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Issue 1421
Issue 1421: April 17, 2019


TOP STORIES


IAC HANDOUTS


OFFICIAL RELEASES AND ANNOUNCEMENTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


Total U.S. measles cases for 2019 climb to 555 this week with 90 new cases reported since last week; CDC issues important measles outbreak information to its partners

On April 15, CDC posted its latest updated number of 2019 measles cases in the U.S. on its Measles Cases and Outbreaks web page, now increased to 555 cases across 20 states (as of April 11). This number reflects an increase of 90 cases over the previous week's total of 465, with the outbreaks now including one additional state.  

CDC sent a statement to immunization partners outlining important measles information to share with others. Portions of the statement are reprinted below.

There have been multiple outbreaks of measles in the U.S. So far this year, there have been 555 cases in 20 states. This is the second-greatest number of cases reported in the U.S. since measles was eliminated in 2000. We anticipate there will be continued opportunities for measles to spread as we continue through the spring travel season and into early summer.

Measles is highly contagious and spreads through the air when an infected person coughs or sneezes. Healthcare professionals should be vigilant about measles.

  • Ensure all patients are up to date on MMR vaccine.
  • Consider measles in patients presenting with febrile rash illness and clinically compatible measles symptoms (cough, runny nose, and conjunctivitis). Patients exposed to measles while traveling for Passover could begin to develop symptoms between late April through mid-May.
  • Ask patients about recent travel internationally or to domestic venues frequented by international travelers, as well as a history of measles exposures in their communities.
  • Promptly isolate patients with suspected measles to avoid disease spread and immediately report the suspect measles case to the health department.
  • Obtain specimens for testing from patients with suspected measles, including viral specimens for genotyping, which can help determine the source of the virus. Contact the local health department with questions about submitting specimens for testing.

Measles is so contagious that if one person has it, up to 9 of 10 people around them will also become infected if they are not protected. The virus can cause serious health complications, such as pneumonia or encephalitis, and even death.
 
CDC continues to encourage parents to get their children vaccinated on schedule with the MMR vaccine. People 6 months and older should be protected with the vaccine before leaving on international trips. 
 
For additional information and resources on measles, please visit the CDC's measles website.

 
Access additional information about U.S. measles cases in 2019 on CDC's Measles Cases and Outbreaks web page.

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New York City’s health commissioner declares measles emergency, requiring vaccinations in parts of Brooklyn

On April 9, the New York City (NYC) Department of Health and Mental Hygiene ordered every adult and child who lives, works, or resides in certain zip codes in Brooklyn and has not received the measles, mumps, and rubella (MMR) vaccine to be vaccinated. During a press conference, Mayor Bill de Blasio; Deputy Mayor of Health and Human Services Dr. Herminia Palacio; and Health Commissioner Dr. Oxiris Barbot declared that members of the health department will check the vaccination records of any individual who may have been in contact with infected patients. Those who have not received the MMR vaccine or do not have evidence of immunity may be charged with a violation and could be fined $1,000.

According to the NYC Department of Health and Mental Hygiene's Measles web page, as of April 15, 2019, there have been 329 confirmed cases of measles in Brooklyn and Queens since October. Most of these cases have involved members of the Orthodox Jewish community.

Portions of the declaration are reprinted below.

IT IS HEREBY ORDERED that any person who lives, works, or resides within the 11205, 11206, 11211, and/or 11249 zip codes and who has not received the MMR vaccine within forty eight (48) hours of this Order being signed by me shall be vaccinated against measles unless such person can demonstrate immunity to the disease or document to the satisfaction of the Department that he or she should be medically exempt from this requirement.  
 
IT IS FURTHER ORDERED that the parent or guardian of any child older than six months of age who lives, works, or resides within the 11205, 11206, 11211, and/or 11249 zip codes and who has not received the MMR vaccine within forty eight (48) hours of this Order being signed by me shall cause such child to be vaccinated against measles unless such parent or guardian can demonstrate that the child has immunity to the disease or document that he or she should be medically exempt from this requirement. 


