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Issue 1387
Issue 1387: October 3, 2018


TOP STORIES


IAC HANDOUTS


OFFICIAL RELEASES AND ANNOUNCEMENTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS

 


TOP STORIES


CDC reports on influenza vaccination coverage of healthcare professionals in 2017–18   

CDC published Influenza Vaccination Coverage Among Health Care Personnel—United States, 2017–18 Influenza Season in the September 28 issue of MMWR (pages 1050–1054). The first paragraph is reprinted below.

The Advisory Committee on Immunization Practices (ACIP) recommends that all health care personnel receive an annual influenza vaccination to reduce influenza-related morbidity and mortality among health care personnel and their patients and to reduce absenteeism among health care personnel. CDC conducted an opt-in Internet panel survey of 2,265 U.S. health care personnel to estimate influenza vaccination coverage among these persons during the 2017–18 influenza season. Overall, 78.4% of health care personnel reported receiving influenza vaccination during the 2017–18 season, similar to reported coverage in the previous four influenza seasons. As in previous seasons, coverage was highest among personnel who were required by their employer to be vaccinated (94.8%) and lowest among those working in settings where vaccination was not required, promoted, or offered on-site (47.6%). Health care personnel working in long-term care settings, the majority of whom work as assistants or aides, have lower influenza vaccination coverage than do health care personnel working in all other health care settings, which puts the elderly in long-term settings at increased risk for severe complications for influenza. Implementing workplace strategies shown to improve vaccination coverage among health care personnel, including vaccination requirements and active promotion of on-site vaccinations at no cost, can help ensure health care personnel and patients are protected against influenza. CDC’s long-term care web-based toolkit provides resources, strategies, and educational materials for increasing influenza vaccination among health care personnel in long-term care settings.



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CDC publishes report on influenza vaccination coverage of pregnant women in 2017–18

CDC published Influenza and Tdap Vaccination Coverage Among Pregnant Women—United States, April 2018 in the September 28 issue of MMWR (pages 1055–1059). The first paragraph is reprinted below.

Vaccinating pregnant women with influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines can reduce the risk for influenza and pertussis for themselves and their infants. The Advisory Committee on Immunization Practices (ACIP) recommends that all women who are or might be pregnant during the influenza season receive influenza vaccine, which can be administered any time during pregnancy. The ACIP also recommends that women receive Tdap during each pregnancy, preferably from 27 through 36 weeks’ gestation. To assess influenza and Tdap vaccination coverage among women pregnant during the 2017–18 influenza season, CDC analyzed data from an Internet panel survey conducted during March 28–April 10, 2018. Among 1,771 survey respondents pregnant during the peak influenza vaccination period (October 2017–January 2018), 49.1% reported receiving influenza vaccine before or during their pregnancy. Among 700 respondents who had a live birth, 54.4% reported receiving Tdap during their pregnancy. Women who reported receiving a provider offer of vaccination had higher vaccination coverage than did women who received a recommendation but no offer and women who did not receive a recommendation. Reasons for nonvaccination included concern about effectiveness of the influenza vaccine and lack of knowledge regarding the need for Tdap vaccination during every pregnancy. Provider offers or referrals for vaccination in combination with patient education could reduce missed opportunities for vaccination and increase vaccination coverage among pregnant women.

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CDC reports on barriers to Tdap receipt among mothers of infants with pertussis

CDC published Barriers to Receipt of Prenatal Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine (Tdap) Among Mothers of Infants Aged <4 Months with Pertussis—California, 2016 in the September 28 issue of MMWR (pages 1068–1071). The first paragraph is reprinted below.

Vaccination with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is recommended for all pregnant women to protect infants who are too young for vaccination from severe pertussis-related outcomes. However, Tdap vaccine coverage among pregnant women remains suboptimal in California. California mothers whose infants developed pertussis in 2016 and their prenatal care providers were interviewed to ascertain possible reasons for low Tdap vaccine coverage. Mothers who were offered Tdap vaccination on-site during a routine prenatal visit were more likely to be vaccinated than were mothers who were referred off-site for vaccination. Mothers insured by Medicaid were less likely to receive Tdap vaccine than were mothers with private insurance, even when the vaccine was stocked on-site. Nearly all vaccinated mothers received Tdap vaccine in their prenatal clinic. Incorporating Tdap vaccination into routine prenatal care visits is an effective means to increase prenatal Tdap vaccination coverage.

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Available online: six-part series of online training sessions on implementing standing orders protocols for adult immunization in your healthcare setting

Standing orders protocols (SOPs) are known to improve immunization coverage rates, but are underutilized by providers serving adult patients. The content for a six-part webinar series will help healthcare settings implement SOPs for adult immunizations. 

