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Issue 1032: December 18, 2012







Happy holidays from all of us at IAC!
All of us at IAC wish you, our readers, a safe, happy, and relaxing holiday season—free from influenza, pertussis, and all other vaccine-preventable diseases.

We'll be back with you on January 2.

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IAC welcomes Dr. William Atkinson as associate director for immunization education
William L. Atkinson, MD, MPH, recently joined the Immunization Action Coalition as associate director for immunization education. In July, Dr. Atkinson retired from the Centers of Disease Control and Prevention (CDC) after 25 years of service. At the time of his retirement, he was medical epidemiologist and training team lead, Immunization Services Division, National Center for Immunization and Respiratory Diseases (NCIRD), a position he held for 17 years.

During his tenure at CDC, he produced, wrote, and/or appeared in more than 100 broadcasts and webcasts that were viewed by more than 300,000 healthcare providers. He also gave more than 600 invited lectures and taught more than 100 two-day training courses across the United States, addressing more than 150,000 attendees.

Dr. Atkinson’s skill as a communicator is not limited to his speaking prowess. He excels as a writer, as well. In 1995, he conceived, developed, and took the lead in writing one of CDC's most widely sought-after books, Epidemiology and Prevention of Vaccine-Preventable Diseases (aka the Pink Book). The book is now in its twelfth edition, and more than 400,000 copies have been distributed. He is the author or coauthor of 52 publications and book chapters, primarily relating to measles and other vaccine-preventable diseases. He contributed to several editions of the American Academy of Pediatrics Red Book and to Vaccines, the highly regarded textbook edited by Stanley A. Plotkin, MD, Walter A. Orenstein, MD, and Paul A. Offit, MD.

Dr. Atkinson was the first recipient of CDC’s highest immunization honor, the Phil Horne Award. He was also the 2001 recipient of the Bill Watson Medal of Excellence, the highest award given to a CDC employee, and the recipient of the 2003 Excellence in Distance Training Award of the United States Distance Learning Association.  He was a recipient of the IAC Superhero Award in 2001.

Throughout his career, Bill has used his creativity, dynamic personality, and exceptional teaching abilities to the benefit of the immunization community. His numerous accomplishments serve as an inspiration to all of us.

In announcing Dr. Atkinson's new position, IAC Executive Director Deborah L. Wexler, MD, said, “Bill’s contributions to IAC have been immeasurable. From writing his first “Ask the Experts” column for IAC in 1995 to reviewing IAC’s educational materials, he has been an enormously valued partner to IAC for nearly 20 years. He was IAC’s CDC project officer from 2000 to 2004, a time of critical expansion for IAC. Since then, he has consistently helped to clarify and sharpen our work. As IAC’s founder, I am so appreciative of all that Bill has contributed.”

Dr.  Atkinson’s photograph has been added to IAC’s staff web page.

Related Links
  • Read more about Dr. Atkinson's career and accomplishments on pages 1 and 5 of the May 2012 issue of Needle Tips and on page 5 of the October 2012 issue.
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AAP and WHO concur that a UN committee's proposal to remove thimerosal from vaccines would put global immunization efforts at risk
As part of its work in developing an international treaty that would lead to eliminating controllable mercury pollution and exposure throughout the world, The United Nations Environment Programme (UNEP) is considering recommending the removal of thimerosal (ethyl mercury) from vaccines worldwide. Thimerosal, which is currently used as a preservative in some U.S. vaccines and in vaccines around the world, has no recognized serious toxic effects as currently used.

In response to UNEP's proposed recommendation, the World Health Organization's Strategic Advisory Group of Experts (SAGE) on Immunization recommended that thimerosal continue to be used in the global vaccine supply. The American Academy of Pediatrics (AAP) concurs. AAP published Ban on all mercury-based products would risk global immunization efforts, says AAP, WHO in the June 2012 issue of AAP News (published online ahead of print). In addition, AAP published four related articles in the December 17 eFirst Pages issue of its journal, Pediatrics. Portions of the AAP News article are reprinted below. Links to the four Pediatrics articles are given at the end of this IAC Express article. 

From the AAP News article:

The Academy has endorsed a recommendation by the World Health Organization’s Strategic Advisory Group of Experts (SAGE) on Immunization that the preservative thimerosal be retained for use in the global vaccine supply.

The announcement is in response to a United Nations Environment Programme (UNEP) proposal to completely eliminate mercury in all products and processes. Such a ban would mean thimerosal, which contains ethylmercury, could not be used in any vaccine products worldwide.

