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Issue 1231
Issue 1231: February 24, 2016

Ask the Experts
Ask the Experts—Question of the Week: Although licensed by the Food and Drug Administration for use through age 4…read more


TOP STORIES


IAC HANDOUTS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


CDC reports on vaccine administration errors with the meningococcal conjugate vaccine Menveo

CDC published Notes from the Field: Administration Error Involving a Meningococcal Conjugate Vaccine—United States, March 1, 2010–September 22, 2015 in the February 19 issue of MMWR (pages 161–162). The entire article is reprinted below.

Menveo (GlaxoSmithKline, previously Novartis AG) is a conjugate vaccine that was recommended in October 2010 for routine use in adolescents (preferably aged 11 or 12 years, with a booster at 16 years), and among persons aged 2 through 54 years with certain immunosuppressive conditions, to prevent invasive meningococcal disease caused by Neisseria meningitidis serogroups A, C, Y, and W-135. These recommendations have since been updated. Menveo is supplied in two vials that must be combined before administration. The MenA lyophilized (freeze-dried) component must be reconstituted with the MenCYW-135 liquid component. To administer the vaccine, the liquid component is drawn into a syringe, and used to reconstitute the lyophilized component. The resulting solution is administered by intramuscular injection. Failure to prepare Menveo as directed by the manufacturer’s instructions can lead to lack of protection against the intended pathogens (N. meningitidis serogroups A, C, Y, and/or W-135). Recently, an immunization provider administered only the lyophilized component of Menveo, subsequently administered a properly prepared dose of Menveo to the same patient, and asked CDC if this practice was safe. This question prompted CDC to search the Vaccine Adverse Event Reporting System (VAERS) database for reports during March 1, 2010–September 22, 2015, of only one component of Menveo being administered. Additionally, to more broadly identify disproportional reporting of adverse events in general following Menveo immunization compared with other vaccines in VAERS (including errors in vaccine preparation and administration), the Food and Drug Administration performed data mining with empiric Bayesian methods.

There were 390 reports of administration of only one component of Menveo to a total of 407 recipients. A total of 269 (66%) recipients received only the liquid MenCYW-135 component, and 138 recipients received only the lyophilized MenA component, reconstituted in sterile water, saline, a different liquid vaccine (hepatitis B vaccine in two cases, and diphtheria-tetanus-acellular pertussis [DTaP] vaccine in one case), or an unspecified diluent. Six reports described clusters of events; five described administration of only the liquid MenCYW-135 component to a total of 21 recipients, and one described administration of only the lyophilized MenA component to two recipients. Among 314 recipients whose sex was reported, 160 (51%) were male. The median age of 293 recipients with known age was 15 years (range = 0–65 years); 87% were aged 11–20 years. Among all 407 recipients, 346 (85%) experienced no adverse event; the reported adverse events included redness, fever, and pain. Medical Dictionary for Regulatory Activities (MedDRA) preferred terms that were reported at least twice as frequently as expected for Menveo (compared with all other vaccines) were all associated with administration of only one component of Menveo.

Vaccination providers should follow the instructions provided with Menveo (including vaccine labeling, packaging, and product insert) regarding proper administration. Vaccines requiring reconstitution should only be reconstituted with the specific diluent supplied by the manufacturer for that vaccine. A recipient who receives an improperly prepared dose of Menveo should receive a repeat dose of meningococcal conjugate vaccine prepared according to manufacturer instructions; this repeat dose can be administered at any time.

As a passive surveillance system, VAERS might capture only a fraction of events where only one component of Menveo is administered; therefore, these errors might be more common than VAERS data indicate. Administration of only one vaccine component is not unique to Menveo. Similar errors have been reported for Pentacel, another vaccine packaged as separate liquid (DTaP and inactivated poliovirus vaccine) and lyophilized (
Haemophilus influenzae type b) components that must be combined before administration. By carefully following instructions included with the vaccine, administration errors with Menveo and similarly packaged vaccines can be prevented. Some reports to VAERS noted that the errors in administering Menveo were detected by routine processes as part of quality assurance. Strategies to prevent errors in vaccine administration are available from CDC.

