Issue 1154: November 25, 2014

Ask the Experts–Question of the Week: A one-month-old infant was exposed for the last 6 days to chickenpox. What should be done … read more

Your donation to IAC supports our shared goal to protect everyone through immunization

As many of us prepare for the Thanksgiving holiday, we at IAC are so grateful for being part of the special community of dedicated people who work day in and day out to protect health and save lives through immunization.
Our thanks go out to each of you who have furthered our shared mission by using our information and resources, providing us with valuable feedback about our services, and, most of all, through your day-to-day work as advocates and vocal supporters of immunization. Our immunization objectives could not be accomplished without your daily commitment to promoting good health.
With our annual end-of-year fundraising campaign under way, we want to thank all of you who have already supported us through a donation to our “Give to the Max Day” campaign or IAC’s holiday fundraising letter mailed last week. Please let us know if you would like to be added to our appeal letter mailing list for next year. We make an effort to offer you several convenient opportunities to support IAC. If you have not donated yet, this is the ideal time to finalize your annual gift to IAC. 
Please visit the Immunization Action Coalition donation page at and read the appeal letter from IAC Executive Director Dr. Deborah Wexler, sharing some of IAC’s accomplishments in 2014. All of you play a critical role in these accomplishments. Vaccines do their most powerful work in your skilled and dedicated hands, and we do our utmost to keep you informed with the very latest in reliable vaccine information.
We hope you will continue to support our work with your donation today. Your tax-deductible gift fuels our shared effort to protect communities across the nation through immunization. We thank you for your support, wish you joy in this holiday season, and look forward to continuing to support your critical work in saving lives in 2015. Happy Thanksgiving!

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Extensive collection of U.S. immunization facts and policy now available online

The Vaccine Facts and Policy (VFAP) project is making available, for the first time in one location, an expansive compilation of detailed immunization data from every major jurisdiction in the United States.

The project website,, includes information within five major topic areas related to immunization law and policy including: demographics and rates, fiscal environment, law and policy, strategies and initiatives, and the structure of immunization programs. Users may customize their experience by searching the data by jurisdiction or topic.
By making this interactive and well-referenced database freely available, the project seeks to enhance the ability of immunization stakeholders, healthcare providers, the vaccine industry, policymakers, legislators, advocates, and consumers to access consistent information and work together in pursuit of higher immunization coverage against vaccine-preventable diseases.
The project is a partnership of the Milken Institute School of Public Health at the George Washington University (GW), the Association of Immunization Managers (AIM), and the Immunization Action Coalition (IAC). This unique partnership builds upon the strengths of each organization, enhancing the value and functionality of the project. Funding has been provided by an educational grant from Pfizer, Inc. which provides no input into the content or conduct of the project.

Frequently Asked Questions (FAQ) about the VFAP project are answered online.

IAC partners are urged to spread word of the VFAP project to their stakeholders through newsletters, emails, and social media. The FAQ and a one-page VFAP information sheet may be used in these communications.

Please contact Katelyn Wells at AIM with any questions or suggestions, or if you would like a presentation of the site given to your collaborators, committees, or workgroups.

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IAC issues correction to FluBlok age indication in last week's special "Ask the Experts" edition of IAC Express

IAC published an "Ask the Experts" Q&A in the October issues of Needle Tips and Vaccinate Adults that included the following sentence: "If someone age 18 through 49 years has a severe allergy to eggs with symptoms suggestive of anaphylaxis, then the provider can use a recombinant influenza vaccine (RIV3, Flublok, Protein Sciences) that is egg-free." Although this statement was true when Needle Tips and Vaccinate Adults were published, on October 29 FDA approved an expanded age licensure for Flublok to include patients age 18 years and older.

Unfortunately, this Q&A was reprinted in last week's "Ask the Experts" edition of IAC Express without updating the information. Please be aware that Flublok can now be given to patients age 18 years and older. Thanks to Laura from Wisconsin for catching this error.

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CDC NetConference scheduled for December 3; focus will be on influenza and the workings of ACIP

CDC will present a Current Issues in Immunization NetConference on December 3 from 12:00 to 1:00 p.m. (ET).

Topics and Speakers:
  • "Update on influenza activity and antiviral use policies in the US," presented by Joseph Bresee, MD, chief, Epidemiology and Prevention Branch, Influenza Division, CDC
  • "Developing Vaccine Recommendations and Policy in the United States—Advisory Committee on Immunization Practices," presented by Jean C. Smith, MD, MPH
  • "National Influenza Vaccination Week," presented by Cindy Alvarez, BS, health communication specialist, co-lead for National Influenza Vaccination Communications Campaign, Health Communication Science Office, CDC
Andrew Kroger, MD, MPH, will moderate the conference.

This is a limited registration event. Registration (required) will close on December 2 or earlier if the course is full.

Information about continuing education credits will be provided during the session.

