Issue 1149: October 28, 2014

Ask the Experts–Question of the Week: The Vaccine Information Statement for inactivated influenza vaccine states that you…read more

New! October issue of Vaccinate Adults now online

The October 2014 issue of Vaccinate Adults is now online.

Click on the image below to download the entire October issue of (PDF) Vaccinate Adults.

October issue of Vaccinate Adults

This issue features important information about the recently released ACIP recommendations for influenza and pneumococcal vaccine. In addition, it presents an array of immunization materials that healthcare professionals can use in their practice settings, including a new how-to guide about the use of standing orders for administering vaccines. 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: October issue of Needle Tips available online

The October 2014 issue of Needle Tips is available online.

Click on the image below to download the entire October issue (PDF) of Needle Tips.

Download the October issue of Needle Tips

Related Links If you would like to receive immediate email notification whenever new issues of Needle Tips or Vaccinate Adults are released, visit IAC's subscribe page to sign up.

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CDC releases updated pediatric multi-vaccine Vaccine Information Statement

CDC posted its updated pediatric multi-vaccine Vaccine Information Statement (VIS) on October 22. This VIS may be used in place of the individual VISs for DTaP, Hib, hepatitis B, polio, and PCV13 when two or more of these vaccines are administered to children 2 months through 6 years of age.

Note that this VIS no longer includes rotavirus vaccine because its unique recommendations aren’t easily harmonized with those for other infant vaccines. The individual rotavirus VIS should be used.

Remaining stocks of the previous (11/16/12) edition of the multi-vaccine VIS should be discarded.

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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 450 organizations are now enrolled.

Since October 7, when IAC Express last reported on the Influenza Vaccination Honor Roll, eight healthcare organizations have been enrolled.

Newly added healthcare organizations, hospitals, health departments, and government entities
  • Akron General Medical Center, Akron, OH
  • Carnegie Indian Health Clinic, Carnegie, OK
  • Columbia St. Mary’s, Milwaukee, WI
  • Comanche County Memorial Hospital, Lawton, OK
  • Complete Children's Health, Lincoln, NE
  • Indian Health Service: Lawton Indian Hospital, Lawton, OK
  • Shoshone Medical Center, Kellogg, ID
  • Tuba City Regional Health Care Corporation, Tuba City, AZ
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CDC publishes article on the history of the Advisory Committee on Immunization Practices

CDC published History and Evolution of the Advisory Committee on Immunization Practices—United States, 1964–2014 in the October 24 issue of MMWR (pages 955–958). The first part of the "Discussion" section is reprinted below.

The 50 years of ACIP's progress reflects the steady increase in the number of vaccines recommended for the civilian population of the United States: from six routine childhood vaccines in 1964, to today's 16 separate antigens that are recommended for routine use in children and adolescents, as well as the vaccines recommended for the adult population. With the passage of the Federal Advisory Committee Act in 1972, ACIP meetings became open to the public, and committee records were required to be made available to the public, thereby increasing transparency and visibility of the decision-making process. An important change was made in 1978, when the chair of the committee was appointed from among the ACIP members, none of whom is a federal government employee, thereby ensuring independence from government. Inclusion of liaison organizations representing various important professional societies or associations facilitates discussion of implementation aspects of introducing a new vaccine to the immunization program, harmonization of recommendations among stakeholders, and rapid dissemination of the recommendations back to the membership of the professional organization. The role played by ACIP in adding childhood vaccines to the VFC program has contributed to the strength of the U.S. immunization program, which has seen increases in vaccination coverage ever since the program was implemented in 1994.

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CDC publishes report on an influenza outbreak in a vaccinated population

CDC published Influenza Outbreak in a Vaccinated Population—USS Ardent, February 2014 in the October 24 issue of MMWR (pages 947–949). A summary made available to the press is reprinted below.

In February 2014, 25 of the 102 crew members of a US Navy minesweeper sought medical care because of influenza-like illness attributed to an influenza A(H3N2) virus antigenically similar to the H3N2 component of the 2013-14 vaccine. Among the crew members, 99 percent had received influenza vaccination, including 24 of the 25 ill persons. Outbreak management included use of an antiviral medication, exclusion of the ill from the ship for 48 hours, disinfection, hand washing, and cough etiquette. No crew member had onset of symptoms more than 6 days after the first crew member had symptoms and ultimately 43 working days were lost.

