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Immunization Action Coalition
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2019 Issues
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Issue 1431
Issue 1431: June 19, 2019


TOP STORIES


IAC HANDOUTS


OFFICIAL RELEASES AND ANNOUNCEMENTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING

 


TOP STORIES


New York State eliminates non-medical exemptions for vaccination

On June 13, the New York state legislature passed, and Governor Andrew Cuomo signed, legislation to remove non-medical exemptions from school vaccination requirements for children. The law will take effect immediately, but will give students up to 30 days to document required vaccinations. The first two paragraphs of the governor's statement are reprinted below.

Governor Andrew M. Cuomo today signed legislation (S.2994A/A.2371), sponsored by Senator Brad Hoylman and Assembly Member Jeffrey Dinowitz, removing non-medical exemptions from school vaccination requirements for children. The United States is currently experiencing the worst outbreak of measles in more than 25 years, with outbreaks in pockets of New York primarily driving the crisis. As a result of non-medical vaccination exemptions, many communities across New York have unacceptably low rates of vaccination, and those unvaccinated children can often attend school where they may spread the disease to other unvaccinated students. This new law will help protect the public amid this ongoing outbreak.

"The science is crystal clear: Vaccines are safe, effective and the best way to keep our children safe. This administration has taken aggressive action to contain the measles outbreak, but given its scale, additional steps are needed to end this public health crisis," Governor Cuomo said. "While I understand and respect freedom of religion, our first job is to protect the public health and by signing this measure into law, we will help prevent further transmissions and stop this outbreak right in its tracks."


Read the complete statement: Governor Cuomo Signs Legislation Removing Non-Medical Exemptions from School Vaccination Requirements.

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Total number of U.S. measles cases for 2019 climbs to 1,044 with 22 new cases reported since last week

CDC has posted its latest update on 2019 measles cases in the U.S. on its Measles Cases and Outbreaks web page. The web page shows a preliminary estimate of 1,044 cases across 28 states as of June 13. This is the greatest number of cases reported in the U.S. since 1992 and since measles was declared eliminated from the U.S. in 2000.

The states that have reported cases to CDC are Arizona, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, New Mexico, Nevada, New Hampshire, New Jersey, New York, Oklahoma, Oregon, Pennsylvania, Texas, Tennessee, Virginia, and Washington.

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

Measles outbreaks (defined as 3 or more cases) are currently ongoing in 2019 in the following jurisdictions:

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CDC reports on trends in human rabies deaths and exposures in the United States

On June 12, CDC published a new Vital Signs report titled Trends in Human Rabies Deaths and Exposures—United States, 1938–2018 as an MMWR Early Release. On the same day, CDC provided a press release titled Bats Lead in U.S. Rabies Risk: Awareness of Rabies Threats Crucial to Preventing Deadly Disease. The MMWR Early Release was republished on June 14 in the regular edition of MMWR.

The press release is reprinted below.

Bats are responsible for roughly 7 in 10 rabies deaths among people who are infected with the rabies virus in the United States, possibly because people may not know of the risk bats pose, according to the Vital Signs report released today by the Centers for Disease Control and Prevention. The large percentage of deaths tied to bats is particularly striking since bats account for just a third of the 5,000 rabid animals reported each year in the U.S. Rabid dogs that people encounter while traveling overseas are the second-leading cause of rabies cases in Americans.

The U.S. averages 1–3 human cases of rabies a year now, down from 30–50 cases per year in the 1940s. This decrease is largely due to routine pet vaccination and availability of post-exposure prophylaxis (PEP), which combines rabies vaccine and rabies immune globulin to prevent infection after exposure to the virus. Each year, about 55,000 people in the U.S. seek PEP after a potential rabies exposure. Rabies is nearly always fatal if people don’t get rabies PEP before symptoms start.

The U.S. rabies landscape has shifted dramatically during the past 81 years. Before 1960, bites from rabid dogs caused most human rabies cases in the U.S. Mass pet-vaccination programs and leash laws enacted in the 1950s significantly reduced rabies in dogs. As dog rabies declined, rabies in bats, raccoons, foxes, and skunks became more apparent. These animals have remained the primary hosts of the virus in the U.S., although any mammal—including unvaccinated dogs and cats—can get rabies if bitten by another animal that is rabid. Some animals that people may think spread rabies—like opossums and squirrels—rarely do.

