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Issue 1274
Issue 1274: November 9, 2016

Ask the Experts
Ask the Experts—Question of the Week: An adolescent received the first dose of hepatitis B vaccine at age 11 years but did not…read more


TOP STORIES


VACCINE INFORMATION STATEMENTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS



TOP STORIES


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

The October 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 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, they include 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).

Click on the images below to download the October 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 Contents, Ask the Experts section, magazine viewer, and back issues.

Vaccinate Adults: View the Table of Contents, Ask 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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CDC releases ACIP recommendations for use of meningococcal conjugate vaccines in HIV-infected persons

CDC published Recommendations for Use of Meningococcal Conjugate Vaccines in HIV-Infected Persons—Advisory Committee on Immunization Practices, 2016 in the November 4 issue of MMWR (pages 1189–94). A summary made available to the press is reprinted below.

At its June 2016 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of meningococcal conjugate (serogroups A, C, W, and Y) vaccine for people age 2 months or older with human immunodeficiency virus (HIV) infection. ACIP has previously recommended routine vaccination of people age 2 months or older who have certain medical conditions that increase risk for meningococcal disease. Routine vaccination with meningococcal conjugate vaccine is also recommended for all healthy adolescents in the United States.

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Three cases of meningococcal serogroup B disease confirmed at the University of Wisconsin–Madison; University Health Services recommends vaccination for all undergraduates through age 25

The University of Wisconsin–Madison confirmed a third case of meningococcal serogroup B disease recently. An excerpt from the university's press release is reprinted below.

Testing has identified meningococcal disease in a third UW–Madison student. This student is currently being treated at a local hospital. University Health Services (UHS) is working with Public Health Madison Dane County to notify individuals who have been in close contact with the student so appropriate preventive care can be provided...

UHS­, in consultation with local and state health officials, continues to strongly urge that all UW–Madison undergraduate students through age 25 get vaccinated against meningococcal disease serogroup B...

To date, more than 12,000 students—about 41 percent of the undergraduate population—have received first doses of the vaccine.


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Four healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination

Six hundred organizations are now enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, medical practices, professional organizations, health departments, and government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel.

Since October 12, when IAC Express last reported on the Influenza Vaccination Honor Roll, four additional healthcare organizations have been enrolled.

IAC urges qualifying healthcare organizations to apply.

Newly added healthcare organizations, hospitals, government agencies, and medical practices

  • Gallatin City-County Health Department, Bozeman, MT
  • Hebrew Senior Life, Boston, MA
  • North Oaks Health System, Hammond, LA
  • Norton County Hospital and Medical Clinic, Norton, KS

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IAC issues a clarification for November 2 Question of the Week

In IAC Express issue #1273, the Question of the Week and answer read:

A 32-year-old patient with ulcerative colitis is taking high-dose immunosuppressive medications (6-mercaptopurine). Should he receive meningococcal vaccine?

There is no specific indication for meningococcal vaccine in this patient. He is older than 21 years, and the risk–based recommendations are restricted to specific forms of altered immunocompetence (persistent complement component deficiency, functional or anatomic asplenia, use of eculizumab and HIV infection) and are not inclusive of other forms of altered immunocompetence.


It should have been specified that the question relates to MenACWY (MCV4) and not MenB vaccine. The indications listed in the answer are for quadrivalent meningococcal vaccine. ACIP does not consider HIV infection to be an indication for MenB vaccine.

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VACCINE INFORMATION STATEMENTS


IAC posts Hmong-, Farsi-, Khmer-, and Korean-language translations of the HPV9 VIS

IAC recently posted Hmong-, Farsi-, Khmer-, and Korean-language translations of the HPV9 VIS. IAC thanks the California Department of Public Health for the translations.

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IAC posts Hmong-, Farsi-, and Korean-language translations of the PCV13 VIS

IAC recently posted Hmong-, Farsi-, and Korean-language translations of the PCV13 VIS. IAC thanks the California Department of Public Health for the translations.

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IAC posts Hmong-, Korean-, and Tagalog-language translations of the Tdap VIS

IAC recently posted Hmong-, Korean-, and Tagalog-language translations of the Tdap VIS. IAC thanks the California Department of Public Health for the translations.

