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IAC Express 2010
Issue number 885: August 30, 2010

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Contents of this Issue Select a title to jump to the article.
New: August 2010 issue of Vaccinate Adults is now online Reminder: August 2010 issue of Needle Tips available online New DVD for 2010! "Immunization Techniques: Best Practices with Infants, Children, and Adults"--from the California Department of Public Health, Immunization Branch Eight new healthcare organizations have been added to IAC's Honor Roll for Patient Safety MMWR reports on measles transmission associated with air travel MMWR publishes estimates of deaths associated with influenza from 1976-2007 FDA issues MedWatch report about transmitting bloodborne pathogens with fingerstick and point-of-care blood testing devices Take me out to the ballgame! IAC's Video of the Week promotes immunization with a baseball theme IAC updates Spanish translations of influenza vaccination screening questionnaires VISs for influenza, varicella, and Td/Tdap vaccines now available in additional languages Avoid mixing up DTaP and Tdap with this handy chart National Meningitis Association promotes adolescent immunization MMWR details changes in measurement of Hib vaccination coverage "CDC Features" teaches kids about rabies IAC's "Screening Questionnaire for Adult Immunization" and "If You Have Chronic Hepatitis B Virus (HBV) Infection. . ." now available in Turkish Massachusetts immunization conference to be held October 7 in Marlborough World Influenza Congress scheduled for December 7-9 in Amsterdam

Abbreviations

AAFP, American Academy of Family Physicians; AAP, American Academy of Pediatrics; ACIP, Advisory Committee on Immunization Practices; AMA, American Medical Association; 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; NIVS, National Influenza Vaccine Summit; VIS, Vaccine Information Statement; VPD, vaccine-preventable disease; WHO, World Health Organization.

Issue 885: August 30, 2010

New: August 2010 issue of Vaccinate Adults is now online

The August 2010 issue of Vaccinate Adults has just been placed online at http://www.immunize.org/va/va29.pdf

This issue emphasizes the importance of vaccinating everyone against influenza. Note: Vaccinate Adults is an abbreviated version of Needle Tips (which was published one week earlier) with the pediatric content removed.

The issue includes these influenza-related features:

Where to Find Influenza Vaccination Resources
Influenza Vaccine Products for the 2010-11 Season
Screening Questionnaires for Influenza Vaccination
Standing Orders for Administering Influenza Vaccines
A "Dear Provider" letter from Anne Schuchat, MD, director, NCIRD, CDC
Many influenza educational materials for patients & staff

To access the Vaccinate Adults web page where you can view the table of contents and print individual sections, go to: http://www.immunize.org/va Back issues are accessible from this page as well.

To download a PDF of the entire 14-page issue, go to: http://www.immunize.org/va/va29.pdf

Reminder: August 2010 issue of Needle Tips available online

The August 2010 issue of Needle Tips is available online for viewing, downloading, and printing. The issue emphasizes the importance of vaccinating everyone age 6 months and older against influenza.

To download the entire issue right now, go to: http://www.immunize.org/nslt.d/n46/n46.pdf

Complete information about this issue of Needle Tips is available at http://www.immunize.org/nt There you will find a link for displaying and printing the entire 18-page PDF of the issue, along with a table of contents for viewing and printing individual sections of Needle Tips.

New DVD for 2010! "Immunization Techniques: Best Practices with Infants, Children, and Adults"--from the California Department of Public Health, Immunization Branch

The California Department of Public Health (CDPH), Immunization Branch, recently updated its award-winning training video, "Immunization Techniques: Best Practices with Infants, Children, and Adults." The 25-minute program can be used to train new employees and to refresh the skills of experienced staff. The video demonstrates the skills and techniques needed to administer vaccines to patients of all ages. It includes instruction on the following:

Selecting, preparing, and administering injectable, oral, and nasal vaccines
Documenting immunizations
Making patients comfortable and educating them
Facilitating staff and patient communication

Prices start at $17 each for 1-9 copies and are greatly reduced for large orders, dropping to $4.25 each for 1,000-1,500 copies.

To learn more about the DVD, and find out how to order it, go to: http://www.immunize.org/shop/toolkit_iztechdvd.asp

For quotes on larger quantities, call (651) 647-9009 or email admininfo@immunize.org

The Immunization Action Coalition is the only nationwide vendor of this new DVD.

Note for healthcare settings located in California: Contact your local health department immunization program for a free copy.

Eight new healthcare organizations have been added to IAC's Honor Roll for Patient Safety

IAC encourages qualifying healthcare organizations to apply for its Honor Roll for Patient Safety. The honor roll recognizes hospitals, medical practices, professional organizations, and government entities that have taken a stand for patient safety by strengthening mandatory influenza vaccination policies for healthcare workers.

