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Issue 1432
Issue 1432: June 26, 2019


TOP STORIES


FEATURED RESOURCES

 
JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


Total number of U.S. measles cases for 2019 climbs to 1,077 with 33 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 1,077 cases across 28 states as of June 20. 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:

Related Links

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CDC notifies partners and providers of MMR vaccination recommendations for international travelers and for people living in or traveling domestically to areas with ongoing measles outbreaks in the U.S.

CDC sent by email the following letter to partners and providers on June 17:

Dear Partners and Providers,

Measles cases continue to climb in the United States. The current outbreak began with importations into under-vaccinated communities by U.S. residents returning from international travel. With summer travel season here, the Centers for Disease Control and Prevention (CDC) would like to remind you of the MMR vaccination recommendations for international travelers and persons living in or traveling domestically to areas with ongoing measles outbreaks and community-wide transmission.

INTERNATIONAL TRAVEL

The MMR vaccination recommendations for international travel have not changed.

Infants under 12 months old

  • Get an early dose at 6–11 months
  • Follow the recommended schedule and get another dose at 12–15 months and a final dose at 4–6 years

Children over 12 months old

  • Get first dose immediately
  • Get second dose 28 days after first dose

Teens and adults with no evidence of immunity*

  • Get first dose immediately
  • Get second dose 28 days after first dose

* Acceptable presumptive evidence of immunity against measles includes at least one of the following: written documentation of adequate vaccination, laboratory evidence of immunity, laboratory confirmation of measles, or birth in the United States before 1957.

Patients who need MMR vaccine should be fully vaccinated at least 2 weeks before departure. If the trip is less than 2 weeks away, and the patient is not protected against measles, give him/her a dose of MMR vaccine. Two doses of MMR vaccine provide 97% protection against measles; one dose provides 93% protection.

DOMESTIC TRAVEL TO OUTBREAK AREAS

CDC’s MMR vaccination recommendations for persons residing in or visiting domestic measles outbreak areas within the U.S. have also not changed. You should ensure that people who live in and are traveling to areas in the U.S. where there is ongoing, community-wide transmission of measles are up to date on MMR vaccine. To decide whether to vaccinate an infant visitor less than 12 months of age, follow local health department guidance for the affected area (e.g., if no recommendation was made to vaccinate infant residents, do not vaccinate infant visitors).

Certain areas of New York (state and city) are experiencing large on-going outbreaks, and they have issued guidance for individuals who will spend time in certain communities.

Thank you for your continued efforts to protect your communities from measles. For more measles outbreak resources, visit our toolkit [Measles Outbreak Toolkit for Healthcare Providers]. We will soon be adding new resources to that toolkit, including a poster to use in provider offices with travel recommendations for MMR vaccine, as well as short videos with examples of who needs MMR vaccine when, and an interactive MMR vaccine recommendations quiz.

Related Links

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FDA issues Public Health Alert concerning hepatitis A virus contamination of Kroger brand frozen blackberries and Costco Kirkland Signature Brand Three Berry Blend

The Food and Drug Administration (FDA) recently issued a Public Health Alert on June 12 concerning hepatitis A virus contamination of Kroger's Private Selection brand of frozen blackberries and Costco's Kirkland Signature Brand Three Berry Blend. Townsend Farms is the supplier of these frozen blackberry products.

So far, the FDA and CDC have not been made aware of any hepatitis A cases among consumers, but symptoms of the disease can be delayed. The FDA recommends that anyone who has consumed these products and who has not been vaccinated against hepatitis A should consult with their healthcare professional.


Read the FDA full press release, which provides further details about recalled items and recommendations for consumers: Public Health Alert Concerning Hepatitis A Virus Contamination of Kroger Brand Frozen Blackberries and Costco Kirkland Signature Brand Three Berry Blend

Related Links

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CDC publishes report on influenza activity in the U.S. during the 2018–19 season and the composition of the 2019–20 influenza vaccine in this week’s MMWR

CDC published Update: Influenza Activity in the United States during the 2018–19 Season and Composition of the 2019–20 Influenza Vaccine in the June 21 issue of MMWR. A summary made available to the press is reprinted below.