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National Influenza Vaccination Week begins December 7

Just a reminder that National Influenza Vaccination Week (NIVW) will be held this year on December 7–13. This event highlights the importance of continuing influenza vaccination throughout the season. CDC features useful resources on its NIVW web section. This site will be updated as the week approaches, so check back frequently. The NIVW calendar of events submission form is now available, so don’t forget to share your plans with CDC and your colleagues.

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

IAC Spotlight! "Like" IAC on Facebook and "follow" IAC on Twitter!

IAC invites you to connect with us on Facebook and Twitter. IAC's Facebook page is designed to help parents and all interested Facebook users learn about vaccines and their importance. If you have a personal or organizational Facebook page, please take a minute to "like" IAC on Facebook. If you have an account on Twitter, please take a minute to "follow" @ImmunizeAction on Twitter. Also, you and your patients are invited to view and repost videos available from IAC's YouTube account.

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American Association of Diabetes Educators publishes report on hepatitis B vaccination of people with diabetes

The American Association of Diabetes Educators (AADE) recently published a report titled Hepatitis B Vaccination in Diabetes Care: Awareness, Priorities and Action among Diabetes Educators and Adults with Diabetes. In 2011, ACIP recommended hepatitis B vaccination for all adults age 19–59 years with diabetes, and adults age 60 years and older at discretion of the treating clinician. However, according to CDC, less than 1/3 of U.S. adults with diabetes have been vaccinated against hepatitis B.

The AADE report explores the barriers and gaps in educating people with diabetes about the importance of hepatitis B vaccination. For example, 52 percent of diabetes educators were unaware of the related CDC recommendations. Time is a limitation—72 percent said that setting goals and improving patient self-care habits were their priorities in working with patients, while only 7 percent said that vaccination was a priority. Related Links Back to top

IAC posts nine new translations of the pediatric multi-vaccine VIS

CDC posted an updated version of the pediatric multi-vaccine Vaccine Information Statement (VIS) on October 22. IAC recently posted nine translations of this revised VIS.

New pediatric multi-vaccine VIS translations include ArabicBurmeseChinese (simplified)Chinese (traditional)FrenchRussianSomaliSpanish, and Vietnamese. All of these translations are available at

IAC has provided these translations through a cooperative agreement with CDC's National Center for Immunization and Respiratory Diseases.  Back to top

NACCHO invites eligible local health departments to apply for funding to improve HPV vaccination rates

The National Association of County & City Health Officials (NACCHO) recently released a Request for Applications (RFA) to solicit applications from local health departments (LHDs) to participate in a demonstration project to increase the capacity of selected LHDs to work with healthcare providers and other key stakeholders in their communities to increase HPV vaccination rates. NACCHO invites eligible LHDs to submit applications.

Applications are due December 19 by 5:00 p.m. (ET). Please direct questions to

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CDC announces the expansion of VariZIG distribution in the United States

CDC published Announcement: Expansion of VariZIG Distribution in the United States in the November 21 issue of MMWR (page 1092). The entire announcement is reprinted below.

In July 2013, CDC published updated recommendations for the use of VariZIG for postexposure prophylaxis of varicella for persons at high risk for severe disease who lack evidence of immunity to varicella and for whom varicella vaccine is contraindicated. At the time of the recommendation, VariZIG was available from only one U.S. distributor (FFF Enterprises; Temecula, California; telephone, 800-843-7477; online at Now, VariZIG is also available from a second distributor (ASD Healthcare; Frisco, Texas; telephone, 800-746-6273; online at

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New! WHO's newsletter about reliable online vaccine safety resources 

In 2003, the World Health Organization (WHO) launched the Vaccine Safety Net project (VSN). The objective of VSN is to help public health authorities, health professionals, and the public access reliable information about vaccine safety via the Internet. To this end, VSN has published an approved list of websites with reliable immunization information based on established criteria. Both IAC websites, and, are approved by VSN. This month, VSN started publishing the Vaccine Safety Net Newsletter.

WHO developed this new publication in response to the growing number of websites providing misinformation regarding vaccine safety. The Vaccine Safety Net Newsletter aims to disseminate news and information regarding VSN, foster communication and synergy among VSN members, and promote good information practices for websites providing information about vaccine safety. The newsletter will be published in English on a quarterly basis.

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CDC reports on global routine vaccination coverage

CDC published Global Routine Vaccination Coverage, 2013 in the November 21 issue of MMWR (pages 1055–1058). A summary made available to the press is reprinted below.

Since the Expanded Program on Immunization was established in 1974, the proportion of children vaccinated with the original four vaccines has increased substantially from <5% to 84%, and many new vaccines have been added to recommended schedules. However, coverage has plateaued over the last five years and many children, particularly in developing countries, are still not being fully vaccinated. Nearly 70% of incompletely vaccinated children worldwide live in only 10 countries, highlighting inequity among countries. As additional vaccines are incorporated into vaccination schedules, immunization platforms beyond the first year of life become more important. Improvements in equity of access and use of immunization services will help ensure that all children are protected from vaccine-preventable diseases.

