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Issue 1093: December 10, 2013

IAC Spotlight! Real-life stories about vaccine-preventable diseases

Are you searching for compelling reports and stories about people with vaccine-preventable diseases as a way to educate staff and patients about the importance of immunization? Look no further. IAC offers personal accounts about vaccine-preventable diseases on both of our websites: and

For years, IAC has published Unprotected People Reports, real-life accounts of people who have suffered or died from vaccine-preventable diseases. The Unprotected People Report web section on provides access to more than 100 personal testimonies, remembrances, case reports, and newspaper articles, as well as to opinion pieces about the value of immunization.

The "Vaccine Information You Need” website,, features Personal Testimonies about vaccine-preventable diseases and the value of immunization. The collection of more than 50 compelling and eye-opening personal testimonies can be used to educate staff and patients about the importance of immunization. The testimonies are organized by age group and disease.

IAC recently posted a new Unprotected People Report, titled Ramona's Story. Ramona Town Rae, a grandmother, describes her family's experience when her 6-month-old granddaughter contracted pertussis (whooping cough). IAC thanks Ramona Town Rae for sharing her personal story and photograph; treating physician Dr. Thomas M. Weiser and Joe Law, Portland Area Indian Health Service, Portland, Oregon; and Amy Groom, Centers for Disease Control and Prevention Public Health Advisor and Indian Health Service Immunization Program Manager.

Additionally, IAC offers links to similar resources from our immunization partners, including personal stories from Every Child By Two, California Immunization Coalition’s "Shot by Shot" website, Children's Hospital of Philadelphia Vaccine Education Center, Families Fighting Flu, National Foundation for Infectious Diseases, National Meningitis Association, and the book The Forgotten Story from the Texas Children’s Hospital.

Related Links Do you have a personal account, remembrance, or patient story to share with others? Please upload your photo and document via IAC's Submit Your Story form.

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Analysis of newly available data highlights the value of immunization—100 million cases of vaccine-preventable diseases averted since 1924

On November 28, the New England Journal of Medicine (NEJM) published an article titled Contagious Diseases in the United States from 1888 to the Present. The authors used newly available digitized data from weekly surveillance reports of notifiable diseases for U.S. cities and states from 1888 through 2011 to derive a quantitative history of disease reduction in the United States, focusing on the effects of vaccination programs. The authors estimate that more than 100 million cases of polio, measles, mumps, rubella, hepatitis A, diphtheria, and pertussis have been prevented by vaccination programs.

The extensive database used for this analysis is part of Project Tycho, a new online resource available to the public. More information about Project Tycho can be found in the "Featured Resources" section of this issue of IAC Express.

The full NEJM article is available to subscribers only, but much related information can be found in resources listed below.

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Institute for Safe Medication Practices publishes first annual review of data submitted to its National Vaccine Errors Reporting Program

In September 2012, the Institute for Safe Medication Practices (ISMP) partnered with the California Department of Public Health to develop the National Vaccine Errors Reporting System (VERP) to promote ongoing learning about potentially preventable harm associated with immunizations. In the November 28 issue of Medication Safety Alert!, ISMP has published an overview of what has been learned from reports submitted during the first year of the program.

The VERP program was created to allow healthcare professionals to confidentially report vaccine administration errors and near misses. By collecting and quantifying information about these errors, ISMP will be better able to advocate for changes in vaccine names, labeling, or other appropriate modifications that could reduce the likelihood of future vaccine errors. Healthcare professionals can easily and confidentially report an error using the online error reporting form.

Note: If an adverse event occurs following a vaccine administration error, a report should also be sent to the Vaccine Adverse Event Reporting System (VAERS).

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CDC publishes report on influenza vaccination coverage among people with asthma

CDC published Vaccination Coverage Among Persons with Asthma—United States, 2010–2011 Influenza Season in the December 6 issue of MMWR (pages 973–978). The first paragraph is reprinted below.

