Issue 1055: May 14, 2013

TOP STORIES

IAC HANDOUTS

VACCINE INFORMATION STATEMENTS

OFFICIAL RELEASES AND ANNOUNCEMENTS

FEATURED RESOURCES

JOURNAL ARTICLES AND NEWSLETTERS

EDUCATION AND TRAINING



TOP STORIES

CDC publishes interim recommendations on influenza vaccination
CDC published Prevention and Control of Influenza with Vaccines: Interim Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2013 in the May 10 issue of MMWR (page 356). A summary made available to the press is reprinted below.

Four new influenza vaccine products will be available alongside previously approved products for the 20132014 influenza season. These new products are acceptable alternatives to other licensed products when used within their licensed indications. For persons for whom more than one type of vaccine is appropriate and available, the Advisory Committee on Immunization Practices (ACIP) does not express a preference for use of any particular product over another. This report summarizes recommendations for the use of influenza vaccines approved by ACIP on February 21, 2013. 

The article includes a link to a table of all influenza vaccines that are currently licensed and expected to be available for the 2013–14 season and their approved age indications.

An expanded 2013 ACIP influenza vaccination recommendation statement is scheduled to be published in MMWR Recommendations and Reports before the start of the 2013–14 influenza season. Providers should consult the expanded 2013 ACIP influenza vaccination statement for complete and updated information.

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AAP reaffirms policy regarding parents who refuse immunization for their children
On April 29, the American Academy of Pediatrics (AAP) published Reaffirmation: Responding to Parents Who Refuse Immunization for Their Children. The reaffirmation includes one change in wording, as follows: In the section “Responding to Parents Who Refuse Immunization for Their Children,” sixth paragraph, the fifth sentence should read “In general, pediatricians should endeavor not to discharge patients from their practices solely because a parent refuses to immunize a child.”

The original policy statement was published on May 1, 2005.

Related Link

IAC's AAP Policy Statements web section

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Opinion piece by Dr. Paul Offit about religious exemptions to medical care published in the Philadelphia Inquirer
On May 9, the Philadelphia Inquirer published an opinion piece by Paul Offit, MD, director of the Vaccine Education Center at the Children's Hospital of Philadelphia. End Religious Exemption is a response to a proposed Pennsylvania senate bill intended to tighten child-protection laws that nevertheless exempts parents who withhold medical or surgical care because of religious beliefs. One of Dr. Offit's examples is vaccination related—a 1991 measles outbreak in Philadelphia related to religious exemptions.

Although this opinion piece focuses on Pennsylvania and all medical procedures, vaccination proponents may find Dr. Offit's arguments useful as they struggle with the same issue in their states.

Related Link

IAC's Mandates and Exemptions web section

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IAC Spotlight! Personal testimonies on vaccine-preventable diseases; polio survivor recalls loss of twin to  the disease in recently added testimony
The "Vaccine Information You Need” website–www.vaccineinformation.org–features Personal Testimonies about vaccine-preventable diseases and the value of immunization. The collection of more than 50 compelling and eye-opening reports can be used to educate staff and patients about the importance of immunization. The testimonies are organized by age group and disease.

IAC recently posted Polio Survivor Recalls Tragic Loss of Twin and Classmates, which describes the experience of polio survivor Janice Flood Nichols. Ms. Nichols, author of Twin Voices: A Memoir of Polio, the Forgotten Killer, was diagnosed with polio as a child, as was her twin brother. Her twin brother was lost to the disease, but Janice survived and became one of the polio pioneers who were given the Salk vaccine in 1954.

Additionally, this section offers links to similar resources from our immunization partners such as personal stories from Every Child By Two, California Immunization Coalition’s Shot by Shot website, Children's Hospital of Philadelphia Vaccine Education Center, Families Fighting Flu, National Foundation for Infectious Diseases, and National Meningitis Association, and the book The Forgotten Story from the Texas Children’s Hospital.

Related Links Do you have a personal account, remembrance, or patient story to share with others? Please upload your photo and document via IAC's Submit Your Story form.

