Issue 1128: June 24, 2014

Ask the Experts–Question of the Week: I have a five-month-old patient who received hepatitis B vaccine at birth, at 2… read more


TOP STORIES
IAC HANDOUTS
VACCINE INFORMATION STATEMENTS
OFFICIAL RELEASES AND ANNOUNCEMENTS
FEATURED RESOURCES
EDUCATION AND TRAINING  
TOP STORIES
CDC publishes ACIP's recommendations for use of MenACWY-CRM vaccine in children age 2–23 months at increased risk for meningococcal disease

CDC published Use of MenACWY-CRM Vaccine in Children Aged 2–23 Months at Increased Risk for Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices, 2013 in the June 20 issue of MMWR (pages 527–530). The first paragraph and the first two paragraphs of the section titled "Recommendations" are reprinted below.

During its October 2013 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended use of a third meningococcal conjugate vaccine, MenACWY-CRM (Menveo, Novartis), as an additional option for vaccinating infants aged 2 through 23 months at increased risk for meningococcal disease. MenACWY-CRM is the first quadrivalent meningococcal conjugate vaccine licensed for use in children aged 2 through 8 months. MenACWY-D (Menactra, Sanofi Pasteur) is recommended for use in children aged 9 through 23 months who are at increased risk for meningococcal disease, and Hib-MenCY-TT (MenHibrix, GlaxoSmithKline) is recommended for use in children aged 6 weeks through 18 months at increased risk. This report summarizes information on MenACWY-CRM administration in infants and provides recommendations for vaccine use in infants aged 2 through 23 months who are at increased risk for meningococcal disease. Because the burden of meningococcal disease in infants is low in the United States and the majority of cases that do occur are caused by serogroup B, which is not included in any vaccine licensed in the United States, only those infants who are at increased risk for meningococcal disease are recommended to receive a meningococcal vaccine.

Vaccination with an age- and formulation-appropriate meningococcal conjugate vaccine is recommended for infants aged 2 through 23 months at increased risk for meningococcal disease. As described previously, infants at increased risk for meningococcal disease are:
  • those with persistent complement component deficiencies (C3, C5–C9, properdin, factor D, and factor H),
  • those with functional or anatomic asplenia (including sickle cell disease),
  • healthy infants in communities with a meningococcal disease outbreak for which vaccination is recommended, and
  • those traveling to or residing in areas where meningococcal disease is hyperendemic or epidemic.
Routine vaccination against meningococcal disease is not recommended for children aged 2 months through 10 years.

Please read the complete article for more detail on the recommendations.

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Measles outbreak spreads in Ohio; Governor Kasich signs executive order allowing pharmacists to give MMR to people 18 years and older

From March 24 to June 20, there have been 339 cases of measles reported in Ohio. Officials are working hard to bring the outbreak under control, but cases continue to be reported. As part of the plan to quickly provide protection to those who need vaccination, Governor John Kasich signed an executive order on June 9 that allows licensed pharmacists to administer the MMR vaccine to individuals age 18 years and older. People who are not immune to measles or who have infants too young to be vaccinated are advised to avoid traveling to areas where outbreaks are occurring.

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Plan ahead for National Immunization Awareness Month in August with new toolkit

Every year in August, National Immunization Awareness Month (NIAM) provides an opportunity to raise awareness of the importance of immunization and the need for improving national vaccination coverage levels. The National Public Health Information Coalition in collaboration with CDC has developed a National Immunization Awareness Month Communication Toolkit that includes key messages, vaccine information, sample news releases and articles, sample social media messages, and links to web resources from CDC and other organizations. The observance features a different population each week:
  • A Healthy Start: (babies from birth to age 2 and pregnant women), August 3–9
  • Back to School (children, pre-teens and teens to age 18), August 10–16
  • Off to the Future (young adults age 19-26), August 17–23
  • Not Just for Kids: (adults age 26+), August 24–30
Feel free to mix and match, copy, or adapt the contents of the toolkit to fit the particular needs of your own organization or community. Visit the online toolkit now—August is not far away!

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IAC Spotlight! Personal testimonies on vaccine-preventable diseases; essay by author Roald Dahl about the heartbreaking loss of his 7-year-old daughter Olivia from measles

The Immunization Action Coalition's website for the public, www.vaccineinformation.org, features Personal Testimonies about vaccine-preventable diseases and the value of immunization. The collection of more than 50 compelling and eye-opening reports can be used to educate staff and patients about the importance of immunization. The testimonies are organized by age group and disease.

IAC recently posted a powerful essay by Roald Dahl titled Measles: A Dangerous Illness. In 1962, Roald Dahl (author of “Charlie and the Chocolate Factory” and other beloved books for children and young adults) suffered a heartbreaking loss: the death of his 7-year-old daughter Olivia from the complications of measles encephalitis. More than 20 years after Olivia’s death, Dahl wrote this personal essay in her memory. Dahl aimed his essay at parents who were refusing to give their children the measles vaccine in the United Kingdom. He encourages all parents to get their children vaccinated. As Dahl states in his essay: “It really is almost a crime to allow your child to go unimmunised.”

