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Issue 1270

Issue 1270: October 19, 2016

Ask the Experts
Ask the Experts—Question of the Week: I've seen the recommendation stating air bubbles in manufacturer-filled syringes do not…read more


TOP STORIES


IAC HANDOUTS


OFFICIAL RELEASES AND ANNOUNCEMENTS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS



TOP STORIES


New! October 2016 issue of Vaccinate Adults is available online

The October 2016 issue of Vaccinate Adults is now online. Vaccinate Adults is an abbreviated version of Needle Tips with the pediatric content removed.

Click on the image below to download the entire October issue of Vaccinate Adults (16-page, 7.9 MB PDF).

Access the Table of Contents to download individual sections or pages.

Download the November issue of Vaccinate Adults

This issue features important information about the 2016–17 influenza recommendations, including related "Ask the Experts" Q&As 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, CDC. In addition, it includes many immunization resources that healthcare professionals can use in their practice settings, including IAC's standing orders templates for administering influenza and pneumococcal vaccines (PCV13 and PPSV23) to adults.

Related Links

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

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Reminder! October 2016 issue of Needle Tips is available online

The October 2016 issue of Needle Tips is now online.

Click on the image below to download the entire October issue of Needle Tips (18-page, 8.3 MB PDF).

Access the Table of Contents (HTML) to download individual sections or pages.

Download the November issue of Vaccinate Adults

Related Links

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

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IAC Spotlight! IAC enrolls five new birthing institutions into its Hepatitis B Birth Dose Honor Roll; six previously honored institutions qualify for additional years' honors

The Immunization Action Coalition (IAC) is pleased to announce that five new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.

  • Hopkins County Memorial Hospital, Sulphur Springs, TX (94%)
  • Saint Mary's Hospital, Waterbury, CT (99%)
  • UConn Health, Farmington, CT (96%)
  • Waterbury Hospital, Waterbury, CT (97%)
  • Women's Health & Birth Center, Clarion Hospital, Clarion, PA (95%)

The following institution is being recognized for a second year:

  • Lowell General Hospital, Lowell, MA (94%)

The following institutions are being recognized for a third year:

  • Highlands Regional Medical Center, Prestonburg, KY (97%)
  • Manchester Memorial Hospital, Manchester, KY (100%)
  • Spectrum Health Grand Rapids Hospital, Grand Rapids, MI (98%)

The following institution is being recognized for a fourth year:

  • Laughlin Memorial Hospital, Greeneville, TN (97%)

Note: Waterbury Hospital applied at one time for five year periods—from 1/1/2011 through 12/31/2015, with percentages ranging from 91% to 97%.

The Honor Roll now includes 294 birthing institutions from 38 states, Puerto Rico, and Guam. Eighty-five institutions have qualified for two years, 30 institutions have qualified three times, four institutions have qualified four times, and two institutions have qualified five times.

The Honor Roll is a key part of IAC’s major initiative urging the nation’s hospitals to Give birth to the end of Hep B. Hospitals and birthing centers are recognized for attaining high coverage rates for administering hepatitis B vaccine at birth and meeting specific additional criteria. The initiative urges qualifying healthcare organizations to apply for the Hepatitis B Birth Dose Honor Roll online.

To be included in the Hepatitis B Birth Dose Honor Roll, a birthing institution must have: (1) reported a coverage rate of 90 percent or greater, over a 12-month period, for administering hepatitis B vaccine before hospital discharge to all newborns, including those whose parents refuse vaccination, and (2) implemented specific written policies, procedures, and protocols to protect all newborns from hepatitis B virus infection prior to hospital discharge.

Honorees are also awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IAC Express’s approximately 50,000 readers.

Please visit the Hepatitis B Birth Dose Honor Roll web page that lists these institutions and their exceptional efforts to protect infants from perinatal hepatitis B transmission.

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Indian Health Service now requires seasonal influenza vaccination for its civilian healthcare personnel

The Indian Health Service (IHS), an agency within the Department of Health and Human Services that provides healthcare to American Indians and Alaska Natives, issued a policy statement requiring mandatory seasonal influenza immunizations for civilian health personnel. An excerpt from the policy is reprinted below.

All Civil Service employees, contract staff, temporary employees, students, and volunteers who work in an IHS health care facility, must receive a seasonal influenza vaccination by October 31 of each year or have on file a valid medical or religious exemption. The vaccination deadline may be extended if seasonal influenza vaccine supply is inadequate or sufficiently protracted to preclude timely vaccination.

Access the complete policy statement: Mandatory Seasonal Influenza Immunizations for the Civilian Health Care Personnel

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Reminder! MCV4: You’re Not Done If You Give Just One; Give 2 Doses to Strengthen Protection initiative offers resources for healthcare professionals

Data published by CDC from its 2015 National Immunization Survey-Teen report found that only 33.3 percent of adolescents who were age 17 years at the time of the interview had received the recommended second dose of meningococcal (A, C, W, Y) conjugate vaccine (MCV4). This important booster is recommended at age 16 years to help prevent meningococcal meningitis. Although 82.5 percent of teens aged 13–17 years received the first recommended MCV4 vaccination, only one-third had received the important second dose to help boost their protection against this devastating illness at a time in life when they are at greatest risk for meningococcal disease.

