Issue 1147: October 14, 2014

Ask the Experts–Question of the Week: I have a 2-month-old child with a cast for hip dysplasia that completely covers the entire … read more


TOP STORIES
IAC HANDOUTS
VACCINE INFORMATION STATEMENTS
OFFICIAL RELEASES AND ANNOUNCEMENTS
FEATURED RESOURCES
JOURNAL ARTICLES AND NEWSLETTERS  
TOP STORIES
New! October issue of Needle Tips is now available online

The October 2014 issue of Needle Tips is now available online.

Click on the image below to download the entire October issue (PDF) of Needle Tips.

October issue of Needle Tips
This issue features important information about the recently released ACIP recommendations for influenza and pneumococcal vaccine. In addition, it presents an array of immunization materials that healthcare professionals can use in their practice settings, including a new how-to guide about the use of standing orders for administering vaccines. It also features the "Ask the Experts" column from CDC medical officer Andrew T. Kroger, MD, MPH, and nurse educator Donna L. Weaver, RN, MN.

Related Links If you would like to receive immediate email notification whenever new issues of Needle Tips are released, visit IAC's subscribe page to sign up.

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American Liver Foundation endorses IAC's Give Birth to the End of Hep B campaign

On October 6, the American Liver Foundation (ALF) issued a press release endorsing IAC's Give Birth to the End of Hep B campaign. This initiative, launched in July 2013, urges hospitals and birthing centers to meet the national standard of care by providing a universal birth dose of hepatitis B vaccine to all newborns prior to hospital discharge. The first three paragraphs of the ALF press release are printed below.

The American Liver Foundation, along with the National Task Force on Hepatitis B, endorses the Immunization Action Coalition’s (IAC) national initiative Give Birth to the End of Hep B, a campaign to promote the hepatitis B vaccine birth dose for all newborns. The Immunization Action Coalition is a national organization that aims to increase immunization rates and to prevent disease.

“The IAC’s initiative speaks to its commitment to end vaccine-preventable disease such as hepatitis B virus (HBV),” says Tom Nealon, chair of the national board of the American Liver Foundation. “The IAC’s
Give Birth to the End of Hep B campaign will promote the birth dose guidelines, ensuring that the universal birth dose for hepatitis B will be an established practice at hospitals and birthing centers nation-wide.”

The IAC initiative will also recognize institutions that meet the national standard of care through a Hepatitis B Birth Dose Honor Roll for their effort and commitment on hepatitis B prevention.


Related Links The American Association for the Study of Liver Disease created the American Liver Foundation in 1976 to facilitate, advocate, and promote education, support, and research for the prevention, treatment, and cure of liver disease. Visit the ALF website at www.liverfoundation.org.

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

The Immunization Action Coalition (IAC) is pleased to announce that eight 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.
  • Community Hospital East, Indianapolis, IN (99%)
  • Houlton Regional Hospital, Houlton, ME (96%)
  • Kapiolani Medical Center for Women and Children, Honolulu, HI (99%)
  • Mercy Hospital St. Louis, St. Louis, MO (91%)
  • Methodist Dallas Medical Center, Dallas, TX (96%)
  • Northern Maine Medical Center, Fort Kent, ME (100%)
  • Rumford Hospital, Rumford, ME (93%)
  • St. Mary Medical Center, Hobart, IN (100%)
The Honor Roll now includes 130 birthing institutions from 27 states and Puerto Rico.

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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Translational Neurodegeneration retracts its article about MMR leading to autism

On October 3, the journal Translational Neurodegeneration officially retracted an article titled "Measles-mumps-rubella vaccination timing and autism among young African American boys." Following is the retraction statement from Translational Neurodegeneration.

The Editor and Publisher regretfully retract the article as there were undeclared competing interests on the part of the author which compromised the peer review process. Furthermore, post-publication peer review raised concerns about the validity of the methods and statistical analysis, therefore the Editors no longer have confidence in the soundness of the findings. We apologise to all affected parties for the inconvenience caused.

