Issue 1137: August 12, 2014

Ask the Experts–Question of the Week: A 16-year-old has a written record of receiving two doses of DTaP at 2 and 5… read more


WHO declares Ebola outbreak in Africa a public health emergency

A meeting of an Emergency Committee convened by the WHO director-general regarding the 2014 Ebola virus disease outbreak in West Africa was held on August 6–7. It was the unanimous view of the committee that the conditions for a Public Health Emergency of International Concern have been met. A section of the related WHO statement follows:

The Committee advised that:
  • the Ebola outbreak in West Africa constitutes an ‘extraordinary event’ and a public health risk to other States
  • the possible consequences of further international spread are particularly serious in view of the virulence of the virus, the intensive community and health facility transmission patterns, and the weak health systems in the currently affected and most at-risk countries
  • a coordinated international response is deemed essential to stop and reverse the international spread of Ebola
Access the complete WHO Statement on the Meeting of the International Health Regulations Emergency Committee Regarding the 2014 Ebola Outbreak in West Africa.
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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.
  • Community Hospital South, Indianapolis, IN (95%)
  • Coney Island Hospital, Brooklyn, NY (99%)
  • Flushing Hospital Medical Center, Flushing, NY (99%)
  • Harlem Hospital Center, New York, NY (92%)
  • Kings County Hospital Center, Brooklyn, NY (98%)
  • Metropolitan Hospital Center, Women and Children's Services Health, New York, NY (100%)
  • St. Joseph's Hospital, Syracuse, NY (92%)
The Honor Roll now includes 108 birthing institutions from 25 states and Puerto Rico.

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 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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IAC Spotlight! Seven 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 29, when IAC Express last reported on the Influenza Vaccination Honor Roll, seven healthcare organizations have been enrolled.

Newly added healthcare organizations, medical practices, and public health agencies
  • Akron Children's Hospital, Akron, OH
  • Hennepin County Medical Center, Minneapolis, MN
  • Jennie M. Melham Memorial Medical Center, Broken Bow, NE
  • Loup Basin Public Health Department, Burwell, NE
  • Norton County Health Department, Norton, KS
  • Methodist Dallas Medical Center, Dallas, TX
  • T.J. Samson Community Hospital, Glasgow, KY
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Training modules on how to assess the need for adult immunization now available on Medscape

The Provider Work Group of the National Adult Immunization and Influenza Summit, along with Medscape and other partners, have developed a module on adult immunization assessment. This is the first of what will be a four-module interactive series on the Standards for Adult Immunization Practice. Check out the following two offerings to test your knowledge and learn more about assessing adult immunization needs. Related Links Back to top

Applications now open to host the 2016 National Conference on Immunization and Health Coalitions; deadline is October 1

Applications are open to host the 2016 National Conference on Immunization and Health Coalitions. Applications are due October 15, and can be downloaded from the conference website at This biennial conference provides a unique opportunity to network with colleagues and learn up-to-date immunization and coalition-building skills.
Please share this widely with potentially interested coalitions. The planning team at WithinReach would be happy to discuss any questions or ideas you have. Contact Sara Jaye Sanford, MPH, at or (206) 830-5175.

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New! "Zoster Vaccine: CDC Answers Your Questions" features commonly asked Q&As

IAC has just released a new Q&A handout for healthcare professionals titled Zoster Vaccine: CDC Answers Your Questions. Adult vaccination rates are unacceptably low, and zoster (shingles) vaccine is particularly underutilized. This two-page resource includes questions and answers about zoster vaccine, including recommendations, contraindications and precautions, administration, and storage and handling. 

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New! IAC develops "catch-up" guidance table for DTaP, Tdap, and Td vaccination in patients who have fallen behind schedule

IAC recently developed a new resource for healthcare professionals to assist when "catching up" children, adolescents, and adults with DTaP, Tdap, and Td who have fallen behind schedule or are unvaccinated. DTaP, Tdap, and Td Catch-up Vaccination Recommendations by Prior Vaccine History and Age provides guidance in the form of an easy-to-read table.

Related Link IAC's Handouts for Patients & Staff section on 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 updates "When Do Children and Teens Need Vaccinations?"

IAC recently updated its parent handout, When Do Children and Teens Need Vaccinations?, by adding some descriptive text.

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IAC updates "Do I Need Any Vaccines Today?," a screening questionnaire for adult immunization

IAC updates its adult immunization screening questionnaire, Do I Need Any Vaccines Today?, by including adult Hib vaccination. This three-page screening questionnaire helps adult patients determine which vaccines they might need.

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IAC redesigns "All kids need hepatitis B shots!"

IAC's All kids need hepatitis B shots!, a parent handout, has been redesigned as a one-page sheet, and now includes photographs.