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New slide deck on meningococcal disease prevention and how to increase second dose coverage is available for healthcare professionals' use

In 2015, IAC, in collaboration with Sanofi Pasteur, launched a new initiative, MCV4: You’re Not Done If You Give Just One; Give 2 Doses to Strengthen Protection. This project was developed in response to the low immunization rates found for the recommended second (booster) dose of meningococcal ACWY (MCV4) vaccine. According to CDC's 2014 National Immunization Survey-Teen, less than one-third of 17-year-olds have received the recommended second dose, leaving them inadequately protected at a time they are at increased risk of infection.
 
A valuable new training resource for healthcare professionals (HCPs) has just been added to the project website, www.Give2MCV4.org. A downloadable slide deck (with accompanying speaker notes) is available for your use when making presentations to HCPs. The presentation was designed to:

  • Educate HCPs about the seriousness of meningococcal disease and the risk it poses to adolescents
  • Raise awareness of the low immunization rates for the second (booster) dose of MCV4
  • Offer tools and resources to help HCPs increase their immunization rates and close the meningococcal booster dose gap 

The slide deck, which may be used free of charge, is available in two convenient formats.

  • PDF version of the slides (without speaker notes)
  • PowerPoint version, which can be downloaded and used for presentations to HCPs. The slide deck may be viewed with the embedded speaker notes. Be sure to read the “Important Notes” on the download page for assistance in how to view the speaker notes.

This new “ready-to-use” resource has been added to the project’s expanding list of valuable tools for HCPs and their patients. In addition to a wealth of resources available on meningococcal disease prevention, the website includes materials about increasing coverage for all recommended adolescent vaccines. Be sure to take advantage of these great educational tools.

To access the slide deck in either format, go to www.give2mcv4.org/essential-tools/slide-deck.

Related Links

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IAC Spotlight! Six healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination

Almost 600 organizations are now enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, medical practices, professional organizations, health departments, and government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel. 

Since January 20, when IAC Express last reported on the Influenza Vaccination Honor Roll, six additional healthcare organizations have been enrolled.

IAC urges qualifying healthcare organizations to apply.

Newly added healthcare organizations, hospitals, government agencies, and medical practices

  • Central Regional Hospital, Butner, NC
  • Deer Lodge Medical Center, Deer Lodge, MT
  • Fredonia Regional Hospital, Fredonia, KS
  • Karmanos Cancer Center, Detroit, MI
  • North Kansas City Hospital, North Kansas, MO
  • South County Hospital, Wakefield, RI

Related Links

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IAC enrolls five new birthing institutions into its Hepatitis B Birth Dose Honor Roll; one previously honored institution qualifies for two additional years

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.

  • Avera Holy Family Hospital, Estherville, IA (99%)
  • Brownfield Regional Medical Center, Brownfield, TX (93%)
  • MetroHealth Medical Center, Cleveland, OH (96%)
  • Seminole Memorial Hospital, Seminole, TX (92%)
  • St. David's Round Rock Medical Center, Round Rock, TX (93%)

In addition, the following institution is being recognized for a second and third year period:

  • Union Hospital, Terre Haute, IN (93% for both 2014 and 2015)

The Honor Roll now includes 226 birthing institutions from 34 states and Puerto Rico. Seventy-two institutions have qualified for a second year and seven institutions have qualified three times.

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 percent 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.

Related Links

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Deadline extended to February 26 for nominating candidates for the 2016 NAIIS Immunization Excellence Awards

The National Adult and Influenza Immunization Summit (NAIIS) has extended the deadline for nominations for its 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 now February 26, 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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IAC’s “Take a Stand™” workshops proving highly successful around the country: Register NOW for a session in Seattle, Phoenix, or Tucson in March

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; San Francisco, Sacramento, Los Angeles and San Diego, CA; and Fort Worth, San Antonio, and Houston, TX. 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 the following three 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 Washington and Arizona 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

Related Links

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VEC’s #BeLikeBen campaign offers an opportunity to recognize those making a difference in their communities

The director of the Vaccine Education Center at the Children's Hospital of Philadelphia (VEC), Paul Offit, MD, recently received the Benjamin Franklin Founder Award. Presented each year in commemoration of Ben Franklin’s birthday, the award seeks to recognize an individual who has made significant accomplishments in a field of interest to Franklin. This year’s theme was public health. To celebrate Dr. Offit’s award and highlight Dr. Franklin’s accomplishments, VEC’s February issue of its Parents PACK newsletter, a monthly e-newsletter about vaccines for the public, was about Ben Franklin and the importance of groups and individuals that work to make their communities better. VEC hopes that the newsletter, and a related social media campaign, can remind people how much better our communities are when members work to help others.

