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Issue 1291
Issue 1291: February 22, 2017

Ask the Experts
Ask the Experts—Question of the Week: Is systemic lupus erythematosus (SLE, lupus) a risk-based indication . . . read more


TOP STORIES


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING

 


TOP STORIES


CDC publishes errata on assessing poliovirus vaccination status for children from outside the U.S.

CDC published Errata: Vol. 66, No. 1 in the February 17 issue of MMWR (page 180). The errata is published below in its entirety.

In the report Guidance for Assessment of Poliovirus Vaccination Status and Vaccination of Children Who Have Received Poliovirus Vaccine Outside the United States, on page 24, under the section “Children with documentation of poliovirus vaccination.” the first paragraph should have read as follows:

Previous poliovirus vaccination is valid if documentation indicates receipt of IPV or tOPV. tOPV was used for routine poliovirus vaccination before April 1, 2016 in all OPV-using countries. Therefore, if a child has documentation of receipt of an OPV dose (rather than “tOPV”) before April 1, 2016, this represents a tOPV dose and should be counted towards the U.S. vaccination schedule, unless specifically notated that it was administered during a vaccination campaign.* Consistent with the polio eradication strategy, doses of OPV administered on or after April 1, 2016 are either bOPV (used in routine vaccination and campaigns), or mOPV (used in a type-specific outbreak response); these doses do not count towards the U.S. vaccination requirements for protection against all three poliovirus types. Persons aged <18 years with doses of OPV that do not count towards the U.S. vaccination requirements should receive IPV to complete the schedule according to the U.S. IPV schedule.

* mOPV or bOPV were often used in vaccination campaigns but doses administered during vaccination campaigns are not typically recorded in parent-held records. These doses do not count towards the U.S. vaccination requirements.


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National Infant Immunization Week to be held April 22–29; register for a related webinar on February 28

National Infant Immunization Week (NIIW) is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and celebrate the achievements of immunization programs and their partners in promoting healthy communities. NIIW will be held this year on April 22–29.

Visit CDC's updated NIIW website to find promotional and educational materials to help you plan your NIIW activities, and tailor them to the needs of your community.

The VICNetwork is hosting a webinar on February 28, at 2:00 p.m. (ET) that will focus on preparations for NIIW. During the webinar, you will hear the latest information to help you plan your events and activities for NIIW, and learn about NIIW planning tools, digital communication resources, and CDC activities planned for the week. Presenters will share materials and resources available for a variety of audiences, including healthcare professionals and parents of young children. The Arizona Partnership for Immunization (TAPI) will share their experiences working with child care providers. 

Access registration information for the webinar.

The Virtual Immunization Communication Network (VICNetwork) is a partnership between the National Public Health Information Coalition, the professional network of public health communicators in the United States and U.S. territories, and the California Immunization Coalition.

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CDC publishes update on influenza activity in the United States from October 2, 2016 through February 4, 2017

CDC published Update: Influenza Activity—United States, October 2, 2016–February 4, 2017 in the February 17 issue of MMWR (pages 159–66). A summary made available to the press is reprinted below.

Influenza activity in the U.S. began to increase in mid-December and remained elevated as of February 4, 2017. Influenza A (H3) viruses accounted for the majority of the circulating influenza viruses, but influenza A (H1N1) pdm09 and influenza B viruses were identified also. Influenza activity has been moderate so far this season, and severity indicators are within the range of what has been observed in previous seasons when influenza A (H3N2) viruses predominated.

Elevated influenza activity in parts of the U.S. is expected for several more weeks. Healthcare providers should continue to offer and encourage vaccination to all unvaccinated persons age ≥6 months. Influenza antiviral medications are an important adjunct to vaccination in the treatment and prevention of influenza. Early treatment with neuraminidase inhibitor antiviral medications is recommended for patients with severe, complicated, or progressive influenza illness and for those at high risk of influenza complications, including adults age ≥65 years. 


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CDC publishes interim estimates of 2016–17 seasonal influenza vaccine effectiveness

CDC published Interim Estimates of 2016–17 Seasonal Influenza Vaccine Effectiveness—United States, February 2017 in the February 17 issue of MMWR (pages 167–71). A summary made available to the press is reprinted below.

