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Issue 1373: July 5, 2018








New York State's highest court upholds NYC Board of Health's 2013 mandate that children ages 6–59 months attending city-regulated child care or school-based programs receive annual influenza vaccination

In a unanimous decision on June 28, New York State's highest court, the Court of Appeals, upheld the New York City (NYC) Board of Health's 2013 mandate that all children ages 6–59 months attending city-regulated child care or school-based programs receive an annual influenza vaccination by December 31.
The 2013 vaccination mandate had been struck down by two lower courts: first by the New York State Supreme Court and subsequently by the Appellate Division upon appeal. The New York State Court of Appeals reversed the lower courts' decisions by finding in its June 28 decision, Garcia v. New York City Department of Health and Mental Hygiene, that the mandate was well within the Board's authority to regulate for public health.

​The first two paragraphs of the NYC Department of Health and Mental Hygiene's June 28 media release are reprinted below.
Health Commissioner Dr. Mary T. Bassett, said: “This is a great win for New York City children. We are very pleased this unanimous decision has recognized the Board of Health’s mandate to protect the health of young children. Vaccines save lives and are an effective public health tool to prevent the spread of disease. The severity of this past influenza season reminds us of how deadly influenza can be. The influenza vaccine is the best protection against seasonal influenza for everyone. Children who receive the influenza vaccine are less likely to get sick, less likely to need medical attention and less likely to die from influenza. This decision will help us protect more than 150,000 children in City-regulated day cares and preschools across the city.”

​Richard Dearing, Chief of the Appeals Division of the NYC Law Department, said: “We are pleased with this unanimous decision, which recognizes the ‘very direct connection’ between the Board’s flu vaccine rule and ‘the preservation of health and safety,’ and agreed that the rule is ‘squarely within’ with the Board’s delegated powers and consistent with state law.”

Access the complete press release on the NYC Health Commissioner's "Statements" web page.

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Updated! CDC’s vaccine storage and handling web-on-demand video revised for 2018; continuing education credit available

One of the most important safeguards for the nation's vaccine supply is proper storage and handling. CDC's updated web-on-demand vaccine storage and handling video, Keys to Storing and Handling Your Vaccine Supply—2018, is designed to decrease vaccine storage and handling errors by demonstrating recommended best practices and addressing frequently asked questions. Continuing education credit is available until April 18, 2020.

Institute for Safe Medication Practices publishes Part II of its report on vaccination errors collected by its system in 2017​

The Institute for Safe Medication Practices (ISMP) is the nation’s only 501(c)(3) nonprofit organization devoted entirely to medication error prevention and safe medication use. ISMP's Vaccine Error Reporting Program (VERP) was created to allow healthcare professionals and patients to report vaccine errors confidentially.
ISMP published ISMP National Vaccine Errors Reporting Program Part II: Preparing for immunization activities and campaigns in the June 28 issue of its Medication Safety Alert newsletter. This publication is the second part of ISMP's report on errors collected by its system in 2017. A selection from the report is reprinted below.

​Although we have learned important information from the error reports submitted to the ISMP VERP, analysis of the 2017 data differs little from previous years’ analyses. Overall, the vaccines involved in the most frequently reported errors have not changed since 2012 and include DTaP, Tdap, DTaP-IPV, DTaP-IPV/Hib, HepA, HepB, influenza virus vaccines, MMRV, and 9vHPV. Furthermore, these errors occurred for many of the same reasons previously noted during analysis of the ISMP VERP data, particularly:

Product-related contributing factors
  • Age-dependent formulations of the same vaccine
  • Similar brand and generic names, abbreviations, and container labels/packaging
  • Conjugate antigen listed on labels mistaken as the target vaccine name 
Knowledge and information-related contributing factors
  • Unfamiliarity with the indicated ages, dosing, and intervals
  • Unfamiliarity with mixing and preparing the vaccines
  • Unfamiliarity with vaccine schedules, including individualized catch-up schedules
  • Incomplete or confusing vaccination history in a state or local vaccine registry ​​

Practice-related contributing factors

  • Failure to verify the patient’s age before administration
  • Failure to check the chart and vaccine registry for date of prior vaccination
  • Failure to document vaccination in the medical record and/or vaccine registry
  • Miscommunication of vaccine orders and ambiguous due dates
Read Part II of the report released on June 28: ISMP National Vaccine Errors Reporting Program Part II: Preparing for immunization activities and campaigns (PDF format). It is also available in HTML format.

