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Issue 1197: August 4, 2015

Ask the Experts
Ask the Experts—Question of the Week: An adult patient had a bone marrow transplant and had previously received a Tdap…read more

It's August! National Immunization Awareness Month is here!

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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CDC reports on adolescent vaccination coverage rates in 2014

CDC published National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years—United States, 2014 in the July 31 issue of MMWR (pages 784–792). The first paragraph of the report is reprinted below.

Routine immunization is recommended for adolescents aged 11–12 years by the Advisory Committee on Immunization Practices (ACIP) for protection against diseases including pertussis, meningococcal disease, and human papillomavirus (HPV)–associated cancers. To assess vaccination coverage among adolescents, CDC analyzed data collected regarding 20,827 adolescents through the 2014 National Immunization Survey-Teen (NIS-Teen). From 2013 to 2014, coverage among adolescents aged 13–17 years increased for all routinely recommended vaccines: from 84.7% to 87.6% for ≥1 tetanus-diphtheria-acellular pertussis (Tdap) vaccine dose, from 76.6% to 79.3% for ≥1 meningococcal conjugate (MenACWY) vaccine dose, from 56.7% to 60.0% and from 33.6% to 41.7% for ≥1 HPV vaccine dose among females and males, respectively. Coverage differed by state and local area. Despite overall progress in vaccination coverage among adolescents, HPV vaccination coverage continues to lag behind Tdap and MenACWY coverage at state and national levels. Seven public health jurisdictions achieved significant increases in ≥1- or ≥3-dose HPV vaccination coverage among females in 2014, demonstrating that substantial improvement in HPV vaccination coverage is feasible.

On July 30, CDC held a press telebriefing about the NIS-Teen results. The first two paragraphs of a related CDC press release are reprinted below.

The number of 13- to 17-year-old boys and girls getting the human papillomavirus (HPV) vaccine increased slightly for the second year in a row, according to data from CDC’s 2014 National Immunization Survey-Teen (NIS-Teen), published in this week’s Morbidity and Mortality Weekly Report (MMWR).

Despite these increases, 4 out of 10 adolescent girls and 6 out of 10 adolescent boys have not started the recommended HPV vaccine series, leaving them vulnerable to cancers caused by HPV infections. Persistent HPV infections can cause cancers of the cervix, vagina, and vulva in women; cancers of the penis in men; and cancers of the anus and oropharynx (back of the throat, base of the tongue, and tonsils) in men and women. CDC recommends the vaccine for girls and boys at age 11 to 12 years.

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CDC announces availability of additional guidance for providers regarding 9-valent HPV vaccine in MMWR 

CDC published Announcement: Additional Guidance Online for Providers Regarding 9-Valent HPV Vaccine Use Among Persons Who Previously Received HPV Vaccination in the July 31 issue of MMWR (page 806). The complete announcement is reprinted below.

A 9-valent human papillomavirus (HPV) vaccine (Gardasil 9, Merck and Co., Inc.) was licensed for use in females and males in the United States in December 2014. This is the third HPV vaccine licensed by the Food and Drug Administration; the other vaccines are the bivalent HPV vaccine, licensed for use in females, and the quadrivalent HPV vaccine, licensed for use in females and males.

In February 2015, the Advisory Committee on Immunization Practices (ACIP) recommended 9-valent HPV vaccine as one of three HPV vaccines that can be used for routine vaccination of females and one of two HPV vaccines for routine vaccination of males. ACIP recommendations were published in a March 2015 report. Additional information has been posted on the CDC website to provide guidance on issues that were not addressed in the March report but are likely to arise during the transition to 9-valent HPV vaccine, including questions about use of 9-valent HPV vaccine among persons who previously received bivalent or quadrivalent HPV vaccine (

IAC wrote about the availability of this guidance in the July 28 issue of IAC Express.

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The Lancet publishes report and editorial on Ebola vaccine trial

On July 31, the journal The Lancet published an article online titled Efficacy and effectiveness of an rVSV-vectored vaccine expressing Ebola surface glycoprotein: interim results from the Guinea ring vaccination cluster-randomised trial. The "Background" and "Interpretation" sections are reprinted below.

