has been refreshed! Take a tour.
Issue 1182: May 12, 2015

Ask the Experts–Question of the Week: How effective are the current pertussis vaccines and do they provide any protection…read more


CDC announces Hepatitis Awareness Month and National Hepatitis Testing Day 

The month of May is designated as Hepatitis Awareness Month in the U.S., and May 19 is designated Hepatitis Testing Day. During May, CDC and its public health partners work to shed light on this hidden epidemic by raising awareness of viral hepatitis and encouraging priority populations to get tested.

CDC published the following three articles related to hepatitis in the May 8 issue of MMWR. The text from Hepatitis Awareness Month and National Hepatitis Testing Day—May 2015 is reprinted in its entirety below.

This month marks the 20th anniversary of Hepatitis Awareness Month and the 4th National Hepatitis Testing Day (May 19) in the United States. Although care and treatment can be life-saving, many of the 3 million persons estimated to be living with hepatitis C virus (HCV) infection are unaware of their infection and are not receiving preventive services and medical management. In addition, an emerging epidemic of HCV infection among a new demographic of persons who inject drugs is unfolding in several areas throughout the nation. Guided by the goals of the 2014 U.S. Department of Health and Human Services Action Plan for the Prevention, Care, and Treatment of Viral Hepatitis, CDC continues its activities to expand access to HCV testing, care, and treatment to stem morbidity and mortality, and to reduce HCV infections caused by drug use behaviors. Efforts to address each of these strategic imperatives are highlighted by the two reports in this issue of MMWR.

The first report shows that trends in new cases of HCV infection are highly correlated with trends in substance abuse treatment admissions for opioid dependency and opioid injection in four states in the central Appalachian Region. The second report describes strategies for integrating HCV testing into primary care settings. These reports demonstrate how data can be used to identify patterns of risk for HCV transmission among persons who inject drugs and how programs can be successfully implemented to identify persons disproportionately affected by HCV infection and ensure they receive appropriate medical care and treatment.

Related Links Back to top

CDC NetConference scheduled for May 20; topics will be HPV vaccination and vaccine administration errors reported to VAERS

CDC will present a "Current Issues in Immunization NetConference" on May 20 from 12:00 to 1:00 p.m. (ET).

Topics and Speakers:
  • "HPV Vaccination Update—2015," presented by Susan Hariri, PhD, Epidemiology and Statistics Branch, Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
  • "Vaccine Administration Errors reported to the Vaccine Adverse Event Reporting System (VAERS)," presented by Beth F. Hibbs RN, MPH, Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, CDC
Raymond A. Strikas, MD, MPH, will moderate the conference.

This is a limited registration event. Registration is required.

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

Related Links Back to top

Now available! IAC's sturdy laminated versions of the 2015 U.S. child/teen immunization schedule and the 2015 U.S. adult immunization schedule—order a supply for your healthcare setting today!

IAC's laminated versions of the 2015 U.S. child/teen immunization schedule and the 2015 U.S. adult immunization schedule 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 child and adolescent schedule has eight pages (i.e., four double-sided pages) and is folded to measure 8.5" x 11". The adult immunization schedule has six pages (i.e., three double-sided pages) and is folded to measure 8.5" x 11". Laminated Child and Teen Laminated Schedule Adult Laminated 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 email

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.

Back to top

IAC makes available The Vaccine Handbook: A Practical Guide for Clinicians, a.k.a. "The Purple Book," by Dr. Gary Marshall

The Vaccine Handbook: A Practical Guide for Clinicians (“The Purple Book,” 2015, 560 pages) is a uniquely comprehensive source of practical, up-to-date information for vaccine providers and educators. Its author, Gary S. Marshall, MD, has drawn together the latest vaccine science and guidance into a concise, user-friendly, practical resource for the private office, public health clinic, academic medical center, and hospital.
Order your copy of The Vaccine Handbook today!
IAC Executive Director Deborah Wexler, MD, is enthusiastic about helping get this book circulated as widely as possible. “During more than 20 years in the field of immunization education, I have not seen a book that is so brimming with state-of-the-science vaccine information,” she states. "This book belongs in the hands of every medical student, physician-in-training, doctor, nursing student, and nurse who provides vaccines to patients.”
The Vaccine Handbook provides:
  • Information on every licensed vaccine in the United States
  • Rationale behind authoritative vaccine recommendations
  • Contingencies encountered in everyday practice
  • A chapter dedicated to addressing vaccine concerns
  • Background on how vaccine policy is made
  • Standards and regulations
  • Office logistics, including billing procedures, and much more
About the Author
Gary Marshall, MD, is professor of pediatrics at the University of Louisville School of Medicine in Kentucky, where he serves as chief of the division of pediatric infectious diseases and director of the Pediatric Clinical Trials Unit. In addition to being a busy clinician, he is nationally known for his work in the areas of vaccine research, advocacy, and education.

