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Immunization Action Coalition

IAC Express 2011

Issue number 923: April 11, 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. CDC website posts ACIP's provisional recommendations for use of Tdap vaccine among healthcare personnel
  2. APHA and AMDA issue position statements in support of mandating influenza vaccination for healthcare workers, joining seven other professional associations on IAC's Honor Roll for Patient Safety
  3. Pediatric Infectious Diseases Society adopts position statement regarding personal belief exemption from immunization mandates
  4. IAC's Video of the Week features a discussion between authors Paul Offit and Seth Mnookin on the challenges of communicating vaccine information
  5. CDC issues new edition of the VIS for yellow fever vaccine
  6. IAC updates its two professional educational-guidance handouts on medical management of vaccine reactions
  7. CDC reports on measles imported by returning U.S. travelers ages 6-23 months during 2001-11
  8. CDC reports on a measles outbreak in Hennepin County, Minnesota, during February-March 2011
  9. Spotlight on immunize.org: answers to frequently asked questions
  10. IAC updates online "Ask the Experts" Q&A section related to MMR vaccine
  11. Important update: CDC's April 21 Net Conference will cover ACIP's changes to the use of Tdap vaccine in adolescents and adults, as well as the general recommendations for combination vaccines
  12. CDC reports on an assessment of the completeness of reporting on perinatal hepatitis B infection in the U.S.
  13. Six updated IAC handouts now available in Turkish
  14. Proportion of deaths from influenza and pneumonia remains higher than expected, so please keep vaccinating!
  15. Award-winning DVD! "Immunization Techniques: Best Practices with Infants, Children, and Adults"--from the California Department of Public Health, Immunization Branch
  16. CDC reports on an assessment of influenza-like illness surveillance at the U.S. Air Force Academy in 2009
  17. Some of PKIDs' April and May webinars on using social media are related to immunization
 
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 923: April 11, 2011
1.  CDC website posts ACIP's provisional recommendations for use of Tdap vaccine among healthcare personnel

On April 4, CDC's website posted ACIP's provisional recommendation titled "ACIP Provisional Recommendations for Health Care Personnel on use of Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine (Tdap) and use of Postexposure Antimicrobial Prophylaxis." Portions of the provisional recommendations are reprinted below.


On February 23, 2011, the ACIP approved revised recommendations for healthcare personnel on use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine (Tdap) and use of postexposure antimicrobial prophylaxis. Revised recommendations on use of Tdap in healthcare personnel incorporate the changes made by ACIP at the October 2010 meeting and support direct language to remove barriers to facilitate the uptake of Tdap.

USE OF TDAP IN HEALTHCARE PERSONNEL:
  • The ACIP recommends that all healthcare personnel (HCP), regardless of age, should receive a single dose of Tdap as soon as feasible if they have not previously received Tdap and regardless of the time since last Td dose.
     
  • Tdap is not currently licensed for multiple administrations. After receipt of Tdap, HCP should receive routine booster immunization against tetanus and diphtheria according to previously published guidelines.
     
  • Hospitals** and ambulatory-care facilities should provide Tdap for HCP and use approaches that maximize vaccination rates (e.g., education about the benefits of vaccination, convenient access, and the provision of Tdap at no charge).

POSTEXPOSURE ANTIMICROBIAL PROPHYLAXIS IN HEALTHCARE PERSONNEL:

  • Healthcare facilities should maximize efforts to prevent transmission of Bordetella pertussis. Respiratory precautions should be taken to prevent unprotected exposure to pertussis.
     
  • Data on the need for postexposure antimicrobial prophylaxis in Tdap-vaccinated HCP are inconclusive. Some vaccinated HCP are still at risk for B. pertussis. Tdap may not preclude the need for postexposure antimicrobial prophylaxis.
     
  • Postexposure antimicrobial prophylaxis is recommend for all HCP who have unprotected exposure to pertussis and are likely to expose a patient at risk for severe pertussis (e.g., hospitalized neonates and pregnant women). Other HCP should either receive postexposure antimicrobial prophylaxis or be monitored daily for 21 days after pertussis exposure and treated at the onset of signs and symptoms of pertussis.
     

**Hospitals, as defined by the Joint Commission on Accreditation of Healthcare Organizations, do not include long-term-care facilities such as nursing homes, skilled-nursing facilities, or rehabilitation and convalescent care facilities. Ambulatory-care settings include all outpatient and walk-in facilities.


