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2019 Issues
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Issue 1440
Issue 1440: August 14, 2019


TOP STORIES


OFFICIAL RELEASES AND ANNOUNCEMENTS


WORLD NEWS


FEATURED RESOURCES


EDUCATION AND TRAINING


CONFERENCES AND MEETINGS

 


TOP STORIES


“Dear Colleague” letter stressing importance of 16-year-old immunization visit has been signed by AAFP, AAP, ACHA, ACOG, APhA, SAHM, and IAC          

On August 1, IAC and six professional societies published a "Dear Colleague" letter titled 16-Year-Old Patients: Make Sure They Receive Their Annual Well Visit and Vaccinations. Selections from this call-to-action letter are reprinted below.

Dear Colleague:

The American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), American College Health Association (ACHA), American College of Obstetricians and Gynecologists (ACOG), American Pharmacists Association (APhA), Society for Adolescent Health and Medicine (SAHM), and Immunization Action Coalition (IAC) urge you and your fellow healthcare professionals to make sure that your patients who are 16 years of age receive the vaccines that are recommended for them in accordance with the
Recommended Child and Adolescent Immunization Schedule for ages 18 years or younger, United States, 2019, approved by AAFP, AAP, ACOG, and CDC....

Immunization coverage rates for several adolescent vaccines are poor

According to data from CDC, coverage rates for several recommended adolescent vaccinations are quite low. For example:

  • The coverage rate for the second (booster) dose of quadrivalent meningococcal conjugate vaccine (MenACWY), which is recommended at age 16, was only 44% by the 18th birthday.
  • Human papillomavirus (HPV) vaccine coverage for ≥1 dose among all adolescents was only 66% (69% for females; 63% for males); and only 49% of all adolescents were fully vaccinated with a complete series (53% for females; 44% for males).
  • Less than half (47%) of adolescents age 13–17 years had received influenza vaccine....

Vaccination at age 16 years has been highlighted on the U.S. Immunization Schedule

Beginning in 2017, the official U.S. immunization schedule implemented a significant format change by creating a stand-alone column for age 16 years. Like the 4–6 years and 11–12 years columns, it is highlighted by a gray-shaded heading. The “16 year” age column was also separated out from the previous “16–18 year” age range to highlight the need for the recommended MenACWY 2nd dose at age 16 years.

Along with MenACWY at age 16, influenza vaccine (seasonally) is recommended. In addition, vaccination with meningococcal serogroup B vaccine (MenB) is recommended for individual clinical decision making. Focusing on a 16-year-old visit also allows catch-up on vaccine doses for adolescents who may have fallen behind on vaccines such as HPV, Tdap, and others....


Access the complete "Dear Colleague" letter: 16-Year-Old Patients: Make Sure They Receive Their Annual Well Visit and Vaccinations.

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Join us TODAY, August 14, at 1:00 p.m. (ET)! Dr. Sharon G. Humiston, IAC's associate director for research, will present a webinar on adolescent immunization and the 16-year platform 

Join Sharon G. Humiston, MD, MPH, FAAP, IAC's associate director for research, for a 1-hour webinar titled "Adolescent Immunization Update and the 16-Year-Old Platform" TODAY, August 14, at 1:00 p.m. (ET). During her presentation, Dr. Humiston will review the “need-to-know” facts of adolescent immunization, including the recommendations for adolescent vaccination at 11–12 years of age and those at age 16. 

Click here to register now!

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New powerful tools, quick navigation, beautiful design: Visit Give2MenACWY.org to enhance your efforts at increasing MenACWY booster dose rates and other adolescent vaccines

On August 7, IAC announced a major upgrade to its collaborative website promoting the importance of receiving a booster dose of meningococcal ACWY (MenACWY) vaccine.

 

Aimed at healthcare professionals, the site has been revised to incorporate newly updated materials and to highlight the importance of all recommended vaccines for 16-year-olds. A simplified navigation structure makes locating information a breeze.
 
