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Issue 1380: August 15, 2018









National Immunization Awareness Month continues; upcoming week will focus on protecting preteens and teens

Every year in August, National Immunization Awareness Month (NIAM) provides an opportunity to raise awareness of the importance of immunization and the need for improving national vaccination coverage levels. NIAM is co-sponsored by the National Public Health Information Coalition (NPHIC) and CDC. The third week, August 19–25, focuses on vaccinations for preteens and teens. The theme for the week is "Ensure a healthy future with vaccines." 


The 2018 edition of the communications toolkit, put out by NPHIC in collaboration with CDC, contains key messages, vaccine information, sample news releases and articles, sample social media messages, links to web resources from CDC and other organizations, and logos, web banners, posters, and graphics to use with social media. The website also includes a place for you to share your NIAM activities and view what others are doing for NIAM, using the hashtag #NIAM18.

Previous weeks of NIAM focused on getting ready for back to school, pregnant women, and babies and young children. The final week will focus on adult immunization.

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Available online: six-part series of online training sessions on implementing standing orders protocols for adult immunization in your healthcare setting

Standing orders protocols (SOPs) are known to improve immunization coverage rates, but are underutilized by providers serving adult patients. The content for a six-part webinar series will help healthcare settings implement SOPs for adult immunizations. 

The Executive Summary, provided by IAC executive director Dr. Deborah Wexler, gives a concise overview of the entire series presented by Drs. William Atkinson and Litjen Tan. Attending this series does not earn Continuing Education (CE) credit. The series is developed and provided by IAC, IDCareLive, and Pfizer.

Registration is free, but is required in order to view any session. The link will bring up a short registration form to create a free IDCareLive account, if you don’t already have one. After signing up, you will be transferred directly to the intended page.

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In case you missed this! CDC, AAFP, AAP, and ACOG all recommend that newborns receive hepatitis B vaccine within 24 hours of birth

Technically Speaking, a monthly column written by IAC executive director Dr. Deborah Wexler, is featured in Children's Hospital of Philadelphia's Vaccine Education Center (VEC) monthly e-newsletter for healthcare professionals. Her most recent column on the hepatitis B vaccine birth dose is reprinted below.

CDC Publishes Recommendations that Newborns Receive Hepatitis B Vaccine within 24 Hours of Birth — AAFP, AAP and ACOG Concur
Published July/August 2018

On January 12, 2018, CDC published “Prevention of Hepatitis B Virus Infection in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP) in MMWR Recommendations and Reports," (Vol.67, No.1). This 36-page document contains full recommendations for the use of hepatitis B vaccine in infants, children, teens and adults, as well as guidance on many other related topics.

What has changed for newborns?
The most significant change in these published recommendations is that medically stable newborns who weigh at least 2,000 gm and whose mothers’ hepatitis B surface antigen (HBsAg) test is documented to be negative, should receive hepatitis B vaccine within 24 hours of birth. Prior to this (since 2005), the recommendation was to administer the birth dose of hepatitis B vaccine at any time prior to hospital discharge. There was also language permitting a delay in administering the birth dose until after hospital discharge, but this was only during rare circumstances and on a case-by-case basis when certain specific criteria were met. However, this option is no longer included in the hepatitis B recommendations for newborns.

AAFP, AAP and ACOG agree
The American Academy of Family Physicians (AAFP), American Academy of Pediatrics (AAP), and American College of Obstetricians and Gynecologists (ACOG) are all in agreement with the recommendation to vaccinate newborns within 24 hours of birth. AAP included this in its recently published Red Book 2018–2021: Report of the Committee on Infectious Diseases (page 421, Table 3.24).

Administering the hepatitis B birth dose within 24 hours of birth was first published in 2017 in the Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger, United States, 2017, which was endorsed by AAFP, AAP and ACOG. It appears in the 2018 immunization schedule for children and adolescents as well.

ACIP-specific wording
The exact language regarding universal hepatitis B vaccination of infants in the ACIP recommendations on pages 16–17 is reprinted below:

Universal Vaccination of Infants

  • All infants should receive the HepB vaccine series as part of the recommended childhood immunization schedule, beginning at birth as a safety net. 
  • For all medically stable infants weighing > 2,000 grams at birth and born to HBsAg-negative mothers, the first dose of vaccine should be administered within 24 hours of birth (new recommendation). Only single-antigen HepB vaccine should be used for the birth dose.

To access CDC guidance on hepatitis B-related topics such as the management of low birth weight infants, infants whose mothers are HBsAg positive or whose HBsAg status is unknown, and the management of HBsAg-positive mothers, consult the ACIP recommendations for hepatitis B.

Access the entire hepatitis B birth dose Technically Speaking article which also provides links to many useful resources from IAC, CDC, and VEC.

You can access the current and past issues of Technically Speaking from a box in the middle of the home page, from the "Guide to" at the bottom of every web page, or by going directly to

Check out the July 2018 issue of VEC's Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events. To subscribe to this newsletter, go to the sign-up form.

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IAC Spotlight! Find whatever you're looking for on by using the Google search engine located on all IAC web pages

IAC's Google Search engine on is a fast way to find whatever you are looking for on the IAC website. Located in the upper right-hand corner of every page, this function searches the entire IAC website for whatever you're looking for in your search. It's the quickest way to find what you need! 

Try out the Google Search engine in the upper right-hand corner of any web page today.

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IAC posts its newest PowerPoint slide set, "What Are Standing Orders Protocols?"; use it "as is" or modify it to fit your needs

IAC recently developed and posted its newest PowerPoint slide set, What Are Standing Orders Protocols? This 53-slide set also includes speaker’s notes explaining standing orders for immunization and describing how they can help increase immunization coverage rates. The slide set presents an overview of factors contributing to low vaccination rates, essential components of standing orders, and how standing orders benefit medical practices, as well as links to additional IAC resources on standing orders. 
There are two additional PowerPoint slide sets available to help you implement standing orders for adults.

