Issue 1077: September 17, 2013








New! September 2013 issue of Vaccinate Adults now online

The September issue of Vaccinate Adults is now online.

Download the September issue of Vaccinate Adults

Note: Vaccinate Adults is an abbreviated version of Needle Tips with the pediatric content removed.

This issue of Vaccinate Adults calls attention to the importance of monitoring vaccine storage temperatures and features Vaccinations for Pregnant Women, a new patient handout from IAC, developed in partnership with the American College of Obstetricians and Gynecologists.

As always, the issue features the "Ask the Experts" column from CDC medical officer Andrew T. Kroger, MD, MPH; nurse educator Donna L. Weaver, RN, MN; and medical officer Iyabode Akinsanya-Beysolow, MD, MPH.

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Reminder: September 2013 issue of Needle Tips is online

The September issue of Needle Tips is online.
Download the September issue of Needle Tips

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IAC Spotlight! Six more healthcare organizations join IAC's Honor Roll for Patient Safety—Mandatory Influenza Vaccination for Healthcare Workers

IAC urges qualifying healthcare organizations to apply for its Honor Roll for Patient Safety. The honor roll recognizes hospitals, medical practices, professional organizations, and government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel. More than 275 organizations are now enrolled.

Since August 6, when IAC Express last reported on the Honor Roll for Patient Safety, the following six organizations have been enrolled.

Newly added healthcare organizations
Healthcare organizations and medical practices: Tsehootsooi Medical Center, Fort Defiance, AZ; UIC Family Health Center, Rockford, IL; Central Montana Medical Center, Lewistown, MT; Jamestown Regional Medical Center, Jamestown, ND; Crouse Community Center, Morrisville, NY; and Platte Health Center Avera, Platte, SD.

Related Links

  • Listing of all honorees by state
  • Position statements from professional societies and leading healthcare organizations in support of mandatory influenza vaccination
  • Honor roll web section, which includes access to the application form (see the gold trophy cup in right column, and click on the words "Apply for the Honor Roll")

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CDC publishes report on 2012 national, state, and local vaccination coverage among children age 19–35 months; related NIS data is released

CDC published National, State, and Local Area Vaccination Coverage Among Children Aged 19–35 Months—United States, 2012 in the September 13 issue of MMWR (pages 733–740). A press summary of the article is reprinted below. Note: On September 12, CDC released data from a related National Immunization Survey (NIS); a link to it is provided at the end of this IAC Express article.

When parents make sure their children stay up-to-date on their vaccines, they can help protect their own children from serious diseases and prevent these diseases from spreading to family members, friends, and throughout their communities.  Immunization of U.S. children aged 19–35 months remains high, with coverage for many routine vaccines remaining near or above 90 percent, according to the 2012 National Immunization Survey (NIS). However, low vaccination rates for measles in some states are a concern, and measles continues to cause outbreaks in communities with susceptible children and adults. Today, CDC reported a higher than normal number of measles cases so far this year in the United States and described recent outbreaks of the disease.  All of the measles cases reported in the United States in 2013 are considered to be associated with importations from other countries, and most U.S. residents who got measles this year were unvaccinated due to philosophical objections to vaccination. The Vaccines for Children Program (VFC) has been critical to achieving and maintaining high immunization rates among U.S. children.  This year marks the 20th anniversary of the passage of the legislation that created the program, which removes financial barriers to vaccination for eligible children, helping to ensure they have access to life-protecting and life-saving vaccines.

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Dr. Anne Schuchat briefs the media on immunization among U.S. infants and on recent measles outbreaks

On September 12, NCIRD Director Anne Schuchat, MD, presided over a media telebriefing during which she discussed 2012 immunization rates among U.S. infants, recent U.S. measles cases and outbreaks, and the 20th anniversary of the passage of the legislation that created the Vaccines for Children program. A transcript of the telebriefing is available, as is an audio recording.

This issue of IAC Express includes five related articles; links to all are given below. 

Related Links

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CDC publishes report on measles in the United States from January 1 to August 24, 2013

CDC published Measles—United States, January 1–August 24, 2013 in the September 13 issue of MMWR (pages 741–743). A press summary of the article is reprinted below.

Unvaccinated people place themselves and others in their communities at risk for measles and other vaccine preventable diseases. Measles is a highly contagious viral disease that is preventable by vaccination. In the United States, measles elimination (i.e. absence of year round transmission) was declared in 2000. However, measles continues to be imported into the United States from countries where measles is still common. During January 1–August 24, 2013, 159 measles cases, including 8 outbreaks were reported to CDC. An outbreak in New York City is the largest outbreak reported in the United States since 1996 (58 cases). Most cases were import-associated [157 (99 percent)] and in persons who were unvaccinated [131 (82 percent)] or had unknown vaccination status [15 (9 percent)]. Among U.S. residents who were unvaccinated, 92 (79 percent) have philosophical objection to vaccination. High vaccine coverage is important to prevent spread of measles following importation.

