Issue 1183: May 19, 2015

Ask the Experts—Question of the Week: For an adult who experienced probable thrombocytopenic purpura after one…read more

New! May issue of Needle Tips is now online

The May 2015 issue of Needle Tips is now online.

Click on the image below to download the entire May issue of Needle Tips (PDF).
Download the March issue of Needle Tips
This issue of Needle Tips features our lead article summarizing what’s new in ACIP recommendations in 2015, along with IAC’s "Ask the Experts" column from CDC’s medical officer Andrew T. Kroger, MD, MPH, and nurse educator Donna L. Weaver, RN, MN. You’ll also find a wide array of immunization materials that healthcare professionals can use in their practice settings, including the 2015 official recommended U.S. immunization schedules for both child/teen and adult patients.

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The National Adult and Influenza Immunization Summit announces 2015 Immunization Excellence Award winners

The National Adult and Influenza Immunization Summit (NAIIS) has announced the recipients of its 2015 Immunization Excellence Awards. There are six categories of recognition: Influenza Season Campaign, Healthcare Personnel Campaign, "Immunization Neighborhood" Champion, Adult Immunization Champion, Corporate Campaign, and Adult Immunization Publication. Nominees were evaluated based on the areas of impact, originality, challenges, opportunities, collaboration, coordination, and communication with partners and stakeholders. The awards were presented on May 13 at the National Adult and Influenza Immunization Summit meeting in Atlanta.

Here are the 2015 winners:
  • In the category Laura Scott Influenza Season Campaign (in memoriam of Laura Scott who cofounded Families Fighting Flu and served as its executive director for 10 years), the winner is the Minnesota Immunization Networking Initiative (Minneapolis, MN); the honorable mention award recipient is the Michigan Department of Community Health & Alana's Foundation (Lansing, MI)
  • In the category Healthcare Personnel Campaign, the winner is the University of California San Francisco Medical Center (San Francisco, CA)
  • In the category "Immunization Neighborhood" Champion, the winner is Safeway Pharmacy (Pleasanton, CA)
  • In the category Adult Immunization Champion, the winner is JoAnn Stadtfeld (Cranberry, PA); the recipient of the honorable mention award is Laura Schwartzwald (Brainerd, MN)
  • In the category Corporate Campaign, the winner is Walgreen Co. (Deerfield, IL); the honorable award recipient is HealthMap Vaccine Finder/Uber Health (Boston, MA).
  • In the category Adult Immunization Publication, the winner is the American College of Obstetricians & Gynecologists (Washington, DC)
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IAC Spotlight! Need help responding to vaccine-hesitant parents? Visit IAC’s redesigned “Talking about Vaccines” web section for practical tips and key resources
In healthcare settings across the nation, healthcare professionals (HCP) are called upon to attest to the safety of vaccines, the importance of vaccination, and the potentially dangerous consequences of not vaccinating. With appreciation for the challenges facing busy HCP, IAC has redesigned its Talking about Vaccines web section to provide HCP with background information and practical resources that will help them efficiently and easily discuss immunization with parents and patients.  
The "Talking about Vaccines" section includes 11 topics: The web section gathers a curated collection of educational print materials, videos, podcasts, blogs, journal articles, PowerPoint presentations, websites, and more, from many trusted sources such as the Immunization Action Coalition, Centers for Disease Control and Prevention, American Academy of Pediatrics, Every Child By Two, Institute of Medicine, and Vaccine Education Center at Children’s Hospital of Philadelphia. Please visit often!

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CDC releases hepatitis A travel advisory for travelers to Tulum, Mexico

Public health officials have recently identified 27 cases of hepatitis A in U.S. travelers who have traveled to Tulum, Mexico, according to a CDC travel health notice published on May 1. Unvaccinated travelers to Tulum and other areas where hepatitis A is common are at risk of getting infected with the virus. This advisory is classified as "Watch–Level 1, Practice Usual Precautions." An excerpt from the advisory follows.

What is the current situation?
As of May 1, 2015, a total of 27 cases of hepatitis A have been reported in US travelers who went to Tulum, Mexico. All of the people traveled between the dates of February 15, 2015, and March 20, 2015.

CDC recommends that travelers to Mexico get vaccinated against hepatitis A and follow all food and water precautions.

What can travelers do to prevent hepatitis A?
Get a hepatitis A vaccine:

- Ask your doctor or nurse about hepatitis A vaccine.
  • The hepatitis A vaccine is given in 2 doses, 6 months apart. The vaccine is nearly 100% effective and has been a routine childhood vaccine in the United States since 2005.
    • If you returned from travel to Tulum, Mexico, in the last 14 days, talk to your doctor about receiving a dose of hepatitis A vaccine, which can prevent or reduce the symptoms of hepatitis A if given within 14 days of exposure.
  • See Vaccine Information Statements (VIS) for more information.
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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.

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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

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IAC corrects an error of omission in its "Guide to Contraindications and Precautions to Commonly Used Vaccines" 

IAC has corrected its resource for healthcare professionals, Guide to Contraindications and Precautions to Commonly Used Vaccines, to include the current ACIP language about live attenuated influenza vaccine (LAIV) and children age 2–4 years who have asthma or wheezing, which had been omitted in the previous version dated 3/15. This section of the handout now reads: "In addition, ACIP recommends that LAIV not be used in the following populations...children ages 2 through 4 years who have asthma or had wheezing within the past 12 months, per healthcare provider statement..."

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 revises its handout for parents and patients, "Tips for Locating Old Immunization Records"

IAC has revised Tips for Locating Old Immunization Records with updated information about state immunization information systems. This handout is targeted to parents and patients who are trying to track down old vaccination records.