To obtain all PowerPoint slide sets, go to IAC's PowerPoint Slide Sets web page. Just below the presentation's title 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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Just released! Dr. Paul Offit's latest book: Bad Advice: Or Why Celebrities, Politicians, and Activists Aren't Your Best Source of Health Information

Paul Offit, MD, director, Vaccine Education Center at Children's Hospital of Philadelphia, as well as the Maurice R. Hilleman Professor of Vaccinology and professor of pediatrics at the Perelman School of Medicine at the University of Pennsylvania, has written a new book titled Bad Advice: Or Why Celebrities, Politicians, and Activists Aren’t Your Best Source of Health Information. A selection from a description of the book from Dr. Offit's website is reprinted below.

Science doesn’t speak for itself. Neck-deep in work that can be messy and confounding, and naive in the ways of public communication, scientists are often unable to package their insights into the neat narratives that the public requires. Enter the celebrities, the advocates, the lobbyists, and the funders behind them, who take advantage of scientists’ reluctance to provide easy answers, flooding the media with misleading or incorrect claims about health risks. Amid this onslaught of spurious information, Americans are more confused than ever about what’s good for them and what isn’t.

In Bad Advice, Paul A. Offit shares hard-earned wisdom on the do’s and don’ts of battling misinformation....

The book can be purchased through Dr. Offit's website (click on the images at the bottom of the page); from the publisher, Columbia University Press; or through your favorite bookstore or seller.

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Three healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination; 677 now enrolled

There are now 677 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 July 5, when IAC Express last reported on the Influenza Vaccination Honor Roll, three additional healthcare organizations have been enrolled.

IAC urges qualifying healthcare organizations to apply.

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

  • French Hospital Medical Center, San Luis Obispo, CA
  • Marian Regional Medical Center, Santa Maria, CA
  • North Valley Hospital, Whitefish, MT

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IAC posts updated temperature logs for refrigerators and freezers in both Celsius and Fahrenheit formats

IAC recently updated its four temperature logs for healthcare professionals to help with safe vaccine storage and handling. Changes were made to the instructions for recording daily temperatures.

IAC’s frequently downloaded temperature logs for refrigerators and freezers are widely used to help clinics monitor and document the temperature readings within vaccine storage units. Below are the updated logs.

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IAC updates "Vaccine Storage Troubleshooting Record" in fillable and non-fillable formats

IAC recently revised its "Vaccine Storage Troubleshooting Record" to allow healthcare personnel to record their notes about reportable events that occurred in vaccine storage. These forms can be used to document any unacceptable vaccine storage event, such as exposure of refrigerated vaccines to temperatures that are outside the manufacturers' recommended storage ranges. IAC's non-fillable format offers examples of completed records, including the actions taken. The fillable format allows users to document electronically or by hand. Below are the updated tools.

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WHO reports on yellow fever in Africa and the Americas in this week's Weekly Epidemiological Record

WHO's Weekly Epidemiological Record published an article titled Yellow fever in Africa and the Americas, 2017. The first paragraph is reprinted below.

Epidemiology and outbreak response
In 2017, there were major yellow fever (YF) outbreaks in Brazil and Nigeria. These outbreaks were not marked by the rapid urban spread seen in 2016 in Angola and the Democratic Republic of the Congo (DRC), yet they illustrate the increased risk of YF and urban outbreaks with international spread. The Eliminate Yellow Fever Epidemics (EYE1) strategy was developed with the goal to reduce the risk of YF through a continuum ranging from outbreak detection and response, to prevention.

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Still available! IAC's sturdy laminated version of the 2018 U.S. adult immunization schedule—order a supply for your healthcare setting today! Child/teen schedules sold out.

IAC's laminated versions of 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. The schedule is eight pages (i.e., four double-sided pages) and is folded to measure 8.5" x 11". 

The child/teen immunization schedules are sold out. If you wish to order a quantity of 500 or more, you can email to request a quote.                           

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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"Mortality among Patients with Chronic Hepatitis B Infection: The Chronic Hepatitis Cohort Study” published in July issue of Clinical Infectious Diseases

On July 28, Clinical Infectious Diseases published Mortality among Patients with Chronic Hepatitis B (CHB) Infection: The Chronic Hepatitis Cohort Study (CHeCS) (D Bixler et al.). The abstract's conclusion is reprinted below.

Compared to the general population, CHB patients die at a younger age and at higher rates from all causes and liver-related causes. Death certificates underrepresent the true mortality from CHB.

Access the abstract: Mortality among Patients with Chronic Hepatitis B (CHB) Infection: The Chronic Hepatitis Cohort Study.

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Register for CDC’s #PreteenVaxScene webinar, "National Immunization Awareness Month: Effectively Recommending Vaccines Across the Lifespan," on August 17
Join CDC on August 17 at 1:00 p.m. (ET) for the next #PreteenVaxScene webinar, National Immunization Awareness Month: Effectively Recommending Vaccines Across the Lifespan. This webinar will feature two practicing family physicians, both recently recognized as CDC Childhood Immunization Champions, who will discuss how they talk about vaccines and address common questions for all of their patients.

Registration (required) is open now.

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Weekly CDC webinar series on "The Pink Book" chapter topics continues August 22 with "Polio and Hib"; 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 August 22 webinar will cover "Polio and Hib" 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). Free continuing education is available for healthcare personnel including physicians, nurses, nurse practitioners, pharmacists, physician’s assistants, and others.

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. 

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.

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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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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.

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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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