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Issue 1419
Issue 1419: April 3, 2019


TOP STORIES


IAC HANDOUTS


VACCINE INFORMATION STATEMENTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS

 


TOP STORIES


Available now! IAC’s sturdy laminated versions of the 2019 U.S. child/adolescent immunization schedule and the 2019 U.S. adult immunization schedule—order them for your exam rooms today! Bulk purchase prices available.

IAC's laminated versions of the 2019 U.S. child/adolescent immunization schedule and the 2019 U.S. adult immunization schedule are available now. These schedules are covered with a tough coating you can wipe down; they will stand up to a year's worth of use in every area of your healthcare setting where immunizations are given. The child/adolescent schedule is eight pages (i.e., four double-sided pages) and the adult schedule is six pages (i.e., three double-sided pages). Both schedules are folded to measure 8.5" x 11". 

Adult Laminated Immunization Schedules

Adult Laminated Immunization Schedules

Laminated schedules are printed in color for easy reading. They come complete with essential tables and notes, and they replicate the newly designed CDC schedule format.

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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CDC issues Health Alert Network (HAN) advisory due to the widespread continuation of influenza along with an increase in influenza A(H3N2) activity

On March 28, the CDC Health Alert Network (HAN) released Influenza Season Continues with an Increase in Influenza A(H3N2) Activity. The "Summary" section and the beginning of the "Recommendations" section are reprinted below.

Summary

The Centers for Disease Control and Prevention (CDC) is issuing this health advisory to notify clinicians that influenza activity remains high in the United States, with an increasing proportion of activity due to influenza A(H3N2) viruses, continued circulation of influenza A(H1N1) viruses, and low levels of influenza B viruses. Influenza should be considered as a possible diagnosis for patients with respiratory illness while local influenza activity remains elevated. Because influenza A(H3N2) viruses may be associated with severe disease in older adults, this health advisory serves as a reminder that early empiric treatment with influenza antiviral medications is recommended for hospitalized and high-risk patients, especially those 65 years and older. Antiviral treatment should be started as soon as possible after illness onset and should not wait for laboratory confirmation.

The Health Alert Advisory provides detailed recommendations under the following headings: 

  1. All Hospitalized, Severely Ill, and High-Risk Patients with Suspected or Confirmed Influenza Should Be Treated with Antivirals
  2. Antivirals in Non-High-Risk Patients with Uncomplicated Influenza 
  3. Choice of Antiviral Medication
  4. Timing of Treatment and Implications for Patient Evaluation, Treatment, and Testing 

Access the complete HAN for more background information and detailed guidance for health departments and healthcare providers: Influenza Season Continues with an Increase in Influenza A(H3N2) Activity.

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Influenza remains widespread; CDC reports an estimate of up to 46,800 influenza-related deaths so far this season 

According to CDC, influenza continues to be widespread in the period ending March 23. The proportion of outpatient visits for influenza-like illness decreased from 4.4% in the previous week to 3.8%, which is above the national baseline of 2.2%. CDC estimates that flu has caused as many as 35.9 million flu illnesses, 508,000 hospitalizations, and 46,800 deaths so far this season. CDC reported 1 additional influenza-associated pediatric death this season, for a total of 77. Last season, there was a record-setting number of pediatric deaths in the U.S. (185). Be sure to protect all your patients for whom vaccination is recommended.

CDC stated in its Weekly U.S. Influenza Surveillance Report, FluView, that during the week ending March 23, the geographic spread of influenza in 34 states was reported as widespread; 14 states reported regional activity; the District of Columbia and two states reported local activity; the Virgin Islands reported sporadic activity; and Guam did not report.

Influenza vaccination is recommended for everyone six months of age and older. If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to a clinic or pharmacy that provides vaccines or to the HealthMap Vaccine Finder to locate sites near their workplaces or homes that offer influenza vaccination services.

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

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National Infant Immunization Week, celebrating its 25th anniversary, to be held April 27–May 4; newly launched 2019 digital media toolkit available now

National Infant Immunization Week (NIIW), which will be held April 27–May 4, is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and to celebrate the achievements of immunization programs and their partners in promoting healthy communities. In 2019, NIIW is celebrating its 25th anniversary.

CDC's newly launched 2019 NIIW Digital Media Toolkit is now available for planning and implementing your activities. 



The toolkit includes: 

  • Sample NIIW announcements
  • Sample social media content
  • NIIW social media graphics, sized for Facebook, Instagram, and Twitter
  • Links to multimedia materials to share with parents, including animated videos, posters, and infographics
  • Links to updated immunization slide decks for clinicians
  • Details about the #ivax2protect Twitter Storm on April 30th and the Instagram Q&A event on May 2nd

Since 1994, hundreds of communities across the United States have joined to celebrate the critical role vaccination plays in protecting our children, communities, and public health.