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IAC HANDOUTS

New! IAC develops eight easy-to-read handouts that encourage adults and teens to get vaccinated
IAC has just posted eight new easy-to-read handouts for adults and teens that promote vaccination against hepatitis A, hepatitis B, HPV, influenza, meningococcal disease, pneumococcal disease, zoster, and pertussis. These handouts were specifically developed to be short and non-medical, and to emphasize the dangers of these vaccine-preventable diseases and the importance of vaccination.

Download these new resources and share them with your adult and teen patients!
  1. Protect yourself from hepatitis A. . . Get vaccinated!
  2. Protect yourself from hepatitis B. . . Get vaccinated!
  3. Protect yourself from HPV. . . Get vaccinated!
  4. Protect yourself from influenza. . . Get vaccinated!
  5. Protect yourself from meningococcal disease. . . Get vaccinated!
  6. Protect yourself from pneumococcal disease. . . Get vaccinated!
  7. Protect yourself from shingles. . . Get vaccinated!
  8. Protect yourself from whooping cough. .  Get vaccinated!
All these handouts can be accessed from IAC's new Easy-to-Read Handouts web page. Similar handouts for infant and child vaccination will be released at a future date.

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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IAC updates its educational pieces "Current Dates of Vaccine Information Statements" and "It's Federal Law! You must give your patients current Vaccine Information Statements"
IAC recently revised Current Dates of Vaccine Information Statements (VISs) and It's Federal Law! You must give your patients current Vaccine Information Statements (VISs). Both now include the issue date of the most recent version of the Tdap VIS, which CDC posted on May 9 (see next article).

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VACCINE INFORMATION STATEMENTS

CDC releases updated Tdap VIS; additional document available for providers
On May 9, CDC released an updated Tdap Vaccine Information Statement (VIS). This VIS contains information about Tdap only. When vaccinating patients with Td, providers should continue to use the 1/24/12 Td/Tdap VIS until a VIS dedicated exclusively to Td (currently in development) is available.

Changes to the updated VIS relate primarily to recent changes in ACIP recommendations regarding use of Tdap during pregnancy.

CDC created a second document, Provider Information: Tdap VIS, as a quick reference for providers. It gives additional information about the vaccine, such as contraindications and precautions and links to pertinent ACIP recommendations. CDC now provides such supplementary provider information with each new and updated VIS.

IAC updated two related handouts to include this new Tdap VIS date: Current Dates of Vaccine Information Statements (VISs) and It's Federal Law! You must give your patients current Vaccine Information Statements (VISs).

Related Links
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OFFICIAL RELEASES AND ANNOUNCEMENTS

CDC publishes updated guidance on HCV testing
CDC published Testing for HCV Infection: An Update of Guidance for Clinicians and Laboratorians in the May 10 issue of MMWR (pages 362-365). The third paragraph of the article is reprinted below.

CDC is issuing this update in guidance because of 1) changes in the availability of certain commercial HCV antibody tests, 2) evidence that many persons who are identified as reactive by an HCV antibody test might not subsequently be evaluated to determine if they have current HCV infection, and 3) significant advances in the development of antiviral agents with improved efficacy against HCV. Although previous guidance has focused on strategies to detect and confirm HCV antibody, reactive results from HCV antibody testing cannot distinguish between persons whose past HCV infection has resolved and those who are currently HCV infected. Persons with current infection who are not identified as currently infected will not receive appropriate preventive services, clinical evaluation, and medical treatment. Testing strategies must ensure the identification of those persons with current HCV infection.

Related Link

Transcript from May 7 CDC Telebriefing on Hepatitis C Testing, featuring Tom Frieden, MD, MPH, director of the Centers for Disease Control and Prevention, and John Ward, MD, director of CDC's Division of Viral Hepatitis.

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FEATURED RESOURCES

It's Hepatitis Awareness Month; organizations offer resources to promote hepatitis awareness and education
May is Hepatitis Awareness Month and May 19 has been designated as a national Hepatitis Testing Day in the United States. Because millions of Americans have chronic viral hepatitis, and most of them do not know they are infected, many organizations are offering resources to help promote hepatitis awareness and education.

