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Immunization Action Coalition

IAC Express 2011

Issue number 909: January 18, 2011

Please click here to subscribe to IAC Express as well as other FREE IAC periodicals.
Contents of this Issue
Select a title to jump to the article.
  1. New: January 2011 issue of Vaccinate Adults is now online
  2. Reminder: January 2011 issue of Needle Tips available online
  3. MMWR publishes ACIP's updated recommendations for the use of Tdap vaccine
  4. Check it out: IAC develops a timely new web page--"The Fraud Behind the MMR Scare"
  5. Wall Street Journal publishes Dr. Paul A. Offit's editorial on Andrew Wakefield's failed 1998 study
  6. Spotlight on immunize.org: More on Vaccinate Adults, including back issues and magazine viewer option
  7. IAC's Video of the Week explores the future of immunization
  8. IAC updates two of its most popular handouts, "Healthcare Personnel Vaccination Recommendations" and "Vaccinations for Adults: You're NEVER too old to get immunized!"
  9. IAC website posts an updated version of All Star Pediatrics' "Sample Vaccine Policy Statement"
  10. IAC updates two of its standing orders for administering vaccines to adults
  11. CDC's February 3 Net Conference to cover the recommended 2011 U.S. immunization schedules for children and adults
  12. Influenza vaccination is recommended for almost everyone, so please keep vaccinating!
  13. MMWR reports on the costs a county health department incurred in responding to a school-based pertussis outbreak in Omaha in 2008
  14. Award-winning DVD! "Immunization Techniques: Best Practices with Infants, Children, and Adults"--from the California Department of Public Health, Immunization Branch
  15. CDC's 2011 report on U.S. health disparities and inequalities includes a section on influenza vaccination coverage during 2000-2010
  16. CDC website posts interim guidance on the use of influenza antiviral agents during the 2010-11 influenza season
  17. MMWR reports on progress made in immunization information systems in the U.S. during 2009
  18. MMWR publishes errata to CDC's "Sexually Transmitted Diseases Treatment Guidelines, 2010"
  19. Operation Immunization conference scheduled for April 12 in Greensburg, PA
 
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 909: January 18, 2011
1.  New: January 2011 issue of Vaccinate Adults is now online

The January 2011 issue of Vaccinate Adults is now online for downloading at http://www.immunize.org/va/va30.pdf

The issue features information on ACIP's vote at its October 2010 meeting for expanded use of Tdap. Note: Vaccinate Adults is an abbreviated version of the January 2011 issue of Needle Tips with the pediatric content removed.

The January issue also includes these features:
  • Ask the Experts column from CDC experts William L. Atkinson, MD, MPH, and Andrew T. Kroger, MD, MPH, which contains information on the new Tdap recommendations
     
  • The newly updated "Summary of Recommendations for Adult Immunization," one of IAC's most popular educational handouts for healthcare professionals

To access the Vaccinate Adults table of contents where you can view 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 12-page issue, go to: http://www.immunize.org/va/va30.pdf

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2 Reminder: January 2011 issue of Needle Tips available online

The January 2011 issue of Needle Tips is available online for viewing, downloading, and printing.

To download the entire issue right now, go to: http://www.immunize.org/nslt.d/n47/n47.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.
 
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3 MMWR publishes ACIP's updated recommendations for the use of Tdap vaccine

CDC published "Updated Recommendations for Use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis (Tdap) Vaccine from the Advisory Committee on Immunization Practices, 2010" in the January 14 issue of MMWR. The first two paragraphs of the article and a Box titled "Summary of updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine--Advisory Committee on Immunization Practices, 2010" are reprinted below.


Despite sustained high coverage for childhood pertussis vaccination, pertussis remains poorly controlled in the United States. A total of 16,858 pertussis cases and 12 infant deaths were reported in 2009 (CDC, unpublished data, 2009). Although 2005 recommendations by the Advisory Committee on Immunization Practices (ACIP) called for vaccination with tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) for adolescents and adults to improve immunity against pertussis, Tdap coverage is 56% among adolescents and <6% among adults. In October 2010, ACIP recommended expanded use of Tdap. This report provides the updated recommendations, summarizes the safety and effectiveness data considered by ACIP, and provides guidance for implementing the recommendations.

