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Issue 1103: February 4, 2014

2014 U.S. Recommended Immunization Schedules for people age 0–18 years and adults age 19 years and older are now available

CDC published online the Recommended Immunization Schedules for Persons Aged 0 Through 18 Years, United States, 2014, and the Recommended Immunization Schedule for Adults Aged 19 Years and Older, United States, 2014, on January 31 and February 3, respectively.

The recommended birth through 18 years and catch-up immunization schedules have been approved by the ACIP, the American Academy of Pediatrics, the American Academy of Family Physicians, and the American College of Obstetricians and Gynecologists.

The recommended adult immunization schedule has been approved by the Advisory Committee on Immunization Practices, the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Physicians, and the American College of Nurse-Midwives.

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CDC publishes information about rotavirus vaccine administration errors

CDC published Notes from the Field: Rotavirus Vaccine Administration Errors—United States, 2006–2013 in the January 31 issue of MMWR (page 81). The entire article is reprinted below.

Two live rotavirus oral vaccines, RotaTeq (RV5) (Merck & Co., Inc.) and Rotarix (RV1) (GlaxoSmithKline Biologicals), are approved for prevention of rotavirus gastroenteritis and recommended at ages 2, 4 (RV5/RV1), and 6 (RV5) months by the Advisory Committee on Immunization Practices. Because most childhood vaccines are injectable, vaccination providers might have less experience administering oral vaccines. To assess that hypothesis, CDC searched for reports to the Vaccine Adverse Event Reporting System (VAERS) of rotavirus vaccine administration errors involving injection and eye splashes in the United States during the period January 1, 2006–August 1, 2013. A total of 66 reports were found.

There were 39 reports of administration by injection (33 for RV1 and six for RV5). This included a cluster of six reports involving RV1 by a nurse who did not receive proper training or read the package insert. Nineteen of the 39 reports (49%) documented an adverse event; irritability (seven cases) and injection site redness (five) were the most commonly reported adverse events. Thirty of 39 reports (77%) did not have an explanation for the error; for those that did, reasons included misinterpreting package insert instructions, confusing the RV1 oral applicator syringe with a syringe for injection, confusing the RV1 vial with a vial used for injectable vaccine, inadequate training, and not reading the package insert.

There were 27 reports of eye splashes. In 21 cases, infants coughed, sneezed, or spit vaccine into the eyes of vaccination providers, parents (one) or themselves (three). Nonserious adverse events consistent with minor eye irritation were described in 21 of the 27 reports.

As a passive surveillance system, VAERS might capture only a small fraction of vaccine administration errors. However, with approximately 55 million doses distributed, these incidents appear to be rare. Vaccination providers should follow instructions in package inserts regarding proper administration. An injected dose of RV1 or RV5 is not considered a valid dose, and a properly administered oral replacement dose should be given within the appropriate age and dosing schedule. Vaccination providers should be aware of the potential for eye splashes. Vaccine should be administered gently inside the cheek to minimize coughing, sneezing, and spitting. If a child does regurgitate, spit out, or vomit during or after administration, administration of a replacement dose is not indicated. Administration errors are largely preventable with proper education and training.

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CDC publishes Grand Rounds report on reducing HPV infection and related cancers

In the January 31 issue of MMWR (pages 69–72), CDC published CDC Grand Rounds: Reducing the Burden of HPV-Associated Cancer and Disease. The first two paragraphs of the "Current and Future Challenges for HPV Prevention" section are reprinted below.

Improving vaccination coverage is important to reduce the burden of cancer and disease caused by HPV. National HPV vaccination coverage data reveal a concerning trend among female adolescents aged 13–17 years. In comparison with other vaccinations recommended for adolescents (e.g., tetanus, diphtheria, and acellular pertussis vaccine [Tdap] and meningococcal conjugate vaccine [MenACWY]), HPV vaccination coverage for adolescent girls has increased slowly and remains far below Healthy People 2020 targets; an average increase in HPV vaccination coverage of 6 percentage points was observed each year from 2007 through 2011, but no increase occurred from 2011 to 2012. Coverage for adolescent girls with at least 1 dose of HPV vaccine was 53.8%, and coverage with all 3 doses was 33.4% in 2012. Wide variations by state also were observed in 2012, with coverage of 3 doses among adolescent girls ranging from a low of 12.1% in Mississippi to a high of 57.7% in Rhode Island.