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Vaccine Education Center releases suite of videos for parents

The Vaccine Education Center at the Children's Hospital of Philadelphia (VEC) has released a series of 14 videos for parents on YouTube. Each video in the series is two to four minutes long and features Paul Offit, MD, answering common vaccine-related questions. Talking About Vaccines answers questions such as:
  • Why do newborns get the hepatitis B vaccine?
  • Why are vaccines required before my child goes to school?
  • Why is the HPV vaccine given to children at 11–12 years of age?
  • Are vaccines safe during pregnancy?
Dr. Offit is the chief of Infectious Diseases and the director of the Vaccine Education Center at the Children's Hospital of Philadelphia, as well as the Maurice R. Hilleman Professor of Vaccinology and professor of pediatrics at the University of Pennsylvania School of Medicine. Related Links Back to top

PKIDs offers collection of resources about meningococcal disease

Parents of Kids with Infectious Diseases (PKIDs) has put together a new web section that highlights a collection of resources related to meningococcal disease and related vaccination, including thought-provoking videos and posters. Related Links Back to top

Review published in Pediatrics highlights the importance of Tdap vaccination during pregnancy

On May 11, the journal Pediatrics published an article titled Strategies to Decrease Pertussis Transmission to Infants online. The abstract is reprinted below.

The Global Pertussis Initiative (GPI) is an expert scientific forum addressing the worldwide burden of pertussis, which remains a serious health issue, especially in infants. This age cohort is at risk for developing pertussis by transmission from those in close proximity. Risk is increased in infants aged 0 to 6 weeks, as they are too young to be vaccinated. Older infants are at risk when their vaccination schedules are incomplete. Infants also bear the greatest disease burden owing to their high risk for pertussis-related complications and death; therefore, protecting them is a high priority. Two vaccine strategies have been proposed to protect infants. The first involves vaccinating pregnant women, which directly protects through the passive transfer of pertussis antibodies. The second strategy, cocooning, involves vaccinating parents, caregivers, and other close contacts, which indirectly protects infants from transmission by preventing disease in those in close proximity. The goal of this review was to present and discuss evidence on these 2 strategies. Based on available data, the GPI recommends vaccination during pregnancy as the primary strategy, given its efficacy, safety, and logistic advantages over a cocoon approach. If vaccination during pregnancy is not feasible, then all individuals having close contact with infants <6 months old should be immunized consistent with local health authority guidelines. These efforts are anticipated to minimize pertussis transmission to vulnerable infants, although real-world effectiveness data are limited. Countries should educate lay and medical communities on pertussis and introduce robust surveillance practices while implementing these protective strategies. Related Links Back to top

New study finds that current vaccines will reduce most HPV-associated cancers; the new 9-valent vaccine will contribute to an additional reduction

On April 29, the Journal of the National Cancer Institute published data from a CDC-initiated and sponsored study in an article titled US Assessment of HPV Types in Cancers: Implications for Current and 9-Valent HPV Vaccine. Researchers examined human papillomavirus (HPV) DNA in tissue samples of cancer cases from seven population-based cancer registries. A section from a related letter sent from CDC to partners is reprinted below.

The new 9-valent HPV vaccine...has the potential to protect against 10% more of HPV-related cancers than previous vaccines. By analyzing the HPV DNA from tissues in cancer registries, researchers determined that the 9v HPV vaccine could protect against over 80% of all cervical cancers, an additional 15% potential protection from the additional types in the 9-valent vaccine. The data also showed the 9-valent vaccine has the potential to additionally protect against around 5% of oropharyngeal cancers, the other most common HPV-associated cancer. The paper reports that the 9-valent vaccine has the potential to protect against an additional 14% of vulvar, 18% of vaginal, 9% of penile, and 8% of anal cancers. Related Links

HPV Resources from IAC HPV Resources from CDC HPV Resources from the Vaccine Education Center
HPV Resources from AAP
HPV resource from ACOG
HPV Resource from Voices for Vaccines
HPV resource from National Association of County and City Health Officials (NACCHO)
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CDC publishes two articles about Ebola in MMWR

CDC published the following two articles about Ebola in the May 15 issue of MMWR. Related Link Back to top

White House Initiative on Asian Americans and Pacific Islanders, Hep B United, and the National Viral Hepatitis Roundtable to sponsor May 21 webinar on hepatitis and the Affordable Care Act

The White House Initiative on Asian Americans and Pacific Islanders, Hep B United, and the National Viral Hepatitis Roundtable will sponsor a one-hour webinar on viral hepatitis and the Affordable Care Act on May 21 at 3:00 p.m. (ET). In 2013 and 2014, the U.S. Preventive Services Task Force (USPSTF) issued a “B grade” recommending hepatitis B virus (HBV) screening for persons at high risk for infection and hepatitis C virus (HCV) screening for persons at risk for infection and one-time screening for adults born between 1945 and 1965. Join this interactive session to learn more about implementation of the USPSTF hepatitis screening recommendations and what this means for viral hepatitis preventive services under the Affordable Care Act. Related Links Back to top

Question of the Week

For an adult who experienced probable thrombocytopenic purpura after one dose of MMR as a child, it is my understanding that they should not receive MMR vaccine. Is this correct? This person has a positive serology for mumps and rubella but not measles. 
A history of thrombocytopenia is considered a precaution, not a contraindication to MMR vaccine. What that means is that a provider should weigh the benefits of giving a dose of vaccine, even given the history, if circumstances indicate that the risk of disease is high (such as in an outbreak setting).

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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