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Issue 1211: October 27, 2015

Ask the Experts
Ask the Experts—Question of the Week: Why is human papillomavirus (HPV) vaccine (Cervarix, GSK; Gardasil and Gardasil 9, Merck…read more








Reminder! Register today for IAC’s "Take a Stand™” workshops; next up: Portsmouth, VA (Nov. 10); Nashville, TN (Nov. 18); and Little Rock, AR (Nov. 19)

The Immunization Action Coalition (IAC), with support from Pfizer, has launched Take a Stand™, a new national effort designed to improve adult immunization rates by increasing the use of standing orders in medical practices.*
The core of this project is a no-cost, interactive workshop led by national experts, including L.J Tan, MS, PhD, William Atkinson, MD, MPH, and Deborah Wexler, MD, from IAC, and Alexandra Stewart, JD, from George Washington University. These workshops will be presented in 22 cities across the United States beginning in October 2015 and continuing through June 2016. 

Seating is limited for the next three fast-approaching workshops:

If you are a medical staff member in a medical practice serving adults near Portsmouth, Nashville, or Little Rock, register today for this free educational workshopPhysicians, practice managers, nurse practitioners, physician assistants, and nurses in medical offices that serve adults are encouraged to attend. 
Wondering if these workshops are coming to a city near you? You can find details about the workshop locations and schedule, a preliminary agenda, and online registration information on the Take a Stand website

About the Workshops

Adult vaccine-preventable diseases contribute to significant morbidity, mortality, and cost in the United States, but adult immunization rates remain low. Strong evidence supports the use of standing orders programs to improve these rates, and their use is recommended by numerous agencies and provider associations. However, adoption of this important intervention may be inhibited by poor understanding of the benefits of standing orders programs or the misperception that they are difficult to implement. The workshops are designed to help physicians and their practice staff easily obtain the information and training they need to overcome these perceived barriers. An additional unique feature of the training is the availability of one year of direct support for workshop attendees as they install or enhance a standing orders program in their practices.
Please “take a stand” with us and spread the word about this unique opportunity for medical clinics to improve their adult immunization rates while empowering staff and streamlining facility operations.
* Standing orders are written protocols approved by a physician or other authorized practitioner that allow qualified health care professionals (who are eligible to do so under state law, such as registered nurses or pharmacists) to assess the need for vaccination and to vaccinate patients meeting certain criteria. 
Workshop Information

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IAC provides summary article about votes taken at October 21 ACIP meeting

The most recent meeting of the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) was held October 21 in Atlanta. Although the ACIP-approved recommendations do not become official until they are approved by the CDC Director and published in the Morbidity and Mortality Weekly Report (MMWR), the following provides a summary of the decisions as they were voted on at the meeting:
2016 Child and Adolescent Immunization Schedule

ACIP approved changes from the 2015 schedule that include:
For the colored chart displaying vaccine recommendations by age of administration
  • Reordering of the vaccines to reflect, as much as possible, the ages at which routine vaccination should occur;
  • Addition of a new bar for meningococcal B vaccine to indicate vaccination of children ages 10 and older with high-risk conditions, and a permissive recommendation to vaccinate children ages 16 through 18 years;
  • Addition of a purple bar for Hib vaccine denoting the need to vaccinate children ages 5 through 18 years who have high-risk conditions. 

In the footnotes accompanying the colored chart

  • Addition of a new recommendation for a dose of IPV for children age 5 years and older whose only polio vaccine has been OPV given before the age of 4 years;
  • Incorporation of HPV recommendations for high-risk children ages 9 through 10 years;
  • Incorporation of meningococcal B vaccine recommendations into the meningococcal vaccines footnote. 

2016 Adult Immunization Schedule

ACIP approved changes from the 2015 schedule that include:
For the colored chart displaying vaccine recommendations by age of administration AND the colored chart displaying vaccine recommendations for adults with specified medical and other indications

  • Addition of a new bar for meningococcal B vaccine to indicate vaccination of adults ages 19 years and older with high-risk conditions;
  • Addition of clarifying text in many of the colored bars.

In the footnotes accompanying the colored charts

  • Revision to the interval for PCV13 following PPSV23;
  • Clarification that residents of nursing homes and other long-term-care facilities should be assessed for need for PPSV23 (previously stated that all should be vaccinated);
  • Incorporation of meningococcal B vaccine recommendations into the meningococcal vaccines footnote.  