Background: A recombinant, replication-competent vesicular stomatitis virus-based vaccine expressing a surface glycoprotein of Zaire Ebolavirus (rVSV-ZEBOV) is a promising Ebola vaccine candidate. We report the results of an interim analysis of a trial of rVSV-ZEBOV in Guinea, West Africa.

Interpretation: The results of this interim analysis indicate that rVSV-ZEBOV might be highly efficacious and safe in preventing Ebola virus disease and is most likely effective at the population level when delivered during an Ebola virus disease outbreak via a ring vaccination strategy.

On the same day, The Lancet published an editorial titled An Ebola vaccine: first results and promising opportunities. The first and last paragraphs are reprinted below.

Today, The Lancet publishes the first results from a phase 3 cluster randomised trial of a novel Ebola virus vaccine. The study, sponsored and led by WHO, is a remarkable scientific and logistical achievement. In the midst of an extreme public health emergency, researchers, health workers, and community facilitators in Guinea included 7,651 people in a trial to test the efficacy of a recombinant, replication-competent vesicular stomatitis virus-based vaccine expressing a surface glycoprotein of Ebola (Zaire). The authors conclude that their interim analysis indicates the vaccine “might be highly efficacious and safe.”

One important message goes beyond even Ebola—the power of multilateralism and inclusive partnership to devise and execute critical clinical research. Ebola has been a catastrophe for West Africa. But out of this epidemic has come the opportunity to build unprecedented collaborations to generate evidence to advance health. There have been few better examples to prove the value and importance of WHO to strengthen global health security.

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Join August 11 Twitter chat on vaccines with ABC News' chief health and medical editor Dr. Richard Besser

You're invited to join moderator Dr. Richard Besser, ABC News’ chief health and medical editor, for a Twitter talk about immunization on August 11 from 1:00–2:00 p.m. (ET). ABC would like to hear from researchers, healthcare professionals, public health experts, bloggers, and patients themselves. It is always helpful for healthcare and public health professionals to provide evidenced-based information for the public during such an open forum, which will almost certainly include some vaccine misinformation.
Tweet Chat Directions
  • Make sure you have an active Twitter Account
  • Sign into at 12:45 p.m. (ET) the day of the chat. If unavailable, try,, or
  • Once you are signed in, tweet comments, facts, images, videos, and vines as often as you like. Be sure to use the hashtag #abcDRBchat and the “T” for Topic in each tweet. Please note that topics are not available ahead of the chat.
If you have questions, please feel free to email

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Time magazine highlights the "heroes and villains" of vaccination

On July 29, Time magazine published a feature online titled Meet the Heroes and Villains of Vaccine History. The "heroes" include Edward Jenner, Jonas Salk, Albert Sabin, Maurice Hilleman, Pearl Kendrick, Grace Eldering, and California State Senator Richard Pan, the pediatrician who is now facing a recall election due to his sponsorship of Senate Bill 277 (eliminated philosophical and religious exemptions to vaccination in the state).

The villains include Andrew Wakefield, Jenny McCarthy, Jim Carrey, and Rob Schneider.

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IAC Spotlight! Four healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination

More than 500 organizations are now enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, medical practices, professional organizations, health departments, and government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel. 

Since June 30, when IAC Express last reported on the Influenza Vaccination Honor Roll, four healthcare organizations have been enrolled.

IAC urges qualifying healthcare organizations to apply.

Newly added healthcare organizations, hospitals, government agencies, and medical practices
  • Hospital Auxilio Mutuo, San Juan, PR
  • Sabetha Community Hospital, Sabetha, KS 
  • St. Joseph's Hospital Health Center, Syracuse, NY
  • UCLA Health, Los Angeles, CA
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IAC enrolls four more birthing institutions into its Hepatitis B Birth Dose Honor Roll; two previously honored institutions qualify for a second year

The Immunization Action Coalition (IAC) is pleased to announce that four new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll, which now numbers more than 200 honorees. The newly added birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.
  • Eden Medical Center, Castro Valley, CA (97%)
  • Fort Madison Community Hospital, Fort Madison, IA (96%)
  • St. Rose Hospital, Hayward, CA (100%)
  • Union Hospital of Cecil County, Elkton, MD (95%)
In addition, the following two institutions are being recognized for a second year.
  • Manchester Memorial Hospital, Manchester, KY (99%)
  • St. Claire Regional Medical Center, Morehead, KY (98%)
The Honor Roll now includes 208 birthing institutions from 34 states and Puerto Rico. Fifty institutions have qualified for a second year and one institution has qualified three times.