The social media campaign encourages use of the phrase #BeLikeBen on social media channels to share ways that you or others are making your communities better. As part of the social media campaign, VEC is inviting groups and individuals to recognize those in their communities who, like Ben Franklin, make their communities better by doing things that benefit others. Ideas are not limited to vaccines; people make their communities better in many ways. Whether donating blood or advocating for children, the homeless or the environment, communities are better for everyone when individuals and groups within them go above and beyond. Please consider joining their campaign to inspire others to #BeLikeBen on your Twitter, Facebook, and other social media channels.

Related Link

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IAC HANDOUTS


IAC updates "Screening Checklist for Contraindications to Vaccines for Children and Teens" and "Screening Checklist for Contraindications to Vaccines for Adults"

IAC recently updated its two popular screening checklists for contraindications to vaccines given to children/teens and adults.

The Screening Checklist for Contraindications to Vaccines for Children and Teens had "1–3 months" changed to "In the past 3 months" as part of the explanation to question #9, and two references added. Additional small changes were made to page 2.

The Screening Checklist for Contraindications to Vaccines for Adults was updated with two new references and additional small changes on page 2.

Related Link

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IAC corrects recently updated handout, "Vaccinations for Preteens and Teens, Age 11–19 Years"

IAC recently posted an updated version of "Vaccinations for Preteens and Teens, Age 11–19 Years," but sharp-eyed readers caught an error. The version posted on February 10 referred to the meningococcal serotype B vaccine series as "1 dose," whereas it actually is two or three doses, depending on brand. The error is now corrected. 

[Note: If you recently accessed this handout from IAC's website, you may initially pull up the incorrect version if it is cached on your system. You should be able to solve this problem by cleaning out your cache, hitting "refresh" or "reload," or using a different browser.]

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 revises "Guidance for Developing Admission Orders in Labor & Delivery and Newborn Units to Prevent Hepatitis B Virus Transmission" and "Sample Text for Developing Admission Orders in Newborn Units for the Hepatitis B Vaccine Birth Dose" to include new guidance on 9–12 month post-vaccination serology

In October, CDC published an updated recommendation for the timing of postvaccination serologic testing (PVST) of infants born to HBsAg-positive women, shortening the interval for PVST from age 9–18 months to age 9–12 months. IAC has revised the following two handouts for healthcare professionals to include this change:

Other small changes were made as well.

Related Links

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New: IAC updates handout about hepatitis B virus transmission and divides into separate pieces, one about transmission in medical settings and one about transmission in the community

IAC recently updated its handout titled "Unusual Cases of Hepatitis B Virus Transmission," and divided it into the following two separate resources:

Unusual Cases of Hepatitis B Virus Transmission in Medical Settings provides references for twenty documented examples of hepatitis B virus (HBV) transmission between patients, from patients to healthcare professionals, and from healthcare professionals to patients. These cases show the importance of hepatitis B vaccination for healthcare personnel and proper infection control practices.

Unusual Cases of Hepatitis B Virus Transmission in the Community includes twelve reports of some uncommon methods of HBV transmission in community settings that illustrate how every unvaccinated person is at some (albeit limited) risk of HBV infection. This handout is a good resource to share with parents who believe their child has no risk of ever coming in contact with the virus. 

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IAC reviews "Top Ten Reasons to Protect Your Child by Vaccinating" and posts Arabic translation of this handout for parents

IAC's handout, Top Ten Reasons to Protect Your Child by Vaccinating, provides parents with a list of ways vaccination protects their children (and those around him or her) against serious diseases. IAC recently reviewed and re-dated this handout before it was translated into Arabic.

IAC thanks CQ Fluency for this translation.

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FEATURED RESOURCES


NFID offers coloring books in English and Spanish to teach children about influenza prevention

The National Foundation for Infectious Diseases (NFID) has developed a coloring book to teach children about preventing influenza. This resource is available with English or Spanish text. 

Related Links

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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 continues to increase slightly in the United States. Flu activity most often peaks in February and can last into May. 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


CDC reports on influenza activity in the U.S. from October 4–February 6

CDC published Update: Influenza Activity—United States, October 4, 2015–February 6, 2016 in the February 19 issue of MMWR (pages 146–153). A summary made available to the press is reprinted below.

