Issue 1169: March 3, 2015

Ask the Experts–Question of the Week: A patient born in 1970 has a history of measles disease and is also immunosuppressed due to multiple…read more

New! March issue of Needle Tips available online

The March 2015 issue of Needle Tips is now online.

Click on the image below to download the entire March issue of Needle Tips (PDF).
Download the March issue of Needle Tips
This issue features important information about the ongoing multi-state measles outbreak. It presents an array of immunization materials that healthcare professionals can use in their practice settings, including up-to-date versions of IAC's popular "Summary of Recommendations" for both child/teen and adult patients. 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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IAC featured in current issue of WHO's newsletter about reliable online vaccine safety websites

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.

In November 2014, VSN started publishing the Vaccine Safety Net Newsletter. 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 second issue of the Vaccine Safety Net Newsletter was published in February and includes a feature about the Immunization Action Coalition (IAC).

The newsletter is published in English, on a quarterly basis, and can be accessed on the WHO's VSN website.

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ACIP reaffirms recommendation for annual influenza vaccination; states no preference for LAIV or IIV

CDC released a statement to the media after the close of the February 25–26 ACIP meeting. The first paragraph is reprinted below.

Today the Advisory Committee on Immunization Practices (ACIP) voted on its annual influenza vaccine recommendations for 2015–2016. ACIP voted to continue to recommend that all persons 6 months and older be vaccinated annually against influenza. However ACIP did not renew the 2014–2015 preference for using the nasal spray flu vaccine (i.e., LAIV) instead of the flu shot (i.e., IIV) in healthy children 2 through 8 years of age when immediately available. The preferential recommendation was originally approved on June 25, 2014, after a review of data from several influenza seasons suggested that the nasal spray vaccine could offer better protection than the flu shot for children in this age group. The decision not to renew the preferential recommendation was made based on new data from more recent seasons which have not confirmed superior effectiveness of LAIV observed in earlier studies. ACIP recommends that children 6 months and older get an annual influenza vaccine with no preference stated for either the nasal spray vaccine or the flu shot. Back to top

CDC releases 2015 immunization schedules app

CDC recently released an updated version of its CDC Vaccine Schedules app to help clinicians and other healthcare professionals quickly access the current recommended immunization schedules. This app is intended for healthcare professionals who recommend or administer vaccines. You can immediately access all CDC-recommended immunization schedules, tables, and footnotes from your mobile device. The app is optimized for tablets and useful on smartphones. It visually mimics the printed schedules, which are reviewed and published annually.

To receive an email notice when this app and/or the immunization schedules are updated or changed, be sure to subscribe to CDC's immunization schedule email updates. Go to and enter your email address in the right-hand column box for “Get email updates."

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New CDC study highlights burden of pneumonia hospitalizations on U.S. children

On February 25, CDC notified the press about the results of a study that highlights the burden of pneumonia hospitalizations on U.S. children. The first two paragraphs are reprinted below.

Children younger than 5 years of age accounted for 70 percent of pneumonia hospitalizations among children, the Centers for Disease Control and Prevention reported in a study published today. Pneumonia remains a leading cause of hospitalization among children in the United States. The two-and-a-half-year study published in the New England Journal of Medicine by CDC researchers and three U.S. children’s medical centers estimated the burden of community-acquired pneumonia hospitalizations among U.S. children. Researchers also found that respiratory viruses, rather than bacterial pathogens, were most commonly detected in children hospitalized with pneumonia.

“Pneumonia puts thousands of young children in the hospital each year at a cost in the U.S. of about $1 billion, not to mention suffering of kids and hardship for their families,” said CDC Director Tom Frieden, MD, MPH. “This ground-breaking study shows how badly we need faster, less-expensive diagnostic tests for doctors to accurately diagnose the cause of pneumonia so they can effectively treat it.”

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Reminder: National Infant Immunization Week is April 18–25; new resources available from CDC

National Infant Immunization Week (NIIW) will be held this year on April 18–25. NIIW is an annual observance to promote the benefits of childhood immunizations and improve the health of children age two years and younger. Since 1994, local and state health departments, national immunization partners, healthcare providers, community leaders, and clinicians have come together with CDC during this week to highlight the impact of vaccination on the lives of infants and children and to call attention to immunization achievements.
This year, CDC has new resources available to increase awareness among pregnant women and healthcare providers that Tdap vaccine is recommended during the third trimester of every pregnancy. This recommendation helps protect babies from pertussis during the first few months of life, when they are most vulnerable to serious disease and complications.
Visit the NIIW website to find promotional and educational materials to help you plan your NIIW activities, and tailor them to the needs of your community.
Visit CDC's Pregnancy and Whooping Cough website to find out more about the Tdap recommendation for pregnant women.

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IAC Spotlight! U.S. Immunization Schedules web page offers quick access to child, teen, and adult guidance for 2015

Looking for an easy way to find the 2015 U.S. recommended immunization schedules for children and adolescents, as well as adults? It's all in one place on! Visit CDC Schedules on for one-stop access to all the official schedules, including immunization schedules apps for mobile devices. 

In addition to the CDC schedules, this section offers links to purchase IAC's laminated versions of the immunization schedules (includes tables of contraindications and precautions), which are based on CDC's schedules. IAC's 2015 laminated immunization schedules are currently in production and will begin shipping in mid-March. 

