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Issue 1349
Issue 1349: February 14, 2018


TOP STORIES


VACCINE INFORMATION STATEMENTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS

 


TOP STORIES


CDC releases new VIS for recombinant zoster vaccine, updates VIS for live zoster vaccine, and posts final VISs for MMR, MMRV, and varicella

On February 12, CDC released a new Vaccine information Statement (VIS) for recombinant zoster (shingles) vaccine, as well as a revised VIS for live zoster (shingles) vaccine. CDC also released final versions of the MMR, MMRV, and varicella (chickenpox) VISs; these VISs were updated from “interim” to “final” versions. CDC encourages providers to begin using these VISs immediately; however, stocks of the previous editions may be used until gone.

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CDC reports that 63 U.S. children have died from influenza this season; CDC provides media advisory about widespread influenza activity

CDC has reported in its Weekly U.S. Influenza Surveillance Report, FluView, that as of the week ending February 3, influenza activity increased. The total pediatric deaths have climbed to 63 since October 1, 2017. The proportion of outpatient visits for influenza-like illness (ILI) was 7.7%, which is above the national baseline of 2.2%. All 10 regions reported ILI at or above region-specific baseline levels. The geographic spread of influenza in Puerto Rico and 48 states was reported as widespread.

On February 9, CDC held an update for the media titled "CDC Update on Flu Activity."

Access the complete press briefing transcript of this media advisory.

Listen to an audio recording of the media advisory. 

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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Following the MMWR Early Release last week of articles on the 2018 child, teen, and adult immunization schedules, CDC published the same articles in the current issue of MMWR

On February 6, CDC published articles on the 2018 national immunization schedules for children, teen, and adults as an MMWR Early Release; this news was covered in IAC Express on February 7. The same two articles were published in the current issue of MMWR.

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CDC issues easy-to-read versions of the 2018 child, teen, and adult immunization schedules 

Easy-to-read versions of the 2018 schedules are now posted on the CDC website, available in HTML and in PDF format in color and black and white.

Please share with the patients and parents in your sphere of influence.

Access versions formatted for displaying on a website in English and Spanish.

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Shingrix and Zostavax, the two licensed zoster vaccines, differ in their storage, handling, and administration requirements; make sure you know the differences 

It's important to know the differences between the two zoster vaccines regarding storage and handling as well as vaccine administration. Here is a brief review of the guidance for each of them.
 
Shingrix vaccine storage, handling, and administration guidance

  • Shingrix (recombinant zoster vaccine, RZV; GSK): The lyophilized vaccine and its adjuvant solution both must be stored at refrigerator temperature, between 2° and 8°C (between 36° and 46°F). Protect the vials from light. Do not freeze. Vaccine or adjuvant solution that has been frozen must be discarded. If vaccine that was frozen was administered, the dose does not count and should be repeated. The repeat dose can be administered immediately. There is no interval that must be met between these doses.
  • After reconstitution, administer RZV immediately by the intramuscular route only or store the reconstituted vaccine refrigerated between 2° and 8°C (between 36° and 46°F) and use within 6 hours. Discard reconstituted vaccine if not used within 6 hours or if frozen. 

Zostavax vaccine storage, handling, and administration guidance

  • Zostavax (zoster vaccine live, ZVL; Merck): The vaccine must be stored in a freezer at a temperature between -50°C and -15°C (between -58°F and +5°F) until it is reconstituted. The diluent should be stored separately at room temperature or in the refrigerator. ZVL may be stored at refrigerator temperature between 2°C and 8°C (between 36°F and 46°F) for up to 72 continuous hours prior to reconstitution. ZVL stored between 2°C and 8°C that is not used within 72 hours of removal from a freezer should be discarded.
  • ZVL is to be administered subcutaneously (Subcut) immediately after reconstitution to minimize loss of potency. If the vaccine is not administered within 30 minutes of reconstitution, it must be discarded.

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IAC's "Ask the Experts" Q&As on zoster vaccines have been updated by CDC experts

IAC's Ask the Experts zoster web page containing questions and answers about both zoster vaccines has been updated by experts at CDC.

Visit the page to get answers to your questions concerning the storing, handling, administration, and other issues related to zoster vaccines.
 
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IAC Spotlight! IAC’s recently updated rotating screen on the home page of immunize.org makes it easier than ever to access three of the most visited sections of the website

Recently updated, IAC's rotating screen on the home page of immunize.org makes it easier than ever to access three of the most visited sections of the website: IAC Express, Ask the Experts, and Handouts.