Influenza activity in the United States has been increasing since late December 2015 and continues to increase through February 6, 2016. Influenza A (H3N2), influenza A (H1N1)pdm09, and influenza B viruses have co-circulated this season, with influenza A (H3N2) viruses predominating during October until early December, and influenza A (H1N1)pdm09 viruses predominating from mid-December until early February. Although early vaccine effectiveness estimates are not yet available for the 2015–16 Northern Hemisphere vaccine, most of the viruses characterized by the CDC to date are antigenically similar to components in the 2015–16 Northern Hemisphere influenza vaccines. Vaccination is the best way to prevent influenza infection and health care providers should continue to encourage vaccination for unvaccinated persons aged ≥6 months throughout the influenza season.

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JAMA publishes article about the benefits of vaccination and the importance of sustainable vaccine pricing

On February 8, the Journal of the American Medical Association (JAMA) published a "Viewpoint" by H. Cody Meissner, MD, titled Immunization Policy and the Importance of Sustainable Vaccine Pricing online. The end of the first paragraph and the beginning of the second paragraphs are reprinted below.

A report from the Centers for Disease Control and Prevention (CDC) describing the benefits of vaccination of the 2009 birth cohort through 18 years of age estimated that 20 million cases of vaccine-preventable disease will not occur, 42,000 early deaths related to these diseases will be avoided, and $76 billion in direct and indirect costs will be averted. This economic benefit stands in stark contrast to the comparatively small cost for vaccine purchases. The estimated vaccine purchasing cost for a similar birth cohort based on 2015 pricing is $7.8 billion, based on CDC costs, and $11.6 billion at private sector pricing.

Development of a novel vaccine is a risky and expensive endeavor with research, licensing, and production costs approaching or exceeding $1 billion. For a small company attempting to secure capital venture funding or for an established pharmaceutical company committed to developing innovative vaccines, expectation of a return on investment is essential. Pricing of licensed, newer vaccines generally far exceeds production costs, but revenue drives future vaccine development. The difficult question becomes what is a reasonable return on investment?

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WHO publishes article about risk communication in the World Epidemiological Record

On February 19, WHO's published an article titled Risk communication—A moving target in the fight against infectious hazards and epidemics in its publication Weekly Epidemiological Record. The first paragraph is reprinted below.

Risk communication is central to epidemic and pandemic control. It has been practised widely in the past but with varying levels of success. Risk communication should have a full place at the outbreak response table, on par and in step with all other public health interventions. Lessons from recent experience provide a learning opportunity to enable this field of public health work to further evolve. 

Related Link

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EDUCATION AND TRAINING


NFID to offer March 4 webinar about the February ACIP meeting and an April 5 webinar about vaccines for immunocompromised adults
 
The National Foundation for Infectious Diseases (NFID) will be offering the following two webinars this spring:

Updates from February 2016 ACIP Meeting
March 4, 12:00 p.m. (ET)
William Schaffner, MD, NFID medical director and liaison to the Advisory Committee on Immunization Practices (ACIP), will discuss updates from the February 2016 ACIP meeting, including updated recommendations for adult vaccination.  

Access registration information.

Vaccines for Immunocompromised Adults
April 5, 12:00 p.m. (ET)
Lorry G. Rubin, MD, director, Division of Pediatric Infectious Diseases at Cohen Children’s Medical Center of New York, and professor, Pediatrics at Hofstra Northwell School of Medicine, will discuss recommended vaccines for immunocompromised adults.  

Access registration information.

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CONFERENCES AND MEETINGS


Reminder: Poster deadline for the National Conference on Immunization Coalitions and Partnerships is February 29

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, with a submission deadline of February 29. The Indiana Immunization Coalition will print all posters—presenters will NOT need to travel with their poster. 

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.

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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ASK THE EXPERTS

Question of the Week

Although licensed by the Food and Drug Administration for use through age 4 years, a dose of Pentacel was inadvertently given to a six-year-old. Do any components of the Pentacel dose need to be repeated?   

Pentacel (DTaP-IPV/Hib) inadvertently administered to children six years of age and older is considered a vaccine administration error. However, none of the vaccine components need to be repeated.


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.

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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VACCINATING ADULTS: A STEP-BY-STEP GUIDE
VACCINE CONCERNS
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Alternative Medicine
Autism
Importance of Vaccination
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VACCINE INFORMATION STATEMENTS
Translations
Vaccine Index
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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.