To access the complete provisional recommendations, go to: http://www.cdc.gov/vaccines/recs/provisional/default.htm#acip
 
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2 APHA and AMDA issue position statements in support of mandating influenza vaccination for healthcare workers, joining seven other professional associations on IAC's Honor Roll for Patient Safety

The American Public Health Association (APHA) and American Medical Directors Association (AMDA) recently released position statements supporting mandatory annual influenza vaccination of healthcare personnel. APHA and AMDA join the following seven professional associations included on IAC's Honor Roll for Patient Safety for developing position statements that endorse influenza vaccination mandates for healthcare workers:

American Academy of Pediatrics (AAP); American College of Physicians (ACP); Association for Professionals in Infection Control and Epidemiology (APIC); Infectious Diseases Society of America (IDSA); National Foundation for Infectious Diseases (NFID); National Patient Safety Foundation (NPSF); and Society for Healthcare Epidemiology of America (SHEA).

To access the APHA position paper, go to: http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1410

To access the AMDA position statement, go to: http://www.amda.com/governance/resolutions/J11.cfm

The Immunization Action Coalition's Honor Roll for Patient Safety recognizes the professional associations listed above for developing position statements that advocate mandatory healthcare worker influenza vaccination. To access all position statements, go to: http://www.immunize.org/honor-roll Scroll down to the subhead titled Position Statements Endorsing Strong Mandates for Healthcare Workers.

IAC's honor roll recognizes hospitals, medical practices, professional organizations, and government entities that have taken a stand for patient safety by strengthening their mandatory influenza vaccination policies for healthcare workers. To find out more about the honor roll, access specific information on the mandates of the enrolled organizations, or submit your organization's application for the honor roll, go to: http://www.immunize.org/honor-roll
 
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3 Pediatric Infectious Diseases Society adopts position statement regarding personal belief exemption from immunization mandates

In March, the Pediatric Infectious Diseases Society (PIDS) adopted a position statement titled "A Statement Regarding Personal Belief Exemption from Immunization Mandates." In the statement, PIDS outlines its rationale for its position, which is that PIDS "opposes any legislation or regulation that would allow children to be exempted from mandatory immunizations based simply on their parents', or, in the case of adolescents, their own, secular personal beliefs."

To access the complete position statement, go to: http://www.pids.org/images/stories/pdf/pids-pbe-statement.pdf
 
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4 IAC's Video of the Week features a discussion between authors Paul Offit and Seth Mnookin on the challenges of communicating vaccine information

IAC encourages IAC Express readers to watch a 16-minute video of a discussion between Dr. Paul Offit, a pediatric infectious disease expert and rotavirus vaccine developer, and Seth Mnookin, contributing editor to Vanity Fair magazine and other publications. Both have recently published well-received books on current vaccination issues. The video is part of a YouTube video series produced by the College of Physicians of Philadelphia.

The video will be available on the home page of IAC's website through April 17. To access it, go to: http://www.immunize.org and click on the image under the words Video of the Week. After April 17, it is available on the History of Vaccines website at http://www.historyofvaccines.org/content/blog/interview-paul-offit-and-seth-mnookin The History of Vaccines is a project of the College of Physicians of Philadelphia. For more information, 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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5 CDC issues new edition of the VIS for yellow fever vaccine

On March 30, CDC issued a new edition of the VIS for yellow fever vaccine. Information in the new edition corresponds with information found in the most recently published ACIP yellow fever recommendations (published July 2010). Because the new edition of the VIS contains updated information on rates of adverse events, as well as other changes, CDC suggests that healthcare providers start using it immediately.

To access the new edition of the yellow fever VIS, go to: http://www.immunize.org/vis/yellow_fever.pdf

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
 
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6 IAC updates its two professional educational-guidance handouts on medical management of vaccine reactions

IAC recently revised the following two educational pieces for healthcare professionals: "Medical Management of Vaccine Reactions in Children and Teens" and "Medical Management of Vaccine Reactions in Adult Patients."

To access "Medical Management of Vaccine Reactions in Children and Teens," go to: http://www.immunize.org/catg.d/p3082a.pdf

To access "Medical Management of Vaccine Reactions in Adult Patients," go to: http://www.immunize.org/catg.d/p3082.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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7 CDC reports on measles imported by returning U.S. travelers ages 6-23 months during 2001-11

CDC published "Measles Imported by Returning U.S. Travelers Aged 6-23 Months, 2001-2011" in the April 8 issue of MMWR. The first paragraph is reprinted below.