The colorful new Give2MenACWY.org website is divided into five easy-to-access sections: 

  • Vaccinate Teens – The tools included on this web page offer helpful information on teen vaccination schedules and tips for improving adolescent immunization rates.
  • Give 2 Doses – Fewer than half of teens have received the recommended second dose of MenACWY vaccine. This web page offers tools to help providers improve second dose coverage.
  • 16-Year-Old Visit – These resources help both providers and their patients remember the important vaccines recommended for 16-year-olds.
  • Tools for Providers – These tools from CDC, IAC, and other organizations explain meningococcal ACWY vaccine recommendations and assist in improving adolescent coverage for all recommended vaccines.
  • Resources – This section contains a wealth of information to assist provider efforts to improve adolescent immunization rates. The materials are subdivided into subsections for print materials, links to organizations involved in adolescent immunization, personal stories about the importance of vaccination, and additional resources of interest. 

Additional time savings are provided by the site’s single location where all website materials are listed according to whether they are primarily of interest to providers or to patients/parents. Other sections relate to general adolescent immunization, as well as meningococcal disease and vaccine information.
 
Visit Give2MenACWY.org and enjoy browsing (and hopefully deploying) its terrific resources, brought to you by our collaboration with Sanofi Pasteur.
  
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August is National Immunization Awareness Month; promote vaccination with CDC resources

August is National Immunization Awareness Month (NIAM). This annual observance highlights the efforts of healthcare professionals to protect patients of all ages against vaccine-preventable diseases through on-time vaccination.

CDC’s NIAM web page includes two toolkits, one for communicating with healthcare professionals and the other for communicating with parents and patients. Each includes key messages, sample social media content, and educational resources.

CDC has provided the following four messages for NIAM, with accompanying graphics for social media.





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Total number of U.S. measles cases for 2019 reaches 1,182 with 10 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 1,182 cases across 30 states as of August 8. 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. CDC has provided the following summary:

  • Measles can cause serious complications. As of August 8, 2019, 124 of the people who got measles this year were hospitalized, and 64 reported having complications, including pneumonia and encephalitis.
  • The majority of cases are among people who were not vaccinated against measles.
  • More than 75% of the cases this year are linked to outbreaks in New York and New York City. Measles is more likely to spread and cause outbreaks in U.S. communities where groups of people are unvaccinated.
  • All measles cases this year have been caused by measles wild-type D8 or B3.

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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July's Technically Speaking column by IAC Executive Director Dr. Deborah Wexler is titled "ACIP updates its guidance on the use of HPV, PCV13, HepA, HPV, and MenB vaccines at June 26–27 meeting"
 
Technically Speaking is a monthly column written by IAC Executive Director Dr. Deborah Wexler for Vaccine Update, a monthly e-newsletter from the Vaccine Education Center (VEC) at Children's Hospital of Philadelphia (CHOP). The column covers practical topics in immunization, such as vaccine administration, immunization scheduling, vaccine storage and handling, and vaccine recommendations.

July's column is titled ACIP Updates Its Guidance on the Use of HPV, PCV13, HepA, HPV, and MenB Vaccines at June 26–27 Meeting and is reprinted below.

ACIP Updates Its Guidance on the Use of HPV, PCV13, HepA, HPV, and MenB Vaccines at June 26–27 Meeting
Published July 2018

The Advisory Committee on Immunization Practices (ACIP) met in Atlanta on June 26–27, 2019.

During the meeting, several topics were discussed for informational purposes only. Specifically, the Committee received an update on the current measles outbreak in the United States, discussed updated safety data on recombinant zoster vaccine (Shingrix, GSK), considered future policy options for use of tetanus-diphtheria-pertussis (Tdap) vaccine, and reviewed dengue epidemiology and Dengvaxia (Sanofi) Phase III clinical trials.

In addition, ACIP broke a single-meeting record by taking 18 separate votes during the June meeting, encompassing 11 votes on five different vaccines and seven votes related to inclusion of specific vaccines into the Vaccines For Children (VFC) program. These individual votes are highlighted below.

Human Papillomavirus Vaccine (HPV)

ACIP approved two new recommendations for use of HPV vaccine (Gardasil-9, Merck).