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CDC reports on progress towards polio eradication in Nigeria

CDC published Progress Toward Poliomyelitis Eradication—Nigeria, January 2013–September 2014 in the November 21 issue of MMWR (pages 1059–1063). A summary made available to the press is reprinted below.

Nigeria is on the brink of eradicating wild poliovirus (WPV), with only 6 WPV cases reported this year. This is a substantial decrease from 122 cases in 2012 and 53 cases for the entire year in 2013. A polio-free Africa is within reach. National program innovations and strategies to improve polio vaccine coverage for underserved and hard-to-reach communities have resulted in tangible successes, but the final steps toward polio eradication in Nigeria will require that these efforts continue. If eradication becomes a reality, lessons learned and resources used toward this effort can be redirected toward addressing other national public health issues. Nigeria is one of three countries worldwide (the others are Afghanistan and Pakistan) where WPV transmission has never been stopped.

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CDC provides update on the Ebola epidemic in West Africa

CDC published Update: Ebola Virus Disease Epidemic—West Africa, November 2014 in the November 21 issue of MMWR (pages 1064–1066). This report was previously published as an MMWR Early Release on November 18. The first two sentences from the second paragraph are reprinted below.

According to the latest World Health Organization update on November 14, 2014, a total of 14,383 Ebola cases have been reported as of November 11 from three West African countries (Guinea, Liberia, and Sierra Leone) where transmission is widespread and intense. The highest reported case counts were from Liberia (6,878 cases) and Sierra Leone (5,586), followed by Guinea (1,919).

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CDC reprints six articles about Ebola that were previously published as MMWR Early Releases

CDC published the following six articles in the November 21 issue of MMWR. These articles were previously published as MMWR Early Releases on November 14, and were previously covered in IAC Express on November 18.
  1. Evidence for a Decrease in Transmission of Ebola Virus—Lofa County, Liberia, June 8–November 1, 2014
  2. Evidence for Declining Numbers of Ebola Cases—Montserrado County, Liberia, June–October 2014
  3. Ebola Virus Disease Cases Among Health Care Workers Not Working in Ebola Treatment Units—Liberia, June–August 2014
  4. Ebola Epidemic—Liberia, March–October 2014
  5. Ebola Virus Disease Cluster in the United States—Dallas County, Texas, 2014
  6. Response to Importation of a Case of Ebola Virus Disease—Ohio, October 2014
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ACOG to sponsor December 3 webinar on adult immunization

The American College of Obstetricians and Gynecologists (ACOG) is sponsoring a one-hour webinar at 12:00 p.m. (ET) on December 3 titled "Give It Your Best Shot—Adult Vaccinations for Ob-Gyn Providers." The course is free, offers one CME credit, and is open to all (not just ACOG fellows). The presentation will detail ACOG and CDC’s immunization recommendations, address the most common concerns and misconceptions around vaccines, and explain the importance of immunizations for adults and pregnant women.

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National Hepatitis Training Institute at the University of Alabama at Birmingham offers online training about viral hepatitis

The University of Alabama at Birmingham’s National Hepatitis Training Institute, a CDC grantee, has developed a free educational web-based resource for health professionals to improve understanding of viral hepatitis prevention, diagnosis, management, and treatment. The curriculum contains six modules and can be accessed at

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Many presentations from 2014 National Immunization Conference now available online

The 2014 National Immunization Conference, "U.S. Immunization in a Time of Change," was held September 29–30 in Atlanta. A number of presenters have agreed to share their presentations online; you can access available presentations on the Task Force for Global Health website. Back to top

Presentation slides from the October ACIP meeting now available online

ACIP recently posted the presentation slides from its October 29–30 meeting.

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Question of the Week

A one-month-old infant was exposed for the last 6 days to chickenpox. What should be done to protect the exposed infant, who is too young to vaccinate and past the time for varicella zoster immune globulin (VZIG) administration (96 hours)? 

Answer: There is no evidence that healthy full-term infants born to women in whom varicella occurs more than 48 hours after delivery are at increased risk for serious complications such as pneumonia or death. VZIG (VariZIG, Emergent) can be given up to 10 days after exposure but is only recommended for newborn infants whose mothers have signs and symptoms of varicella around the time of delivery (5 days before to 2 days after), hospitalized premature infants born at 28 or more weeks of gestation whose mothers do not have evidence of immunity to varicella, or hospitalized premature infants born at less than 28 weeks of gestation or who weigh 1,000 grams or less at birth regardless of their mothers’ evidence of immunity to varicella. Assuming this is an infant discharged from the hospital at home, VZIG would not be recommended. Varicella, if it develops, would be managed as for any child. 

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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