In the first 2 months of 2011, CDC received reports of seven imported measles cases among returning U.S. travelers aged 6-23 months; four required hospitalization. Young children are at greater risk for severe measles, death, or sequelae such as subacute sclerosing panencephalitis. Although all seven children had been eligible for vaccination before travel, none had received measles, mumps, and rubella (MMR) vaccine, the only measles-containing vaccine currently available in the United States. To characterize imported measles cases reported in the first 2 months of 2011 in U.S. travelers aged 6-23 months and compare them with cases in recent years, CDC analyzed data from the National Notifiable Diseases Surveillance System (NNDSS) for the period January 2001-February 2011. The results of that analysis indicated that, during January-February 2011, a total of 13 imported cases were reported in U.S. residents, including the seven children aged 6-23 months. During 2001-2010, a total of 159 imported cases were reported in U.S. residents, including 47 (range: 3-8 per year) in children aged 6-23 months (three of whom had been vaccinated before travel). Because measles remains endemic in much of the world, international travelers should be up-to-date on vaccinations. In accordance with the Advisory Committee for Immunization Practices (ACIP) recommendations, U.S. children who travel or live abroad should be vaccinated at an earlier age than those living in the United States because of the greater risk for exposure to measles outside the United States, and particularly outside the Americas. . . .


To access the full article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6013a1.htm
 
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8 CDC reports on a measles outbreak in Hennepin County, Minnesota, during February-March 2011

CDC published "Notes from the Field: Measles Outbreak--Hennepin County, Minnesota, February-March 2011" in the April 8 issue of MMWR. Portions of the article are reprinted below.


On March 2, 2011, the Minnesota Department of Health (MDH) confirmed measles in a Hennepin County resident aged 9 months. As of April 1, investigation of contacts and heightened surveillance had revealed a total of 13 epidemiologically linked cases in Hennepin County residents. Of those cases, 11 were laboratory confirmed, and two were in household contacts of confirmed cases and met the clinical case definition for measles.

The patients included children aged 4 months-4 years and one adult aged 51 years; seven of the 13 were of Somali decent. Eight patients were hospitalized. Vaccination status was known for 11 patients: five were too young to have been vaccinated, and six (all of Somali descent) had not been vaccinated because of parental concerns about the safety of the measles, mumps, and rubella (MMR) vaccine. The most recent rash onset was March 28. An additional, unrelated case of measles was confirmed in a Hennepin County resident aged 34 years who was exposed in Orlando, Florida, sometime during March 1-10. . . .


To access the full article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6013a6.htm

Note from the IAC Express editor: To access information about the measles outbreak in the Twin Cities area and to read updated vaccination recommendations for all Hennepin County residents and Somalis living in the greater metropolitan area, go to the Minnesota Department of Health website at: http://www.health.state.mn.us/divs/idepc/diseases/measles At this link, you can also subscribe to receive regular updates about the measles outbreak.
 
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9 Spotlight on immunize.org: answers to frequently asked questions

Looking for help locating information on our website? Look no further. The Frequently Asked Questions (FAQs) web section includes a listing of answers to FAQs about IAC's handouts, VISs, periodicals, and additional website content. The FAQs section also includes contact information for CDC and others as well as helpful resources in your quest to find answers to your vaccine-related questions.

To access IAC's FAQs section, visit http://www.immunize.org/faq
 
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10.  IAC updates online "Ask the Experts" Q&A section related to MMR vaccine

IAC's online "Ask the Experts" Q&A section about measles-mumps-rubella (MMR) vaccine was recently updated with input from vaccination experts at CDC. IAC's "Ask the Experts" Q&As are reviewed and updated annually. The process is ongoing; IAC Express will inform readers as sections are reviewed and revised.

To access the revised measles, mumps, and rubella Q&As, go to: http://www.immunize.org/askexperts/experts_mmr.asp

To access the index page of "Ask the Experts" Q&As for all other vaccines, go to: http://www.immunize.org/askexperts
 
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11.  Important update: CDC's April 21 Net Conference will cover ACIP's changes to the use of Tdap vaccine in adolescents and adults, as well as the general recommendations for combination vaccines

The next "Current Issues in Immunization" Net Conference will be held on April 21 from noon to 1PM Eastern Time. Andrew Kroger, MD, MPH, will speak on the general recommendations for combination vaccines. Jennifer L. Liang, DVM, MPVM, will discuss recent policy changes ACIP made to the recommendations for use of Tdap vaccine in adolescents and adults.

Registration is limited and will close on April 19 or when the course is full. To register, go to: http://www2.cdc.gov/vaccines/ed/ciinc

IMPORTANT NOTE: The July 14 Net Conference has been rescheduled for June 2.
 
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12.  CDC reports on an assessment of the completeness of reporting on perinatal hepatitis B infection in the U.S.

CDC published "Assessing Completeness of Perinatal Hepatitis B Virus Infection Reporting Through Comparison of Immunization Program and Surveillance Data--United States" in the April 8 issue of MMWR. A press summary of the article is reprinted below.


