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Issue 1165: February 3, 2015

Ask the Experts–Question of the Week: Our patient is a 78-year-old female who received PCV13 (Prevnar13, Pfizer), then…read more

2015 U.S. recommended immunization schedule for adults now available

On February 3, CDC published online the Recommended Immunization Schedules for Adults, United States, 2015.
Each year, the Advisory Committee on Immunization Practices (ACIP) updates the immunization schedules to reflect current recommendations for licensed vaccines. In October 2014, ACIP approved the recommended immunization schedules for 2015. The 2015 recommended immunization schedules are effective January 1, 2015; the MMWR notice about the schedules’ publication date will be published February 6, 2015.

The recommended adult immunization schedule has been approved by the ACIP, the American Academy of Family Physicians, the American College of Physicians, the American College of Obstetricians, the American College of Gynecologists, and the American College of Nurse-Midwives.

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CDC updates the press on multi-state measles outbreak as number of cases increases

On January 29, CDC held a telebriefing for the press about the multi-state measles outbreak that started in California in December 2014. An excerpt from an introductory statement made by Anne Schuchat, MD, assistant surgeon general, United States Public Health Service, and director of CDC’s National Center for Immunization and Respiratory Diseases, is reprinted below.

Thank you so much for joining us this afternoon. I want to talk to you today about measles and here's why. It's only January and we have already had a very large number of measles cases. As many cases as we typically have all year in typical years. This worries me and I want to do everything possible to prevent measles from getting a foothold in the United States and becoming endemic again. I want to make sure that parents who think that measles is gone and haven't made sure that they or their children are vaccinated are aware that measles is still around and it can be serious. And that MMR vaccine is safe and effective and highly recommended. From January 1 until January 28, 2015, a total of 84 people in 14 states have been reported as having measles. Most of these cases are part of an ongoing large multi-state outbreak linked to the Disneyland theme parks in California. CDC is working with state and local health departments to control this outbreak, which started in late December.

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Many resources available to help educate healthcare professionals and the public about measles

In light of the ongoing measles outbreak that started in California in 2014, and has spread to 14 states and Mexico, CDC has highlighted a number of resources to help healthcare providers recognize and diagnose measles. In addition, a number of resources from various sources are available to educate parents.

For healthcare professionals For parents and members of the public Related Links Back to top

CDC provides healthcare providers with new resources about using antivirals to treat patients with influenza

CDC has reported widespread influenza activity in most U.S. states, with influenza A (H3N2) viruses most common. H3N2-predominant influenza seasons have been associated with increased hospitalizations and deaths in older people and young children. Hospitalization rates are especially high among people 65 years and older. Antiviral medications are effective in treating influenza and reducing complications, and are available and recommended, but evidence suggests that they are underutilized. The following are some resources developed by CDC to help healthcare professionals properly use antiviral treatment when appropriate: Back to top

Reminder: CDC requests nominations for its Childhood Immunization Champion Awards for every state

The CDC Childhood Immunization Champion Award is an annual award that recognizes individuals who make a significant contribution toward improving public health through their work involving childhood immunization in their state.
Each year, up to one CDC Immunization Champion from each of the 50 U.S. states, eight U.S. territories and freely associated states, and the District of Columbia will be honored. Champions can include coalition members, parents, healthcare professionals (e.g., physicians, nurses, physicians’ assistants, nurse practitioners, medical assistants), and other immunization leaders who meet the award criteria. Immunization program managers, state and federal government employees paid by state or federal immunization funding, individuals who have been affiliated with and/or employed by pharmaceutical companies, and those who have already received the award are not eligible to apply (for details, see page 3 of the nomination packet).

Awardees will be announced during National Infant Immunization Week (NIIW), which runs April 18–25 this year. Champions will receive a certificate of recognition, will be featured on CDC’s web site, and may be recognized by their immunization program during NIIW.

All nomination forms are due to respective immunization programs. The suggested due date is February 6, 2015, but states may select a different deadline. Please contact your state immunization program to confirm your state’s deadline.

