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Issue 1200: August 25, 2015

Ask the Experts
Ask the Experts—Question of the Week: Should international travelers receive both meningococcal…read more

IAC announces new initiative: MCV4: You’re Not Done If You Give Just One; Give 2 Doses to Strengthen Protection

Recent data published by CDC from its National Immunization Survey-Teen report found that only 28.5 percent of adolescents who were age 17 years at the time of the interview had received the recommended second dose of meningococcal (A, C, W, Y) conjugate vaccine (MCV4). This important booster is recommended at age 16 years to help prevent meningococcal meningitis. Although 79.3 percent of teens aged 13–17 years received the first recommended MCV4 vaccination, less than one-third had received the important second dose to help boost their protection against this devastating illness at a time in life when they are at greatest risk for meningococcal disease.
To help educate providers with important resources about the MCV4 booster vaccination, the Immunization Action Coalition, in collaboration with Sanofi Pasteur, launched a new initiative titled MCV4: You’re Not Done If You Give Just One; Give 2 Doses to Strengthen Protection. This initiative was developed to raise awareness about the extremely low immunization rates for MCV4 booster doses, help health care providers know their second dose MCV4 coverage rate, and supply tools for providers to increase rates and help close the MCV4 booster gap.
Why Focus on Improving Booster Vaccination Rates?
CDC recommends that a child receive one dose of MCV4 vaccine at age 11 or 12 years, followed by a second (or booster) vaccination at age 16, as the protection provided by the first dose wanes within five years in many teens. This means teens might have decreased protection from ages 16–21 years, when they are at greatest risk of meningococcal disease. 
Be sure to visit the website, www.give2mcv4.organd download and use the free, helpful materials available there, including fact sheets, talking points, an overview of adolescent immunization recommendations, Q&As, and other great materials.
Want to share news about this important initiative with others? Copy and share this information in your newsletter or other communications. In addition, check out these social media post resources to copy and share widely.
Check out the new MCV4 website and help strengthen protection against meningococcal meningitis! You can find important resources for health care providers. Remember – You’re Not Done If You Give Just One; Give 2 Doses to Strengthen Protection! 

New @immunizeaction project reminds health care providers about the importance of the 2nd meningococcal vaccination:

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National Immunization Awareness Month's theme this week is vaccination of infants and young children

Every August, National Immunization Awareness Month (NIAM) provides an opportunity to raise awareness about the importance of immunization and the need for improving national vaccination coverage levels. Each week of NIAM focuses on the importance of immunization for a different audience. The week of August 23–29 will highlight vaccination of infants and young children, with the theme "A healthy start begins with on-time vaccinations."

Take a look at the NIAM Communication Toolkit: Birth to Age 6 for ways to promote vaccination of infants and young children.

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WHO Recommendations on Vaccine Hesitancy, published in special issue of the journal Vaccine, are free to download

On August 14, the journal Vaccine published a special issue about vaccine hesitancy worldwide. This compelling issue of Vaccine, including an introduction and nine articles, is titled WHO Recommendations Regarding Vaccine Hesitancy, and the entire issue is available for free online. This issue of Vaccine is free to download. In addition, WHO released a related statement to the press titled Vaccine hesitancy: A growing challenge for immunization programmes. The first three paragraphs of the press release are reprinted below.

People who delay or refuse vaccines for themselves or their children are presenting a growing challenge for countries seeking to close the immunization gap. Globally, 1 in 5 children still do not receive routine life-saving immunizations, and an estimated 1.5 million children still die each year of diseases that could be prevented by vaccines that already exist, according to WHO.

In a special issue of the journal
Vaccine, guest-edited by WHO and published today, experts review the role of vaccine hesitancy in limiting vaccine coverage and explore strategies to address it. Vaccine hesitancy refers to delay in acceptance or refusal of safe vaccines despite availability of vaccination services.

The issue is complex and context specific, varying across time, place and vaccines. It is influenced by factors such as misinformation, complacency, convenience, and confidence.

