Issue 1135: July 29, 2014

Ask the Experts–Question of the Week: We have a 10-year-old getting renal dialysis. The nephrologist will be starting her on  …read more


CDC reports on adolescent vaccination coverage rates in 2013

CDC published National, Regional, and State Vaccination Coverage Among Adolescents Aged 13–17 Years—United States, 2013, in the July 25 issue of MMWR (pages 625–633). A summary made available to the press is reprinted below.

While there was a modest increase in vaccination coverage among adolescents (aged 13–17) for each of the routinely recommended adolescent vaccines from 2012 to 2013, progress is occurring at an unacceptably slow pace for HPV vaccination. Only 57.3 percent of girls and 34.6 percent of boys have received at least 1 dose of HPV. Coverage rates for Tdap and meningococcal vaccines continue to be strong with 86 percent of teens having received Tdap and 77.8 percent of teens having received the first dose of meningococcal vaccine. This report includes the first estimate of uptake of the second dose of meningococcal vaccine with 29.6 percent of teens (aged 17 years) having received it. 

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CDC publishes information on HPV vaccination coverage among adolescents and postlicensure safety monitoring 

CDC published Human Papillomavirus Vaccination Coverage Among Adolescents and Postlicensure Vaccine Safety Monitoring—United States, 2006–2014, in the July 25 issue of MMWR (pages 620–624). A summary made available to the press is reprinted below.

With only a modest increase in coverage, HPV vaccination rates among adolescents remained low for another year. The vaccine is safe, effective, and prevents cancer, but it continues to be underutilized and missed opportunities are common. Had HPV vaccine been administered during health care visits when another vaccine was administered, vaccination coverage for ≥1 dose could have reached 91.3 percent by age 13 years for adolescent girls born in 2000. Only 64.4 percent of parents of girls and 41.6 percent of parents of boys reported receiving a recommendation. More parents of teens who received the HPV vaccine reported getting a vaccine recommendation, confirming findings from other research that a recommendation from a healthcare professional is extremely influential in determining whether or not parents get HPV vaccine for their preteen.

Related Links

From AAFP, AAP, ACOG, ACP, CDC, and IAC HPV Resources from IAC HPV Resources from CDC HPV Resources from the Vaccine Education Center
HPV resources from AAP
HPV Resources from Voices for Vaccines
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IAC Spotlight! Nine 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 July 8, when IAC Express last reported on the Influenza Vaccination Honor Roll, nine healthcare organizations have been enrolled.

Newly added healthcare organizations, medical practices, and public health agencies
  • Barton Health, South Lake Tahoe, CA
  • Clinica Family Health Services, Lafayette, CO
  • HRHCare, Amenia, NY
  • Lifetime Health Medical Group, Pittsford, NY
  • Manchester Memorial Hospital, Manchester, KY
  • Norton Healthcare, Louisville, KY
  • Saint Joseph Mount Sterling, Mount Sterling, KY
  • Sanford Health, Luverne, MN
  • Southeast Missouri Mental Health Center, Farmington, MO
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Celebrate World Hepatitis Day with national leaders via live streaming

On July 30, from 12:00–2:30 p.m. (ET), the White House Office of National AIDS Policy, Office of National Drug Control Policy, and White House Initiative on Asian Americans and Pacific Islanders will commemorate World Hepatitis Day and recognize leaders in the field. The event will feature remarks from senior federal officials as well as community leaders, including:
  • Michael Botticelli, acting director, White House Office of National Drug Control Policy
  • Douglas Brooks, director, White House Office of National AIDS Policy
  • Ambassador Deborah Birx, U.S. global AIDS ambassador
  • Dr. Howard Koh, assistant secretary for health, U.S. Department of Health and Human Services
  • Dr. Paul Farmer, Partners in Health
Anyone interesting in participating can join this event by logging onto at the scheduled time. Please share this message with your colleagues, state and local partners, and others who have an interest in viral hepatitis so that they, too, can observe World Hepatitis Day.