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Registration for the May National Adult and Influenza Immunization Summit invitation-only meeting now open

The 2015 National Adult and Influenza Immunization Summit (NAIIS) will take place on May 12–14, in Atlanta, Georgia. A preliminary agenda and registration information are available on the Summit website. Note: The password needed for registration to this invitation-only meeting has been shared directly with Summit members. If you are not a Summit member and are interested in more information about becoming a member or attending this meeting, please email Dr. Litjen Tan at Back to top

IAC Spotlight! Hundreds of images/photos about vaccination and vaccine-preventable diseases are available for your use

When it comes to educating the public and healthcare professionals about the serious health effects of vaccine-preventable diseases, nothing else packs the punch of a visual image. The IAC Image Library on provides access to hundreds of disease and vaccination-related images.

IAC has brought together images of people suffering from vaccine-preventable diseases; pictures of healthcare professionals vaccinating children, teens, and adults; and photos taken during various global immunization campaigns, as well as pathology specimens and micrographs of viruses and bacteria. Almost all of the images are free to download and can be used in lectures, articles, and presentations.

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IAC enrolls eight more birthing institutions into its Hepatitis B Birth Dose Honor Roll; four previously honored institutions qualify for a second year

The Immunization Action Coalition (IAC) is pleased to announce that eight 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.
  • Baptist Memorial Hospital-North Mississippi, Oxford, MS (100%)
  • Baptist Memorial Hospital-Union County, New Albany, MS (100%)
  • Mercy Hospital Ada, Ada, OK (96%)
  • Mercy Hospital Aurora, Aurora, MO (91%)
  • Mercy Hospital Fort Smith, Fort Smith, AR (95%)
  • Mercy Hospital Lebanon, Lebanon, MO (97%)
  • Mercy Hospital NWA, Rogers, AR (90%)
  • Singing River Hospital, Pascagoula, MS (98%)
In addition, the following four institutions are being recognized for a second year.
  • Gwinnett Medical Center, Lawrenceville, GA (93%)
  • Kings County Hospital Center, Brooklyn, NY (96%)
  • Olney Hamilton Hospital, Olney, TX (100%)
  • Riverside Regional Medical Center, Newport News, VA (96%)
The Honor Roll now includes 174 birthing institutions from 29 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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Reminder: Nominations are now open for the National Adult and Influenza Immunization Summit excellence awards; deadline is February 13

The National Adult and Influenza Immunization Summit (NAIIS) is now soliciting nominations for the 2015 NAIIS Immunization Excellence Awards. The 2015 awards recognize individuals and organizations that made extraordinary contributions towards improving vaccination rates within their communities during 2014. The awards focus on individuals and organizations that exemplify the meaning of the “immunization neighborhood” (collaboration, coordination, and communication among immunization stakeholders dedicated to meeting the immunization needs of the patient and protecting the community from vaccine-preventable diseases). The "Adult Immunization Publication Award" has been added this year, making a total of six categories. Unless specifically indicated in the award description, the immunization activities should be broader than influenza activity. A National Winner and possibly an Honorable Mention recipient will be selected for each award category.

Award Categories
  • Influenza Season Campaign
  • Healthcare Personnel Campaign
  • “Immunization Neighborhood” Champion
  • Adult Immunization Champion
  • Corporate Campaign
  • New! Adult Immunization Publication Award
The award winners will be announced at the 2015 National Adult and Influenza Immunization Summit meeting in Atlanta. The national winner in each category will be invited to present their programs at the National Adult and Influenza Immunization Summit meeting.

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IAC updates "Medical Management of Vaccine Reactions in Children and Teens"

IAC recently revised Medical Management of Vaccine Reactions in Children and Teens by adding the following text on pages 2 and 3: "According to AAP's Red Book, for children age 12 years or older, the diphenhydramine maximum single dose is 100 mg."

Related Link 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 updates "Administering Vaccines: Dose, Route, Site and Needle Size" and "Administering Vaccines to Adults: Dose, Route, Site and Needle Size"

IAC recently redesigned and made some minor edits to its healthcare professional resources Administering Vaccines: Dose, Route, Site and Needle Size and Administering Vaccines to Adults: Dose, Route, Site, and Needle Size.

