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Issue 1233
Issue 1233: March 9, 2016

Ask the Experts
Ask the Experts—Question of the Week: An adult patient with asplenia received Menactra two weeks after a dose of PCV13…read more


TOP STORIES


IAC HANDOUTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


CONFERENCES AND MEETINGS

 


TOP STORIES


IAC's 84-page HepB birth dose guidebook Hepatitis B: What Hospitals Need to Do to Protect Newborns is now available in hard copy for purchase

In July 2013, the Immunization Action Coalition (IAC) launched a major initiative urging the nation’s hospitals to Give birth to the end of Hep B. As part of this project, IAC developed a comprehensive guidebook for helping hospitals and birthing centers establish, implement, and optimize their birth dose policies. Hepatitis B: What Hospitals Need to Do to Protect Newborns was reviewed by the American Academy of Family Physicians, American Academy of Pediatricians, American College of Obstetricians and Gynecologists, and CDC, and is a complete policy and best practices guide for newborn hepatitis B immunization.

The guide has always been available for downloading from IAC's website, but now, for the first time, you can order a beautiful hard copy of this 84-page resource for $20 plus shipping. Discounts are available for those ordering in bulk.

Check out the Shop IAC: Hepatitis B: What Hospitals Need to Do to Protect Newborns page on IAC's website for more information on ordering this valuable resource.

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CDC releases Spanish-language version of the 2016 easy-to-read adult immunization schedule

CDC has released the Spanish version of its easy-to-read adult immunization schedule.

English version: 

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IAC’s “Take a Stand™” workshops are highly successful across the nation: 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:
 
"The workshop was over and beyond what I expected...I recommend these workshops to anyone involved in immunizations." H.A.C.H., RN (California)
 
"Our workshop was…led by a deep field of nationally ranked authorities who literally wrote the book on vaccine-preventable diseases. Everyone was very knowledgeable, down to earth, and friendly. A well-paced, informal workshop with great audience participation. This is everything you need if starting from square one to implement standing orders for vaccines." 
S.P, MD (Pasadena, CA)
 
"As a new manager and nursing supervisor, this workshop was instrumental in helping me understand setting up standing orders and implementation."
T.B., BSN, MSN, APN, CNS, nursing supervisor (San Diego, CA)
 
"The information in this workshop was very timely. Increasing access to adult vaccination is challenging. These standing orders greatly simplify the process for clinicians." 
J.D., PharmD, pharmacist (Sacramento, CA)
 
"The workshop was informative and made me feel motivated and ready to implement strategies to improve on our delivery service."
M.M.G., clinic supervisor (San Antonio, TX)
 
"The Take A Stand workshop will prepare you with everything you need to implement standing orders for vaccination and overcome any barriers that previously stood in your way."
G.B.K, RN, (Houston, TX)
 
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

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IAC HANDOUTS


IAC updates its "Questions and Answers" handouts about influenza and pneumococcal disease and vaccines

IAC recently updated the following two "Question and Answer" handouts for patients, parents, and the general public:

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 eight patient vaccination schedules in its suite of handouts focused on adults, including those in risk groups

IAC recently updated the following eight handouts to include information about meningococcal serotype B vaccination and to revise the recommendation for pneumococcal vaccination scheduling. The first two pieces listed also received edits to the information about Hib vaccination. These pieces are part of a suite of handouts for adult patients that focuses on routine vaccination and vaccination of risk groups.

  1. Vaccinations for Adults—You're never too old to get immunized!; also available in SpanishArabic, ChineseFrenchKoreanRussian, and Vietnamese
  2. Vaccinations for Adults with HIV Infection; also available in Spanish
  3. Vaccinations for Adults with Diabetes; also available in Spanish
  4. Vaccinations for Adults with Heart Disease; also available in Spanish
  5. Vaccinations for Adults with Lung Disease; also available in Spanish
  6. Vaccinations for Adults with Hepatitis C Infection; also available in Spanish
  7. Vaccinations for Adults without a Spleen
  8. Vaccinations for Men Who Have Sex with Men

Visit IAC's Adult Vaccination web page to access all handouts in this series for adult patients, as well as resources for healthcare professionals providing vaccination services to adults.

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IAC revises "Screening Checklist for Contraindications to Live Attenuated Intranasal Influenza Vaccination"

IAC recently revised Screening Checklist for Contraindications to Live Attenuated Intranasal Influenza Vaccination to add information about treatment of influenza with antivirals.


WORLD NEWS


CDC and WHO report on progress toward measles elimination in Nepal in this week's MMWR and Weekly Epidemiological Report, respectively

CDC published Progress Toward Measles Elimination—Nepal, 2007–2014 in the March 4 issue of MMWR (pages 206–210). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Progress towards measles elimination in Nepal, 2007–2014. A media summary of the MMWR article is reprinted below.
 
