Issue 1190: June 23, 2015

Ask the Experts
Ask the Experts—Question of the Week: Is it necessary for us to record the actual date that the Vaccine Information Statement (VIS)…read more

Reminder: May issues of Needle Tips and Vaccinate Adults available online

The May 2015 issues of Needle Tips and Vaccinate Adults are available online. Vaccinate Adults is an abbreviated version of Needle Tips with the pediatric content removed.

Click on the images below to download the entire May issues (PDF) of Needle Tips and/or Vaccinate Adults.

May issue of Needle TipsMay issue of Vaccinate Adults

Needle Tips: View the table of contentsmagazine viewer, and back issues.

Vaccinate Adults: View the table of contentsmagazine viewer, and back issues.

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.

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CDC's Health Alert Network publishes a health advisory for clinicians: consider not only Ebola virus disease, but also other infectious diseases, when evaluating ill travelers from Liberia to the United States

On June 19, CDC's Health Alert Network published Clinical Considerations for the Evaluation of Ill Travelers from Liberia to the United States. The "Summary" section is reprinted below.


CDC recommends that healthcare providers consider not only Ebola virus disease (EVD), but also other much more likely infectious diseases, including malaria, when evaluating ill travelers from Liberia to the United States. Signs and symptoms of EVD are non-specific and overlap with many other more prevalent infectious diseases in West Africa. For any patient returning from West Africa and presenting with non-specific signs and symptoms consistent with EVD, providers should use clinical judgment, taking into account the patient’s epidemiological history for management, diagnostic testing, and treatment and coordinate healthcare as needed with the state or local health department to ensure that these patients get appropriate care without delay. The rapid identification of the cause of an acute illness in a Person Under Investigation (PUI) enables rapid treatment and resolution of symptoms.

Access the complete HAN advisory, which includes CDC's recommendations for evaluation of other more common acute conditions and diagnostic testing to confirm the diagnosis.

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IAC enrolls the 200th birthing institution into its Hepatitis B Birth Dose Honor Roll!

The Immunization Action Coalition (IAC) launched its Hepatitis B Birth Dose Honor Roll in July 2013; this week the 200th birthing institution was honored! In addition, 47 institutions have renewed their qualifications for a second—or in one case, a third—year. Honorees come from 32 states and Puerto Rico. IAC urges hospitals and other birthing institutions to look at the materials at the end of this article to investigate the criteria for inclusion and consider applying.

The newly added birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.
  • Down East Community Hospital, Machias, ME (92%)
  • Newton Medical Center, Newton, KS (91%)
  • Sabetha Community Hospital, Sabetha, KS (92%)
In addition, the following two institutions are being recognized for a second year:
  • Hallmark Health System/Melrose Wakefield Hospital, Melrose, MA (98%)
  • Highlands Regional Medical Center, Prestonburg, KY (99%)
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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ACIP publishes recommendations for yellow fever booster doses

CDC published Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015 in the June 19 issue of MMWR (pages 647–650). A summary made available to the press is reprinted below.

On February 26, 2015, the ACIP voted that a single dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers. This recommendation was established based on reviewing available information about the safety and long-term protection offered by yellow fever vaccine. The World Health Organization made similar recommendations in 2013, stating one dose of yellow fever vaccine is sufficient to provide lifelong protection. The current recommendations from ACIP, however, note certain people who should receive additional dose(s) of yellow fever vaccine because of an impaired immune response to the vaccine or because they will be at increased risk for yellow fever disease.

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New: 2016 edition of CDC Health Information for International Travel now available for purchase

CDC Health Information for International Travel (also known as "The Yellow Book") is published every two years as a reference for those who advise international travelers about health risks. The Yellow Book is written primarily for healthcare professionals, but is a useful resource for anyone interested in healthy international travel. The newly released 2016 edition features comprehensive updates, a variety of new sections, and expanded disease maps (including country-level yellow fever vaccine recommendation maps).

CDC Health Information for International Travel is currently available for sale from Oxford University Press, and can also be ordered from major online booksellers.

Note: The online version of 2016 edition of "The Yellow Book" is not yet available on CDC's website.

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CDC offers 15-part webinar on Epidemiology and Prevention of Vaccine-Preventable Diseases; sessions will be archived

CDC has announced that it will present a 15-part webinar series to provide a chapter-by-chapter overview of the 13th edition of its book, Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). This is a live series of one-hour webinars that will start on July 8 and end on October 14. All sessions will begin at 12:00 p.m. (ET). Continuing education credit will be available for each session.

Read more about the series.

Participation in this series requires advance registration. Virtual seats are available for the first 500 registrants, but each session will also be archived and available within two weeks after each event.

Download Epidemiology and Prevention of Vaccine-Preventable Diseases  Order Epidemiology and Prevention of Vaccine-Preventable Diseases  Back to top

IAC Spotlight! Where you'll find books and periodicals for reference and reading 

The "Books and Periodicals" section on provides up-to-date listings of key vaccine-related reference books and nonfiction reading material for healthcare professionals and their patients. For each item listed, you’ll find publication details, a brief summary, and ordering information.

