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Issue 1196: July 28, 2015

Ask the Experts
Ask the Experts—Question of the Week: A healthy child received only one dose of pneumococcal conjugate…read more

It's just around the corner! August is National Immunization Awareness Month (NIAM)

Every year in August, National Immunization Awareness Month (NIAM) provides an opportunity to raise awareness of the importance of immunization and the need for improving national vaccination coverage levels. The National Public Health Information Coalition, in collaboration with CDC, has developed a National Immunization Awareness Month Communication Toolkit that includes key messages, vaccine information, sample news releases and articles, sample social media messages, and links to web resources from CDC and other organizations.

The observance features a different group each week of August:
  • Week 1 (Aug. 2–8)—Preteens and Teens: Ensure a healthy future with vaccines 
  • Week 2 (Aug. 9–15)—Pregnant Women: Protect yourself and pass protection on to your baby  
  • Week 3 (Aug. 16–22)—Adults: Vaccines are not just for kids
  • Week 4 (Aug. 23–30)—Infants and Children: A healthy start begins with on-time vaccinations
CDC has provided the following suggestions to help you promote vaccination during each week of NIAM:
  1. Update your materials with the latest information and key messages that are provided in the toolkit.
  2. Place matte articles (i.e., formatted, ready-to-print articles that are free to use in any publication) in newsletters, on your website, or in local news outlets. The articles provided in the toolkit assist in educating and motivating consumers to talk to their healthcare professional and get vaccinated, and also encourage healthcare professionals to strongly recommend the vaccines patients need. You can tailor the articles to your particular audience(s) to maximize their impact.
  3. Place NIAM logos and banners on your website and/or social media platforms to highlight your participation in NIAM.
  4. Create buzz for NIAM by using the social media messages in the toolkit. The messages are crafted in a way that enables you to use them as they are—or tailor them as you see fit for your audience(s).
  5. Share your plans for NIAM by completing this online form.
  6. See what other organizations have planned for NIAM to help you plan your activities. (Note: This web page will be updated as NIAM activities are received.)
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Today is World Hepatitis Day; CDC publishes related announcement in MMWR

Today, July 28, is World Hepatitis Day. In the July 24 issue of MMWR (page 753), CDC published World Hepatitis Day—July 28, 2015. The first and last paragraphs of the announcement are reprinted below.

July 28, 2015, marks the fifth annual World Hepatitis Day, established in 2010 by the World Health Organization to increase awareness and understanding of viral hepatitis. Millions of acute hepatitis infections occur each year, and approximately 400 million persons are living with chronic hepatitis B or hepatitis C. An estimated 1.4 million persons die each year from the various forms of viral hepatitis. The theme of this year's World Hepatitis Day is "Prevent Hepatitis. Act Now." Key messages will focus on risks, safe injection practices, vaccination, and testing and treatment.

Additional information about World Hepatitis Day is available at Resources for health professionals are available at

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Gerontological Society of America announces ICAMP Academy, an opportunity for healthcare professionals to prepare themselves to become immunization champions

The Gerontological Society of America (GSA) is pleased to announce an exciting and unique opportunity to prepare healthcare professionals to become immunization champions in their organizations. The ICAMP Academy—a multidisciplinary leadership component of GSA’s Immunization Champions, Advocates, and Mentors Program (ICAMP)—is set for October 26–27 in Rosemont, Illinois, near downtown Chicago. Through this program, participants are not instructed how to vaccinate, but rather how to improve organizational performance on immunization quality metrics and lead their organization’s immunization efforts.

Healthcare professionals who are committed to improving adult health through vaccination are invited to apply to this 1.5-day multidisciplinary program. The ICAMP Academy was developed by GSA’s National Adult Vaccination Program (NAVP) for multidisciplinary providers including physicians, nurses, pharmacists, physician assistants, and nurse practitioners. Coach air travel, hotel room, travel expenses, and program fees for participants are fully covered by ICAMP sponsors.

We encourage you to refer and recommend this opportunity to individuals in your organization who actively support adult immunization. Applications will be reviewed by the NAVP workgroup, and participants will be chosen based upon their dedication to improving adult health through immunization and their interest in quality healthcare delivery performance outcomes.

The ICAMP Academy’s agenda offers participants insights on how to implement the National Vaccine Advisory Committee’s Standards for Adult Immunization Practice through the use of practical tools and sharing of best practices. This innovative program was designed by experts who have achieved success in improving immunization rates in their practices and communities.     

Applications to attend the ICAMP Academy are being accepted through August 30, 2015. Apply now, as space is limited. Please go to for additional information about NAVP’s ICAMP Academy.