More than 60 organizations are now enrolled.

Since July 6, when IAC Express last reported on the Honor Roll for Patient Safety, six institutions have enrolled and two medical practices have enrolled. The latest additions to the honor roll are Abington Memorial Hospital, Abington, PA; High Point Regional Health System, High Point, NC; Hospital Auxilio Mutuo, San Juan, Puerto Rico; Iowa Health-Des Moines, IA; Kindred Hospital Westminster, Westminster, CA; MCG Health, Augusta, GA; Saint Mary's Medical Group, Grand Rapids, MI; and Yampa Valley Medical Associates, Steamboat Springs, CO.

To be included in the honor roll, an organization's mandate must require influenza vaccination for employees and must include serious measures to prevent transmission of influenza from unvaccinated workers to patients. Such measures might include a mask requirement, reassignment to non-patient-care duties, or dismissal of the employee.

To find out specific information on the mandates of the enrolled organizations or to submit your organization's application for the honor roll, go to: http://www.immunize.org/honor-roll

MMWR reports on measles transmission associated with air travel

CDC published "Notes from the Field: Measles Transmission Associated with International Air Travel--Massachusetts and New York, July-August 2010" in the August 27 issue of MMWR. The entire article is reprinted below.

On July 8, 2010, the Massachusetts Department of Public Health (MDPH) notified CDC of a case of laboratory-confirmed measles in an unvaccinated airline passenger aged 23 months. The child had arrived hours earlier on a flight from Switzerland and was contagious during the flight. After obtaining the flight manifest, CDC shared locating information with relevant state health departments; of 31 passengers considered exposed (i.e., seated within two rows and any infant seated anywhere on the airplane), 29 (94%) were notified.

On July 28, the New York State Department of Health (NYSDOH) notified CDC and MDPH that one of the airline contacts had developed laboratory-confirmed measles. The ill traveler came to the United States as a chaperone for students from Europe and Asia attending an educational program. During July 20-23 (while contagious and before being isolated), he exposed 270 students and counselors in Massachusetts and New York. Member of this group were scheduled to return to their home countries from July 30 through August 6. Because exposed, susceptible persons who are incubating measles might be infectious 5-21 days after initial exposure, the surveillance period was determined to be until August 14. CDC Quarantine Stations in Boston and New York worked with NYSDOH and MDPH to assess the immune status of contacts before permitting them to fly. Presumptive evidence of immunity to measles was defined as (1) documentation of at least 1 dose of measles-containing vaccine or (2) serologic evidence of immunity.

Of the 270 persons considered exposed, 268 (99%) were cleared to fly as scheduled: 242 provided documentation of vaccination and 26 had serologic evidence of immunity. Two persons lacked evidence of immunity and voluntarily postponed their departures until the end of the surveillance period. CDC requested that the airlines waive any fees for changing flights. No febrile rash illnesses have been reported among exposed persons.

To prevent the spread of measles, international travelers are encouraged to have evidence of measles immunity. Persons with measles or those who might be incubating measles should avoid travel aboard commercial airlines until they are no longer infectious. Organizations hosting international students should consider asking participants to provide documentation of adequate vaccination.

To access the full article in web-text (HTML) format, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5933a4.htm

MMWR publishes estimates of deaths associated with influenza from 1976-2007

CDC published "Estimates of Deaths Associated with Seasonal Influenza--United States, 1976-2007" in the August 27 issue of MMWR. The Editorial Note is reprinted below.

This report updates estimates of the number of influenza-associated deaths from the 1976-77 through 2006-07 influenza seasons and demonstrates the substantial variability in mortality estimates by year, influenza virus type/subtype, and age group. The estimated rates of influenza-associated hospitalizations and deaths vary substantially from one influenza season to the next, depending, in part, on the characteristics of the circulating influenza virus strains. Because of this variability, a single estimate cannot be used to summarize influenza-associated deaths. This report provides estimates for two categories of underlying cause of death codes, pneumonia and influenza causes, and respiratory and circulatory causes; if only one category is used to summarize the mortality effects of influenza, the respiratory and circulatory data likely provide the most accurate estimates. During the past three decades, the estimated number of annual influenza-associated deaths from respiratory and circulatory causes ranged from a low of 3,349 to a high of 48,614 deaths.

To access the full article in web-text (HTML) format, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5933a1.htm

To access the full article in PDF format, go to: http://www.cdc.gov/mmwr/PDF/wk/mm5933.pdf (pages 1057-1062)

FDA issues MedWatch report about transmitting bloodborne pathogens with fingerstick and point-of-care blood testing devices

On August 26, the FDA Safety Information and Adverse Event Reporting Program issued a MedWatch report titled "Fingerstick Devices to Obtain Blood Specimens: Initial Communication--Risk of Transmitting Bloodborne Pathogens" The first five paragraphs follow.