Protecting against rabies
Staying away from wildlife, especially bats, is key to preventing rabies in people. Bats carry rabies virus in every U.S. state except Hawaii, and can spread the virus year-round. However, anecdotal case reports suggest that people may not be fully aware that bats pose a rabies risk—and so they may not seek life-saving rabies PEP if they are bitten or scratched by a bat. If people wake up with a bat in the room, CDC recommends that they assume they may have been exposed to rabies and see a healthcare provider right away to determine if they need to receive PEP for rabies.


Travelers need to remain vigilant
Americans who travel internationally should research the rabies risk at their destination, especially the risk from dogs, which still carry rabies in many countries around the world. Globally, rabid dogs cause about 98 percent of the 59,000 human deaths from rabies each year. CDC recommends travelers avoid animals, have a plan to get care if they are scratched or bitten, and have travel health insurance to pay for treatment should they need it. Some travelers may also want to consider pre-exposure vaccination depending on their specific travel plans. More information is available on CDC’s Travel Health website.

Imported dogs pose a risk as well. CDC estimates more than 1 million dogs enter the U.S. annually, and 107,000 are imported from countries where rabies in dogs is common. Since 2015, three rabid dogs are known to have been brought into the U.S., posing a risk to people and pets who came in contact with them. Due to the robust U.S. public health surveillance system, these cases were rapidly identified and rabies didn’t spread. Emergency efforts to respond to rabid imported dogs cost more than $200,000 per occurrence, but are necessary to prevent cases of rabies in people and potential reintroduction of the virus into the U.S. dog population.

To read the Vital Signs report, visit www.cdc.gov/vitalsigns. For more information on rabies, please visit www.cdc.gov/rabies.


CDC also released the following key points on its Vital Signs web section:

  • Every 10 minutes, someone in the US is treated for possible exposure to rabies
  • About 5,000 animals—mostly wildlife—test positive for rabies each year in the US
  • 7 out of 10 Americans who die from rabies in the U.S. were infected by bats

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It's Pride Month: CDC reminds providers to vaccinate men who have sex with men against hepatitis A 
 
On June 11, CDC's National Prevention Information Network sent out a bulletin titled Pride Month: Hepatitis A Vaccination Among Men Who Have Sex with Men. The text is reprinted below.

June is Pride month, and this year marks the 50th Anniversary of Stonewall. New York City is hosting World Pride at the end of June, the first time World Pride is being held in the United States.

While hepatitis A and B vaccines are recommended for men who have sex with men, vaccine rates among this group remain low. CDC would like to take this time to ask that you join us in spreading the word about the need for men who have sex with men to get vaccinated for hepatitis A, which is particularly important during the ongoing outbreaks in multiple states. CDC has developed the following resources which can be tailored with local information, if so desired.


EDUCATIONAL RESOURCES

In addition, CDC has a web feature designed to educate gay and bisexual men about the outbreak and the importance of getting vaccinated. CDC will be using this as a landing page for social media outreach connected to Pride and using #PrideMonth and #Pride2019.

SOCIAL MEDIA

  • Sample social media posts are also available for both Twitter and Facebook to help spread the word about outbreaks that are occurring among MSM. Please email the communications team at cxj4@cdc.gov.

PROMOTE VACCINATION SERVICES

  • If you want to let MSM know of places to get vaccinated other than your clinic or health department, consider publicizing the VaccineFinder site. People can put in their zip code to locate vaccine clinics and pharmacies.

STAY CONNECTED

  • Follow @cdchep on Twitter for information about hepatitis resources, tools, publications, campaign updates, and events.
  • Sign up for monthly emails from the Division of Viral Hepatitis about new publications, recommendations, new materials, or significant events.

CDC Division of Viral Hepatitis (viralhepatitisoutbreak@cdc.gov)



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CDC publishes report about administration of expired injectable influenza vaccine

CDC published Notes from the Field: Administration of Expired Injectable Influenza Vaccines Reported to the Vaccine Adverse Event Reporting System—United States, July 2018–March 2019 in the June 14 issue of MMWR. The beginning of the first paragraph and the final paragraph of this report are reprinted below.