Read the Order of the Commissioner, issued April 9.

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IAC Spotlight! IAC's “Talking About Vaccines: Religious Concerns” web page contains a wide variety of resources to help you answer questions from parents and patients who have religious concerns about immunization

In general, religions around the world support immunization. IAC's Talking About Vaccines: Religious Concerns web page on immunize.org contains numerous resources that will help you have conversations with parents and patients who have religious concerns about immunizations.

When you visit the Talking About Vaccines: Religious Concerns web page, in the middle of the page, you'll find sections titled:
  • Statements from religious organizations on human fetal cells
  • Use of porcine and animal products
  • Rabbinical statements on vaccines
In the right-hand column, you will find featured resources, including an article from Slate titled Why Is There a Religious Exemption for Vaccinations? Almost No Religions Object to Them. Other resources include a perspective video featuring Dr. Paul Offit, PowerPoint slide sets, journal articles, and more information about religious concerns.
 
To easily locate this web page from anywhere on immunize.org, go to the light blue band of tabs across the top and select the "Talking About Vaccines" tab (far right), and then from the drop-down menu select "Religious Concerns."

Visit the Talking About Vaccines: Religious Concerns web page.

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Vaxopedia website releases new post titled “Which Measles Records Will We Break This Year?”

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 Which Measles Records Will We Break This Year? will be of interest to many of our readers. An excerpt is reprinted below.

The Rockland County, New York measles outbreak, which has been going on since September 2018, has the record for being the longest outbreak since the endemic spread of measles was eliminated in the United States.

What other records will we break?

What other records are there?

  • 37 cases – the record low for the number of measles cases in a year, set in 2004
  • 667 cases – the recent record high set in 2014 and the most cases since 1994, when there were 963 cases.
  • 383 cases – the largest single outbreak since the endemic spread of measles was eliminated, set in Ohio in 2014

So, it’s mid-April and we are nearly 500 cases and the ongoing outbreak in Brooklyn is already at 285 cases…

Read the post in its entirety: Which Measles Records Will We Break This Year?

Some additional measles articles from the site include:

Related Links

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Reminder! National Infant Immunization Week is April 27–May 4; many resources available to help you plan activities

National Infant Immunization Week (NIIW) 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. NIIW will be held this year on April 27–May 4.

Visit CDC's updated NIIW website to find promotional and educational materials to help you plan your NIIW activities, including those in the 2019 Digital Media Toolkit, and tailor them to the needs of your community. If you're looking for planning ideas and tools, you can access guidance on CDC's Planning Your NIIW web page.



CDC would like to hear from organizations planning a 2019 NIIW activity. Please complete the NIIW Activity Form so others can learn what you're doing to educate and inspire parents and providers to protect infants and toddlers from vaccine-preventable diseases.

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Influenza activity decreased this week but remains elevated; CDC reports an estimate of up to 50,900 influenza-related deaths so far this season

According to CDC, influenza activity decreased in the U.S. but remains elevated in the period ending April 6. The proportion of outpatient visits for influenza-like illness decreased from 3.2% in the previous week to 2.8%, which is above the national baseline of 2.2%. CDC estimates that flu has caused as many as 38.1 million flu illnesses, 549,000 hospitalizations, and 50,900 deaths so far this season. 

CDC has reported four additional influenza-associated pediatric deaths this season, for a total of 86. Last season, there was a record-setting 185 pediatric deaths in the U.S.  

CDC stated in its Weekly U.S. Influenza Surveillance Report, FluView, that during the week ending April 6, the geographic spread of influenza in 20 states was reported as widespread; Puerto Rico and 25 states reported regional activity; the District of Columbia and five states reported local activity; the U.S. Virgin Islands reported sporadic activity; 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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Five healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination

There are now 830 organizations enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, long-term care facilities (LTCFs), medical practices, pharmacies, professional organizations, health departments, and government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel.