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IAC Spotlight! During National Immunization Awareness Month and beyond, refer parents to IAC's website for the public:

IAC's website for the public,, is one of the most user-friendly sources of scientifically accurate and easily navigable immunization information on the Web today.

Information on the website is organized into sections based on the four age groups listed below. This arrangement allows visitors to easily find vaccine schedules and other information pertinent to people of a specific age: Highlights of
  • Vaccines You Need: Detailed information about the immunization schedules, arranged by age group—infants and childrenpreteensteens, and adults
  • Personal Testimonies: Stories of suffering and loss from vaccine-preventable diseases, organized by age group and disease
  • Video Library: Searchable collection of videos and public service announcements about vaccine-preventable diseases and the importance of vaccination
  • Vaccine-Preventable Diseases: Information and resources for all vaccine-preventable diseases, including those associated with international travel
  • Vaccine Basics: Basic and helpful information on vaccines and vaccination, ranging from “Paying for Vaccines” to “How Vaccines Work”
  • Resources: Frequently updated listing of helpful resources, including brochures, blogs, videos, and more, for people in all age groups who seek information about vaccines
If you have a website, blog, or Facebook page, please link to

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Vaccine Education Center releases new resources, including an online video suite, a DVD, and an activity book for children

The Vaccine Education Center (VEC) at the Children's Hospital of Philadelphia has developed a number of new immunization-related resources for health care professionals and their patients.

A new set of “Talking About Vaccines With Dr. Paul Offit” videos has been posted on VEC's YouTube page. This set of videos focuses on questions about vaccine safety and science, including:
  • Is natural infection better than vaccination?
  • Can a vaccine give me the disease it’s supposed to protect me against?
  • Can a flu vaccine give you the flu?
  • How are vaccines tested before they can be given to kids?
  • What are the different types of vaccines?
  • Is the aluminum in vaccines safe?
  • Is there a difference between aluminum that is injected vs. ingested?
  • Are fetal cells used to make vaccines?
  • Is there mercury in vaccines?
  • Do vaccines cause allergies?
  • Are there vaccines that children with allergies need to avoid?
  • What is the harm in delaying or spacing out vaccines?
  • Are vaccines safe?
  • Do vaccines cause autism?
  • Do vaccines cause autoimmune or chronic disorders?
  • Why do we still need vaccines?
  • How do you know whether a vaccine has been tested long enough?
The previously published video series, “Age Groups and Vaccines,” is now available on DVD. Each DVD is $3 plus shipping, and can be ordered online or using the printable order form. You can also view these videos on VEC's YouTube page.

"My Vaccine Activity Book" is a new 16-page activity book that includes coloring pages as well as games and puzzles for children to enjoy while learning about vaccines. Children can also complete a certificate for helping to keep their community safe when they are vaccinated. One to 99 coloring books can be ordered for $1 each plus shipping. Quantities of 100 or more can be ordered for $0.75 each plus shipping. To locate the coloring book file on the VEC website, go to "Resources" and select “Booklets, Posters and Other Materials” from the right column.

View the activity book online.

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PBS's NOVA "Vaccines—Calling the Shots" to be rebroadcast on August 26

NOVA, PBS's popular science series, will rebroadcast a one-hour film about vaccination on August 26. Vaccines—Calling the Shots, first aired on September 10, 2014, interviews many experts, explores the history and science behind vaccinations, and sheds light on the risks of opting out. The first two paragraphs of a related press release are reprinted below.

Measles. Mumps. Whooping cough. Diseases that were largely eradicated in the United States a generation ago are returning. Across America and around the globe, children are getting sick and dying from preventable diseases—in part, because some parents are choosing to skip their children’s shots. How and why do vaccines work? What are the biggest concerns and misconceptions, and what are the risks to the child and society when people decide to forego immunization? The award-winning science series NOVA helps viewers find the answers they need.
Misinformation about vaccines can spread quickly, creating confusion about the relative risks of vaccinating vs. not vaccinating. "Vaccines—Calling the Shots" is an important new film that encourages parents to ask questions and use the best available evidence to make decisions about how to protect their children.