“As many as 84 million children globally are dependent on vaccines whose safe distribution requires availability of thimerosal as a preservative,” said Louis Z. Cooper, M.D., FAAP, an AAP past president (2001-’02) who works closely with the International Pediatric Association.

Thimerosal is included in various vaccines in resource-poor countries that rely on the more affordable multi-use vials. In the United States, thimerosal is found in only one childhood influenza vaccine and in trace amounts in a few others as part of the manufacturing process.

Despite claims of anti-vaccine proponents who have erroneously linked thimerosal to autism, studies over the past 15 years have not shown evidence of harm. Some of those activists confused ethylmercury with the dangerous neurotoxin methylmercury.

“You’re going to have some people who feel that any amount of mercury in the environment is not a good thing,” said Michael Brady, M.D., FAAP, chair of the AAP Committee on Infectious Diseases.

“Thimerosal does contain mercury, and it is reasonable to try and reduce the amount of mercury that exists in the environment,” Dr. Brady said. “However, the portion of mercury in the environment that is resulting from thimerosal in vaccines is infinitesimally small. And its current use has allowed us to safely provide vaccines to millions of children around the world.”

Reporting on recommendations from SAGE, the WHO’s May 26
Weekly Epidemiological Record [IAC Express editor's note: See the section on page 215 titled "Information on vaccines for an Intergovernmental Negotiating Committee to prepare a global legally binding instrument on the use of mercury."] states that replacing thimerosal with an alternative preservative may affect the quality, safety and efficacy of vaccines. SAGE proposed—and the Academy concurs—that this portion of the ban should be dropped from the UNEP plan.

Related Links (from the journal Pediatrics, December 17)
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AAP's Red Book Online issues special alert about an erratum to AAP's 2012–13 Influenza Policy Statement 
On December 13, the American Academy of Pediatrics (AAP)  electronic publication Red Book Online issued a special alert titled "Erratum for AAP 2012–13 Influenza Policy Statement." The special alert is reprinted below.

An official erratum to the American Academy of Pediatrics policy statement "Recommendations for Prevention and Control of Influenza in Children, 2012–2013" (Pediatrics 2012;130[4]:780-792) is scheduled for publication in the February 2013 issue of Pediatrics. The erratum is as follows:
  • In Table 4, p 790, the Chemoprophylaxis column for oseltamivir for children weighing >23–40 kg (>51–88 lb) should read 60 mg once daily.
  • Also in Table 4, footnote "a," 8th line, the concentration should read 6 mg/mL.
The corrected Table 4–Antiviral Dosage and Schedule is posted on the Influenza Resource Page, 2012–2013 on Red Book Online. You can also access a full list of resources from the policy statement on the page, as well as useful references that are freely accessible to all visitors to the site.

Note: Red Book Online, is an electronic version of the AAP publication Red Book: 2012 Report of the Committee on Infectious Diseases. Access to most online content requires a subscription.

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IAC Spotlight! Ten vaccine-related slide set presentations available from IAC, CDC, and other trusted sources
Looking for slides for an upcoming presentation on immunization? Look no further. The PowerPoint Presentations web section includes ten immunization-related slide sets from IAC, CDC, AAP, Autism Science Foundation, California Immunization Coalition, and WHO. Browse IAC’s collection of presentation slides for ideas and content for your next educational offering on improving immunization practices. They are posted in PDF format, and IAC's three slide sets are available in PowerPoint format by request.

IAC recently updated two slide sets:
To obtain any of IAC's three slide sets in PowerPoint format, simply request them from IAC by sending an email to

IAC’s Presentations section on immunization and vaccine-preventable diseases is part of IAC’s online Directory of Immunization Resources.

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IAC updates its professional-education resource "Vaccines with Diluents: How to Use Them"
IAC recently added information about the combination Hib-meningitis vaccine MenHibrix (Hib-MenCY; GlaxoSmithKline) to its professional-education resource Vaccines with Diluents: How to Use Them.

IAC's Handouts for Patients & Staff web section offers healthcare professionals and the public more than 250 FREE English-language handouts (many also available in translation), which we encourage website users to print out, copy, and distribute widely.

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IAC updates, redesigns, and renames its template "Notification of Vaccination Letter"
IAC recently changed the name of its template "Notification of Vaccination Letter" to Notification of Vaccination Letter Template. The template letter lists the vaccines routinely administered to children and adults. It offers sample text that you can use to create a letter to notify medical practices that you have vaccinated their patient. In addition to being renamed, the template letter was redesigned and its content was updated.