  • Harmonization of upper age limit for routine catch-up vaccination of males and females: The current HPV recommendation calls for routine catch-up vaccination of females through age 26 and males through age 21, though males with risk factors or who want to be protected may be vaccinated through age 26. ACIP voted unanimously to harmonize the routine catch-up vaccination schedule for both males and females through age 26. 
     
  • Shared clinical decision making* for vaccination of persons age 27 through 45 years: In a split (10 to 4) vote, ACIP approved vaccination of persons age 27–45 years based on "shared clinical decision making" between the patient and clinician. Members in support of the recommendation noted this option offers providers case-by-case flexibility and allows potential insurance coverage for HPV vaccine in this age group.

*Shared clinical decision making means the decision to vaccinate persons age 27 through 45 years should be based on a discussion of benefits and risks between the patient and the clinician.

Pneumococcal Conjugate Vaccine for Immunocompetent Older Adults

When the pneumococcal conjugate vaccine (PCV13, Prevnar 13, Pfizer) recommendation for adults age >65 years was initially passed in 2014, ACIP recommended that all immunocompetent adults in this age group receive a dose of PCV13, followed by a dose of pneumococcal polysaccharide vaccine (PPSV23, Pneumovax 23, Merck) at least one year later. At the time this was approved, Committee members requested the recommendation be revisited after several years to examine the indirect impact of childhood PCV13 immunization on the rates of invasive pneumococcal disease in adults. Due to high rates of childhood immunization resulting in decreased transmission of vaccine-containing serotypes, available data indicate the anticipated impact from continued PCV13 use in older adults is minimal.

ACIP took three separate votes in the process of agreeing on the final recommendation. After the majority of committee members failed to approve policy options to (1) continue the current recommendation of PCV13 followed by PPSV23 or (2) eliminate the PCV13 recommendation in this age group entirely, the committee approved (in a 13 to 1 vote) the following recommendation:

  • Shared clinical decision making*: ACIP recommends PCV13 based on shared clinical decision making for adults 65 years and older who do not have an immunocompromising condition** and who have not previously received PCV13. All adults 65 years and older should receive a dose of PPSV23.

* Shared clinical decision making means the decision to vaccinate persons age 65 years and older who are not at high risk for invasive pneumococcal diseases should be based on a discussion of benefits and risks between the patient and the clinician.

** Immunocompromising conditions are defined as chronic renal failure, nephrotic syndrome, immunodeficiency, iatrogenic immunosuppression, generalized malignancy, HIV, Hodgkin disease, leukemia, lymphoma, multiple myeloma, solid organ transplants, cochlear implants, CSF leaks, congenital or acquired asplenia, sickle cell disease, or other hemoglobinopathies.

Of note, the recommendations for vaccination of adults at high risk of invasive pneumococcal disease (MMWR, Vol. 61, No. 40, pages 816–819) have not changed.

Hepatitis A Vaccine

Unlike in the pre-vaccine era, when hepatitis A virus (HAV) transmission was most often associated with asymptomatic children, recent outbreaks have primarily affected adults. Although sporadic foodborne outbreaks occur, person-to-person spread is now the dominant mode of HAV transmission. In addition, persons with HIV are recognized to have increased HAV infection severity.

In recognition of this changing epidemiology, ACIP unanimously approved the following recommendations for use of hepatitis A vaccine:

  • Catch-up vaccination of children and adolescents: ACIP recommends that all children and adolescents age 2 through 18 years who have not previously received hepatitis A vaccine be vaccinated at any age (i.e., children and adolescents are recommended for catch-up vaccination).
     
  • Vaccination of persons with HIV infection: ACIP recommends that all persons with HIV age >1 year be vaccinated with hepatitis A vaccine.
     
  • Updated hepatitis A vaccine recommendations to be published: ACIP affirms the updated statement "Prevention of Hepatitis A Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices."

