Issue 1124: June 3, 2014

Ask the Experts–Question of the Week: Is pneumococcal polysaccharide vaccine (PPSV23) contraindicated in pregnancy?… read more


CDC releases training video on vaccine storage and handling; continuing education credit available

CDC recently released a new web-on-demand video (45 min) titled Keys to Storing and Handling Your Vaccine Supply. This resource is designed to decrease vaccine storage and handling errors and preserve the nation's vaccine supply by demonstrating the recommended best practices for storage and handling of vaccines. The presenters are Donna Weaver, RN, MN, and JoEllen Wolicki, BSN, RN, both nurse educators with CDC's National Center for Immunization and Respiratory Diseases. Continuing education credit is available until April 17, 2016, for those who complete the course. Information about applying for credit is available on the web page.

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Please volunteer for a telephone interview with the American Academy of Pediatrics on vaccine storage and handling 

The American Academy of Pediatrics (AAP) has been asked by CDC to do telephone interviews with primary care office personnel about their vaccine storage and handling practices in order to identify ways to prevent storage of expired vaccine.  

Your practice won’t be judged or penalized based on your vaccine storage history or what you say in the interviews and participation will be kept confidential. Your input will help shape future guidance, tools, and resources related to vaccine storage and handling. Of course, this is completely voluntary and you are able to withdraw from participation at any time.

AAP wants to interview the person who knows the most about the office systems for storing vaccines. The phone interview will be scheduled at a time convenient for you and will take about 60 minutes. Neither you nor your practice will be named or otherwise identified in any report or summary publication generated from these interviews.

Participants will be offered a $75 Amazon gift card as an honorarium for the time spent.

Please contact Jill Hernandez with questions or to talk about volunteering by email at or phone at (800) 433-9016 x4270.

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Institute for Safe Medication Practices publishes article on reported vaccine diluent errors 

On May 22, the Institute for Safe Medication Practices (ISMP) published an article titled Administering Just the Diluent or One of Two Vaccine Components Leaves Patients Unprotected in its Medication Safety Alert newsletter. The second paragraph is reprinted below.

Errors of this type are reported frequently. They account for 6% of all error types reported to the ISMP National Vaccine Errors Reporting Program, which began in late 2012. There are currently 12 vaccines that come with specific diluents and 2 vaccines provided with two-component containers that must be mixed prior to administering the dose. Reported errors with these vaccines frequently involve multiple patients. Typically, a practitioner dispensing or administering the vaccine fails to notice that a single dose requires combining the contents of two vials. Many times, these vials look very similar and may both emphasize the name of the active drug.

The Institute for Safe Medication Practices is the nation’s only 501(c)(3) nonprofit organization devoted entirely to medication error prevention and safe medication use. In September 2012, 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. 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, be sure to send a report to the Vaccine Adverse Event Reporting System (VAERS).

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

The Immunization Action Coalition (IAC) is pleased to announce that seven new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.
  • Adirondack Medical Center, Saranac Lake, NY (91%)
  • Boston Medical Center, Boston, MA (94%)
  • Dorminy Medical Center, Fitzgerald, GA (97%)
  • Memorial Hospital and Manor, Bainbridge, GA (97%)
  • Phoebe Putney Memorial Hospital, Albany, GA (100%)
  • Riverside Regional Medical Center, Newport News, VA (96%)
  • Riverside Shore Memorial Hospital, Nassawadox, VA (93%)
The Honor Roll now includes 86 birthing institutions from 24 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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Presentation slides from the National Adult and Influenza Immunization Summit now available online

The 2014 National Adult and Influenza Immunization Summit (NAIIS) was held in Atlanta on May 13–15, with over 300 people attending. Slides of the presentations made at the summit are now available on the summit website.

In addition, the NAIIS 2014 Immunization Excellence Awards were presented during the summit meeting. The 2014 awards recognize individuals and organizations that made extraordinary contributions towards improving vaccination rates within their communities during 2013. The awards focus on individuals and organizations that exemplify the meaning of the “immunization neighborhood." Descriptions of the winning projects are available for review.

NAIIS is led by IAC, CDC, and the National Vaccine Program Office, and includes more than 140 organizations and 800 participants. NAIIS recently launched its new website at to provide information about the annual summit meeting and NAIIS workgroups, as well as links to many resources related to adult vaccination. Explore the new website by clicking on any of the featured sections.

If you are an adult vaccine advocate and would like to become part of NAIIS, please email Dr. Litjen Tan, chief strategy officer at IAC and co-chair of NAIIS, for more information.

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U.S. Preventive Services Task Force recommends HBV screening for populations at high risk of infection

In May, the U.S. Preventive Services Task Force (USPSTF) recommended screening for hepatitis B virus (HBV) infection in persons at high risk. The new statement recommends testing adolescents and adults who are at high risk for HBV infection, and rates this recommendation a "B" grade. A "B" grade is defined as follows: "The USPSTF recommends the service. There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial." This is an importance change, as the former related USPSTF recommendation was a “D” grade, which meant hepatitis B screening was not recommended for anyone except pregnant women.