NIIW is the perfect time to highlight the important role vaccines play in protecting children and communities from serious diseases.

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73 more cases of measles reported by CDC this week, bringing the reported total of U.S. measles cases this year to 387, which surpasses the 12-month total for 2018 

On March 28, CDC posted its latest weekly update of 2019 measles cases in the U.S. on its Measles Cases and Outbreaks web page, showing a preliminary estimate of 387 cases across 15 states. This number reflects an increase of 73 cases over the previous week's estimate of 314, and it surpasses the 12-month total for 2018 of 372. The current reported total is the second-greatest number of cases reported in the U.S. since measles was eliminated in 2000. 

Beginning February 21, the reported number of cases in the U.S. was 206, the numbers have risen weekly to 228, 268, 314, and 387. The states that have reported cases to CDC are Arizona, California, Colorado, Connecticut, Georgia, Illinois, Kentucky, Michigan, Missouri, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington.

On March 28, CDC held a teleconference with several public health partner organizations. One of the PowerPoint presentations given was titled Measles in the U.S. in 2019. CDC gave IAC permission to post the PDF version of the slide set on IAC's website for public viewing. It is available at http://www.immunize.org/cdc/cdc-measles-us-3-28-2019.pdf.

If you would like to obtain the actual PowerPoint slide set for use in your community, contact Liz Ryan at childhoodvaccines@cdc.gov.

Access the following measles resources from CDC in both English and Spanish.

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New York’s Rockland County declares state of emergency for measles and bars unvaccinated children and teens from public places

A press release from the Rockland County, NY, county executive Ed Day announced a county-wide state of emergency as of midnight March 27 barring all unvaccinated children and teens under 18 years of age from public places for the next 30 days. According to the Rockland County Department of Health's Measles Information web page, there were 157 confirmed reported cases of measles as of March 29. Among those cases, 82.8% had no MMR vaccinations. 

Read the declaration of the local state of emergency, first issued March 26 and amended March 28.

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Philadelphia Department of Public Health issues health alert following mumps outbreak of 106 cases at Temple University; Temple holds large-scale campaign to vaccinate students   

In response to a mumps outbreak at Temple University, the Philadelphia Department of Public Health issued a Health Alert on March 25. On its first day of a campaign to vaccinate students against mumps because of the outbreak, Temple delivered 2,285 doses of MMR vaccine to students, according to The Inquirer

Related Links

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IAC Spotlight! Visit IAC’s newly updated Vaccine Information Statement (VIS) web section for VISs in up to 50 languages, as well as information about their use

In 2018, visitors to IAC's immunize.org website downloaded more than 3 million copies of Vaccine Information Statements (VISs) from its VIS web section.

IAC's VIS web section offers 28 VISs in English. The site also offers translations in 48 other languages—alphabetically, from Amharic to Yiddish! (Note: Not all VISs are available in all languages.) 

The VIS web section main page, in which the VISs are listed by disease in the Vaccine Index, is found at www.immunize.org/vis. You can also access VISs sorted by language in the Language Index. Both pages also feature a handy table of current VIS dates, an easy way to check that you are using the most recent version. IAC has recently reviewed and updated the VIS web section to several of IAC's VIS web pages.

A sheet in PDF format that lists the current VIS dates is available at http://www.immunize.org/catg.d/p2029.pdf.

IAC has a cooperative agreement with CDC to provide VIS translations in several languages for routinely recommended vaccines for children and adults, including Arabic, Chinese, French, Russian, Spanish, Somali, and Vietnamese. Most other VIS translations have been donated by other organizations, including several state health departments, who generously partner with us to provide translations. You can see all available translations here

IAC's VIS main page also includes links to information about new VISs, instructions for correctly using VISs, FAQs from CDC, and more.

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IAC HANDOUTS

IAC posts revised “Screening Checklist for Contraindications to Vaccines for Children and Teens” and “Screening Checklist for Contraindications to Vaccines for Adults”

IAC recently revised "Screening Checklist for Contraindications to Vaccines for Children and Teens" and "Screening Checklist for Contraindications to Vaccines for Adults." Changes were made to add absence of a spleen, a cochlear implant, complement component deficiency, or a spinal fluid leak as conditions for which live attenuated influenza vaccine is not recommended, the addition of aspirin as a precaution to varicella vaccine, and a new reference for immunosuppressive immune modulators.





