Issue 1130: July 8, 2014

Ask the Experts–Question of the Week: Should adult patients who are not asplenic but who have hypogammaglobulinemia receive… read more



New! July issue of Vaccinate Adults is now available online

The July 2014 issue of Vaccinate Adults is now online. Download the July 2014 issue of Vaccinate Adults
This issue presents an array of immunization materials that healthcare professionals can use in their practice settings, including IAC's popular "Summary of Recommendations for Adult Immunization." 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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Reminder: July issue of Needle Tips is available online

The July 2014 issue of Needle Tips is now online. Download the July 2014 issue of Needle Tips
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CDC publishes interim guidance for polio vaccination and travel in an MMWR Early Release issued on July 7

On July 7, CDC published an MMWR Early Release titled Interim CDC Guidance for Polio Vaccination for Travel to and from Countries Affected by Wild Poliovirus. This report provides an update on CDC policy for polio vaccination of travelers for health protection. The "Vaccine Recommendations and Requirements" and "Vaccine Recommendations for Travelers to Countries with WPV [wild poliovirus] Circulation" sections are reprinted below.

Vaccine Recommendations and Requirements
Advisory Committee on Immunization Practices (ACIP) and CDC recommendations are evidence-based and provide public health recommendations to the general public on the basis of the best available epidemiological and scientific data to prevent poliovirus infection. This includes recommendations for travelers visiting countries with WPV circulation in the last 12 months or countries and provinces where they will be in situations with a high risk for exposure to persons with imported poliovirus infection.

Three countries are still endemic for polio (Afghanistan, Nigeria, and Pakistan). Countries where WPV has circulated during the previous 12 months include those endemic countries and those with polio outbreaks or environmental evidence of active WPV circulation during this time (Cameroon, Ethiopia, Equatorial Guinea, Iraq, Israel, Somalia, and Syria). Travelers working in health-care settings, refugee camps, or other humanitarian aid settings in these and neighboring countries might be at particular risk for exposure to WPV.

Recommendations for vaccination under the International Health Regulations differ from ACIP and CDC recommendations and include exit requirements for proof of polio vaccination when leaving the country at borders or through airports. If implemented by a country, these requirements could be mandatory and are intended to prevent exportation of WPV.

Vaccine Recommendations for Travelers to Countries with WPV Circulation
Persons at greatest risk for acquiring polio are unvaccinated persons. In the United States, infants and children should be vaccinated against polio as part of a routine immunization series. Before traveling to areas with WPV circulation, all travelers should ensure that they have completed the recommended age-appropriate polio vaccine series and have received a booster dose, if necessary.

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IAC Spotlight! Eight 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 June 17, when IAC Express last reported on the Influenza Vaccination Honor Roll, eight healthcare organizations have been enrolled.

Newly added healthcare organizations, medical practices, and public health agencies
  • Community Health Center, Bremerton, WA
  • Doctors Hospital at White Rock Lake, Dallas, TX
  • HealthSouth Rehabilitation Hospital of San Juan, San Juan, PR
  • Hospital General Menonita de Aibonito, Aibonito, PR
  • Hospital Menonita Cayey, Cayey, PR
  • Springfield Clinic, Springfield, IL
  • U.S. Naval Hospital Guam, FPO, AP 96538-1600, GU
  • VOCES Coalición de Vacunación de Puerto Rico, Guyanabo, PR
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New study published in Pediatrics reinforces the safety of vaccination

On July 1, the journal Pediatrics published an early release article online titled Safety of Vaccines Used for Routine Immunization of U.S. Children: A Systematic Review. The journal also published a related commentary by Carrie L. Byington, MD, FAAP, titled Vaccines: Can Transparency Increase Confidence and Reduce Hesitancy? A related press release from the American Academy of Pediatrics (AAP) is reprinted below.

A systematic review of research on vaccine safety, published online July 1 in Pediatrics, updates a 2011 Institute of Medicine (IOM) report on the safety of vaccines recommended for children aged six years and younger. The study, "Safety of Vaccines Used for Routine Immunization of U.S. Children: A Systematic Review," to be published in the August 2014 Pediatrics, is part of a larger report on the safety of vaccines for adults, adolescents and children requested by the Agency for Healthcare Research and Quality. Researchers from the RAND Corporation conducted a systematic review of the evidence published since the IOM report on vaccines for children under age 6, including DTaP (diphtheria, tetanus and acellular pertussis), hepatitis A, hepatitis B, influenza, meningococcal, MMR (measles, mumps and rubella), and varicella vaccines. The report also reviews the evidence on several childhood vaccines that were not studied in the 2011 IOM report, including Haemophilus influenza type b (Hib), pneumococcal, rotavirus, and inactivated poliovirus vaccines. The evidence is strong that MMR vaccine is not associated with autism, which is consistent with previous reviews on the topic. Researchers also identified strong evidence that MMR, DTaP, Td (tetanus), Hib and hepatitis B vaccines are not associated with childhood leukemia. Studies did show an association of several serious adverse events with vaccines, but these events were very rare, such as intussusception after rotavirus vaccine. Researchers conclude the findings may allay concerns of some parents about vaccine safety. See more at:

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Vaccine Education Center plans September 10 Current Issues in Vaccines webinar 

The Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia will present a free one-hour webinar, beginning at noon (ET) on September 10. Continuing education credits will be available. Part of its Current Issues in Vaccines series, the webinar will feature Paul Offit, MD, director of VEC. Dr. Offit will discuss the following topics:
  • Yellow fever vaccine: Can one dose last a lifetime?
  • Influenza vaccine: Is LAIV better than IIV?
  • HPV vaccine: Are two doses as good as three?
  • HPV vaccine: New 9-valent vaccine
  • Vaccine safety: Febrile seizures
  • PCV13: What about adults?
  • Measles: Update on recent outbreak
Registration (required) is open now.