AUDIENCE: Primary Care, Nursing, Laboratory

ISSUE: FDA and CDC have noted a progressive increase in the reports of bloodborne infection transmission over the past 10 to 15 years (primarily hepatitis B virus), resulting from the shared use of fingerstick and point-of-care (POC) blood testing devices.

Fingerstick and POC blood testing devices used on more than one patient may not be safe for several reasons. Improper use or device malfunction can lead to the use of the contaminated lancet blade on more than one patient. It is difficult for healthcare staff to ensure that all blood has been removed from POC blood testing devices and the reusable portions of the fingerstick device. If POC blood testing devices are used on multiple patients and are not cleaned and disinfected correctly and thoroughly between each patient, contaminated blood left on them could result in bloodborne pathogen transmission among patients.

BACKGROUND: Fingerstick devices are instruments equipped with a lancet. These devices are used for making skin punctures to obtain small blood specimens which are tested for blood glucose, hemoglobin, and other blood components. Some fingerstick devices are packaged with POC blood testing devices, such as blood glucose meters and PT/INR [prothrombin time/international normalized ratio] anticoagulation meters, while other fingerstick devices and lancet blades are sold separately.

RECOMMENDATION: Fingerstick devices should never be used for more than one person. Whenever possible, POC blood testing devices, such as blood glucose meters and PT/INR anticoagulation meters, should be used only on one patient and not shared. If dedicating POC blood testing devices to a single patient is not possible, the devices should be properly cleaned and disinfected after every use as described in the device labeling.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program. . . .

For information on how to report adverse events or side effects related to the use of these products, and to read the full report, go to: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm224135.htm

Take me out to the ballgame! IAC's Video of the Week promotes immunization with a baseball theme

IAC encourages IAC Express readers to watch a 3-minute video with a baseball theme that promotes immunization. This exciting video premiered on the big screen during "Immunization Night" at the Philadelphia Phillies game on August 25. The video was developed by the Southeast Pennsylvania Immunization Coalition, the statewide Pennsylvania Immunization Coalition, and Weiss Communications.

If your organization would like to show this video at a local baseball game (major league, minor league, Little League, whatever!), contact Ann Gordon, Pennsylvania Immunization Coalition, at avgordon@co.bucks.pa.us or (215) 345-3477.

The video will be available on the home page of IAC's website through September 6. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week. After that date, the video will continue to be available on YouTube at http://www.youtube.com/watch?v=W3faEh5N7ko

Remember to bookmark IAC's home page to view a new video every Monday. To view an IAC Video of the Week from the past, go to the video archive at http://www.immunize.org/votw

IAC updates Spanish translations of influenza vaccination screening questionnaires

IAC recently updated its Spanish translations of "Screening Questionnaire for Inactivated Injectable Influenza Vaccination" and "Screening Questionnaire for Live Attenuated Intranasal Influenza Vaccination" to match the English versions dated 8/10.

For the Spanish screening questionnaire about injectable influenza vaccine, go to: http://www.immunize.org/catg.d/p4066-01.pdf

For English: http://www.immunize.org/catg.d/p4066.pdf

For the Spanish screening questionnaire for nasal-spray influenza vaccine, go to: http://www.immunize.org/catg.d/p4067-01.pdf

For English: http://www.immunize.org/catg.d/p4067.pdf

IAC's Handouts for Patients and Staff web section offers healthcare professionals and the public approximately 250 FREE English-language handouts (many also available in translation), which we encourage website users to print out, copy, and distribute widely. To access all of IAC's free handouts, go to: http://www.immunize.org/handouts

10.

VISs for influenza, varicella, and Td/Tdap vaccines now available in additional languages

Dated 8/10/10, the VISs for trivalent inactivated influenza vaccine (TIV; injectable) and live attenuated intranasal influenza vaccine (LAIV; nasal spray) are now available in Indonesian and Turkish. Dated 3/13/08, the VIS for varicella vaccine is now available in Spanish. Dated 11/18/08, the VIS for tetanus-diphtheria (Td) and tetanus-diphtheria-acellular pertussis (Tdap) vaccines is now available in Hmong.

IAC gratefully acknowledges Wentworth Douglass Hospital, Dover, NH, for the Indonesian translations; Mustafa Kozanoglu, MD, Adana, Turkey, for the Turkish translations; the Department of Human Services, Oregon Immunization Program, for the Spanish translation; and the California Department of Public Health, Immunization Branch, for the Hmong translation.

