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Issue 1251
Issue 1251: June 15, 2016

Ask the Experts
Ask the Experts—Question of the Week: We have a 20-week-old infant who was born prematurely. The infant has never…read more


TOP STORIES


IAC HANDOUTS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS



TOP STORIES


Reminder: May issues of Needle Tips and Vaccinate Adults are available online

The May issues of Needle Tips and Vaccinate Adults are now available online. Vaccinate Adults is an abbreviated version of Needle Tips with the pediatric content removed. Both publications feature the importance of using standing orders for improving immunization coverage, the 2016 U.S. recommended immunization schedules, how to order laminated pocket guides, and many ready-to-copy educational materials. Also featured is the ever-popular column "Ask the Experts" from CDC medical officer Andrew T. Kroger, MD, MPH, and nurse educator Donna L. Weaver, RN, MN, both with the National Center for Immunization and Respiratory Diseases.

Click on the images below to download the May issues (PDF) of Needle Tips and/or Vaccinate Adults.

Download the November issue of Needle TipsDownload the November issue of Vaccinate Adults

Needle Tips: View the Table of ContentsAsk the Experts section, magazine viewer, and back issues.

Vaccinate Adults: View the Table of ContentsAsk the Experts section, magazine viewer, and back issues.

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

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New! IAC releases “10 Steps to Implementing Standing Orders for Immunization in Your Practice Setting”

IAC recently posted a new resource for healthcare professionals titled 10 Steps to Implementing Standing Orders for Immunization in Your Practice Setting. This six-page “cookbook” about how to implement standing orders has been presented in 22 workshops across the U.S. over the past nine months. It provides step-by-step guidance on developing and implementing standing orders in your practice.

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 and administer vaccine to patients meeting certain criteria, such as age or underlying medical condition. The qualified healthcare professionals must also be eligible by state law to administer certain medications, such as epinephrine, under standing orders should a medical emergency (rare event) occur.

Having standing orders in place streamlines your practice workflow by eliminating the need to obtain an individual physician’s order to vaccinate each patient. Standing orders carried out by nurses or other qualified healthcare professionals are the most consistently effective means for increasing vaccination rates and reducing missed opportunities for vaccination, which improves the quality of care for patients.

Standing orders are straightforward to use. The challenge is to integrate them into the practice setting so they can be used to their full potential. This process requires some preparation up front to assure everyone in the practice understands the reasons why standing orders are being implemented and their roles in successfully implementing them. The new resource from IAC includes suggested steps to help you work through this process.

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FDA approves Vaxchora for the prevention of cholera

On June 10, the U.S. Food and Drug Administration (FDA) approved Vaxchora (PaxVax) for the prevention of cholera. The vaccine was approved for use in adults 18 through 64 years old traveling to cholera-affected areas. It is the only FDA-approved vaccine to prevent cholera. 

More information is available in the FDA news release.

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MMWR reports on 2015–2016 influenza season in the United States and 2016–2017 vaccine composition

CDC published Influenza ActivityUnited States, 201516 Season and Composition of the 201617 Influenza Vaccine in the June 10 issue of MMWR (pages 567–575). The introductory paragraph is reprinted below.

During the 2015–16 influenza season (October 4, 2015–May 21, 2016) in the United States, influenza activity was lower and peaked later compared with the previous three seasons (2012–13, 2013–14, and 2014–15). Activity remained low from October 2015 until late December 2015 and peaked in mid-March 2016. During the most recent 18 influenza seasons (including this season), only two other seasons have peaked in March (2011–12 and 2005–06). Overall influenza activity was moderate this season, with a lower percentage of outpatient visits for influenza-like illness (ILI), lower hospitalization rates, and a lower percentage of deaths attributed to pneumonia and influenza (P&I) compared with the preceding three seasons. Influenza A(H1N1)pdm09 viruses predominated overall, but influenza A(H3N2) viruses were more commonly identified from October to early December, and influenza B viruses were more commonly identified from mid-April through mid-May. The majority of viruses characterized this season were antigenically similar to the reference viruses representing the recommended components of the 2015–16 Northern Hemisphere influenza vaccine. This report summarizes influenza activity in the United States during the 2015–16 influenza season (October 4, 2015–May 21, 2016) and reports the vaccine virus components recommended for the 2016–17 Northern Hemisphere influenza vaccines.


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IAC Spotlight! IAC updates Vaccine Timeline of historic dates and events

IAC recently updated its Vaccine Timeline web page. The page now includes important dates and events related to vaccines and immunization beginning in 400 BC and going through the present.

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NFID releases report: “Addressing the Challenges of Influenza Vaccination on U.S. College Campuses”

The National Foundation for Infectious Diseases (NFID) recently released a report titled Addressing the Challenges of Influenza Vaccination on U.S. College Campuses. The report explores the low rate of influenza vaccination for college students and strategies to address it. The overview of the report is reprinted below.

