Issue 1079: September 24, 2013






Reminder: September issues of Needle Tips and Vaccinate Adults available online

The September 2013 issues of Needle Tips and Vaccinate Adults are available online. Vaccinate Adults is an abbreviated version of Needle Tips with the pediatric content removed.

Click on the images below to download the entire September 2013 issues (PDF) of Needle Tips and/or Vaccinate Adults.

Needle Tips: View the table of contents, magazine viewer, and back issues.

Vaccinate Adults: View the table of contents, magazine viewer, and back issues.

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CDC publishes 2013–14 recommendations for prevention and control of influenza with vaccines

On September 20, CDC issued Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2013–2014, which was published as one of CDC's MMWR Recommendations and Reports. The summary section of the recommendations is reprinted below.

This report updates the 2012 recommendations by CDC's Advisory Committee on Immunization Practices (ACIP) regarding the use of influenza vaccines for the prevention and control of seasonal influenza (CDC. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices [ACIP]. MMWR 2012;61:613–8). Routine annual influenza vaccination is recommended for all persons aged ≥6 months. For the 2013–14 influenza season, it is expected that trivalent live attenuated influenza vaccine (LAIV3) will be replaced by a quadrivalent LAIV formulation (LAIV4). Inactivated influenza vaccines (IIVs) will be available in both trivalent (IIV3) and quadrivalent (IIV4) formulations. Vaccine virus strains included in the 2013–14 U.S. trivalent influenza vaccines will be an A/California/7/2009 (H1N1)–like virus, an H3N2 virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011, and a B/Massachusetts/2/2012–like virus. Quadrivalent vaccines will include an additional influenza B virus strain, a B/Brisbane/60/2008–like virus, intended to ensure that both influenza B virus antigenic lineages (Victoria and Yamagata) are included in the vaccine. This report describes recently approved vaccines, including LAIV4, IIV4, trivalent cell culture-based inactivated influenza vaccine (ccIIV3), and trivalent recombinant influenza vaccine (RIV3). No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one product is otherwise appropriate. This information is intended for vaccination providers, immunization program personnel, and public health personnel. These recommendations and other information are available at CDC's influenza website; any updates also will be found at this website. Vaccination and health-care providers should check the CDC influenza website periodically for additional information.

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Fourteen birthing institutions have been enrolled in IAC's Hepatitis B Birth Dose Honor Roll

The Immunization Action Coalition (IAC) is delighted to announce the first 14 institutions accepted into its Hepatitis B Birth Dose Honor Roll:
  • Passavant Area Hospital, Jacksonville, IL (98%)
  • Oakwood Annapolis Hospital, Wayne, MI (92%)
  • Pennock Health Services Family Birthing Center, Hasting, MI (90%)
  • Spectrum Health Ludington Hospital, Ludington, MI (95%)
  • Pipestone County Medical Center, Pipestone, MN (95%)
  • Albany Medical Center, Albany, NY (99%)
  • Guthrie Corning Hospital, Corning, NY (96%)
  • St. James Mercy Hospital, Hornell, NY (97%)
  • Wyoming County Community Hospital, Warsaw, NY (94%)
  • Wilson Memorial Hospital, Sidney, OH (90%)
  • Wood County Hospital, Bowling Green, OH (93%)
  • St. Anthony Shawnee Hospital, Shawnee, OK (97%)
  • Women & Infants Hospital of Rhode Island, Providence, RI (94%)
  • Laughlin Memorial Hospital, Greenville, TN (93%)

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

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

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

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

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New York Times publishes Dr. Stanley A. Plotkin’s commentary calling for a vaccine to protect humans against Lyme disease

On September 18, the New York Times published Bring Back the Lyme Vaccine, a commentary written by Stanley A. Plotkin, MD, professor of pediatrics, University of Pennsylvania.

The commentary briefly recounts the significant cardiac complications Dr. Plotkin's son experienced from Lyme infection and discusses other complications from the disease. Dr. Plotkin relates the history of a previously approved Lyme disease vaccine, which is no longer available. His commentary concludes with a call for the public to remind CDC of high public demand for the development, manufacture, and approval of a vaccine to protect against Lyme disease, a disease that affects 300,000 Americans each year.

