Issue 1063: June 25, 2013

TOP STORIES

IAC HANDOUTS

OFFICIAL RELEASES AND ANNOUNCEMENTS

FEATURED RESOURCES

JOURNAL ARTICLES AND NEWSLETTERS

EDUCATION AND TRAINING

CONFERENCES AND MEETINGS



TOP STORIES

CDC study indicates HPV vaccination significantly lowers HPV infection rates in teen girls
On June 19, CDC issued a press release titled New study shows HPV vaccine helping lower HPV infection rates in teen girls. Portions of the press release are reprinted below.

A new study looking at the prevalence of human papillomavirus (HPV) infections in girls and women before and after the introduction of the HPV vaccine shows a significant reduction in vaccine-type HPV in U.S. teens. The study, published in . . . the Journal of Infectious Diseases reveals that since the vaccine was introduced in 2006, vaccine-type HPV prevalence decreased 56 percent among female teenagers 14–19 years of age.

About 79 million Americans, most in their late teens and early 20s, are infected with HPV. Each year, about 14 million people become newly infected.

“This report shows that HPV vaccine works well, and the report should be a wake-up call to our nation to protect the next generation by increasing HPV vaccination rates,” said CDC Director Tom Frieden, M.D., M.P.H.  “Unfortunately only one third of girls aged 13–17 have been fully vaccinated with HPV vaccine. Countries such as Rwanda have vaccinated more than 80 percent of their teen girls. Our low vaccination rates represent 50,000 preventable tragedies—50,000 girls alive today will develop cervical cancer over their lifetime that would have been prevented if we reach 80 percent vaccination rates.  For every year we delay in doing so, another 4,400 girls will develop cervical cancer in their lifetimes.”


The Study
The Journal of Infectious Diseases (JID) published the study results in an article titled "Reduction in Human Papillomavirus (HPV) Prevalence Among Young Women Following HPV Vaccine Introduction in the United States, National Health and Nutrition Examination Surveys, 2003–2010." It was published electronically ahead of print on June 19 and will appear in print in the July 15 JID issue.

The Results and Conclusions sections from the article's abstract are reprinted below.

Results. Among females aged 14–19 years, the vaccine-type HPV prevalence (HPV-6, -11, -16, or -18) decreased from 11.5% (95% confidence interval [CI], 9.2–14.4) in 2003–2006 to 5.1% (95% CI, 3.8–6.6) in 2007–2010, a decline of 56% (95% CI, 38–69). Among other age groups, the prevalence did not differ significantly between the 2 time periods (P > .05). The vaccine effectiveness of at least 1 dose was 82% (95% CI, 53–93).

Conclusions. Within 4 years of vaccine introduction, the vaccine-type HPV prevalence decreased among females aged 14–19 years despite low vaccine uptake. The estimated vaccine effectiveness was high.


The complete article is available online for Journal of Infectious Diseases subscribers only.

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Rotavirus and pertussis vaccines discussed at June ACIP meeting
The June meeting of the Advisory Committee on Immunization Practices (ACIP) included information and discussion sessions on rotavirus and pertussis vaccines. A summation of the sessions’ content follows:

Rotavirus: Update on Intussusception
Data from three U.S. studies of rotavirus vaccines demonstrated a small increased risk of intussusception in about 1 in 20,000 to 1 in 100,000 infants from the two rotavirus vaccines licensed for use in the U.S. (RotaTeq [Merck] and Rotarix [GlaxoSmithKline]). CDC continues to recommend that all U.S. infants receive rotavirus vaccine.  The risk-benefit analysis continues to demonstrate that the benefits of rotavirus vaccination continue to outweigh the risks associated with vaccination, including the small risk of intussusception. Steps moving forward will include continued monitoring to further quantify this risk, systematic evaluation of the data by CDC’s ACIP, and education for healthcare professionals and parents.
  • To inform parents of the small increased risk of intussusception, the Vaccine Information Statement (VIS) will be revised to include this new information.  When the revised VIS is available it will be posted on CDC's Vaccine Information Statements web section.
     