The 2018–19 influenza season in the United States was of moderate severity and lasted 21 weeks, making it the longest season in 10 years. Influenza vaccination is the best way to reduce the risk of influenza and its potentially serious consequences, including hospitalizations in adults and deaths in children. Influenza antiviral medications are an important adjunct to vaccination in the treatment and prevention of influenza. U.S. influenza-like illness activity began increasing in November 2018, peaked during mid-February, and returned below baseline in mid-April 2019. Influenza A viruses predominated with very little influenza B activity. Two waves of influenza A were notable during this extended season: A(H1N1)pdm09 from October 2018 to mid-February 2019 and A(H3N2) from February through May 2019. Compared to the 2017–18 season, hospitalization rates were lower among adults but higher among children. The majority of A(H1N1)pdm09 and influenza B viruses characterized antigenically and genetically were similar to recommended Northern Hemisphere 2018–2019 cell grown vaccine reference viruses; however, the majority of A(H3N2) viruses were antigenically distinct from the vaccine virus, prompting a change to the 2019–20 Northern Hemisphere A(H3N2) vaccine component to an A/Kansas/14/2017 (H3N2)-like virus.

Access the complete report: Update: Influenza Activity in the United States during the 2018–19 Season and Composition of the 2019–20 Influenza Vaccine


Related Link

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

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IAC Spotlight! Explore IAC’s “Ask the Experts” web section for answers to more than 1,000 Q&As from CDC experts about vaccine recommendations, administration, storage and handling, scheduling, and more 

IAC’s Ask the Experts web section is a compilation of common as well as challenging questions and answers (Q&As) about vaccines and their administration. William Atkinson, MD, MPH, IAC's associate director for immunization education, manages this web section, with answers provided by experts from CDC's National Center for Immunization and Respiratory Diseases, including Andrew T. Kroger, MD, MPH; Mark S. Freedman, DVM, MPH, DACVPM; Tina S. Objio, MSN, MHA, RN; Candice L. Robinson, MD, MPH; Raymond A. Strikas, MD, MPH, FACP, FIDSA; and JoEllen Wolicki, BSN, RN.    

The "Ask the Experts" index page can be found at www.immunize.org/askexperts. Here you will find more than 1,000 Q&As on all vaccines routinely recommended in the United States, as well as information on such topics as administering vaccines, documenting vaccination, scheduling vaccines, vaccine recommendations, precautions and contraindications, storage and handling, travel vaccines, billing and reimbursement, and vaccine safety. 

Here are links to some of our most popular pages within the "Ask the Experts" web section:

Explore all IAC's "Ask the Experts" Q&As by clicking on the graphic below and bookmarking this valuable resource.



New and updated "Ask the Experts" questions and answers are emailed to IAC Express subscribers five times per year. You can access the four most recent IAC Express "Ask the Experts" sets of Q&As from the main web page of Ask the Experts in the far-right column.

If you have a question about vaccination that is not covered in the "Ask the Experts" web section, feel free to email it to us at admin@immunize.org.

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Washington Post reports on a foundation that has contributed more than 3 million dollars to anti-vaccine groups in recent years

The Selz Foundation, funded by philanthropists Bernard and Lisa Selz, has provided more than $3 million in the past three years to groups that spread misinformation about vaccines. During this period, the foundation's largest anti-vaccination expenditure went to the Informed Consent Action Network, which advocates for parental choice in vaccines and spreads anti-vaccination messaging. Receiving three-fourths of its income from the Selz Foundation has made the Informed Consent Action Network into the highest-funded anti-vaccine organization in the U.S. The chief executive and public face of the Selz Foundation, Del Bigtree, who has no medical credentials, has been touring the country to speak publicly in areas with large measles outbreaks, such as Brooklyn and Rockland County, and also has been presenting a weekly live-stream broadcast.