Interim influenza vaccine effectiveness estimates for the 2016–17 season indicate that vaccination reduced the risk for influenza-associated medical visits by approximately half. Based on data from 3,144 children and adults with acute respiratory illness enrolled during November 28, 2016 to February 4, 2017, at five study sites with outpatient medical facilities in the U.S., the overall estimated effectiveness of the 2016–17 seasonal influenza vaccine for preventing medically attended, laboratory-confirmed influenza virus infection was 48%. Vaccine effectiveness was 43% against the predominant influenza A (H3N2) virus and 73% against illness caused by influenza B virus. Influenza activity is likely to continue for several more weeks in the U.S., and vaccination efforts should continue as long as influenza viruses are circulating.

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IAC Spotlight! Guide to Immunize.org now found on the bottom of all pages on IAC's website for healthcare professionals

The Immunization Action Coalition (IAC) has recently added a "Guide to Immunize.org"—an abbreviated table of contents—to the bottom of all of the pages on the www.immunize.org website. Now just by scrolling down a page, you can find a prominent, alphabetical reference for other popular sections of the website—just click on a link to be redirected. We hope this makes your navigation of this very large website easier!

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Voices for Vaccines releases second podcast—an interview with Dr. Paul Offit about outbreaks of vaccine-preventable diseases

Voices for Vaccines (VFV) has posted the second entry in its new Vax Talk podcast series: Outbreaks! In this podcast, Paul Offit, MD, director, Vaccine Education Center at the Children’s Hospital of Philadelphia, will discuss the current landscape of vaccine-preventable disease outbreaks, including outbreaks of mumps and measles.

Voices for Vaccines is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters. VFV invites everyone who values vaccines to become a member. Please spread the word to your friends and colleagues to register for the conference call and to join VFV!
 
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Check out “Making the CASE for Vaccines,” a guide written by the Autism Science Foundation

“Making the CASE for Vaccines” is a guide written by the Autism Science Foundation for medical and public health professionals on how to discuss vaccines with parents. The CASE model (Corroborate, About me, Science, Explain) provides a framework for communicating about vaccine science. In addition, this guide offers a clear and definitive background of scientific research on this subject, and provides information on the causes, diagnosis, and treatment of autism. 

Download Making the CASE for Vaccines (9 pages; PDF format).

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Final reminder: Nominations open for the National Adult and Influenza Immunization Summit Excellence Awards through February 24

The National Adult and Influenza Immunization Summit (NAIIS) is still soliciting nominations for the 2017 Immunization Excellence Awards. These prestigious awards recognize individuals and organizations that have made extraordinary contributions towards improving vaccination rates within their communities during 2016. The awards focus on individuals and organizations that exemplify the meaning of the "immunization neighborhood" (collaboration, coordination, and communication among immunization stakeholders dedicated to meeting the immunization needs of the patient and protecting the community from vaccine-preventable diseases).

The national winner in each category will be invited to present their program at the 2017 NAIIS meeting, to be held May 9–11 in Atlanta, Georgia. The deadline for receipt of nominations is Friday, February 24.

Nominations are being accepted for the following six award categories:     

  • NEW: Non-Healthcare Employer Campaign
  • Laura Scott NAIIS Immunization Excellence Award for Outstanding Influenza Season Activities Campaign
  • “Immunization Neighborhood” Champion
  • Adult Immunization Champion
  • Corporate Campaign
  • Adult Immunization Publication Award

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WORLD NEWS


WHO reports on human rabies transmitted by dogs

On February 17, WHO's Weekly Epidemiological Record published an article titled Human rabies: 2016 updates and call for data. The first paragraph is reprinted below.
 
Rabies is an infectious viral disease that is almost always fatal following the onset of clinical signs. The virus claims an estimated 59,000 (95% confidence intervals (CI):25–159,000) human lives annually, mostly among underserved populations in Africa and Asia. Over 95% of rabies deaths in humans result from virus transmission through the bites of infected dogs. Rabies is 100% preventable through timely administration of post-exposure prophylaxis (PEP) to bite victims, however fatalities still occur in many endemic countries. The substantial human suffering and cost of providing PEP treatment could be avoided through elimination of the virus at source. Elimination is feasible through mass vaccination of domestic dog populations; this not only reduces the number of deaths attributable to rabies, but also the need for PEP as part of dog-bite patient care in the longer term. In this report, rabies refers specifically to human rabies transmitted by dogs, where not indicated otherwise.