According to the Centers for Disease Control and Prevention (CDC), annual vaccination is the best way to reduce the chances that an individual will get influenza (flu). Yet on U.S. college campuses, flu vaccination rates remain strikingly low, hovering between eight and 39 percent, and falling dramatically short of the 70 percent Healthy People 2020 target recommendation as well as the American College Health Association (ACHA) Healthy Campus 2020 target goal of approximately 50 percent.

Motivating college students to get an annual flu vaccination remains a public health challenge; therefore, the National Foundation for Infectious Diseases (NFID) convened a College Influenza Stakeholder Summit that included subject matter experts from academia, student organizations, professional medical associations, patient advocacy organizations, and industry (see page 8 for a complete list of participating organizations) to better understand the causes behind this vaccination gap. By bringing together these experts, the Summit sought to better understand the key barriers that prevent college students from getting an annual flu vaccine, as well as to identify strategies which would help students both recognize their risk and motivate them to get vaccinated.


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Free bulk quantities of pneumococcal and zoster vaccination laminated pocket guides available from IAC for distribution within your organization

IAC is pleased to announce the availability of bulk quantities of two newly updated laminated pocket guides for use by healthcare professionals, yours free for the ordering! The guides address issues related to the administration of (1) pneumococcal conjugate (PCV13) and polysaccharide (PPSV23) vaccines and (2) zoster vaccine.

These concise pocket guides provide front-line healthcare personnel with quick reference information highlighting:

  • Indications and contraindications for each vaccine
  • Targeted populations to be vaccinated
  • Details on how to administer the vaccines
  • Talking points for discussions with patients

Each guide is laminated for durability, and the compact size (3¾" x 6¾") is designed to fit in a shirt or lab coat pocket.

The pocket guides are available at no cost to your organization. However, to assist us in controlling our mailing costs, we ask that you order in bulk (with a minimum order of 25) and that you manage the distribution of the guides (e.g., through internal networks, educational forums, member meetings, mass mailings) to your constituents.

To view the pocket guides and place your order, please visit www.immunize.org/pocketguides or click on either image below. These cards are for healthcare professional use only, not for distribution to patients.

Laminated Child and Teen Laminated Schedule


Laminated Child and Teen Laminated Schedule

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IAC HANDOUTS


IAC updates “Decision to Not Vaccinate My Child”

IAC recently revised Decision to Not Vaccinate My Child. The form for parents was reformatted and information about meningococcal B disease and vaccination was added. References were updated on the second page for healthcare providers.

Related Links

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FEATURED RESOURCES


CDC 2016 easy-to-read immunization schedule for preteens and teens now available in Spanish

Earlier this year, CDC posted its easy-to-read "2016 Recommended Immunizations for Children 7–18 Years Old" schedule for parents. The Spanish-language version, Vacunas recomendadas para los niños desde los 7 hasta los 18 años de edad, is now available. The English-language version is now also available in black and white, as well as color.

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Now available! IAC's sturdy laminated versions of the 2016 U.S. child/teen immunization schedule and the 2016 U.S. adult immunization schedule—order a supply for your healthcare setting today!

IAC's laminated versions of the 2016 U.S. child/teen immunization schedule and the 2016 U.S. adult immunization schedule are covered with a tough, washable coating; they will stand up to a year's worth of use in every area of your healthcare setting where immunizations are given. Both schedules are eight pages (i.e., four double-sided pages) and are folded to measure 8.5" x 11".

Laminated Child and Teen Laminated Schedule

Adult Laminated Immunization Schedules

Laminated schedules are printed in color for easy reading, come complete with essential tables and footnotes, and include contraindications and precautions—a feature that will help you make an on-the-spot determination about the safety of vaccinating patients of any age.

PRICING
1–4 copies: $7.50 each
5–19 copies: $5.50 each
20–99 copies: $4.50 each
100–499 copies: $4.00 each
500–999 copies: $3.50 each

For quotes on customizing or placing orders for 1,000 copies or more, call (651) 647-9009 or email admininfo@immunize.org.

You can access specific information on both schedules, view images of both, order online, or download an order form at the Shop IAC: Laminated Schedules web page.


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Download Dr. Gary Marshall's The Vaccine Handbook: A Practical Guide for Clinicians (“The Purple Book") as a new app for iOS devices or purchase as a print book

The Vaccine Handbook: A Practical Guide for Clinicians (“The Purple Book,” 2015) is a 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. This book is now available as a new app for iOS devices.

Information about the iOS app version of The Vaccine Handbook: A Practical Guide for Clinicians

The Vaccine Handbook App contains the 5th edition of the book, updated with the latest immunization schedules and recommendations. The app enhances the utility of an already valuable print resource by including functions like keyword search, internal links, bookmarking, quick access to schedules and tables, hyperlinks to external sources, and the ability for real-time updates. A resources section provides ready access to authoritative immunization-related websites. Available through a collaboration between the publisher and Sanofi Pasteur, registration as well as reporting under Open Payments is required. (Offer void in Minnesota.) Click on the image below to visit the relevant App Store page to download this resource today.
Download new app!
Information about the print version of The Vaccine Handbook: A Practical Guide for Clinicians

The fifth edition of this valuable guide (560 pages) is 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! Click on the image below to visit the "Shop IAC: The Vaccine Handbook" web page.
Order your copy of The Vaccine Handbook today!
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.