The newly released fifth edition of this invaluable guide is now available on IAC’s website at

The price of the handbook is $29.95 each, plus shipping charges. Discount pricing is available for more than 10 copies. Order copies for your staff or for distribution at an upcoming conference.

Quantity Discount Pricing
  • 1–10 books: no discount + shipping
  • 11–50 books: 5% + shipping
  • 51–100 books: 10% + shipping
  • 101–500 books: 15% + shipping
  • 501–1000 books: 20% + shipping
For quotes on larger quantities, email

Order your copy today! Back to top
CDC's Travelers' Health publishes alert about Hajj and Umrah in Saudi Arabia

CDC's Travelers' Health recently published a Level 2 Alert ("Practice Enhanced Precautions") for people planning to travel to Saudi Arabia for Hajj or Umrah pilgrimages. The first two paragraphs of this notice are reprinted below.

The annual Hajj pilgrimage to Mecca, Saudi Arabia, is among the largest mass gatherings in the world. It draws about 3 million Muslims from around the world, and more than 11,000 Americans make the pilgrimage each year. This year, Hajj will take place from approximately September 20–25, 2015. Umrah is a similar pilgrimage that can be undertaken at any time of the year but is likely to be more crowded during the month of Ramadan (approximately June 17 to July 17, 2015).

Because of the crowds, mass gatherings such as Hajj and Umrah are associated with unique health risks. If you plan to travel to Saudi Arabia for Hajj or Umrah, follow CDC’s recommendations, such as being up-to-date on your vaccines, to help keep you safe and healthy.
Back to top

New report finds global rabies burden is considerably higher than previous estimates: 59,000 people die every year from rabies

A new study from the Global Alliance for Rabies Control’s Partners for Rabies Prevention Group found that 160 people die each day from canine rabies. Four paragraphs from a related press release are reprinted below.

A global study on canine rabies, published today (16 April 2015), has found that 160 people die every single day from the disease. The report is the first study to consider the impact in terms of deaths and the economic costs of rabies across all countries. Even though the disease is preventable, the study says that around 59,000 people die every year of rabies transmitted by dogs.

The multi-author study, by the Global Alliance for Rabies Control’s Partners for Rabies Prevention Group, also shows that annual economic losses because of the disease are around 8.6 billion US dollars, mostly due to premature deaths, but also because of spending on human vaccines, lost income for victims of animal bites and other costs.

The study finds that overwhelmingly the greatest risk of canine rabies is in the poorest countries; the death rate (deaths/100,000 people) is highest in countries in sub-Saharan Africa, while India has the highest number of fatalities, with over 20,000 human deaths annually. The proportion of dogs vaccinated is far below that necessary to control the disease across almost all countries of Africa and Asia.

Rabies is close to 100% fatal, but it is also almost 100% preventable, and the best, most cost-effective way of preventing canine rabies is by vaccinating dogs. This needs to be supplemented by improving access to human vaccines.
Back to top

WHO issues update regarding the international spread of wild poliovirus following its fifth emergency committee meeting

On May 5, the World Health Organization (WHO) issued a statement following the fifth meeting of the Emergency Committee under the International Health Regulations regarding the international spread of wild poliovirus in 2014–15. An excerpt from the WHO media statement follows.

The Committee noted that after nearly one year since the declaration that the international spread of polio constituted a Public Health Emergency of International Concern (PHEIC), strong progress has been made by countries in response to the Temporary Recommendations issued by the Director-General, and that this was a commendable achievement. No cases of wild poliovirus have been reported in Africa for eight months; in 2015, Pakistan and Afghanistan have reported less than half the number of cases that were reported during the same period in 2014; there has been no exportation from Pakistan since October 2014; and the number of persistently missed and inaccessible children is declining in Pakistan. The number of inaccessible children has declined from an estimated 300,000 to 50,000 in Federally Administered Tribal Areas. Pakistan continued to implement the Temporary Recommendations; since November, an average of 370,000 international travellers per month were vaccinated pre-departure at health facilities and points of exit.

Related Links Back to top

CDC publishes report on Hispanic health

CDC published Vital Signs: Leading Causes of Death, Prevalence of Diseases and Risk Factors, and Use of Health Services Among Hispanics in the United States—2009–2013 in the May 8 issue of MMWR (pages 469–478). This report was previously published as an MMWR Early Release on May 5. A paragraph related to hepatitis and related vaccination is reprinted below.