In 2013, Nepal adopted a goal for national measles elimination by 2019. This report updates a previous report and summarizes progress toward measles elimination in Nepal during 2007–2014. During 2007–2014, estimated coverage with the first MCV dose [measles vaccine] (MCV1) increased from 81 percent to 88 percent. Approximately 3.9 to 9.7 million children were vaccinated in supplementary immunization activities (SIAs) conducted in 2008 and 2014, respectively. Reported suspected measles incidence declined by 13 percent during 2007–2014, from 54 to 47 cases per million population.


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FEATURED RESOURCES


Voices for Vaccines releases new toolkit to guide conversations with vaccine-hesitant family and friends

Voices for Vaccines (VFV) is a national organization of parents and others who are dedicated to raising the level of the voices of parents who support immunization. The VFV philosophy is that advocating should be easy to do for anyone, so they have created a number of resources to take the difficulty out of promoting immunization, including a new toolkit titled Don't Hesitate: Talking to Your Vaccine-Hesitant Loved Ones with Compassion and Confidence. VFV invites parents to download these tips to help initiate conversations with their family and friends, and encourages clinics and public health offices to print copies for interested parents.

VFV offers many more toolkits and resources on its website at www.voicesforvaccines.org/tools.

VFV invites everyone who appreciates vaccines (parents and otherwise) to join. Please spread the word to your friends and colleagues to join VFV!
 
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VEC's Vaccines and Teens: The Busy Social Years booklet updated to include information about HPV9 and meningococcal B vaccines 

The Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia recently updated its Vaccines and Teens: The Busy Social Years booklet to include information about HPV9 and meningococcal B vaccines. 

Healthcare professionals can also order hard copies of this booklet or other VEC resources for a nominal cost.

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Influenza is spreading and serious; please keep vaccinating your patients

According to the most recent week's FluView report from CDC, influenza activity remained elevated 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


Study describes the importance of healthcare providers in parental decisions about HPV vaccination

The February 5 issue of the journal Vaccine includes an article titled HPV vaccination coverage of teen girls: The influence of health care providers. The "Results" and "Conclusion" sections of the abstract are reprinted below.

Results
Among teen girls either unvaccinated or fully vaccinated against HPV, teen girls whose parent was positively influenced to vaccinate their teen daughter against HPV were 48.2 percentage points more likely to be fully vaccinated. Parents who reported being positively influenced to vaccinate against HPV were 28.9 percentage points more likely to report that their daughter's HCP talked about the HPV vaccine, 27.2 percentage points more likely to report that their daughter's HCP gave enough time to discuss the HPV shot, and 43.4 percentage points more likely to report that their daughter's HCP recommended the HPV vaccine (p<0.05). Among teen girls administered 1–2 doses of the HPV vaccine, 87.0% had missed opportunities for HPV vaccine administration.

Conclusion
Results suggest that an important pathway to achieving higher ≥3 dose HPV vaccine coverage is by increasing HPV vaccination series initiation though HCP talking to parents about the HPV vaccine, giving parents time to discuss the vaccine, and by making a strong recommendation for the HPV. Also, HPV vaccination series completion rates may be increased by eliminating missed opportunities to vaccinate against HPV and scheduling additional follow-up visits to administer missing HPV vaccine doses.


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 CDC publishes surveillance report on malaria in the United States

On March 4, CDC published an MMWR Surveillance Summary titled Malaria Surveillance—United States, 2013. The first section of the abstract is reprinted below.

Problem/Condition
Malaria in humans is caused by intraerythrocytic protozoa of the genus 
Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is also occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquito-borne transmission. Malaria surveillance in the United States is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers.

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CONFERENCES AND MEETINGS


Idaho Immunization Summit scheduled for November 2–4 in Boise; meeting will include CDC's "Pink Book" course

The 2016 Idaho Immunization Summit will be held November 2–4 in Boise. The program will include CDC's live two-day "Epidemiology & Prevention of Vaccine-Preventable Diseases" course (a.k.a. the "Pink Book" course) on November 2 and 3. This course provides a comprehensive review of immunizations and the diseases they prevent. Continuing education credits are available.

A half-day Immunization Summit will take place on November 4, with reporter Tara Haelle as the keynote speaker. The theme for this Immunization Summit is vaccine hesitancy and how to approach immunization concerns with confidence. The conference is sponsored by the Idaho Immunization Program and the Idaho Immunization Program.

Related Link

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ASK THE EXPERTS

Question of the Week

An adult patient with asplenia received Menactra two weeks after a dose of PCV13. Should the PCV13 dose be repeated?      

Yes. ACIP recommends that for persons 2 through 55 years of age with a high-risk condition (asplenia or complement component deficiency), Menactra be administered at least 4 weeks after completion of all PCV13 doses. See the footnote of the table on page 16 here for more information on this issue.


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 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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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.