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WHO announces that Ebola vaccine trials may start as early as January

On October 21, Dr. Marie Paule Kieny, assistant director general of the World Health Organization (WHO), announced at a press conference that Ebola vaccine trials could begin as early as January 2015 in West Africa, dependent on the results of small vaccine trials now underway.

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Vaccine Education Center plans November 19 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 November 19. 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:
  • Meningococcal serogroup B vaccines: Will they receive a routine recommendation?
  • HPV vaccine: Update on the new 9-valent vaccine
  • The bird flu (H5N1) vaccine: Where do we stand?
  • Tdap vaccine and healthcare personnel
Registration (required) is open now.

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Join the Voices for Vaccines' November 17 conference call on influenza featuring IAC's Dr. L.J Tan

This year, even more than in the past, patients and parents seem to have questions about influenza. To answer these questions, Voices for Vaccines (VFV) has invited L.J (Litjen) Tan, MS, PhD, IAC's chief strategy officer, to speak on the November 17 VFV conference call at noon (ET). Dr. Tan is the co-chair of the National Adult and Influenza Immunization Summit.

To register for this call, you must email

Click here for more information about this conference call: What to Do about the Flu

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!
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IAC updates "Pneumococcal Vaccination Recommendations for Children and Adults by Age and/or Risk Factor"

IAC has revised Pneumococcal Vaccination Recommendations for Children and Adults by Age and/or Risk Factor to reflect the recent ACIP recommendation to provide a dose of PCV13 to all adults age 65 years and older.

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 posts 25 new VIS translations, including Armenian, Farsi, Haitian Creole, Hmong, Korean, Portuguese, and Tagalog

IAC recently posted 25 new VIS translations as detailed below:

Armenian VIS translations Farsi VIS translations Haitian Creole VIS translations Hmong VIS translations Korean VIS translations Portuguese VIS translations Tagalog VIS translations IAC has provided these translations through a cooperative agreement with CDC's National Center for Immunization and Respiratory Diseases. 

Visit IAC's VIS web section for VISs in more than 35 languages.

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CDC announces active post-arrival Ebola monitoring for travelers from countries most affected by the disease

On October 22, CDC issued a press release titled CDC Announces Active Post-Arrival Monitoring for Travelers from Impacted Countries. The first paragraph is reprinted below.

The Centers for Disease Control and Prevention (CDC) announced that public health authorities will begin active post-arrival monitoring of travelers whose travel originates in Liberia, Sierra Leone, or Guinea.  These travelers are now arriving to the United States at one of five airports where entry screening is being conducted by Customs and Border Protection and CDC. Active post-arrival monitoring means that travelers without febrile illness or symptoms consistent with Ebola will be followed up daily by state and local health departments for 21 days from the date of their departure from West Africa. Six states (New York, Pennsylvania, Maryland, Virginia, New Jersey, and Georgia), where approximately 70% of incoming travelers are headed, have already taken steps to plan and implement active post-arrival monitoring which will begin on Monday, October 27. Active post-arrival monitoring will begin in the remaining states in the days following. CDC is providing assistance with active post-arrival monitoring to state and local health departments, including information on travelers arriving in their states, and upon request, technical support, consultation and funding.

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WHO publishes position paper on use of HPV vaccines

The World Health Organization (WHO) published Human papillomavirus vaccines: WHO position paper, October 2014, in the October 24 issue of WHO's Weekly Epidemiological Record. WHO position papers are concerned primarily with the use of vaccines in large-scale immunization programs around the world.

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World Polio Day—October 24, 2014—announced in the MMWR

CDC published World Polio Day—October 24, 2014 in the October 24 issue of MMWR (page 941). The entire announcement is reprinted below.
World Polio Day was established for annual observance on October 24 by Rotary International more than a decade ago to commemorate the fight against poliomyelitis. Widespread use of poliovirus vaccine led to an increasing number of polio-free countries and to establishment of the Global Polio Eradication Initiative (GPEI) in 1988. As of October 14, a total of 243 polio cases had been reported in 2014, with 92% of the cases reported from Nigeria, Afghanistan, and Pakistan, the only three countries where transmission of indigenous wild poliovirus has continued uninterrupted.

