Issue 1358: April 4, 2018









Reminder: National Infant Immunization Week to be held April 21–28

National Infant Immunization Week (NIIW) is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and celebrate the achievements of immunization programs and their partners in promoting healthy communities. NIIW will be held this year on April 21–28.

CDC's 2018 NIIW Digital Media Toolkit is now available for planning and implementing your NIIW activities. The media toolkit contains a range of suggested social media activities, including digital graphics and messaging, as well as tools for planning and developing promotional materials for the press and public service announcements.

Visit CDC's updated NIIW website to find a wide assortment of promotional and educational materials to help you plan your NIIW activities, and tailor them to the needs of your community. 

CDC would like to hear from organizations planning a 2018 NIIW activity. Please complete the NIIW Activity Form so others can learn what you're doing to educate and inspire parents and providers to protect infants and toddlers from vaccine-preventable diseases. If you're looking for ideas, you can access guidance on CDC's Planning Your NIIW web page.

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Hawaii reports almost 1,000 mumps cases—most in adults—with 29 reports of complications 

The Hawaii State Department of Health is investigating an increasing number of cases of mumps virus infection in the state. As of March 29, 947 cases had been confirmed in children and adults, both vaccinated and unvaccinated.

Case count by county:

  • Honolulu: 761
  • Hawaii: 134
  • Kauai: 49
  • Maui: 3

Nearly 60% of cases have been in adults aged 18 years and older. There have been 29 reports of complications due to mumps infection, such as orchitis and hearing loss.

Access the State of Hawaii, Department of Health advisory about the mumps outbreak.

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CDC reports on three deaths associated with human adenovirus type 7 at a substance abuse rehabilitation facility in New Jersey

CDC published Notes from the Field: Fatalities Associated with Human Adenovirus Type 7 at a Substance Abuse Rehabilitation Facility—New Jersey, 2017 in the March 30 issue of MMWR (pages 371–2). Selections from this report are reprinted below.

On February 3, 2017, a local health department notified the New Jersey Department of Health (NJDOH) of a severe respiratory illness outbreak, including two hospitalizations and one death, at a substance abuse treatment facility. During December 2016–January 2017, NJDOH surveillance for noninfluenza respiratory viruses identified multiple human adenovirus (HAdV) cases in the surrounding community. ... A combined HAdV-4 and HadV-7 live oral vaccine is available but is currently limited to military use....

Among the three fatal cases, time from symptom onset to death ranged from 4 to 37 days; patients ranged in age from 54 to 64 years, and two were men....

HAdV-7 is known to cause morbidity and mortality, particularly in military training facilities. Adenovirus morbidity and mortality associated with nonmilitary congregate settings are less well described, although severe morbidity and mortality have been documented among immunocompromised patients. This outbreak investigation documents severe morbidity and mortality associated with HAdV-7 among persons in a substance abuse treatment facility with specific comorbidities including diabetes mellitus type 2, alcoholism, and cirrhosis and highlights the challenges of illness containment in a communal environment. Clinicians and public health practitioners should be aware of HAdV-7 as a potential cause of severe respiratory illness in these settings.

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CDC releases new Anthrax Vaccine Information Statement

On March 21, CDC released an updated Anthrax Vaccine Information Statement (VIS).

The rich text format (RTF) version of this VIS can be accessed from CDC's website. RTF files are intended for use in electronic systems, such as electronic medical records, immunization information systems, or other electronic databases.

Visit IAC's VIS web section for VISs in up to 50 languages.

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IAC Spotlight: IAC's Calendar of Events highlights conferences, workshops, and other immunization-related events

IAC maintains a Calendar of Events on its website for healthcare professionals at This is an easy way to find out about upcoming regional, state, and national conferences, workshops, and electronic continuing educational opportunities. The calendar also includes special weeks of observances.

If you have an immunization-related event that you would like your colleagues to know about via this Calendar of Events, email IAC.

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NFID releases "Call to Action: Improving Healthcare Personnel Immunization Rates" 

The National Foundation for Infectious Diseases (NFID) recently published Call to Action: Improving Healthcare Personnel Immunization Rates. The recommendations in this Call to Action are based on the discussions at a November 2017 Summit convened by NFID. 

Sections of the introductory section from the Call to Action are reprinted below.