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2013 measles outbreak in religious community in Brooklyn, NY, is largest since 1996

CDC published Notes from the Field: Measles Outbreak Among Members of a Religious Community—Brooklyn, New York, March–June 2013 in the September 13 issue of MMWR (page 752). Portions of the article are reprinted below.

On March 13, 2013, an intentionally unvaccinated adolescent aged 17 years returned to New York City from London, United Kingdom, while infectious with measles. This importation led to the largest outbreak of measles in the United States since 1996. . . .

A total of 58 cases were identified, including six generations of measles infection in two neighborhoods of the borough of Brooklyn. All cases were in members of the orthodox Jewish community. No case was identified in a person who had documented measles vaccination at the time of exposure; 12 (21%) of the cases were in infants too young (aged <12 months) for routine immunization with measles, mumps, and rubella (MMR) vaccine.

The outbreak was first recognized in Brooklyn’s Borough Park neighborhood, where the median age of 28 infected persons was 10 years (range: 0–32 years), and 79% of cases in persons aged ≥12 months were in three extended families whose members declined use of measles vaccine. The outbreak spread to the Williamsburg neighborhood, where the median age of 30 infected persons was 19 months (range: 0 months–32 years), and the primary reasons for lack of vaccination were refusal (nine, 30%) and delay (eight, 27%).

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Measles outbreak in North Carolina religious community sickens 23

CDC published Notes from the Field: Measles Outbreak Associated with a Traveler Returning from India—North Carolina, April–May 2013 in the September 13 issue of MMWR (page 753). Portions of the article are reprinted below.

On April 14, 2013, public health officials in North Carolina were notified of suspected measles infections in two unvaccinated members of a family. Measles was confirmed by laboratory testing at the State Laboratory of Public Health on April 16, 2013. Investigators learned that a third unvaccinated member of the household had developed fever and rash 11 days earlier, after returning to the United States from a 3-month visit to India, but measles had not been suspected until household contacts sought evaluation for similar symptoms.

During April and May, direct and indirect transmission from the returning traveler resulted in 22 identified cases of measles
(including the two cases first reported), for a total of 23 cases overall. Most cases were among residents of a largely unvaccinated religious community in rural North Carolina. Eighteen (78%) of the 23 patients were unvaccinated, three (13%) had been fully vaccinated with 2 doses of measles vaccine, and two (9%) had unknown vaccination status. The 23 patients ranged in age from 1 to 59 years.

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CDC announces 20th anniversary of the Vaccines for Children Program, makes related resources available

On September 12, CDC posted a digital press kit titled 20 Years of Success: CDC Celebrates 20th Anniversary of Vaccines for Children Program. The first paragraph is reprinted below. Note: The press kit contains a selection of VFC-related resources for healthcare professionals and the public, including a slide show, videos, and online print materials.

This year marks the 20th Anniversary of passage of the legislation that created the Vaccines for Children Program (VFC), one of our nation’s most successful public-private partnerships for improving public health. This national program helps provide vaccines to children whose parents or guardians may not be able to afford them, and helps many more children have a better chance of getting their vaccines according to the recommended immunization schedule, protecting babies, children and adolescents from 16 serious diseases including measles, mumps, whooping cough, chickenpox, flu and diphtheria.

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IAC updates online Ask the Experts Q&A web sections on diphtheria-tetanus-pertussis, HPV, influenza, and pneumococcal diseases and vaccines

Based on content review by vaccine experts at CDC, IAC recently updated the following sections of Ask the Experts.
To access Ask the Experts sections for other vaccines and diseases, see the Ask the Experts index page.

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IAC adds new FluLaval information to "Influenza Vaccine Products for the 2013–2014 Influenza Season"

IAC recently updated Influenza Vaccine Products for the 2013–2014 Influenza Season. A product was added (FluLaval quadrivalent inactivated influenza vaccine [IIV4]), and the age indication of another product was changed (FluLaval trivalent inactivated influenza vaccine [IIV3]). IAC made both changes to reflect FDA actions taken on August 16, 2013. To find out more about the FDA actions, see the  August 27 IAC Express article titled FDA extends FluLaval IIV (GlaxoSmithKline) age range to include children and teens age 3–17 years; licenses quadrivalent FluLaval product.

Visit IAC's influenza handouts web section to access all of IAC's influenza handouts and educational materials

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 and CDC change the color of the recently revised freezer temperature logs

IAC and CDC recently changed the color of both the Fahrenheit version and the Celsius version of the professional resource titled "Temperature Log for Freezer." Both versions had been red; they have been changed to blue to make it easier for users to distinguish them from the Fahrenheit and Celsius versions of "Temperature Log for Refrigerator," which are red.