Current plans are for these revised schedules to be referenced in MMWR and posted on the CDC website in early February 2016.
The official minutes and presentation slides from the October meeting will be available on the ACIP Meeting Information web page within the next few weeks. Registration is now open for in-person attendance of the February 2016 meeting. Registration is not required to view the meeting via web stream.

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CDC publishes ACIP recommendations for the use of serogroup B meningococcal vaccines in adolescents and young adults

In the October 23 issue of MMWR (pages 1171–1175), CDC published Use of Serogroup B Meningococcal Vaccines in Adolescents and Young Adults: Recommendations of the Advisory Committee on Immunization Practices, 2015. At its June 2015 meeting, ACIP recommended that adolescents and young adults aged 16–23 years may be vaccinated with a serogroup B meningococcal (MenB) vaccine to provide short-term protection against most strains of serogroup B meningococcal disease. This report summarizes the deliberations of ACIP, the rationale for its decision, and recommendations for use of MenB vaccines in adolescents and young adults. The "Recommendations" section is reprinted below in its entirety.


A MenB vaccine series may be administered to adolescents and young adults aged 16–23 years to provide short-term protection against most strains of serogroup B meningococcal disease. The preferred age for MenB vaccination is 16–18 years (recommendation Category B).

MenB vaccine should either be administered as a 3-dose series of MenB-FHbp [Trumenba; Wyeth Pharmaceuticals, Inc.] or a 2-dose series of MenB-4C [Bexsero; GSK]. The two MenB vaccines are not interchangeable; the same vaccine product must be used for all doses. On the basis of available data and expert opinion, MenB-FHbp or MenB-4C may be administered concomitantly with other vaccines indicated for this age, but at a different anatomic site, if feasible.

No randomized controlled clinical trials have been conducted to evaluate use of MenB vaccines in pregnant or lactating women. Vaccination should be deferred in pregnant and lactating women unless the woman is at increased risk, and, after consultation with her health care provider, the benefits of vaccination are considered to outweigh the potential risks.

Additional information for health care providers and parents can be found on the CDC website at

In February 2015, ACIP recommended routine use (recommendation Category A) of MenB vaccines in certain groups of persons at increased risk for serogroup B meningococcal disease, including during outbreaks of serogroup B meningococcal disease. College campuses that have recently experienced an outbreak of serogroup B meningococcal disease should continue to follow the recommendations for use of MenB vaccines in outbreak settings that recommend vaccination for persons aged ≥10 years.

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Editors' note: Beginning in November, IAC Express will be published every Wednesday

Beginning in November, IAC will change the weekly publication day of IAC Express from Tuesday to Wednesday. We are making this change in order to streamline our production process. Subscribers will receive the next issue (#1212) of IAC Express on Wednesday, November 4.

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CDC releases combined summary of notifiable infectious, noninfectious diseases; all nationally notifiable conditions are now in the same MMWR volume

CDC published the summaries of all notifiable conditions—infectious and noninfectious—in the October 23 volume of Supplements to MMWR. The reports being released are in the Summary of Notifiable Noninfectious Conditions and Disease Outbreaks—United States. Together, the reports are referred to as the "Summary (Infectious and Noninfectious)." The reports were prepared by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE). The following is a selection of excerpts from a related CDC press release:
Notifiable diseases and conditions are those for which regular, frequent, and timely information is necessary for prevention and control. Monitoring this data gives CDC and other public health authorities the ability to detect and respond to sudden changes in the occurrence and distribution of health threats. State and local health departments voluntarily submit the data to CDC....
The Summary (Infectious) summarizes data on dozens of nationally notifiable diseases and conditions in the United States. Highlights include:

...Influenza-associated pediatric deaths: From Dec. 30, 2012, to Dec. 28, 2013, CDC received reports of 161 deaths among people under the age 18 years—a more than three-fold increase compared with 2012, and a two-fold decrease compared with the pandemic year 2009. There were 69 pediatric deaths from seasonal influenza per calendar year during 2005–2012 and 358 pediatric deaths reported during the 2009–2010 flu pandemic.

Measles: There were 10 measles outbreaks in 2013, accounting for three-fourths of reported cases. The three largest outbreaks accounted for more than half of cases. In each outbreak, measles spread after a U.S. resident who caught measles abroad introduced the extremely contagious viral infection into communities with pockets of people unvaccinated because of philosophical or religious beliefs.

Meningococcal disease: In 2013, U.S. rates of meningococcal disease continued to be at historic lows. However, there were serogroup B outbreaks at two universities—one in California and one in New Jersey—resulting in 13 cases and one death.