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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Alliance for Aging Research releases white paper on improving adult vaccination rates

On July 29, the Alliance for Aging Research published a white paper titled Our Best Shot: Expanding Prevention Through Vaccination in Older Adults. A paragraph from the "Executive Summary" section is reprinted below.

Our analysis identifies obstacles that reduce the likelihood that older adults will use different vaccines and measures the extent to which financial, information, health barriers and demographic factors contribute to underutilization of vaccines. Based on the results of this analysis and other findings in the literature we conclude with policy recommendations to reduce barriers or mitigate their effect on vaccination rates among older adults in the US.

Access the complete 58-page report: Our Best Shot: Expanding Prevention Through Vaccination in Older Adults

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Third issue of WHO's Vaccine Safety Net Newsletter is now online

The World Health Organization (WHO) has just published the third edition of its new quarterly Vaccine Safety Net Newsletter. In this edition, you will have the opportunity to learn about Vaccine Safety Net developments, VSN members’ latest news, and WHO tools and resources for vaccine pharmacovigilance. As for each edition, a special focus is given to one of the VSN members: this month VSN shines the spotlight on Caring for Kids, a member since 2005.
The Vaccine Safety Net Newsletter aims to disseminate news and information regarding the VSN, foster communication and synergy among VSN members, and promote good information practices for websites providing information on vaccine safety.

To subscribe to this newsletter, send an email to with the exact text "subscribe vsn" in the body of your email message. 

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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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Every Child By Two's webinar with Alison Singer speaking about the latest autism research is now archived for online viewing

Every Child By Two hosted a one-hour webinar on July 15, titled Autism 101: Understanding and Communicating about Autism. The webinar featured Alison Singer, co-founder and president of the Autism Science Foundation. Ms. Singer provided an overview of autism, including the most recent research regarding early diagnosis, interventions, and potential causes. She reviewed the CASE Method, which combines emotional and scientific talking points aimed at swaying parent’s emotional response regarding vaccines and helping them to face the issue more logically. This webinar is now archived and available online for viewing at your convenience.

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WHO offers online course in vaccine safety basics in English and French

The WHO Global Vaccine Safety group offers an online training course on vaccine safety basics to help participants understand the origin and nature of adverse events, the importance of pharmacovigilance, and risk and crisis communication. The course covers the main elements of vaccine safety and includes modern learning tools and assessments, navigation aids, and a glossary.

The course, available in English and French, is designed to serve a broad range of individuals involved in vaccine safety, including vaccinating healthcare professionals, national regulatory staff, and more.

For users that do not have constant online access, the course is downloadable in both CD-ROM and PDF formats. Back to top

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

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 three 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 updates its "You Call the Shots" module on Haemophilus influenzae type b (Hib)

CDC recently announced that it had updated the Haemophilus influenzae type b (Hib) module in the web-based training course You Call the Shots. The training series is funded through a cooperative agreement between CDC and the Association for Prevention Teaching and Research (APTR). Continuing education credit is available for viewing a module and completing an evaluation.

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Archived video broadcast of the June 2015 ACIP meeting now available; ACIP will meet next on October 21–22

ACIP recently posted the archived video broadcast footage from the ACIP meeting held June 24–25. Presentation slides from this meeting are also available.

Reminder: CDC's Advisory Committee on Immunization Practices (ACIP) will hold its next meeting on October 21–22 in Atlanta. To attend the meeting, ACIP attendees (participants and visitors) must register online. The registration deadline for non-U.S. citizens is September 30; for U.S. citizens it's October 7. Registration is not required to watch the live webcast of the meeting.

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Question of the Week

An adult patient had a bone marrow transplant and had previously received a Tdap vaccine. The oncologist recommended another dose of Tdap. Is this acceptable in this situation? 

Yes. A dose of Tdap 6 months after a bone marrow transplant is appropriate.

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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