The Executive Summary, provided by IAC executive director Dr. Deborah Wexler, gives a concise overview of the entire series presented by Drs. William Atkinson and Litjen Tan. Attending this series does not earn Continuing Education (CE) credit. The series is developed and provided by IAC, IDCareLive, and Pfizer.

Registration is free, but is required in order to view any session. The link will bring up a short registration form to create a free IDCareLive account, if you don’t already have one. After signing up, you will be transferred directly to the intended page. 

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IAC updates two of its popular Ask the Experts sections: one on MMR and the second on HPV vaccine 

IAC's Ask the Experts: Measles, Mumps, and Rubella and Ask the Experts: Human Papillomavirus (HPV) web pages have been completely reviewed and updated by experts at CDC.

Ask the Experts: Measles, Mumps, and Rubella: Revisions include updates on case counts and outbreaks and revision of website links and references. There are no new recommendations.

Ask the Experts: Human Papillomavirus (HPV): Revisions were made to disease burden. Also, several website links and references were updated. 

IAC’s Ask the Experts web section is a compilation of common as well as challenging questions and answers (Q&As) about vaccines and their administration. William Atkinson, MD, MPH, IAC's associate director for immunization education, manages this web section, with answers provided by Andrew T. Kroger, MD, MPH; Candice L. Robinson, MD, MPH; Raymond A. Strikas, MD, MPH, FACP, FIDSA; Tina S. Objio, MSN, MHA, RN; and JoEllen Wolicki, BSN, RN, all from the National Center for Immunization and Respiratory Diseases, CDC.

IAC Express publishes five special editions each year of Ask the Experts Q&As answered by CDC experts. You can access the four most recent IAC Express Ask the Experts sets of Q&As from the main web page of Ask the Experts, in the right-hand column.

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San Diego County reports on third meningococcal B case at San Diego State University

On September 28, the County of San Diego reported that a third student from San Diego State University (SDSU) had been diagnosed with meningococcal B disease. The county is recommending that all unimmunized SDSU undergraduate students under the age of 24 get vaccinated with one of two available meningococcal B vaccines. The San Diego County Health and Human Services Agency and SDSU Student Health Services are working together to facilitate vaccinations for undergraduate students. 

Read the county's press release: Third Meningococcal Case at SDSU, County Declares Outbreak

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IAC Spotlight! IAC’s recently updated Partners web page is a great way to learn about organizations and professional societies that work in the immunization field 

The IAC Immunization Partners web page features a exhaustive listing of governmental and nonprofit organizations and professional societies that work in the field of immunization in the United States. The alphabetical list includes short descriptions and links to the organizations' websites, as well as some links to specific resources or information.

Check out the IAC Immunization Partners web page to learn more.

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IAC enrolls five new birthing institutions into its Hepatitis B Birth Dose Honor Roll; 13 previously honored institutions qualify for additional years' honors

The Immunization Action Coalition (IAC) is pleased to announce that five new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.

  • Geary Community Hospital, Junction City, KS (93%)
  • Jackson Hospital, Marianna, FL (98%)
  • Kearny County Hospital, Lakin, KS (96%)
  • Newman Regional Health, Emporia, KS (96%)
  • TriStar Centennial Women's Hospital, Nashville, TN (96%)

The following nine institutions are being recognized for a second year:

  • Families Are First Birthing Center Bristol Hospital, Bristol, CT (91%)
  • MHP Medical Center/Major Hospital, Shelbyville, IN (100%)
  • Munson Healthcare, Grayling, MI (90%)
  • New York Presbyterian Queens, Flushing, NY (93%)
  • Oaklawn Hospital, Marshall, MI (90%)
  • Pratt Regional Medical Center, Pratt, KS (94%)
  • St. Mary Mercy Hospital, Livonia, MI (92%)
  • Scenic Mountain Medical Center, Big Spring, TX (98%)
  • South Central Kansas Medical Center, Arkansas City, KS (96%)

In addition, the following two institutions are being recognized for a third year:

  • Holland Hospital, Holland, MI (90%)
  • Oaklawn Hospital, Marshall, MI (91%)

The following two institutions are being recognized for a fourth year:

  • Miami Valley Hospital, Dayton, OH (97%)
  • Miami Valley Hospital South, Centerville, OH (98%)

Finally, the following three institutions are being recognized for a fifth year:

  • Miami Valley Hospital, Dayton, OH (98%)
  • Miami Valley Hospital South, Centerville, OH (98%)
  • Sinai-Grace Hospital, Detroit Medical Center, Detroit, MI (93%)

Note: Three of these institutions qualified for multiple 12-month periods at one time.