When the updated hepatitis A vaccine recommendations are published in Morbidity and Mortality Weekly Report (MMWR), they will include guidance related to consideration of pre-vaccination testing for certain populations expected to have high rates of previous HAV infection (pre-vaccination testing is not recommended for the general population) and post-vaccination testing of persons whose subsequent clinical management depends on knowledge of their immune status, such as persons with HIV infection and other immunocompromised persons. The publication also will incorporate changes to the list of high-risk persons for hepatitis A infection, specifically (1) persons with clotting factor disorders will be removed from this listing (changes in clotting factor preparation practices and donor screening have greatly reduced the risk for hepatitis A for clotting factor recipients) and (2) pregnant women and persons with chronic liver disease will be added. Finally, the updated MMWR will contain guidance on handling interrupted schedules, minimum dosing intervals, and other immunization management issues and considerations.

Meningococcal B Vaccine (MenB)

When ACIP initially passed a recommendation for meningococcal B vaccine (MenB) for persons at increased risk of infection, the committee did not recommend booster doses for persons who remain at increased risk or who are at risk in an outbreak setting. Since that time, additional data has indicated waning immunity 1–2 years following primary MenB vaccination and a robust immune response following receipt of a booster dose. Armed with this new information, ACIP unanimously approved the following recommendations:

  • Booster doses for persons at increased risk
     
    • Persons with certain conditions and microbiologists: For persons >10 years with complement deficiency, complement inhibitor use, asplenia, or who are microbiologists, ACIP recommends a MenB booster dose 1 year following completion of a MenB primary series followed by MenB booster doses every 2–3 years thereafter, for as long as increased risk remains.
       
    • During an outbreak: For persons age >10 years determined by public health officials to be at increased risk during an outbreak, ACIP recommends a one-time booster dose if it has been >1 year since completion of a MenB primary series. A booster dose interval of >6 months may be considered by public health officials depending on the specific outbreak, vaccination strategy, and projected duration of elevated risk.
       
  • Updated MenB recommendations to be published: ACIP affirms the updated statement "Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices."
     
    • When published, this updated statement will include the new booster recommendations and will incorporate all existing ACIP recommendations for MenACWY and MenB vaccines into a single document.
       
    • An important change in wording will be included in the updated ACIP statement. Previous "Category B" language for MenB primary vaccination in adolescents will be modified to state "ACIP recommends a MenB primary series for individuals aged 16–23 years based on shared clinical decision making." This distinction clarifies the importance of the provider and patient discussing and deciding together whether MenB vaccine should be given to the patient.
       
    • A final change incorporated with the updated statement’s publication will be removal of the current appendices that provide guidance on chemoprophylaxis of close contacts and management of outbreaks.

Influenza Vaccine

ACIP discussed vaccine availability and updated guidance for the 2019–2020 influenza season and unanimously approved the following recommendation:

  • Updated influenza vaccine statement to be published: ACIP affirms the updated statement "Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2019–20 Influenza Season."

The new statement will include information about vaccine licensure changes and a new table highlighting the dose volume differences between the four inactivated influenza vaccine preparations expected to be available for children age 6 through 35 months. In addition, updated guidance will outline optimal timing for vaccination, groups that should be the focus of efforts if vaccine supply is limited, clarification on the number of vaccine doses needed for 8-year-olds who have their ninth birthday before receipt of a recommended second dose of vaccine, and concomitant receipt of two vaccines containing novel adjuvants.

Vaccines For Children (VFC) Program Resolutions

ACIP unanimously approved 7 resolutions to include specific vaccines in the VFC program and to encompass updated ACIP recommendations. The resolutions do not alter the vaccine recommendations themselves.

  • Combination Pediatric Hexavalent Vaccine (4 resolutions): Although Vaxelis (DTaP-IPV-Hib-HepB, Merck-Sanofi) is not expected to reach the U.S. market until 2021, ACIP is supportive of its inclusion as an available option in the VFC program. This required four separate resolutions for each vaccine component, i.e., DTaP, polio, Hib, and hepatitis B.
     
  • Influenza: The purpose of this resolution is to update the table of inactivated influenza vaccines in the VFC Program.
     