When the screen rotates to IAC Express, you can access the latest issue or the "Subscribe" page with one click. When the screen rotates to "Ask the Experts," you can access answers from CDC experts to over 1000 questions about vaccines and their use. Clicking on the Handouts screen when it is in view brings you to over 250 CDC-reviewed educational materials for patients and staff.

The rotating screen also cycles to the News & Information section, which includes the latest issue of IAC Express and of Technically Speaking, breaking news, and official releases; the screen rotates to Shop IAC as well, with immunization-related products available for purchase from IAC. 

Visit the home page of immunize.org to find the information and materials you need more quickly than ever!

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Every Child by Two publishes a special report on the state of our nation’s “ImmUnion” and shares it with members of Congress

Every Child By Two (ECBT) recently shared a special report titled 2018 State of the ImmUnion: A Report on Vaccine-Preventable Diseases in the U.S. with members of Congress to highlight the power of vaccines and suggest areas of action to fortify the health of our nation. While the medical community has the ability to protect Americans of all ages from deadly infectious diseases, public health workers continue to battle disease outbreaks across the nation that threaten the health and well-being of our citizens. Many Americans continue to lack access to life-saving vaccines that can protect them, their families, and their communities from preventable diseases, while others fail to realize that vaccines are available to protect them from many life-threatening diseases.
 
This report highlights the successes of vaccines, the economic and societal savings incurred as a result of vaccines, challenges facing the public health system, and key areas to focus on to achieve optimal protection for all Americans. The report includes details on the following:

  • Immense success of vaccines in preventing illness and saving lives
  • Economic and societal savings as a result of high vaccination rates
  • Challenges facing the public health system that threaten our country’s progress in combating vaccine-preventable diseases among all age groups
  • Key areas of focus for legislators to help ensure optimal protection against these devastating diseases
  • Links to educational and vaccine policy resources from partner organizations 

ECBT is hopeful that this report will not only help congressional leaders learn more about the vaccination rates in their home states, but will also help public health advocates prioritize the benefits of immunizations in the years ahead as we face emerging health and budget threats. Please help to disseminate the messages in the report over the coming months as state and federal legislators continue to address vaccine budget and policy issues.  

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Voices for Vaccines releases a new Vax Talk podcast episode, "Ask Dr. Offit," in which he answers listeners' questions on topics ranging from influenza to pertussis to advocacy

Voices for Vaccines (VFV) has posted the 14th entry in its Vax Talk podcast series: Ask Dr. Offit. In this podcast, Paul Offit, MD, director, Vaccine Education Center at the Children’s Hospital of Philadelphia, responds to questions listeners submitted online on topics ranging from influenza to pertussis to advocacy. 

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 join VFV!
 
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CDC publishes "Notes from the Field: Assessment of Rabies Exposure Risk Among Residents of a University Sorority House—Indiana, February 2017” in this week's MMWR

CDC published Notes from the Field: Assessment of Rabies Exposure Risk Among Residents of a University Sorority House—Indiana, February 2017 in the February 9 issue of MMWR (page 166).

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CDC publishes “Potential Confounding of Diagnosis of Rabies in Patients with Recent Receipt of Intravenous Immune Globulin" in this week's MMWR

CDC published Potential Confounding of Diagnosis of Rabies in Patients with Recent Receipt of Intravenous Immune Globulin (IVIG) in the February 9 issue of MMWR (pages 161–165). A brief excerpt from the Summary appears below:

This report describes six patients who met the case definition for human rabies because they had illnesses compatible with rabies, had not been vaccinated against rabies, and were found to have a high concentration of serum RLNAs. However, none of these patients received a rabies diagnosis; rather, they were considered to have been passively immunized for rabies through receipt of IVIG.

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IAC's new 142-page book, Vaccinating Adults: A Step-by-Step Guide, describes how to implement adult vaccination services in your healthcare setting and provides a review for staff who already vaccinate adults; IAC Guide available for free download or purchase

The Immunization Action Coalition (IAC) recently 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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VACCINE INFORMATION STATEMENTS


IAC posts Pohnpeian-language translations of VISs for hepatitis A, HPV, MenACWY, MMR, Tdap, and varicella 

IAC recently posted Pohnpeian-language translations of the VISs for hepatitis A, human papillomavirus (HPV), meningococcal (MenACWY), MMR, Tdap, and varicella (chickenpox). IAC thanks the Hawaii Department of Public Health for the translations.

