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Issue 1232
Issue 1232: March 2, 2016

Ask the Experts
Ask the Experts—Question of the Week: I have a patient who is traveling internationally and needs MMR vaccine…read more


TOP STORIES


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


Vaccine Education Center plans Current Issues in Vaccines webinar on March 23
 
The Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia, together with the Pennsylvania chapter of the American Academy of Pediatrics, will present a one-hour webinar beginning at 12:00 p.m. (ET) on March 23. Part of its Current Issues in Vaccines series, the webinar will feature Paul Offit, MD, director of VEC. Dr. Offit's topics for this webinar will be:
  • HPV vaccine: Is it time for a two-dose schedule?
  • Meningococcal serogroup B vaccines: The latest evidence
  • Influenza vaccines and egg allergy: An update

Free continuing education credits (CME, CEU, and CPE) will be available for both the live and archived events. 

Registration (required) is open now.

Related Link


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Pediatrics publishes study showing a decrease in the prevalence of HPV after introduction of the HPV vaccination program in the United States

On February 22, the journal Pediatrics published Prevalence of HPV After Introduction of the Vaccination Program in the United States online. The "What This Study Adds" summary states: "This study extends previous observations of quadrivalent HPV vaccine impact and examines cross-protection. Within 6 years of vaccine introduction, there were decreases in national vaccine type HPV prevalence of 64% and 34% among females aged 14 to 19 years and 20 to 24 years, respectively." The complete abstract is reprinted below.

BACKGROUND
Since mid-2006, human papillomavirus (HPV) vaccination has been recommended for females aged 11 to 12 years and through 26 years if not previously vaccinated.

METHODS
HPV DNA prevalence was analyzed in cervicovaginal specimens from females aged 14 to 34 years in NHANES in the prevaccine era (2003–2006) and 4 years of the vaccine era (2009–2012) according to age group. Prevalence of quadrivalent HPV vaccine (4vHPV) types (HPV-6, -11, -16, and -18) and other HPV type categories were compared between eras. Prevalence among sexually active females aged 14 to 24 years was also analyzed according to vaccination history.

RESULTS
Between the prevacccine and vaccine eras, 4vHPV type prevalence declined from 11.5% to 4.3% (adjusted prevalence ratio [aPR]: 0.36 [95% confidence interval (CI): 0.21–0.61]) among females aged 14 to 19 years and from 18.5% to 12.1% (aPR: 0.66 [95% CI: 0.47–0.93]) among females aged 20 to 24 years. There was no decrease in 4vHPV type prevalence in older age groups. Within the vaccine era, among sexually active females aged 14 to 24 years, 4vHPV type prevalence was lower in vaccinated (≥1 dose) compared with unvaccinated females: 2.1% vs 16.9% (aPR: 0.11 [95% CI: 0.05–0.24]). There were no statistically significant changes in other HPV type categories that indicate cross-protection.

CONCLUSIONS
Within 6 years of vaccine introduction, there was a 64% decrease in 4vHPV type prevalence among females aged 14 to 19 years and a 34% decrease among those aged 20 to 24 years. This finding extends previous observations of population impact in the United States and demonstrates the first national evidence of impact among females in their 20s.


Access the complete article in PDF format: Prevalence of HPV After Introduction of the Vaccination Program in the United States

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CDC reports that influenza vaccine effectiveness is approximately 60% this season

On February 24, CDC published a press release titled Flu Vaccine Nearly 60 Percent Effective. The first paragraphs are reprinted below.

The Centers for Disease Control and Prevention today reported preliminary overall influenza vaccine effectiveness (VE) of 59 percent this season. These data were presented at a meeting of the agency's Advisory Committee for Immunization Practices (ACIP) in Atlanta. This finding is comparable to past estimates for seasons when most circulating flu viruses and vaccine viruses have been similar.

"This means that getting a flu vaccine this season reduced the risk of having to go to the doctor because of flu by nearly 60 percent,” said Joseph Bresee, MD, chief of CDC’s Epidemiology and Prevention Branch. "It’s good news and underscores the importance and the benefit of both annual and ongoing vaccination efforts this season."

There were sufficient data from the U.S. Flu VE Network to also calculate more specific VE estimates:

  • 51 percent VE against the H1N1 viruses responsible for most flu illness this season
  • 76 percent VE against all influenza B viruses
  • 79 percent VE against the B/Yamagata lineage of B viruses

At this time, there are not enough data to estimate VE by age group, nor to estimate VE against H3N2 viruses or B/Victoria lineage viruses.

Access the complete press release: Flu Vaccine Nearly 60 Percent Effective

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IAC Spotlight! "Ask the Experts" web section about HPV vaccination updated

The Human papillomavirus (HPV) web section of "Ask the Experts" was recently updated.

