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Issue 1255
Issue 1255: July 13, 2016

Ask the Experts
Ask the Experts—Question of the Week: I have patients who are in their 70s or 80s and remember getting a pneumococcal…read more


TOP STORIES

IAC HANDOUTS

VACCINE INFORMATION STATEMENTS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS



TOP STORIES


CDC releases updated Vaccine Storage and Handling Toolkit along with additional new resources
 
CDC's Vaccine Storage and Handling Toolkit web page for healthcare professionals now contains a link to the newly updated and redesigned Vaccine Storage and Handling Toolkit PDF guide for 2016.

The new Vaccine Storage and Handling Toolkit reflects best practices for vaccine storage and handling from Advisory Committee on Immunization Practices recommendations, product information from vaccine manufacturers, and scientific studies.

The 2016 Vaccine Storage and Handling Toolkit reflects an adjustment in CDC’s guidance on the Fahrenheit temperature range for storing refrigerated vaccines. The new recommended Fahrenheit temperature range is 36°F–46°F (previously 35°F–46°F). The Celsius temperature range (2°C–8°C) remains unchanged, as stated in all manufacturer package inserts for routinely recommended vaccines. CDC has published a question and answer document titled Adjustment to CDC’s Recommended Fahrenheit Temperature Range for Refrigerated Vaccine Storage that explains the rationale behind this decision and practical information on implementing this new standard.

The 2016 Toolkit has a new design to help healthcare providers find the information they need quickly and easily. The beginning chapters address the three main elements of an effective cold chain: a well-trained staff, reliable storage and temperature monitoring equipment, and accurate vaccine inventory management. The remaining chapters focus on emergency management of vaccine and developing standard operating procedures for routine and emergency storage and handling.

For more detailed information on storage and handling recommendations and guidance for individual vaccines, please refer to the manufacturers' package inserts found on IAC's website.

Additional resources released by CDC include:

Related Links

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CDC confirms that the influenza VISs will remain the same for the 2016–17 influenza season 

CDC has confirmed that the influenza Vaccine Information Statements (VISs) will remain the same for the 2016–2017 influenza season. Healthcare providers do not need to wait for new publications of influenza VISs as they have in previous years. Current VISs can be found on CDC's website at www.cdc.gov/vaccines/hcp/vis/index.html as well as on IAC’s website at www.immunize.org/vis.

The content in the existing influenza VISs was designed to remain valid for multiple years. Even with changes to the 2016–2017 influenza recommendations (for example, regarding egg allergy or LAIV use), the current VISs are still accurate.

You can access all influenza VISs, including translations, from IAC's website at www.immunize.org/vis


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MMWR reports on HPV-associated cancers

CDC published Human Papillomavirus–Associated Cancers—United States, 20082012 in the July 8 issue of MMWR (pages 661–666). A summary made available to the press is reprinted below.

The number of human papillomavirus (HPV)-associated cancers is on the rise according to a recent CDC study. HPV-associated cancers are typically located in the head and neck region, as well as the genitals and some reproductive organs, of men and women. From 2008 to 2012, HPV-associated cancers climbed to nearly 39,000, an increase over the previous five-year study period. These numbers include more than 11,700 cases of cervical cancer and 12,600 oropharyngeal cancers among males. CDC scientists stress that 28,500 cases of HPV-caused cancer could be prevented by HPV vaccine. Cervical cancer screening can find precancers before they develop into cancer.


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Register now! On July 28, Dr. William Atkinson will present "Adolescent Immunization: Where We Are Now and How We Can Do Better" webinar

Since the Advisory Committee on Immunization Practices (ACIP) made its first routine adolescent immunization recommendation for tetanus/acellular pertussis/diphtheria (Tdap) vaccine in 2005, several other important vaccines have been added to the ACIP’s recommended immunization schedule for adolescents. Now Tdap, meningococcal ACWY, meningococcal B (a “category B” recommendation, meaning it is recommended, but with individual clinical decision making), human papillomavirus (HPV), and influenza vaccines are all recommended for this age group. Although data from the 2014 National Immunization Survey–Teen (NIS-Teen) indicate vaccine coverage for adolescents is relatively high for the single recommended dose of Tdap, vaccines that require more than one dose to complete the series remain far below desired coverage levels.