Approximately 24,000 women with hepatitis B give birth each year, and without vaccination, their infants are at risk of contracting the disease. Infants infected with hepatitis B have a 90 percent chance of developing a life-long infection and a 25 percent risk of premature death. To prevent mother-to-child transmission of hepatitis B, all pregnant women need to be tested for hepatitis B and all infections should be reported to local and state health departments. If infected, a woman should be referred for evaluation and treatment, and her infant should receive hepatitis B vaccine at the time of birth in order to prevent infection. All infants should receive the first shot in the hepatitis B vaccine series before getting discharged from the hospital. Identifying pregnant women who are infected with hepatitis B and providing clinical care and monitoring of the women and their infants can prevent future cases of liver disease, liver cancer, and even death. This article describes how federally funded state and local immunization programs work to eliminate hepatitis B in the United States by monitoring hepatitis B infected pregnant women and their infants. Actively collected immunization program data on infant hepatitis B infections are more complete than passively collected surveillance data.


To access the full article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6013a4.htm
 
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13.  Six updated IAC handouts now available in Turkish

Current versions of six IAC handouts are now available in Turkish translation. IAC gratefully acknowledges Mustafa Kozanoglu, MD, Adana, Turkey, for the translations. The handouts are as follows.

1. "ALL KIDS NEED HEPATITIS B SHOTS!"
Turkish: http://www.immunize.org/catg.d/p4055-21.pdf
English: http://www.immunize.org/catg.d/p4055.pdf

2. "IMMUNIZATIONS FOR BABIES: A GUIDE FOR PARENTS--THESE ARE THE VACCINATIONS YOUR BABY NEEDS!"
Turkish: http://www.immunize.org/catg.d/p4010-21.pdf
English: http://www.immunize.org/catg.d/p4010.pdf

3. "ARE YOU 11-19 YEARS OLD? THEN YOU NEED TO BE VACCINATED AGAINST THESE SERIOUS DISEASES!"
Turkish: http://www.immunize.org/catg.d/p4020-21.pdf
English: http://www.immunize.org/catg.d/p4020.pdf

4. "SCREENING QUESTIONNAIRE FOR ADULT IMMUNIZATION"
Turkish: http://www.immunize.org/catg.d/p4065-21.pdf
English: http://www.immunize.org/catg.d/p4065.pdf

5. "SCREENING QUESTIONNAIRE FOR CHILD AND TEEN IMMUNIZATION"
Turkish: http://www.immunize.org/catg.d/p4060-21.pdf
English: http://www.immunize.org/catg.d/p4060.pdf

6. "WHEN DO CHILDREN AND TEENS NEED VACCINATIONS?"
Turkish: http://www.immunize.org/catg.d/p4050-21.pdf
English: http://www.immunize.org/catg.d/p4050.pdf
 
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14.  Proportion of deaths from influenza and pneumonia remains higher than expected, so please keep vaccinating!

CDC reports that as of the week ending April 2, the proportion of deaths attributed to pneumonia and influenza was at or above the level expected for the tenth consecutive week. Influenza vaccination is recommended for everyone age 6 months and older, so please keep vaccinating your patients.
 
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15.  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, has 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 $3 each for 1,000-1,499 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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16.  CDC reports on an assessment of influenza-like illness surveillance at the U.S. Air Force Academy in 2009

CDC published "Assessment of ESSENCE Performance for Influenza-Like Illness Surveillance After an Influenza Outbreak--U.S. Air Force Academy, Colorado, 2009" in the April 8 issue of MMWR. Portions of a press summary of the article are reprinted below.


The Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE), version II, is an Internet-based syndromic disease surveillance system designed as an early warning system to detect and monitor an outbreak. After a 2009 pandemic influenza A (H1N1) outbreak at the U.S. Air Force Academy, CDC conducted an evaluation of the ESSENCE influenza-like illness (ILI) surveillance system and found strengths in data quality, flexibility, representativeness, and ability to monitor seasonal influenza. However, ESSENCE was not useful for detecting or monitoring the localized 2009 H1N1 outbreak due to a lack of timeliness (1-3 day delay), inadequate sensitivity (71.4 percent), and poor predictive value positive (31.8 percent). . . .


To access the full article, go to: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6013a3.htm
 
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17.  Some of PKIDs' April and May webinars on using social media are related to immunization

PKIDs (Parents of Kids with Infectious Diseases) has scheduled new webinars for April and May, some of which focus on using social media in communicating immunization information.

Simple registration (free) is all that's required to learn more about the webinars, register for them, and watch archived versions of them. To register, go to http://network.pkids.org or http://www.pkids.org/cme
 
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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.