ACIP recommends a single Tdap dose for persons aged 11 through 18 years who have completed the recommended childhood diphtheria and tetanus toxoids and pertussis/ diphtheria and tetanus toxoids and acellular pertussis (DTP/DTaP) vaccination series and for adults aged 19 through 64 years. Two Tdap vaccines are available in the United States. Boostrix (GlaxoSmithKline Biologicals, Rixensart, Belgium) is licensed for use in persons aged 10 through 64 years, and Adacel (sanofi pasteur, Toronto, Canada) is licensed for use in persons aged 11 through 64 years. Both Tdap products are licensed for use at an interval of at least 5 years between the tetanus and diphtheria toxoids (Td) and Tdap dose. On October 27, 2010, ACIP approved the following additional recommendations: (1) use of Tdap regardless of interval since the last tetanus- or diphtheria-toxoid containing vaccine, (2) use of Tdap in certain adults aged 65 years and older, and (3) use of Tdap in undervaccinated children aged 7 through 10 years. . . .

BOX. Summary of updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine--Advisory Committee on Immunization Practices, 2010

General Recommendations
For routine use, adolescents aged 11 through 18 years who have completed the recommended childhood diphtheriaand tetanus toxoids and pertussis/diphtheria and tetanus toxoids and acellular pertussis (DTP/DTaP) vaccination series and adults aged 19 through 64 years should receive a single dose of Tdap. Adolescents should preferably receive Tdap at the 11 to 12 year-old preventive healthcare visit.

Timing of Tdap
  • Can be administered regardless of interval since the last tetanus- or diphtheria-toxoid containing vaccine.

Adults Aged 65 years and Older

  • Those who have or anticipate having close contact with an infant aged less than 12 months should receive a single dose of Tdap.
  • Other adults ages 65 years and older may be given a single dose of Tdap.

Children Aged 7 Through 10 Years

  • Those not fully vaccinated against pertussis** and for whom no contraindication to pertussis vaccine exists should receive a single dose of Tdap.
  • Those never vaccinated against tetanus, diphtheria, or pertussis or who have unknown vaccination status should receive a series of three vaccinations containing tetanus and diphtheria toxoids. The first of these three doses should be Tdap.


** Fully vaccinated is defined as 5 doses of DTaP or 4 doses of DTaP if the fourth dose was administered on or after the fourth birthday


To access the updated recommendations in ready-to-print (PDF) format, go to: http://www.cdc.gov/mmwr/pdf/wk/mm6001.pdf and see pages 13-15.

To access the updated recommendations in web-text (HTML) format, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6001a4.htm

 
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4 Check it out: IAC develops a timely new web page--"The Fraud Behind the MMR Scare"

IAC recently developed a web page that links website users to media coverage of issues raised by the British Medical Journal's (BMJ) special three-part series about Dr. Andrew Wakefield's 1998 paper that linked MMR vaccine and the development of autism. Written by investigative journalist Brian Deer, the series clearly documents how Wakefield's study was actually an elaborate fraud.

Titled "The Fraud Behind the MMR Scare," IAC's web page currently has links to the first two parts of the BMJ series, accompanying BMJ editorials, related print news coverage and commentary, and videos of broadcast media coverage.

Links to additional media coverage, including the final part of the BMJ series, will be added as they become available.

Visit the web page often to stay informed of developments. Go to: http://www.immunize.org/bmj-deer-mmr-wakefield

 
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5 Wall Street Journal publishes Dr. Paul A. Offit's editorial on Andrew Wakefield's failed 1998 study

On January 11, the Wall Street Journal (WSJ) published an editorial by Dr. Paul A. Offit titled "Junk Science Isn't a Victimless Crime." The editorial stresses that though Andrew Wakefield's 1998 study failed to prove a connection between receipt of MMR vaccine and development of autism, it was published in the well-respected medical journal The Lancet, was publicized widely in the media, and met with insufficient explanations from public health scientists as to why Wakefield's hypothesis didn't make sense.

Dr. Offit is the chief of Infectious Diseases and the director of the Vaccine Education Center at the Children's Hospital of Philadelphia, as well as the Maurice R. Hilleman Professor of Vaccinology and professor of pediatrics at the University of Pennsylvania School of Medicine.

In an unusual move, WSJ has made the editorial available online to non-subscribers. To read Dr. Offit's commentary on the WSJ website, go to: http://online.wsj.com/article/SB10001424052748703779704576073744290909186.html?KEYWORDS=dr+Paul+offit

To access the commentary from IAC's new "The Fraud Behind the MMR Scare" web page, go to: http://www.immunize.org/bmj-deer-mmr-wakefield and click on the pertinent link.

For information on IAC's new web page, see article #4 in this issue of IAC Express.
 