Every year, injectable inactivated influenza vaccine (IIV) has a standard expiration date of June 30 for the upcoming influenza season (i.e., July 1–June 30 of the following year). Vaccination with an expired influenza vaccine might not protect against influenza infection because different influenza virus strains can be included in the vaccine each year; in addition, protection against viruses included in the vaccine could wane if vaccine potency decreases over time. During July 11, 2018–March 29, 2019 in the United States, the Vaccine Adverse Event Reporting System (VAERS) received 125 reports of 192 patients receiving expired IIV during the 2018–19 influenza season, during which time 169.1 million doses of seasonal influenza vaccine were distributed....

Vaccines should be inspected for expiration before they are administered or transported to other facilities. Facility vaccine coordinators need to be aware of the standard expiration date of June 30 for IIV and make plans for the safe disposal or return of any remaining doses of IIV after that date. Sometimes unused vaccine may be returned for credit, even if the doses must be discarded. State immunization programs or vaccine manufacturers should be contacted to determine whether such provisions apply. Any person who receives an expired influenza vaccine should be revaccinated with the current season’s influenza vaccine.


Access the complete report: Notes from the Field: Administration of Expired Injectable Influenza Vaccines Reported to the Vaccine Adverse Event Reporting System—United States, July 2018–March 2019.

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IAC Spotlight! IAC's "Talking about Vaccines: Vaccine Safety" web page features information from many organizations to help providers communicate with parents and patients

IAC's Talking about Vaccines: Vaccine Safety web page on immunize.org was recently updated and contains many resources from IAC, CDC, and others to help healthcare professionals address concerns about vaccine safety.

The resources listed in the left column of this web page link to materials on the websites of the following organizations:

  • IAC
  • CDC
  • U.S. Food and Drug Administration (FDA)
  • Vaccine Education Center at Children’s Hospital of Philadelphia
  • National Academy of Medicine
  • Vaxopedia
  • Johns Hopkins University School of Public Health
  • College of Physicians of Philadelphia
  • World Health Organization (WHO)

In the right column of the web page, you will find more resources, including the following:

  • Videos for parents and healthcare professionals
  • PowerPoint slide sets
  • Vaccine Safety Monitoring Activities
  • Link to IAC's website for the public, www.vaccineinformation.org

To easily locate this web page from anywhere on immunize.org, go to the light blue band of tabs across the top, choose the "Talking About Vaccines" tab (far right), and then select "Vaccine Safety" from the drop-down menu.

The direct link is www.immunize.org/safety.

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Digital marketing email service MailChimp curtails promotion of anti-vaccine misinformation

MailChimp, a digital email marketing service, has joined a number of other important technology and social media companies in working to combat anti-vaccine misinformation. A section of a June 13 article from NBC News is reprinted below.

Digital marketer MailChimp has removed several anti-vaccination activists from its platform and will no longer provide services to newsletters that push anti-vaccination content.

The move to block the anti-vaccination rhetoric follows similar actions by other tech companies and comes on the heels of increased pressure from public health advocates and lawmakers on digital platforms to curtail the spread of health misinformation....

The company began quietly enforcing this decision last week.

“We trust the world’s leading health authorities, like the CDC, WHO, and the AAP, and follow their guidance when assessing this type of misuse of our platform,” the spokesperson said, referring to the Centers for Disease Control and Prevention, the World Health Organization and the American Academy of Pediatrics.

Vaccine misinformation that had once been allowed to flourish on the fringes of many mainstream internet destinations has come under growing scrutiny in the past six months, particularly as health officials have warned about the resurgence of some preventable diseases.

Earlier in 2019, Amazon pulled anti-vaccination documentaries from its Prime Video service and several books from its marketplace. Facebook began to stop advertising that spread “vaccine hoaxes” and said it planned to reduce the visibility of vaccine misinformation shared on its platform. YouTube also disabled advertising on anti-vaccination videos and lowered in ranking health misinformation content in its search results. Pinterest has blocked all vaccine-related search results....


Read the complete NBC News article: Digital marketer MailChimp Bans Anti-Vaccination Content.

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IAC enrolls 7 new birthing institutions into its Hepatitis B Birth Dose Honor Roll; 13 previously honored institutions qualify for additional years' honors

The Immunization Action Coalition (IAC) is pleased to announce that 7 new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll, for a total of 467 honorees. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.