To address this problem, William Atkinson, MD, MPH, IAC's associate director for immunization education, will present a one-hour webinar on adolescent immunization on July 28 at 12:00 p.m. (ET). During his presentation, Dr. Atkinson will review the recommendations for each adolescent vaccine, provide strategies to improve coverage rates in this population, and list available resources to assist immunization providers in their efforts to improve coverage rates.

Register for the webinar here.

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California issues meningococcal disease health advisory for at-risk gay and bisexual men and all people with HIV

On June 24, the California Department of Public Health issued a health advisory for at-risk gay men, bisexual men, and all people with HIV in response to an outbreak of meningococcal disease. A selection from the advisory is reprinted below.

Since the beginning of May, nine meningococcal disease cases have been identified in men living in Los Angeles and Orange Counties, most of whom were gay or bisexual men. One patient has died as a result of the infection. Six of the cases are known to be caused by a particular strain (serogroup C) of meningococcal bacteria and one other case is awaiting serogroup confirmation.

Several outbreaks and clusters of serogroup C meningococcal disease among gay and bisexual men have been reported in New York City, Los Angeles County, and Chicago since 2014. Similar outbreaks have also been reported recently in Europe. Many of the men affected by these outbreaks were infected with HIV.

HIV-infected people are at increased risk of contracting meningococcal disease. Because of this increased risk, the U.S. Advisory Committee on Immunization Practices recommend this week that all HIV-infected persons aged 2 months and older be routinely vaccinated with the meningococcal vaccine that protects against serogroups A, C, W and Y disease (MenACWY).

All HIV-infected adults should receive two doses of MenACWY. Gay and bisexual men who are at increased risk for meningococcal disease and are not HIV-infected should receive one dose of MenACWY vaccine. Those who have not been tested for HIV within the last year should be offered an HIV test along with vaccination. Adults may locate meningococcal vaccines in their area by using CDC’s Adult Vaccine Finder.


Related Links

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Arizona confirms two new cases of measles, bringing the total to 22 cases

Two new cases of measles were confirmed in Arizona, bringing the outbreak total to 22 cases since May. The case totals and potential exposure areas can be found in a July 2 news release from the Arizona Department of Health Services.

Related Links

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CDC publishes best practices for diagnosing Haemophilus influenzae and Neisseria meningitidis disease

CDC recently published Best Practices for Use of Polymerase Chain Reaction (PCR) for Diagnosing Haemophilus influenzae and Neisseria meningitidis Disease and Public Health Importance of Identifying Serotype/Serogroup. The resource is aimed at clinicians and laboratory scientists.

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Providers and partners can join CDC as flu prevention partners

CDC encourages partner organizations to promote influenza vaccination within their communities, coordinate or host influenza vaccination clinics, and increase awareness about the importance and benefits of annual influenza vaccination. Resources for flu prevention partners, including digital and print materials, are available on the web page. To subscribe to routine influenza-related updates from CDC, click here.

Additionally, CDC released animated images to promote influenza prevention. Visit CDC's Animated Images web section or click on the image below.



Related Links

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

Bulk quantities of two recently updated laminated pocket guides for use by healthcare professionals are 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


“Influenza Vaccine Products for the 2016–2017 Influenza Season” now available

Two weeks ago, IAC released its updated Influenza Vaccine Products for the 2016–2017 Influenza Season. The resource for providers offers information about licensed vaccine products in the 2016–2017 season, and includes age indications and billing codes. With this week’s update, we have re-inserted live attenuated influenza vaccine (LAIV, FluMist) which, though not recommended by ACIP for use during the 2016–17 season in the United States, may be used in other countries.

Related Links

IAC's Handouts for Patients & Staff web section provides 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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VACCINE INFORMATION STATEMENTS


IAC posts Portuguese-language translations of the HPV9 and Meningococcal ACWY VISs

IAC recently posted Portuguese-language translations of the HPV9 and Meningococcal ACWY VISs. IAC thanks the Massachusetts Department of Public Health for the translations.

