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Issue 1228
Issue 1228: February 3, 2016

Ask the Experts
Ask the Experts—Question of the Week: We have an 18-year-old male who had a history of chickenpox disease…read more


TOP STORIES


OFFICIAL RELEASES AND ANNOUNCEMENTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


2016 U.S. recommended immunization schedules for 0 through 18 years and "catch up" now available

On February 1, CDC published the Recommended Immunization Schedules for Persons Aged 0 Through 18 Years, United States, 2016 online.
 
Each year, the Advisory Committee on Immunization Practices (ACIP) updates the immunization schedules to reflect current recommendations for licensed vaccines. In October 2015, ACIP approved the recommended immunization schedules for 2016. You can read about what changed in the schedule and footnotes between 2015 and 2016 here.

The recommended birth through 18 years and catch-up immunization schedules have been approved by the ACIP, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists.

CDC published a related article titled Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years—United States, 2016 in an MMWR Early Release on February 2.

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2016 U.S. recommended immunization schedule for adults now available 

On February 1, CDC published online the Recommended Immunization Schedules for Adults, United States, 2016.
 
Each year, the Advisory Committee on Immunization Practices (ACIP) updates the immunization schedules to reflect current recommendations for licensed vaccines. In October 2015, ACIP approved the recommended immunization schedules for 2016. You can read about what changed in the adult schedule and footnotes between 2015 and 2016 
here.

The recommended adult immunization schedule has been approved by the ACIP, the American Academy of Family Physicians, the American College of Physicians, the American College of Obstetricians and Gynecologists, and the American College of Nurse-Midwives.

CDC published a related article titled 
Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older—United States, 2016 in an MMWR Early Release on February 2.

Related Links

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National Infant Immunization Week scheduled April 16–23; visit CDC's website for resources

National Infant Immunization Week (NIIW) will be held this year on April 16–23. NIIW is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and celebrate the achievements of immunization programs and their partners in promoting healthy communities.

Visit CDC's updated NIIW website to find promotional and educational materials to help you plan your NIIW activities, and tailor them to the needs of your community.

CDC would like to hear from organizations planning a 2016 NIIW activity. Please complete the NIIW Activity Form so others can learn what you're doing to educate and inspire parents and providers to protect infants and toddlers from vaccine-preventable diseases. If you're looking for ideas, you can access events scheduled for 2016, and NIIW events held in 2013, 2014, and 2015 from CDC's NIIW Activities around the World web page.

Related Links

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Nominations are now open for the National Adult and Influenza Immunization Summit Excellence Awards; submission deadline is February 15

The National Adult and Influenza Immunization Summit (NAIIS) is now soliciting nominations for the 2016 Immunization Excellence Awards. These prestigious awards recognize individuals and organizations that have made extraordinary contributions towards improving vaccination rates within their communities during 2015. The national winner in each category will be invited to present their program at the 2016 NAIIS meeting in Atlanta, Georgia. The deadline for receipt of nominations is February 15, 2016.

Award nominations will be accepted for:

  • Laura Scott NAIIS Immunization Excellence Award for Outstanding Influenza Season Activities
  • “Immunization Neighborhood” Champion
  • Adult Immunization Champion
  • Corporate Campaign
  • Adult Immunization Publication

Additional award to be presented (no nomination):

  • Influencer Award—selected by the NAIIS Organizing Committee to recognize an individual or organization in the media, legislature, or community whose activities, contributions, and/or willingness to go above and beyond have advanced adult and/or influenza immunization implementation

Related Links

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CDC reports increase in hepatitis B virus infection related to injection drug use in Kentucky, Tennessee, and West Virginia

CDC published Increases in Acute Hepatitis B Virus Infections—Kentucky, Tennessee, and West Virginia, 2006–2013 in the January 29 issue of MMWR (pages 47–50). The first paragraph is reprinted below.