  • Henderson Hospital, Henderson, NV (91%)
  • Holy Redeemer Hospital, Meadowbrook, PA (90%)
  • INTEGRIS Southwest Medical Center, Oklahoma City, OK (97%)
  • Logansport Memorial Hospital, Logansport, IN (90%)
  • Ohio Valley Medical Center, Wheeling, WV (90%)
  • Spectrum Health Zeeland Community Hospital, Zeeland, MI (90%)
  • West Kendall Baptist Hospital, Miami, FL (93%)

The following 4 institutions are being recognized for a second year:

  • Claxton-Hepburn Medical Center, Ogdensburg, NY (92%)
  • Guthrie Cortland Medical Center, Cortland, NY (96%)
  • Montefiore New Rochelle, New Rochelle, NY (92%)
  • Women's Health & Birth Center, Clarion Hospital, Clarion, PA (96%)

In addition, the following 4 institutions are being recognized for a third year:

  • Adirondack Medical Center, Saranac Lake, NY (90%)
  • Missouri Delta Medical Center, Sikeston, MO (98%)
  • Montefiore New Rochelle, New Rochelle, NY (95%)
  • Spectrum Health Lakeland in St. Joseph, St. Joseph, MI (94%)

The following 5 institutions are being recognized for a fourth year:

  • Mercy Health Saint Mary's, Grand Rapids, MI (91%)
  • Missouri Delta Medical Center, Sikeston, MO (99%)
  • Montefiore New Rochelle, New Rochelle, NY (97%)
  • North Ottawa Community Health System, Grand Haven, MI (92%)
  • Spectrum Health Big Rapids Hospital, Big Rapids, MI (92%)

The following 2 institutions are being recognized for a fifth year:

  • Montefiore New Rochelle, New Rochelle, NY (98%)
  • Spectrum Health Lakeland in Niles, Niles, MI (90%)

The following 3 institutions are being recognized for a sixth year:

  • Beaumont Hospital–Wayne, Wayne, MI (90%)
  • Hillsdale Hospital, Hillsdale, MI (92%)
  • Montefiore New Rochelle, New Rochelle, NY (96%)

Finally, and with the greatest achievement, the following institution is being recognized for a seventh year:

  • Montefiore New Rochelle, New Rochelle, NY (94%)

Note: Two of these institutions qualified for multiple 12-month periods at one time.

The Honor Roll now includes 467 birthing institutions from 44 states, Puerto Rico, Guam, and an overseas U.S. military base. One hundred fourteen institutions have qualified for two years, 52 institutions have qualified three times, 30 institutions have qualified four times, 19 institutions have qualified five times, 6 institutions have qualified six times, 3 institutions have qualified seven times, and 1 institution has qualified eight times.

The Honor Roll is a key part of IAC’s major initiative urging the nation’s hospitals to Give Birth to the End of Hep B. Hospitals and birthing centers are recognized for attaining high coverage rates for administering hepatitis B vaccine at birth and meeting specific additional criteria. The initiative urges qualifying healthcare organizations to apply for the Hepatitis B Birth Dose Honor Roll online.

To be included in the Hepatitis B Birth Dose Honor Roll, a birthing institution must have: (1) reported a coverage rate of 90 percent or greater, over a 12-month period, for administering hepatitis B vaccine before hospital discharge to all newborns, including those whose parents refuse vaccination, and (2) implemented specific written policies, procedures, and protocols to protect all newborns from hepatitis B virus infection prior to hospital discharge.

Honorees are also awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IAC Express’s approximately 50,000 readers.

Please visit the Hepatitis B Birth Dose Honor Roll web page that lists these institutions and their exceptional efforts to protect infants from perinatal hepatitis B transmission.

Related IAC Resources

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IAC HANDOUTS


IAC updates Spanish-language version of "Questions Parents Ask about Vaccinations for Babies"

IAC recently updated the Spanish-language version of "Questions Parents Ask about Vaccinations for Babies." This handout for parents now matches the English-language version that was revised in March.

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OFFICIAL RELEASES AND ANNOUNCEMENTS


CDC reflects on the 10-year anniversary of the H1N1 influenza pandemic

CDC has developed a new web section to reflect upon the H1N1 influenza pandemic which started 10 years ago this spring. Three paragraphs from this web section are reprinted below.