  • Hepatitis A: The purpose of this resolution is to streamline the Recommended Vaccination Schedule and Intervals section, update the language related to catch-up vaccination, add information about the accelerated Twinrix (HepA-HepB, GSK) schedule, clarify the timing of vaccine and immunoglobulin receipt, and remove pregnancy as a precaution.
     
  • Meningococcal B: The purpose of this revision is to update the resolution to reflect (a) currently available meningococcal conjugate vaccines and (b) new recommendations for booster doses for serogroup B meningococcal vaccines. In addition, the language regarding the intervals for one of the serogroup B vaccines covered by the resolution has been updated to more closely reflect the current ACIP recommended language.

All recommendations approved by ACIP are provisional until they are approved by the CDC director and published in MMWRPresentation slides from the June meeting are posted on the ACIP website.

CDC Additional Information

You can access the current and past issues of Technically Speaking in the following ways: from a box in the middle of the immunize.org home page, from the "Guide to immunize.org" at the bottom of every web page, or by going directly to the www.immunize.org/technically-speaking main page

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IAC Spotlight! IAC's Clinic Tools: Documenting Vaccinations web page provides resources from IAC, CDC, and other organizations

IAC's Clinic Tools: Documenting Vaccinations web page on immunize.org is a collection of resources from IAC, CDC, and other organizations. This web page can be found by selecting the "Clinic Tools" tab (third from the left) in the blue banner across the top of every immunize.org web page and then selecting "Documenting Vaccinations" in the drop-down menu.

In the left-hand column of the page, you will find IAC's educational materials related to documenting vaccines, such as Vaccine Administration Record for Children and TeensVaccine Administration Record for Adults, and Current Dates of Vaccine Information Statements (VISs), as well as screening checklists and declination forms.



The right-hand column of the page features resources from CDC, including links to ACIP recommendations, General Best Practice Guidelines for Immunization, and the Pink Book, as well as some resources from other organizations.

Visit the Clinic Tools: Documenting Vaccinations page on immunize.org.

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Register for the 2019 National Conference for Immunization Coalitions and Partnerships by August 31 to receive the discounted rate; conference to take place November 13–15 in Honolulu

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

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

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OFFICIAL RELEASES AND ANNOUNCEMENTS


State of Florida declares a public health emergency in response to hepatitis A outbreak

On August 1, the Florida Department of Health issued a press release titled Florida Surgeon General Scott A. Rivkees Issues Public Health Emergency in Response to Hepatitis A Outbreak. Selections from the press release are reprinted below.

Today, Florida Surgeon General Dr. Scott Rivkees declared a Public Health Emergency to address the increase in Hepatitis A cases in Florida due to the current national outbreak. The declaration builds upon the Public Health Advisory that was issued by the Florida Department of Health (FDOH) on November 18, 2018 and reemphasizes the importance of the Hepatitis A vaccination as the best way to prevent Hepatitis A infection.

To provide information to the public, FDOH has launched a dedicated webpage for Hepatitis A: FloridaHealth.gov/hepa. On this page, visitors can find general information, frequently asked questions, and surveillance data from FDOH, as well as fact sheets for the general public, health care providers, and food service workers. For questions about Hepatitis A, the department has also established a dedicated email address: HepA@flhealth.gov, and information line: 1-844-CALL-DOH (1-(844) 225-5364), available Monday–Friday, 8 a.m.–5 p.m....

While anyone can contract hepatitis A, individuals who are considered by the CDC and FDOH to be high risk include: those who are experiencing homelessness; intravenous and non-intravenous drug users; men who have sex with other men; individuals in an emergency room or other acute care setting, after being administered an opioid antagonist, such as naloxone; individuals working with homeless persons or intravenous drug users outside of health care settings; and first responders....


Read the complete document: Florida Surgeon General Scott A. Rivkees Issues Public Health Emergency in Response to Hepatitis A Outbreak.