Additionally, this section offers links to similar resources from IAC's immunization partner organizations, including personal stories from Every Child By Two, California Immunization Coalition’s "Shot by Shot" website, Children's Hospital of Philadelphia Vaccine Education Center, Families Fighting Flu, National Foundation for Infectious Diseases, National Meningitis Association, and the book The Forgotten Story from the Texas Children’s Hospital.

Related Links Do you have a personal account, remembrance, or patient story to share with others? Please upload your photo and document via IAC's Submit Your Story form.

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IAC enrolls five more birthing institutions into its Hepatitis B Birth Dose Honor Roll

The Immunization Action Coalition (IAC) is pleased to announce that five new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.
  • Hallmark Health System/Melrose Wakefield Hospital, Melrose, MA (96%)
  • Holy Family Hospital, Methuen, MA (96%)
  • Mercy Medical Center, Mason City, IA (93%)
  • Signature Healthcare Brockton Hospital, Brockton, MA (98%)
  • St. Vincent Frankfort Hospital, Frankfort, IN (97%)
In addition, Alice Hyde Medical Center (Malone, NY) is being recognized for a second year with a reported coverage rate of 98%; the medical center was first enrolled into IAC's Hepatitis B Birth Dose Honor Roll in 2013.

The Honor Roll now includes 91 birthing institutions from 25 states.

The Honor Roll is a key part of IAC’s major initiative urging the nation’s hospitals to Give birth to the end of Hep B. Hospitals and birthing centers are recognized for attaining high coverage rates for administering hepatitis B vaccine at birth and meeting specific additional criteria. The initiative urges qualifying healthcare organizations to apply for the Hepatitis B Birth Dose Honor Roll online.

To be included in the Hepatitis B Birth Dose Honor Roll, a birthing institution must have: (1) reported a coverage rate of 90% or greater, over a 12-month period, for administering hepatitis B vaccine before hospital discharge to all newborns, including those whose parents refuse vaccination, and (2) implemented specific written policies, procedures, and protocols to protect all newborns from hepatitis B virus infection prior to hospital discharge.

Honorees are also awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IAC Express’s approximately 50,000 readers.

Please visit the Hepatitis B Birth Dose Honor Roll web page that lists these institutions and their exceptional efforts to protect infants from perinatal hepatitis B transmission.

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CDC's Clinician Outreach and Communication Activity webinar on the status of measles in the U.S.; free continuing education credit available

On July 1 at 2:00 p.m. (ET), CDC's Clinician Outreach and Communication Activity (COCA) offers a free one-hour webinar titled Record High U.S. Measles Cases: Patient Vaccination, Clinical Assessment and Management, with Jane Seward, MBBS, MPH, deputy director, Division of Viral Diseases, NCIRD, CDC. During this COCA call, clinicians will learn the status of measles in the U.S. and CDC vaccination recommendations and guidelines for patient assessment and management. Continuing education credit is available for COCA calls.

COCA provides timely, accurate, and credible information to clinicians related to emergency preparedness and response and emerging public health threats. COCA fosters partnerships with national clinician organizations to strengthen information-sharing networks before, during, and after a public health emergency. To sign up for COCA Updates, call announcements, clinical reminders, and other COCA clinician resources, send an email to coca@cdc.gov.

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IAC HANDOUTS
IAC updates nine translations of "Screening Checklist for Contraindications to Vaccines for Adults"

In May, IAC updated its Screening Checklist for Contraindications to Vaccines for Adults in English. Changes were made to the second page only, the reference page for healthcare professionals that explains why certain questions on the screening checklist are asked. Updates on page 2 include facts related to new influenza vaccine products such as the recombinant influenza vaccine, and changing the terminology from trivalent influenza vaccine (TIV) to inactivated influenza vaccine (IIV).

This week, IAC posted the updated checklist in SpanishArabic, ChineseFrench, Hmong, Korean, Russian, Turkish, and Vietnamese. Only the second page (in English) was changed. The screening checklists themselves (page 1) are unchanged except for the date.

Access all IAC's screening checklists and questionnaires.

IAC's Handouts for Patients & Staff web section offers healthcare professionals and the public more than 300 handouts, including translations, which we encourage website users to print out, copy, and distribute widely.

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IAC updates its staff education materials: "Current Dates of Vaccine Information Statements (VISs)" and "It's Federal Law! You must give your patients current Vaccine Information Statements (VISs)"

IAC recently revised Current Dates of Vaccine Information Statements (VISs) as well as It's Federal Law! You must give your patients current Vaccine Information Statements (VISs) to reflect the 6/11/14 release date of the recently updated adenovirus VIS.