IAC’s Ask the Experts web section is a compilation of common as well as challenging questions and answers (Q&As) about vaccines and their administration. The experts are Andrew T. Kroger, MD, MPH, medical officer, and Donna L. Weaver, RN, MN, nurse educator. Both are at CDC's National Center for Immunization and Respiratory Diseases. The Q&As have been featured in previous issues of IAC ExpressNeedle Tips, and Vaccinate Adults.

Related Links

Subscribe to IAC Express and receive a new "Ask the Experts" Q&A every week, as well as several special editions of "Ask the Experts" throughout the year.

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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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Reminder:  Two free CME courses on adult immunization available through IAC and Med-IQ 

Don't forget that IAC has partnered with one of the nation’s premiere continuing medical education (CME) providers, Med-IQ, to offer two online courses, Vaccinating Adults With Chronic Disorders: The Specialist’s Role and Vaccinating Adults With Chronic Disorders: Insights for the Primary Care Clinician.
 
IAC’s Dr. L.J Tan recruited stellar faculty members for a guided roundtable discussion on which course audio clips are based. You will hear from experts in immunization, a cardiologist, an endocrinologist, a pharmacist, and a nurse practitioner.
 
The trainings focus on the challenges of vaccinating adults with chronic disease, from either a specialist’s perspective or from that of primary care physicians and pharmacists. The frontline perspectives and practical strategies offered will educate and empower you to be a more effective vaccinator.
 
The 30-minute specialist’s course offers 0.5 AMA PRA Category 1 credit.
 
The one-hour primary care clinician course offers 1.0 AMA PRA Category 1 credit and 1.0 Accreditation Council for Pharmacy Education (ACPE) credit.

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Reminder: Submissions for the National Adult and Influenza Immunization Summit adult vaccine video contest due by March 21

The National Adult and Influenza Immunization Summit (NAIIS) is asking the public to help educate adults about the importance of adult vaccination. Help raise awareness about the importance of adult vaccines by making a short, creative video that promotes adult immunization. The top videos will be posted on the Summit website and the public will have the opportunity to vote for their favorite. In addition to a monetary prize of $750 and $350 for the first and second-place video respectively, the top three videos will receive recognition from NAIIS, the National Foundation for Infectious Diseases, IAC, and other partners.

All submissions must include at least one of these messages:

  • Vaccines aren’t just for kids; adults need vaccines too
  • Adults can’t afford to risk getting sick
  • Adults can protect their health and the health of those around them by getting the recommended vaccines
  • Adults should talk to their healthcare professional to make sure they are up to date with the vaccines recommended for them

Access rules and guidelines for the video contest.

Deadline for submission is March 21, 2016, 11:59 p.m. (ET).

Related Links

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FEATURED RESOURCES


Influenza is spreading and serious; please keep vaccinating your patients

According to the most recent 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


New research shows a vaccination program of 9vHPV for both genders can improve health outcomes and save costs 


On February 18, the journal Human Vaccines & Immunotherapeutics published The impact and cost-effectiveness of nonavalent HPV vaccination in the United States: Estimates from a simplified transmission model online. The "Introduction" and "Conclusions" sections are reprinted below.

Introduction
The objective of this study was to assess the incremental costs and benefits of the 9-valent HPV vaccine (9vHPV) compared with the quadrivalent HPV vaccine (4vHPV). Like 4vHPV, 9vHPV protects against HPV types 6, 11, 16, and 18. 9vHPV also protects against 5 additional HPV types 31, 33, 45, 52, and 58.

Conclusions
Compared with a vaccination program of 4vHPV for both sexes, a vaccination program of 9vHPV for both sexes can improve health outcomes and can be cost saving.


Access the complete abstract: The impact and cost-effectiveness of nonavalent HPV vaccination in the United States: Estimates from a simplified transmission model

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EDUCATION AND TRAINING


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


CDC recently updated the pneumoccocal 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.

The pneumococcal module was updated in February. 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 


October 2015 ACIP meeting minutes are now available; ACIP will meet next on June 22–23


ACIP recently posted the minutes from the Advisory Committee on Immunization Practices (ACIP) meeting held on October 21. Presentation slides and archived video broadcast footage from the meeting were made available earlier.

ACIP will hold its next meeting on June 22–23 in Atlanta. To attend the meeting, ACIP attendees (participants and visitors) must register online. The registration deadline for non-U.S. citizens is May 18; for U.S. citizens, it's June 6. Registration is not required to watch the live webcast of the meeting.

Related Links

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ASK THE EXPERTS

Question of the Week

I have a patient who is traveling internationally and needs MMR vaccine. He recently received an injectable steroid. How long should he wait before receiving MMR vaccine?  

There is no need to wait a specific interval before giving MMR. Injectable steroids are not considered immunosuppressive for the purpose of vaccination decisions, and so there is no concern about safety or efficacy of MMR. 


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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