On September 21, the New York Times published a related editorial, The Quest for a Lyme Vaccine, urging patients and physicians "to press federal health officials to revisit the need for a vaccine."

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IAC Spotlight! IAC's "Ask the Experts" Q&As give you the answers

Looking for answers to your questions about Tdap, pneumococcal vaccination, or vaccine storage and handling? Look no further. IAC’s Ask the Experts web section is a compilation of common yet challenging questions and answers (Q&As) about vaccines and their administration. The experts are Andrew T. Kroger, MD, MPH, medical officer; Donna L. Weaver, RN, MN, nurse educator; and Iyabode Akinsanya-Beysolow, MD, MPH, medical officer. All are at CDC's National Center for Immunization and Respiratory Diseases. The Q&As have been featured in previous issues of IAC Express, Needle Tips, and Vaccinate Adults.

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NFID news conference on influenza and pneumococcal disease scheduled for September 26

The National Foundation for Infectious Diseases (NFID) is hosting a 1-hour news conference on September 26 at 10 a.m. ET. Titled “Influenza Outlook 2013-2014: Preparing the Nation to Protect against Infectious Diseases Every Year,” the conference will feature leading experts discussing influenza and pneumococcal disease and vaccination coverage. Howard K. Koh, MD, MPH, assistant secretary for health at the U.S. Department of Health and Human Services, will speak, as will Anne Schuchat, MD, director, National Center for Immunization and Respiratory Diseases, CDC. William Schaffner, MD, immediate past president, NFID, will moderate the event.

Interested individuals can participate via live webcast or teleconference by calling in at (800) 277-3988 or by joining the webcast (registration required).

During the news conference and throughout flu season, NFID will be providing a variety of shareable flu content on Facebook and Twitter (@nfidvaccines). We encourage you to help spread awareness by sharing these messages with your followers and using #fightflu. Feel free to also share this information with your colleagues.

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Coming September 27, the American Health Care Association's Twitter chat on seniors and the flu season

The American Health Care Association (AHCA; @AHCAncal) is hosting a Twitter chat about seniors and flu season on September 27 at 2 p.m. ET. The Immunization Action Coalition (@ImmunizeAction) and Centers for Disease Control and Prevention (@CDCflu) will participate in the chat, which will include tips for healthcare personnel.

You can participate in the chat by tweeting your comments and questions using the hashtag, #seniorflu.

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CDC's provider information on the rotavirus VIS can help providers talk with parents about intussusception

CDC recently posted Provider Information: Rotavirus VIS. In addition to presenting information on contraindications and precautions and the benefits of vaccination, the web page includes background information on intussusception and the risk of instussusception following rotavirus vaccination. CDC's What's New with VISs web page includes the following related information:

The most significant change in the August 26, 2013 updated rotavirus VIS is in the estimated rates of intussusception following vaccination. Because this change concerns a potential adverse event, the new VIS should be used beginning immediately. The accompanying Provider Information Sheet gives more detailed information for discussing the vaccine with parents. When using the multi-vaccine VIS for patients receiving rotavirus vaccine, give the new rotavirus VIS in addition to the multi-VIS. The multi-VIS is being updated to reflect these changes.

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IAC posts translations of influenza VISs in Bengali, Burmese, Chuukese, Polish, and Urdu

IAC recently posted translations of both the inactivated influenza vaccine (IIV) VIS and the live attenuated influenza vaccine (LAIV) VIS in Bengali, Burmese, Chuukese (spoken on certain Micronesian islands), Polish, and Urdu. IAC thanks the New York City Department of Health and Mental Hygiene for the Bengali, Polish, and Urdu translations, and the Hawaii Department of Health for the Chuukese translations.

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IAC posts additional VIS translations in Burmese, simplified Chinese, Farsi, French, Somali, Spanish, Thai, and Turkish

IAC recently posted additional translations of the following VISs:
IAC thanks  Asian Pacific Health Care Venture, Los Angeles, for the Thai translation and Dr. Mustafa Kozanoglu for the Turkish translation.