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CDC publishes article about World Hepatitis Day—July 28, 2014 

CDC published World Hepatitis Day—July 28, 2014, in the July 25 issue of MMWR (page 613). The complete article is reprinted below.

July 28, 2014, marks the 4th annual World Hepatitis Day. Nearly 400 million persons are living with hepatitis B or hepatitis C, and more than 1 million die annually as a result of their infection. This year, the 67th World Health Assembly (WHA) reaffirmed the global commitment to prevent and control viral hepatitis through the passage of resolution WHA 67.6, which calls for raising public awareness, improving surveillance, strengthening prevention interventions, and increasing access to care and treatment services.

Blood transfusions save lives, and globally more than 100 million units of blood are donated annually. Ensuring access to safe blood is a key strategy for the prevention of hepatitis B and C. In many of the poorest countries of the world, less than 50% of the blood supply comes from voluntary, unpaid donors that were adequately screened for transfusion transmitted infections, including hepatitis B and C.

Prevention and control of hepatitis remains a major challenge in sub-Saharan Africa. This issue of MMWR includes a report from sub-Saharan Africa describing substantial increases in the number of blood units donated and screened for hepatitis B and C during the last decade. Despite these gains, the report demonstrates that the risk for transmission of hepatitis B and C through transfusion persists in many countries in the region. It is estimated that in sub-Saharan Africa, more than 45,000 hepatitis B virus or hepatitis C virus infections are transmitted through contaminated transfusions annually.

Resources and information about World Hepatitis Day are available at

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Clarification of statement about MMR vaccine recommendations for international travel

The April 29 edition of IAC Express (issue #1118) quoted portions of an April 25 MMWR article titled Notes from the Field: Measles—California, January 1–April 18, 2014. The second sentence of the last paragraph of the article (“Vaccine recommendations for travel outside North or South America by those born ”) suggested that MMR vaccine recommendations for international travelers did not apply to international destinations in North or South America. We checked with the measles subject matter experts at CDC who informed us that this statement is not correct. MMR vaccination recommendations for international travelers apply to all international destinations, including those in North and South America. Thanks to alert reader Pat in Pennsylvania for pointing out this discrepancy.

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IAC updates "Don’t Be Guilty of These Preventable Errors in Vaccine Storage and Handling!"

IAC recently updated Don’t Be Guilty of These Preventable Errors in Vaccine Storage and Handling! to incorporate new recommendations from CDC on vaccine storage and handling. The handout also was redesigned with color accents.

Related Links 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 redesigns one-page version of "After the Shots ... What to do if your child has discomfort"

IAC recently redesigned its one-page handout for parents, After the Shots ... What to do if your child has discomfort. This handout is also available in seven translations at

IAC also maintains a two-page version of After the Shots ... What to do if your child has discomfort that includes dosing tables for medicines to reduce pain and fever. This more complicated handout is only available in English and Turkish.

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IAC's website offers links to books on immunization for both adults and children

IAC's online Directory of Immunization Resources includes a section of books for parents, some written to teach children about immunization and some written for adults on both vaccine basics and current controversies. The children's books include:
  • Vaccines for Maxine by Geri Rodda, RN. Learn all about vaccines as Maxine and her puppy put on a dream-world play.
  • Flu and You by Geri Rodda, RN. Influenza arrives each fall, with plans to spread its germs to all! Follow Influenza as she goes to school, home, and the playground. Learn healthy habits to avoid catching and spreading the flu.
  • The Saturday Shot; A Nellie Park Adventure by Morgan Thomas. Join author Morgan Thomas on her creative journey with Nellie Park, a girl who is facing her biggest fear—the needle. The Saturday Shot is the perfect remedy for kids of all ages dealing with a vaccination appointment.
The selection of books for adults include some with basic information for parents of newborns, as well as a number of readable and well-researched publications on the history of vaccines, the anti-vaccine movement, and the safety of vaccines.

Access the Publications for Parents web section for more information on these books, including links to ordering information.