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FEATURED RESOURCES


PKIDs offers shareable entertaining immunization-related videos on its Facebook page

PKIDs (Parents of Kids with Infectious Diseases) has several 16-second entertaining immunization-related videos on their Facebook page that organizations and individuals are free to share on their own pages, or download to upload elsewhere.
 
To access the videos from the PKIDs Facebook page, look at the left column, click on "Videos" and then on any video you want to see.

To access the videos from YouTube page, go to https://www.youtube.com/user/PKIDsOrg.

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Influenza is spreading and serious; please keep vaccinating your 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


Study indicates that autism starts months before symptoms appear

On February 15, the journal Nature published an article titled Early Brain Development in Infants at High Risk for Autism Spectrum Disorder. The abstract is reprinted below.

Brain enlargement has been observed in children with autism spectrum disorder (ASD), but the timing of this phenomenon, and the relationship between ASD and the appearance of behavioural symptoms, are unknown. Retrospective head circumference and longitudinal brain volume studies of two-year olds followed up at four years of age have provided evidence that increased brain volume may emerge early in development. Studies of infants at high familial risk of autism can provide insight into the early development of autism and have shown that characteristic social deficits in ASD emerge during the latter part of the first and in the second year of life. These observations suggest that prospective brain-imaging studies of infants at high familial risk of ASD might identify early postnatal changes in brain volume that occur before an ASD diagnosis. In this prospective neuroimaging study of 106 infants at high familial risk of ASD and 42 low-risk infants, we show that hyperexpansion of the cortical surface area between 6 and 12 months of age precedes brain volume overgrowth observed between 12 and 24 months in 15 high-risk infants who were diagnosed with autism at 24 months. Brain volume overgrowth was linked to the emergence and severity of autistic social deficits. A deep-learning algorithm that primarily uses surface area information from magnetic resonance imaging of the brain of 6–12-month-old individuals predicted the diagnosis of autism in individual high-risk children at 24 months (with a positive predictive value of 81% and a sensitivity of 88%). These findings demonstrate that early brain changes occur during the period in which autistic behaviours are first emerging.

Access the complete article: Early Brain Development in Infants at High Risk for Autism Spectrum Disorder

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EDUCATION AND TRAINING


CDC updates its "You Call the Shots" modules on HPV, vaccine storage and handling, and VFC; free CE credit available 

CDC recently updated the following 3 modules of its web-based training course You Call the Shots:

This nurse education training program has 16 modules on a variety of immunization topics. Continuing education credit is available for viewing a module and completing an evaluation. The training course is supported by CDC through a cooperative agreement with the Association for Prevention Teaching and Research. Participants can access information about obtaining CE credit from the You Call the Shots main page.

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ACOG to sponsor March 6 webinar on the need for a maternal immunization strategy for respiratory syncytial virus


The American College of Obstetricians and Gynecologists (ACOG) will present a webinar titled "Respiratory Syncytial Virus: The Need for a Maternal Immunization Strategy" on March 6 at 12:00 p.m. (ET). This free webinar is open to all, and will provide an overview of currently recommended maternal immunizations and introduce an upcoming vaccine to prevent respiratory syncytial virus (RSV) disease. The session will highlight the burden of RSV disease, the rational for maternal immunization against the disease, an update on the development of RSV vaccines, and how this vaccine fits into the ob-gyn’s role. Continuing Medical Education credit (1 CME) is provided through joint providership with ACOG.

Access registration information.

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ASK THE EXPERTS

Question of the Week

Is systemic lupus erythematosus (SLE, lupus) a risk-based indication for pneumococcal vaccines?   

Lupus per se is not an indication for either pneumococcal vaccine. However, immunosuppressive medication that may be used to treat lupus could create an indication for administering both pneumococcal vaccines. Also, if the patient has certain complications of lupus (such as nephrotic syndrome), the person would be a candidate for pneumococcal vaccines. Both immunosuppression and nephrotic syndrome are indications for administering both PCV13 (Prevnar, Pfizer) AND PPSV23 (Pneumovax, Merck). Administer PCV13 first, then PPSV23 8 weeks later. A handy document that summarizes indications for both pneumococcal vaccines is available at www.immunize.org/catg.d/p2019.pdf.


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. 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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