As many as 2.2 million persons in the United States are chronically infected with hepatitis B virus (HBV), and approximately 15%–25% of persons with chronic HBV infection will die prematurely from cirrhosis or liver cancer. Since 2006, the overall U.S. incidence of acute HBV infection has remained stable; the rate in 2013 was 1.0 case per 100,000 persons. Hepatitis B vaccination is highly effective in preventing HBV infection and is recommended for all infants (beginning at birth), all adolescents, and adults at risk for HBV infection (e.g., persons who inject drugs, men who have sexual contact with men, persons infected with human immunodeficiency virus [HIV], and others). Hepatitis B vaccination coverage is low among adults: 2013 National Health Interview Survey data indicated that coverage with ≥3 doses of hepatitis B vaccine was 32.6% for adults aged 19–49 years. Injection drug use is a risk factor for both hepatitis C virus (HCV) and HBV. Among young adults in some rural U.S. communities, an increased incidence of HCV infection has been associated with a concurrent increase of injection drug use; and recent data indicate an increase of acute HCV infection in the Appalachian region associated with injection drug use. Using data from the National Notifiable Diseases Surveillance System (NNDSS) during 2006–2013, CDC assessed the incidence of acute HBV infection in three of the four Appalachian states (Kentucky, Tennessee, and West Virginia) included in the HCV infection study. Similar to the increase of HCV infections recently reported, an increase in incident cases of acute HBV infection in these three states has occurred among non-Hispanic whites (whites) aged 30–39 years who reported injection drug use as a common risk factor. Since 2009, cases of acute HBV infection have been reported from more non-urban than urban regions. Evidence-based services to prevent HBV infection are needed.

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CDC's Health Advisory Network issues advisory about infection control practices and hepatitis C transmission in dialysis units

On January 27, the CDC Health Alert Network (HAN) issued a Health Advisory titled CDC Urging Dialysis Providers and Facilities to Assess and Improve Infection Control Practices to Stop Hepatitis C Virus Transmission in Patients Undergoing Hemodialysis. Portions of the "Background" and "Summary" sections are reprinted below.

Between 2014 and 2015, CDC has been contacted about 36 cases of acute HCV infection in 19 different hemodialysis clinics in eight states. While investigations are ongoing, so far, HCV transmission between patients has been demonstrated at nine of those clinics, based on epidemiologic and viral sequencing evidence. Lapses in infection control (e.g., injection safety, environmental disinfection, and hand hygiene) were commonly identified at these facilities. 


Infection control lapses in dialysis care could expose patients to HCV. Any case of new HCV infection in a patient undergoing hemodialysis should prompt immediate action. CDC is urging dialysis providers and facilities to:

  1. Assess current infection control practices and environmental cleaning and disinfection practices within the facility to ensure adherence to infection control standards; 
  2. Address any gaps identified by the assessments; 
  3. Screen patients for HCV, following CDC guidelines, to detect infections, determine treatment potential, and halt secondary transmission; and 
  4. Promptly report all acute HCV infections to the state or local health department.

Access the complete HAN Advisory, which includes recommendations for dialysis providers, health departments, and patients: CDC Urging Dialysis Providers and Facilities to Assess and Improve Infection Control Practices to Stop Hepatitis C Virus Transmission in Patients Undergoing Hemodialysis

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IAC’s “Take a Stand™” workshops proving highly successful around the country: Register NOW for the next sessions in Texas (February 16–19)

The Immunization Action Coalition (IAC), with support from Pfizer, has implemented Take a Stand™, a national effort designed to improve adult immunization rates by increasing the use of standing orders in medical practices.*
 
At the core of this project are free workshops led by national experts, including L.J Tan, MS, PhDWilliam Atkinson, MD, MPH; and Deborah Wexler, MD, from IAC, and Alexandra Stewart, JD, from George Washington University. These workshops already have been conducted in Louisville, KY; Chicago, IL; Portsmouth, VA; Nashville, TN; Little Rock, AR; and San Francisco, Sacramento, Los Angeles and San Diego, CA. To illustrate how these have been going, here is a small sampling of comments received from attendees:
 
“Not only does this workshop provide great education, but it provides you with the tools and resources you need to implement this within your practice.” J.M., APN, MPH (Chicago, IL)
 
“This workshop gave us great ideas and information. Can’t wait to go back and start this process to get our Standing Orders going.” 
T.S., clinical manager (Fredericksburg, VA)
 
“Fantastic—great expertise, resources, tools and advice.” 
D.S. (Nashville, TN)
 
“This workshop is excellent for nursing directors/managers in the ambulatory setting. Excellent resources for preventive services.” 
L.R., primary care service line nursing director (Little Rock, AR)
 
Don’t miss your chance to join these satisfied attendees. The next workshops are scheduled in three Texas cities.