Related Links from CDC

Related Links from IAC

Miscellaneous Related Links
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Order IAC's popular full-size  laminated versions of the 2013 U.S. immunization schedules today!
IAC's laminated versions of the 2013 U.S. child/teen and adult immunization schedules are covered with a tough, washable coating that lets them stand up to a year's worth of use in every area of your healthcare setting where immunizations are given. Each has six pages (i.e., three double-sided pages) and is folded to measure 8.5" by 11".

IAC's Laminated Child and Teen Immunization SchedulesIAC's Laminated Adult Immunization Schedules
Laminated schedules are printed in color for easy reading, come complete with essential tables and footnotes, and include contraindications and precautions—a feature that will help you make an on-the-spot determination about the safety of vaccinating patients of any age.

PRICING
1-4 copies: $7.50 each
5-19 copies: $5.50 each
20-99 copies: $4.50 each
100-499 copies: $4.00 each
500-999 copies: $3.50 each

For quotes on customizing or placing orders for 1,000 copies or more, call (651) 647-9009 or email admininfo@immunize.org

You can access specific information on both schedules, view images of both, order online, or download an order form at the Shop IAC: Laminated Schedules web page.

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JOURNAL ARTICLES AND NEWSLETTERS

CDC reports on HCV infection testing and reporting in the U.S.
CDC published Vital Signs: Evaluation of Hepatitis C Virus Infection Testing and Reporting—Eight U.S. Sites, 2005–2011 in the May 10 issue of MMWR (pages 357-361). The abstract for this report is reprinted below.

Background: Hepatitis C virus (HCV) infection is a serious public health problem. New infections continue to occur, and morbidity and mortality are increasing among an estimated 2.7–3.9 million persons in the United States living with HCV infection. Most persons are unaware of their infection status. Existing CDC guidelines for laboratory testing and reporting of antibody to HCV do not distinguish between past infection that has resolved and current infection that requires care and evaluation for treatment. To identify current infection, a test for HCV RNA is needed.

Methods: Surveillance data reported to CDC from eight U.S. sites during 2005–2011 were analyzed to determine the proportion of persons newly reported on the basis of a positive test result for HCV infection. Persons reported with a positive result from an HCV antibody test only were compared with persons reported with a positive result for HCV RNA and examined by birth cohort (1945–1965 compared with all other years), surveillance site, and number of reported deaths. Annual rates of persons newly reported with HCV infection in 2011 also were calculated for each site.

Results: Of 217,755 persons newly reported, 107,209 (49.2%) were HCV antibody positive only, and 110,546 (50.8%) were reported with a positive HCV RNA result that confirmed current HCV infection. In both groups, persons were most likely to have been born during 1945–1965 (58.5% of those who were HCV antibody positive only; 67.2% of those who were HCV RNA positive). Among all persons newly reported for whom death data were available, 6,734 (3.4%) were known to have died; deaths were most likely among persons aged 50–59 years. In 2011, across all sites, the annual rate of persons newly reported with HCV infection (positive HCV antibody only and HCV RNA positive) was 84.7 per 100,000 population.

Conclusions: Hepatitis C is a commonly reported disease predominantly affecting persons born during 1945–1965, with deaths more frequent among persons of relatively young age. The lack of an HCV RNA test for approximately one half of persons newly reported suggests that testing and reporting must improve to detect all persons with current infection.

Implications for Public Health: In an era of continued HCV transmission and expanding options for curative antiviral therapies, surveillance that identifies current HCV infection can help assess the need for services and link persons with infection to appropriate care and treatment.


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CDC reprints MMWR Early Release article about avian influenza A(H7N9) in May 10 MMWR
CDC published Emergence of Avian Influenza A(H7N9) Virus Causing Severe Human Illness—China, February–April 2013 in the May 10 issue of MMWR (page 366-371). This report was previously published as an MMWR Early Release on May 1, and covered in IAC Express #1054.

Related Links

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EDUCATION AND TRAINING

Archive of March 21 Current Issues in Immunization NetConference available online
Broadcast on March 21, the latest Current Issues in Immunization NetConference has been archived. This conference includes an update on adult immunizations, information on the new Tdap vaccine recommendation for pregnant women, and the 2013 childhood and adolescent immunization schedules.

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About IZ Express

IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.

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ISSN 2771-8085

Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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