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Issue 1338
Issue 1338: November 29, 2017

Ask the Experts
Ask the Experts—Question of the Week: A dose of pneumococcal conjugate vaccine was administered into my patient's . . . read more


TOP STORIES


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


New: IAC's updated 142-page book, Vaccinating Adults: A Step-by-Step Guide now available for purchase or free download

Last week, the Immunization Action Coalition (IAC) announced the publication of its new book, Vaccinating Adults: A Step-by-Step Guide (Guide).



This completely updated guide on adult immunization (originally published in 2004) provides easy-to-use, practical information covering important “how-to” activities to help providers enhance their existing adult immunization services or introduce them into any clinical setting, including:

  • setting up for vaccination services,
  • storing and handling vaccines,
  • deciding which people should receive which vaccines,
  • administering vaccines,
  • documenting vaccinations (including legal issues), and
  • understanding financial considerations and billing information. 

In addition, the Guide is filled with hundreds of web addresses and references to help providers stay up to date on the latest immunization information, both now and in the future.

Two options are available to obtain a copy of the updated Guide:

  • Purchase a copy
    A limited number of printed editions of this 142-page book are available for purchase at www.immunize.org/shop. The Guide’s lie-flat binding and 10 tabbed sections make it easy to locate the information being sought. Purchased copies are delivered in a box that includes Immunization Techniques: Best Practices with Infants, Children, and Adults, a 25-minute training DVD developed by the California Department of Public Health. Also included are several selected IAC print materials, such as the "Skills Checklist for Vaccine Administration," an assessment tool to assist in evaluating the skill level of staff who administer vaccines.
     
  • Download for free and print it yourself
    The entire Guide is available to download/print free of charge at www.immunize.org/guide. The downloaded version is suitable for double-sided printing. Options are available online to download the entire book or selected chapters.

The development of the Guide was supported by the National Vaccine Program Office (NVPO) and the Centers for Disease Control and Prevention (CDC). Expert staff from both agencies also provided early technical review of the content.

The Guide is a uniquely valuable resource to assist providers in increasing adult immunization rates. Be sure to get a copy today!

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National Influenza Vaccination Week will be observed December 3–9

National Influenza Vaccination Week will be held December 3–9 this year. This event highlights the importance of continuing influenza vaccination throughout the season. Resources to encourage vaccination—in English and Spanish—including fact sheets, flyers, and posters, are available on CDC's website. Web buttons, badges, animated GIFs, and web banners are available from CDC as well.



Visit CDC's National Influenza Vaccination Week web section to explore the many resources for healthcare professionals, patients, parents, and the media.

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CDC publishes report on the cost associated with two measles case investigations in Colorado

CDC published Public Health Economic Burden Associated with Two Single Measles Case Investigations—Colorado, 2016–2017 in the November 24 issue of MMWR (pages 1272–5). The first paragraph is reprinted below.

During July 2016–January 2017, two unrelated measles cases were identified in the Denver, Colorado area after patients traveled to countries with endemic measles transmission. Each case resulted in multiple exposures at health care facilities and public venues, and activated an immediate and complex response by local and state public health agencies, with activities led by the Tri-County Health Department (TCHD), which serves Adams, Arapahoe, and Douglas counties. To track the economic burden associated with investigating and responding to single measles cases, personnel hours and supply costs incurred during each investigation were tracked prospectively. No secondary cases of measles were identified in either investigation. Postexposure prophylaxis (PEP) was administered to 31 contacts involving the first case; no contacts of the second case were eligible for PEP because of a delay in diagnosing measles disease. Public health costs of disease investigation in the first and second case were estimated at $49,769 and $18,423, respectively. Single measles cases prompted coordinated public health action and were costly and resource-intensive for local public health agencies.