It is the professional responsibility of healthcare personnel [HCP] to prevent illness in themselves, which can be subsequently transmitted to others. This approach also serves to protect patients, families, visitors, and communities from illnesses and negative health outcomes that occur due to vaccine-preventable diseases. Immunization programs specifically targeting healthcare personnel are recognized as an essential component of an effective infection prevention and control program in all settings where healthcare is delivered.

Guidelines issued by ACIP and the Healthcare Infection Control Practices Advisory Committee (HICPAC) serve to provide recommendations on both specific vaccines for HCP immunization programs, as well as guidance for implementation and incorporation of these vaccines into routine practice....

However, despite the availability of guidelines and endorsements from professional healthcare associations to follow the guidance, rates for ACIP-recommended vaccines range substantially among healthcare personnel, ranging from 46 to 79 percent.

The call to action is clear: all healthcare personnel who work directly with patients, or who work in any capacity in a healthcare setting, should be vaccinated in accordance with CDC recommendations. This action and responsibility is an essential step that will reduce the likelihood of becoming ill or spreading vaccine-preventable diseases to others....

Access the complete Call to Action: Improving Healthcare Personnel Immunization Rates.

If you have ideas regarding ways NFID might disseminate this document, please share your thoughts with Marla Dalton, NFID executive director.

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Voices for Vaccines releases new podcast about the role of fathers in vaccine advocacy; sponsor a future podcast!

Voices for Vaccines (VFV) has posted the 16th episode in its Vax Talk podcast series: What about the Dads? In it, Karen Ernst, Voices for Vaccines, and Dr. Nathan Boonstra, Blank Children's Hospital, talk to Dean Masello, writer (, comedian, and stay-at-home dad. 

This latest Vax Talk podcast, What about the Dads?, was sponsored by the Immunization Action Coalition. Sponsors help empower a great grassroots movement to increase vaccine protection through parental involvement.

VFV would be thrilled if you or your organization were to sponsor a Vax Talk podcast. If this is a possibility, please email Karen Ernst, VFV executive director, at for more information. There are multiple levels of possible support, and VFV will be happy to work with you to customize the arrangement. 

VFV is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters.

VFV invites everyone who values vaccines to become a member. Please spread the word to your friends and colleagues to join VFV!

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IAC's new 142-page book, Vaccinating Adults: A Step-by-Step Guide, describes how to implement adult vaccination services in your healthcare setting and provides a review for staff who already vaccinate adults; IAC Guide available for free download

The Immunization Action Coalition (IAC) recently announced the publication of its new book, Vaccinating Adults: A Step-by-Step Guide (Guide).

This completely updated guide on adult immunization (originally published in 2004) provides easy-to-use, practical information covering important “how-to” activities to help providers enhance their existing adult immunization services or introduce them into any clinical setting, including:

  • setting up for vaccination services,
  • storing and handling vaccines,
  • deciding which people should receive which vaccines,
  • administering vaccines,
  • documenting vaccinations (including legal issues), and
  • understanding financial considerations and billing information. 

In addition, the Guide is filled with hundreds of web addresses and references to help providers stay up to date on the latest immunization information, both now and in the future.

The entire Guide is available to download/print free of charge at The downloaded version is suitable for double-sided printing. Options are available online to download the entire book or selected chapters. The development of the Guide was supported by the National Vaccine Program Office (NVPO) and the Centers for Disease Control and Prevention (CDC). Expert staff from both agencies also provided early technical review of the content.

The Guide is a uniquely valuable resource to assist providers in increasing adult immunization rates. Be sure to get a copy today!

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WHO issues updated position paper on typhoid vaccines

The World Health Organization (WHO) published Typhoid vaccines: WHO position paper—March 2018 in the March 30 issue of its Weekly Epidemiological Record. This is the most recent addition to a WHO-issued series of regularly updated position papers on vaccines that have an international public health impact. These WHO papers are concerned primarily with the use of vaccines in global immunization programs.

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New HPV communication simulation app can help providers practice introducing the HPV vaccine and addressing parents’ concerns 

Communication between providers and parents is key to improving HPV vaccination rates. HPV Vaccine: Same Way, Same Day is a brief, interactive role-play simulation designed to enhance healthcare providers’ ability to introduce the HPV vaccine and address hesitant parents’ concerns. The simulation was developed by the Academic Pediatric Association, the American Academy of Pediatrics, and Kognito.

Add this complimentary app to your mobile device:
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Flu vaccination still recommended as long as influenza viruses are circulating

CDC has reported in its Weekly U.S. Influenza Surveillance Report, FluView, that as of the week ending March 24, influenza activity decreased in the United States, although it was still widespread in Puerto Rico and 16 states, with 4 additional pediatric deaths. The total number of pediatric deaths since October 1, 2017 is 137.

