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Issue 1129: July 1, 2014

Ask the Experts–Question of the Week: Many travelers do not return for their second dose of hepatitis A vaccine… read more

New! July issue of Needle Tips now available online

The July 2014 issue of Needle Tips is now online.
Download the November issue of Needle Tips This issue features important information about the status of state legislation and non-medical exemptions to vaccination. In addition, it presents an array of immunization materials that healthcare professionals can use in their practice settings, including IAC's popular summaries of vaccine recommendations. It also features the "Ask the Experts" column from CDC medical officer Andrew T. Kroger, MD, MPH, and nurse educator Donna L. Weaver, RN, MN.

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ACIP votes to preferentially recommend live nasal spray influenza vaccine when available for healthy children age 2–8 years

At its meeting on June 25, ACIP voted to recommend a preference for using live attenuated influenza vaccine (LAIV) instead of inactivated influenza vaccine (IIV) in healthy children age 2–8 years. A related press release from CDC is reprinted below.

Today, the Advisory Committee on Immunization Practices (ACIP) voted to recommend a preference for using the nasal spray flu vaccine (i.e., LAIV) instead of the flu shot (i.e., IIV) in healthy children 2–8 years of age when it is immediately available. ACIP is a panel of immunization experts that advises the Centers for Disease Control and Prevention (CDC). This new ACIP recommendation is based on a review of available studies that suggests the nasal spray flu vaccine can provide better protection than the flu shot in this age group against laboratory-confirmed, medically attended flu illness. The recommendation also says that if the nasal spray flu vaccine is not immediately available, the flu shot should be given so that opportunities to vaccinate children are not missed or delayed. Flu shots continue to be approved and recommended for vaccination of children and adults as indicated. Since 2010, CDC and ACIP have recommended that everyone 6 months and older get a flu vaccine annually with rare exception. This new ACIP recommendation must next be approved by the CDC director. The recommendation would then be incorporated into the 2014–2015 influenza prevention and control recommendations, and published in a Morbidity and Mortality Weekly Report (MMWR), at which point it would become official CDC policy.

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CDC updates its Vaccine Storage & Handling Toolkit

In May, CDC released an updated version of its Vaccine Storage & Handling Toolkit, originally published online in 2012. The toolkit is based on the recommendations of the Advisory Committee on Immunization Practices (ACIP), equipment manufacturers' product information, and studies from the National Institute for Scientific Technology. Here's a direct link to the updated PDF document.

The toolkit outlines best practice strategies and recommendations on the following topics:
  • Points to consider in selecting, maintaining, and using vaccine storage units and thermometers
  • Consistent maintenance of the cold chain
  • Routine storage and handling practices
  • Inventory management
  • Emergency procedures for protecting vaccine inventories
On the toolkit web page, you'll also find related resources such as training materials, slide sets, and other helpful items.

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IAC Spotlight! "Like" IAC on Facebook and "follow" IAC on Twitter!

IAC invites you to connect with us on Facebook and Twitter. IAC's Facebook page is designed to help parents and all interested Facebook users learn about vaccines and their importance. If you have a personal or organizational Facebook page, please take a minute to "like" IAC on Facebook. If you have an account on Twitter, please take a minute to "follow" @ImmunizeAction on Twitter. Also, you and your patients are invited to view and repost videos available from IAC's YouTube account.

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CDC releases two new videos to help providers double-check injection practices

As part of its work in investigating outbreaks as a result of unsafe injection practices, CDC has insight into the mistakes and knowledge gaps that put healthcare professionals and their patients at risk. In response, CDC's One & Only Campaign has created two short videos that detail critical information to help all providers and facility managers double-check their injection safety knowledge.

You can access these new videos, Managing Patient Safety, One Injection at a Time and Check Your Steps! Make Every Injection Safe on YouTube.

The One & Only Campaign is a public health campaign, led by CDC and the Safe Injection Practices Coalition, to raise awareness among patients and healthcare providers about safe injection practices.

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National Quality Forum's draft report on adult immunization now available for comment

The National Quality Forum (NQF) has been working on a project called Prioritizing Measure Gaps: Adult Immunization. The project seeks to identify critical areas for performance measurement to optimize vaccination rates and outcomes across adult populations. A draft report titled Priority Setting for Health Care Performance Measurement: Getting to Measures that Matter for Adult Immunizations was released on June 16, and can be accessed from the NQF website. Comments on the draft will be accepted through 6:00 p.m. (ET), July 14. The link to provide your input can be found at the top of the same web page under "comments"; to make a comment you must first register with NQF.

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Registration for National Immunization Conference is now open 

CDC, the Task Force for Global Health, and the CDC Foundation will host the National Immunization Conference, "U.S. Immunization in a Time of Change," September 29–30, in Atlanta, Georgia. Registration is now open, and as this conference will be much smaller in scale than previous National Immunization Conferences, with attendance limited to approximately 800 people, it would be prudent to register early.

Access information on conference registration and lodging.

