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Issue 1020
IAC Express: Weekly immunization news and information
Issue 1020: October 16, 2012

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TOP STORIES

New! October 2012 issue of Needle Tips now online
The October 2012 issue of Needle Tips is now online. Download the October issue of Needle Tips

This issue presents an array of materials that healthcare professionals can use to vaccinate everyone against influenza. Readers will also find important information about ways to improve coverage of HPV vaccination in teens, as well as a new educational handout for the public about cocooning as a vaccination strategy to protect babies and revised standing orders for administering pneumococcal vaccines to adults that includes information about administering PCV13. As always, the issue features the "Ask the Experts" column from CDC medical epidemiologist Andrew T. Kroger, MD, MPH; nurse educator Donna L. Weaver, RN, MN; and medical officer Iyabode Akinsanya-Beysolow, MD, MPH. And last but not least, William L. Atkinson, MD, MPH, joins the staff of IAC as associate director for immunization education.

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CDC publishes recommendations for use of PCV13 and PPSV23 in adults with immunocompromising conditions
CDC published Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine for Adults with Immunocompromising Conditions: Recommendations of the Advisory Committee on Immunization Practices (ACIP) in the October 12 issue of MMWR (pages 816-819). Part of the first paragraph and the section titled "ACIP Recommendations for PCV13 and PPSV23 Use" are reprinted below.

On June 20, 2012, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of 13-valent pneumococcal conjugate vaccine (PCV13; Prevnar 13, Wyeth Pharmaceuticals, Inc., a subsidiary of Pfizer, Inc.) for adults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear implants. PCV13 should be administered to eligible adults in addition to the 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax 23, Merck & Co. Inc.), the vaccine currently recommended for these groups of adults....

ACIP Recommendations for PCV13 and PPSV23 Use
Adults with specified immunocompromising conditions who are eligible for pneumococcal vaccine should be vaccinated with PCV13 during their next pneumococcal vaccination opportunity.

Pneumococcal vaccine-naïve persons. ACIP recommends that adults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants, and who have not previously received PCV13 or PPSV23, should receive a dose of PCV13 first, followed by a dose of PPSV23 at least 8 weeks later. Subsequent doses of PPSV23 should follow current PPSV23 recommendations for adults at high risk. Specifically, a second PPSV23 dose is recommended 5 years after the first PPSV23 dose for persons aged 19–64 years with functional or anatomic asplenia and for persons with immunocompromising conditions. Additionally, those who received PPSV23 before age 65 years for any indication should receive another dose of the vaccine at age 65 years, or later if at least 5 years have elapsed since their previous PPSV23 dose.

Previous vaccination with PPSV23. Adults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants, who previously have received ≥1 doses of PPSV23 should be given a PCV13 dose ≥1 year after the last PPSV23 dose was received. For those who require additional doses of PPSV23, the first such dose should be given no sooner than 8 weeks after PCV13 and at least 5 years after the most recent dose of PPSV23.


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Rhode Island Department of Health adopts new influenza prevention regulations for healthcare personnel
The Rhode Island Department of Health has adopted new requirements that will make influenza immunization mandatory for all workers, students, trainees, and volunteers who may have face-to-face interaction with patients at a healthcare facility.

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Spotlight on immunize.org: IAC in the News web section
Did you know that IAC's immunization experts have been contributing to national and local news stories about vaccines and vaccine-preventable diseases? In the October 5 issue of Nature, Diane Peterson (IAC's associate director for immunization projects) is quoted in the news article titled US States Make Opting Out of Vaccinations Harder. To access the latest media coverage in which IAC has made news or been a contributor, please visit the IAC in the News web section and click on any article you are interested in viewing.

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IAC HANDOUTS

IAC develops new handout for families: "Cocooning Protects Babies"
IAC created a new patient-education handout that provides information about the dangers of pertussis and influenza in infants and the benefits of vaccinating those around them. Cocooning Protects Babies explains the concept of protecting babies by vaccinating their parents (including pregnant women), siblings, grandparents, friends, child-care providers, babysitters, and healthcare providers. It also includes a simple summary of the related pertussis and influenza immunization recommendations.

IAC's Handouts for Patients and 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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IAC updates "First Do No Harm: Mandatory Influenza Vaccination Policies for Healthcare Personnel (HCP) Help Protect Patients"
IAC recently updated  First Do No Harm: Mandatory Influenza Vaccination Policies for Healthcare Personnel (HCP) Help Protect Patients to add new information about mandatory influenza vaccination policies for healthcare personnel. The second page was expanded to include new practical resources for healthcare institutions including links to vaccination recommmendations, tool kits, and useful print pieces like screening checklists, declination forms, and sample standing orders.

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FEATURED RESOURCES

CDC releases FAQs about its interim vaccine storage and handling guidance document
CDC recently published Vaccine Storage and Handling: Interim Guidance (see IAC Express #1019 for a summary of this new document). Subsequently, CDC has posted Interim Guidelines for Vaccine Storage and Handling: Frequently Asked Questions.

CDC advises vaccine providers to read the guide and frequently asked questions (FAQs) carefully, as this interim guidance is an important first step to improving storage and handling practices.

Related Links

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JOURNAL ARTICLES

CDC reports on vaccination recall letter study in Montana
In the October 12 issue of MMWR (pages 811-815), CDC published Evaluation of Vaccination Recall Letter System for Medicaid-Enrolled Children Aged 19–23 Months — Montana, 2011. The first paragraph is printed below.

Reminder and recall systems alert the parents of children due (reminder) or overdue (recall) for vaccination and have been associated with increased vaccination coverage. To evaluate the potential of a state-generated recall letter to increase vaccination coverage among Montana children, the Montana Department of Public Health and Human Services (DPHHS) pilot tested a recall letter system targeted at parents of children aged 19–23 months enrolled in Montana Medicaid and not known to have completed a subset of the routinely recommended vaccination series. Data extracted from Medicaid billing records and the web-based immunization registry database (WIZRD) then in use by Montana were used to ascertain whether children were up-to-date for the study vaccination series. Of the 1,865 children enrolled in Montana Medicaid and aged 19–23 months, 878 (47%) were eligible for study participation. One recall letter was sent to parents of 438 (50%) eligible children selected randomly. A reassessment of each child's vaccination status was completed 3 months after the initial mailing. At 3 months, 32% of children whose parents were sent letters were known to have completed the study vaccination series, which was not significantly different from the 28% of children who were vaccinated but whose parents had not been sent letters. Further research is needed to determine why the recall letter had limited effectiveness in this pilot study and to develop more effective methods for increasing vaccination coverage in Montana.

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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. U38IP000589 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: Baxter Healthcare Corp.; CSL Biotherapies; GlaxoSmithKline; MedImmune, Inc.; Merck Sharp & Dohme Corp.; Novartis Vaccines; Ortho Clinical Diagnostics, Inc.; Pfizer, Inc.; and sanofi pasteur.
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Video: Continuing Education on HPV Vaccine: A Shot of Cancer Prevention
Continuing Education on HPV Vaccine: A Shot of Cancer Prevention: This continuing education opportunity is intended for pediatricians, physicians in primary care and family medicine, pediatric nurses, nurse practitioners, and other healthcare professionals involved in the treatment, management, and prevention of human papillomavirus (HPV)-related disease in adolescents and/or young men and women at risk for HPV infection. Presented by Anne Schuchat, MD, RADM; Lauri E. Markowitz, MD; Mona Saraiya, MD, MPH, CAPT Valid for CME/CE through 08/10/2013
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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.
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