According to PBS, NOVA is the most-watched prime time science series on American television, reaching an average of five million viewers weekly. This documentary is a great opportunity to provide evidence-based information about the safety and efficacy of vaccines to a large audience. Spread the word!

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IAC updates its professional resource "Current Dates of Vaccine Information Statements"

IAC recently revised Current Dates of Vaccine Information Statements to reflect new VIS dates. CDC released updated VISs for both inactivated and live influenza vaccines on 8/7/2015, and a VIS for meningococcal serogroup B vaccines on 8/14/2015.

Related Links IAC's Handouts for Patients & Staff web section offers health care 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.

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IAC updates "How to Administer Intramuscular, Intradermal, and Intranasal Influenza Vaccines"

IAC has updated its resource for health care professionals, How to Administer Intramuscular, Intradermal, and Intranasal Influenza Vaccines. The abbreviation "RIV" was changed to "RIV3" and the abbreviation for "intranasal" is now "NAS."

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IAC makes minor changes to "Using Standing Orders for Administering Vaccines: What You Should Know"

IAC recently made some minor edits to its resource for health care professionals, Using Standing Orders for Administering Vaccines: What You Should Know.

The use of standing orders for vaccination facilitates the delivery of immunization services to patients in clinics, hospitals, and community settings. Standing orders have been shown to increase vaccination coverage rates. This piece answers the following questions:
  • What are standing orders?
  • Who recommends standing orders?
  • What are the elements of a standing order?
  • Who is authorized to administer vaccines under standing orders?
  • Who is authorized to sign the standing order?
  • What should be done with the standing orders after they have been signed?
  • Do standing orders need to be renewed?
  • Where can I find sample standing orders?
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CDC updates two new resources in its Provider Resources for Vaccine Conversations with Parents suite

CDC recently updated two of the plain language fact sheets in its Provider Resources for Vaccine Conversations with Parents suite of handouts for parents. CDC developed these materials, in collaboration with the American Academy of Pediatrics and the American Academy of Family Physicians, to help immunization providers assess parents' needs, identify the role they want to play in making decisions for their child’s health, and then communicate in ways that meet their needs. The updated fact sheets are: Related Links Back to top

CDC posts Spanish-language version of its easy-to-read adult immunization schedule online

CDC has posted a Spanish-language version of its easy-to-read (patient-focused) adult immunization schedule on its website.

Access 2015–Vacunas recomendadas para adultos según la edad.

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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 and WHO report on progress toward polio elimination in Nigeria in this week's MMWR and Weekly Epidemiological Report, respectively

CDC published Progress Toward Poliomyelitis Eradication—Nigeria, January 2014–July 2015 in the August 21 issue of MMWR. On the same day, WHO's Weekly Epidemiological Record published a similar article titled Progress towards poliomyelitis eradication in Nigeria, January 2014–July 2015. A summary of the MMWR article made available to the press by CDC is reprinted below.

Pending final laboratory testing of 218 remaining specimens of 16,617 specimens collected since January 2015, Nigeria could be removed from the WHO list of polio-endemic countries in September 2015. When this occurs, it opens the door for certification of a polio-free Africa region by 2017. Lessons learned during the efforts to eradicate polio will allow Nigeria to successfully use existing infrastructure to address other public health issues.

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Register now for the CDC webinar series on "The Pink Book" chapter topics or listen to any of the archived sessions soon; opportunity to earn continuing education credit ends 30 days after posting

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. However, please note that continuing education will only be available for 30 days after each session is posted, so if you are interested in obtaining credit, plan accordingly.

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 six 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 Email CDC with comments, questions, or suggestions about the contents of this book.

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Question of the Week

Should international travelers receive both meningococcal conjugate vaccine and meningococcal serogroup B vaccine? 

Travelers are not considered to be a group at increased risk for serogroup B meningococcal disease and are not recommended to receive serogroup B vaccine. Meningococcal conjugate vaccine continues to be recommended for certain international travelers (residents of and travelers to sub-Saharan Africa and the Hajj in Saudi Arabia).

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

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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