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IAC Spotlight! Eleven new videos added to the vaccineinformation.org video library; our searchable collection now numbers more than 165 videos about vaccine-preventable diseases and the importance of immunization

IAC's website for the general public, www.vaccineinformation.orgfeatures an impressive Video Library. This month, 11 new videos have been added to IAC's collection of more than 165 videos,including "Facing Influenza" and "I Just Can't Wait for My Vaccine!" The video library is searchable by keyword and by a preset "Popular Searches" drop-down menu, which offers more than 10 categories of topics to choose from. The results of a video search can be sorted by date of posting or by title of the video.

Some popular search categories include: Videos in this curated collection include personal testimonies from parents who have suffered the tragic loss of a child, public service announcements about the importance of immunization, and videos about vaccine-preventable diseases, as well as animation to help illustrate the concepts of immunization. The featured videos are from many sources, including the following trusted organizations: CDC, PKIDs, California Immunization Coalition’s Shot-by-Shot project, Families Fighting Flu, state health departments, and local immunization coalitions.

We urge you to link to IAC’s website, www.vaccineinformation.org, from your website, blog, and/or Facebook page.

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CDC confirms Ebola diagnosis in healthcare worker who provided care for the Dallas index patient

On October 12, the Centers for Disease Control and Prevention (CDC) confirmed test results reported by the Texas Department of State Health Services’ public health laboratory showing that a healthcare worker at Texas Presbyterian Hospital is positive for Ebola. The healthcare worker, who provided care for the Dallas index patient, was isolated soon after symptoms started and remains so now. An excerpt from a related CDC media statement released is reprinted below.

...the Centers for Disease Control and Prevention (CDC) confirmed test results reported late last night by the Texas Department of State Health Services’ public health laboratory showing that a healthcare worker at Texas Presbyterian Hospital is positive for Ebola. The healthcare worker, who provided care for the Dallas index patient, was isolated soon after symptoms started and remains so now.

On Friday, October 10, the healthcare worker reported a low-grade fever overnight and was referred for testing. The healthcare worker had been self-monitoring for fever and symptoms. As a precaution, after identification of fever, the healthcare worker was isolated and CDC staff interviewed the patient to determine additional contacts or potential exposures. At this time, one close contact has been identified and is being monitored.

The hospital and patient were notified of the preliminary and confirmatory test results. Treatment decisions will be made by the patient and hospital.


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Enhanced Ebola screening to start at five U.S. airports

On October 8, CDC announced a new program that would add layers of Ebola disease screening at airports that receive more than 94% of West African travelers. The first two paragraphs of a related press release are reprinted below.

The Centers for Disease Control and Prevention (CDC) and the Department of Homeland Security's Customs & Border Protection (CBP) this week will begin new layers of entry screening at five U.S. airports that receive over 94 percent of travelers from the Ebola-affected nations of Guinea, Liberia, and Sierra Leone.

New York's JFK International Airport will begin the new screening on Saturday. In the 12 months ending July 2014, JFK received nearly half of travelers from the three West African nations. The enhanced entry screening at Washington-Dulles, Newark, Chicago-O'Hare, and Atlanta international airports will be implemented next week.


Read the CDC press release: "Enhanced Ebola Screening to Start at Five U.S. Airports and New Tracking Program for all People Entering U.S. from Ebola-affected Countries."

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CDC publishes report about assessment of Ebola disease, healthcare infrastructure, and preparedness in Liberia

CDC published Assessment of Ebola Virus Disease, Health Care Infrastructure, and Preparedness—Four Counties, Southeastern Liberia, August 2014 in the October 10 issue of MMWR (pages 891–893). This report was previously published as an MMWR Early Release on October 7. The first paragraph is reprinted below.

Ebola virus disease (Ebola) is a multisystem disease caused by a virus of the genus Ebolavirus. In late March 2014, Ebola cases were described in Liberia, with epicenters in Lofa County and later in Montserrado County. While information about case burden and health care infrastructure was available for the two epicenters, little information was available about remote counties in southeastern Liberia. Over 9 days, August 6–14, 2014, Ebola case burden, healthcare infrastructure, and emergency preparedness were assessed in collaboration with the Liberian Ministry of Health and Social Welfare in four counties in southeastern Liberia: Grand Gedeh, Grand Kru, River Gee, and Maryland. Data were collected by healthcare facility visits to three of the four county referral hospitals and by unstructured interviews with county and district health officials, hospital administrators, physicians, nurses, physician assistants, and health educators in all four counties. Local burial practices were discussed with county officials, but no direct observation of burial practices was conducted. Basic information about Ebola surveillance and epidemiology, case investigation, contact tracing, case management, and infection control was provided to local officials.