Novel flu viruses: In 2013, there were 21 cases of human infection with variant flu viruses in the U.S.—all associated with direct or indirect contact with swine. There were no human-to-human transmissions. Any public health laboratory that receives a suspicious specimen of flu virus—one that cannot be subtyped using standard methods—immediately submits that specimen to CDC for further testing.

Whooping cough (pertussis): Reported pertussis cases decreased from 2012 to 2013. However, cases continue to exceed those reported during the 1990s and early 2000s.

Salmonellosis: Salmonella causes an estimated 1.2 million illnesses per year in the U.S. The largest multistate outbreak in 2013 was traced to contaminated chicken. Other notable outbreaks were linked to live poultry, tahini sesame paste, cucumbers, and small pet turtles.

Hepatitis C (HCV): After receiving reports of about 800 to 1,000 cases of acute HCV infection per year from 2006-2010, there was an increase of 73.9 percent to 2,138 cases in 2013. Investigations show a marked increase in the number of acute cases of HCV among young, nonminority people who inject drugs, many of whom also abuse oral prescription opioid drugs....

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IAC Spotlight! Three health care organizations join IAC's Influenza Vaccination Honor Roll for mandatory health care worker vaccination

More than 575 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 health care personnel. 

Since October 16, when IAC Express last reported on the Influenza Vaccination Honor Roll, three additional health care organizations have been enrolled.

IAC urges qualifying health care organizations to apply.

Newly added health care organizations, hospitals, government agencies, and medical practices
  • Kootenai Health, Coeur d’Alene, ID
  • University of Pittsburgh Medical Center (UPMC), Pittsburgh, PA
  • University of Toledo Medical Center, Toledo, OH

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Don’t forget the Summit Awards in your immunization programmatic planning this fall

The National Adult and Influenza Immunization Summit (NAIIS) is soliciting candidates for the 2016 NAIIS Immunization Excellence Awards. The 2016 awards recognize individuals and organizations making extraordinary contributions toward improving vaccination rates within their communities during 2015. The awards focus on individuals and organizations exemplifying the meaning of the “immunization neighborhood” (collaboration, coordination, and communication among immunization stakeholders dedicated to meeting the immunization needs of the patient and protecting the community from vaccine-preventable diseases).

National Awards will be presented in the following categories:

  1. Influenza Season Campaign (Laura Scott NAIIS Immunization Excellence Award for Outstanding Influenza Season Activities)
  2. “Immunization Neighborhood” Champion
  3. Adult Immunization Champion
  4. Corporate Campaign
  5. Adult Immunization Publication Award

A National Winner will be selected for each award category, and, where appropriate, an Honorable Mention recipient.

Additional award to be presented: “Influencer Award” Selected by the NAIIS Summit Organizing Committee to recognize an individual or organization in the media, legislature, or community whose activities, contributions and/or willingness to go above and beyond have advanced adult and/or influenza immunization implementation. There is no nomination application for the Influencer Award, but the Organizing Committee would be interested in receiving input on individuals or organizations to consider.

The winners will be presented with their awards at the National Adult and Influenza Immunization Summit meeting (to be held in May 10–12, 2016, location TBD). The national winner in each category will be invited to present his or her program at the meeting. Submit nominations online by February 15, 2016.

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Dr. Paul Offit inducted into two prestigious societies: The American Academy of Arts and Sciences and the Committee for Skeptical Inquiry

In October, Paul Offit, MD, professor of pediatrics and director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, was honored with inductions into the following prestigious societies:

  1. American Academy of Arts and Sciences (AAAS): Dr. Offit had been inducted as a member of the 235th class of AAAS. One of the nation’s oldest learned societies and independent research centers, the Academy includes among this year’s 147 inductees prominent scientists, artists, literary figures, and leaders of academic, business, philanthropic, and cultural institutions from across the United States and internationally.  
  2. Committee for Skeptical Inquiry (CSI): Dr. Offit is one of ten distinguished scientists, scholars, educators, and investigators from five countries who have recently been elected fellows of CSI, copublisher of the Skeptical Inquirer. CSI is one of the world’s leading organizations for the promotion of scientific thinking and the critical examination of extraordinary claims from a scientific point of view.

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HealthMap Vaccine Finder needs your help

Given the impact of influenza during the 2014–2015 season, health care providers all over the country are already preparing for this year’s influx of patients seeking vaccines. It is important that the public be able to quickly find vaccines in their area when they need them.

HealthMap Vaccine Finder is a free, online service that provides users with the most reliable and current information on vaccine availability in their area. Providers must opt-in to participate, and listing your location is free. Over 50,000 pharmacies, clinics, and health departments are already registered in the system.