INFLUENZA VISs
To access the Indonesian and Turkish translations of the VIS for injectable influenza vaccine, as well as the injectable influenza vaccine VIS in English and other translations, go to: http://www.immunize.org/vis/vis_flu_inactive.asp

To access the Indonesian and Turkish translation of the VIS for nasal-spray influenza vaccine, as well as the nasal-spray influenza vaccine VIS in English and other translations, go to: http://www.immunize.org/vis/vis_flu_live.asp

VARICELLA VIS
To access the Spanish translation of the VIS for varicella vaccine, as well as the varicella vaccine VIS in English and other translations, go to: http://www.immunize.org/vis/vis_chickenpox.asp

Td/Tdap VIS
To access the Hmong translation of the VIS for Td/Tdap vaccines, as well as the Td/Tdap vaccines VIS in English and other translations, go to: http://www.immunize.org/vis/vis_td-tdap.asp

For information about the use of VISs, and for VISs in more than 35 languages, visit IAC's VIS web section at http://www.immunize.org/vis

11.

Avoid mixing up DTaP and Tdap with this handy chart

With the rise in pertussis cases and deaths, it is especially important that patients are properly vaccinated against pertussis. Unfortunately, both CDC and IAC have received emails from healthcare professionals who have inadvertently given DTaP to adults or Tdap to infants or young children.

The EZ-IZ program has developed a colorful chart to help providers keep DTaP and Tdap products straight. The chart includes combination vaccines. To access this resource, go to: http://www.eziz.org/PDF/IMM-508.pdf

You can access other useful free resources from EZ-IZ at http://www.eziz.org EZ-IZ is a program of the California Vaccines for Children (VFC) Program.

12.

National Meningitis Association promotes adolescent immunization

Vaccines are an important part of staying healthy at any age. However, despite recommendations from CDC for routine adolescent immunization, vaccination rates among this group are low. Low vaccination rates mean many adolescents are vulnerable to serious, sometimes life-threatening illnesses, including meningococcal disease, pertussis, and HPV.

Recognizing the importance of all adolescent vaccines, the National Meningitis Association (NMA) recently launched an educational program to help raise awareness of the importance of adolescent vaccination in select states, identified in conjunction with CDC, where vaccination rates remain low. As part of this effort, NMA created www.preteenvaccines.org, a Web resource with important information about routine, catch-up, and risk-based vaccines for adolescents, as well as a tracker that parents can use to help ensure their children are up to date on recommended vaccines.

To access the campaign website, go to: http://www.preteenvaccines.org

The National Meningitis Association is a nonprofit organization founded by parents whose children have died or have been severely affected by meningococcal disease.

13.

MMWR details changes in measurement of Hib vaccination coverage

CDC published "Changes in Measurement of Haemophilus influenzae serotype b (Hib) Vaccination Coverage--National Immunization Survey, United States, 2009" in the August 27 issue of MMWR.

To access the article in web-text (HTML) format, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5933a3.htm

14.

"CDC Features" teaches kids about rabies

The "CDC Features" web section now includes information for children about how to prevent rabies.

To access "Knowing How to Prevent Rabies isn't Just for Adults. Kids Can Get the Facts Too," go to: http://www.cdc.gov/Features/RabiesAndKids

To access an alphabetical index of all "CDC Features," go to: http://www.cdc.gov/features

15.

IAC's "Screening Questionnaire for Adult Immunization" and "If You Have Chronic Hepatitis B Virus (HBV) Infection. . ." now available in Turkish

Updated in April 2009, IAC's "Screening Questionnaire for Adult Immunization" is now available in Turkish, as is the patient-education handout "If You Have Chronic Hepatitis B Virus (HBV) Infection . . ." (updated in June 2010). IAC gratefully acknowledges Mustafa Kozanoglu, MD, for the translations.

To access the Turkish version of "Screening Questionnaire for Adult Immunization," go to: http://www.immunize.org/catg.d/p4065-21.pdf

For English: http://www.immunize.org/catg.d/p4065.pdf

To access the Turkish version of "If You Have Chronic Hepatitis B Virus (HBV) Infection . . ." go to: http://www.immunize.org/catg.d/p4120-21.pdf

For English: http://www.immunize.org/catg.d/p4120.pdf

16.

Massachusetts immunization conference to be held October 7 in Marlborough

The 15th annual Massachusetts Immunization Action Partnership Pediatric Immunization Skills Building Conference will be held October 7 in Marlborough. For more information, go to: http://www.mass.gov/Eeohhs2/docs/dph/cdc/immunization/miap_brochure.pdf

17.

World Influenza Congress scheduled for December 7-9 in Amsterdam

The World Influenza Congress will be held December 7-9 in Amsterdam. For more information, go to: http://www.terrapinn.com/2010/flu/conf.stm

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