Access the revised screening checklists below. Related Link 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 "Guide to Contraindications and Precautions to Commonly Used Vaccines" and "Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults"

IAC recently revised its "Guide to Contraindications and Precautions to Commonly Used Vaccines" (which covers vaccines for children and adults) and "Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults." The former title covers both child and adult vaccines. Changes were made to add precautions for a) interferon gamma release assay (IGRA) testing for MMR, b) family history of seizures for MMRV, and c) use of aspirin for varicella. In addition, footnotes were added for HPV vaccine and pregnancy and for LAIV for people with functional or anatomic asplenia, complement component deficiency, cochlear implant, or CSF leak.

Access these revised guidance pieces below.

Related Links

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VACCINE INFORMATION STATEMENTS


IAC updates Thai translation of the DTaP VIS

IAC recently posted an updated Thai translation of the DTaP VIS. IAC thanks the Asian Pacific Health Care Venture Inc. for generously providing the translation. Access the updated translation below.

Related Links

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IAC posts new Punjabi translation of the PPSV VIS

IAC recently posted a new Punjabi translation of the PPSV VIS. IAC thanks Jaspreet Dhami, RN, BSN (Adventist Health and Rideout at Marysville, CA) for the translation. Access the new Punjabi translation below.

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WORLD NEWS


WHO publishes "Addendum to the 'Recommended Composition of Influenza Virus Vaccines for Use in the 2019–2020 Northern Hemisphere Influenza Season'" in this week's Weekly Epidemiological Record

WHO published Addendum to the "Recommended Composition of Influenza Virus Vaccines for Use in the 2019–2020 Northern Hemisphere Influenza Season" in the March 21 issue of Weekly Epidemiological Record (pages 166–168). The first paragraph is reprinted below.

On 21 February 2019 WHO announced a recommendation on the composition of 3 of the 4 components of influenza vaccines for use in the 2019–2020 northern hemisphere influenza season (https://www.who.int/ influenza/vaccines/virus/recommendations/2019_20_ north/en/). The decision on the A(H3N2) component was postponed to allow more time to better understand the distribution and proportions of recently circulating antigenically and genetically diverse A(H3N2) viruses and to develop and fully characterize appropriate candidate vaccine viruses. This addendum provides the recommendation and supporting data for the A(H3N2) component of 2019–2020 northern hemisphere influenza vaccines.

Related Link

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FEATURED RESOURCES


Vaxopedia website releases new post titled “Who’s Who in the Anti-Vaccine Movement—2019 Edition”

Vaxopedia, a website created by pediatrician Vincent Iannelli, MD, provides a wealth of immunization information with the goal of helping parents and healthcare professionals stay up to date about vaccines. A recent post titled Who’s Who in the Anti-Vaccine Movement—2019 Edition will be of interest to many of our readers. At the end, you will find a section titled "More on Who's Who in the Anti-Vaccine Movement—2019 Edition" with additional links to media articles and to previous posts on Vaxopedia.

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GW Public Health Online posts resources with visuals on the history of measles in the U.S. and on the development of vaccines

GW Public Health Online recently posted two resources on vaccines by the George Washington University Masters of Public Health Online program. These resources, enhanced with visuals, are: A History of Measles in the United States and Producing Prevention: The Complex Development of Vaccines. 

A History of Measles in the United States, posted on March 19, features a graphic that provides an overview of the history of vaccines from 1795 to the present day.

Producing Prevention: The Complex Development of Vaccines, posted on March 6, discusses the difference between "immunization" and "vaccination," the phases of vaccine development, who is involved in vaccine development, and vaccines in times of crisis.

Related Link

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IAC's 142-page book, Vaccinating Adults: A Step-by-Step Guide, describes how to implement adult vaccination services in your healthcare setting and provides a review for staff who already vaccinate adults; IAC Guide available for free download

In late 2017, the Immunization Action Coalition (IAC) announced the publication of its new book, Vaccinating Adults: A Step-by-Step Guide (Guide).



This completely updated guide on adult immunization (originally published in 2004) provides easy-to-use, practical information covering important “how-to” activities to help providers enhance their existing adult immunization services or introduce them into any clinical setting, including:

  • setting up for vaccination services,
  • storing and handling vaccines,
  • deciding which people should receive which vaccines,
  • administering vaccines,
  • documenting vaccinations (including legal issues), and
  • understanding financial considerations and billing information.

In addition, the Guide is filled with hundreds of web addresses and references to help providers stay up to date on the latest immunization information, both now and in the future.

The entire Guide is available to download/print free of charge at www.immunize.org/guide. The downloaded version is suitable for double-sided printing. Options are available online to download the entire book or selected chapters. The development of the Guide was supported by the National Vaccine Program Office (NVPO) and the Centers for Disease Control and Prevention (CDC). Expert staff from both agencies also provided early technical review of the content.

The Guide is a uniquely valuable resource to assist providers in increasing adult immunization rates. Be sure to get a copy today!

