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Issue 1312
Issue 1312: June 21, 2017

Ask the Experts
Ask the Experts—Question of the Week: We received a report of an infant who received rotavirus vaccine intramuscularly . . . read more


TOP STORIES


IAC HANDOUTS

WORLD NEWS

FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


Hepatitis A outbreak claims fourth life in southern California

The recent hepatitis A outbreak in San Diego County has led to four deaths, according to official news from the County of San Diego communications office. So far the outbreak has totaled 160 cases, with 120 people hospitalized. A selection from the county's news release is reprinted below.

Public health investigators are continuing to evaluate cases, but thus far no common food, drink, or drug source has been identified as the cause. Most of those who have become ill are either homeless and/or using illicit drugs. The County has been working with community partners to conduct vaccination clinics for people who are at risk for hepatitis A. These partners include homeless services providers, community health clinics, faith-based community organizations, substance use treatment providers, hospital emergency departments, jails, and probation facilities.

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FDA investigates findings of hepatitis A link to frozen tuna

An outbreak of hepatitis A linked to frozen tuna has led to a U.S. Food and Drug Administration (FDA) investigation and the posting of facts and advice on its website. FDA and CDC are assisting state and local officials in assessing the risk of hepatitis A virus exposure from potentially contaminated frozen tuna distributed by Hilo Fish Company and sourced from Sustainable Seafood Company (Lots F5-6 Soui Dau Industrial Zone, Can Lam Khanh Hoa Province, Vietnam) and Santa Cruz Seafood, Inc. (General Santos Fishport Complex Tambler, General Santos City, 9500, Philippines). 

CDC is advising unvaccinated consumers who have eaten the recalled product within the last two weeks that post-exposure prophylaxis may help prevent hepatitis A virus infection.

The current recall resulted from follow-up after the Hawaii Department of Health notified FDA of a frozen tuna sample, sourced from PT Deho Canning Co., which tested positive for hepatitis A on May 1. The initially recalled product has been removed from circulation and the newly recalled frozen tuna lots were not shipped to Hawaii, but were shipped to the mainland U.S.

FDA is providing a list of establishments in Texas, Oklahoma, and California that may currently have potentially contaminated tuna in commerce to help alert consumers. 

Access more information provided by FDA about the outbreak.

Related Links

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CDC reports 3,176 cases of mumps in 42 states across the U.S. from January through May

Preliminary data from CDC indicate that from January 1 to May 20, 42 states and the District of Columbia reported mumps infections in 3,176 people. Although it is not mandatory to report mumps outbreaks to CDC, many health departments will contact CDC when they experience an unusually high number of cases.

From year to year, mumps cases can range from roughly a couple hundred to a couple thousand. For example, in 2016 there were approximately 5,833 cases reported to CDC, and in 2012, there were 229. Before the U.S. mumps vaccination program started in 1967, about 186,000 cases were reported each year, but the actual number of cases was likely much higher due to underreporting. Since the pre-vaccine era, there has been a more than 99% decrease in mumps cases in the United States.

Related Links

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IAC Spotlight! Looking for the top patient handouts and staff education materials on immunize.org? Visit our newly updated Top Handouts web page.

Do you want to know the most frequently downloaded and practical educational materials for patients, parents, and staff on the immunize.org website? It’s easy! All you have to do is visit IAC’s Top Handouts web page at www.immunize.org/handouts/top-picks.asp. Here you’ll find 25 of the most popular print resources from IAC, all of them technically reviewed by CDC for accuracy.
 
We've compiled some of IAC’s most downloaded handouts.

You can bookmark this page and refer to it often. You’ll find Top Handouts by visiting the Handouts web section on immunize.org and clicking on the Top Handouts link from the alphabetical listing of topics.

These are some of the pages within IAC's Handouts web section:

Related Link

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Reminder: Dr. William L. Atkinson, IAC's associate director for immunization education, will present a webinar on adolescent immunization on July 10

William L. Atkinson, MD, MPH, IAC's associate director for immunization education, will present a one-hour webinar on adolescent immunization on July 10 at 1:00 p.m. (ET). During his presentation, Dr. Atkinson will review the recommendations for adolescent vaccines, including those recommended at 11–12 years of age and those at age 16.

Registration information for the webinar will be provided in a future issue of IAC Express. In the meantime, be sure to reserve July 10 from 1:00 p.m.–2:00 p.m. (ET) on your calendar.

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Unity Consortium publishes a call to action on adolescent immunization

The Unity Consortium has issued a call to action to increase adolescent immunization coverage with a white paper titled Adolescent Immunization: Understanding Challenges and Framing Solutions for Healthcare Providers. Developed in collaboration with a panel of nationwide experts in public health, adolescent health, and immunization, the call to action lays forth the following 5 "INSPECT" imperatives:

  • Increase access, expand, and integrate the Immunization Neighborhood
  • Leverage technology and improve information Sharing
  • Establish an immunization Platform for older adolescents at age 16
  • Educate parents and teens to raise the priority for immunization
  • Develop and empower immunization Champions and Talk about quality performance
Read the full paper: Adolescent Immunization: Understanding Challenges and Framing Solutions for Healthcare Providers

The mission of the Unity Consortium is improving adolescent health through a focus on prevention and immunization. Visit the Unity website for more information.