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CDC website has a huge compendium of resources for  promoting childhood vaccination
In recent months, CDC has developed a variety of new educational resources for promoting childhood vaccination. Following is a listing of many that you and your colleagues might find helpful to use in your work settings. 

General Childhood Vaccination Materials
Pertussis Outbreak Materials
CDC has a cadre of experts who can speak about childhood immunization topics at partner webinars, conferences, meetings, and media events. To explore partnership opportunities with CDC experts, or other partnership activities, email

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Vial mix-up chart pictures the vials and packaging for various Tdap and DTaP vaccine products
With so many vaccine products available for preventing tetanus, diphtheria, and pertussis, it's easy for healthcare personnel to confuse one product with another when preparing to administer vaccines. To cut down on confusion, the Immunization Branch of the California Department of Public Health (CDPH) recently posted an updated version of its full-color Tdap or DTaP vial mix-up chart on its EZIZ website. The chart pictures the correct vials, syringes, and boxes for various Tdap, DTaP, and combination DTaP vaccine products.

Important Note: The ages given on the chart reflect California's pertussis immunization policy. Check with your state health department to find the policy that pertains to your location.

About EZIZ
The CDPH immunization skills training portal, EZIZ, provides interactive immunization lessons, job aids, and updated vaccine news and information of interest to California's VFC providers and others involved in immunization in other parts of the nation.

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Influenza vaccination is recommended for nearly everyone, so please vaccinate your patients
Influenza vaccination is recommended for everyone age 6 months and older, so please continue to vaccinate your patients.

If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to the HealthMap Vaccine Finder to locate sites near their workplace or home that offer influenza vaccination services.

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

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CDC publishes article on establishing surveillance networks for acute meningitis and encephalitis syndromes in Bangladesh, China, and India
CDC published Expanding Poliomyelitis and Measles Surveillance Networks to Establish Surveillance for Acute Meningitis and Encephalitis Syndrome—Bangladesh, China, and India, 2006–2008 in the December 14 issue of MMWR (pages 1008–1011). A press summary of the article is reprinted below.

Syndromic and laboratory surveillance of vaccine-preventable diseases (VPDs) such as polio and measles has led to development of capacity and infrastructure, and substantial reductions in disease burden. In Bangladesh, China, and India, polio and measles surveillance networks were able to accommodate testing for Japanese encephalitis; however, efforts to use these networks to identify bacterial etiologies of meningitis were less successful, because of differences in laboratory personnel and procedures and specimen processing. Integrating surveillance for new VPDs into existing networks may improve efficient use of limited resources; and efforts should focus on identifying areas of synergy, and building upon commonalities among existing VPD surveillance systems.

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Free CE credit available for viewing CDC's video on unsafe injection practices
The November 12 webinar "Grand Rounds: Unsafe Injection Practices in the U.S. Healthcare System" is now available as an archived video. In the video, several CDC experts discuss how unsafe injection practices, which put patients at risk of infection, have occurred during a variety of procedures and in many different settings. The video also focuses on strategies to prevent unsafe injections through renewed attention to infection control and injection safety practices.

Free continuing education credit is available for viewing the video.

Related Link
  • CDC's digital press kit The Impact of Unsafe Injection Practices in U.S. Healthcare Settings includes extensive resources from CDC and other healthcare organizations
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Clinical Vaccinology course to be held in Chicago on March 8–10; early registration ends on January 21
The National Foundation for Infectious Diseases, the Emory Department of Medicine, Division of Infectious Diseases, and the Emory Vaccine Center are sponsoring a Clinical Vaccinology Course, which will be held in Chicago on March 8–10. 

Register by the January 21 early-registration deadline and save $100 on the registration fee. Registrations are being accepted online and by mail.

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About IZ Express

IZ Express is supported in part by Grant No. 1NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of and do not necessarily represent the official views of CDC.

IZ Express Disclaimer
ISSN 2771-8085

Editorial Information

  • Editor-in-Chief
    Kelly L. Moore, MD, MPH
  • Managing Editor
    John D. Grabenstein, RPh, PhD
  • Associate Editor
    Sharon G. Humiston, MD, MPH
  • Writer/Publication Coordinator
    Taryn Chapman, MS
    Courtnay Londo, MA
  • Style and Copy Editor
    Marian Deegan, JD
  • Web Edition Managers
    Arkady Shakhnovich
    Jermaine Royes
  • Contributing Writer
    Laurel H. Wood, MPA
  • Technical Reviewer
    Kayla Ohlde

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