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VACCINE INFORMATION STATEMENTS
IAC posts 16 new VIS translations, including six for Hib, six for Td, two for typhoid, and two for Japanese encephalitis vaccines

IAC recently posted the following new Vaccine Information Statement (VIS) translations. The Portuguese translations are courtesy of the Massachusetts Department of Public Health. The Spanish, Cambodian, traditional Chinese, Farsi, Hmong, Korean, and Tagalog translations are courtesy of the California Department of Public Health. IAC greatly appreciates its generous translation partners!

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OFFICIAL RELEASES AND ANNOUNCEMENTS
WHO publishes position paper on varicella and herpes zoster vaccines

The World Health Organization (WHO) published Varicella and herpes zoster vaccines: WHO position paper, June 2014 in the June 20 issue of the Weekly Epidemiological Record. This is part of a series of regularly updated position papers on vaccines against diseases that have an international public health impact.

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FEATURED RESOURCES
IAC's sturdy laminated versions of the 2014 U.S. child/teen immunization schedule and the 2014 U.S. adult immunization schedule—order a supply for your healthcare setting today!

IAC's laminated versions of the 2014 U.S. child/teen immunization schedule and the 2014 U.S. adult immunization schedule are covered with a tough, washable coating; they will stand up to a year's worth of use in every area of your healthcare setting where immunizations are given.

The child and adolescent schedule has eight pages (i.e., four double-sided pages) and is folded to measure 8.5" x 11". The adult immunization schedule has six pages (i.e., three double-sided pages) and is folded to measure 8.5" x 11".
IAC's Laminated Child and Teen Immunization SchedulesIAC's Laminated Adult Immunization Schedules
Laminated schedules are printed in color for easy reading, come complete with essential tables and footnotes, and include contraindications and precautions—a feature that will help you make an on-the-spot determination about the safety of vaccinating patients of any age.

PRICING
1–4 copies: $7.50 each
5–19 copies: $5.50 each
20–99 copies: $4.50 each
100–499 copies: $4.00 each
500–999 copies: $3.50 each

For quotes on customizing or placing orders for 1,000 copies or more, call (651) 647-9009 or emailadmininfo@immunize.org.

You can access specific information on both schedules, view images of both, order online, or download an order form at the Shop IAC: Laminated Schedules web page.

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EDUCATION AND TRAINING
Minutes from February 2014 ACIP meeting now available; follow June ACIP meeting via live webcast

ACIP recently posted the minutes from the ACIP meeting held on February 26–27. Presentation slides and archived video broadcast footage from this meeting are also available.

The next ACIP meeting will be held June 25–26. The meeting is available online via live webcast. Registration is not required to watch the live webcast of the meeting; the call-in information is located on the "Register for a Meeting" web page. The live meeting recording and presenter slides are always made available online after the meeting as well.

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Presentation slides from National Conference on Immunization and Health Coalitions now available

The 2014 National Conference on Immunization and Health Coalitions (NCIHC) was held May 21–23 in Seattle. The presentation slides from this year's NCIHC are now available on the conference website. If you weren't able to attend this conference, check out the many informative presentations online at your convenience.

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Ask the Experts
Question of the Week

I have a five-month-old patient who received hepatitis B vaccine at birth, at 2 months, and at 5 months of age. I realize that the third dose was given too early and so the child should be given another dose after they turn 6 months old. However, I am unclear how long I have to wait to give the fourth (repeat) dose? Is it 4 or 8 weeks?
 
Answer: This is addressed in the ACIP’s General Recommendations on Immunization: "Doses of any vaccine administered 5 or more days earlier than the minimum interval or age should not be counted as valid doses and should be repeated as age appropriate. The repeat dose should be spaced after the invalid dose by the recommended minimum interval” (see www.cdc.gov/mmwr/pdf/rr/rr6002.pdf, page 5 and Table 1, page 36). So in this situation you would repeat the dose 8 weeks after the invalid dose.

About IAC's Question of the Week

This week's issue of IAC Express includes a new feature called "Question of the Week." Each week, IAC Express highlights a new, topical, or important-to-reiterate Q&A. This new feature is a cooperative venture between IAC and CDC. William L. Atkinson, MD, MPH, IAC's associate director for immunization education, chooses a new Q&A to feature every week from a set of Q&As prepared by experts at CDC’s National Center for Immunization and Respiratory Diseases.   
 
We hope you enjoy this new feature and find it helpful when dealing with difficult real-life scenarios in your vaccination practice. Please encourage your healthcare professional colleagues to sign up to receive IAC Express at www.immunize.org/subscribe.

If you have a question for the CDC immunization experts, you can email them directly at nipinfo@cdc.gov. There is no charge for this service.

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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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