Janelle Tangonan Anderson
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This page was reviewed on October 30, 2012
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This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 6NH23IP22550) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.