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Importance of adult immunizations highlighted in Becker’s Hospital Review article

An important article from the National Adult and Influenza Immunization Summit (NAIIS), Making Prevention the Priority—How to Boost Adult Immunization Rates, was highlighted in a recent issue of Becker’s Hospital Review, one of the most widely read publications of people working in hospital management.
 
As noted in the article, “Despite providers’ and health agencies’ efforts to advocate for the importance of vaccinating adults—especially those most vulnerable to infection—rates of adult immunization remain low, creating a substantial burden on the American health system.” The article includes several steps hospitals and health systems can take to begin improving adult immunizations in the communities they serve and concludes that “adult immunizations have the potential to make a substantial impact on care outcomes while remaining cost-effective for hospitals.”
 
The article is available as an online publication or a downloadable PDF that may be shared with partners.

Related Links 

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IAC HANDOUTS

IAC revises "When Do Children and Teens Need Vaccinations?"

IAC recently revised its parent handout titled When Do Children and Teens Need Vaccinations? Changes were made to incorporate the recommendation to administer hepatitis B vaccine within 24 hours of birth and also to include the new 2-dose HPV recommendation, with a new corresponding footnote (#3) stating that children with certain medical conditions will need a third HPV dose.

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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IAC updates "Standing Orders Administering Diphtheria, Tetanus, and Acellular Pertussis (DTaP) Vaccine to Children Younger Than Age 7 Years"

IAC recently updated its resource for healthcare professionals, Standing Orders for Administering DTaP Vaccine to Children Younger Than Age 7 Years. This standing orders template now follows the new IAC standing orders format of incorporating lists in bullet form and also using charts and tables whenever possible (e.g., needle length and gauge, detailed information about scheduling and spacing vaccination for infants and children who fall behind) for increased clarity and readability.

Related Link

  • IAC's Standing Orders web section with standing orders templates for administering vaccines and for the medical management of vaccine reactions

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IAC updates "Guidance for Developing Admission Orders in Labor and Delivery and Newborn Units to Prevent Hepatitis B" as well as "Sample Text for Developing Admission Orders in Newborn Units for the Hepatitis B Vaccine Birth Dose" 

IAC recently updated the following two resources for hospitals to help in protecting newborns against hepatitis B virus infection:

  1. Guidance for Developing Admission Orders in Labor & Delivery and Newborn Units to Prevent Hepatitis B Virus Transmission
  2. Sample Text for Developing Admission Orders in Newborn Units for the Hepatitis B Vaccine Birth Dose

The updated versions include the new recommendation from CDC/AAP/AAFP/ACOG that normal-weight infants born to HBsAg-negative mothers should be vaccinated within 24 hours of birth or at hospital discharge, whichever comes first. (Previously, the recommendation was to administer hepatitis B vaccine "before hospital discharge.")

Related Links

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WORLD NEWS


WHO reports on maternal and neonatal tetanus in Equatorial Guinea in this week's Weekly Epidemiological Report

The World Health Organization (WHO) published Validation of maternal and neonatal tetanus elimination in Equatorial Guinea, 2016 in the June 16 issue of its Weekly Epidemiological Report.

Related Link

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FEATURED RESOURCES

New edition of The Vaccine Handbook: A Practical Guide for Clinicians, a.k.a. "The Purple Book," by Dr. Gary Marshall available for purchase from IAC

The 6th edition of The Vaccine Handbook: A Practical Guide for Clinicians ("The Purple Book") is considered a vital source of practical, up-to-date information for vaccine providers and educators. Now printed in color and updated with the latest vaccine information through early 2017, "The Purple Book" draws 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.

The sixth edition of this valuable guide (592 pages) is available on IAC's website at www.immunize.org/vaccine-handbook. The price of the handbook is $34.95 per copy, plus shipping charges. Order copies for your staff or for distribution at an upcoming conference.

Discount pricing is available for more than 10 copies. 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!

The Vaccine Handbook App for Apple iPhones and iPads is available free from IAC. Sorry, the app is not available for android devices. Book purchase is not necessary but registration to obtain the app is required.

The app is fully searchable, allows for bookmarking, highlighting and annotation, and contains hyperlinks to valuable content from nonprofit and governmental sources.

Click on the image below to visit the The Vaccine Handbook App page in the iTunes store.

Download new app!

About the Author
Gary S. 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.

Related Links

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Still available! IAC's sturdy laminated versions of the 2017 U.S. child/teen immunization schedule and the 2017 U.S. adult immunization schedule—order a supply for your healthcare setting today!

IAC's laminated versions of the 2017 U.S. child/teen immunization schedule and the 2017 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

Canada experienced measles outbreak with unique virus genotyping in 2015  

CDC's Emerging Infectious Diseases journal recently published Measles Outbreak with Unique Virus Genotyping, Ontario, Canada, 2015 online as part of the July 2017 issue. The abstract is reprinted below.