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6 Spotlight on immunize.org: More on Vaccinate Adults, including back issues and magazine viewer option

Looking for more information about Vaccinate Adults, IAC's one-of-a-kind periodical for adult medical specialists who provide vaccination services? Look no further. In addition to the current issue, IAC's Vaccinate Adults web section provides links to previous issues of the periodical, which date back to 1997. The direct link to the Vaccinate Adults web section is http://www.immunize.org/va

To access the Vaccinate Adults archive directly, visit http://www.immunize.org/va/back-issues.asp

In addition, you can access Vaccinate Adults using a magazine-style viewer: It allows readers to flip pages, search content, rotate the page into horizontal or vertical modes, and zoom out to see the entire issue at a glance.

To access Vaccinate Adults using our magazine viewer, visit http://www.immunize.org/va/magazine-viewer.asp

To access all these features, as well as a link to a web page with praise from Vaccinate Adults readers, visit the Vaccinate Adults home page at http://www.immunize.org/va
 
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7 IAC's Video of the Week explores the future of immunization

IAC encourages IAC Express readers to watch a 12-minute video on the future of immunization. Stanley Plotkin, MD, developer of the rubella vaccine and others, discusses the impact of molecular biology on vaccine development and muses on future directions for vaccinology. This footage is provided courtesy of The Vaccine Makers project and is housed on the History of Vaccines website.

The video will be available on the home page of IAC's website through January 23. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week.

To access the History of Vaccines website, go to: http://www.historyofvaccines.org

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

 
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8 IAC updates two of its most popular handouts, "Healthcare Personnel Vaccination Recommendations" and "Vaccinations for Adults: You're NEVER too old to get immunized!"

IAC recently revised the following two handouts for healthcare professionals and their patients.

(1) IAC updated "Healthcare Personnel Vaccination Recommendations" to reflect changes in ACIP recommendations for Tdap vaccination. Go to: http://www.immunize.org/catg.d/p2017.pdf

(2) IAC updated "Vaccinations for Adults: You're NEVER too old to get immunized!" to reflect changes in ACIP recommendations for influenza, pneumococcal, Tdap, meningococcal, and hepatitis B vaccination. Go to: http://www.immunize.org/catg.d/p4030.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
 
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9 IAC website posts an updated version of All Star Pediatrics' "Sample Vaccine Policy Statement"

IAC has posted an updated version of "Sample Vaccine Policy Statement" from Brad Dyer, MD, All Star Pediatrics (Lionville, PA) on its website. The policy statement gives healthcare professionals a template they can modify to create their own vaccine policy statement to communicate their practice's strong support for childhood vaccination to the parents of their patients. It was updated with 2010 pertussis statistics and other additions. To access it, go to: http://www.immunize.org/catg.d/p2067.pdf
 
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10.  IAC updates two of its standing orders for administering vaccines to adults

IAC recently revised the following two standing orders for administering vaccines go adults.

(1) IAC updated "Standing Orders for Administering Hepatitis A Vaccine to Adults" to clarify a note about giving the vaccine to adults older than age 40. Go to: http://www.immunize.org/catg.d/p3077.pdf

(2) IAC updated "Standing Orders for Administering Pneumococcal Vaccine to Adults" to clarify which adults are in need of a second dose. Go to: http://www.immunize.org/catg.d/p3075.pdf

To access a table with links to all IAC's standing orders protocols for vaccine administration and medical management of vaccine reactions, as well as guidance for newborn-nursery hepatitis B vaccination, go to: http://www.immunize.org/standing-orders
 
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11.  CDC's February 3 Net Conference to cover the recommended 2011 U.S. immunization schedules for children and adults

The next "Current Issues in Immunization" net conference will be held on February 3 from noon to 1 p.m. Eastern time. William Atkinson, MD, MPH, will speak on the recommended 2011 U.S. immunization schedules for people ages 0 through 18 years; Abigail Shefer, MD, will speak on the recommended 2011 U.S. immunization schedule for adults. The program moderator is Andrew Kroger, MD, MPH.

Registration is limited and will close on February 2 or when the course is full. To register, go to: http://www2.cdc.gov/vaccines/ed/ciinc
 
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12.  Influenza vaccination is recommended for almost everyone, so please keep vaccinating!

Influenza vaccination is recommended for everyone age 6 months and older, so please keep vaccinating your patients.

If you don't have influenza vaccine, you can direct patients to the Google Flu Vaccine Finder. It helps the public find nearby locations where influenza vaccine is available. It's as simple as entering a zip code. Visit the Google Flu Vaccine Finder: http://www.google.com/flushot

Following is a list of resources related to influenza disease and vaccination for healthcare professionals and the public.