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Join the Voices for Vaccines' July 11 conference call featuring Shannon Des Roches Rosa

On July 11 at 12:00 p.m. (ET), Voices for Vaccines  is hosting a very important discussion with Shannon Des Roches Rosa. She will share what she has learned from people with autism and their families, including what they have taught her about neurodiversity and what they want you to know about autism.

Shannon Des Roches Rosa is an author and a outspoken advocate for neurodiversity. She writes at her Squidalicious blog, is a contributing editor at BlogHer, and is a co-founder and senior editor of "The Thinking Person's Guide to Autism."

To register for this call, you must email

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 register for the conference call and to join VFV!

IAC updates "After the Shots... What to do if your child has discomfort"

IAC recently updated After the Shots... What to do if your child has discomfort to reflect only the current pediatric products available for pain and fever management. The following text was added to page 2 regarding old formulations of discontinued acetaminophen and ibuprofen products: "No longer available for purchase in the U.S. Please discard old product."
A simplified version of this handout (no dosing tables) is also available in English and seven translations at

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IAC updates "Pneumococcus: Questions and Answers"

IAC recently updated Pneumococcus: Questions and Answers to include new data and ACIP recommendations.

This handout is part of a series of Q&A pieces for healthcare professionals, patients, and parents about vaccine-preventable diseases and the vaccines that prevent them.

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The Center for Biologics Evaluation and Research (CBER) at FDA has a new location

The U.S. Food and Drug Administration (FDA) announced that it has moved the offices and laboratories of the Center for Biologics Evaluation and Research (CBER) from Bethesda and Rockville, Maryland, to the FDA White Oak campus in Silver Spring, Maryland. CBER is the Center within FDA that regulates biological products for human use under applicable federal laws, including the Public Health Service Act and the Federal Food, Drug, and Cosmetic Act.

CBER’s new mailing address is:
            U.S. Food and Drug Administration
            Center for Biologics Evaluation and Research
            Document Control Center
            10903 New Hampshire Avenue
            WO71, G112
            Silver Spring, MD 20993-0002

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CDC posts four new vaccine storage and handling fact sheets

CDC has developed four new vaccine storage and handling fact sheets that illustrate best practices for both refrigerated and frozen vaccines. Written in plain language, they include assessments to reinforce key points. While they are developed and branded by the CDC, each contains an area where an organization can insert its own logo. Related Links Back to top

Voices for Vaccines provides parents with helpful information about measles

Voices for Vaccines (VFV) is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters. VFV recently developed a handy web page for parents titled You Can Do Something about Measles Outbreaks. The page provides background information about the current measles outbreaks, and suggests ways for parents to protect their children and communities and promote vaccination.

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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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June issue of CDC's Immunization Works newsletter now available

CDC recently released the June 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. The information is in the public domain and can be reproduced and circulated widely.

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Archive of CDC's May 22 "Current Issues in Immunization NetConference" on measles now available online

Broadcast on May 22, the latest Current Issues in Immunization NetConference has been archived. The conference featured Gregory S. Wallace, MD, MS, MPH, speaking on "Why Measles Matter."

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Reminder: ACOG in partnership with AAP to offer immunization business strategies webinar on July 30

The American College of Obstetricians and Gynecologists (ACOG) will be offering a free webinar from noon–1:00 p.m. (ET) on July 30 titled Immunization Business & Clinical Strategies for Ob-Gyn Practices. The webinar is sponsored by ACOG’s Immunization Program in collaboration with the American Academy of Pediatrics.

Topics covered will include:
  • Strategies for coding/billing procedures, product ordering, and global fee negotiations
  • High-priority vaccines, relevance to the patient population, and guidelines for administration
  • Role of an immunization champion, including responsibilities for managing the office immunization program
  • Benefits of being connected to states' immunization registries and where to access additional information regarding specific state registries
To register, you must create an account on the ACOG webinar platform, however, there are no restrictions on who can register.

Access more details on the webinar, including registration information.

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Ask the Experts
Question of the Week

Should adult patients who are not asplenic but who have hypogammaglobulinemia receive Haemophilus influenzae type b (Hib) conjugate vaccine? The February 2014 Hib ACIP statement includes immunoglobulin deficiency in its "high-risk groups" for Hib disease, but the recommendations seem to imply that Hib vaccine is not necessarily for adults with immunoglobulin deficiency whose spleens are intact. Am I interpreting ACIP correctly on this matter?
Answer: You are interpreting the recommendations correctly, and age is an important factor in this issue. The recommendation for Hib vaccination for asplenia applies to persons of all ages. The recommendation for Hib vaccination for immunoglobulin deficiency applies only to children 12 through 59 months of age.   

About IAC's Question of the Week

Each week, IAC Express highlights a new, topical, or important-to-reiterate Q&A. This 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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