Strategies to increase adolescent HPV vaccination coverage rates in the United States include reminder/recall systems to increase first dose and series completion rates; standing orders for vaccination; education of patients, parents, and health-care providers; health insurance reforms to reduce out-of-pocket costs for vaccines; and increasing the use of alternative vaccination sites (e.g., schools). School requirements have been found to increase vaccination coverage for Tdap and MenACWY; however, HPV vaccine is required for school entry in only a few jurisdictions. Health-care providers should administer HPV vaccine during visits when Tdap and MenACWY are administered. The single most important predictor of vaccination in the clinical setting is a strong recommendation from a health-care provider.

Access the complete report

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IAC Spotlight! Eighteen more healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination

IAC urges qualifying healthcare organizations to apply for its Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, medical practices, professional organizations, health departments, and government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel. More than 400 organizations are now enrolled.

Since January 21, when IAC Express last reported on the Influenza Vaccination Honor Roll, 18 organizations have been enrolled.

Newly added healthcare organizations, medical practices, and health agencies
  • Atlantic General Hospital/Health System, Berlin, MD
  • Bay County Medical Care Facility, Essexville, MI
  • Castle Rock Adventist Hospital, Castle Rock, CO
  • Clarke County Hospital, Osceola, IA
  • Finger Lakes Health, Geneva, NY
  • Florida Hospital Fish Memorial, Orange City, FL
  • Genesee County Health Department, Batavia, NY
  • Huron Family Practice Center, Port Huron, MI
  • Kanza Health Clinic, Newkirk, OK
  • Lancaster General Health, Lancaster, PA
  • Margaret Mary Health, Batesville, IN
  • McLaren Bay Region, Bay City, MI
  • Mercy Hospital Grayling, Grayling, MI
  • St. Joseph's Hospital and Medical Center, Phoenix, AZ
  • South Dakota Urban Indian Health, Sioux Falls, SD
  • Stewart Memorial Community Hospital, Lake City, IA
  • Trego County Lemke Memorial Hospital, WaKeeney, KS
  • WakeMed, Raleigh, NC
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IAC updates its professional-education resource "Vaccines with Diluents: How to Use Them"

IAC recently updated Vaccines with Diluents: How to Use Them with some revised text and footnotes. This resource helps healthcare professionals correctly mix vaccines that require reconstitution.

Access IAC's Administering Vaccines web section for more related resources for immunization providers.

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 its staff education materials "Current Dates of Vaccine Information Statements" and "It's Federal Law! You must give your patients current Vaccine Information Statements (VISs)"

IAC recently revised Current Dates of Vaccine Information Statements (VISs) and It's Federal Law! You must give your patients current Vaccine Information Statements (VISs). Both now include the issue date of the most recent version of the VIS for Japanese encephalitis vaccine. CDC posted this VIS to its website on January 24. For information on the VIS for Japanese encephalitis vaccine, see the IAC Express article titled CDC releases updated Japanese encephalitis VIS, which was published on January 28.
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Test your vaccination knowledge with IAC's quizzes

Want a quick opportunity to check your knowledge of current immunization recommendations or vaccine administration techniques? Test yourself with IAC's short quizzes to see how much you know. These quizzes have recently been reviewed for accuracy and found to be up to date.

Want to brush up on immunization basics? ACIP's General Recommendations on Immunization is a great place to start!

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IAC revises "Notification of Vaccination Letter Template"

IAC recently revised its Notification of Vaccination Letter Template with edits to the hepatitis B, hepatitis A, and influenza vaccine sections. This resource gives healthcare professionals an easy way to give other clinicians information about vaccines provided, minimizing both duplication of services and missed opportunities.

Access IAC's Documenting Vaccination web section for more related resources for immunization providers.