The new statement recommends hepatitis B screening for:
  • People who were born in countries where hepatitis B is common
  • U.S.-born people who were not vaccinated against hepatitis B when they were babies and whose parents came from countries where hepatitis B is common
  • People who are HIV-positive, or have a weakened immune system, or are being treated for kidney failure with dialysis
  • Injection drug users
  • People living with or having sex with people infected with hepatitis B
  • Men who have sex with men
USPSTF recommendations are important because they increase awareness and ensure that recommended services are covered by most private and public payers. Please take the time to read the new statement, especially if you work with at-risk populations.

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IAC Spotlight! “Technically Speaking” column from IAC’s executive director covers practical topics about delivering vaccination services

IAC is pleased to remind readers of its Technically Speaking web section. It features a monthly column about practical vaccine topics written by IAC Executive Director Deborah L. Wexler, MD. The columns cover subject matter in vaccine delivery such as needle length, vaccine administration, cold chain, and immunization schedules. Dr. Wexler’s column made its debut in 2010 in Vaccine Update for Healthcare Providers, a monthly e-newsletter of the Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia, and is a regular feature. Check out the recent issue of VEC’s Vaccine Update for Healthcare Providers. This e-newsletter keeps providers up to date on vaccine-related issues. To subscribe to the VEC e-newsletter, fill out VEC's online Vaccine Update Newsletter Sign-up Form

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IAC updates and reformats "Questions Frequently Asked About Hepatitis B"

IAC recently reformatted and made other minor changes to Questions Frequently Asked About Hepatitis B, a four-page handout for patients and members of the general public. This resource includes many detailed Q&As about prevention, transmission, diagnosis, and treatment of hepatitis B virus infection.

Related Links IAC's Handouts for Patients & Staff web section offers healthcare professionals and the public more than 300 FREE handouts (including translations), which we encourage website users to print out, copy, and distribute widely.

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Voices for Vaccines offers tools to help parents and others advocate for vaccines

Voices for Vaccines (VFV) aims to motivate and inspire parents to speak up on behalf of immunizing children, while making it easy to do so. The VFV website includes a "Tools" section that includes the following resources for parents, healthcare professionals, and others who want to effectively advocate for vaccines:
  • Archive of monthly conference calls
  • Parent Advocate Toolkit
  • "Kick the Flu Out of School" Contest Toolkit
  • New and Expectant Parent Toolkit
  • Writing an Op-Ed for Publication Toolkit
  • "Spread the Word" flyer
To access all this great information, go to the VFV Tools web section.

Voices for Vaccines is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters. VFV invites everyone who appreciates vaccines to become a member of their organization. Please spread the word to your friends and colleagues to join VFV! Back to top

CDC updates ACIP Abbreviations for Vaccines web page

CDC recently updated its ACIP Abbreviations for Vaccines web page. The page includes a table of standardized vaccine acronyms, developed jointly by CDC, ACIP work groups, the editor of the Morbidity and Mortality Weekly Report, the editor of Epidemiology and Prevention of Vaccine-Preventable Diseases (the "Pink Book"), ACIP members, and liaison organizations to ACIP. These acronyms are intended to provide a uniform approach to vaccine references.

Access the table in PDF format.

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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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Meeting of the Strategic Advisory Group of Experts on Immunization publishes summary of April meeting

The Strategic Advisory Group of Experts (SAGE) on Immunization met on April 1–3 in Geneva, Switzerland. On May 23, WHO's Weekly Epidemiological Record published a summary of this meeting. Meeting of the Strategic Advisory Group of Experts on Immunization, April 2014—Conclusions and Recommendations provides a summary of the meeting's discussions, conclusions, and recommendations.

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CDC publishes update on progress toward polio elimination

CDC published Progress Toward Polio Eradication—Worldwide, 2013–2014 in the May 30 issue of MMWR (pages 468–472). A summary made available to the press is reprinted below.

By 2012, a >99 percent reduction in polio cases had occurred since 1988. But with wild poliovirus still circulating, the world’s health ministers recently declared completion of polio eradication to be a programmatic emergency. In the three countries where the spread of wild poliovirus has never been stopped—Afghanistan, Nigeria, and Pakistan—fewer communities were affected by polio in 2013 than in 2012, particularly in Afghanistan and Nigeria. However, polio spread outside of these countries in 2013 and caused outbreaks in five countries in Africa and the Middle East, spreading to two additional countries in 2014 to date. Because of limitations in access and security, the number of cases in Pakistan has increased from 2012 to 2013. WHO has declared the international spread of wild poliovirus in 2014 a Public Health Emergency of International Concern.

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 Ask the Experts

Question of the Week

Is pneumococcal polysaccharide vaccine (PPSV23) contraindicated in pregnancy? Our patient has asthma and is pregnant.
Answer: No. According to the 2014 adult immunization schedule, PPSV23 is recommended in pregnancy if some other risk factor is present (e.g., on the basis of medical, occupational, lifestyle, or other indications). See footnote 9 of the 2014 adult immunization schedule at

About IAC's Question of the Week

This week's issue of IAC Express includes a new feature called "Question of the Week." Each week, IAC Express will highlight a new, topical, or important-to-reiterate Q&A. This new feature is 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 at

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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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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