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CDC NetConference scheduled for October 23; focus will be on adult immunization, including new pneumococcal vaccination recommendations for adults age 65 years and older

CDC will present a Current Issues in Immunization NetConference on October 23 from 12:00 to 1:00 p.m. (ET).

Topics and Speakers:
  • "ACIP Recommendations for Use of Pneumococcal Vaccines among Adults 65 Years of Age or Older," presented by Tamara Pilishvili, MPH, epidemiologist and CDC lead for ACIP Pneumococcal Vaccines Work Group, National Center for Immunization and Respiratory Diseases, CDC
  • "Improving Awareness and Use of Vaccines Recommended for Adults," presented by Carolyn B. Bridges, MD, FACP, CAPT USPHS, associate director for adult immunizations, National Center for Immunization and Respiratory Diseases, CDC
Raymond Strikas, MD, MPH, FACP, will moderate the conference.

This is a limited registration event. Registration (required) will close on October 22 or earlier if the course is full.

Information about continuing education credits will be provided in the course of the session.


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CDC updates influenza module in its "You Call the Shots" training course

CDC recently announced that it had updated the influenza vaccine module in the web-based training course "You Call the Shots." Continuing education credit is available for viewing a module and completing an evaluation.

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IAC HANDOUTS
New IAC resource for healthcare professionals: "Using Standing Orders for Administering Vaccines: What You Should Know"

IAC recently developed and posted a new resource for healthcare professionals titled Using Standing Orders for Administering Vaccines: What You Should Know.

The use of standing orders for vaccination facilitates the delivery of immunization services to patients in clinics, hospitals, and community settings. Standing orders have been shown to increase vaccination coverage rates. This new piece answers the following questions:
  • What are standing orders?
  • Who recommends standing orders?
  • What are the elements of a standing order?
  • Who is authorized to administer vaccines under standing orders?
  • Who is authorized to sign the standing order?
  • What should be done with the standing orders after they have been signed?
  • Do standing orders need to be renewed?
  • Where can I find sample standing orders?
Related Links 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 sample standing orders for administering polio vaccine to children and teens

IAC recently updated Standing Orders for Administering Inactivated Poliovirus Vaccine to Children & Teens.

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IAC updates "Influenza: Questions and Answers"

IAC recently updated Influenza: Questions and Answers to include new data and recommendations for the 2014–15 influenza season.

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VACCINE INFORMATION STATEMENTS
IAC posts Haitian Creole and Portuguese translations of the 2014–15 influenza VISs

IAC recently posted Haitian Creole and Portuguese translations of the 2014–15 inactivated influenza vaccine (IIV) Vaccine Information Statement (VIS) and the 2014–15 live, intranasal influenza vaccine (LAIV) VIS on its website.

IAC now has 18 translations of the IIV VIS and 17 translations of the LAIV VIS for  2014–15.

New translations of the 2014–15 inactivated influenza vaccine (IIV) VIS New translations of the 2014–15 live, intranasal influenza vaccine (LAIV) VIS IAC thanks the Massachusetts Department of Public Health for these translations.

IAC has posted many other translations of the influenza VISs in previous weeks. Visit IAC's VIS section to see what is currently available. Back to top


OFFICIAL RELEASES AND ANNOUNCEMENTS
WHO announces composition of seasonal influenza vaccine for the 2015 southern hemisphere influenza season

The World Health Organization (WHO) recently released information about the composition of the strains that will be used for seasonal influenza vaccination in the southern hemisphere in 2015.

It is recommended that vaccines for use in the 2015 influenza season (southern hemisphere winter) contain the following:
  • an A/California/7/2009 (H1N1)pdm09-like virus;
  • an A/Switzerland/9715293/2013 (H3N2)-like virus;
  • a B/Phuket/3073/2013-like virus.
It is recommended that quadrivalent vaccines containing two influenza B viruses contain the above three viruses and a B/Brisbane/60/2008-like virus.