The Honor Roll now includes 422 birthing institutions from 40 states, Puerto Rico, Guam, and an overseas U.S. military base. One hundred-three institutions have qualified for two years, 46 institutions have qualified three times, 21 institutions have qualified four times, ten institutions have qualified five times, one institution has qualified six times, and one institution has qualified seven times.

The Honor Roll is a key part of IAC’s major initiative urging the nation’s hospitals to Give birth to the end of Hep B. Hospitals and birthing centers are recognized for attaining high coverage rates for administering hepatitis B vaccine at birth and meeting specific additional criteria. The initiative urges qualifying healthcare organizations to apply for the Hepatitis B Birth Dose Honor Roll online.

To be included in the Hepatitis B Birth Dose Honor Roll, a birthing institution must have: (1) reported a coverage rate of 90 percent or greater, over a 12-month period, for administering hepatitis B vaccine before hospital discharge to all newborns, including those whose parents refuse vaccination, and (2) implemented specific written policies, procedures, and protocols to protect all newborns from hepatitis B virus infection prior to hospital discharge.

Honorees are also awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IAC Express’s approximately 50,000 readers.

Please visit the Hepatitis B Birth Dose Honor Roll web page that lists these institutions and their exceptional efforts to protect infants from perinatal hepatitis B transmission.

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Adult primary care providers: Help the National Task Force on Hepatitis B Focus on Asian and Pacific Islander Americans to understand the challenges of providing hepatitis B care in the primary care setting by completing a survey

The National Task Force on Hepatitis B Focus on Asian and Pacific Islander Americans is conducting a survey among primary care providers to better understand the challenges of providing hepatitis B care in the primary care setting. 
 
The organization would greatly appreciate family or internal medicine primary care providers taking a few minutes to complete this survey.
 
The National Task Force on Hepatitis B Focus on Asian Pacific Islander Americans is a volunteer-based national coalition that brings together scientists, health professionals, not-for-profit organizations, and concerned citizens in a concerted effort to eliminate the transmission of hepatitis B and decrease health disparities among those chronically infected. 

Take the survey.

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IAC HANDOUTS


IAC makes small correction to its recently updated "Summary of Recommendations for Adult Immunization"

IAC has made a small correction to its recently updated Summary of Recommendations for Adult Immunization. Revisions were made on page 5 to correct a bullet in the third column for defining which high-risk people need MenB; it now says "1st–3rd" rather than "2nd–4th" when referring to the list in the second column. Many thanks to Mike, a sharp-eyed pharmacist from Utah, for pointing this out. 

When downloading the corrected version, you may have to "refresh" the page or use a different browser if you recently accessed the piece, as the previous version may be cached in your system.

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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OFFICIAL RELEASES AND ANNOUNCEMENTS


FDA Commissioner Scott Gottlieb releases statement on preparations for the upcoming influenza season

On September 27, the U.S. Food and Drug Administration (FDA) posted a press release titled Statement by FDA Commissioner Scott Gottlieb, M.D., on preparations for the upcoming flu season and vaccinations. Selections from the first two paragraphs are reprinted below.

This week marks the official start of “flu season” for 2018–2019. The FDA, along with its partners across the Department of Health and Human Services, has been working throughout the year to prepare the development of a safe, effective flu vaccine for the season. ... With the severity of last year’s flu season, I know that there are questions about the effectiveness and benefits of the flu vaccine. I want to take this opportunity to update you on what we’ve learned from last season, the steps we’re taking to improve our readiness and the effectiveness of this coming year’s flu vaccine, and the continued importance of getting vaccinated.

While the effectiveness of the vaccine may vary year to year, I want to assure you that evidence remains strong to support the benefits of the annual flu vaccine for most people. Though flu season is generally thought of as starting in September, we at the FDA work year-round to prepare for each flu season. And we’re committed to working together with the scientific and medical communities to better protect the public against the flu and apply lessons learned to improve vaccine effectiveness each year....


Access the complete press release: Statement by FDA Commissioner Scott Gottlieb, M.D., on preparations for the upcoming flu season and vaccinations.

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WORLD NEWS


WHO reports on progress toward polio containment worldwide in this week's Weekly Epidemiological Record

On September 28, the World Health Organization (WHO) published Progress towards poliovirus containment worldwide, 2017–2018 in its Weekly Epidemiological Record. The first five sentences of the Introduction are reprinted below.

Substantial progress has been made since the World Health Assembly resolved to eradicate poliomyelitis in 1988. Of the 3 wild poliovirus (WPV) types, type 2 (WPV2) was declared eradicated in 2015, and type 3 (WPV3) has not been reported since 2012. In 2017 and 2018, only Afghanistan and Pakistan reported WPV type 1 (WPV1) transmission. When global eradication of poliomyelitis is achieved, facilities that hold poliovirus materials will have to minimize the risk of its reintroduction into communities and reestablishment of transmission. Poliovirus containment includes management of biorisk in laboratories, vaccine production sites and other facilities that retain the viruses after eradication; the initial milestone is for containment of type 2 polioviruses (PV2). 

