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Issue 1371: June 20, 2018











CDC reports that the total number of 172 pediatric deaths in 2017–18 flu season is the highest on record, excluding pandemics

On June 8, CDC issued a news report stating that the total number of 172 pediatric deaths from influenza in the 2017–18 flu season is the highest on record, excluding pandemics. The first paragraph of the CDC report appears below.

The CDC is reporting an additional pediatric flu-related death this week, bringing the total number this season to 172. This number exceeds the 2012–2013 season, which previously set the record for the highest number of flu-related deaths in children reported during a single flu season (excluding pandemics). Approximately 80% of these deaths occurred in children who had not received a flu vaccination this season. CDC recommends an annual flu vaccine for everyone 6 months and older. These deaths are a somber reminder of the importance of flu vaccination and the potential seriousness of flu. CDC experts have described the 2017–2018 season as a high severity season, with influenza-like-illness (ILI) remaining at or above baseline for 19 consecutive weeks, record-breaking flu hospitalization rates, and elevated pneumonia and influenza mortality for 16 weeks.

Access the full news release on the CDC website: CDC Reported Flu Deaths in Children Exceeds Seasonal High (6/8/18)

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AAP issues its recommendations on the use of nasal spray influenza vaccine for 2018–19 season that differ from ACIP’s

On June 7, the American Academy of Pediatrics (AAP) released an article in the AAP News that states their recommendation that the nasal spray influenza vaccine (LAIV4, FluMist) should have limited use; that is, LAIV4 may be offered for children who would not otherwise receive an influenza vaccine (and for whom it is appropriate by age and health status).
This recommendation does not agree with that of the ACIP recommendation stating that either inactivated influenza vaccine (IIV) or LAIV4 may be used for the 2018–19 flu season. The AAP will publish its complete influenza vaccine recommendations in September. 
View the AAP and ACIP recommendations for the use of LAIV4 below:

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Dr. Paul A. Offit presents video commentary on AAP’s live attenuated influenza vaccine recommendations for 2018–19

In a recent Medscape video, Dr. Paul A. Offit presented video commentary on AAP's recommendations for 2018–19 regarding the live attenuated vaccine, known as FluMist. A transcription of his commentary appears along with the video.

View the Medscape video with Dr. Offit: FluMist: Reasonable Vaccine Option or "Last Resort" for the Upcoming Flu Season? (6/9/18)​

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New CDC web page provides a list of errata and updates that have been made to “General Best Practice Guidelines for Immunization: Best Practices Guidance of the ACIP” since its publication in 2017

CDC's new List of Errata/Updates web page provides a list of errata and updates that have been made to General Best Practice Guidelines for Immunization: Best Practices Guidance of ACIP. The list is updated whenever it is determined changes are necessary.
By releasing "General Best Practice Guidelines for Immunization" online on April 20, 2017, ACIP created a living document that can be updated on an ongoing basis to give vaccination providers the most up-to-date guidance on vaccination practice. This document replaced ACIP's "General Recommendations on Immunization," published in 2011. The document (in both HTML and PDF format) has been updated several times since its initial publication in 2017, and the changes have been made to both the HTML and PDF versions. The page numbers for the errata and updates listed on the errata/updates web page correspond with the 194-page PDF version of the General Best Practice Guidelines. 
Vaccination providers, immunization managers, and anyone interested in updates to "General Best Practice Guidelines for Immunization" may also sign up to receive e-mail notifications whenever new information is released. Submit your email address in the appropriate box in the left column here.

Related Links

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IAC Spotlight! IAC's A–Z Index helps you find what you’re looking for on

Did you know there's an A–Z Index on IAC's A–Z Index, which lists almost everything on the website in alphabetical order, makes it easy to find what you’re looking for. More than 200 items are listed, and several items are cross-referenced.

You will find a link to the A–Z Index page at the very top of every page of You will also find it at the beginning of the alphabetized list in the "Guide to" at the bottom of every web page you open on
The A–Z Index is always in view on—it puts everything you are searching for at your fingertips.