Please direct any questions to

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Help promote NIAM by joining the #TeamVax Thunderclap campaign on August 17 

August is National Immunization Awareness Month (NIAM), which is a great opportunity to promote the importance of vaccination through social media. CDC's National Center for Immunization and Respiratory Diseases invites everyone to join in the #TeamVax Thunderclap campaign on August 17 to support vaccination during NIAM. Thunderclap is a platform that uses the power of crowds to amplify a single important message across supporter social media profiles, allowing supporters to sign up in advance to share a unified message at a specific time via their individual Facebook, Twitter, or Tumblr account. The collective action creates a wave of support—or “thunderclap”—across social media.

On August 17 at 3:00 p.m. (ET), the #TeamVax message will be released, thus creating a thunderclap announcement that is heard far and wide. Please, sign up now and help CDC reach supporters. Show your support by going to and clicking on the red button. You can choose to have the message post on your Twitter, Facebook, or Tumblr account—or on all three.

When you use #TeamVax, you’re saying that you are part of the majority of people who choose the safe, proven disease protection that vaccines offer.

If you have questions about Thunderclap or #TeamVax, please email Related Links Back to top

Twelve new videos added to IAC's video library, a searchable collection of nearly 200 videos about vaccine-preventable diseases and the importance of immunization on

IAC's website for the public, features an impressive Video Library. This month, 12 new videos have been added to IAC's collection of more than 190 videos, including "The Right Thing to Do," "Why Vaccines Work," and "#UDontGetIt Official Campaign Video." The video library is searchable by keyword and by a preset "Popular Searches" drop-down menu, which offers more than 10 categories of topics to choose from. The results of a video search can be sorted by date of posting or by title of the video.

Some popular search categories include: Videos in this curated collection include personal testimonies from parents who have suffered the tragic loss of a child, public service announcements about the importance of immunization, and videos about vaccine-preventable diseases, as well as animation to help illustrate the concepts of immunization. The featured videos are from many sources, including the following trusted organizations: CDC, PKIDs, California Immunization Coalition’s Shot-by-Shot project, Families Fighting Flu, state health departments, and local immunization coalitions.

We urge you to link to IAC’s websites, and, from your website, blog, and/or Facebook page.

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Reminder: Register now for the CDC webinar series on "The Pink Book" chapter topics or listen to archived sessions online

CDC is presenting a 15-part webinar series to provide a chapter-by-chapter overview of the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). This is a live series of one-hour webinars that started on July 8. All sessions 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. The following two sessions are now archived and can be viewed online; a transcript of each broadcast is also available. Download Epidemiology and Prevention of Vaccine-Preventable Diseases  Order Epidemiology and Prevention of Vaccine-Preventable Diseases  Back to top

CDC releases supplemental information and guidance for providers regarding use of 9-valent HPV vaccine

CDC has posted a useful new resource for immunization providers regarding use of HPV9 vaccine (Gardasil 9, Merck). Supplemental information and guidance for vaccination providers regarding use of 9-valent HPV vaccine summarizes the recommendations and provides additional guidance for issues that are likely to arise during the transition from HPV4 to HPV9 vaccine. Such issues include how to handle series completion with patients who have started HPV vaccination with either the bivalent or quadrivalent product, and considerations for people who have already completed the HPV series.

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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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New England Journal of Medicine publishes a "Perspective" column on the end of personal belief exemptions in California 

On July 22, the New England Journal of Medicine published a "Perspective" column online titled Shifting Vaccination Politics—The End of Personal-Belief Exemptions in California by Michelle M. Mello, JD, PhD, David M. Studdert, LLB, ScD, and Wendy E. Parmet, JD. Three paragraphs are reprinted below.

The passage of SB 277 was anything but a foregone conclusion. Although California's predominantly liberal populace generally tolerates assertive public health policies, a vocal libertarian minority ardently opposes vaccination mandates. The bill's opponents mobilized fiercely against it, attending hearings with toddlers in tow and organizing strident protests. The pediatrician-senator who sponsored the bill received death threats.

Nevertheless, four factors converged to enable its passage. First, legislative supporters showed extraordinary backbone in resisting pressure to abandon the measure. Second, the DPH publicized data showing that rates of personal-belief exemptions in California have doubled since 2007, and analysts noted that vaccination coverage is low enough to jeopardize herd immunity in a quarter of schools. Third, the widely publicized Disneyland measles outbreak brought home the risks posed by lost herd immunity. Researchers swiftly concluded that “substandard vaccination compliance is likely to blame for the 2015 measles outbreak.” The outbreak created a political opening and energized legislators, parents, and interest groups that aren't ordinarily activated around vaccination issues.

Fourth, the bill's proponents focused on the specific threat to schoolchildren who are too medically fragile to receive vaccinations, effectively framing vaccine refusal as a decision that endangers others rather than a purely “personal” one. For this argument, they found an appealing poster child in 7-year-old Rhett Krawitt, a patient with leukemia who made headlines when he and his parents asked his school to bar unvaccinated children and testified in support of SB 277.