The Reference Books web section includes books such as The Vaccine Handbook: A Practical Guide for Clinicians (5th edition) by Gary Marshall, MD; Vaccines (6th edition) by Stanley A. Plotkin, MD, Walter A. Orenstein, MD, and Paul A. Offit, MD; and Epidemiology and Prevention of Vaccine-Preventable Diseases (13th edition) by Jennifer Hamborsky, MPH, CHES, Andrew Kroger, MD, MPH, and Charles (Skip) Wolfe.

The Publications for Parents web section includes the new book by Wendy Sue Swanson, MD (a.k.a. Seattle Mama Doc) titled Mama Doc Medicine: Finding Calm and Confidence in Parenting, Child Health, and World-Life Balance.

The Nonfiction Books web section includes books such as The Panic Virus: A True Story of Medicine, Science, and Fear by journalist Seth Mnookin and Deadly Choices: How the Anti-Vaccine Movement Threatens Us All by Paul A. Offit, MD.

The Periodicals web section includes journals on immunization topics and vaccine research.

If you have additional books or periodicals to recommend for inclusion on, please send your suggestion(s) to

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IAC posts Karen language translations of the Hib, Td, and Tdap VISs

IAC recently posted Karen translations of the Haemophilus influenzae type b (Hib), Td, and Tdap VISs. IAC thanks Language Services Associates & St. Peter's Health Partners, Albany, NY, for the translations. Visit IAC's VIS web section for VISs in more than 35 languages.

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IAC replaces previously posted Cambodian (Khmer) translations of the PCV13 and pediatric multi-vaccine VISs due to a font problem

IAC has replaced previously posted Cambodian (Khmer) translations of the PCV13 and pediatric multi-vaccine VISs due to a font problem. Many thanks to the medical student who pointed out that some of the fonts had been corrupted and to the California Department of Health for providing the original translations and then correcting the problem. Back to top

MediaPlanet's Vaccine Awareness campaign includes new articles on the efficacy and safety of vaccines

MediaPlanet published a Vaccine Awareness campaign as part of a multi-page newspaper supplement that was included in USA Today newspapers in New York City, Chicago, and Los Angeles on June 19. The campaign was also published online. Every Child By Two (ECBT) worked with MediaPlanet to help develop the content of this supplement, suggesting different vaccine-related topics to cover and organization and people to contact. ECBT's newest immunization champion, Dr. Tim Jacks, and ECBT spokesperson actor Amanda Peet are featured in articles within the Vaccine Awareness campaign, and ECBT wrote the online editorial, “Fact or Fiction: Addressing Parents’ Top Vaccination Questions." In addition, there are more vaccine-related articles, including an excellent one for parents by Dr. Paul Offit, Vaccine Education Center, The Children's Hospital of Philadelphia.

The vaccine-related articles that were published in the Vaccine Awareness newspaper supplement can be viewed online at Click on an article of interest and navigate from article to article by clicking on the "next article" arrow at the bottom. The following are direct links to the specific articles that ECBT was involved with: 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.

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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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CDC reports on vaccine-derived polioviruses worldwide in this week's MMWR

CDC published Update on Vaccine-Derived Polioviruses—Worldwide, January 2014–March 2015 in the June 19 issue of MMWR (pages 640–646). A summary of the MMWR article made available to the press by CDC is reprinted below.

Vaccine-derived polioviruses (VDPVs), recognized by their high genetic divergence from the OPV strains, fall into three categories: 1) cVDPVs from outbreaks, 2) iVDPVs from patients with primary immunodeficiencies, and 3) ambiguous VDPVs (aVDPVs) that cannot be more definitively identified. During January 2014–March 2015, new cVDPV outbreaks were identified in Madagascar and South Sudan; outbreaks in Afghanistan and Somalia stopped; outbreaks in Nigeria and Pakistan had nearly stopped. Nine newly identified persons in seven countries were found to excrete iVDPVs. Because >97% of cVDPVs since 2006 and 65% of iVDPVs since 1962 are type 2, WHO plans coordinated worldwide replacement of trivalent OPV with bivalent OPV (types 1 and 3) by April 2016, preceded by introduction of at least one dose of IPV.

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Watch "HPV Vaccine is Cancer Prevention: CDC's Clinician Engagement Initiative" webinar online

On April 30, CDC, along with the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP), sponsored a webinar titled “HPV Vaccine is Cancer Prevention: CDC's Clinician Engagement Initiative.” The speakers presented an overview of why HPV vaccination is a critical cancer prevention tool and provided tips for helping clinicians in pediatrics increase acceptance and uptake of HPV vaccine.

This webinar can now be viewed on YouTube at your convenience.

Related Links

From AAFP, AAP, ACOG, ACP, CDC, and IAC HPV Resources from IAC HPV Resources from CDC HPV Resources from the Vaccine Education Center
HPV Resources from AAP
HPV resources from ACOG
HPV Resource from Voices for Vaccines
HPV Resource from the National Association of County and City Health Officials (NACCHO)
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Question of the Week

Is it necessary for us to record the actual date that the Vaccine Information Statement (VIS) was provided or can it be assumed that the VIS was provided on the day the shot was given? 
Federal law requires that the provider record in the medical record the date the VIS was provided and the date the vaccine was administered. In addition, providers are required to record the edition date of the VIS (found on the back at the right bottom corner), the name, office address, and title of the healthcare provider who administers the vaccine, and the vaccine manufacturer and lot number.

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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