In the spring of 2009, a novel influenza A (H1N1) virus emerged. It was detected first in the United States and spread quickly across the United States and the world. This new H1N1 virus contained a unique combination of influenza genes not previously identified in animals or people. This virus was designated as influenza A (H1N1)pdm09 virus. Ten years later work continues to better understand influenza, prevent disease, and prepare for the next pandemic.

The (H1N1)pdm09 virus was very different from H1N1 viruses that were circulating at the time of the pandemic. Few young people had any existing immunity (as detected by antibody response) to the (H1N1)pdm09 virus, but nearly one-third of people over 60 years old had antibodies against this virus, likely from exposure to an older H1N1 virus earlier in their lives. Since the (H1N1)pdm09 virus was very different from circulating H1N1 viruses, vaccination with seasonal flu vaccines offered little cross-protection against (H1N1)pdm09 virus infection. While a monovalent (H1N1)pdm09 vaccine was produced, it was not available in large quantities until late November—after the peak of illness during the second wave had come and gone in the United States. From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases (range: 43.3–89.3 million), 274,304 hospitalizations (range: 195,086–402,719), and 12,469 deaths (range: 8868–18,306) in the United States due to the (H1N1)pdm09 virus.

Additionally, CDC estimated that 151,700–575,400 people worldwide died from (H1N1)pdm09 virus infection during the first year the virus circulated. Globally, 80 percent of (H1N1)pdm09 virus-related deaths were estimated to have occurred in people younger than 65 years of age. This differs greatly from typical seasonal influenza epidemics, during which about 70 percent to 90 percent of deaths are estimated to occur in people 65 years and older.


Visit CDC's 2009 H1N1 Pandemic (H1N1pdm09 virus) web section for more information, including a summary of progress since 2009, ongoing challenges, links to historical resources, photos and videos, and more.

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WORLD NEWS


WHO reports on progress toward measles eradication in Pakistan in this week's Weekly Epidemiological Record

WHO published Progress towards Measles Elimination in Pakistan, 2000–2018 in the June 14 issue of its Weekly Epidemiological Record. The introductory section is reprinted below.

In 1997, during the 41st session of the WHO Regional Committee for the Eastern Mediterranean, the 21 countries in the Region passed a resolution to eliminate measles. In 2015, this goal was included as a priority in the Eastern Mediterranean Vaccine Action Plan 2016–2020 (EMVAP), which was approved at the 62nd session of the Regional Committee. To achieve this goal, the WHO Regional Office for the Eastern Mediterranean (EMRO) developed a 4-pronged strategy: (1) achieve ≥95% vaccination coverage with the first dose of measles-containing vaccine (MCV1) among children in every district of each country through routine immunization services; (2) achieve ≥95% vaccination coverage with a second MCV dose (MCV2) in every district of each country through either a routine 2-dose vaccination schedule or supplementary immunization activities (SIAs); (3) conduct high-quality, case-based surveillance in all countries; and (4) provide optimal clinical management of cases of measles, including dietary supplementation with vitamin A.

Pakistan, an EMR [Eastern Mediterranean Region] country with a population of >200 million, accounts for nearly a third of the overall EMR population. This report describes progress and challenges toward measles elimination in Pakistan during 2000–2018. Estimated coverage with MCV1 increased from 57% in 2000 to 76% in 2017. MCV2 was introduced nationwide in 2009, and coverage increased from 30% in 2009 to 45% in 2017. During 2000–2018, approximately 232.5 million children received MCV during SIAs. The reported confirmed measles incidence increased from an average of 24.6 per million during 2000–2009 to an average of 80.4 during 2010–2018, with peaks in 2013 (230.3) and 2018 (153.6). In 2017 and 2018, the rates of non-measles cases were 2.1 and 1.5 per 100 000 population, respectively. To achieve measles elimination, MCV1 and MCV2 coverage must be increased, strategies found to identify and reach communities that do not have vaccination services and the sensitivity of measles case-based surveillance increased in all districts.


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FEATURED RESOURCES


Still available! IAC’s sturdy laminated 2019 U.S. child/adolescent immunization schedules—order some for your exam rooms today! Bulk purchase prices available.

IAC's laminated 2019 U.S. child/adolescent immunization schedule is still available. The adult schedules have sold out. 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 is folded to measure 8.5" x 11". 

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 the schedule, view an image, order online, or download an order form at the Shop IAC: Laminated Schedules web page.