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JOURNAL ARTICLES AND NEWSLETTERS


Study finds reduction in HPV infection and related conditions since vaccine’s introduction

A recently published study titled Impact and Effectiveness Of the Quadrivalent Human Papillomavirus Vaccine: A Systematic Review of Ten Years of Real-World Experience found that HPV vaccination has been successful at reducing HPV infection and incidence of related conditions. The abstract is reprinted below.

Prophylactic HPV-vaccination programs constitute major public-health initiatives worldwide. We assessed the global effect of 4vHPV vaccination on HPV infection and disease. PubMed and Embase were systematically searched for peer-reviewed articles from January-2007 through February-2016 to identify observational studies reporting the impact or effectiveness of 4vHPV vaccination on infection, anogenital warts, and cervical cancer or precancerous lesions. Over the last decade, the impact of HPV-vaccination in real-world settings has become increasingly evident, especially among girls vaccinated before HPV exposure in countries with high vaccine uptake. Maximal reductions of ∼90% for HPV 6/11/16/18 infection, ∼90% for genital warts, ∼60% for low-grade cytological cervical abnormalities, and ∼90% for high-grade histologically-proven cervical abnormalities have been reported. The full public-health potential of HPV vaccination is not yet realized. HPV-related disease remains a significant source of morbidity and mortality in developing and developed nations, underscoring the need for HPV-vaccination programs with high population coverage.

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EDUCATION AND TRAINING


Ohio AAP offers free webinar on HPV vaccination
 
On June 23, the Ohio Chapter of the American Academy of Pediatrics will present a webinar explaining current trends in HPV-related disease, the safety and efficacy of the immunization, key barriers to series completion, and important strategies to improve rates in boys and girls. The one-hour webinar begins at 12:00 p.m. (ET). Anyone is welcome to register, however the one hour of continuing education credit is available for Ohio residents only.

Registration and more information is available on Ohio AAP's webinar web page.

Related Links
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Weekly CDC webinar series on "The Pink Book" chapter topics continues through September 21; register now

CDC is presenting a 15-part webinar series to provide a chapter-by-chapter overview of the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). This is a live series of one-hour webinars that started June 1. Recordings of sessions will be available online after each webinar. All sessions begin at 12:00 p.m. (ET). Information about receiving continuing education credit will be available for each session after it is archived. CE credit may be available for up to a year after the date it was live.

Registration and more information is available on CDC's Pink Book Webinar Series web page.

Download Epidemiology and Prevention of Vaccine-Preventable Diseases

Order Epidemiology and Prevention of Vaccine-Preventable Diseases

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CONFERENCES AND MEETINGS


2016 Nevada Health Conference scheduled for October 17–18

The 2016 Nevada Health Conference will be held in Reno on October 17–18. The conference is targeted at healthcare professionals including, but not limited to: physicians, nurses, pharmacists, health science students, medical assistants, public health staff, social workers, epidemiologists, health educators, program managers, child care professionals, and other persons who administer child and adult healthcare services.

Access more information and registration on the conference web page.

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Webcast instructions for June ACIP meeting now available

The Advisory Committee on Immunization Practices (ACIP) recently posted the instructions for accessing the webcast for the June 22–23 meeting. More information on viewing, a draft agenda, and instructions for public comment are available on the ACIP web page.

Related Links

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ASK THE EXPERTS

Question of the Week

We have a 20-week-old infant who was born prematurely. The infant has never received rotavirus vaccine and is technically past the maximum age for first dose. Should we give rotavirus vaccine to this infant?

ACIP recommends vaccination of preterm infants according to the same schedule and precautions as full-term infants. In preterm infants (as in full-term infants), the maximum chronological age for the first dose is 14 weeks 6 days. Vaccination should not be initiated for infants aged 15 weeks 0 days or older because of insufficient data on safety of dose 1 of rotavirus vaccine in older infants. For more information, see page 19 of ACIP's recommendations on rotavirus vaccination.

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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Marco Arturo: Boy on Vaccines: Marco Arturo, a 12-year-old self-identified "scientist," posted a video (gone viral) on his Facebook page on a "delicate topic…vaccines." Marco holds up a folder that contains "every bit of evidence in the universe" that vaccines cause autism. It is empty! He encourages parents to vaccinate their kids for themselves and others. View the CNN coverage of this video.
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Editor: Deborah L. Wexler, MD
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Issue Abbreviations
AAFP: American Academy of Family Physicians
AAP: American Academy of Pediatrics
ACIP: Advisory Committee on Immunization Practices
CDC: Centers for Disease Control and Prevention
FDA: Food and Drug Administration
IAC: Immunization Action Coalition
MMWR: Morbidity and Mortality Weekly Report
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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.