Asthma was the most common underlying condition among persons hospitalized with pandemic influenza A (H1N1) virus infection in 2009. Although persons with asthma are not more likely than others to get influenza, influenza can make asthma symptoms worse, trigger asthma attacks, and lead to pneumonia or other complications that result in hospitalization and even death. During 1964–2010, the Advisory Committee on Immunization Practices (ACIP) recommended that all adults and children aged ≥6 months with asthma receive an influenza vaccination annually. Beginning with the 2010–11 influenza season, ACIP expanded its annual vaccination recommendation to include all persons aged ≥6 months, while emphasizing that protection of persons at higher risk for influenza-related complications continue as a focus of vaccination efforts. To provide the first update of national vaccination coverage among persons aged ≥2 years with asthma since the new ACIP recommendation, CDC analyzed data from the 2010 and 2011 National Health Interview Survey (NHIS). This report describes the results of that analysis, which indicated that influenza vaccination during the 2010–11 season among persons with asthma was 50%, up from 36% 5 years earlier. However, vaccination coverage across all age groups, including among those with health insurance, a usual place for health care, and one or more health-care visits in the past 12 months, remained well below Healthy People 2020 targets of 80% for children aged 6 months–17 years and 90% for adults aged ≥18 years who are at high risk. These findings highlight the need to educate health-care providers and persons with asthma about the importance of annual influenza vaccination.

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Recently published study provides warning that measles still a threat in the U.S.

On December 5, JAMA Pediatrics published Elimination of Endemic Measles, Rubella, and Congenital Rubella Syndrome from the Western Hemisphere online. The authors reported that the U.S. has officially sustained elimination of measles, rubella, and congenital rubella syndrome for a decade (defined as the absence of a chain of transmission that is continuous for 12 months or more). However measles is still a threat, due to international importations and limited local transmission.

In the same issue, Mark Grabowsky, MD, MPH, wrote in an editorial: "The greatest threat to the US vaccination program may now come from parents’ hesitancy to vaccinate their children." According to CDC, the U.S. is experiencing a spike in measles cases, with 175 confirmed cases and 20 hospitalizations in 2013. More than 98% of these cases were unvaccinated.

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IAC updates "Vaccines Work!" handout for parents

IAC recently updated Vaccines Work! to incorporate new statistics. This piece uses CDC data to demonstrate dramatic declines in vaccine-preventable diseases when compared with the pre-vaccine era.

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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Stakeholders publish report on possible ways to increase HPV vaccination

On August 16, the National Coalition of STD Directors and the American Sexual Health Association convened a small group of stakeholders from the policy, HPV, immunization, and sexual health fields to brainstorm potential policy actions to enhance HPV disease awareness with a particular focus on increasing HPV vaccination rates. In October, the group released a summary report online that includes seven potential next steps and policy actions.
Access the meeting summary: Revisiting HPV Disease Policy at the State Level: Are There Next Steps?

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CDC publishes announcement about National Influenza Vaccination Week in MMWR

CDC published Announcement: National Influenza Vaccination Week—December 8–14, 2013, in the December 6 issue of MMWR (page 988). The complete announcement is reprinted below.

The U.S. Department of Health and Human Services, CDC, state and local health departments, and other health agencies will observe National Influenza Vaccination Week December 8–14, 2013, with educational and promotional activities scheduled across the country. The observance was begun in 2005 to highlight the importance of annual influenza vaccination and to foster greater use of influenza vaccine in the months of December, January, and beyond. As of November 15, 2013, approximately 126 million doses of 2013–14 seasonal influenza vaccine had been distributed to vaccination providers in the United States.

The Advisory Committee on Immunization Practices recommends influenza vaccination for all persons aged ≥6 months. Influenza vaccination is especially important for certain persons at higher risk for influenza-related complications. Persons in high-risk groups include children aged <5 years, and especially children aged <2 years; persons with certain chronic health conditions, such as heart disease, asthma, and diabetes; pregnant women; and adults aged ≥65 years. In addition, health-care personnel are at greater risk for acquiring influenza and can transmit it to their patients.

Educational materials, web tools, and CDC's planned activities for National Influenza Vaccination Week are available at, whereas general materials regarding influenza vaccination are available at Additional information and resources for health-care professionals are available at Current influenza vaccination coverage estimates are available at

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Stay up to date with CDC's free email subscription service

CDC offers an email service that alerts subscribers when selected website information is updated. This service is an easy way for immunization providers to stay up to date with new information and resources.