The province of Ontario continues to experience measles virus transmissions despite the elimination of measles in Canada. We describe an unusual outbreak of measles in Ontario, Canada, in early 2015 that involved cases with a unique strain of virus and no known association among primary case-patients. A total of 18 cases of measles were reported from 4 public health units during the outbreak period (January 25–March 23, 2015); none of these cases occurred in persons who had recently traveled. Despite enhancements to case-patient interview methods and epidemiologic analyses, a source patient was not identified. However, the molecular epidemiologic analysis, which included extended sequencing, strongly suggested that all cases derived from a single importation of measles virus genotype D4. The use of timely genotype sequencing, rigorous epidemiologic investigation, and a better understanding of the gaps in surveillance are needed to maintain Ontario’s measles elimination status.

Related Link

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EDUCATION AND TRAINING


NFID to sponsor July 13 webinar about June 2017 ACIP meeting

The National Foundation for Infectious Diseases (NFID) will be offering a 1-hour webinar on July 13 at 1:00 p.m. (ET). William Schaffner, MD, NFID medical director and liaison to ACIP, will discuss updates from the June 2017 ACIP meeting, including updated recommendations for adult vaccination. Continuing medical education and continuing nursing education credits are available.

Access registration information.

Related Links

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Register now for CDC’s July 13 webinar: “Partner Resource Showcase: New Tools for HPV Vaccination” 

Learn about the newest HPV vaccine resources in CDC's webinar "Partner Resource Showcase: New Tools for HPS Vaccination," on July 13, from 10–11 a.m. (ET). Presentations will be given by representatives from the following CDC partner organizations:

  • American Academy of Pediatricians
  • American Cancer Society
  • Academic Pediatrics Association
  • National Area Health Education Center Organization
  • National Association of County and City Health Officials
  • National HPV Vaccination Roundtable

Register for the webinar.

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Register now for the June 28 VICNetwork webinar: "Creating a Pro-Immunization Culture and Preparing for National Immunization Awareness Month" 

The Virtual Immunization Communication Network (VIC Network) is sponsoring a webinar on June 28 from 2:00–3:00 p.m. (ET). The webinar will introduce this year’s National Immunization Awareness Month (NIAM) Communication Toolkit to help prepare for NIAM in August. The webinar will highlight the NIAM 2017 features and updates in this toolkit that provides weekly themes, materials, resources, and templates to promote immunization awareness across the lifespan.

Register for the webinar.

Related Links

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Reminder: Weekly CDC webinar series on "The Pink Book" chapter topics continues through October 11; 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 weekly 1-hour webinars that started June 14 and will run though October 11. Recordings of sessions will be available online within 2 weeks after each webinar. All sessions begin at 12:00 p.m. (ET). Continuing education will be available for each event.

The webinar series will provide an overview of vaccines and the diseases they prevent, general recommendations for vaccines, vaccination principles, and immunization strategies for providers. 

Registration and more information is available on CDC's Pink Book Webinar Series web page.

All the sections of "The Pink Book" (i.e., chapters, appendices, 2017 supplement) are available to download at no charge at www.cdc.gov/vaccines/pubs/pinkbook/index.html.

You can also order this resource from the Public Health Foundation for $40 plus shipping and handling. This print version does not include the 2017 supplement.

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Continuing education credit is available for reading ACIP's "General Best Practice Guidelines for Immunization"

CDC is offering continuing education (CE) credit for reading ACIP's recently published General Best Practice Guidelines for Immunization, which updates and replaces ACIP's 2011 "General Recommendations on Immunization."

The field of immunization is marked by constant change, including licensing of new vaccines, new vaccination recommendations, and new findings about how vaccines work and their adverse events. This document provides clinicians and other healthcare providers with ACIP’s best practices guidance on immunization.

CE credit is available until April 20, 2019. 

Related Link

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CONFERENCES AND MEETINGS


Tune into CDC's ACIP meeting June 21–22 (Wednesday and Thursday) via live webcast

Tune into the Advisory Committee on Immunization Practices (ACIP) meeting in Atlanta on June 21 and 22 (Wednesday and Thursday) via live webcast.

View the ACIP Meeting Information web page.

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ASK THE EXPERTS

Question of the Week

We received a report of an infant who received rotavirus vaccine intramuscularly rather than orally. Is this dose valid? If not, when should it be repeated?  

The rotavirus vaccine dose given by the intramuscular route is not valid and should be repeated by the oral route as soon as possible. In a review of such rotavirus vaccine administration errors, there usually were not adverse reactions, and those documented were limited to local reactions and general, brief irritability. Please see https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6304a4.htm for more information.
 
Please take steps to ensure that such vaccine administration errors are avoided in the future. This event should be reported to the Vaccine Adverse Event Reporting System at https://vaers.hhs.gov even if an adverse reaction does not result from it.


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.

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. 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.
IAC Express Disclaimer
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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
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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.