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IAC updates translations of the one-page version of "After the Shots ... What to do if your child has discomfort"

In July, IAC redesigned its one-page handout for parents, After the Shots ... What to do if your child has discomfort. The seven translations of this handout—Spanish, Arabic, Chinese, French, Korean, Russian, and Vietnamese—have now been updated to match the English version.

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.

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WHO publishes health requirements for travelers to Saudi Arabia for the 2014 Hajj and Umra seasons in Weekly Epidemiological Record (WER)

The August 8 issue of the WHO periodical, WER, includes an article titled Health conditions for travelers to Saudi Arabia for the pilgrimage to Mecca (Hajj), 2014, which includes vaccination information. The purpose of the article is to inform visitors of the full requirements for entry into Saudi Arabia; publication does not imply that WHO endorses all the measures.

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WHO publishes information about cholera in WER

The August 1 issue of the WHO periodical, WER, includes an article titled Cholera, 2013. It includes information on cholera vaccines, with recommendations for the use of oral cholera vaccines. The first two paragraphs of the section titled "Update: oral cholera vaccines" are reprinted below.


Currently there are 2 WHO pre-qualified OCVs (Dukoral and Shanchol). Both vaccines are licensed in several countries. 

OCVs have proved to be safe, immunogenic and effective. Both vaccines have been used in mass vaccination campaigns with WHO support, and their use has enabled evidence to be collected on the effectiveness and feasibility on implementation of oral cholera vaccination campaigns as a public health tool in protecting populations at high risk of cholera.

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Every Child By Two's "Daily Clips" has a new look—subscribe today

Every Child By Two has redesigned its Daily Clips news service, in conjunction with National Immunization Awareness Month. This service provides subscribers with the day's news and blog clips that discuss vaccines, and encourage immunization partners to use the information to engage with local print and television reports on vaccine issues. Subscribers can also comment on posts.

To subscribe to this newsletter, email Every Child By Two at

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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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MMWR reports on receipt of recommended clinical preventive services by adults and includes vaccination

CDC published Relationship of Income and Health Care Coverage to Receipt of Recommended Clinical Preventive Services by Adults—United States, 2011–2012 in the August 7 issue of MMWR (pages 666–670). An excerpt from the article is reprinted below.

Each year in the United States, an estimated 100,000 deaths could be prevented if persons received recommended clinical preventive care. The Affordable Care Act has reduced cost as a barrier to care by expanding access to insurance and requiring many health plans to cover certain recommended preventive services without copayments or deductibles. To establish a baseline for the receipt of these services and to begin monitoring the effects of the law, CDC analyzed responses from persons aged ≥18 years in the National Health Interview Survey (NHIS) for the years 2011 and 2012 combined. This report summarizes the findings for six services covered by the Affordable Care Act...

For the six services examined, prevalence of receipt of service was as follows: zoster vaccination, 17.9%; influenza vaccination, 39.4%; HIV testing, 41.7%; smoking cessation discussion, 52.0%; pneumococcal vaccination, 61.4%; and tetanus vaccination, 62.0%. A higher percentage of adults with health insurance received five of six recommended clinical preventive services (all but HIV testing) compared with those who were uninsured. Among those five services, the service receipt prevalence ratio for those with insurance compared with those without insurance ranged from 1.2 for tetanus vaccination to 3.4 for pneumococcal vaccination. However, service receipt for persons with health insurance was <50% for three of six recommended clinical preventive services.

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Immunize Georgia Conference scheduled for September 11

The 21st annual Immunize Georgia Conference, "You Are the Key to Protecting Every Adult & Child," will be held at the Georgia International Convention Center on September 11. Open to all healthcare professionals, the conference is an opportunity to learn from outstanding speakers and to network with other private and public health professionals across the state of Georgia.

Scheduled speakers include Anne Schuchat, MD, director, National Center for Immunization and Respiratory Diseases (NCIRD), CDC; Larry Pickering, MD, FAAP, senior advisor to the director, NCIRD, CDC; Audrey Martyn, MPH, influenza surveillance coordinator, Georgia Department of Public Health; Donna Weaver, RN, NM, NCIRD, CDC; and Carolyn Bridges, MD, associate director of adult immunizations, NCIRD, CDC.

More information can be accessed at

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Ask the Experts
Question of the Week

A 16-year-old has a written record of receiving two doses of DTaP at 2 and 5 months of age and one dose of Tdap at 15 years of age. Since she has had three doses of pertussis-containing vaccine, would she still need two additional doses of Td?  
Answer: Since the first DTaP was received before 12 months of age and one Tdap dose has been given, this person needs one dose of Td 6 calendar months after the Tdap dose. A routine Td booster should be administered every 10 years. See IAC's new handout: DTaP, Tdap, and Td Catch-up Vaccination Recommendations by Prior Vaccine History and 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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