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WORLD NEWS


WHO summarizes the 2018–2019 influenza season in the northern hemisphere in this week's Weekly Epidemiological Record

The World Health Organization (WHO) published a report titled Review of the 2018–2019 Influenza Season in the Northern Hemisphere in the August 9 issue of the Weekly Epidemiological Record. A selection from the article is reprinted below.

In the North American subregion (Canada and the United States of America [USA]), the timing of this season was generally similar to that of previous seasons. Influenza activity started to increase in early November 2018 and peaked in early February to mid-March of 2019. Activity began to decrease in late March but remained above inter-seasonal levels through mid-April, longer than in previous seasons. Influenza activity was still above inter-seasonal levels in mid-May.

Influenza A viruses predominated in the North American subregion during this influenza season, accounting for 96% and 95–96% of influenza-positive samples in Canada and the USA, respectively....


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FEATURED RESOURCES


New! “FLU VACCINE” buttons and stickers now available for purchase from IAC

Start your preparations for the 2019–20 influenza season by ordering IAC's new “FLU VACCINE” buttons and stickers from SHOP IAC. These new resources are modeled after “I Voted” stickers, which are given to voters in many states as they leave the polls on Election Day. The flu vaccine buttons and stickers are bright red to help broadcast your important vaccination message. And the cost is low!



“FLU VACCINE” BUTTONS

Demonstrate your clinic-wide support for protecting everyone from influenza by purchasing buttons for all staff to wear. Measuring 1.25" across, the button is understated in size but carries a bold message! Brightly colored red, round button with white text and a metal pin that clasps on the back.

Pin on your lab coat, uniform, other clothing, tote bag, or backpack to show support for influenza vaccination. Wear it when flu vaccine is available in your clinic to remind patients and the public to protect themselves from influenza.
 
Buttons are delivered in bags of 10 buttons per bag. Click here for pricing and ordering.

“FLU VACCINE” STICKERS
 
These brightly colored red, round stickers measure 1.5" across. Printed on Avery labels, they adhere well to clothing and have an easy-peel-off back.
 
Wearing these brightly colored stickers, your patients will be letting their communities know that influenza vaccination is important.

Suitable for clinic staff, too! Urge all staff to wear them at work during flu vaccination season. This sends a powerful reminder to patients to get vaccinated.
 
Stickers are delivered to you cut individually (not on rolls)—available in bundles of 100. Click here for pricing and ordering information.

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CDC makes its web section for parents more user-friendly

CDC recently redesigned its vaccine web content for parents. The concise pages with engaging visuals are designed to be viewed on mobile devices. The updates encourage parents to discover and share information; for example, the Making the Vaccine Decision section addresses common concerns of parents-to-be and new parents. Before a well-child visit, parents can visit Vaccines by Age to quickly learn which vaccines are recommended for their child.

Visit the redesigned Vaccines for Your Children website, and share the link with parents.



The redesign is based on user experience science and usability test results. The CDC webmaster would appreciate feedback about the site; email NCIRDwebteam@cdc.gov.

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CDC shares its new “Basics of IISs” infographic

CDC has posted a “Basics of IISs” infographic that you can download from the Immunization Information Systems (IIS) website at www.cdc.gov/vaccines/programs/iis/index.html. You can also access the infographic directly as a PDF by clicking on the graphic below.



“Basics of IISs” provides an overview of how IISs support and connect patients/consumers, healthcare professionals, and public health. It provides a simple visual introduction to how IISs work for people who may not be familiar with IISs, such as policy makers, healthcare professionals, patients, parents, and even public health staff. 

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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 review.

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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EDUCATION AND TRAINING


Immunize Nevada to offer August 20 webinar titled "MMR Recommendations During the 2019 U.S. Measles Outbreaks"
 
Immunize Nevada will host a 1-hour webinar titled MMR Recommendations During the 2019 U.S. Measles Outbreaks on August 20 at 12:30 p.m. (PT). Andrew Kroger, MD, MPH, medical officer, National Center for Immunization and Respiratory Diseases, CDC, will be the presenter.