Related Links

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CDC posts information on hepatitis A vaccine shortage

CDC recently posted the following notice about adult hepatitis A vaccine on its Current Vaccine Shortages & Delays web page:

In light of ongoing outbreaks of Hepatitis A among adults in several U.S. cities, the demand for adult Hepatitis A vaccine has increased substantially over the past 6 months and vaccine supply to meet this unexpected demand in the U.S. has become constrained. U.S.-licensed manufacturers of Hepatitis A vaccine for adults (GlaxoSmithKline and Merck Vaccines) report that unexpected demand globally has also constrained supplies for this vaccine outside the U.S. In order to address current supply constraints in the U.S., CDC staff are working directly with public health officials to provide guidance about how best to target vaccine distribution. In addition, U.S.-licensed manufacturers of adult Hepatitis A vaccine are exploring options to increase domestic supply and are working collaboratively with CDC to monitor and manage public and private vaccine orders to make the best use of supplies of adult Hepatitis A vaccine during this period of unexpected increased demand. Of note, the constraints described in this footnote do not apply to the pediatric Hepatitis A vaccine supply in the U.S. 

Related Link

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Kentucky officials declare hepatitis A outbreak; 7 more cases reported in San Diego County

The Kentucky Department for Public Health (KDPH) has declared a hepatitis A outbreak. Thirty-one cases have been reported in 13 counties. This is a 50% increase in cases over the average of 20 per year during the past 10 years. Similar to the outbreak in San Diego County, risk factors of homelessness and/or drug use have been identified in 12 of the cases. KDPH has reported: "Thus far test results match the genotype associated with an acute Hepatitis A outbreak in California."

Although the outbreak has been slowing in the San Diego area, seven new cases have been reported for a total of 553, with 20 deaths. 

Besides Kentucky and California, the hepatitis A outbreak now includes cases in Michigan, Utah, Arizona, and Colorado. 

A webinar titled Hepatitis A 2017 Outbreak Response—Lessons from Big Cities, hosted and recorded by the National Association of County and City Health Officials (NACCHO) on November 3, is now available online. In the webinar, county health officials from California and Michigan describe the outbreak, lessons learned, and ways other health departments can prepare against hepatitis A outbreaks.

Related Links

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

There are now 644 organizations 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 18, 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
  • Lakeshore Community Health Care, Sheboygan, WI
  • Marshfield Medical Center, Marshfield, WI
  • PediatriCare Associates, Fair Lawn, NJ
  • Summit Physician Services, Chambersburg, PA

Related Links

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Kaiser Health News publishes powerful personal story titled "Shingles: Don't let it get you the way it got me" 

On November 20, Kaiser Health News published an personal story by Bruce Horovitz titled Don't let shingles get you the way it got me. Two paragraphs are reprinted below.

Shingles tried to kill me. Like an insidious invading army, the virus that more commonly causes chickenpox in children attacked the right side of my head, leaving me permanently deaf in my right ear. Shingles almost destroyed my voice box, too, and it caused my right eyelid and lower lip to temporarily droop....

Now, five years later, having won my wretched battle with the virus, I have some advice for fellow middle-agers: Get the shingles vaccine. Particularly if you’ve reached the big 5-0.


Read the full article: Don't let shingles get you the way it got me.

Related Link

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WORLD NEWS


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

CDC published Progress Toward Poliomyelitis Eradication—Pakistan, January 2016–September 2017 in the November 24 issue of MMWR (pages 1276–80). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Progress towards poliomyelitis eradication: Pakistan, January 2016– September 2017. A summary made available to the press by CDC is reprinted below.

Pakistan is one of three countries—including Afghanistan and Nigeria—where WPV [wild poliovirus] has never stopped circulating. During 2017, Pakistan made significant improvements to its polio eradication program. As a result, the number of reported polio cases decreased by 69 percent, with five WPV cases compared to 16 cases reported during the same period in 2016. Despite the decrease, the virus continues to circulate in certain areas and children continue to be missed by immunization campaigns.