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IAC Spotlight! IAC's State Information web section is the "go-to" place for linking to state immunization websites, mandates, and coordinators 

IAC's State Information web section on is the "go-to" place for finding up-to-date information about state immunization websites, immunization mandates, state/city/territory immunization program managers and perinatal hepatitis B coordinators, and Indian Health Service (IHS) area immunization coordinators. Links to the following web pages contained within the State Information web section appear on its main page and in a column on the left side of the page: 
  • The State Immunization Websites web page within this section provides quick access to the state-level immunization websites for all 50 states
  • The State Mandates on Immunization and Vaccine-preventable Diseases web page provides links for quickly obtaining information on the following:
    • Mandates for 12 vaccine-preventable diseases, listed in alphabetical order 
    • Exemptions, listed by numerous nationally recognized organizations, including IAC, CDC, AAFP, AAP, and AMA 
    • Other related resources from CDC, the Association of State and Territorial Health Officials, and National Conference of State Legislatures
  • The State/City/Territory/IHS Coordinators web page provides contact information for immunization and hepatitis B coordinators for states, cities, territories, and Indian Health Service locations. You will also find a link from the Council of State and Territorial Epidemiologists for After Hours Epi-On-Call should an emergency contact be needed.
If you note any updates from your state that are needed on IAC's State Mandates on Immunization and Vaccine-preventable Diseases web page, please notify Diane Peterson at We appreciate receiving the very latest information from IAC Express readers.
Explore the wealth of state-level information available on the State Information web section of!

CDC publishes “Progress in Vaccine-Preventable and Respiratory Infectious Diseases—First 10 Years of the CDC National Center for Immunization and Respiratory Diseases, 2006–2015”

CDC published Progress in Vaccine-Preventable and Respiratory Infectious Diseases—First 10 Years of the CDC National Center for Immunization and Respiratory Diseases, 2006–2015, by A. Schuchat, et al., in the July issue of Emerging Infectious Diseases, which focuses on vaccine-preventable diseases. The abstract is reprinted below.

The need for closer linkages between scientific and programmatic areas focused on addressing vaccine-preventable and acute respiratory infections led to establishment of the National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention. During its first 10 years (2006–2015), NCIRD worked with partners to improve preparedness and response to pandemic influenza and other emergent respiratory infections, provide an evidence base for addition of 7 newly recommended vaccines, and modernize vaccine distribution. Clinical tools were developed for improved conversations with parents, which helped sustain childhood immunization as a social norm. Coverage increased for vaccines to protect adolescents against pertussis, meningococcal meningitis, and human papillomavirus–associated cancers. NCIRD programs supported outbreak response for new respiratory pathogens and oversaw response of the Centers for Disease Control and Prevention to the 2009 influenza A(H1N1) pandemic. Other national public health institutes might also find closer linkages between epidemiology, laboratory, and immunization programs useful.

View the article in HTML format on CDC's Emerging Infectious Diseases web page.

Five healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination; 674 now enrolled

There are now 674 organizations enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, medical practices, professional organizations, health departments, and government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel.

Since May 23, when IAC Express last reported on the Influenza Vaccination Honor Roll, five additional healthcare organizations have been enrolled.

IAC urges qualifying healthcare organizations to apply.

Newly added healthcare organizations, hospitals, government agencies, and medical practices

  • Alaska VA Healthcare System, Anchorage, AK
  • Castro Valley Pediatrics, Hayward, CA
  • Kaiser Permanente Mid-Atlantic States, Rockville, MD
  • Utica Park Clinic, Tulsa, OK
  • Cancer Center of Guam, Tamuning, GU

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IAC revises “Standing Orders for Administering Meningococcal ACWY Vaccine to Children and Teens”

IAC recently revised Standing Orders for Administering Meningococcal ACWY Vaccine to Children and Teens by expanding the chart for administering intramuscular injections to include both preferred and secondary sites, updating instructions for documentation in the patient's medical record, and adding revisions to VAERS reporting procedures.

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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 updates “Standing Orders for Administering Tdap to Pregnant Women”

IAC recently updated Standing Orders for Administering Tdap to Pregnant Women by completely reformatting it and updating its content.

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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 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

In late 2017, the Immunization Action Coalition (IAC) 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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Vaccine Education Center at Children's Hospital of Philadelphia publishes June issue of its newsletter Vaccine Update 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 ProfessionalsThe June issue includes the following articles:

Additional resources, including information booklets for patients, are available in the full newsletter.

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

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Weekly CDC webinar series on "The Pink Book" chapter topics continues July 11 with "Vaccine Storage and Handling and Administration"; register now for series running through September 26

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 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 July 11 webinar will cover "Vaccine Storage and Handling and Administration" 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. 

New! Free continuing education from MMWR and Medscape: "Prevention of Tetanus, Diphtheria, and Pertussis with Vaccines: Recommendations of the ACIP"

CDC’s MMWR and Medscape have jointly introduced a new free continuing education (CE) activity that describes current recommendations from the Advisory Committee on Immunization Practices (ACIP) regarding CDC's recently published "Prevention of Tetanus, Diphtheria, and Pertussis with Vaccines in the United States: Recommendations of the ACIP."

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.

This activity is intended for public health officials, family medicine practitioners, infectious disease clinicians, nurses, obstetrician-gynecologists, pediatricians, pharmacists, and other clinicians caring for patients for whom vaccination against tetanus, diphtheria, and pertussis may be indicated.

​Access the course on Medscape by visiting CDC's Medscape CME Activity web page and scroll down to the second item: Prevention of Tetanus, Diphtheria, and Pertussis with Vaccines in the United States: Recommendations of the ACIP.

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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.

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ISSN: 1526-1786
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Copyright (C) 2018 Immunization Action Coalition
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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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