Register for the webinar

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American College of Physicians to offer webinar series about adult vaccination on August 23, September 12, and September 23 

The American College of Physicians (ACP) will offer a webinar series as part of their fall immunization campaign. Join one or all of these sessions to learn more about adult immunization. 
Click on the links above to register for any of the sessions. You will need to register for each webinar individually. 

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Alliance for Aging Research's August 27 webinar will explore why vaccination has been a low priority item in Medicare Annual Wellness Visits, and ways to change this

The Alliance for Aging Research is sponsoring a 1-hour webinar on August 27 at 11:00 a.m. (ET) titled Why are discussions about prevention through vaccination a low priority at the Medicare Annual Wellness Visit, and what can be done to fix this? A recent survey commissioned by the Alliance for Aging Research, and distributed to primary care physicians and nurse practitioners online, found that vaccine discussions are a low priority at the Medicare Annual Wellness Visit, and that more education is needed to overcome barriers. 

Registration information

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NACCHO to offer August 28 webinar about mumps in detention facilities

The National Association of County and City Health Officials (NACCHO) will offer a 1-hour webinar on August 28 at 2:00 p.m. (ET) titled Mumps in U.S. Detention Facilities. A partial description of the session provided by NACCHO and CDC is reprinted below.

Since September 2018, there have been over 800 mumps cases in adult migrants detained in U.S. detention facilities, who are under Immigration and Customs Enforcement (ICE) custody. Detention facilities should follow local or state health department guidance and recommendations for mumps outbreak control. Effective public health interventions in this setting require understanding of facility and custody operations, which often involve frequent transfers of detainees and multiple entities with authority for operations and detainee custody. For this, it is important for health departments and the facility to work together to develop appropriate control measures based on the local epidemiology and the specific needs of each facility.

This webinar will provide an overview from CDC and ICE regarding mumps cases and provide guidance to help health departments to respond more efficiently and help to stop outbreaks sooner....


Registration information

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CDC and Medscape offer new commentary on navigating difficult immunization conversations with parents; CE credit available

Medscape has posted an online training program titled Pediatric Immunization: Navigating Difficult Conversations with Parents. This activity is intended for pediatricians, primary care physicians, nurse practitioners, physician assistants, and nurses, and can provide CME/CE credit. The program was developed as part of an agreement with CDC. The author is John B. Dunn, MD, MPH, medical director for Preventive Care, Kaiser Permanente Washington, Seattle, WA.        

If you are not a registered user on Medscape, you can register for free and get unlimited access to all Medscape features, including continuing education activities.

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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:
  • August 21: Polio and Hib
  • August 28: Varicella and Zoster
Recordings of sessions will be available online within 2 weeks after each webinar.

Information on registration and program details are 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.
 



Presentation slides and videos from June ACIP meeting are now available

ACIP recently posted the presentation slides and videos from the ACIP meeting held June 26–27.

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About IAC Express
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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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ISSN: 1526-1786
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Video of the Week
Randy's Story: #justB Determined: Randy, whose wife is chronically infected with hepatitis B, talks about his son Cody, who was admitted to the U.S. Naval Academy. Although Cody and his brother were vaccinated at birth, Cody tested hepatitis B positive during basic training and was discharged. The Dept. of Defense prohibits being in the military with hepatitis B. Randy is working to change this discriminatory policy. (Source: Hepatitis B Foundation)
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Technically Speaking
Read Dr. Wexler's monthly column for practical advice on vaccination topics
Read Dr. Wexler's column for the Vaccine Education Center's monthly newsletter, Vaccine Update
Vaccinating Adults:
A Step-by-Step Guide
Vaccinating Adults: A Step-by-Step Guide
New! IAC's 142-page book available for free download.
Calendar of Events
Conferences, meetings, and training opportunities
Conferences, meetings, and training opportunities
Patient Record Cards
Purchase IAC's patient record cards today!
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DVD Immunization Techniques
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Every practice should have this award winning, "how-to" training video
Protect Newborns Guidebook
Protect Newborns Guidebook
Comprehensive guide Hepatitis B: What Hospitals Need to Do to Protect Newborns
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
 
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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.