You can click on the "Sign up to be notified when this page is updated" link on a specific page of interest (e.g., Advisory Committee on Immunization Practices [ACIP]) or go to the CDC Email Updates page, complete a subscription profile, and sign up for multiple topics of interest. CDC will then send you an alert by email when new information on the topics you've selected (e.g., VISs, schedules, ACIP recommendations, statistics, registries, news) have been updated on the agency's website.

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Reminder: If you vaccinate children and teens, be sure to download AAP's revised immunization training guide and procedure manual

Revised in July, AAP's Immunization Training Guide & Practice Procedure Manual is designed to assist pediatric office staff in all aspects of immunizing patients. Intended to be used by physicians, nurse practitioners, physician assistants, nurses, medical assistants, and office managers, the guide covers an array of topics, all of which are summarized on AAP's Immunization web page.

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Project Tycho database makes health data available to everyone

The Project Tycho database is a free online resource where anyone can access 125 years of U.S. weekly and nationally notifiable disease surveillance data. The following is a November 28 press release from the University of Pittsburgh.

After four years of data digitization and processing, the Project Tycho Web site provides open access to newly digitized and integrated data from the entire 125 years history of United States weekly nationally notifiable disease surveillance data since 1888. These data can now be used by scientists, decision makers, investors, and the general public for any purpose. The Project Tycho aim is to advance the availability and use of public health data for science and decision making in public health, leading to better programs and more efficient control of diseases.

Three levels of data have been made available: Level 1 data include data that have been standardized for specific analyses, Level 2 data include standardized data that can be used immediately for analysis, and Level 3 data are raw data that cannot be used for analysis without extensive data management.

The Project Tycho database is managed by an academic team from the University of Pittsburgh and funded by the Bill & Melinda Gates Foundation and the National Institutes of Health.

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Family Planning and Immunization Integration Working Group releases new toolkit

A new toolkit developed by the Family Planning and Immunization Integration Working Group features relevant resources developed by partner institutions. The objectives of the toolkit are
  • To provide a repository of information on integrated family planning and immunization service delivery.
  • To make evidence-based information and tools accessible for health professionals and others around the world.
  • To identify gaps in existing resources and provide new resources and tools as needed to fill gaps.
This toolkit is primarily targeted to international family planning and immunization healthcare workers.

Access the Family Planning and Immunization Integration Toolkit

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Influenza is serious; vaccination is recommended for nearly everyone, so please keep vaccinating your patients

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: Back to top

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 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 hand them out to healthcare professionals at your workplace or at conferences. Each staff person who administers influenza and pneumococcal vaccines needs these handy resources.

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

Related Links 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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CDC reports on global progress in eliminating rubella and congenital rubella syndrome

CDC published Rubella and Congenital Rubella Syndrome Control and Elimination—Global Progress, 2000–2012 in the December 6 issue of MMWR (pages 983–986). A summary made available to the press is reprinted below.

Rubella infection during early pregnancy causes devastating pregnancy outcomes, including fetal death, miscarriages and severe birth defects, known as congenital rubella syndrome (CRS). They are all vaccine preventable. While global immunization and disease surveillance activities to control rubella and CRS have increased since 2000, progress has been slow. Fortunately, a new phase of rubella and CRS control has begun. The Global Vaccine Action Plan (2011–2020) and the Measles-Rubella Strategic Plan (2012–2020) include milestones to eliminate rubella in five of the six World Health Organization (WHO) regions by 2020. These plans are supported by (1) WHO recommendations to introduce rubella-containing vaccines into countries not currently providing the vaccine, (2) donor funding to support introduction, and (3) the momentum of measles elimination activities (to which rubella control activities are closely linked).

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November issue of CDC's Immunization Works newsletter now available

CDC recently released the November issue of its monthly newsletter Immunization Works and posted it on the website of the National Center for Immunization and Respiratory Diseases (NCIRD). The newsletter offers the immunization community information about current topics. This information is in the public domain and can be reproduced and circulated widely.

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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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