Related Links Access IAC's Directory of Immunization Resources, a compendium of helpful immunization resources from a variety of organizations: government, professional associations, nonprofit organizations, private industry, and more.

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IAC's sturdy laminated version of the 2014 U.S. adult immunization schedule is still available for purchase—order a supply for your healthcare setting today!

Limited quantities of IAC's 2014 U.S. adult immunization schedule are still available for purchase. IAC's laminated schedules 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 adult immunization schedule has six pages (i.e., three double-sided pages) and is folded to measure 8.5" x 11".
IAC'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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CDC publishes article about WHO Global Rotavirus Surveillance Network

CDC published WHO Global Rotavirus Surveillance Network: A Strategic Review of the First 5 Years, 2008–2012 in the July 25 issue of MMWR (pages 634–637). A summary made available to the press is reprinted below.

Rotavirus is a leading cause of severe gastroenteritis among children aged <5 years worldwide, accounting for approximately 5 percent of child deaths annually. Since 2009, WHO has recommended that rotavirus vaccines be introduced in all national immunization programmes, particularly in countries with high diarrhea-related child mortality. To provide data for country decision making around rotavirus vaccine introduction and use, WHO since 2008 has coordinated a Global Rotavirus Surveillance Network that included 178 sentinel surveillance hospitals in 60 countries globally in 2012. A strategic review of the network conducted in 2013 demonstrated that network data were useful for country policy decisions and also identified areas for improvement of the network. Consistent and high-quality sentinel hospital surveillance provides critical data to inform decisions related to vaccine introduction and vaccination program sustainability.        

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CDC reports on progress toward prevention of transfusion-transmitted HBV and HCV infection in sub-Saharan Africa

CDC published Progress Toward Prevention of Transfusion-Transmitted Hepatitis B and Hepatitis C Infection—Sub-Saharan Africa, 2000–2011 in the July 25 issue of MMWR (pages 613–619). A summary made available to the press is reprinted below.

In sub-Saharan Africa, hepatitis B virus (HBV) and hepatitis C virus (HCV) infections spread through blood transfusions remain a public health burden. Reducing the number of donated blood units with HBV and HCV is a priority for countries seeking ways to increase the safety of national blood supplies. From 2000 to 2011, the number of countries in sub-Saharan Africa screening >95 percent of donated blood units for HBV increased from 76 percent to 94 percent, while the number of countries screening >95 percent of donated blood units for HCV increased from 34 percent to 86 percent. Over the same period, there was a 37 percent decrease in the proportion of donated blood units with markers of HBV infection and 51 percent decrease in proportion of donated blood units with markers of HCV infection.

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October 20–22 Nevada Health Conference includes CDC's Epidemiology & Prevention of Vaccine-Preventable Diseases course

The 2014 Nevada Health Conference will be held October 20–22 in Reno, Nevada. The conference will include presentations by regional and national experts speaking on topics related to the theme “Keeping our Children, Families and Communities Healthy." CDC's live two-day Epidemiology & Prevention of Vaccine-Preventable Diseases course is scheduled for October 21–22. The course provides a comprehensive review of immunizations and the diseases they prevent. Continuing education credits are available.

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Ask the Experts
Question of the Week

We have a 10-year-old getting renal dialysis. The nephrologist will be starting her on a monoclonal antibody that interferes with C5 complement. If we administer a MCV4 and a PPSV23 now, and then give her a PCV13 in 8 weeks, will the PCV13 interfere with the efficacy of the PPSV23 or the MCV4?  
Answer: Recommendations to separate MCV4 and PCV13 only apply to persons with functional or anatomic asplenia. So the best schedule is to give MCV4 (either MCV4-D or MCV4-CRM) simultaneously with PCV13, and then PPSV23 in eight weeks. ACIP recommends giving PCV13 before PPSV23 in order to maximize the immune response from PCV13. PPSV23 blunts the immune response to PCV13 if PCV13 is given after PPSV23, although in children there is a smaller effect than in adults.

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

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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