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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 "how to" guide on adult immunization provides easy-to-use, practical information covering essential adult immunization activities. It helps vaccine providers enhance their existing adult immunization services or introduce them into any clinical setting. Topics include:

  • 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


New England Journal of Medicine publishes article about allowing adolescents to independently consent to vaccination

On June 5, the New England Journal of Medicine published Vaccination over Parental Objection—Should Adolescents Be Allowed to Consent to Receiving Vaccines? online (Silverman RD, Opel DJ, and Omer SB). The final paragraph is reprinted below.

Parental involvement in vaccination decisions remains important. Many vaccine-hesitant parents ultimately agree to vaccination. Yet adolescents need not be harmed by parental decisions that are based on misinformation or disinformation. Allowing adolescents to consent to vaccination despite persistent parental resistance facilitates access to a medically recommended and evidence-based treatment. It promotes the minor’s health, poses minimal personal risk, and offers substantial prosocial benefits, including reinforcement of the norm of vaccination and enhancement of community protection against the spread of dangerous and costly yet preventable diseases. Given such benefits, we believe that states should enact laws that expand both access to vaccines and the rights of minors who are at least 12 to 14 years of age to consent to vaccination.

Read the complete article: Vaccination over Parental Objection—Should Adolescents Be Allowed to Consent to Receiving Vaccines?

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Pediatrics publishes study about the decline in pediatric herpes zoster cases and the relationship to varicella vaccination

The June issue of Pediatrics includes an article titled Incidence of Herpes Zoster Among Children: 2003–2014 (Weinmann S, et al.). Three sections of the abstract are reprinted below.

BACKGROUND AND OBJECTIVES
After the 1996 introduction of routine varicella vaccination in the United States, most studies evaluating pediatric herpes zoster (HZ) incidence reported lower incidence over time, with varying degrees of decline. Using the combined databases of 6 integrated health care organizations, we examined HZ incidence in children over a 12-year period in the varicella vaccine era.

RESULTS
The study included 6,372,067 children with ≥1 month of health plan membership. For the 12-year period, the crude HZ incidence rate for all subjects was 74 per 100,000 person years, and the rate among children who were vaccinated was 38 per 100,000 person years, which was 78% lower than that among children who were unvaccinated (170 per 100,000 person years; P < .0001). Overall HZ incidence declined by 72% (P < .0001) from 2003 through 2014. Annual rates in children who were vaccinated were consistently lower than in children who were unvaccinated.

CONCLUSIONS
With this population-based study, we confirm the decline in pediatric HZ incidence and the significantly lower incidence among children who are vaccinated, reinforcing the benefit of routine varicella vaccination to prevent pediatric HZ.


Access the complete abstract: Incidence of Herpes Zoster Among Children: 2003–2014.

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EDUCATION AND TRAINING


Reminder: Weekly CDC webinar series on "The Pink Book" chapter topics runs through September 25; register now

CDC is again presenting a 15-part webinar series to provide a chapter-by-chapter overview of the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). This is a live series of weekly 1-hour webinars that started June 5 and will run through September 25. The next two webinars are scheduled as follows:
  • June 19: General Best Practice Guidelines, Part 2, and Vaccine Safety
  • July 10: Immunization Strategies
Recordings of sessions will be available online within 2 weeks after each webinar. All sessions begin at 12:00 p.m. (ET). Continuing education will be available for each event.

The webinar series will provide an overview of vaccines and the diseases they prevent, general recommendations for vaccines, vaccination principles, and immunization strategies for providers.

Registration and more information is available on CDC's Pink Book Webinar Series web page.

All the sections of "The Pink Book" (i.e., chapters, appendices, 2017 supplement) are available to download at no charge at www.cdc.gov/vaccines/pubs/pinkbook/index.html.

You can also order this resource from the Public Health Foundation for $40 plus shipping and handling.
 

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.