Influenza vaccination is recommended for everyone six months of age 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 healthcare professionals and the public:

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Vaccine Education Center publishes March issue of its newsletter for healthcare professionals

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia publishes a monthly immunization-focused newsletter titled Vaccine Update for Healthcare Professionals. The March issue includes the following articles:

Additional news items and resources are available in the full newsletter.

Access the sign-up form to subscribe to Vaccine Update for Healthcare Professionals.

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CDC reports on two cases of meningococcal disease in one family that occurred 15 months apart

CDC published Two Cases of Meningococcal Disease in One Family Separated by an Extended Period—Colorado, 2015–2016 in the March 30 issue of MMWR (pages 366–8). A summary made available to the press is reprinted below.

A strain of meningococcal disease in a Colorado grandmother showed up 15 months later in her 3-month-old grandchild, even though the grandmother was appropriately treated and recovered. Improved laboratory methods allowed public health to link these cases, something not possible before the use of whole genome sequencing. The questions surrounding this household disease link underscore the need for more precise evaluation of such cases and better documentation of preventive treatment among family members.

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CDC study shows no increased risk of death or hospitalization to newborns when their mothers received influenza and Tdap vaccines during pregnancy

A study by CDC researchers titled Infant Hospitalizations and Mortality After Maternal Vaccination was published in the March 2018 issue of Pediatrics (L. Sukumaran, et al). The "Background" and "Conclusions" sections of the abstract are reprinted below.

The Advisory Committee on Immunization Practices currently recommends pregnant women receive influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines. There are limited studies of the long-term safety in infants for vaccines administered during pregnancy. We evaluate whether maternal receipt of influenza and Tdap vaccines increases the risk of infant hospitalization or death in the first 6 months of life.

We found no association between vaccination during pregnancy and risk of infant hospitalization or death in the first 6 months of life. These findings support the safety of current recommendations for influenza and Tdap vaccination during pregnancy.

Access the complete article: Infant Hospitalizations and Mortality After Maternal Vaccination.

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Study finds that children with autism syndrome disorder, as well as their younger siblings, were undervaccinated compared with the general population

On March 26, JAMA Pediatrics published Vaccination Patterns in Children After Autism Spectrum Disorder Diagnosis and in Their Younger Siblings (O. Zerbo, et al.) online. The "Key Points" are reprinted below.

After receiving an autism spectrum disorder diagnosis, do children obtain all of their remaining scheduled vaccines, and are the younger siblings of these children vaccinated according to vaccine recommendations?

In a matched cohort study of 3,729 children with autism spectrum disorder and 592,907 children without autism spectrum disorder, we found that children with autism spectrum disorder were less likely to be fully vaccinated for vaccines recommended between ages 4 and 6 years. The younger siblings were also less likely to be fully vaccinated for vaccines recommended at any age.

Children with autism spectrum disorder and their younger siblings are at increased risk of vaccine-preventable diseases.

Access the abstract: Vaccination Patterns in Children After Autism Spectrum Disorder Diagnosis and in Their Younger Siblings.

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NFID webinar about improving healthcare personnel immunization rates scheduled for April 5
The National Foundation for Infectious Diseases (NFID) will present a webinar titled "Improving Healthcare Personnel Immunization Rates" on April 5 at 12:00 p.m. (ET). Ruth M. Carrico, PhD, NP, CIC, NFID director and associate professor, University of Louisville, and Patricia A. Stinchfield, RN, MS, CPNP, CIC, NFID secretary and senior director, Infection Prevention and Control, Children's Minnesota, will discuss specific strategies and best practices to increase healthcare personnel immunization in various healthcare settings.
MMWR and Medscape offer free continuing education credit for learning about hepatitis B virus prevention
MMWR and Medscape are collaborating to offer free continuing education credit for physicians, nurses, and pharmacists who complete an online course about prevention of hepatitis B virus infection. The content is based on ACIP's hepatitis B vaccination recommendations, released in January.

Access the course: Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices.

Medscape provides online continuing medical education for selected journal articles, allowing clinicians the opportunity to earn Medscape CME credit. In addition, Medscape is jointly accredited by the Accreditation Council for Continuing Medical Education, the Accreditation Council for Pharmacy Education, and the American Nurses Credentialing Center, to provide continuing education for the healthcare team. If you are not a registered user on Medscape, you can register for free or login without a password and get unlimited access to all continuing education activities and other Medscape features.

