Issue 1185: June 2, 2015

Ask the Experts
Ask the Experts—Question of the Week: An infant is going to be traveling internationally before turning one year of age, but is not…read more

New! May issue of Vaccinate Adults is now online

The May 2015 issue of Vaccinate Adults is now online. Vaccinate Adults is an abbreviated version of Needle Tips with the pediatric content removed.

This issue of Vaccinate Adults 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 schedule for adults. 

Click on the image below to download the entire May issue of (PDF) Vaccinate Adults.

Download May 2015 issue of Vaccinate Adults

Related Links Back to top

Reminder: May issue of Needle Tips available online

The May 2015 issue of Needle Tips is available online. 

Click on the image below to download the entire May issue (PDF) of Needle Tips.

Download the March issue of Needle Tips

Related Links If you would like to receive immediate email notification whenever new issues of Needle Tips or Vaccinate Adults are released, visit IAC's subscribe page to sign up.

Back to top

Vermont eliminates philosophical exemptions to vaccination

On May 28, Vermont Governor Peter Shumlin signed a bill that eliminated personal exemptions to vaccination in the state.

Governor Shumlin released the following statement:

Vaccines work and parents should get their kids vaccinated. I know there are strong feelings on both sides of this issue. I wish the legislation passed three years ago had worked to sufficiently increase vaccination rates. However we’re not where we need to be to protect our kids from dangerous diseases, and I hope this legislation will have the effect of increasing vaccination rates.

The American Academy of Pediatrics Vermont Chapter (AAPVT) also released a statement; three paragraphs from this statement are reprinted below.

“Vermont’s pediatricians would like to thank Governor Shumlin, as well as the General Assembly and Health Commissioner Harry Chen, MD, for their courage on this important issue,” said Barbara Frankowski, MD, president of the AAPVT. “Eliminating the philosophical exemption will no doubt protect the health of Vermonters by increasing the state’s immunization rates and ensuring that it is more difficult for deadly and debilitating diseases to gain a foothold in the state.”

By eliminating the philosophical exemption, the AAPVT says, the state has signaled just how important immunizations are to the well-being of not only children, but all members of society. 

“This isn’t just a private health issue that affects a single child or family, but a public health issue that impacts all Vermonters, in all parts of the state,” said Dr. Frankowski. “As a community, we all rely on each other’s cooperation to stave off diseases that plagued generations before us, but that we are lucky enough to know little about today.”
Related Links Back to top

Join the Voices for Vaccines' June 17 conference call featuring political scientist Brendan Nyhan speaking on effective health messaging and vaccines

Brendan Nyhan, assistant professor in the Department of Government at Dartmouth College, and contributor to "The Upshot" at The New York Times, will be the speaker on the June 17 Voices for Vaccines (VFV) conference call at noon (ET). Mr. Nyhan will discuss effective health messaging.

To register for this call, you must email

Voices for Vaccines is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters. VFV invites everyone who appreciates vaccines to become a member of their organization. Please spread the word to your friends and colleagues to register for the conference call and to join VFV!
Related Links Back to top

IAC updates sample standing orders for administering HPV vaccine to children, teens, and adults

IAC recently revised its sample standing orders for administering human papillomavirus vaccine to include 9-valent HPV vaccine (Gardasil 9, Merck). Related Links 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.

Back to top
American Academy of Pediatrics releases updated HPV vaccine recommendations

The American Academy of Pediatrics recently released updated recommendations on the use of HPV vaccines, including HPV9 vaccine. A section of a related article in the AAP News is reprinted below.

AAP recommendations

All 11- and 12-year-old children should receive HPV vaccine as part of the adolescent immunization platform.

The Academy recommends three doses of HPV9, HPV4 (as availabilities last) or HPV2 for routine immunization of females 11 or 12 years of age. Three doses of either HPV9 or HPV4 (as availabilities last) are recommended for routine immunization of males 11 or 12 years of age. The second dose should be administered at least one to two months after the first dose, and the third dose should be administered at least six months after the first dose.

The vaccination series can be started as young as 9 years of age. In the case of sexual abuse, HPV vaccination is recommended beginning at 9 years of age.

Any of the three vaccines are recommended for females 13 through 26 years of age who have not been immunized or have not completed the series.

Either HPV9 or HPV4 is recommended for immunization of males 13 through 21 years of age who have not been immunized or have not completed the series as well as for men
who have sex with men and people who are immunocompromised (including those with HIV infection) through 26 years of age. Men 22 through 26 years of age who have not been immunized or have not completed the vaccine series may receive HPV9 or HPV4 vaccine. Cost-efficacy models do not justify a stronger recommendation in this age group.

Revaccination of people vaccinated with HPV4 or HPV2 is not recommended but may be done safely.

The Academy’s recommendations mirror those of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.

Related Links Back to top

WHO reports on Strategic Advisory Group of Experts on Immunization's April meeting

The May 29 issue of the WHO periodical Weekly Epidemiological Record includes a report titled Meeting of the Strategic Advisory Group of Experts on Immunization, April 2015: conclusions and recommendations.

The Strategic Advisory Group of Experts (SAGE) on Immunization was established by the director-general of the World Health Organization in 1999 to provide guidance on the work of WHO. SAGE is the principal advisory group to WHO for vaccines and immunization.

Related Links Back to top

Still 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

Reminder: Registration deadline for June ACIP meeting is June 3 for non-U.S. citizens and June 10 for U.S. citizens; draft agenda now available

CDC's Advisory Committee on Immunization Practices (ACIP) will hold its next meeting on June 24–25 in Atlanta at CDC's Clifton Road campus. To attend the meeting, ACIP attendees (participants and visitors) must register online. The registration deadline for non-U.S. citizens is June 3; it's June 10 for U.S. citizens. Registration is not required to watch the live webcast of the meeting. Back to top

Meeting minutes from February 2015 ACIP meeting now available

ACIP recently posted the minutes from the ACIP meeting held on February 26. Presentation slides and archived video broadcast footage from this meeting are also available.

Back to top

Question of the Week

An infant is going to be traveling internationally before turning one year of age, but is not scheduled to travel for a few months. Do we need to wait to vaccinate with MMR vaccine until some point closer to departure? 

Infants 6 through 11 months of age are recommended to receive MMR vaccine if they will be traveling internationally. There is no need to wait until travel is imminent. Optimally there should be one month between vaccine administration and travel, so vaccinate now if the infant is at least 6 months old and you know travel will occur before the child’s first birthday.

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 .