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Issue 1263
Issue 1263: August 31, 2016

Ask the Experts
Ask the Experts—Question of the Week: As I understand, the 4-day grace period for HPV vaccination can be applied to the…read more


TOP STORIES


IAC HANDOUTS


VACCINE INFORMATION STATEMENTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING



TOP STORIES


CDC publishes 2016–17 influenza vaccination recommendations

CDC published Prevention and Control of Seasonal Influenza with Vaccines Recommendations of the Advisory Committee on Immunization Practices—United States, 2016–17 Influenza Season in the August 26 Recommendations and Reports issue of MMWR (pages 1–54). A selection from the "Summary" section is reprinted below.

Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. For the 2016–17 influenza season, inactivated influenza vaccines (IIVs) will be available in both trivalent (IIV3) and quadrivalent (IIV4) formulations. Recombinant influenza vaccine (RIV) will be available in a trivalent formulation (RIV3). In light of concerns regarding low effectiveness against influenza A(H1N1)pdm09 in the United States during the 2013–14 and 2015–16 seasons, for the 2016–17 season, ACIP makes the interim recommendation that live attenuated influenza vaccine (LAIV4) should not be used. Vaccine virus strains included in the 2016–17 U.S. trivalent influenza vaccines will be an A/California/7/2009 (H1N1)–like virus, an A/Hong Kong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008–like virus (Victoria lineage). Quadrivalent vaccines will include an additional influenza B virus strain, a B/Phuket/3073/2013-like virus (Yamagata lineage).

Recommendations for use of different vaccine types and specific populations are discussed. A licensed, age-appropriate vaccine should be used. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended product is otherwise appropriate.

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AAP releases new policy statement titled "Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance," which urges states to eliminate all non-medical exemptions to vaccine requirements; related resources now available

The American Academy of Pediatrics (AAP) recently published a new policy statement, Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance. The statement urges lawmakers to eliminate all non-medical exemptions for child care and school attendance. The abstract is reprinted below.

Routine childhood immunizations against infectious diseases are an integral part of our public health infrastructure. They provide direct protection to the immunized individual and indirect protection to children and adults unable to be immunized via the effect of community immunity. All 50 states, the District of Columbia, and Puerto Rico have regulations requiring proof of immunization for child care and school attendance as a public health strategy to protect children in these settings and to secondarily serve as a mechanism to promote timely immunization of children by their caregivers. Although all states and the District of Columbia have mechanisms to exempt school attendees from specific immunization requirements for medical reasons, the majority also have a heterogeneous collection of regulations and laws that allow nonmedical exemptions from childhood immunizations otherwise required for child care and school attendance. The American Academy of Pediatrics (AAP) supports regulations and laws requiring certification of immunization to attend child care and school as a sound means of providing a safe environment for attendees and employees of these settings. The AAP also supports medically indicated exemptions to specific immunizations as determined for each individual child. The AAP views nonmedical exemptions to school-required immunizations as inappropriate for individual, public health, and ethical reasons and advocates for their elimination.

To equip pediatricians with resources to approach vaccine-hesitant families, AAP additionally published a clinical report titled Countering Vaccine Hesitancy. A selection from the "Introduction" section is reprinted below.

Immunizations have had an enormous impact on the health of children, and the prevention of disease by vaccination is one of the single greatest public health achievements of the last century. However, over the past decade acceptance of vaccines has been challenged by individuals and groups who question their benefit. Increasing numbers of people are requesting alternative vaccination schedules or postponing or declining vaccination. In a national telephone survey of 1500 parents of children 6 to 23 months of age conducted in 2010 with a response rate of 46%, approximately 3% of respondents had refused all vaccines and 19.4% had refused or delayed at least 1 of the recommended childhood vaccines. A study conducted in a metropolitan area of Oregon reported that rates of alternative immunization schedule usage have increased nearly fourfold in recent years, and in some parts of the country the use of “personal belief exemptions” from vaccinations has grown to rates in excess of 5% of the school-aged population.

In conjunction with the policy statement and report, a free online course, Challenging Cases: Vaccine Hesitancy, is available through next year.

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CDC reports on adolescent vaccination coverage rates in 2015

CDC published National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years—United States, 2015 in the August 26 issue of MMWR (pages 850–858). The first paragraph of the report is reprinted below.

The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents aged 11–12 years routinely receive vaccines to prevent diseases, including human papillomavirus (HPV)-associated cancers, pertussis, and meningococcal disease. To assess vaccination coverage among adolescents in the United States, CDC analyzed data collected regarding 21,875 adolescents through the 2015 National Immunization Survey-Teen (NIS-Teen). During 2014–2015, coverage among adolescents aged 13–17 years increased for each HPV vaccine dose among males, including ≥1 HPV vaccine dose (from 41.7% to 49.8%), and increased modestly for ≥1 HPV vaccine dose among females (from 60.0% to 62.8%) and ≥1 quadrivalent meningococcal conjugate vaccine (MenACWY) dose (from 79.3% to 81.3%). Coverage with ≥1 HPV vaccine dose was higher among adolescents living in households below the poverty level, compared with adolescents in households at or above the poverty level. HPV vaccination coverage (≥1, ≥2, or ≥3 doses) increased in 28 states/local areas among males and in seven states among females. Despite limited progress, HPV vaccination coverage remained lower than MenACWY and tetanus, diphtheria, and acellular pertussis vaccine (Tdap) coverage, indicating continued missed opportunities for HPV-associated cancer prevention.