To access IAC's handouts related to influenza, including screening questionnaires, patient education pieces, and sample standing orders, go to: http://www.immunize.org/handouts/influenza-vaccines.asp

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13.  MMWR reports on the costs a county health department incurred in responding to a school-based pertussis outbreak in Omaha in 2008

CDC published "Local Health Department Costs Associated with Response to a School-Based Pertussis Outbreak--Omaha, Nebraska, September-November 2008" in the January 14 issue of MMWR. A summary made available to the press is reprinted below in its entirety.


The elevated incidence of pertussis and the burden of response placed on health departments warrants exploring the impact of alternative response and chemoprophylaxis strategies.

The cost of pertussis outbreak containment can strain local public health resources. This report measures the cost, from a local health department perspective, to contain a pertussis outbreak in a private school with approximately 600 students. The cost for 24 cases of pertussis was estimated at $52,131 (or approximately $2,172 per case). Investigations and developing recommendations were the most resource-intensive aspects of the outbreak.


To access the full article in web-text (HTML) format, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6001a2.htm
 
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14.  Award-winning DVD! "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.

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15.  CDC's 2011 report on U.S. health disparities and inequalities includes a section on influenza vaccination coverage during 2000-2010

On January 14, CDC published "CDC Health Disparities and Inequalities Report--United States, 2011" as an MMWR Supplement. The report includes a section titled "Influenza Vaccination Coverage--United States, 2000-2010."

To access the influenza section of the report, go to http://www.cdc.gov/mmwr/pdf/other/su6001.pdf and see pages 38-41.
 
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16.  CDC website posts interim guidance on the use of influenza antiviral agents during the 2010-11 influenza season

On December 21, 2010, CDC posted "Interim Guidance on the Use of Influenza Antiviral Agents During the 2010-2011 Influenza Season." The guidance updates previous recommendations made by CDC's Advisory Committee on Immunization Practices (ACIP) regarding the use of antiviral agents for the prevention and treatment of influenza.

The guidance has been submitted to MMWR and will appear in that publication at a later date. In the interests of making the guidance available to healthcare providers as quickly as possible, it is being published online in the interim.

To access it, go to: http://www.cdc.gov/flu/professionals/antivirals/guidance

 
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17.  MMWR reports on progress made in immunization information systems in the U.S. during 2009

CDC published "Progress in Immunization Information Systems--United States, 2009" in the January 14 issue of MMWR. A portion of a summary made available to the press is reprinted below.


In 2009, 77 percent of all U.S. children aged <6 years (18.4 million children) participated in an Immunization Information System (IIS). Also, 59 percent of IIS grantees reported being able to send and receive Health Level Seven (HL7) messages, and another 8 percent of grantees with IIS were partially able to meet HL7 capability by either sending or receiving messages. Enhancing the interoperability of IIS and electronic health record systems will help provide greater consistency in data exchange and likely reduce interface costs over time. Increased IIS data accuracy, timeliness, and completeness can improve the quality of IIS-based coverage assessments, better support clinical decisions at the healthcare provider level, and increase availability of the data for other public health functions.


To access the full article in web-text (HTML) format, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6001a3.htm
 
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18.  MMWR publishes errata to CDC's "Sexually Transmitted Diseases Treatment Guidelines, 2010"

CDC published " Errata: Vol. 59, No. RR-12" in the January 14 issue of MMWR. It concerns corrections made to the section on gonococcal infections in CDC's recommendations titled "Sexually Transmitted Diseases Treatment Guidelines, 2010," which were published on December 17, 2010. The errata are reprinted below in their entirety.


In the Recommendations and Reports, "Sexually Transmitted Diseases Treatment Guidelines, 2010," three errors occurred. In the "Recommended Regimens" boxes on pages 50 and 51, the recommendation for doxycycline should read "100 mg orally twice a day for 7 days." In the "Alternative Regimens" box on page 57, the first recommendation for tinidazole should read "2 g orally once daily for 2 days."


To access the errata in web-text (HTML) format, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6001a8.htm
 
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19.  Operation Immunization conference scheduled for April 12 in Greensburg, PA

The Southwest Immunization Coalition in collaboration with Penn State College of Medicine is sponsoring the ninth annual Operation Immunization conference. It will be held April 12 in Greensburg, PA. The conference brings together immunization partners to share information, discuss current issues, and recommend strategies to improve immunization rates in Pennsylvania.

For comprehensive information, including the conference agenda, speakers, registration, and accommodations, go to: http://www.pennstatehershey.org/web/ce/home/programs/southwest-immunization
 
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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. 5U38IP000290) 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.