Issue 1119: May 6, 2014

WHO Director-General declares the international spread of wild poliovirus in 2014 a Public Health Emergency of International Concern

On May 5, the World Health Organization (WHO) issued a statement on the meeting of the International Health Regulations Emergency Committee concerning the international spread of wild poliovirus. The Emergency Committee convened by the Director-General under the International Health Regulations (2005) [IHR (2005)] was held by teleconference on April 28 and 29, 2014. An excerpt from the WHO statement is reprinted below.

Members of the Emergency Committee and expert advisors to the Committee met on both days of the meeting. The following affected States Parties participated in the informational session of the meeting on Monday 28 April 2014: Afghanistan, Cameroon, Equatorial Guinea, Ethiopia, Israel, Nigeria, Pakistan, Somalia and the Syrian Arab Republic.

During the informational session, the WHO Secretariat provided an update on and assessment of recent progress in stopping endemic and imported polioviruses and the international spread of wild polioviruses in 2014 as of 26 April. The above affected States Parties presented on recent developments in their countries.

After discussion and deliberation on the information provided, and in the context of the global polio eradication initiative, the Committee advised that the international spread of polio to date in 2014 constitutes an ‘extraordinary event’ and a public health risk to other States for which a coordinated international response is essential. The current situation stands in stark contrast to the near-cessation of international spread of wild poliovirus from January 2012 through the 2013 low transmission season for this disease (i.e. January to April). If unchecked, this situation could result in failure to eradicate globally one of the world’s most serious vaccine preventable diseases. It was the unanimous view of the Committee that the conditions for a Public Health Emergency of International Concern (PHEIC) have been met....

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Coming soon! "Question of the Week" in IAC Express

IAC's Ask the Experts feature is one of our most popular offerings. With the help of experts from CDC's National Center for Immunization and Respiratory Diseases, IAC publishes new "Ask the Experts" Q&As in Needle Tips, Vaccine Adults, and IAC Express at least four times a year. Due to the number of new and recurring vaccination questions directed to CDC and IAC, we decided to start featuring a "Question of the Week" every week in IAC Express.
This new feature will be a cooperative venture between IAC and CDC. William L. Atkinson, MD, MPH, IAC's associate director for immunization education, will select a new Q&A every week based on common or especially intriguing questions that come to CDC.
We hope you enjoy this new feature and find it helpful when dealing with difficult real-life scenarios in your vaccination practice. Please encourage your healthcare professional colleagues to sign up to receive IAC Express.

If you have a question for the CDC immunization experts, you can email them directly at There is no charge for this service.

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Association of Immunization Managers releases position statement on personal belief exemptions

On April 25, the Association of Immunization Managers (AIM) approved the AIM Position Statement on Personal Belief Exemptions from State Vaccination Mandates. The statement supports the right of states and territories to enact school and childcare vaccination requirements. It encourages states and territories that do not allow personal belief exemptions (PBEs) to maintain this policy, and encourages states and territories with existing exemption policies to assure that exemptions are only available after parental education and acknowledgement of the associated risk to their child and community.

The Association of Immunization Managers membership includes representatives from all 64 state, territorial, and local National Center for Immunization and Respiratory Diseases (NCIRD) awardees.

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IAC clarifies information in IAC Express article about age indications for Tdap products

On April 15, IAC printed an article in IAC Express titled "FDA lowers age of licensure for Adacel vaccine administration from age 11 years to 10 years." The sentence, "Both Tdap products, Adacel (Sanofi Pasteur) and Boostrix (GSK), now have the same age indication, which should help healthcare providers, especially when some students are age 10 years when Tdap vaccine may be required for middle school enrollment" should have read, "Both Tdap products, Adacel (Sanofi Pasteur) and Boostrix (GSK), now have the same lower age indication of 10 years, which should help healthcare providers, especially when some students are age 10 years when Tdap vaccine may be required for middle school enrollment.

We want to remind readers that IAC is committed to providing our audiences with clear and complete factual information as well as to assisting in increasing understanding.

Accordingly, we point out that Adacel is licensed for age 10 through 64 and Boostrix is licensed for age 10 years and older. ACIP states the following about administering Tdap vaccine (Adacel or Boostrix) to people age 65 years and older: "Providers should not miss an opportunity to vaccinate persons aged 65 years and older with Tdap. Therefore, providers may administer the Tdap vaccine they have available. When feasible, Boostrix should be used for adults aged 65 years and older; however, ACIP concluded that either vaccine administered to a person >65 years or older is immunogenic and would provide protection. A dose of either vaccine may be considered valid." For details on the use of Tdap vaccine in people 65 years of age and older, see MMWR, 2012; 61(25):468–470.

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IAC Spotlight! Unprotected People Reports about vaccine-preventable diseases; essay by author Roald Dahl about the heartbreaking loss of his 7-year-old daughter Olivia from measles

For more than 15 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.

IAC recently posted a new Unprotected People Report, titled Measles: A Dangerous Illness. In 1962, Roald Dahl, author of Charlie and the Chocolate Factory and many other beloved books for children and young adults, suffered a heartbreaking loss: the death of his 7-year-old daughter Olivia from the complications of measles encephalitis. More than 20 years after Olivia’s death, Dahl wrote this personal essay in her memory. Dahl aimed his essay at parents who were refusing to give their children the measles vaccine in the United Kingdom. He encourages all parents to get their children vaccinated. As Dahl states in his essay: “It really is almost a crime to allow your child to go unimmunised.”