Related Links

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IAC posts Yiddish-language translation of the DTaP VIS

IAC recently posted a Yiddish-language translation of the VIS for DTaP vaccine. IAC thanks the New York State Department of Health for the translation.

Related Links

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FEATURED RESOURCES


Reminder! Free SHOTS app from STFM is a great tool for new doctors starting their residencies in July

The Group on Immunization Education (GIE) through the Society of Teachers of Family Medicine (STFM) produces a free and user-friendly mobile app called Shots Immunizations, a downloadable application for iPhones and Android devices that was developed to serve as a point-of-care tool. It is available at no cost on the iTunes App Store and the Google Play Store.

Shots Immunizations includes the unified CDC childhood and adolescent schedule, the catch-up schedule, the adult schedule, and the adult medical indications schedule. Each vaccine is covered in sections on the basics, special indications, catch-up vaccination, possible side effects, contraindications, precautions, with additional sections on epidemiologic information about each disease. This app has a proven history as a reliable and useful source of information about all routine vaccines.

For more information, contact Ms. Judy Troy, Project Coordinator for STFM’s Group on Immunization Education.


Related Links

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Also for new residents! 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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Still 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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JOURNAL ARTICLES AND NEWSLETTERS


Study finds HPV vaccination reduces cervical abnormalities

A study recently published in the Canadian Medical Association Journal, titled Effect of human papillomavirus vaccination on cervical cancer screening in Alberta, analyzes the impact of HPV vaccination on cervical cancer screening. A selection from the abstract is reprinted below.

Background: A school-based program with quadrivalent human papillomavirus (HPV) vaccination was implemented in Alberta in 2008. We assessed the impact of this program on Pap test cytology results using databases of province-wide vaccination and cervical cancer screening.

Results: The total study population was 10,204. Adjusting for age, vaccinated women had a higher screening rate than unvaccinated women (13.0% v. 11.4%,p < 0.001). Among women who received full vaccination (≥ 3 doses), the adjusted OR for cervical abnormalities was 0.72 (95% confidence interval [CI] 0.63–0.82). For high-grade lesions, the adjusted OR was 0.50 (95% CI 0.30–0.85). With 2-dose HPV vaccination, the adjusted OR for cervical abnormalities was 1.08 (95% CI 0.84–1.38).

Interpretation: Quadrivalent HPV vaccination significantly reduced high-grade cervical abnormalities but required 3 doses. Vaccination against HPV was associated with screening uptake. Population-based vaccination and screening programs should work together to optimize cervical cancer prevention.

Related Links

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EDUCATION AND TRAINING


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


Minnesota Department of Health's Got Your Shots? Immunization Conference to be held September 8–9

The Minnesota Department of Health's Got Your Shots? Immunization Conference will be held September 8–9, in Minneapolis. This year's theme is "Celebrating and Fostering Immunization Champions." Get more information on the conference website.

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ASK THE EXPERTS

Question of the Week

I have patients who are in their 70s or 80s and remember getting a pneumococcal vaccine “a few years ago.” Should I assume that this was PPSV23? Should I assume that it was given before the 65th birthday?

You can accept a verbal report of PPSV23. Since the recommendation for routine vaccination with PCV13 is relatively recent (November 2014) it is reasonable to assume that PPSV23 was the pneumococcal vaccine that was administered earlier. Try to ascertain how long ago it was given. If you think the dose was given after the 65th birthday and it has been a year since the dose was administered, give a dose of PCV13 now. If the dose was administered before the 65th birthday, administer a dose of PCV13 now, and then administer a dose of PPSV23 one year later, assuming that it has been 5 years since the first dose of PPSV23 was administered.


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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I Didn't Think I Would Be Pro-Vaccination Before I Had Kids: In this "Entertainment Tonight" interview, actress and singer Kristen Bell discusses the reasons she's vaccinated her daughters. Kristen admits to being "pretty crunchy" in her real life, but she explored the evidence and changed her mind about vaccinations.
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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
NCIRD: National Center for Immunization and Respiratory Diseases
VIS: Vaccine Information Statement
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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.