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CDC publishes report on national public health preparedness

On January 29, CDC published The 2013–2014 National Snapshot of Public Health Preparedness. Vaccines are included in the report as one of the essential medical supplies that states, localities, and territorial areas can obtain from CDC’s Strategic National Stockpile to supplement local supplies during times of large scale public health emergencies.

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Interactive map vividly illustrates the increase in certain vaccine-preventable diseases

The Global Health Program at the Council on Foreign Relations has been tracking news reports on outbreaks of vaccine-preventable diseases since the fall of 2008. They have developed an interactive map that visually plots global outbreaks of measles, mumps, whooping cough, polio, rubella, and other diseases that are easily preventable by vaccination.

Access the map and watch the number of outbreaks increase as you use the slider at the top to move from 2008 to 2013. You can search by year, location, number of cases, and type of illness. This resource might be useful when talking about the effect of refusing vaccination with vaccine-hesitant parents.

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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 six 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
National Adult and Influenza Immunization Summit requests nominations for its 2014 Immunization Excellence Awards; deadline is March 25

The National Adult and Influenza Immunization Summit (NAIIS) is soliciting candidates for the 2014 NAIIS Immunization Excellence Awards. The awards recognize individuals and organizations that have made extraordinary contributions toward improved vaccination rates within their communities during the 2013. The deadline for nominations is March 25 (due by close of business).

A national winner and possibly an honorable mention recipient will be selected for each award category. The winners will be presented with their awards at the NAIIS meeting, to be held May 12–15, in Atlanta. The national winner in each category will be invited to present at the meeting.

There are five categories of recognition:
  • Overall Flu Season Activities
  • Healthcare Personnel Campaign
  • "Immunization Neighborhood" Champion
  • Adult Immunization Champion
  • Corporate Campaign
Access complete information and the online nomination form

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Reminder: It's time to submit nominations for CDC's Childhood Immunization Champion Award

The CDC Childhood Immunization Champion Award is an annual award that recognizes individuals who make a significant contribution toward improving public health through their work in childhood immunization.
Each year, up to one CDC Immunization Champion from each of the 50 U.S. states, eight U.S. territories and freely associated states, and the District of Columbia will be honored. Champions can include coalition members, parents, healthcare professionals, and other immunization leaders who meet the award criteria. Immunization program managers, state and federal government employees of health agencies, individuals who have been affiliated with and/or employed by pharmaceutical companies, and those who have already received the award are not eligible to apply.
Awardees will be announced during National Infant Immunization Week, which runs April 26–May 3.
The suggested nomination due date is February 14, but states may select a unique deadline. Please contact your state immunization program to confirm your state’s deadline.
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CDC to offer Twitter chat about healthy travel on February 6

CDC invites healthcare providers and their patients to participate in a Twitter chat about healthy travel abroad, hosted by @USNewsTravel and @YahoolTravel. The one hour chat will take place on February 6 at 2:00 p.m. (ET).

To join the conversation: Follow @CDCTravel and @CDC_NCEIZD on Twitter, watch your Twitter feed on February 6 for instructions on how to join the chat, and use the hashtag #healthytravel during the chat to participate.

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Registration deadline for February 26–27 ACIP meeting is February 10 for U.S. citizens
The Advisory Committee on Immunization Practices (ACIP) will hold its next meeting on February 26–27 in Atlanta at CDC's Clifton Road campus. To attend the meeting, ACIP attendees (participants and visitors) must register online. The registration deadline for U.S. citizens is February 10. Registration is not required to watch the live webcast of the meeting.
The ACIP meeting web section will be updated with detailed information about the meeting, including live webcast instructions. The draft agenda is available now.

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Early bird registration for the National Conference on Immunization and Health Coalitions ends February 14

"Partnering for Prevention from Sea to Summit," the 11th National Conference on Immunization and Health Coalitions (NCIHC) will take place in Seattle from May 21–23. NCIHC is the only national conference solely dedicated to collaboration and partnership as a way to improve the health status of communities. Register by February 14 to get the early bird rate for this great conference!

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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.

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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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