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Issue 1086: November 5, 2013





Pediatrics publishes article by CDC authors on influenza-associated pediatric deaths in the U.S., 2004–2012 CDC posts related commentary

On October 28, the journal Pediatrics published an article by CDC authors titled Influenza-Associated Pediatric Deaths in the United States, 2004–2012 online. The results and conclusions sections of the abstract are reprinted below.

Results: From October 2004 through September 2012, 830 pediatric influenza–associated deaths were reported. The median age was 7 years (interquartile range: 1–12 years). Thirty-five percent of children died before hospital admission. Of 794 children with a known medical history, 43% had no high-risk medical conditions, 33% had neurologic disorders, and 12% had genetic or chromosomal disorders. Children without high-risk medical conditions were more likely to die before hospital admission (relative risk: 1.9; 95% confidence interval: 1.6–2.4) and within 3 days of symptom onset (relative risk: 1.6; 95% confidence interval: 1.3–2.0) than those with high-risk medical conditions.

Conclusions: Influenza can be fatal in children with and without high-risk medical conditions. These findings highlight the importance of recommendations that all children should receive annual influenza vaccination to prevent influenza, and children who are hospitalized, who have severe illness, or who are at high risk of complications (age <2 years or with medical conditions) should receive antiviral treatment as early as possible.

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CDC publishes report on influenza vaccination of pregnant women in Massachusetts during the 2009–2010 influenza season

CDC published Influenza Vaccination Among Pregnant Women—Massachusetts, 2009–2010 in the November 1 issue of MMWR (pages 854–857). A summary made available to the press is reprinted below.

Data from the Massachusetts Pregnancy Risk Assessment Monitoring System [PRAMS] survey showed that during the 2009–2010 influenza season 67.5 percent of women who gave birth received the seasonal vaccine and 57.6 percent received the pH1N1 vaccine, representing some of the highest rates of vaccination coverage among the 29 PRAMS states that collected this information. Targeted education and equity campaigns from the Massachusetts Department of Public Health might have contributed to comparatively higher vaccination coverage rates and fewer disparities in pH1N1 coverage compared with the seasonal vaccine coverage. Efforts to increase influenza vaccination rates among pregnant women could be improved by promoting the importance and availability of vaccine, encouraging providers to recommend and address safety concerns, and by engaging community partners.

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IAC enrolls five more birthing institutions into its Hepatitis B Birth Dose Honor Roll

The Immunization Action Coalition (IAC) is delighted to announce that five new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll. The institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.
  • Lakeland Community Hospital, Niles, MI (92%)
  • Paul B. Hall Regional Medical Center, Paintsville, KY (97%)
  • Sturgis Hospital, Sturgis, MI (93%)
  • West Jefferson Medical Center, Marrero, LA (98%)
  • The Women's Hospital, Newburgh, IN (99%)
The Honor Roll now includes 27 birthing institutions from 16 states.

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, 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 announced 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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AAP endorses CDC meningococcal vaccine guidance

The American Academy of Pediatrics (AAP) has endorsed CDC's recommendations for meningococcal vaccination of children and adults. The November 2013 issue of AAP News, the news magazine of the AAP, includes a feature article about the endorsement.

All vaccine policy statements from AAP are available on IAC's AAP Policy Statements web section.

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Spotlight on access influenza videos and public service announcements

IAC is featuring a collection of videos about influenza and the importance of annual vaccination for the 2013–14 influenza season. The influenza-related videos include personal testimonies from parents who have suffered the tragic loss of their children due to influenza, as well as educational information from expert commentators. The featured videos are from the following organizations: American Nurses Association, American Pharmacists Association, California Immunization Coalition’s Shot-by-Shot project, Centers for Disease Control and Prevention, Department of Health and Human Services, Every Child by Two, Families Fighting Flu, Medscape, National Council on Aging, PKIDs, and state health departments.

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CDC's Immunization Safety Office expands its vaccine safety services for U.S. healthcare providers

CDC’s Immunization Safety Office has expanded its vaccine safety web content to include information provided by the Clinical Immunization Safety Assessment (CISA) Project. CISA is a national network of vaccine safety experts from CDC’s Immunization Safety Office, seven medical research centers, and other partners, which provides a comprehensive vaccine safety public health service to the nation. 

U.S. healthcare providers who have a vaccine safety question about one of their patients can request a free CISA clinical consultation and case evaluation via email. This service is provided free of charge.

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CDC reports on global vaccination coverage

CDC published Global Routine Vaccination Coverage—2012 in the November 1 issue of MMWR (pages 858–861). Part of a summary made available to the press is reprinted below.