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IAC updates its state immunization laws and mandates section on; up-to-date tables and maps are available for several vaccines, including new ones for rotavirus and HPV vaccines

IAC recently updated its State Mandates on Immunization and Vaccine-preventable Diseases section on State data (available in both table and map formats) were revised for the following vaccines: hepatitis A (childcare/schools), hepatitis B (childcare/schools and college), influenza (childcare), meningococcal (school and college), pneumococcal (PCV), Tdap (secondary schools), and varicella (childcare/schools). Also, IAC added two new sections to state mandates: one covers human papillomavirus (HPV) vaccine mandates in secondary schools and the second is for rotavirus vaccine in childcare settings.

Note: IAC also provides links to information maintained by CDC on its State Mandates web page; these data were last updated in July 2011, according to CDC's website.

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Association of Asian Pacific Community Health Organizations launches new website about people affected by hepatitis B

The Association of Asian Pacific Community Health Organizations (AAPCHO) has launched a new website to highlight stories of Asian Americans and Pacific Islanders (AAPIs) who have been affected by hepatitis B.

The "#justB" website ( was created to bring more attention to hepatitis B and the impact it has on the Asian American community. The website will feature a new story each month with each account representing a personal story from an individual affected by the virus, whether it be a person living with hepatitis B, an individual caring for someone with hepatitis B, or someone working within the field.

Chronic hepatitis B infection affects about two million Americans, and more than half are AAPIs. The disease is often overlooked and under-diagnosed. Within AAPI populations, many of those with hepatitis B do not want to disclose their status for fear of alienation from their communities. This campaign of stories is one step by AAPCHO and its partners to help combat the stigma faced by those with hepatitis B.  

To access the website, go to Contact for more information on the project or to submit a story for consideration. 

AAPCHO is a national association of 35 community health organizations dedicated to promoting advocacy, collaboration, and leadership that improves the health status and access of Asian Americans, Native Hawaiian, and other Pacific Islanders in the United States. For more information on AAPCHO, please visit

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Influenza is spreading and serious; please keep vaccinating your patients

According to CDC, U.S. influenza activity is high across most of the country with flu illnesses, hospitalizations, and deaths elevated. Flu season will probably continue for several weeks. While the influenza vaccine may not work as well as usual against some H3N2 viruses, vaccination can still offer protection for some people, reduce hospitalizations and deaths, and will protect against other influenza viruses. Influenza vaccination is recommended for everyone six months of age 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. Influenza antiviral drugs can treat influenza illness. CDC has issued guidance for clinicians on the use of antiviral treatment for the 2014–15 flu season. Early antiviral treatment works best.

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

January issue of CDC's Immunization Works newsletter now available

CDC recently released the January 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. This information is in the public domain and can be reproduced and circulated widely.

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CDC publishes four articles about Ebola

CDC published the following three articles in the January 30 issue of MMWR. All three were previously published as MMWR Early Releases on January 23. CDC published the following article as an MMWR Early Release on January 30. Back to top

Question of the Week

Our patient is a 78-year-old female who received PCV13 (Prevnar13, Pfizer), then received PPSV23 (Pneumovax 23, Merck) approximately 10 weeks later. She had not received PPSV23 previously. Is the PPSV23 dose valid, or does it need to be repeated? 

Answer: Even though the interval was shorter than the recommended 6–12 months, the dose of PPSV23 should be counted and does not need to be repeated. In the future, please note the ACIP recommendations for pneumococcal vaccine-naive patients age 65 and older are as follows: The dose of PPSV23 should be given 6–12 months after a dose of PCV13. If PPSV23 cannot be given during this time window, the dose of PPSV23 should be given during the next visit. The two vaccines should not be coadministered, and the minimum acceptable interval between PCV13 and PPSV23 is 8 weeks. For more information, see ACIP recommendations: Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged ≥65 Years.

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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