Related Links

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FEATURED RESOURCES


Vaccine Education Center develops two new Q&A sheets; one on measles and one on non-standard immunization schedules

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia has developed two new resources for patients and parents.
  1. "Measles: What you need to know" addresses measles disease and vaccination. This piece is part of VEC's Vaccine- and Vaccine Safety-Related Q&A Sheets series, and is available in English and Spanish.  
  2. When Individual Doctors Make Their Own Immunization Schedules addresses schedules implemented by providers to space out or delay vaccines compared with the recommended schedule. This new Q&A sheet is part of VEC's Special Topics series.

Check out both series for many useful resources. You can download any of these Q&A sheets for free or order them from VEC for a nominal charge.

Related Link

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Hepatitis B Foundation releases new video titled "Rensely's Story" in its storytelling project #justB

The Hepatitis B Foundation continues its storytelling campaign: #justB: Real People Sharing their Stories of Hepatitis B. 

Watch the November video, Rensely's Story, about a family struggling to be strong in the face of medical and financial problems after a member's hepatitis B-related liver transplant. 

Related Links

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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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Free app of The Vaccine Handbook available from the Immunization Action Coalition

An app of The Vaccine Handbook is available from the Immunization Action Coalition. The free app, which is available for Apple iPhones and iPads only, contains the complete 2017 (6th) edition of The Vaccine Handbook (“The Purple Book”), by Dr. Gary Marshall, professor of pediatrics and chief of the Division of Pediatric Infectious Diseases at the University of Louisville. The app is fully searchable, with functionality that includes bookmarking, highlighting, user annotation, and links to important vaccination resources.

"The Purple Book" is a comprehensive source of vaccine information, drawing together vaccine science, guidance, and practice into a user-friendly resource for the private office, public health clinic, academic medical center, classroom, and hospital. 

The free app may be found by searching the iTunes App Store for “The Vaccine Handbook App” or clicking on the following link:
https://itunes.apple.com/us/app/the-vaccine-handbook-app/id1043246009?ls=1&mt=8.

Print copies of the book ($34.95 each; bulk discounts are available from the publisher) can be ordered from the Immunization Action Coalition website at www.immunize.org/vaccine-handbook.

Related Links

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JOURNAL ARTICLES AND NEWSLETTERS


American Journal of Preventive Medicine publishes article about Tdap vaccination of healthcare personnel

On November 21, the American Journal of Preventive Medicine published Tdap Vaccination Among Healthcare Personnel—21 States, 2013 (O'Halloran AC, et al.). Two sections of the abstract are reprinted below.

Results
Among all healthcare personnel, 47.2% were vaccinated for Tdap. Physicians had higher Tdap coverage (66.8%) compared with all other healthcare personnel except nurse practitioners and registered nurses (59.5%), whose coverage did not statistically differ from that of physicians. Tdap vaccination coverage was higher among workers in hospitals (53.3%) than in long-term care facilities (33.3%) and other clinical settings, such as dentist, chiropractor, and optometrist offices (39.3%). Healthcare personnel who were younger, who had higher education, higher annual household income, a personal healthcare provider, and health insurance had higher Tdap vaccination coverage compared with reference groups. Tdap vaccination coverage among healthcare personnel in 21 states ranged from 30.6% in Mississippi to 65.9% in Washington.

Conclusions
Improvement in Tdap vaccination among healthcare personnel is needed to potentially reduce opportunities for spread of pertussis in healthcare settings. On-site workplace vaccination, offering vaccines free of charge, and promoting vaccination may increase vaccination among healthcare personnel.


Access the complete article: Tdap Vaccination Among Healthcare Personnel—21 States, 2013.