Since March 27, when IAC Express last reported on the Influenza Vaccination Honor Roll, five additional healthcare organizations have been enrolled.

IAC urges qualifying healthcare organizations to apply by visiting the Application page.

Newly added healthcare organizations, hospitals, government agencies, and medical practices

  • Charter Oaks Health Center, Hartford CT
  • Concord Hospital, Concord, NH
  • Hartford HealthCare, Hartford, CT 
  • McIntosh Senior Living, McIntosh, MN
  • RWJ Barnabus Health, Toms River, NJ

Related Links

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May is Hepatitis Awareness Month; promote hepatitis awareness by using #HepAware19 

It's almost time to celebrate Hepatitis Awareness Month and the eighth annual national Hepatitis Testing Day on May 19!



The Hepatitis Awareness Month and Testing Day Resource Center has free tools to help support your awareness activities and testing events. Resources include buttons, badges, and a quiz widget for your website or email signatures; Live-Read Radio Scripts templates to pitch your events to local radio stations; and sample proclamations for Hepatitis Awareness Month and/or national Hepatitis Testing Day.

If you are planning events and activities, make sure you share with CDC and others what you are doing with pictures, video, etc. by using #HepAware19.

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Join the Meningitis B Action Project in a Day of Action against Meningitis B on April 24
 

On April 24, World Meningitis Day, the Meningitis B Action Project is hosting a Day of Action against Meningitis B. The goal is to inspire a national wave of MenB advocacy actions across the country—in every one of the 50 states. To make it happen, the Meningitis B Action Project is challenging at least one person in each state to commit to one action that they will do on April 24 to raise awareness of MenB and the vaccine available to help prevent it. 

To find out how to help, visit the Day of Action against Meningitis B website and begin planning your action today!

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Voices for Vaccines releases new podcast episode titled “Ethan Lindenberger, the Internet, and Teen Advocacy”

Voices for Vaccines (VFV) has posted a new entry in its Vax Talk podcast series: Ethan Lindenberger, the Internet, and Teen Advocacy. A few months ago, Ethan Linenberger was just a teenager with a Reddit account. He used that account to find out how to get himself vaccinated, and now he is one of the youngest—and smartest—vaccine advocates around. VFV talked to him about vaccines, social media, and how teens can engage in this space.

If you or your organization would like information about how to become a sponsor of a VFV "Vax Talk" podcast, please contact VFV's executive director Karen Ernst, at info@voicesforvaccines.org.

Voices for Vaccines is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters. VFV invites everyone who values vaccines to become a member. Please spread the word to your friends and colleagues to join VFV!

Related Links

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Polio worker killed in Mohmand, Pakistan; reports of other workers killed

A polio worker, Wajid Ali, was shot and killed in the Mohmand tribal district of Khyber-Pakhtunkhwa province in Pakistan. Wajid had been a staff member of the Kamali Union Council of Tehsil Haleemzai since April 2017. WHO issued a press release condemning the killing. A portion of the press release is reprinted below.

“We strongly condemn this and any attack targeting health care staff like Mr. Ali, who are working hard to rid the world of polio and other diseases,” said Dr. Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean. “Health care should never be a target and WHO and our partners will not be deterred by such attacks. We will continue our efforts to work with the Government of Pakistan, UNICEF, and other partners to eradicate polio and ensure the highest possible level of health for all the people of Pakistan.”

Pakistan is one of 3 countries globally where polio remains endemic. The others are Afghanistan and Nigeria. Efforts to eradicate polio have been hindered by attacks such as these.

“We are devastated by this tragic news and extend our sincere condolences to Mr. Ali’s family and friends,” said Dr. Ni’ma Abid, Acting WHO Representative for Pakistan. “The only tribute we can pay to those who have sacrificed their lives to protect Pakistani children from the death and lifelong disability polio brings, is to complete their mission and eradicate polio from Pakistan.”