Be sure to note that these are one-time-only events in each city. 

Who should attend? Clinicians, nurses, and practice managers in medical offices that serve adults, as well as pharmacists and quality improvement managers, will benefit from the workshops.
 
In addition to the Texas sessions, other workshop locations and schedules, a sample agenda, and online registration are available on the Take a Stand™ website at www.standingorders.org

Please “take a stand” with us and spread the word about this unique opportunity for medical practices to improve their adult immunization rates while empowering staff and streamlining facility operations.
 
* Standing orders are written protocols approved by a physician or other authorized practitioner that allow qualified healthcare professionals (who are eligible to do so under state law, such as registered nurses or pharmacists) to assess the need for vaccination and to vaccinate patients meeting certain criteria. 
 
Workshop Information

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IAC Spotlight! Download free vaccine storage and handling resources from immunize.org 

IAC's handout section includes a selection of resources related to vaccine handling and storage. These resources include pieces to help ensure vaccines are stored and handled correctly to avoid errors (e.g., "Do Not Unplug" signs, temperature logs for freezers and refrigerators in Fahrenheit and Celsius, information about correctly reconstituting vaccines), and also worksheets for troubleshooting and responding to emergencies.

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National Conference on Immunization Coalitions and Partnerships calls for poster presentations; poster deadline is February 29 and early bird registration deadline is February 12

The 12th National Conference for Immunization Coalitions and Partnerships, Ready. Set. Vaccinate!, will be held in Indianapolis on May 25–27. The conference planners are currently soliciting posters to be displayed in an exhibit hall at the conference. The Indiana Immunization Coalition will print all posters—presenters will NOT need to travel with their poster. The deadline for poster submission is February 29.

For more information, go to the conference website, and click on the "Submit a Poster Presentation" link. You will then be given the opportunity to download instructions and a template.

The early bird registration rate for the conference is only available until February 12, so plan to register soon.

Note: This conference was formerly known as the National Conference on Immunization and Health Coalitions. The goal of the National Conference for Immunization Coalitions and Partnerships is to improve community health by enhancing the effectiveness of coalitions and partners through training in relevant coalition management and health promotion topics, as well as to provide networking and professional development opportunities.

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OFFICIAL RELEASES AND ANNOUNCEMENTS


MMWR publishes announcement about 50 years of global immunization at CDC 

CDC published Announcement: Fifty Years of Global Immunization at CDC—1966–2015 in the January 29 issue of MMWR (page 70). Two paragraphs from the announcement are reprinted below.

January 2016 marks the 50th anniversary of the establishment of CDC’s Smallpox Eradication Program and the beginning of CDC’s leadership in global immunization. This year CDC will begin implementing a new Strategic Framework for Global Immunization, 2016–2020, that articulates CDC’s vision of a world with healthy persons protected from vaccine preventable disease (VPD), disability, and death.

A major focus during the next 5 years will be to provide scientific leadership and evidence-based guidance to achieve a world free of polio. CDC will also build on and leverage achievement of polio eradication to increase focus on preventing VPD importation into the United States; preventing, detecting, and responding to VPD outbreaks globally as part of the Global Health Security Agenda (https://ghsagenda.org); achieving a world free of measles and rubella; ending VPD deaths among children aged <5 years; and reducing chronic disease and cancer deaths from VPDs.

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WORLD NEWS


WHO publishes position paper on malaria vaccines in the Weekly Epidemiological Report

WHO published Malaria vaccine: WHO position paper—January 2016 in the January 29 issue of its Weekly Epidemiological Record. A paragraph from the "Introduction" section is reprinted below.

This is the first WHO position paper on a malaria vaccine. It focuses primarily on the available evidence concerning the only candidate malaria vaccine to have received a positive regulatory assessment, which was issued by the European Medicines Agency (EMA) in July 2015. Recommendations on the potential use of this Plasmodium falciparum malaria vaccine were discussed by MPAC [Malaria Policy Advisory Committee] in October 2015; evidence presented at that SAGE meeting can be accessed here.

