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Issue 1193: July 14, 2015

Ask the Experts
Ask the Experts—Question of the Week: We have a child who received the second dose of hepatitis A vaccine 3 months after…read more

New! 2016 edition of CDC Health Information for International Travel ("The Yellow Book") now available online

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 has now posted the 2016 edition of "The Yellow Book" online at

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

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Vaccine Education Center redesigns its website

On July 8, the Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia changed its website to a new responsive design format to align with the rest of the hospital's website. The change of format also involved some changes to navigation and organization. The staff at VEC expects that the new design will improve usability, but encourages users to email Charlotte Moser with any problems. To this end, also please update any links to VEC materials on your own websites as needed. Should you find any non-working links, buttons, or navigational tools on our sites, please alert Charlotte immediately, so the team can fix them.

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IAC enrolls five more birthing institutions into its Hepatitis B Birth Dose Honor Roll; three previously honored institutions qualify for a second year

The Immunization Action Coalition (IAC) is pleased to announce that five new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.
  • Atrium Medical Center, Middletown, OH (95%)
  • BSA Health System, Amarillo, TX (99%)
  • Cass County Memorial Hospital, Atlantic, IA (96%)
  • Paoli Hospital-Main Line Health System, Paoli, PA (93%)
  • Perry County Memorial Hospital, Tell City, IN (96%)
In addition, the following three institutions are being recognized for a second year.
  • Kapiolani Medical Center for Women and Children, Honolulu, HI (99%)
  • Memorial Medical Center, Springfield, IL (93%)
  • Phoebe Putney Memorial Hospital, Albany, GA (98%)
The Honor Roll now includes 205 birthing institutions from 33 states and Puerto Rico.

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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Join the Voices for Vaccines' August 13 conference call featuring a parent's view of immunization legislation

Voices for Vaccines will sponsor a conference call at 12:00 p.m. (ET) on August 13, which will feature parent Sundari Kraft. Ms. Kraft is a Colorado mother whose concern about vaccine hesitancy led her to work with other parents and public health officials to introduce immunization-related legislation. She also used her skills to help advise parents in California this past year in their legislative efforts. Other parents who testified in their own home states will also be on hand during this conference call.

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!
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Vaccine Education Center updates three of its educational handouts for parents and patients

The Vaccine Education Center at the Children's Hospital of Philadelphia has updated the following three handouts for parents and patients:
These handouts are part of a series of Q&A sheets about vaccines and vaccine safety.  
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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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WHO reports on human cases of influenza at the human-animal interface

The World Health Organization (WHO) published an article titled Human cases of influenza at the human-animal interface, January 2014–April 2015 in the July 10 issue of the Weekly Epidemiological Report.

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CDC publishes article on Ebola in MMWR

CDC published Community Knowledge, Attitudes, and Practices Regarding Ebola Virus Disease—Five Counties, Liberia, September–October, 2014 in the July 10 issue of MMWR(pages 714–718). A summary made available to the press is reprinted below.

Local cultural practices and beliefs related to Ebola have presented challenges to controlling the current outbreak in West Africa. Community engagement is an important component of Ebola control. Early in the epidemic, Ebola awareness was widespread within communities in Liberia, based on a knowledge, attitudes, and practices (KAP) survey. However, differences were observed between counties based on Ebola incidence. Areas of concerns include large numbers of participants not being confident with Ebola symptom identification and existing fears of Ebola survivors and of Ebola treatment units. Survey findings could be used to inform ongoing health awareness and messaging to address specific fears, misperceptions, and practices regarding Ebola. This study might offer useful insight for other countries during Ebola containment efforts.

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Question of the Week

We have a child who received the second dose of hepatitis A vaccine 3 months after the first dose. A repeat dose (dose #3) was given 4 months after the (invalid) second dose. Both dose #2 and dose #3 appear to be invalid because the intervals were less than 6 months. Should this child receive a fourth dose of hepatitis A vaccine? 

It is true that the recommended minimum interval between doses of hepatitis A vaccine is 6 calendar months. If the second dose is given too early, the repeat dose should be given 6 months after the invalid dose. However, in this situation CDC has recommended that dose #3 can be counted as valid if it was separated by at least 6 months from the first dose. So a fourth dose would not be recommended for this child.

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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