News articles about additional polio health heroes who gave their lives to protect others:

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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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IAC HANDOUTS


IAC updates "Haemophilus influenzae type b (Hib): Questions and Answers" handout

IAC recently reviewed its handout for patients and healthcare professionals titled Haemophilus influenzae type b (Hib): Questions and Answers. This handout was reviewed and did not require any revisions. The only change is a new date.

Related Links

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 patient handout "Vaccines Work!" 

IAC recently reviewed and updated its handout for patients titled Vaccines Work! Changes were made to update morbidity data in the table based on those compiled by CDC. This handout outlines CDC statistics which demonstrate dramatic declines in vaccine-preventable diseases when compared with the pre-vaccine era.

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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OFFICIAL RELEASES AND ANNOUNCEMENTS


NIH issues news release announcing the first-in-human trial of a universal influenza vaccine candidate

A universal flu vaccine (known as H1ssF_3928), developed by scientists at the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH, is undergoing clinical trials in healthy adults. Researchers aim to look at how participants’ immune responses vary based on age and the likelihood of previous exposure to different influenza variants. A portion of the NIH press release is reprinted below. 

H1ssF_3928 is designed to teach the body to make protective immune responses against diverse influenza subtypes by focusing the immune system on a portion of the virus that varies relatively little from strain to strain. The vaccine candidate was developed as part of a broader research agenda to create a so-called “universal” influenza vaccine that can provide long-lasting protection for all age groups from multiple influenza subtypes, including those that might cause a pandemic.

"Seasonal influenza is a perpetual public health challenge, and we continually face the possibility of an influenza pandemic resulting from the emergence and spread of novel influenza viruses,” said NIAID Director Anthony S. Fauci, M.D. “This Phase 1 clinical trial is a step forward in our efforts to develop a durable and broadly protective universal influenza vaccine.”


Read the entire press release: NIH begins first-in-human trial of a universal influenza vaccine candidate.

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WORLD NEWS


Sudan launches large-scale vaccination campaign to immunize over 11 million children against measles and polio

In response to a measles outbreak, the Federal Ministry of Health in Sudan, in collaboration with the World Health Organization (WHO), Gavi, the Vaccine Alliance, and the United Nations Children's Fund (UNICEF), launched a large-scale vaccination campaign to vaccinate over 11 million children against measles and polio. A portion of the press release is reprinted below.

Official statistics in Sudan indicate that measles is the third cause of mortality among infants and the first among vaccine-preventable diseases. As of March 2019, 834 measles cases were reported compared to 4980 in 2018.

Although polio and measles immunization programmes are separate, they have come together this time to bring health security and achieve the desired health protection outcomes in Sudan. More than 38 826 highly skilled workforce of community vaccinators and frontline health workers and social mobilizers were mobilized to implement this massive campaign.


Read the entire press release: Sudan prepares to vaccinate over 11 million children against measles and polio.

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FEATURED RESOURCES



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


CDC publishes "Notes from the Field: Acute Hepatitis A Virus Infection Among Previously Vaccinated Persons with HIV Infection: Implications for Postexposure Prophylaxis—Tennessee, 2018" in this week's MMWR

CDC published Notes from the Field: Acute Hepatitis A Virus Infection Among Previously Vaccinated Persons with HIV Infection: Implications for Postexposure Prophylaxis—Tennessee, 2018 in the April 12 issue of MMWR (pages 328–329). The final paragraph is reprinted below.

Previous vaccination for hepatitis did not reliably provide protection among some persons with HIV infection. Approximately half of the patients with HAV and HIV infections were previously vaccinated. The Advisory Committee on Immunization Practices does not currently address specific PEP considerations for persons with HIV infection who have been fully vaccinated against hepatitis A. CDC guidelines recommend IG and a dose of vaccine as PEP for hepatitis A for previously unvaccinated persons who are immunocompromised, including persons with HIV infection. These findings support the consideration by providers to administer IG as PEP for all persons with HIV infection who experience high-risk exposure to a person with HAV infection, regardless of the exposed persons prior vaccination history or immune status.