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IAC posts Farsi-language translation of the Haemophilus influenzae (Hib) VIS

IAC recently posted a Farsi-language translation of the Haemophilus influenzae (Hib) VIS. IAC thanks the California Department of Public Health for the translation.

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IAC posts Karen-language translations of the hepatitis A, hepatitis B, serogroup B meningococcal (MenB), and polio VISs

IAC recently posted Karen-language translations of the hepatitis A, hepatitis B, serogroup B meningococcal (MenB), and polio VISs. IAC thanks St. Peter's Health Partners for the translations.

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WORLD NEWS


CDC and WHO report on progress toward polio eradication in Afghanistan in this week's MMWR and Weekly Epidemiological Report, respectively

CDC published Progress Toward Poliomyelitis Eradication—Afghanistan, January 2015?August 2016 in the November 4 issue of MMWR (pages 1195–99). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Progress towards poliomyelitis eradication: Afghanistan, January 2015–August 2016. A media summary of the MMWR article is reprinted below.

During 2015, the number of wild poliovirus cases reported in Afghanistan declined by 29% compared with 2014. Trends observed so far in 2016 suggest that poliovirus circulation in the country is limited to a few areas. The drop in the number of polio cases in Afghanistan mirrors global trends, which were at a historic low in 2015. Despite this progress, Afghanistan faces significant constraints in its quest to interrupt poliovirus circulation by the end of the year. The deteriorating security situation in the Eastern and Northeastern regions of the country considerably limits the ability to reach and vaccinate children in these regions, and substantial numbers of children are still being missed in areas that are accessible during polio immunization activities.

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FEATURED RESOURCES


Influenza is serious; many resources are available to help healthcare professionals vaccinate patients

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.

Following is a list of resources related to influenza disease and vaccination for healthcare professionals and the public:

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JOURNAL ARTICLES AND NEWSLETTERS


New research finds fatal measles complication to be more common than previously thought

New research presented at IDWeek found that subacute sclerosing panencephalitis (SSPE), a fatal complication of measles infection, is more common than previously thought. An excerpt from Fatal measles complication more common than previously understood, published in Helio: Infectious Disease News, is reprinted below.

Subacute sclerosing panencephalitis [SSPE]—a 100% fatal complication of measles—occurs much more often than previously thought, according to data presented at IDWeek 2016. The recent finding underscores the importance of herd immunity with the measles-mumps-rubella vaccine to protect infants and those who are immunocompromised...

Previous research estimated that the risk of SSPE was one in 100,000. However, a more recent analysis in Germany established that the rate of SSPE was one in 1,700 among children infected with measles before 5 years of age. The current study suggests the prevalence may be even higher.


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Study finds no link between Tdap vaccination during pregnancy and microcephaly and other birth defects

JAMA recently published a research letter titled Tdap Vaccination During Pregnancy and Microcephaly and Other Structural Birth Defects in Offspring. The first two paragraphs are reprinted below.

In 2012, the US Advisory Committee on Immunization Practices recommended tetanus, diphtheria, and acellular pertussis (Tdap) vaccine be administered during every pregnancy, ideally between 27 and 36 weeks’ gestation. Previously, Tdap was recommended for unvaccinated pregnant women since 2010 in California and since 2011 across the United States.

Cases of microcephaly in Brazil increased substantially during 2015, likely associated with maternal Zika virus infections. However, these cases overlapped with the November 2014 initiation of Brazil’s maternal Tdap program. Previous small observational studies reported no increased risks for birth defects following maternal Tdap vaccination; none focused on microcephaly. This large study examined associations between maternal Tdap vaccination and structural birth defects, including microcephaly, in offspring.


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ASK THE EXPERTS

Question of the Week

An adolescent received the first dose of hepatitis B vaccine at age 11 years but did not return for subsequent doses. If the patient comes back at age 16 years, is it necessary to repeat the first dose of the series?

It is not necessary to restart or add doses to the hepatitis B series (or any other routine vaccine series) because of a prolonged interval between doses. Just continue the series from the point where it was interrupted.


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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IAC Express is supported in part by Grant No. 6NH23IP922550 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
MMWR: Morbidity and Mortality Weekly Report
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VIS: Vaccine Information Statement
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