Note: Until CDC updates the multi-vaccine VIS to reflect changes given on the CDC web page titled Provider Information: Rotavirus VIS, give the new rotavirus VIS in addition to the multi-VIS. For more information, see the article titled "CDC's provider information on the rotavirus VIS can help providers talk with parents about intussusception" in this week's issue of IAC Express. Learn about the multi-vaccine VIS and its use by reading the top few paragraphs on IAC's multi-vaccine VIS web page.

Note: Simplified Chinese is preferred in China, Singapore, and Malaysia. Traditional Chinese is preferred in Hong Kong, Macau, and Taiwan.
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CDC posts fact sheet for the public on human papillomavirus (HPV) and oropharyngeal cancer

CDC recently posted Human papillomavirus (HPV) and Oropharyngeal Cancer - Fact Sheet. Using a question-and-answer format, the fact sheet explains what genital and oral HPV are and how they can cause oropharyngeal cancer. It encourages prevention through the administration of HPV vaccines.

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American Academy of Microbiology report explains why adult vaccination is important

Titled FAQ: Adult Vaccines: A Grown Up Thing To Do, this 16-page report from the American Academy of Microbiology explains how vaccines protect against disease and what vaccination options are available to adults. It also provides insights into the history of vaccines, why they are so safe, and why adults need to stay up to date on vaccines—to protect their health and the health of their loved ones. A PDF of the report is available at the link above; a 2-page brochure about the report is available in English and in Spanish.

Begun in 1955, the American Academy of Microbiology is the honorific leadership group within the American Society for Microbiology, the world's oldest and largest life science organization. The mission of the academy is to recognize scientists for outstanding contributions to microbiology and provide microbiological expertise in the service of science and the public.

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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 assessing and mitigating risks for polio outbreaks in Africa in 2012–13

CDC published Assessing the Risks for Poliovirus Outbreaks in Polio-Free Countries—Africa, 2012–2013 in the September 20 issue of MMWR (pages 768–772). The first paragraph is reprinted below.
In 2012, the World Health Assembly of the World Health Organization (WHO) declared the completion of polio eradication a programmatic emergency. Indigenous wild poliovirus (WPV) transmission remains uninterrupted in Nigeria (in the WHO African Region [AFR]) and in Afghanistan and Pakistan (in the WHO Eastern Mediterranean Region [EMR]). In the WHO AFR, multiple WPV outbreaks have occurred since 2003 after importation of indigenous West African WPV into 21 previously polio-free countries in a "WPV importation belt" that extends across the continent. The Global Polio Eradication Initiative (GPEI) and WHO regional offices have used indicators of population immunity, surveillance quality, and other factors (e.g., high-risk subpopulations and proximity to WPV-affected countries) to assess the risk for outbreaks in polio-free countries and guide the implementation of risk mitigation measures to limit poliovirus transmission after WPV importation and prevent the emergence of circulating vaccine-derived poliovirus (cVDPV). Despite risk mitigation efforts, a polio outbreak, first confirmed in May 2013, is ongoing; as of September 10, a total of 178 WPV type 1 (WPV1) cases have been reported in Somalia (163 cases), Kenya (14 cases) and Ethiopia (1 case), after importation of WPV1 of West African origin. This report summarizes steps taken by the GPEI to assess and mitigate the risks for outbreaks after WPV importation or the emergence of cVDPV in polio-free countries within the WHO AFR's "WPV importation belt." All countries will continue to have some level of risk for WPV outbreaks as long as endemic circulation continues in Afghanistan, Nigeria, and Pakistan.

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CDC corrects error in report on U.S. measles outbreaks in 2013

CDC published Erratum: Vol. 62, No. 36 in the September 20 issue of MMWR. It concerns an error that occurred in an article about measles outbreaks in the United States during 2013, which was published in the September 13 issue of MMWR. The erratum is reprinted below.

In the report, "Measles—United States, January 1–August 24, 2013," an error occurred in Figure 2 on page 742. The three measles cases indicated for Montana should instead be indicated for Missouri.

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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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