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IAC posts corrected Tongan-language translations of VISs for hepatitis A, HPV, MenACWY, MMR, Tdap, and varicella 

IAC recently posted corrected Tongan-language translations of the VISs for hepatitis A, human papillomavirus (HPV), meningococcal (MenACWY), MMR, Tdap, and varicella (chickenpox). Changes were made to correct the spelling for the translation of "mumps" from "møø" or "moo" to "mø" and to change the spelling of "toø" to "tø." IAC thanks the Hawaii Department of Public Health for the translations.

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WORLD NEWS


WHO, UNICEF, and GAVI issue joint statement on their partnership strategy to eliminate yellow fever epidemics in global areas of risk

On January 29, the World Health Organization (WHO), United Nation's Children's Fund (UNICEF), and Gavi issued a joint statement titled Eliminating Yellow Fever Epidemics (EYE) Strategy: Meeting demand for yellow fever vaccines. Confirming their joint commitment to eliminate yellow fever epidemics by 2026, this statement responds to the concern that the current supply of yellow fever vaccine will not meet the growing demand for it in Africa and elsewhere. Below is an excerpt from WHO's website summarizing the EYE strategy and its objectives:

The Global Strategy to Eliminate Yellow Fever Epidemics (EYE) is a comprehensive, long-term strategy built on lessons learned, that aims to end yellow fever epidemics by 2026. The strategy is guided by three strategic objectives: (1) protect at-risk populations; (2) prevent international spread of yellow fever and; (3) contain outbreaks rapidly. These objectives are underpinned by five competencies of success: (i) affordable vaccines and sustained vaccine market; (ii) strong political commitment at global, regional and country levels; (iii) high-level governance with long-term partnerships; (iv) synergies with other health programmes and sectors and; (v) research and development for better tools and practices.

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FEATURED RESOURCES


The Vaccine Handbook:  A Practitioner's Guide to Maximizing Use and Efficacy across the Lifespan, by Drs. Tan, Flaherty, and Gerbie, now available from Oxford University Press; order online with code for 30% discount

Oxford University Press has recently published The Vaccine Handbook:  A Practitioner's Guide to Maximizing Use and Efficacy across the Lifespan, by Drs. Tan, Flaherty, and Gerbie. Copies can be ordered online at a 30% discount using the code AMPROM09. This 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.



According to the publisher's press release, The Vaccine Handbook: A Practitioner's Guide to Maximizing Use and Efficacy across the Lifespancontains strategies for responding to vaccine hesitancy, discusses vaccines required during pregnancy and international travel, and can serve as a reference for clinicians in training and in practice. The book also includes immunization schedules, scripts for responding to patient concerns, and frequently asked questions.

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Jason Mendelsohn, father of three, diagnosed with Stage 4 HPV oral cancer, tells story of his diagnosis, treatment, and survival to raise awareness

Jason Mendelsohn, a 44-year-old father of three, was diagnosed with Stage 4 HPV-related oral cancer after he felt a lump in his neck. To raise awareness about the disease and its prevention, he posted the story of his diagnosis, treatment, and survival in a video on his website, www.supermanhpv.com. He chose the name SupermanHPV to draw attention to the diagnosis and to help spread the word about HPV-related oral cancer. 

View the 2:40 minute video: Jason Mendelsohn's HPV Oral Cancer Testimonial. 

Jason's mission to raise awareness about HPV has resulted in widespread media coverage. The In the Media web page on his website, Awareness and Prevention Starts with You (www.supermanhpv.com), features numerous media articles on his story and on HPV.

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JOURNAL ARTICLES AND NEWSLETTERS


January issue of CDC's Immunization Works newsletter now available

CDC recently released the January issue of its monthly newsletter Immunization Works. The newsletter offers the immunization community information about current topics. The information is in the public domain and can be reproduced and circulated widely.

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Health Psychology publishes study of 5,323 people in 24 countries finding that anti-vaccination attitudes were highest in those with strong conspiracy theory beliefs

Health Psychology, a journal of the American Psychological Association, released an advance online publication on February 1 of a study of anti-vaccination attitudes among 5,323 people in 2400 countries. The study, The Psychological Roots of Anti-Vaccination Attitudes: A 24-Nation Investigation, by M.J. Hornsey, et al., examined the attitudes of those who were opposed to vaccination in relation to other attitudes and fears they held. The researchers sought to understand what motivates people to reject the science around vaccination. Although the researchers found correlations between vaccine resistance and other underlying attitudes, such as fear of needles and particular world views, they found that the belief in conspiracy theories was the most highly correlated belief. 

Read the complete article: The Psychological Roots of Anti-Vaccination Attitudes: A 24-Nation Investigation.

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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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Editor:
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Managing Editor:
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Consulting Editors:
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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
VIS: Vaccine Information Statement
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