Additionally, the Unprotected People Reports web section offers direct 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.

IAC offers personal accounts about vaccine-preventable diseases on both of our websites: and

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

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Resources for Hepatitis Awareness Month and Hepatitis Testing Day

The month of May is designated as Hepatitis Awareness Month in the U.S., and May 19 is designated Hepatitis Testing Day. During May, CDC and its public health partners work to shed light on this hidden epidemic by raising awareness of viral hepatitis and encouraging priority populations to get tested. More than 4 million Americans are living with chronic hepatitis B or chronic hepatitis C virus infections, but most do not know they are infected.

CDC is offering a variety of resources on its website to help in this endeavor, including digital tools (quiz widget and buttons, badges, and website banner), a Hepatitis Testing Day event page where organizations can register their events and members of the public can use their zip code to find a testing site, radio PSAs, an online hepatitis risk assessment, posters, and more resources. Visit CDC's Resources for Hepatitis Awareness Month and Hepatitis Testing Day web section to explore these new resources.

Access CDC's Viral Hepatitis web section

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Multi-lingual Know Hepatitis B campaign launched during Asian American and Pacific Islander Heritage Month

On May 1, in observance of Asian American and Pacific Islander Heritage Month, U.S. Health and Human Services Secretary Kathleen Sebelius released a statement that includes information about hepatitis B infection and the importance of testing and vaccination. A portion of her statement is reprinted below.

... more Asian Americans, Native Hawaiians, and Pacific Islanders now have access to important preventive services and vaccinations at no out-of-pocket cost. This is particularly important with Hepatitis B, as nearly 2 out of 3 people carrying the disease don’t know they are infected and liver cancer caused by the Hepatitis B virus is a leading cause of cancer among Asian Americans.

To combat this silent epidemic, the Centers for Disease Control and Prevention has launched the multi-lingual Know Hepatitis B campaign with community organizations across the country to raise awareness among Asian American and Pacific Islanders about the importance of Hepatitis B testing and vaccination.

Access the complete statement from Secretary Sebelius: Observing Asian American and Pacific Islander Heritage Month.
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IAC's sturdy laminated versions of the 2014 U.S. child/teen immunization schedule and the 2014 U.S. adult immunization schedule—order a supply for your healthcare setting today!

IAC's laminated versions of the 2014 U.S. child/teen immunization schedule and the 2014 U.S. adult immunization schedule are covered with a tough, washable coating; they will stand up to a year's worth of use in every area of your healthcare setting where immunizations are given.

The child and adolescent schedule has eight pages (i.e., four double-sided pages) and is folded to measure 8.5" x 11". The adult immunization schedule has six pages (i.e., three double-sided pages) and is folded to measure 8.5" x 11".
IAC's Laminated Child and Teen Immunization SchedulesIAC's Laminated Adult Immunization Schedules
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.

1–4 copies: $7.50 each
5–19 copies: $5.50 each
20–99 copies: $4.50 each
100–499 copies: $4.00 each
500–999 copies: $3.50 each

For quotes on customizing or placing orders for 1,000 copies or more, call (651) 647-9009 or

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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American Academy of Arts & Sciences publishes report calling for more research on parental trust in vaccines

On April 24, the American Academy of Arts & Sciences published a report titled Public Trust in Vaccines: Defining a Research Agenda. The last paragraph of a related press release is reprinted below.

"Public Trust in Vaccines" identifies priorities for future research that would elucidate how health care providers can best communicate with undecided parents about the individual and community benefits of childhood vaccinations. Key questions include how and when attitudes and beliefs about vaccines are formed, how people make decisions about immunization, how best to present information about vaccines to hesitant parents, and how to identify communities at risk of vaccine-preventable disease outbreaks.

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New study shows that influenza B virus infections can be just as severe as influenza A virus infections

A new study by CDC and partners, Comparing clinical characteristics between hospitalized adults with laboratory-confirmed influenza A and B virus infection, was published online in Clinical Infectious Diseases on April 18. CDC published a related article on its Flu News & Spotlights web section. The first and fourth paragraphs of the CDC spotlight article are reprinted below.

As late-season influenza B viruses currently predominate in the United States, a new study published by CDC and partners highlights the comparative severity of illness associated with influenza A versus influenza B virus infections. The results of the study showed that among hospitalized adults, flu B viruses caused equally severe disease outcomes and clinical characteristics as flu A viruses. This contradicts a common misconception that flu B viruses are associated with milder disease than flu A viruses.

Study findings prompted the authors to conclude that clinicians should not regard flu B infections as less severe than flu A when considering treatment options. These findings support CDC’s existing antiviral treatment recommendations for the treatment of all hospitalized and high-risk patients with suspected or confirmed flu infection. The type of flu virus infection (A or B) should not influence treatment decisions.

Access the complete CDC article: New CDC Study Compares Severity of Illness Caused by Flu A and B Viruses

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CDC publishes information about an investigation of infectious disease risks at a nontransplant anatomical donation center in Arizona

CDC published Notes from the Field: Investigation of Infectious Disease Risks Associated With a Nontransplant Anatomical Donation Center—Arizona, 2014 in the May 2 issue of MMWR (pages 384–385). A portion of the first paragraph is reprinted below.

CDC is investigating reports of potential occupational exposure to human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Mycobacterium tuberculosis among workers performing preparation and dissection procedures on human nontransplant anatomical materials at a nontransplant anatomical donation center in Arizona. CDC is working with Arizona public health officials to inform persons exposed to these potentially infected materials.

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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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