Global coverage with third dose of diphtheria–tetanus–pertussis vaccine (DTP), a key indicator of immunization program performance, substantially improved from less than 5 percent in 1974 to 83 percent in 2012.  However, in 2012, approximately 22.6 million children still did not receive some or all routinely recommended childhood vaccines, leaving them susceptible to vaccine-preventable diseases and death. Over half of these children are in three countries (India, Nigeria, and Indonesia) and 56 percent never received the first dose of DTP vaccine. Strengthening routine immunization systems, especially in countries with the greatest number of undervaccinated children, should be a global priority to reduce morbidity and mortality from vaccine-preventable diseases.

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Bulk quantities of laminated pocket guides for influenza and pneumococcal vaccines are available—free—from the National Adult and Influenza Immunization Summit and IAC

To aid in efforts to vaccinate against two diseases, influenza and pneumococcal, the National Adult and Influenza Immunization Summit (NAIIS) and IAC invite you to place orders now for bulk quantities of the following pocket guides:
  • 2013–14 Influenza Vaccine Pocket Guide (created by IAC in collaboration with NAIIS)
  • Pneumococcal Vaccine Pocket Guide (also created by IAC in collaboration with NAIIS)
Both are free—you can order them in the hundreds or thousands!

These laminated, 3.75" x 6.75", two-color cards serve as a convenient reference for front-line healthcare professionals who vaccinate patients. Place a bulk order now, and your organization will be ready to educate healthcare professionals at upcoming immunization training sessions and conferences. Each staff person who administers influenza and pneumococcal vaccines needs these handy resources.

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These pocket guides are designed to be used by healthcare professionals only; they are NOT patient handouts.

How to Order

Place your order today using IAC's online order form. There is no cost for the pocket guides, shipping, or handling within the U.S.

If you have questions, email

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IAC updates "Checklist for Safe Vaccine Storage and Handling"

IAC recently updated its Checklist for Safe Vaccine Storage and Handling to include recommendations published in CDC's Vaccine Storage & Handling Toolkit. Updates include information related to use of recommended storage units and continuous read thermometers that include probes in glycol-filled bottles, recording of minimum and maximum temperatures, tips for ideal vaccine placement within a storage unit, and links to revised temperature logs and troubleshooting resources. Use this updated checklist to be sure you’re doing everything you should to safeguard your vaccine supply!

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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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Spanish translations of "Vaccinations for Infants and Children, Age 0–10 Years" as well as "Vaccinations for Preteens and Teens, Age 11–19 Years" are now available

IAC's immunization schedules for parents are now available in Spanish.

Access all of IAC's patient/parent immunization schedules in English and Spanish, as well as several additional languages.

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CDC develops new resources to help providers increase HPV vaccination rates

CDC has developed new resources to help healthcare professionals talk to parents and young adults about HPV vaccination. The campaign features the tagline "You are the key to HPV cancer prevention."

Campaign resources include a one-page sheet titled Tips and Time-savers for Talking with Parents about HPV Vaccine, a customizable slide set on the burden of HPV-related cancers, links to HPV vaccination recommendations, fact sheets, Medscape commentaries for provider education, and handouts for parents and patients in English and Spanish.

Access the campaign overview page

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National Institutes of Health publishes article for public that encourages vaccination against HPV

The National Institutes of Health (NIH) publishes NIH News in Health, a monthly online publication for the public that explores health topics of current interest. The October issue includes a feature article titled Protect Yourself Against HPV: Block This Cancer-Causing Virus. The material in this publication is not copyrighted and can be reprinted freely.

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Influenza is serious; be sure to vaccinate everyone age 6 months and older!

Vaccination remains the single most effective means of preventing influenza, and is recommended for everyone age 6 months and older. If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to a clinic or pharmacy that provides vaccines or to the HealthMap Vaccine Finder to locate sites near their workplaces or homes 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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Limited-time offer: 50% off 2013 laminated immunization schedules (use coupon code IAC50)

This special offer won’t last long! Use Coupon Code IAC50 when purchasing full-sized (6 pages, folded to 8.5" x 11”) laminated versions of either or both 2013 U.S. immunization schedules: child/teen and adult.

Laminated 2013 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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Online Medscape course focuses on rotavirus immunization and the risk of intussusception

In an online Medscape course titled "Rotavirus Vaccine and Intussusception: The Latest Data" Frank DeStefano, MD, MPH, takes a detailed look at the very latest data on rotavirus vaccine and the risk of intussusception, the most common cause of acute bowel obstruction in infants. Dr. DeStefano explains that providers should be ready to talk with parents about the benefits of rotavirus vaccine, as well as the small risk for intussusception associated with the vaccine. Dr. DeStefano is director of CDC's Immunization Safety Office.

Continuing medical education credit is available for completing the course and taking a test afterward. Login (free) is required to access the online course.

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Minutes of the June ACIP meeting now online

The CDC website recently posted minutes of ACIP's June meeting. In addition, extensive information on ACIP meetings is available, including details on past and upcoming meetings, meeting dates, registration, draft agendas, minutes, live archives, and presentation slides.

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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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