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FEATURED RESOURCES


AAP offers case studies in an online training format that demonstrate effective vaccine safety communication; slide deck and discussion guide also available 

The American Academy of Pediatrics (AAP) has posted a set of case studies to help physicians address vaccine hesitancy and refusal among families in an effective and efficient manner. The series includes online training and print resources to answer patients and parents who have questions about safety and efficacy of vaccines. The cases feature both pediatric and adult patients.
  • Access AAP's Case Studies training for vaccine safety communication

From the same web page, you can download a related PowerPoint slide set and small group discussion guide, appropriate for noontime and other lecture formats. 

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CDC launches website that provides forecasts of influenza activity made by external research groups 

On January 19, CDC launched a new website that provides forecasts of influenza activity made by external research groups. The website is a product of the “Epidemic Prediction Initiative,” a joint effort between federal and external researchers to advance the science of forecasting infectious diseases, including influenza. Currently, eight research teams have developed different influenza forecasting models providing forecasts to CDC; the new website includes all these forecasts.

Access the new website: FluSight: Seasonal Influenza Forecasting


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ACOG updates its toolkit for influenza immunization during pregnancy
 
In December, the American College of Obstetricians and Gynecologists (ACOG) updated its "Influenza Immunization during Pregnancy" toolkit. The toolkit includes the ACOG committee opinion on influenza vaccination during pregnancy, questions asked frequently by patients and obstetrician–gynecologists, and other resources for pregnant women and their providers.

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Influenza is spreading and serious; please keep vaccinating your patients

According to this week's FluView report from CDC, seasonal influenza activity increased slightly in the United States. While influenza A (H3N2) viruses have been most common since October 1, in the past weeks, influenza A (H1N1)pdm09 viruses have predominated. The vast majority of circulating influenza viruses analyzed this season remain similar to the vaccine virus components for this season's influenza vaccines.

Influenza vaccination is recommended for everyone six months of age 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. Influenza antiviral drugs can treat influenza illness. CDC has issued guidance for clinicians on the use of antiviral treatment in the 2015–16 flu season. Early antiviral treatment works best.


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

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The Vaccine Handbook: A Practical Guide for Clinicians, a.k.a. "The Purple Book," by Dr. Gary Marshall available for purchase from IAC 

The Vaccine Handbook: A Practical Guide for Clinicians (“The Purple Book,” 2015, 560 pages) is a uniquely comprehensive source of practical, up-to-date information for vaccine providers and educators. Its author, Gary S. Marshall, MD, has drawn together the latest vaccine science and guidance into a concise, user-friendly, practical resource for the private office, public health clinic, academic medical center, and hospital.
Order your copy of The Vaccine Handbook today!
IAC Executive Director Deborah Wexler, MD, is enthusiastic about helping get this book circulated as widely as possible. “During more than 20 years in the field of immunization education, I have not seen a book that is so brimming with state-of-the-science vaccine information,” she states. "This book belongs in the hands of every medical student, physician-in-training, doctor, nursing student, and nurse who provides vaccines to patients.”
 
The Vaccine Handbook provides:

  • Information on every licensed vaccine in the United States
  • Rationale behind authoritative vaccine recommendations
  • Contingencies encountered in everyday practice
  • A chapter dedicated to addressing vaccine concerns
  • Background on how vaccine policy is made
  • Standards and regulations
  • Office logistics, including billing procedures, and much more

About the Author
Gary Marshall, MD, is professor of pediatrics at the University of Louisville School of Medicine in Kentucky, where he serves as chief of the division of pediatric infectious diseases and director of the Pediatric Clinical Trials Unit. In addition to being a busy clinician, he is nationally known for his work in the areas of vaccine research, advocacy, and education.

The newly released fifth edition of this invaluable guide is now available on IAC’s website at www.immunize.org/vaccine-handbook.

The price of the handbook is $29.95 each, plus shipping charges. Discount pricing is available for more than 10 copies. Order copies for your staff or for distribution at an upcoming conference.

