Issue 1136: August 5, 2014

Ask the Experts–Question of the Week: What are the CDC guidelines regarding use of multiple dose vaccine vials?… read more


It's National Immunization Awareness Month; learn about many new resources

August is National Immunization Awareness Month (NIAM), providing everyone with an opportunity to raise awareness about the importance of immunization and the need for improving national vaccination coverage levels. The observance features a different population each week:
  • Week 1 (August 3–9): "A Healthy Start" features babies from birth to age 2 and pregnant women
  • Week 2 (August 10–16): "Back to School" features children, preteens, and teens to age 18
  • Week 3 (August 17–23): "Off to the Future" features young adults age 19–26
  • Week 4 (August 24–30): "Not Just for Kids" features adults age 26+
The following are new resources released for National Immunization Awareness Month:
  • The National Public Health Information Coalition, in collaboration with CDC, has developed a National Immunization Awareness Month Communication Toolkit that includes key messages, vaccine information, sample news releases and articles, sample social media messages, and links to web resources from CDC and other organizations
  • The Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia has developed a mobile app called Vaccines on the Go: What You Should Know. This app provides parents and patients with reliable information about the science, safety, and importance of vaccines and the diseases they prevent. Vaccines on the Go includes unique resources such as graphics and links to a variety of VEC-produced videos and print materials. Download the free app, available for Apple and Android devices, or get more information at
  • Every Child By Two has launched a new online interactive resource titled Vaccine-Preventable Diseases eBook; the book can be downloaded, printed, and distributed—either as a whole (PDF format) or as individual web pages by disease
  • CDC's Recognizing National Immunization Awareness Month (NIAM) web section offers resources for parents and patients of different ages
  • PKIDs is spreading the news about its Value of Vaccination program; learn more about it at, check out the website and the social media platforms, and join the conversation!
  • IAC offers resources for parents and patients of all ages on its website for the public at
We encourage you to explore the many ideas and resources presented to see what you can use to promote vaccination in your sphere of influence!

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IAC enrolls the 101st birthing institution into its Hepatitis B Birth Dose Honor Roll; comprehensive slide set now available

The Immunization Action Coalition (IAC) is pleased to announce that six 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.
  • Forest Hills Hospital, Forest Hills, NY (91%)
  • Hospital Dr. Fredrico Trilla, Carolina, PR (99%)
  • Lincoln Medical and Mental Health Center, Bronx, NY (100%)
  • New York Hospital of Queens, Flushing, NY (93%)
  • St. Barnabas Hospital, Bronx, NY (99%)
  • St. Claire Regional Medical Center, Morehead, KY (92%)
The Honor Roll now includes 101 birthing institutions from 25 states and Puerto Rico!

In addition, IAC has added a revised slide set to its website for use by hospitals, health departments, private providers, or anyone else who wants to provide education about why the birth dose is recommended. The presentation, titled Give birth to the end of Hep B, provides an overview of hepatitis B and perinatal infection, current recommendations, and explains why a universal birth dose policy provides a needed safety net.

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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CDC reports on an outbreak of pertussis in a school and religious community in Florida

CDC published Notes from the Field: Outbreak of Pertussis in a School and Religious Community Averse to Health Care and Vaccinations—Columbia County, Florida, 2013 in the August 1 issue of MMWR (page 655). The first two and last paragraphs are reprinted below.

On August 30, 2013, the Florida Department of Health in Columbia County was notified of a Bordetella pertussis laboratory-positive unimmunized child attending a local charter school (316 students from pre-K through 8th grade) in a large religious community averse to health care and vaccinations. Kindergarten immunization records showed that only five (15%) of 34 students were fully immunized with pertussis-antigen–containing vaccines. In seventh grade, only one (5%) of 22 students was fully immunized with pertussis-antigen–containing vaccines. Of the children who were not fully immunized in these two grades, 84% had religious exemptions.

Interviews confirmed that a sibling of the patient had symptoms consistent with pertussis. By September 3, two additional children from the same school were confirmed by polymerase chain reaction to have pertussis. On September 12, the Florida Department of Health in Columbia County declared a communicable disease emergency; children with cough illness were excluded from school, and reentry required an evaluation by a health care provider. After this declaration, 38 additional students were excluded. Prophylaxis or treatment with antibiotics following current guidelines were provided to patients and household contacts. The local health department offered to provide these services free of charge to persons without health care coverage. Pertussis vaccine administered at the health department was available; however, fewer than five persons from the community used this opportunity for vaccination.