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VICNetwork webinar, "Using Digital Media to Engage Parents Around Childhood Vaccines," scheduled for April 26

On April 26 at 1:00 p.m. (ET), the California Immunization Coalition's VICNetwork will sponsor a webinar titled Using Digital Media to Engage Parents Around Childhood Vaccines. The description of this session is reprinted below.

Mothers of young children spend a lot of time online, seeking information and connecting with friends, family, and other moms. Digital media is one of the most cost effective tactics for engaging parents around immunization issues. Learn from three experts who have successfully utilized blogs, testimonial videos, podcasts, Facebook, Twitter, and other digital tactics to promote childhood immunization.

Registration information

The VICNetwork is a nationwide "virtual immunization community" of health educators, public health communicators, and others who promote immunizations to exchange and share resources, materials, and best practices.

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National Influenza Vaccination Disparities Partnership to present webinar on April 11 about ways to cover the costs of immunization

On April 11 at 2:00 p.m. ET, the National Influenza Vaccination Disparities Partnership will host a webinar titled How to Cover the Costs of Vaccination. Panelists will discuss ways they keep their flu outreach programs sustainable year after year, by using a variety of insurance and funding options to provide free or low-cost flu vaccines. These programs include TRICARE for veterans, military, and military families; the Vaccines for Children Program; Medicaid; Medicare; private contributions; and other potential sources of funding. The webinar will cover how these different programs work, who is eligible, and how providers can use these programs to provide free or low-cost flu vaccines in their communities.

Webinar information and registration link

The National Influenza Vaccination Disparities Partnership is a national multi-sector campaign, spearheaded by local influential partners and supported by CDC, that commits to promote the importance of flu vaccination among underserved populations. 

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CDC's Grand Rounds on hepatitis B and C elimination scheduled for April 17; March session on global introduction of new vaccines now available for viewing online

CDC's Public Health Grand Rounds will present Working Together to Eliminate the Threat of Hepatitis B and C on April 17 at 1:00 p.m. (ET). The description is reprinted below.

Viral hepatitis, a group of infectious diseases, affects millions of people worldwide. The World Health Organization (WHO) estimates 325 million people worldwide are living with chronic hepatitis B or chronic hepatitis C. Deaths due to viral hepatitis reached 1.34 million in 2015, comparable to the number of deaths caused by tuberculosis and HIV. Yet, effective measures such as educational programs for people who inject drugs and ensuring infants born to hepatitis B infected mothers are vaccinated against hepatitis B would dramatically reduce hepatitis B and C infections worldwide.

Those interested in viewing this one-hour session should go to the live external webcast link during the scheduled time.

Sessions are archived 3–4 days after each presentation, so you can view any of these presentations on the archive page at your convenience. The March session, "Global Introduction of New Vaccines," has been archived and is available for viewing.

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North Dakota Immunization Conference scheduled for July 17–18

The North Dakota Immunization Conference is scheduled for July 17–18 in Bismarck. Planned sessions include:

  • Adult Immunization Update
  • Billing for Immunizations
  • Childhood and Adolescent Immunization Update
  • Evaluating Clinician-Led HPV AFIX Visits
  • Head and Neck Cancers
  • HPV Vaccinations
  • Immunizations for International Travelers
  • Immunization Recommendations for Immunocompromised Patients
  • Measles Outbreak
  • Meningococcal Vaccines
  • School and Childcare Requirements
  • Somalian Community Outreach
  • Vaccine Hesitant Families

More information

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Thirteenth International Rotavirus Symposium to be held August 29–31 in Minsk, Belarus

The 13th International Rotavirus Symposium will be held August 29–31 in Minsk, Belarus. This event is sponsored by the Bill & Melinda Gates Foundation, CDC, the National Institutes of Health Fogarty International Center, PATH, the ROTA Council, and the Sabin Vaccine Institute.

More information

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About IAC Express
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IAC Express is supported in part by Grant No. 6NH23IP922550 from the National Center for Immunization and Respiratory Diseases, CDC. Its contents are solely the responsibility of IAC and do not necessarily represent the official views of CDC. IAC Express is also supported by educational grants from the following companies: AstraZeneca, Inc.; Merck Sharp & Dohme Corp.; Pfizer, Inc.; and Sanofi Pasteur.

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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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