  • Following rotavirus vaccination, parents or caregivers should watch their infants for signs and symptoms of intussusception including episodes of stomach pain with severe crying (which may be brief), vomiting, blood in the stool, or acting weak or very irritable, especially within the first 7 days after rotavirus vaccination.  Parents or caregivers should contact their child's healthcare professional if the child has any of these signs, even if it has been several weeks since the last dose of vaccine.
     
  • Providers should be aware of the risks and educate parents about the risk of intussusception and the benefits of rotavirus vaccines.
Pertussis Vaccines
The pertussis vaccines session included presentations on Tdap vaccine effectiveness, vaccine safety, cost effectiveness, and maternal Tdap vaccination and cocooning.

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ACIP votes to recommend FluBlok influenza vaccine for people age 18 through 49  with egg allergy
On June 20, CDC's Advisory Committee on Immunization Practices (ACIP) voted to recommend use of FluBlok (Protein Sciences Corp., Meridian, CT) for people age 18 through 49 with egg allergy during the 2013–14 influenza season. Information included in a related June 20 CDC Media Advisory is reprinted below.

The Advisory Committee on Immunization Practices (ACIP) voted today, 13 to 0, in favor of recommending FluBlok during the 2013–2014 influenza season for vaccination of persons 18 through 49 years of age with egg allergy of any severity. FluBlok was licensed by the Food and Drug Administration (FDA) in January 2013. Unlike current production methods for other available seasonal influenza vaccines, FluBlok does not use the influenza virus or chicken eggs in its manufacturing process.

The ACIP recommends that individuals with a severe egg allergy consult with a physician about their allergic conditions prior to vaccination if FluBlok is not available.


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CDC offers continually updated information on current multistate hepatitis A outbreak, as well as resources for healthcare professionals
On June 24, CDC reported on its Viral Hepatitis Outbreak Cases web page that it, FDA, and state and local health departments are currently investigating a multistate hepatitis A outbreak related to a frozen berry and pomegranate mix, "Townsend Farms Organic Antioxidant Blend." On June 3, the manufacturer, Townsend Farms, Inc., Fairview, OR, voluntarily recalled certain lots of the product. Excerpts from the CDC webpage are reprinted below. (To access updated information in the future, click on the hyperlinked text above.)
  • As of June 21, 2013, 119 people have been confirmed to have become ill from Hepatitis A after eating ‘Townsend Farms Organic Antioxidant Blend’ in 7 states: Arizona (16), California (61), Colorado (24), Hawaii (5), New Mexico (5), Nevada (5), and Utah (3).
     
  • 53 (45%) ill people have been hospitalized, and no deaths have been reported.
     
  • FDA is inspecting the processing facilities of Townsend Farms of Fairview, Oregon.
     
  • The FDA has also finalized a protocol to test berries for the Hepatitis A virus (HAV), and is testing samples related to the outbreak for the presence of HAV.
     
  • The outbreak strain of hepatitis A virus (HAV), belonging to genotype 1B, was found in clinical specimens of 36 people in six states. This strain is rarely seen in the Americas but circulates in North Africa and the Middle East.
     
  • According to the label, the “Townsend Farms Organic Antioxidant Blend” frozen berry and pomegranate mix associated with illness contained products originating from the U.S., Argentina, Chile, and Turkey.
CDC resources for healthcare professionals
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Report indicates strong public support for pertussis vaccination of people in contact with newborns
The findings of a national poll of U.S. adults indicate that the public strongly supports the right of the parents of newborns to insist that visitors receive pertussis vaccination before coming in contact with newborn children. The poll findings are published in Protecting Newborns from Whooping Cough, a  colorful two-page document suitable for sharing with expectant parents and others to explain the importance of vaccinating likely contacts of newborns against pertussis as a way of protecting babies against contracting the disease.

Highlights from the report follow:
  • The majority of adults (72%) strongly agrees or agrees that parents have the right to insist that visitors receive the pertussis vaccine before visiting a newborn baby in the hospital. Nearly two-thirds (61%) of adults strongly agree or agree that parents should make sure all adults receive the pertussis vaccine before visiting a newborn baby at home. Most adults (61%) report they don’t know when they last received a vaccination against pertussis.
     
  • Together, these findings emphasize how important it is for parents of newborns—whose children are at greatest risk for serious and sometimes fatal pertussis illness—to take certain steps to protect their children from whooping cough.
     