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Vaccine Education Center plans March 18 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 March 18. 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:
  • The serogroup B meningococcal vaccine: Who should get it?
  • The 9-valent HPV vaccine: New recommendations
  • Influenza vaccines: An update
  • The measles epidemic: A turning point?
Registration (required) is open now.

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WHO issues updated position paper on Japanese encephalitis vaccines in the Weekly Epidemiological Record

The February 27 issue of the World Health Organization (WHO) periodical, Weekly Epidemiological Record, includes the latest WHO position paper on Japanese encephalitis.
A collection of WHO position papers on vaccines is available in alphabetical order.
They are available in chronological order, vaccine listing, and topic listing on IAC's website.

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CDC posts new resources related to measles

In response to the current multi-state measles outbreak, CDC continues to develop more new resources for healthcare professionals and their patients.

Recently developed resources for various audiences IAC has listed many valuable free educational materials about measles for healthcare professionals and patients in previous issues of IAC Express. Please visit the February 17 issue to check out the available resources from a variety of organizations.

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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

February issue of CDC's Immunization Works newsletter now available

CDC recently released the February 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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CDC reports on hepatitis C virus transmission during surgical procedures

CDC published Transmission of Hepatitis C Virus Associated with Surgical Procedures—New Jersey 2010 and Wisconsin 2011 in the February 27 issue of MMWR (pages 165–170). The first two paragraphs are reprinted below.

Incidents of health care–associated hepatitis C virus (HCV) transmission that resulted from breaches in injection safety and infection prevention practices have been previously documented. During 2010 and 2011, separate, unrelated occurrences of HCV infections in New Jersey and Wisconsin associated with surgical procedures were investigated to determine sources of HCV and mechanisms of HCV transmission. Molecular analyses of HCV strains and epidemiologic investigations indicated that transmission likely resulted from breaches of infection prevention practices. Health care and public health professionals should consider health care–associated transmission when evaluating acute HCV infections.

An estimated 3.2 million U.S. residents have chronic HCV infections; during 2011, approximately 16,500 acute HCV infections were diagnosed. Molecular analyses of HCV strains have enhanced investigations of health care–associated transmission by determining the relatedness of strains infecting persons with acute and chronic HCV infection. Two investigations of HCV infection among patients who had surgical procedures highlight the potential for HCV contamination of medications or equipment, which can result in transmissions that are difficult to recognize.

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CDC publishes five articles about Ebola in Africa in MMWR

CDC published the following five articles in the February 27 issue of MMWR. The first article was previously published as an MMWR Early Release on February 24. Related Link Back to top

CDC will host March 6 webinar on current HPV vaccine recommendations

CDC will host a one-hour webinar titled “Update on HPV Vaccine Recommendations" on March 6 at 12:00 p.m. (ET). Lauri Markowitz, MD, will be the presenter. Dr. Markowitz is the team leader of epidemiology research in the Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, and the CDC lead for the HPV Vaccine Working Group of ACIP. Back to top

CDC updates its "You Call the Shots" module on general immunization recommendations

CDC recently announced that it had updated a module titled "General Recommendations on Immunization" in its web-based training course You Call the Shots. Continuing education credit is available for viewing a module and completing an evaluation.

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Coursera offers free six-week course on vaccination, featuring Dr. Paul Offit

Starting in April, Coursera will offer a course titled Vaccines that will discuss issues regarding vaccines and vaccine safety, including the history, science, benefits, and risks of vaccines, together with the controversies and common questions surrounding vaccines, and an update on newly created vaccines and recent outbreaks of previously controlled diseases.

The course runs from April 13 through May 23. Each week features two to four 15–20 minute lectures, presented by Paul Offit, MD, director, Vaccine Education Center at the Children's Hospital of Philadelphia.

Penn's Open Learning Initiative, part of the University of Pennsylvania, also offers a selection of free world-class courses online.

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The College of Physicians of Philadelphia to offer free lecture on March 12 titled "The Fantastic Laboratory: How an Arcane Vaccinology Protected the Innocent in a Desperate Place"

On March 12 from 6:30–8:30 p.m. (ET) The College of Physicians of Philadelphia will offer a free lecture titled The Fantastic Laboratory: How an Arcane Vaccinology Protected the Innocent in a Desperate Place.

Writer Arthur Allen will discuss the lives and work of Rudolf Weigl and Ludwik Fleck, two forgotten scientific heroes who used their knowledge of typhus and vaccines in World War II Poland to save thousands of people and sabotage the Nazis. Paul Offit, MD, director, Vaccine Education Center at the Children's Hospital of Philadelphia, vaccine developer, and author of many books about vaccines, medicine, and social issues, will facilitate the discussion.

This lecture is sponsored by The History of Vaccines (, an education project of The College of Physicians of Philadelphia. Back to top

Question of the Week

A patient born in 1970 has a history of measles disease and is also immunosuppressed due to multiple myeloma. The patient wants to travel to California, but is concerned about the measles outbreak. Should the patient receive the MMR vaccine? 

A history of having had measles is not sufficient evidence of measles immunity. A positive serologic test for measles-specific IgG will confirm that the person is immune and is not at risk of infection regardless of the multiple myeloma. Multiple myeloma is a hematologic cancer and is considered immunosuppressive so MMR vaccine is contraindicated in this person.

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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