In vaccine-averse communities, controlling vaccine-preventable disease outbreaks is challenging, particularly when susceptible community members have prolonged contact in multiple settings. Local public health agencies need to identify and collaborate with institutions and health care resources to reduce morbidity from vaccine-preventable diseases in communities where a substantial number of persons do not have immunity. Physicians should pursue laboratory testing for pertussis in patients with symptoms consistent with the disease. However, physicians also need to understand the importance of reporting presumptive pertussis cases, even without laboratory confirmation, to public health departments.

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Agenda for August ACIP meeting available; follow the meeting online 

CDC has released a final agenda for the next Advisory Committee on Immunization Practices (ACIP) meeting, which will be held on August 13 from 2:00 p.m. to 4:00 p.m. (ET). This is an extra ACIP meeting, scheduled to discuss the use of pneumococcal vaccines in adults. The meeting will be conducted via webinar and telephone. Those interested in participating can access the final agenda and call-in information here.

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Reminder: Registration open for the 2014 National Immunization Conference

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. 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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Merck discontinues production of Comvax vaccine (Hib-HepB)

On July 30, CDC provided the following update about Comvax vaccine on its Current Vaccine Shortages & Delays web page.

Merck has decided to discontinue production of COMVAX (Hib-HepB) vaccine, and has ample supply of PedvaxHIB and RECOMBIVAX HB to meet the historical demand for these products as well as COMVAX. The vaccine can still be purchased directly from Merck, as well as through wholesalers and physician distributors, until all supplies have been depleted. COMVAX will not be available for purchase directly from Merck after December 31, 2014.

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IAC Spotlight! Immunization resources for your clinic or medical setting from IAC, CDC, and other trusted sources

Looking for "how-to" information about providing vaccinations in a clinic or non-traditional setting? Look no further. IAC’s Clinic Resources web section provides a treasure trove of materials for vaccinators.

Topic areas covered in the Clinic Resources section on include Back to top

Invisible Threat documentary available for online viewing; Los Angeles Times features article about the film's production

The film Invisible Threat focuses on understanding the science of vaccination and the misperceptions leading parents to delay or decline life-saving immunizations. This 40-minute independent documentary, produced by award-winning high school student filmmakers, has earned praise from more than 50 organizations. Beginning August 1, the film will be available to watch on-demand from the Vimeo website (cost is $5.00 per 24-hour viewing period) in conjunction with National Immunization Awareness Month. Visit the chstvFILMS website for more information about renting the film and obtaining related educational resources.

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IAC updates its Hepatitis B "Ask the Experts" web section

Based on a content review by vaccine experts at CDC, IAC recently updated the Hepatitis B web section of Ask the Experts.

IAC’s Ask the Experts web section is a compilation of common yet challenging questions and answers (Q&As) about vaccines and their administration. The experts are Andrew T. Kroger, MD, MPH, medical officer, and Donna L. Weaver, RN, MN, nurse educator. Both are at CDC's National Center for Immunization and Respiratory Diseases. The Q&As have been featured in previous issues of IAC ExpressNeedle Tips, and Vaccinate Adults.

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AAP releases updated recommendations on the use of meningococcal vaccines

On July 28, the American Academy of Pediatrics (AAP) released a policy statement online titled Updated Recommendations on the Use of Meningococcal Vaccines.

All vaccine policy statements from AAP are available on IAC's AAP Policy Statements web section.

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WHO publishes guidance on the choice of pertussis vaccines

The World Health Organization (WHO) published Revised Guidance on the Choice of Pertussis Vaccines in the July 25 issue of the Weekly Epidemiological Record. This guidance precedes an updated position paper by WHO addressing pertussis vaccines. The updated position paper is expected in 2015.

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HealthMap Vaccine Finder lets the public find provider locations that administer adult vaccinations; now is a good time for providers to list their vaccination services on HealthMap

The HealthMap Vaccine Finder is a free online service that allows the public to use their zip codes to find adult vaccination services by location.

The start of influenza season is an excellent time for healthcare professionals who provide adult vaccines to list their location on this resource. If you provide influenza, hepatitis A, hepatitis B, HPV, MMR, Td, Tdap, meningococcal, pneumococcal, varicella, or zoster vaccine, consider adding your practice or clinic to HealthMap Vaccine Finder. You don't need to provide all adult vaccines to participate. If you are a provider who doesn't provide all adult vaccines, please refer your patients to HealthMap Vaccine Finder as a way to help them find a source for indicated vaccination.

If you are a provider who participated last year, you can log in to your account and update your information by following the directions on the Help tab.