  • Expectant parents should have a conversation about pertussis vaccine with their family and close friends BEFORE the baby is born. This will allow time for those individuals to seek out pertussis vaccine from their doctor’s office or a local health department, so that when the infant arrives, he or she can be welcomed in a safe way by family and friends.
The report is a publication from C.S. Mott Children’s Hospital, University of Michigan Department of Pediatrics and Communicable Diseases, and University of Michigan Child Health Evaluation and Research (CHEAR) Unit.

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IAC Spotlight! Like us on Facebook
IAC has created a Facebook page at www.facebook.com/VaccineInformation! It is intended for parents and all interested Facebook users to learn about vaccines and their importance.

Recent Facebook posts include information from a newly released CDC study that shows HPV vaccination is lowering rates of HPV, new Facebook application from Sounds of Pertussis featuring Campaign Ambassador Sarah Michelle Gellar, hepatitis A outbreak information and vaccination resources, and more.

If you have a Facebook page, please take a minute to Like Us on Facebook. Thanks!

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Just published: Dr. Paul A. Offit’s new book, Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine
In his newest book, Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine, Paul A. Offit, MD,  writes about the unregulated industry that often includes “alternative therapies” such as vitamins, dietary supplements, acupuncture, and chiropractic manipulation. He discusses the placebo effect and whether descriptors such as alternative, complementary, holistic, or integrative medicine even exist, positing this instead:  “There’s only medicine that works and medicine that doesn’t.” Parts of the book address the historical nature of some of the now popular phenomena, the effects of celebrity in popularizing certain products, and the importance of being a responsible and educated consumer.

A detailed description of the book's content is available on the website of the publisher, HarperCollins. The website also offers access to the websites of online retailers that carry the book in print and electronic formats. The book is also available from your local bookseller.

Dr. Offit is the chief of Infectious Diseases and the director of the Vaccine Education Center at the Children's Hospital of Philadelphia, as well as the Maurice R. Hilleman Professor of Vaccinology and professor of pediatrics at the University of Pennsylvania School of Medicine.

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IAC HANDOUTS

IAC updates seven standing orders templates for vaccine administration
IAC made revisions to the following seven standing orders templates for vaccine administration.
  1. Standing Orders for Administering Hepatitis A Vaccine to Children & Teens
  2. Standing Orders for Administering Hepatitis A Vaccine to Adults
  3. Standing Orders for Administering Hepatitis B Vaccine to Adults
  4. Standing Orders for Administering Measles, Mumps & Rubella Vaccine to Children & Teens
  5. Standing Orders for Administering Measles, Mumps & Rubella Vaccine to Adults
  6. Standing Orders for Administering Varicella (Chickenpox) Vaccine to Children & Teens
  7. Standing Orders for Administering Varicella (Chickenpox) Vaccine to Adults
Related Link
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

GAVI Alliance's 2012 progress report now available online
The GAVI Alliance Progress Report 2012 is now available in an online version accessible by computer, tablet, or smart phone.

A free copy of the report is available by mail.

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FEATURED RESOURCES

Now is the time to order IAC's top-quality immunization products! Get a 10 percent discount on all IAC products ordered by June 30!
Private practices, public clinics, corporations, and health departments find IAC's immunization products to be invaluable for vaccine delivery and patient education. Making purchases in June is a smart move—to coincide with getting ready for the 2013–14 influenza vaccination season. And for clinics and health departments whose fiscal year ends on June 30, it's a good time to stock up before your fiscal year-end dollars run out. If you can make major or bulk purchases, please do—and receive quantity discounts.

Shop now and save 10 percent until June 30
Get 10 percent off the price of all IAC products when you place one or more orders before the end of June. Just enter the coupon code—IACX2013—in the “Coupon Code” field of the shopping cart and click "Apply." Then click “Check Out” to complete the order. Not using the shopping cart? You can still save 10 percent. Just write IACX2013 on the IAC order form, and fax or mail your order to us.

If you're familiar with IAC's top-quality products, you can start shopping by going to the Shop IAC web page now.

IAC'S IMMUNIZATION PRODUCTS
Just click on the links to any of the IAC immunization products listed below to read a complete description of a product, see an image of it, and find out how to order it. For quotes on larger quantities or customizing, call (651) 647-9009 or email admininfo@immunize.org.