Vaccine Finder has recently added formulation information for meningococcal, pneumococcal, and HPV vaccines, in addition to the 7 influenza vaccine formulations and 10 routine adult immunizations previously featured. These improvements, along with a growing network of participating providers, have allowed over one million users to access life-saving vaccine information from over 50,000 locations.

And there’s more to come. HealthMap is partnering with the Centers for Disease Control and Prevention (CDC) and the National Association of County and City Health Officials (NACCHO) to develop "Flu Med Finder," a new capability for use during an influenza pandemic. This near real-time tool will allow users to find antiviral medications in their area in near real-time.

Make sure your community knows about the vaccines that you offer. Register for HealthMap Vaccine Finder and put yourself on the map!

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Save the date! CDC’s 47th National Immunization Conference planned for September 13–15, 2016 

The 47th National Immunization Conference (NIC) is scheduled for September 13–15, 2016, at the Hilton Hotel in Atlanta, Georgia. 

Information regarding lodging, registration, and abstract submission guidelines will be posted on the NIC web section as it becomes available. For questions related to the 47th NIC, email

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IAC updates two easy-to-read vaccine summaries about meningococcal disease and vaccines: one handout for parents and the other for teen and adult patients

IAC recently updated two handouts to include the latest ACIP recommendations for serogroup B meningococcal vaccination: 1) Meningococcal disease is serious...Make sure your child is protected! and 2)  Protect yourself from meningococcal disease...Get vaccinated! These handouts are part of a suite of vaccine summaries for parents and for teens and adults. Please check out all the handouts listed below and consider sharing these short, easy-to-read resources with parents and patients.

Easy-to-read Vaccine Summaries for Parents
Use these one-page handouts to teach parents about the dangers of vaccine-preventable diseases and the value of vaccination.

Access the entire series of Vaccine Summaries for children and their parents.

Easy-to-read Vaccine Summaries for Teens and Adults
IAC's series of one-page, easy-to-read handouts emphasizes the dangers of vaccine-preventable diseases and the importance of vaccination.

Access the entire series of Vaccine Summaries for teens and adults.

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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Translations of Serogroup B Meningococcal VIS are now available in Hmong, Korean, and Tagalog

IAC recently posted translations of the Serogroup B Meningococcal Vaccine Information Statement (VIS) in Hmong, Korean, and Tagalog on its website. IAC thanks the California Department of Public Health for these translations.

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Influenza is serious; many resources are available to help health care professionals in vaccinating

Vaccination remains the single most effective means of preventing influenza, and is recommended for everyone age six months and older. If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to a clinic or pharmacy that provides vaccines or to the HealthMap Vaccine Finder to locate sites near their workplaces or homes that offer influenza vaccination services.

Following is a list of resources related to influenza disease and vaccination for health care professionals and the public:

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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

Order your copy today!

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CDC Vaccine Datalink study: Tdap vaccination during pregnancy following other recent tetanus-containing vaccines is safe

On October 20, the Journal of the American Medical Association published an article titled Association of Tdap Vaccination with Acute Events and Adverse Birth Outcomes among Pregnant Women with Prior Tetanus- Containing Immunizations. A summary provided to the press is reprinted below in its entirety.

Among women who received the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine during pregnancy, there was no increased risk of adverse events in the mothers or adverse birth outcomes in newborns for women who had received a tetanus-containing vaccine in the previous 5 years, according to a study in the October 20 issue of JAMA.

Pertussis (whooping cough) is a vaccine-preventable illness that has been increasing in incidence over the past decade in the United States. Neonates (a baby from birth to four weeks) and infants are at increased risk of pertussis-related hospitalization and death compared with older children and adults. The Advisory Committee on Immunization Practices recommends the Tdap vaccine for pregnant women during each pregnancy, regardless of prior immunization status. However, safety data on repeated Tdap vaccination in pregnancy has been lacking, according to background information in the article.
Lakshmi Sukumaran, M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted a study that included 29,155 pregnant women, ages 14 through 49 years, using data from 2007 to 2013 from 7 Vaccine Safety Datalink sites in California, Colorado, Minnesota, Oregon, Washington, and Wisconsin. The authors examined outcomes for women who received Tdap in pregnancy following a prior tetanus-containing vaccine less than 2 years before, 2 to 5 years before, and more than 5 years before.
The researchers found no significant differences in rates of acute adverse events in the mothers (fever, allergy, and local reactions) or adverse birth outcomes in neonates (small for gestational age, preterm delivery, and low birth weight) when comparing women who were vaccinated with Tdap during pregnancy regardless of the length of time since a prior tetanus-containing vaccine.
“Our findings should reassure patients and clinicians who might be hesitant to give Tdap vaccine to pregnant women who recently received a Tdap or other tetanus-containing vaccination,” the authors write.
The researchers add that future studies are needed to determine if there are differences in other important adverse pregnancy outcomes, such as stillbirth and spontaneous abortion, when Tdap is given in pregnancy in close intervals from prior tetanus-containing vaccines.