If you are a new provider, you must first register for an account. Once you receive your password and log in, you can upload the required information to your account.

Access more information about HealthMap Vaccine Finder.

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Minnesota Department of Health develops new video for healthcare professionals on HPV vaccine communication

Despite the fact that a healthcare provider recommendation is the single best predictor of vaccination, data suggest that providers are not giving strong recommendations for HPV vaccine when patients are 11 or 12 years old. The Minnesota Department of Health (MDH) has developed a 12-minute video for healthcare professionals on HPV vaccine communication. The video begins with humorous vignettes and then presents four model clinical encounters in which providers demonstrate low-stress ways of recommending HPV and answering questions from patients and parents. Each of the model encounters can also be viewed individually.

Access the MDH HPV Video Series for Health Care Providers web page.

Contact to obtain files of any of these videos for use in professional education programs.

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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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Viral Hepatitis Prevention Board updates its website

The Viral Hepatitis Prevention Board (VHPB) released an updated website on July 28: World Hepatitis Day. The renewed VHPB website is accessible at the same address as the previous website: Changes include:
  • New layout, with easy access to all information
  • Presentations of all meetings remain available
  • Updated slide sets with key facts on hepatitis B and C epidemiology, prevention and control, and more
The objective of VHPB is to contribute to the control and prevention of viral hepatitis. Access more information on VHPB.

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July issue of CDC's Immunization Works newsletter now available

CDC recently released the July 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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Public Health Reports details contributions of HHS toward global immunization

A supplement to the September/October 2014 issue of Public Health Reports provides information from the National Vaccine Advisory Committee (NVAC) on the contributions of the U.S. Department of Health and Human Services (HHS) toward global immunization. NVAC provides recommendations and highlights priority areas for HHS to enhance U.S. efforts toward preventing vaccine-preventable diseases worldwide. The analysis provided in the report is intended to build awareness and support for HHS activities as they contribute overall to national global health goals, and highlight areas for potential collaboration with global partners.

Access The HHS National Vaccine Program and Global Immunization NVAC Report and Recommendations Approved by the National Vaccine Advisory Committee on September 12, 2013.

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VICNetwork webinar about influenza scheduled for August 13

The VICNetwork has scheduled a webinar on August 13 that will provide an overview of the 2014–15 influenza season. The session will feature information on communication campaign plans for disparate populations and provide an overview of work with Hispanic, African American, and American Indian/Alaska Native populations.

Speakers for this webinar are Joseph Bresee, M.D., FAAP, chief of the Epidemiology and Prevention Branch in CDC's Influenza Division; Cindy Fowler, health communication specialist, CDC; Carlos Velázquez, MA, project director for CDC's National Influenza Vaccination Promotion Campaign for Health Disparate Populations; and Blake Harper, MPH, public health manager at the National Indian Health Board.

The one-hour webinar begins at 2:00 p.m. (ET).

The Virtual Immunization Communication (VIC) Network is a project of the National Public Health Information Coalition and the California Immunization Coalition. 

Registrations are being accepted.

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Public Health Vaccinology course set for September 3–4 in Atlanta

CDC's National Center for Immunization and Respiratory Diseases is sponsoring a Public Health Vaccinology Course on September 3–4 in Atlanta. The course will focus on the biologic basis of vaccine development, vaccine licensure and recommendations, specific vaccines and vaccine-preventable diseases, immunization program implementation, vaccine hesitancy and risk communication, vaccine safety issues, global vaccines, and maternal immunization. Space is limited, so early registration is recommended. Continuing Medical Education (CME) will be available for the course. Back to top

Archived video broadcast of the June 2014 ACIP meeting now available 

ACIP recently posted the archived video broadcast footage from the ACIP meeting held on June 25–26.

Presentation slides from this meeting are also available.

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Ask the Experts
Question of the Week

What are the CDC guidelines regarding use of multiple dose vaccine vials?   
Answer: Vaccines in multidose vials can be used through the expiration date on the vial unless indicated otherwise by the manufacturer. For example, inactivated polio vaccine in a multidose vial can be used through the expiration date on the vial. For some vaccines, the manufacturer specifies that once the multidose vial has been entered or the rubber stopper punctured, the vaccine must be used within a certain number of days. This is commonly referred to as the "beyond-use date" (BUD). Any vaccine not used within the BUD should be discarded. Specific information regarding the BUD can be found in the product information. For example, the package insert for some inactivated influenza vaccine indicates once the stopper of the multidose vial has been pierced, the vial must be discarded within 28 days. Package inserts for vaccines can be found at

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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