To help educate providers with important resources about the MCV4 booster vaccination, the Immunization Action Coalition, in collaboration with Sanofi Pasteur, started an new initiative titled MCV4: You’re Not Done If You Give Just One; Give 2 Doses to Strengthen Protection. This initiative was developed to raise awareness about the extremely low immunization rates for MCV4 booster doses, help healthcare providers know their second dose MCV4 coverage rate, and supply tools for providers to increase rates and help close the MCV4 booster gap.

Why Focus on Improving Booster Vaccination Rates?
CDC recommends that a child receive one dose of MCV4 vaccine at age 11 or 12 years, followed by a second (or booster) vaccination at age 16, as the protection provided by the first dose wanes within five years in many teens. This means teens might have decreased protection from ages 16–21 years, when they are at greatest risk of meningococcal disease.

Be sure to visit the website, www.give2mcv4.org, and download and use the free, helpful materials available there, including fact sheets, talking points, an easy-to-follow flowchart for routine MCV4 immunization, a downloadable slide set for healthcare professionals, an overview of adolescent immunization recommendations, Q&As, and other great materials.

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October is Liver Cancer Awareness Month; join related Twitter chat on October 25

October is Liver Cancer Awareness Month. On Tuesday, October 25, representatives from Hep B United, CDC’s Division of Viral Hepatitis, and NASTAD (the National Alliance of State and Territorial AIDS Directors) will co-host a twitter chat about reducing liver cancer in people living with hepatitis B and C at 2:00 p.m. (ET) using the hashtag #liverchat. More information on the chat is available on the Hepatitis B Foundation's website.

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IAC HANDOUTS


IAC updates and reformats "What if you don't vaccinate your child?”

IAC recently released an updated and reformatted version of What If You Don’t Vaccinate Your Child? (formerly "What if you don't immunize your child?"). The resource was reformatted from a tri-fold brochure to one-page handout. Additionally, the content was updated.

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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OFFICIAL RELEASES AND ANNOUNCEMENTS


WHO publishes “Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season”

WHO published Recommended composition of influenza virus vaccines for use in the 2017 southern hemisphere influenza season in the October 14 issue of the Weekly Epidemiological Record (pages 469–484). An excerpt from the article is reprinted below.

WHO convenes technical consultations in February and September each year to recommend viruses for inclusion in influenza vaccines for the northern and southern hemisphere influenza seasons, respectively. This recommendation relates to the influenza vaccines for use in the forthcoming southern hemisphere 2017 influenza season. A recommendation will be made in February 2017 relating to vaccines that will be used for the northern hemisphere 2017–2018 influenza season. For countries in equatorial regions, epidemiological considerations influence which recommendation (February or September) individual national and regional authorities consider appropriate...

As in previous years, national or regional authorities approve the composition and formulation of vaccines used in each country. National public health authorities are responsible for making recommendations regarding the use of the vaccine. WHO has published recommendations on the prevention of influenza.


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CDC publishes "Summary of Notifiable Infectious Diseases and Conditions—United States, 2014" in MMWR

CDC published the 2014 summary of notifiable infectious diseases and conditions in the October 14 volume of MMWR. Titled Summary of Notifiable Infectious Diseases and Conditions—United States, 2014, the report is also available as a PDF. The report was prepared by CDC in collaboration with the Council of State and Territorial Epidemiologists.

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FEATURED RESOURCES


CDC develops “Only Flu Shots This Year” handout to help parents understand the new ACIP recommendations

CDC recently released Only Flu Shots This Year, a resource which clarifies the use of injectable vaccine only this year and provides reasons for getting children a flu shot.

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Children’s Hospital of Philadelphia’s Parents PACK posts “What You Should Know—Lessons from FluMist”

The Children's Hospital of Philadelphia's Parents PACK recently posted What You Should Know—Lessons from FluMist, explaining why the nasal spray vaccine is not recommended for the 2016–17 influenza season and providing more information about the injectable version.

Parents PACK (Possessing, Accessing and Communicating Knowledge about vaccines) is a program of the Children's Hospital of Philadelphia. To find more information about their resources and subscribe to their newsletter, visit the Parents PACK web page.

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JOURNAL ARTICLES AND NEWSLETTERS


September issue of CDC's Immunization Works newsletter now available

CDC recently released the September issue of its monthly newsletter Immunization Works and posted it on the website of the National Center for Immunization and Respiratory Diseases (NCIRD). The newsletter offers the immunization community information about current topics. The information is in the public domain and can be reproduced and circulated widely.

Related Links

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ASK THE EXPERTS

Question of the Week

I've seen the recommendation stating air bubbles in manufacturer-filled syringes do not need to be expelled. Can you explain why those air bubbles can be injected but air bubbles in user-filled syringes must be expelled?

It is not wrong to expel the air from syringes filled by manufacturers, but typically it is such a small amount of air (0.2cc–0.3cc) that it is our opinion that it would not cause a problem. When the syringe is inverted during an injection, that small amount of air would typically just clear the medication from the needle. This is based on the recommendation that when the Z-track method is used for intramuscular injection of irritating medication (e.g., iron preparations), the guidance is to leave 0.2cc–0.3cc in the syringe to be sure that all of the medication leaves the needle and is not tracked back through subcutaneous tissue as the needle is withdrawn. While the Z-track injection technique is not recommended for vaccine administration, the Z-track method demonstrates the acceptability of leaving a very small amount of air in the syringe for intramuscular injections.

We do, however, recommend that when drawing vaccine from a vial into a regular syringe, the air be expelled because the amount of air drawn into the syringe may be larger than the amount in a manufacturer-filled syringe. Expelling the air is part of general medication guidelines for drawing medication into a syringe.


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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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
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