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Vaccine Education Center publishes November issue of its newsletter for healthcare professionals

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia publishes a monthly immunization-focused newsletter titled Vaccine Update for Healthcare Professionals. The November issue includes information about VEC's new Q&A handouts (see 9th story in this issue), Dr. Offit's archived webinar of November 15 (see 17th story in this issue), as well as the following:

Additional resources for healthcare professionals and their 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


Reminder: NFID webinar on shingles vaccines to take place on December 6
 
The National Foundation for Infectious Diseases (NFID) will present a webinar titled "Shingles Vaccines: What You Need to Know" on December 6 at 12:00 p.m. (ET). Join Edward A. Belongia, MD, director, Center for Clinical Epidemiology & Population Health at the Marshfield Clinic Research Institute in Marshfield, WI, and Michael D. Hogue, PharmD, professor of Pharmacy at the McWhorter School of Pharmacy and associate dean at the Samford University Center for Faith and Health in Birmingham, AL, for a discussion on the epidemiology of herpes zoster, current ACIP recommendations regarding the use of shingles vaccines, and strategies to increase vaccination rates in older adults.
 

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Free online course provides information about viruses and vaccines for non-scientists and concerned parents 

Tel Aviv University is offering a new free online course titled "Viruses and How to Beat Them." The course is led by Professor Jonathan M. Gershoni, Department of Cell Research and Immunology, Tel Aviv University, Israel. The seven lessons, featuring leading experts and scientists, are designed for the curious non-biologist and focus on:
  • How viruses cause disease
  • The immune system's response to infection
  • How vaccines work and why they are important

The course has been developed purely for the purpose of educating people and increasing the awareness of the importance of vaccines. Feel free to participate and/or to share this information with parents and patients.

The course starts on November 28. A person who enrolls has immediate access to all the lessons up to the date of enrollment and then continues to see lessons as they become available each week until the course ends. Once the course ends, all the lessons are placed in the archive and are available to all those who have participated and enrolled previously.

To enroll, go to: Viruses & How to Beat Them: Cells, Immunity, Vaccines.

Vaccine Education Center's November 15 "Current Issues in Vaccines" webinar now available for viewing at your convenience

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia, together with the Pennsylvania chapter of the American Academy of Pediatrics, presented a one-hour webinar November 15, as part of its "Current Issues in Vaccines" series. The webinar featured Paul Offit, MD, director of VEC, discussing:

  • Shingrix vs. Zostavax
  • Hepatitis B vaccine: Updates
  • Mumps: What to do about the increased rates
  • Influenza vaccine: Will FluMist return?

Watch the recorded webinar.

Free continuing education credits are available (CME, CEU, CPE); instructions for obtaining credits are provided at the end of the recording. Questions asked during the event and event slides are available for online viewing or as printable files.

Related Link

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The deadline for submitting an abstract for CDC's 48th National Immunization Conference (NIC) is December 31.

The conference will be held May 15–17, at the Hilton Hotel in Atlanta. NIC brings together more than 1,500 local, state, federal, and private-sector immunization stakeholders and partners to explore science, policy, education, and planning issues related to immunization and vaccine-preventable diseases.

This three-day conference will include the following session tracks:

  • Adult Immunization
  • Immunization Information Systems
  • Programmatic Issues
  • Health and Risk Communications
  • Epidemiology and Surveillance
  • Childhood/Adolescent Immunization 

Access the guidelines and link for submitting an abstract for the 48th National Immunization Conference.

Related Link

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ASK THE EXPERTS

Question of the Week

A dose of pneumococcal conjugate vaccine was administered into my patient's dialysis port. Does this dose count? 

There are no data on the effectiveness of pneumococcal conjugate vaccine given by the intravenous route. The patient has renal disease, so it is important to ensure that the dose they receive is effective. CDC recommends repeating the dose.


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.; Merck Sharp & Dohme Corp.; Pfizer, Inc.; and Sanofi Pasteur.

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Video of the Week
Samantha's Flu and Pregnancy Story: Samantha did not get a flu shot when pregnant, and she became seriously ill with pneumonia after getting influenza. Her doctor explains that pregnant women are especially susceptible to flu and its complications. After an emergency C-section at 35 weeks and intubation for pneumonia, Samantha encourages everyone to get the flu vaccine. (Source: University of Pittsburgh Medical Center)
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Editor:
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Managing Editor:
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Consulting Editors:
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Jane Myers, EdM

Assistant Managing Editor:
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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
NCIRD: National Center for Immunization and Respiratory Diseases
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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.