Read Recommended composition of influenza virus vaccines for use in the 2015 southern hemisphere influenza season in the October 10 issue of WHO's Weekly Epidemiological Record.

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October 19–25 is International Infection Prevention Week

The Association for Professionals in Infection Control and Epidemiology (APIC) has announced that October 19–25 has been designated International Infection Prevention Week (IIPW). The theme this year is antibiotic resistance.

APIC offers many promotional materials, including sample Facebook and Twitter messages, newsletter copy, web buttons, posters, and more to make it easy to promote the important message about infection prevention's role in patient safety. The Association for Professionals in Infection Control and Epidemiology (APIC) is the leading professional association for infection preventionists with more than 15,000 members.

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FEATURED RESOURCES
Michigan Department of Community Health offers new adolescent vaccination resources

The Michigan Department of Community Health (MDCH) has developed new resources to encourage adolescent vaccination, including posters, flyers, and brochures. These resources are available in Spanish, Arabic, Burmese, Chinese, and Russian, in addition to English.

The materials include contact information for MDCH, but can be obtained in customizable formats. If you are interested in adapting any of these resources, contact Courtnay Londo, MA, adolescent & adult immunization coordinator at MDCH by email at LondoC1@michigan.gov.

Access these new adolescent resources from the Alliance for Immunization in Michigan toolkit. The entire toolkit can be accessed from www.aimtoolkit.org.

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CDC updates its interactive adolescent immunization scheduler

CDC has updated its online interactive immunization scheduler for adolescents age 7–18 to reflect the 2014 immunization schedule. This tool can be used by patients, parents, or healthcare professionals to help determine what vaccines are indicated. Back to top


CDC updates online adolescent and adult vaccine quiz: "What Vaccines Do You Need?"

CDC recently announced that it had updated its adolescent and adult vaccine quiz with the new ACIP pneumococcal recommendations. Back to top


Influenza is serious; many resources are available to help healthcare professionals in vaccinating

Vaccination remains the single most effective means of preventing influenza, and is recommended for everyone age six months and older. If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to a clinic or pharmacy that provides vaccines or to the HealthMap Vaccine Finder to locate sites near their workplaces or homes that offer influenza vaccination services.

Following is a list of resources related to influenza disease and vaccination for healthcare professionals and the public: Back to top


JOURNAL ARTICLES AND NEWSLETTERS
CDC publishes report on acute neurologic disease of unknown etiology in Colorado children; same article previously published as an MMWR Early Release

CDC published Acute Neurologic Illness of Unknown Etiology in Children—Colorado, August–September 2014 in the October 10 issue of MMWR (pages 901–902). This report was previously published as an MMWR Early Release on October 3, and was previously covered in IAC Express on October 7.

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CDC publishes report on cases of acute flaccid paralysis with anterior myelitis in California; same article previously published as an MMWR Early Release

CDC published Acute Flaccid Paralysis with Anterior Myelitis—California, June 2012–June 2014 in the October 10 issue of MMWR (pages 903–906). This report was previously published as an MMWR Early Release on October 3, and was previously covered in IAC Express on October 7.

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Ask the Experts
Question of the Week

I have a 2-month-old child with a cast for hip dysplasia that completely covers the entire anterolateral thigh on both legs. She is not due to have it removed for 10 weeks. What options do we have for her injectable vaccines? 
 
Answer: Ideally, you can arrange to have the cast cut to administer vaccines in the anterolateral thighs. If that option is not available, the gluteal region can be used if not covered by the cast. There are no other sites we recommend for vaccination; however, the inactivated polio vaccine could be given subcutaneously in either arm, if the child is large enough. Rotavirus vaccine is given orally and should be administered. If vaccines cannot be given for the 10 weeks, please advise the family to keep people with any illness away from the child until she has been vaccinated. For more information, see ACIP's General Recommendations on Immunization at www.cdc.gov/mmwr/pdf/rr/rr6002.pdf, page 14–16.

About IAC's Question of the Week

Each week, IAC Express highlights a new, topical, or important-to-reiterate Q&A. This 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.

IZ Express Disclaimer
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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