For more information about the National Immunization Conference, please contact the conference planning team at (404) 639-8225 or via email at

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World Hepatitis Day is July 28

In 2010, the World Health Organization made World Hepatitis Day one of four official disease-specific world health days, to be celebrated each year on July 28. 

Viral hepatitis kills 1.5 million people worldwide each year—as many people as killed by HIV/AIDS. Although viral hepatitis is the eighth largest cause of death worldwide, it has a low profile. Find out how you can join millions around the world to raise awareness about viral hepatitis, and to call for access to treatment and better prevention programs, by visiting the World Hepatitis Day website at Some easy ways to participate include joining the photo wall, uploading information about your related event, and sharing on social media platforms.

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Download CDC's MMWR app to keep up to date on immunization and other health issues

CDC published Notice to ReadersMMWR Express App for iPhone and iPad Now Available in the June 27 issue of MMWR (page 554). The first and last paragraphs are reprinted below.

A new MMWR application, MMWR Express, is now available for free download in the Apple App Store for both iPhone and iPad. This application provides fast access to the blue summary boxes in the MMWR Weekly. Summaries can be viewed by publication date or by searching for a specific subject (e.g., Salmonella). It is the first iPhone/iPad app to provide MMWR content.

This application is one of an expanding collection of mobile applications from CDC. Development of applications for other mobile operating systems is under consideration. When online, MMWR Express can quickly check for new content, ensuring that users always have the most up-to-date information. Users also can share content with others via email, text message, Facebook, or Twitter. The free application is available at

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CDC posts a new adult immunization patient intake form on its website

CDC recently posted its new Adult Immunization Patient Intake Form on the Adult Vaccine Resources section of its website. Healthcare providers are encouraged to distribute the form to their adult patients at appointment check-in to help facilitate the vaccine conversation. Clinics and practices can customize the form with their contact information.

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Vaccine Education Center provides guidance on diagnosing measles

The Vaccine Education Center (VEC) of the Children's Hospital of Philadelphia recently posted a new article titled Have You Ever Diagnosed Measles? on its News and Views About Vaccines web section. In light of the measles outbreaks around the country, this short article provides a useful review to healthcare providers who may have never seen a case of measles.

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Access presentations and interviews on current vaccine topics by Dr. Paul Offit, including his appearances on "The Daily Show" and "The Colbert Report" on the Vaccine Education Center website

Paul Offit, MD, and other experts at the Vaccine Education Center (VEC) of the Children's Hospital of Philadelphia are frequently invited to speak around the nation and to the media about vaccine-related issues. The VEC website includes a collection of some of these presentations and interviews, including a recent Medscape offering titled Measles Outbreaks in the U.S.: Why Now?, and Dr. Offit's humorous and thought-provoking guest appearances on "The Daily Show" and "The Colbert Report."

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Vaccine Education Center publishes new fact sheet on tetanus 

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia recently published a new fact sheet on tetanus. Questions & Answers: Tetanus is part of VEC's Special Topics Series that includes fact sheets about medical topics, most having some information about immunization.

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Ignite! New book explores how community coalitions can get fired up for change

A recently published book by Frances Dunn Butterfoss, PhD, is titled Ignite!, with the fitting subtitle: "Getting Your Community Coalition 'Fired Up' for Change." Ignite was written for volunteers and professionals who are ready to build and sustain innovation organizations and community coalitions that change policies, systems, and environments. The book's four parts—Before You Build It, Build It, Make It Work, and Sustain It—are filled with tools to spark ideas and resources to fire up any organization.

Dr. Butterfoss is the founding president of Coalitions Work, a consulting group based in Virginia. You can access more information on Ignite! and Dr. Butterfoss's earlier book, Coalitions and Partnerships in Community Health, on the Tools & Resources section of the Coalitions Work website.

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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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Slides and transcript from HHS webinar on Lyme disease persistence now available

CDC recently released the slides and transcript from a May 22 Health and Human Services (HHS) webinar on Lyme disease persistence. Approximately 10 to 20 percent of patients treated for Lyme disease with a recommended 2–4 week course of antibiotics will have lingering symptoms of fatigue, pain, or joint and muscle aches. In some cases, these can last for more than 6 months.

The webinar slides and transcript can be accessed from CDC's Post-Treatment Lyme Disease Syndrome web section.

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Ask the Experts
Question of the Week

Many travelers do not return for their second dose of hepatitis A vaccine and present years later, about to travel again. Is there a maximum interval between the first and second doses of hepatitis A vaccine? Should the series be restarted if it has been 5 or more years since the first dose?
Answer: No. There is no maximum interval between doses of hepatitis A vaccine. An interruption in the vaccination schedule does not require restarting the entire series of any other vaccine or toxoid or addition of extra doses, with the exception of oral typhoid vaccine. See the ACIP’s "General Recommendations on Immunization" at, page 10.

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 highlights 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, chooses a new Q&A to feature every week from a set of Q&As prepared by experts at CDC’s National Center for Immunization and Respiratory Diseases.

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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