Access the entire article: Shifting Vaccination Politics—The End of Personal-Belief Exemptions in California

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New England Journal of Medicine publishes a "Perspective" column on establishing a global vaccine-development fund

On July 23, the New England Journal of Medicine published a "Perspective" column online titled Establishing a Global Vaccine-Development Fund by Stanley A. Plotkin, MD, Adel A.F. Mahmoud, MD, PhD, and Jeremy Farrar, MD, PhD. The second paragraph is reprinted below.

Vaccine development is facing a crisis for three reasons: the complexity of the most challenging targets, which necessitates substantial investment of capital and human expertise; the diminishing numbers of vaccine manufacturers able to devote the necessary resources to research, development, and production; and the prevailing business model, which prioritizes the development of vaccines with a large market potential. We consider an international vaccine-development fund to be urgently needed to provide the resources and the momentum to carry vaccines from their conception in academic and government laboratories and small biotechnology firms to development and licensure by industry. Such a fund would enable basic scientists to move candidate vaccines from the laboratory through the so-called valley of death–the critical steps after good preclinical data have been obtained, comprising manufacture to Food and Drug Administration standards, a phase 1 clinical trial, and proof of concept in terms of protective immune responses. This support would permit efficacy assessment to begin—and thereby avert a repetition of the Ebola crisis.

Access the entire article: Establishing a Global Vaccine-Development Fund

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CDC reports on viral hepatitis surveillance in India from 2011–2013

CDC published Viral Hepatitis Surveillance—India, 2011–2013 in the July 24 issue of MMWR (pages 758–762). An excerpt of the summary made available to the press is reprinted below.

The implementation of a viral hepatitis surveillance and monitoring system in India provides a snapshot of viral hepatitis throughout the country and identifies the potential factors contributing to reported outbreaks. India has a considerable burden of viral hepatitis, but national surveillance data to assess the breadth of the issue has been lacking. The National Integrated Disease Surveillance Program (IDSP) began collecting data across all Indian states for epidemic-prone diseases, including viral hepatitis, in 2009. This report summarizes findings from IDSP between 2011 and 2013 and provides the first comprehensive assessment of the burden of acute viral hepatitis in India. 

Access the entire article: Viral Hepatitis Surveillance—India, 2011–2013

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CDC reports on a nationwide hepatitis C elimination program in the Eurasian country of Georgia

CDC published Launch of a Nationwide Hepatitis C Elimination Program—Georgia, April 2015 in the July 24 issue of MMWR (pages 753–757). An excerpt of the introductory paragraph is reprinted below.

Hepatitis C virus (HCV) infects an estimated 130–150 million persons globally and results in an estimated 700,000 deaths annually from hepatocellular carcinoma or cirrhosis. Georgia, a middle-income Eurasian country, has one of the highest estimated HCV prevalences in the world. In 2011, Georgia began offering treatment to a limited number of HCV-infected persons. Beginning in 2013, when new oral medications that can cure >90% of HCV infections were licensed, Georgia engaged partners to develop a comprehensive HCV prevention and control plan, during which the concept of elimination of HCV transmission and disease emerged. To prepare for the launch of an HCV elimination program, Georgia requested CDC's assistance to describe HCV epidemiology, evaluate laboratory and health care capacity, and conduct program monitoring and evaluation. This report describes the activities undertaken to prepare for the program, launched in April 2015, and early results of its initial phase, focused on improving access to affordable diagnostics and free curative treatment for HCV-infected persons with severe liver disease. 

Access the entire article: Launch of a Nationwide Hepatitis C Elimination Program—Georgia, April 2015

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WHO publishes article about genetic diversity of wild-type measles viruses and the global measles nucleotide surveillance database

The July 24 issue of the WHO periodical Weekly Epidemiological Record features an article titled Genetic diversity of wild-type measles viruses and the global measles nucleotide surveillance database (MeaNS).

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NFID Clinical Vaccinology Course scheduled for November 13–15 in Bethesda, MD

The National Foundation of Infectious Disease's Fall 2015 Clinical Vaccinology Course will be held November 13–15 in Bethesda, MD. This 2.5-day course focuses on new developments and issues related to the use of vaccines. Expert faculty provide the latest information on vaccines, including updated recommendations for vaccinations across the lifespan, and innovative and practical strategies for ensuring timely and appropriate immunization. Continuing education credit is available for attendees. Back to top

Question of the Week

A healthy child received only one dose of pneumococcal conjugate vaccine (PCV) at age 10 months. She is now 6 years old. Our state requires one dose of PCV13 after the first birthday for school attendance. Her physician says because she is older than 59 months, she does not need another dose of PCV. What should we do in this situation?

ACIP does not recommend routine PCV vaccination of healthy children 60 months of age or older. If there is a school requirement, the simplest solution is to give the child one dose of PCV13. However, health insurance may not pay for this dose. For more information on the ACIP recommendations for PCV13, go to

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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