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FEATURED RESOURCES


CDC reminds providers about its e-Learn course on proper vaccine administration, as well as other related resources

CDC would like to remind immunization providers about its resources to help educate healthcare professionals about proper vaccine administration technique to help avoid shoulder injuries and other adverse events. Shoulder injuries like bursitis and tendinitis, resulting from improper injection technique, are errors that can easily be avoided. 

Healthcare professionals can earn free continuing education by completing CDC's Vaccine Administration e-Learn, a self-paced vaccine administration course that provides comprehensive training using videos, job aids, and other resources.

CDC offers many more resources in its Vaccine Administration web section, such as the poster shown below.



It is imperative that healthcare personnel always follow safe injection practices, so please explore these materials and share them with your healthcare colleagues.

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Vaccine Education Center updates two Q&A sheets, one about hepatitis B and one about logical fallacies and vaccines  

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia has updated the following two print resources:

Hepatitis B: What You Should Know was updated to include the new adult hepatitis B vaccine, Heplisav-B. This piece is part of VEC's Vaccine- and Vaccine Safety-Related Q&A Sheets series, and is available in English and Spanish online. Any of these Q&A sheets can also be ordered in print for a nominal cost.

Logical Fallacies and Vaccines: What You Should Know describes common fallacies and how they have been used to argue that vaccines are not safe and provides "reality checks" responding to each logical fallacy. This 4-page piece is part of VEC's Special Topics Series—Online Q&A Sheets series.

Related Link


IAC's 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

In late 2017, 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.

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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JOURNAL ARTICLES AND NEWSLETTERS


Vaccine Education Center at Children's Hospital of Philadelphia publishes September issue of its newsletter Vaccine Update 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 September issue includes:

Additional resources are available in the full newsletter.

Access the sign-up form to subscribe to Vaccine Update for Healthcare Professionals.

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CDC publishes report about meningococcal disease surveillance for men who have sex with men

CDC published Meningococcal Disease Surveillance in Men Who Have Sex with Men—United States, 2015–2016 in the September 28 issue of MMWR (pages 1060–1063). The first paragraph is reprinted below.

Meningococcal disease is a rare, but serious, bacterial infection that progresses rapidly and can be life-threatening, even with prompt antibiotic treatment. Men who have sex with men (MSM) have previously been reported to be at increased risk for meningococcal disease compared with other men, and recent outbreaks of serogroup C meningococcal disease among MSM have occurred. However, the epidemiology of meningococcal disease among MSM in the United States is not well described, in part, because information about MSM has not historically been collected as part of routine meningococcal disease surveillance. To better characterize and identify risk factors for meningococcal disease in general, supplementary data and isolates have been collected since 2015 through enhanced meningococcal disease surveillance activities. During 2015–2016, 271 cases of meningococcal disease in men aged ≥18 years were reported to the National Notifiable Diseases Surveillance System (NNDSS) in 45 states participating in this enhanced surveillance. Forty-eight (17.7%) cases were in men identified as MSM, including 17 (37.8%) with human immunodeficiency virus (HIV) infection. Among MSM, 39 (84.8%) cases were caused by Neisseria meningitidis serogroup C, whereas this serogroup was responsible for only 16.4% of cases among men who were not known to be MSM (non-MSM). Despite improvements in surveillance, MSM likely remain underascertained among men with meningococcal disease. Improved surveillance data are needed to understand the prevalence of and risk for meningococcal disease among MSM and inform policy and prevention strategies. Vaccination with quadrivalent meningococcal conjugate (MenACWY) vaccine is recommended for the control of meningococcal disease outbreaks caused by serogroups A, C, W, or Y, including during outbreaks among MSM; in addition, all persons aged ≥2 months with HIV infection should receive MenACWY vaccine because of the increased risk for meningococcal disease.


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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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Dr. David Hill on the Life-Saving Hepatitis B Vaccine: In the U.S., 1,000 cases of hepatitis B are identified in infants each year. The disease can lead to liver failure, liver cancer, and death. This video from the American Academy of Pediatrics tells us that vaccinating newborns against hepatitis B within 24 hours of birth prevents transmission of this potentially deadly infection.
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Editorial Information
Editor:
Deborah L. Wexler, MD
Managing Editor:
Teresa Anderson, DDS, MPH

Consulting Editors:
Marian Deegan, JD
Courtnay Londo, MA
Jane Myers, MA, EdM  
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
NCIRD: National Center for Immunization and Respiratory Diseases
VIS: Vaccine Information Statement
WHO: World Health Organization
 
 
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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.