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JOURNAL ARTICLES AND NEWSLETTERS


March issue of CDC's Immunization Works newsletter now available

CDC recently released the March issue of its monthly newsletter Immunization Works. The newsletter offers the immunization community information about current topics. The information is in the public domain and can be reproduced and circulated widely.

Related Links

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Vaccine Education Center at Children's Hospital of Philadelphia publishes March issue of its newsletter Vaccine Update for Healthcare Professionals

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia publishes a monthly immunization-focused newsletter titled Vaccine Update for Healthcare Professionals. The March issue includes the following articles:

Additional resources, including information booklets for patients, are available in the full newsletter.

Access the sign-up form to subscribe to Vaccine Update for Healthcare Professionals.

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CDC publishes “Imported Toxin-Producing Cutaneous Diphtheria—Minnesota, Washington, and New Mexico, 2015–2018” in this week’s MMWR

CDC published Imported Toxin-Producing Cutaneous Diphtheria—Minnesota, Washington, and New Mexico, 2015–2018 in the March 29 issue of MMWR (pages 281–284). A summary made available to the press is reprinted below.

To promote a prompt public health response and to prevent disease transmission, clinicians should consider a diagnosis of cutaneous diphtheria in patients with wound infections who traveled to countries with endemic disease. Diphtheria is caused by the bacterium Corynebacterium diphtheriae and is rare in the United States. Toxin-producing C. diphtheriae bacteria primarily infect the respiratory tract or the skin. While not typically life threatening, cutaneous diphtheria infections are contagious and can result in new cutaneous or respiratory cases. Laboratory testing identified four cases of cutaneous diphtheria caused by toxin-producing C. diphtheriae in patients who returned from international travel. The recommended public health response for cutaneous diphtheria includes treating patients, providing preventive antibiotics to close contacts, testing patients and close contacts for C. diphtheriae carriage, and providing diphtheria vaccine to incompletely vaccinated patients and close contacts.

Related Link

  • MMWR main page provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements

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The journal Vaccine publishes "It’s Not All about Autism: The Emerging Landscape of Anti-Vaccination Sentiment on Facebook"

The journal Vaccine published It’s Not All about Autism: The Emerging Landscape of Anti-Vaccination Sentiment on Facebook, by B.L. Hoffman, et al., in its April 10 issue. The abstract is reprinted below.

Background

Due in part to declining vaccination rates, in 2018 over 20 states reported at least one case of measles, and over 40,000 cases were confirmed in Europe. Anti-vaccine posts on social media may be facilitating anti-vaccination behaviour. This study aimed to systematically characterize (1) individuals known to publicly post anti-vaccination content on Facebook, (2) the information they convey, and (3) the spread of this content.

Methods

Our data set consisted of 197 individuals who posted anti-vaccination comments in response to a message promoting vaccination. We systematically analysed publicly-available content using quantitative coding, descriptive analysis, social network analysis, and an in-depth qualitative assessment. The final codebook consisted of 26 codes; Cohen’s κ ranged 0.71–1.0 after double-coding.

Results

The majority (89%) of individuals identified as female. Among 136 individuals who divulged their location, 36 states and 8 other countries were represented. In a 2-mode network of individuals and topics, modularity analysis revealed 4 distinct sub-groups labelled as “trust,” “alternatives,” “safety,” and “conspiracy.” For example, a comment representative of “conspiracy” is that poliovirus does not exist and that pesticides caused clinical symptoms of polio. An example from the “alternatives” sub-group is that eating yogurt cures human papillomavirus. Deeper qualitative analysis of all 197 individuals’ profiles found that these individuals also tended to post material against other health-related practices such as water fluoridation and circumcision.

Conclusions

Social media outlets may facilitate anti-vaccination connections and organization by facilitating the diffusion of centuries old arguments and techniques. Arguments against vaccination are diverse but remain consistent within sub-groups of individuals. It would be valuable for health professionals to leverage social networks to deliver more effective, targeted messages to different constituencies.


Read the full article: It’s Not All about Autism: The Emerging Landscape of Anti-Vaccination Sentiment on Facebook.

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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. 6NH23IP922550 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: AstraZeneca, Inc.; Merck Sharp & Dohme Corp.; Pfizer, Inc.; and Sanofi Pasteur.

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Measles Is Beatable. Please Vaccinate Your Children: Dr. Aaron Carroll, professor of pediatrics at Indiana University School of Medicine and a blogger on health research and policy, makes videos at Healthcare Triage News. In this video he describes the current measles outbreak in Clark County, Washington, how the outbreak has spread, how dangerous measles is, and the importance of vaccination.
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Editor:
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Jane Myers, MA, EdM  
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AAFP: American Academy of Family Physicians
AAP: American Academy of Pediatrics
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IAC: Immunization Action Coalition
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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. 6NH23IP22550) 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.