On December 2, 2011, the CDC Emergency Operations Center was activated to strengthen the agency's partnership engagement through GPEI. In April 2012, the World Health Assembly declared completion of polio eradication a programmatic emergency for global public health. In May 2014, the international spread of poliovirus was declared a public health emergency of international concern. Additional information regarding CDC's polio eradication activities is available at, and additional information about GPEI and the global partnership is available at

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Childhood Influenza Immunization Coalition offers many tools to promote vaccination

The Childhood Influenza Immunization Coalition (CIIC) has developed many tools and resources to help healthcare professionals and others interested in children's health promote influenza vaccination. The CIIC website includes videos, a coloring book for children, a series of twelve 'flu facts' that can be shared online every week, a calendar of sample Twitter messages and Facebook posts, and more.

Visit the CIIC website at to explore all the offerings. Questions can be directed to

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Influenza is serious; many resources are available to aid healthcare professionals in vaccinating

Vaccination remains the single most effective means of preventing influenza, and is recommended for everyone age six months and older. If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to a clinic or pharmacy that provides vaccines or to the HealthMap Vaccine Finder to locate sites near their workplaces or homes that offer influenza vaccination services.

Following is a list of resources related to influenza disease and vaccination for healthcare professionals and the public: Back to top

CDC reports on lessons learned during the polio-free certification process in the South-east Asia Region
CDC published Polio-Free Certification and Lessons Learned—South-East Asia Region, March 2014 in the October 24 issue of MMWR (pages 941–946). The first paragraph is reprinted below.

In 1988, the World Health Assembly resolved to interrupt wild poliovirus (WPV) transmission worldwide. By 2006, the annual number of WPV cases had decreased by more than 99%, and only four remaining countries had never interrupted WPV transmission: Afghanistan, India, Nigeria, and Pakistan. The last confirmed WPV case in India occurred in January 2011, leading the World Health Organization (WHO) South-East Asia Regional Commission for the Certification of Polio Eradication (SEA-RCC) in March 2014 to declare the 11-country South-East Asia Region (SEAR), which includes India, to be free from circulating indigenous WPV. SEAR became the fourth region among WHO's six regions to be certified as having interrupted all indigenous WPV circulation; the Region of the Americas was declared polio-free in 1994, the Western Pacific Region in 2000, and the European Region in 2002. Approximately 80% of the world's population now lives in countries of WHO regions that have been certified polio-free. This report summarizes steps taken to certify polio eradication in SEAR and outlines eradication activities and lessons learned in India, the largest member state in the region and the one for which eradication was the most difficult.

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CDC publishes article about control of Ebola in the Firestone district of Liberia

CDC published Control of Ebola Virus Disease—Firestone District, Liberia, 2014 in the October 24 issue of MMWR (pages 959–965). This article was previously published as an MMWR Early Release on October 21. The first part of the first paragraph is reprinted below.

On March 30, 2014, the Ministry of Health and Social Welfare (MOHSW) of Liberia alerted health officials at Firestone Liberia, Inc. (Firestone) of the first known case of Ebola virus disease (Ebola) inside the Firestone rubber tree plantation of Liberia. The patient, who was the wife of a Firestone employee, had cared for a family member with confirmed Ebola in Lofa County, the epicenter of the Ebola outbreak in Liberia during March–April 2014. To prevent a large outbreak among Firestone's 8,500 employees, their dependents, and the surrounding population, the company responded by 1) establishing an incident management system, 2) instituting procedures for the early recognition and isolation of Ebola patients, 3) enforcing adherence to standard Ebola infection control guidelines, and 4) providing differing levels of management for contacts depending on their exposure, including options for voluntary quarantine in the home or in dedicated facilities.

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Texas Immunization Summit to be held in San Antonio on November 5–7

The Immunization Partnership is hosting a Texas Immunization Summit on November 5–7 in San Antonio. This conference will feature many nationally known speakers, and has just added a timely plenary session titled "Preventing Pandemics: Ebola and Neglected Tropical Diseases." Please email with any questions about the conference.

The Immunization Partnership is a nonprofit organization that evolved from the partnership originally dedicated to supporting the Houston-Harris County Immunization Registry. Its mission is to eradicate vaccine-preventable diseases by educating the community, advocating for evidence-based public policy, and supporting immunization best practices.

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Question of the Week

The Vaccine Information Statement for inactivated influenza vaccine states that you should not get the vaccine if you are severely allergic to antibiotics. Which antibiotics are they referring to? 
Answer: The antibiotics, of which there are trace amounts in some influenza vaccines, are neomycin, gentamicin, and polymyxin B. You should check each product’s package insert information to see which, if any, antibiotics are listed. For a list of the package insert information for vaccines, visit FDA's website or IAC's website 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.

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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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