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CDC and WHO report on progress toward polio eradication in Afghanistan in this week's MMWR and Weekly Epidemiological Report, respectively

CDC published Progress toward Poliomyelitis Eradication—Afghanistan, January 2014–August 2015 in the October 23 issue of MMWR (pages 1166–1170). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Progress towards poliomyelitis eradication: Afghanistan, January 2014–August 2015. A media summary of the MMWR article is reprinted below.
There is an urgent need to improve on the level of coordination and oversight of polio eradication activities, particularly with respect to supplementary immunization, in order to eliminate poliovirus transmission in Afghanistan. After having made significant progress towards the eradication of polio in 2013, Afghanistan experienced an increase in wild poliovirus transmission in 2014, with the number of reported polio cases doubling compared with the previous year. While there have been encouraging signs of reduced transmission in the traditional polio reservoirs of Helmand and Kandahar in the Southern Region in 2015, immunity gaps in the conflict-affected Farah Province of the Western Region and cross-border transmission from Pakistan into Nangarhar Province of the Eastern Region have accounted for a majority of polio cases reported this year. To address this problem, the government of Afghanistan should urgently establish emergency operation centers to improve oversight and coordination of polio eradication activities, including the planning and implementation of supplementary immunization activities.

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MMWR Announcement: World Polio Day is October 24

CDC published World Polio Day—October 24, 2015 in the October 23 issue of MMWR (1179). The announcement is reprinted below in its entirety.

October 24 is World Polio Day, which recognizes the global progress made against a disease that at its height crippled over 100 children per week and now has been reduced to fewer than 100 cases per year. World Polio Day serves as a reaffirmation of the global commitment to eradicate this childhood disease. 

The concerted effort of the Global Polio Eradication Initiative partners, including Rotary International, the World Health Organization, the United Nations Children’s Fund, CDC, and the Bill and Melinda Gates Foundation, as well as polio vaccinators and public health workers in the field, has resulted in the World Health Organization announcing the removal of Nigeria from the list of polio-endemic countries in 2015, after a year without a reported wild poliovirus case in that country. Pakistan and Afghanistan are the only remaining polio-endemic countries, with a total of 51 cases reported between them this year as of October 14. 

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Listen to any of the archived sessions of CDC's webinar series on "The Pink Book" chapter topics; opportunity to earn continuing education credit ends 30 days after posting

CDC has just completed a 15-part webinar series that provided a chapter-by-chapter overview of the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). 

Read more about the series.

All 15 sessions are now archived and can be viewed online; a transcript of each broadcast is also available. Continuing education credit is available for 30 days after each session was posted. If you are interested in obtaining credit, plan to view the last two sessions before the dates listed.

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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Reminder: Within Reach and Washington State Department of Health offer free online continuing education course about HPV vaccination

WithinReach, in partnership with the Washington State Department of Health and Cardea, offers an online continuing education (CE) course, You Are the Key to HPV Cancer Prevention. This free, hour-long CE course is designed for physicians, pharmacists, advanced practice clinicians, nurses, medical assistants, and other staff who work with adolescents and their parents. This course helps providers frame the HPV vaccine conversation, encourages providers to make a strong vaccination recommendation, and offers responses to parents’ most common questions. More than 700 people have taken the course since its launch in April 2015, and 80% of participants responding to a post-course survey reported that they intend to make a change to their practice based on this training. 

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Question of the Week

Why is human papillomavirus (HPV) vaccine (Cervarix, GSK; Gardasil and Gardasil 9, Merck) not recommended for people who are known to have had an HPV infection—similar to shingles vaccine—to reduce chances of another outbreak? 
Recommendations for use of HPV vaccine are based on age and not history of prior infection. Contrary to the assumption in your question, routine HPV vaccination is recommended for females through age 26 years and males through age 21 years (and certain males through age 26 years) regardless of their history of prior HPV infection. The chance of being infected with all nine vaccine-preventable strains of HPV included in the vaccine is very low, so there will most likely be benefit from the vaccine even in people with prior HPV infection.

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 health care 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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