IAC Express Disclaimer
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Video of the Week
Surgeon General Jerome Adams: Protect against the Measles: The nation's doctor explains that measles is a highly communicable respiratory disease caused by a virus. He describes the symptoms, contagiousness, and complications of measles, and he states that vaccination with the safe and very effective measles vaccine is the best protection available. (Source: HHS)
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Editorial Information
Editor:
Deborah L. Wexler, MD
Managing Editor:
Teresa Anderson, DDS, MPH

Consulting Editors:
Marian Deegan, JD
Courtnay Londo, MA
Jane Myers, MA, EdM  
Assistant Managing Editor:
Liv Augusta Anderson, MPP
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
NCIRD: National Center for Immunization and Respiratory Diseases
VIS: Vaccine Information Statement
WHO: World Health Organization
 
- Guide to immunize.org -
A-Z INDEX
ABOUT IAC
ACIP RECOMMENDATIONS
ADDITIONAL RESOURCES
ADULT VACCINATION
ADULT VACCINATION GUIDE
ASK THE EXPERTS
Combination Vaccines
Diphtheria
Hepatitis A
Hepatitis B
Vaccine Storage and Handling
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BECKY PAYNE AWARD
BILLING & CODING
BIRTH DOSE GUIDEBOOK
CALENDAR OF EVENTS
CDC INFORMATION
CDC SCHEDULES
CLINIC TOOLS
Administering Vaccines
Adult Vaccination
Documenting Vaccination
Scheduling Vaccination
Screening for Contraindications
Storage & Handling
Vaccine Recommendations
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COALITIONS
CONTRIBUTE TO IAC
DEAR COLLEAGUE LETTER
HPV VACCINE
DEAR COLLEAGUE LETTER
MCV4 DOSE #2
DISEASES & VACCINES
Diphtheria
Hepatitis A
Hepatitis B
Influenza
Varicella
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DONATE TO IAC
EMAIL NEWS SERVICES
EDUCATIONAL MATERIALS
EXEMPTIONS
FAQs
FAVORITES (WEB SECTIONS)
FDA PRODUCT APPROVALS
GIVE BIRTH TO THE END OF
HEP B
HANDOUTS FOR PATIENTS &
STAFF
Administering Vaccines
Adult Vaccination
Documenting Vaccinations
Managing Vaccine Reactions
Parent Handouts
Patient Schedules
Questions & Answers
Recommendations
Screening Checklists
Standing Orders
Storage & Handling
Talking with Parents
Temperature Logs
Top Handouts
Translations
Vaccine Index
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HEPATITIS B BIRTH DOSE
HONOR ROLLS
HepB Birth Dose
Influenza Vaccination for HCP
IAC EARLY YEARS VIDEO
IAC EXPRESS
IMAGES
IMMUNIZATION TECHNIQUES
DVD
LAMINATED SCHEDULES
LAWS AND MANDATES
MANUFACTURERS
NATIONAL ADULT & INFLUENZA IMMUNIZATION SUMMIT
NEWS & INFORMATION
OFFICIAL RELEASES
ACIP
CDC
FDA
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PACKAGE INSERTS
PARTNERS
PAYNE AWARD
PHARMACISTS
PHOTOS
POWERPOINT SLIDE SETS
PRESS ROOM
PROTECT NEWBORNS
FROM HEP B
PUBLICATIONS
IAC Express
Vaccinating Adults:
   A Step-by-Step Guide
REGISTRIES
RESOURCE DIRECTORY
SHOP IAC
Immunization Techniques DVD
Laminated Schedules
Patient Record Cards
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SITE MAP
SLIDE SETS
STANDING ORDERS TEMPLATES
STATE INFORMATION
State Websites
State Laws
State Immunization Managers
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SUBSCRIBE
SUPPORT IAC
TECHNICALLY SPEAKING
TIMELINE FOR VACCINES
TRANSLATE FOR IAC
TRANSLATIONS OF VISs
TRAVEL (INTERNATIONAL)
UNPROTECTED PEOPLE REPORTS
Chickenpox
Diphtheria
Hepatitis A
Hepatitis B
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VACCINATING ADULTS: A STEP-BY-STEP GUIDE
VACCINE CONCERNS
Adjuvants & Ingredients
Alternative Medicine
Autism
Importance of Vaccination
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VACCINE INFORMATION STATEMENTS
Translations
Vaccine Index
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VACCINE MANUFACTURERS
VACCINE POLICY & LICENSURE
ACIP
FDA
WHO
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VACCINE SAFETY
VACCINE TIMELINE
VACCINES & DISEASES
VIDEO ABOUT IAC EARLY YEARS
VIDEOS (VIDEO OF THE WEEK)
WHAT'S NEW OR UPDATED AT IAC
Handouts
VISs and Translations
Web Sections
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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.