Read the full Washington Post story: Meet the New York Couple Donating Millions to the Anti-Vax Movement (6/19/19)

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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 us at 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.

Related Links

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IAC's comprehensive Vaccinating Adults: A Step-by-Step Guide is available for free download either by chapter or in its entirety (142 pages)

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 Guide is available to download/print either by chapter or in its entirety free of charge at www.immunize.org/guide. The downloaded version is suitable for double-sided printing. The National Vaccine Program Office and CDC both supported the development of the Guide and provided early technical content review.

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

Related Links

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JOURNAL ARTICLES AND NEWSLETTERS


Vaccine Education Center at Children's Hospital of Philadelphia publishes June 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 June issue includes the following articles:

Additional resources are available in the full newsletter.

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

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Two studies find rotavirus vaccine administration may be linked to reduction in type 1 diabetes in children

Two studies, one conducted in Australia and one in the U.S., have found that rotavirus vaccination is associated with reduced incidence of type 1 diabetes in children.

Access the two studies: 

Related Links

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CDC publishes “Trends in the Laboratory Detection of Rotavirus before and after Implementation of Routine Rotavirus Vaccination—United States, 2000–2018” in this week’s MMWR

CDC published Trends in the Laboratory Detection of Rotavirus before and after Implementation of Routine Rotavirus Vaccination—United States, 2000–2018 in the June 21 issue of MMWR. A summary made available to the press is reprinted below.

Rotavirus vaccination has dramatically reduced U.S. disease burden and altered seasonal patterns. Improving coverage and on-time rotavirus vaccination of children is critical to maximize public health benefit. Rotavirus, a common cause of gastroenteritis in young children, is preventable with vaccines used in the United States since 2006. CDC analyzed laboratory testing data for rotavirus collected through national surveillance during the pre-vaccine (2000–2006) and post-vaccine (2007–2018) periods. In the post-vaccine period, we observed a decline in annual rotavirus tests; the annual peak in positive tests declined and the rotavirus season was shorter. A biennial rotavirus seasonal pattern emerged with alternating years of low and high disease activity. Rotavirus vaccination has dramatically reduced the disease burden. Peak rotavirus activity declined by more than two thirds, from an annual median of 43.1% in the pre-vaccine era to 14.0% in the post-vaccine era; and peak season was shortened from 26 weeks to 9 weeks. These changes have been sustained over 11 post-vaccine–introduction seasons. To maximize the public health impact, efforts to improve coverage and on-time rotavirus vaccination should continue.

Access the complete article: Trends in the Laboratory Detection of Rotavirus before and after Implementation of Routine Rotavirus Vaccination—United States, 2000–2018

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EDUCATION AND TRAINING


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

Register for CDC's 15-part, live CE-accredited series of 1-hour webinars designed 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"). Topics include specific vaccines and the diseases they prevent, general recommendations for vaccines, vaccination principles, and immunization strategies for providers.  

All sessions begin at 12:00 p.m. (ET). This series began on June 5 and will run through September 25, 2019. The next two webinars are scheduled as follows:
  • July 10: Immunization Strategies
  • July 17: Vaccine Storage and Handling and Administration and Vaccine Administration
Recordings of sessions will be available online within 2 weeks after each webinar.  

Information on registration and program details 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.
 

CONFERENCES AND MEETINGS

Washington State Immunization Summit, hosted by WithinReach and WA State Department of Health, to take place on October 8

The second annual Washington State Immunization Summit will take place on October 8 in Lynnwood, WA. WithinReach and Washington State Department of Health are co-hosting the summit. The 2019 summit will focus on the measles outbreak, vaccination schedule updates, communicating about vaccines, working with special and at-risk populations, and the Washington State Immunization Information System.

View additional information and register for the summit on the event's website.

Related Link

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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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Editor:
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Managing Editor:
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Jane Myers, MA, EdM  
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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
NCIRD: National Center for Immunization and Respiratory Diseases
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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.