Related Links
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Pentacel, Daptacel, and Adacel shortages to last through mid-October; ActHIB supply is tight

CDC recently updated its Current Vaccine Shortages & Delays web section with the information reprinted below. In addition, CDC posted an updated guidance document for vaccinating children when supplies of Pentacel and Daptacel are in short supply. A quick-reference sheet is also available. Links to both documents are given at the end of this IAC Express article. 

Note 1: Sanofi Pasteur’s pertussis-containing vaccines, Daptacel (DTaP), Pentacel (DTaP-IPV-Hib) and Adacel (Tdap), will be in short supply between mid-August and mid-October of 2013, due to the delayed release of new vaccine lots. This delay resulted from an anomaly identified during a routine test procedure of one of the filling lines, and it affects all products filled from that line. GlaxoSmithKline has taken steps to meet increased demand for pertussis-containing vaccines and anticipates being able to address gaps related to these supply limitations, using a combination of products and presentations. Of note, during this time period, due to significant increases in demand for Boostrix (Tdap), GSK has put in place controls to help manage inventory to maintain continued supply to the marketplace. Therefore, backorder and delays in deliveries may occur, but are expected to be short in duration. Also, provider preference for vaccine presentation (syringes/vials) may not be able to be accommodated at times during this period. (Posted 9/11/13)

Note 2: Supply of Sanofi Pasteur’s ActHIB (Hib) is sufficient but tight as a result of the delay in release of Pentacel described in Note 1.  As a precautionary measure, vaccine ordering in the public and private sectors is being controlled through the end of September 2013 to ensure sufficient supplies for providers ordering this vaccine. (Posted (9/9/13)

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Member states of WHO's South-East Asia Region commit to eliminating measles and controlling rubella and congenital rubella syndrome by 2020

On September 13, the World Health Organization issued a press release titled Measles elimination by 2020. Portions of it are reprinted below.

Over 70,700 children died of measles in 11 countries of WHO South-East Asia Region in 2011.This constitutes about 45% of global measles deaths. The 11 Member States of the Region committed to eliminating measles and controlling rubella and congenital syndrome (CRS) by 2020, at the Sixty-sixth Session of the WHO Regional Committee for South-East Asia today. WHO estimates that US$ 800 million are needed to achieve this goal by 2020.

“An estimated 8 million children are not protected against measles in WHO’s South-East Asia Region. The measles and rubella vaccines are safe, effective and inexpensive. The administration of a combined measles rubella vaccine can eliminate both diseases cost effectively,” said Dr Samlee Plianbangchang, WHO’s Regional Director for South-East Asia. “Measles outbreaks are a major development obstacle. I believe that with political will and a strong focus on the vulnerable and hard-to-reach populations, we can eliminate measles and control rubella in the South-East Asia Region by 2020”, he added.

Related Link

  • Access a related article titled "South-East Asia Region to Eliminate Measles by 2020: All six WHO regions now have measles elimination goals," published by the Measles & Rubella Initiative
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Unbelievable limited-time offer—50% off 2013 laminated immunization schedules (use coupon code IAC50)

We’ve never offered this type of discount before, and this special offer won’t last long!  Use Coupon Code IAC50 when purchasing full sized (6 pages, folded to 8.5x11”) laminated versions of either or both 2013 U.S. immunization schedules—child/teen and adult!

2013 Laminated schedules are printed in color for easy reading, come complete with essential tables and footnotes, and include contraindications and precautions—a feature that will help you make an on-the-spot determination about the safety of vaccinating patients of any age.

PRICING—Enter the Coupon Code IAC50 to get the sale price in the shopping cart.

1–4: $7.50 each—SALE $3.75 each
5–19: $5.50 each—SALE $2.75 each
20–99: $4.50 each—SALE $2.25 each
100–499: $4.00 each—SALE $2.00 each
500–999: $3.50 each—SALE $1.75 each

IAC's Laminated Child and Teen Immunization SchedulesIAC's Laminated Adult Immunization Schedules
You can access specific information on both schedules, view images of both, order online, or download an order form at the Shop IAC: Laminated Schedules web page.

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CDC publishes report on influenza vaccination practices of physicians and caregivers of children with neurologic and neurodevelopmental conditions

CDC published Influenza Vaccination Practices of Physicians and Caregivers of Children with Neurologic and Neurodevelopmental Conditions—United States, 2011–12 Influenza Season in the September 13 issue of MMWR (pages 744–746). A press summary of the article is reprinted below.

Children with neurologic and neurodevelopmental conditions can experience flu complications that can be life-threatening.  A yearly flu vaccine can protect children with these conditions in many cases by preventing them from getting sick with the flu. According to findings of a new CDC study, only about half of children with neurologic or neurodevelopmental conditions are vaccinated against the flu each year. Also, most parents look to their child's health care provider for information about vaccines, including the flu shot. The study found that some pediatricians do not recognize specific conditions that put children at high risk for flu illness. Children with these conditions are more likely to have complications if they get sick with flu. This new study explains the important role that healthcare providers play in providing health information about flu vaccinations for children with neurologic and neurodevelopmental conditions.

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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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