This analysis shows some health disparities affecting Hispanics, including higher diabetes and obesity prevalence and higher death rates related to diabetes and chronic liver disease/cirrhosis compared with whites. In 2013, Hispanics were also shown to have higher proportions than whites of deaths from malignant neoplasms of the liver and intrahepatic bile ducts (1.8% versus 0.8%), and viral hepatitis (0.8% versus 0.3). In both Hispanics and whites, deaths attributed to chronic liver disease and cirrhosis were almost equally divided between alcohol and non-alcohol related. Hispanics were recently shown to have a lower prevalence of moderate drinking and a higher prevalence of binge drinking than whites. In 2011, Hispanics had higher death rates than whites from chronic hepatitis B virus and hepatitis C virus infections; in 2013, their adult vaccination coverage was similar to whites for hepatitis A virus vaccine but lower for hepatitis B virus vaccine. The long-term effects of obesity and diabetes have been associated with chronic liver disease, particularly nonalcoholic fatty liver disease, and liver cancer. Liver/intrahepatic bile duct, stomach, and cervical cancers (all associated with infectious etiologies) have been found to be higher among Hispanics compared with whites.

Related Links Back to top

Study shows quadrivalent HPV vaccine provides early benefit in adolescent girls

On April 27, the journal Pediatrics published an article online titled The Early Benefits of Human Papillomavirus Vaccination on Cervical Dysplasia and Anogenital Warts. The "What's Known on This Topic" and "What This Study Adds" sections are reprinted below.

What’s Known on This Topic:
Clinical trials of the quadrivalent human papillomavirus vaccine show it to be highly efficacious in preventing vaccine-type–specific cervical dysplasia and anogenital warts, but few studies have assessed its effects in the real world and none have done so at the program/population level.

What This Study Adds:
This study provides strong evidence of the early benefits of quadrivalent human papillomavirus vaccination on reductions in cervical dysplasia and possible reductions in anogenital warts among girls aged 14 to 17 years, offering additional justification for not delaying vaccination until girls are older.
Back to top

CDC publishes article about possible sexual transmission of Ebola virus; previously published as an MMWR Early Release

CDC published Possible Sexual Transmission of Ebola Virus—Liberia, 2015 in the May 8 issue of MMWR (pages 479–481). This report was previously published as an MMWR Early Release on May 1, and covered in IAC Express on May 5.

Back to top

The College of Physicians of Philadelphia to offer free panel discussion on May 14 on vaccination exemption laws

On May 14 at 6:30 p.m. (ET) The College of Physicians of Philadelphia will offer a free expert panel discussion titled Vaccination and the State: A Panel Discussion on Ending the Personal Belief Exemption in Pennsylvania.

In light of recent measles outbreaks and Pennsylvania’s relatively low rate of measles immunization coverage, several lawmakers are sponsoring legislation to end the state’s philosophical and moral exemption to vaccination. Moderated by Judge James G. Colins, Senator Daylin Leach will present his rationale for introducing the legislation, with Paul A. Offit, MD, FCPP, and Jason L. Schwartz, PhD, examining the arguments for and against the personal belief immunization exemption.

This lecture is sponsored by The History of Vaccines ( and The College of Physicians of Philadelphia. Back to top

Idaho Immunization Summit to be held September 21

The Idaho Immunization Coalition, in partnership with the Idaho Immunization Program, will host its 2015 Immunization Summit on September 21. Keynote speakers will include:
  • David R. Williams, PhD, professor at the Harvard T.H. Chan School of Public Health, an internationally known speaker on the social determinants of health
  • Carolyn Buxton Bridges, MD, associate director of Adult Immunizations, National Center for Immunization and Respiratory Diseases, CDC, whose current focus is on increasing the evidence base of adult vaccinations, vaccine coverage assessment, and adult vaccination policy and education
Access more details on the conference, including registration information

Back to top

Question of the Week

How effective are the current pertussis vaccines and do they provide any protection against parapertussis? 

DTaP vaccines are about 98% effective against pertussis within 1 year of receiving the fifth dose. However, 5 years later, protection declines to about 70%. Tdap vaccines are about 73% effective within 1 year of receiving a single dose. However, 2 to 4 years later protection declines to about 34%.
Parapertussis, like pertussis, can cause a whooping cough-like syndrome. Most studies agree that current pertussis vaccines provide limited to no immunity to parapertussis.

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.

Related Links Back to top

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

This page was updated on .