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Today (Wednesday) is the last day of IAC's 20% off sale! The 20% discounts on record cards, schedules, DVDs, and books on Shop IAC end on Wednesday, August 31

As announced in the August 4 Special Edition of IAC Express, during August, National Immunization Awareness Month, all items in Shop IAC are 20% off! All you need to do to get the 20% discount on your entire order is to enter the coupon code “IAC20” into the Coupon Code box on the Cart Contents page.

Today is the last day of the sale! Check out Shop IAC to order schedules, record cards, handbooks, and more today!

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IAC HANDOUTS


“Influenza Vaccine Products for the 2016–2017 Influenza Season” available with updated information

Earlier this summer, IAC released its updated table for healthcare professionals titled Influenza Vaccine Products for the 2016–2017 Influenza Season. The Flucelvax Medicare billing code is corrected in this week's version. This resource for providers offers information about licensed vaccine products in the 2016–2017 season, and includes age indications and billing codes.

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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VACCINE INFORMATION STATEMENTS


Reminder! Influenza VIS for 2016–2017 influenza season is unchanged from the 2015–2016 version

CDC confirmed earlier this summer 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.

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WORLD NEWS


CDC and WHO report on poliovirus vaccination campaign in India in MMWR and Weekly Epidemiological Report, respectively

CDC published Fractional-Dose Inactivated Poliovirus Vaccine Immunization Campaign—Telangana State, India, June 2016 in the August 26 issue of MMWR (pages 859–863). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Fractional-dose inactivated poliovirus vaccination campaign, Telangana state, India, June 2016. A media summary of the MMWR article is reprinted below.

The government of India and the Global Polio Eradication Initiative conducted a mass vaccination campaign that for the first time used an intradermal one-fifth dose of inactivated poliovirus vaccine (IPV). This campaign was conducted within 14 days of reported isolation of vaccine-derived poliovirus type 2 in Telangana, India. Over six days, more than 300,000 children were vaccinated. A post-campaign survey showed that 94 percent of children were vaccinated with IPV.

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FEATURED RESOURCES


CDC releases new labels for vaccines within storage units

As part of their storage and handling resources, CDC recently released new vaccine labels to help providers organize vaccines within their storage units. Vaccine Labels Examples and 2016–2017 Influenza Season Vaccine Label Examples are available for download now on CDC's website. The labels reflect ACIP guidelines and may include indications different from those of the Food and Drug Administration.

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JOURNAL ARTICLES AND NEWSLETTERS


Vaccine Education Center's newsletter for healthcare professionals includes updated Q&A information sheets for parents, a review of meningococcal B vaccine research, and the Technically Speaking column reviewing hepatitis B vaccine schedules and intervals

The Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia publishes an immunization-focused newsletter titled Vaccine Update for Healthcare Professionals. The July issue includes the following:

Additional resources, including information booklets for patients, are available in the full newsletter.

Access the sign-up form to subscribe to Vaccine Update for Healthcare Professionals.

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EDUCATION AND TRAINING


Vaccine Education Center announces registration for September 21 webinar: “FluMist: What went wrong?”
 
The Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia, together with the Pennsylvania chapter of the American Academy of Pediatrics and supported by the Thomas F. McNair Scott Endowed Research and Lectureship Fund, will present a one-hour webinar, beginning at 12:00 p.m. (ET) on September 21. Part of its Current Issues in Vaccines series, the webinar will feature Paul Offit, MD, director of VEC. Dr. Offit's topic for this webinar will be: "FluMist: What went wrong?"

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

Registration (required) is open now.

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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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ASK THE EXPERTS

Question of the Week

As I understand, the 4-day grace period for HPV vaccination can be applied to the minimum interval between dose #1 and #2 (4 weeks [28 days]) and dose #2 and #3 (12 weeks [84 days]) but you would still need to meet the 112 days between dose #1 and #3 for dose #3 to be valid. Is this right?

The 4-day grace period cannot be applied to both the interval between dose #1 and #2 and the interval between dose #2 and #3 because no grace period is allowed for the interval between dose #1 and #3. This interval must be 16 weeks (112 days). If the grace period is used for one of the first two intervals, then the other interval must be extended by at least that number of days to ensure that dose #1 and #3 meet the absolute minimum interval of 112 days.


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 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.
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Video of the Week
The Origin of Vaccines: English physician Edward Jenner (1749-1823) noted that milkmaids who had been infected with cowpox were resistant to smallpox. Jenner utilized cowpox scabs or pus to protect those he inoculated from what was then a terrible smallpox plague. 150 years later, smallpox was eradicated. (Open Mind)
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Editorial Information
Editor: Deborah L. Wexler, MD
Managing Editor: Teresa Anderson, DDS, MPH
Consulting Editor: Marian Deegan, JD
Assistant Managing Editor: Liv Augusta Anderson, MPP
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
WHO: World Health Organization
 
 
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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.