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IAC posts its newest PowerPoint slide set, “Resources to Help Immunization Providers PREVENT Vaccination Errors”; available for you to use “as is” or to modify to fit your needs  

IAC recently developed and presented the new slide set, Resources to Help Immunization Providers PREVENT Vaccination Errors, as part of a session on vaccination errors at the National Immunization Conference in May. These 43 slides include many links to online resources to help immunization providers prevent vaccination errors related to storage and handling, administration, scheduling, and documentation. These materials were gathered from CDC, IAC, the American Academy of Pediatrics, and several state health departments, and include books, toolkits, web pages, videos, online courses, vaccine labels, print pieces, posters, slide sets, and more.
To obtain this PowerPoint slide set, go to IAC's PowerPoint Slide Sets web page. Just below the presentation's tile and description, click on "Request the PowerPoint slide set" and IAC will email the PowerPoint presentation to you. Once you have received the presentation, you can edit and use it as you see fit.

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IAC revises eight easy-to-read vaccination schedules for adult patients addressing routine adult immunization and for adults in risk groups

IAC recently revised eight easy-to-read vaccination schedules for adult patients. The titles of the eight 1-page handouts are as follows:
The following changes were made to the previous versions of these pieces: 
  • Heplisav-B was incorporated into the hepatitis B
  • Shingrix vaccine was added to the zoster information
Related Links
IAC's Handouts for Patients & Staff web section offers healthcare 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 posts new and updated Turkish translations of 13 VISs

IAC recently posted Turkish translations of 13 additional VISs. IAC thanks Betül Polatdemir, MD, Lokman Hekim Hospital Group, Ankara, and Sibel Bostancıoğlu, MD, Ankara Occupational and Environmental Diseases Hospital, Ankara, Turkey, for the translations.

Access the new Turkish-language translations listed below:

Access the updated Turkish-language translations listed below:
Visit IAC's VIS web section for VISs in up to 50 languages. 

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WHO publishes executive summary of the Immunization and Vaccine-related Implementation Research Advisory Committee's March meeting in this week's Weekly Epidemiological Record ​

WHO published Immunization and Vaccine-related Implementation Research Advisory Committee (IVIR-AC): executive summary, 6–8 March 2018, Chamonix, France, in the June 15 issue of its Weekly Epidemiological Record, pages 345–55. 
​Related Links

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Still available! IAC's sturdy laminated versions of the 2018 U.S. child/teen immunization schedule and the 2018 U.S. adult immunization schedule—order a supply for your healthcare setting today!

IAC's laminated versions of the 2018 U.S. child/teen immunization schedule and the 2018 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. Both schedules are eight pages (i.e., four double-sided pages) and are folded to measure 8.5" x 11".

Adult Laminated Immunization Schedules

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'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!

Related Links

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PLOS Medicine publishes "The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties"

PLOS Medicine has recently published "The state of the antivaccine movement in the United States: A focused examination of nonmedical exemptions in states and counties" by A. Tippins, et al. The "Summary Points" are reprinted below:
  • A social movement of public health vaccine opposition has been growing in the United States in recent years; subsequently, measles outbreaks have also increased. ​​​
  • Since 2009, the number of “philosophical-belief” vaccine nonmedical exemptions (NMEs) has risen in 12 of the 18 states that currently allow this policy: Arkansas (AR), Arizona (AZ), Idaho (ID), Maine (ME), Minnesota (MN), North Dakota (ND), Ohio (OH), Oklahoma (OK), Oregon (OR), Pennsylvania (PA), Texas (TX), and Utah (UT).
  • Several US “hotspot” metropolitan areas stand out for their very large numbers of NMEs. They include Seattle, WA, Spokane, WA, and Portland, OR in the Northwest; Phoenix, AZ, Salt Lake City, UT, Provo, UT, Houston, TX, Fort Worth, TX, Plano, TX, and Austin, TX in the Southwest; Troy, MI, Warren, MI, Detroit, MI, and Kansas City, MO in the Midwest; and Pittsburgh, PA in the Northeast. Additional smaller counties—especially in ID, WI, and UT—also stand out for their high exemption rates.
  • We analyzed the relationship between NME rates and actual vaccine coverage, and found an inverse association between NME rate and measles, mumps, and rubella (MMR) vaccine coverage of kindergarteners in these states (P = 0.03 by Spearman correlation), indicating that states with higher overall NME rates do in fact have lower MMR vaccine coverage (P = 0.007 by beta regression). 
  • Our findings indicate that new foci of antivaccine activities are being established in major metropolitan areas, rendering select cities vulnerable for vaccination-preventable diseases. As noted by the recent experience in Anaheim, California, low vaccination rates resulted in a measles outbreak. In contrast, state closure of NMEs has resulted in an increase of MMR coverage
Read the entire article (HTML format).