Access Notes from the Field: Acute Hepatitis A Virus Infection Among Previously Vaccinated Persons with HIV Infection: Implications for Postexposure Prophylaxis—Tennessee, 2018 in HTML format.

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CDC publishes "Notes from the Field: Hepatitis A Outbreak Associated with Drug Use and Homelessness—West Virginia, 2018" in this week's MMWR

CDC published Notes from the Field: Hepatitis A Outbreak Associated with Drug Use and Homelessness—West Virginia, 2018 in the April 12 issue of MMWR (pages 330–331). The final paragraph is reprinted below.

In other states experiencing similar person-to-person hepatitis A outbreaks, hepatitis A vaccination campaigns have successfully targeted populations at risk by vaccinating in emergency departments and at syringe exchange programs, jails, and drug treatment facilities. Increasing vaccination coverage among groups at high risk for HAV infection as recommended by the Advisory Committee on Immunization Practices can slow ongoing outbreaks and prevent future outbreaks. Engaging partners to provide hepatitis A vaccine to persons at highest risk at all possible points of contact with the health care system and service providers might help improve vaccination coverage among groups at high risk.


Access Notes from the Field: Hepatitis A Outbreak Associated with Drug Use and Homelessness—West Virginia, 2018 in HTML format.

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EDUCATION AND TRAINING


NACCHO and partner organizations offer May 1 webinar on perinatal hepatitis B prevention
 
The National Association of County and City Health Officials (NACCHO), the Hepatitis B Foundation, and Hep B United, will present a one-hour webinar, Exploring National and Local Approaches to Perinatal Hepatitis B Prevention, beginning at 2:00 p.m. (EDT) on May 1. Part of its Hepatitis B: Education and Support for Health Departments series, featured speakers include Dr. Noele Nelson, MD, PhD, MPH, acting branch chief, Prevention Branch, Division of Viral Hepatitis, CDC, and Essi Havor, MSN, RN, APHN-BC, chief nurse, Houston Health Department.
 

Registration open for June 26–27, 2019 ACIP meeting

ACIP will hold its next meeting on June 26–27 in Atlanta. To attend the meeting, ACIP attendees (participants and visitors) must register online. The registration deadline for non-U.S. citizens is May 29; for U.S. citizens, it's June 10. Registration is not required to watch the meeting via webcast or listen to the proceedings via phone. See the first link below for the toll-free phone number and passcode.

Related Links

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2019 National Conference for Immunization Coalitions and Partnerships scheduled for November 13–15 in Honolulu; presentation and poster abstract deadline is May 20

The 14th National Conference for Immunization Coalitions and Partnerships, Navigating from Local to Global, will take place in Honolulu from November 13 through 15, 2019. This is a great opportunity for coalition leaders to learn from expert speakers and network with members of immunization coalitions from around the nation.

The planners are accepting abstract submissions for breakout sessions and posters until May 20. Abstracts are welcome from representatives of all disciplines, including coalition staff and members, community-based providers, healthcare providers, social workers, researchers, government agencies, health communication specialists, and others. 

Please register by August 31, 2019, to receive the early bird rates.

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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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Teen Testifies about Getting Vaccinations Despite His Mother's Opposition: High school student Ethan Linderberger, 18, testified at the U.S. Senate Committee on Health, Education, Labor, and Pensions March 5 hearing. He discussed growing up unvaccinated and hearing from his mom that vaccines were dangerous. As he got older, he looked into vaccines independently, consulted his doctor, and got vaccinated. Source: PBS News Hour
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Editor:
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Issue Abbreviations
AAFP: American Academy of Family Physicians
AAP: American Academy of Pediatrics
ACIP: Advisory Committee on Immunization Practices
CDC: Centers for Disease Control and Prevention
FDA: Food and Drug Administration
IAC: Immunization Action Coalition
MMWR: Morbidity and Mortality Weekly Report
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Immunization Action Coalition  •  2550 University Avenue West  •  Suite 415 North  •  Saint Paul, Minnesota  •  55114
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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.