Quantity Discount Pricing

  • 1–10 books: no discount + shipping
  • 11–50 books: 5% + shipping
  • 51–100 books: 10% + shipping
  • 101–500 books: 15% + shipping
  • 501–1000 books: 20% + shipping

For quotes on larger quantities, email admininfo@immunize.org.

Order your copy today!

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JOURNAL ARTICLES AND NEWSLETTERS


New study shows that 90 percent of participants had evidence of protection 30 years after hepatitis B vaccination

On January 21, The Journal of Infectious Diseases published Antibody Levels and Protection After Hepatitis B Vaccine: Results of a 30-Year Follow-up Study and Response to a Booster Dose online. The abstract is reprinted below.

Background
The duration of protection in children and adults resulting from hepatitis B vaccination is unknown. In 1981, we immunized a cohort of 1,578 Alaska Native adults and children from 15 Alaska communities aged ≥6 months using 3 doses of plasma-derived hepatitis B vaccine.

Methods
Persons were tested for antibody to hepatitis B surface antigen (anti-HBs) levels 30 years after receiving the primary series. Those with levels <10 mIU/mL received 1 booster dose of recombinant hepatitis B vaccine 2–4 weeks later and were then evaluated on the basis of anti-HBs measurements 30 days after the booster.

Results
Among 243 persons (56%) who responded to the original primary series but received no subsequent doses during the 30-year period, 125 (51%) had an anti-HBs level ≥10 mIU/mL. Among participants with anti-HBs levels <10 mIU/mL who were available for follow-up, 75 of 85 (88%) responded to a booster dose with an anti-HBs level ≥10 mIU/mL at 30 days. Initial anti-HBs level after the primary series was correlated with higher anti-HBs levels at 30 years.

Conclusions
Based on anti-HBs level ≥10 mIU/mL at 30 years and an 88% booster dose response, we estimate that ≥90% of participants had evidence of protection 30 years later. Booster doses are not needed.


Access the complete article: 
Antibody Levels and Protection After Hepatitis B Vaccine: Results of a 30-Year Follow-up Study and Response to a Booster Dose

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EDUCATION AND TRAINING


CDC updates its "You Call the Shots" module on HPV; free CE credit available

CDC recently updated the HPV module of its web-based training course You Call the Shots. The nurse education training program has 11 modules on a variety of immunization topics (e.g., DTaP, Hepatitis A, Influenza, Vaccine Storage and Handling, Vaccines For Children). Continuing education credit is available for viewing a module and completing an evaluation. The training course is supported by CDC through a cooperative agreement with the Association for Prevention Teaching and Research.

Participants can access information about obtaining CE credit from the You Call the Shots main page.

Related Links


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CONFERENCES AND MEETINGS


Draft agenda for February ACIP meeting now available online

CDC has released a draft agenda for the next Advisory Committee on Immunization Practices (ACIP) meeting, which will be held February 24 at CDC's Clifton Road campus in Atlanta. If you plan to attend the meeting in person, the registration deadline is February 3 for non-U.S. citizens, and February 10 for U.S. citizens.

Registration is not required to listen to the meeting; the call-in information page is listed below. The live meeting recording and presenter slides are always made available online after the meeting as well.

Related Links


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ASK THE EXPERTS

Question of the Week

We have an 18-year-old male who had a history of chickenpox disease. He now has shingles. We are unsure what we are to advise for future treatment. Should we administer zoster vaccine?   

The Advisory Committee on Immunization Practice does not recommend zoster vaccination for people younger than age 60 years regardless of their history of shingles. Zoster vaccine is licensed by the Food and Drug Administration for people age 50 years and older so a clinician may choose to vaccinate a person 50 through 59 years of age. Insurance may not pay for a dose of zoster vaccine given to a person younger than age 60 years.


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 health care 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.

Related Links


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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.

If you have trouble receiving or displaying IAC Express messages, visit our online help section.

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: AstraZeneca, Inc.; bioCSL Inc.; Merck Sharp & Dohme Corp.; Pfizer, Inc.; and Sanofi Pasteur.
IAC Express Disclaimer
ISSN: 1526-1786

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