Access the article in PDF format. The tables and charts are somewhat easier to view in this version of the article.
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Johns Hopkins study finds Hib and pneumococcal vaccines saved around 1.45 million children’s lives worldwide since 2000

The Lancet Global Health recently published Burden of Streptococcus pneumoniae and Haemophilus influenzae type b disease in children in the era of conjugate vaccines: global, regional, and national estimates for 2000–15. The study, by B. Wahl, et. al, Johns Hopkins Bloomberg School of Public, appeared in the June 11 issue.
Commentary on this study by Cynthia G. Whitney, MD, Respiratory Disease Chief of CDC, was published in the same issue.

Related Link


Weekly CDC webinar series on "The Pink Book" chapter topics continues June 27 with "General Recommendations: Part 2 and Vaccine Safety"; register now for series running through September 26

CDC is again 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 weekly 1-hour webinars that started June 6 and will run through September 26. The webinar series provides an overview of vaccines and the diseases they prevent, general recommendations for vaccines, vaccination principles, and immunization strategies for providers.
The June 27 webinar will cover "General Recommendations: Part 2 and Vaccine Safety" and include a live Q&A session. Recordings of sessions will be available online within 2 weeks after each webinar. All sessions begin at 12:00 p.m. (ET). Continuing education will be available for each event.
Registration and more information is available on CDC's Pink Book Webinar Series web page.

All the sections of "The Pink Book" (i.e., chapters, appendices, 2017 supplement) are available to download at no charge at

You can also order this resource from the Public Health Foundation for $40 plus shipping and handling. 

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2018 American Immunization Registry Association National Meeting scheduled for August 14–16 in Salt Lake City; registration deadline extended
The American Immunization Registry Association (AIRA) promotes the development and use of immunization information systems (IIS) as a tool to prevent vaccine-preventable diseases. The 2018 National AIRA Meeting, "Advancing IIS Together," will be held August 14–16 in Salt Lake City, Utah. The deadline to register for the "early bird" rate has been extended to July 11. 

Visit the AIRA 2018 National Meeting web page for information about the conference, hotel reservations, registration deadlines, and more.

​Related Links

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2018 Idaho Immunization Summit to be held October 11 in Boise, Idaho
The 2018 Idaho Immunization Summit will be held on October 11 in Boise, Idaho, from 8:00 a.m. to 4:00 p.m. (PT). The summit's keynote speaker will be Catherine Flores-Martin, executive director of the California Immunization Coalition.

View the draft agenda.

Register for the summit. Registration covers the summit, educational credits, parking, and meals. Contact Karen Sharpnack, or call 208-961-1514 if you have a question or need a scholarship.

View the 2018 Idaho Immunization Summit web page.
Related Link

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Register now for 2018 World Influenza Conference in Beijing, China, September 7–10

Registration is open for the 2018 World Influenza Conference, which will be held in Beijing, China, September 7–10. Marking the centenary of the 1918 global influenza pandemic, this conference will address the question of whether we are prepared for the next pandemic. It aims to generate dialogue between policy makers, public health officials, field works, and industry.
The hosts of the conference are the Chinese Association of Preventive Medicine, China Center for Disease Control and Prevention, Chinese Academy of Medical Sciences, and the Asia-Pacific Alliance for the Control of Influenza. The conference is organized in collaboration with the European Scientific Working group on Influenza, the National Adult and Influenza Immunization Summit, and the International Society for Influenza and other Respiratory Virus Diseases.
Visit the 2018 World Influenza Conference web page for information regarding registration, accommodations, abstract submissions, and poster registration.

Conference registration (password required). This page provides a link to the organizer to obtain a password.

Related Link

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2018 National Immunization Conference presentations now available for downloading

PowerPoint slides from the 2018 National Immunization Conference (NIC), held May 15–17 in Atlanta, are now available online. You may download the slides through the NIC website or download the mobile app to access the presentations as well. 

To download the slides, go to the agenda page on the conference website and find the session whose presentation you wish to download. Click on the "download presentations" link in the session description. Note that sessions that do have presentation links did not receive authorization to post. 

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About IAC Express
The Immunization Action Coalition welcomes redistribution of this issue of IAC Express or selected articles. When you do so, please add a note that the Immunization Action Coalition is the source of the material and provide a link to this issue.

If you have trouble receiving or displaying IAC Express messages, visit our online help section.

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.

IAC Express Disclaimer
ISSN: 1526-1786
Our mailing address is
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Copyright (C) 2018 Immunization Action Coalition
All rights reserved.

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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