1. LAMINATED VERSIONS OF BOTH 2013 U.S. IMMUNIZATION SCHEDULES—CHILD/TEEN AND ADULT
Printed in color, covered with a tough, washable coating, each schedule includes IAC's table of contraindications and precautions to help you determine the safety of vaccinating patients of any age.

IAC's Laminated Child and Teen Immunization SchedulesIAC's Laminated Adult Immunization Schedules
2. IMMUNIZATION RECORD CARDS
These wallet-sized, nearly indestructible personal record cards are for you to give to your patients; sold in boxes of 250.

Purchase IAC's patient record cards today! NOTE: To order sample immunization record cards, email admininfo@immunize.org.

3. DVD TO TRAIN STAFF—IMMUNIZATION TECHNIQUES: BEST PRACTICES WITH INFANTS, CHILDREN, AND ADULTS
Updated in 2010 by the California Department of Health's Immunization Branch, this DVD demonstrates recommended techniques for administering injectable, nasal, and oral vaccines to people of all ages—make sure your staff is well trained.

Purchase Immunization Techniques DVD

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JOURNAL ARTICLES AND NEWSLETTERS

CDC publishes report on the Global Polio Eradication Initiative's Stop Transmission of Polio (STOP) program
CDC published The Global Polio Eradication Initiative Stop Transmission of Polio (STOP) Program—1999–2013 in the June 21 issue of MMWR (pages 501–503). A press summary of the article is reprinted below.

The Stop Transmission of Polio (STOP) program has aided Global Polio Eradication Initiative  (GPEI) by strengthening the capacity of country-level immunization programs and by allowing at least 1,563 volunteers to gain valuable field experience that prepares them well for subsequent work as staff members of WHO, UNICEF, and other public health agencies. The STOP program recruits and deploys three types of volunteers: field staff and data managers who work with WHO country teams and communications officers who work with UNICEF country teams.  All volunteers undergo 10 days of intense technical, security, and cross-cultural training at CDC in Atlanta before being deployed on field assignments for up to 3–5 months. The STOP program has aided the GPEI by strengthening the capacity of country-level immunization programs by recruiting and deploying volunteers to serve as field staff, data managers, and communications officers.

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CDC corrects error in report on polio outbreaks in Somalia and Kenya
CDC published Erratum: Vol. 62, No. 23 in the June 21 issue of MMWR (page 508). The erratum concerns a report on polio outbreaks in Somalia and Kenya that was published in the June 14 MMWR. The erratum is reprinted below.

In the report, "Notes from the Field: Outbreak of Poliomyelitis—Somalia and Kenya, May 2013," the last sentence should have read as follows: "CDC also recommends that all refugees aged <18 years who have arrived from Kenya since the beginning of April 2013 receive 1 inactivated poliovirus vaccine dose regardless of vaccination history."

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EDUCATION AND TRAINING

Online Medscape course focuses on immunizing the older adult
An online Medscape course titled "Immunizing the Older Adult: Challenges and Opportunities" presents information on the low rate of vaccination in the older adult population. It outlines barriers to older adult vaccination and strategies for increasing vaccination rates in this population. Continuing medical education credit is available for completing the course and taking a test afterward. Login (free) is required to access the online course.

Presenters include Stefan Gravenstein, MD, MPH, professor of medicine, Center for Geriatric Medicine, Case Western Reserve University, Cleveland, OH; Litjen (L.J) Tan, MS, PhD, chief strategy officer, Immunization Action Coalition, St. Paul, MN; Aurora Pop-Vicas, MD, MPH, assistant professor of medicine, Warren Alpert Medical School, Brown University, Providence, RI.

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CONFERENCES AND MEETINGS

Immunize Georgia Conference scheduled for September 12 at Callaway Gardens in Pine Mountain, GA
The twentieth annual Immunize Georgia Conference will take place in Pine Mountain on September 12. Scheduled speakers include Walt Orenstein, MD, Emory Vaccine Center, Emory University; Paul Offit, MD, Vaccine Education Center, Children's Hospital of Philadelphia; and Donna Weaver, RN, MN, Centers for Disease Control and Prevention. Access conference details and registration information by clicking on the hyperlinked text above.

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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.IZ Express DisclaimerISSN 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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