Issue 1382: August 29, 2018










CDC publishes ACIP's 2018–19 influenza vaccination recommendations

CDC published Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season in an August 24 MMWR Recommendations and Reports. The Summary section is reprinted below.

This report updates the 2017–18 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2017;66[No. RR-2]). Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. A licensed, recommended, and age-appropriate vaccine should be used. Inactivated influenza vaccines (IIVs), recombinant influenza vaccine (RIV), and live attenuated influenza vaccine (LAIV) are expected to be available for the 2018–19 season. Standard-dose, unadjuvanted, inactivated influenza vaccines will be available in quadrivalent (IIV4) and trivalent (IIV3) formulations. Recombinant influenza vaccine (RIV4) and live attenuated influenza vaccine (LAIV4) will be available in quadrivalent formulations. High-dose inactivated influenza vaccine (HD-IIV3) and adjuvanted inactivated influenza vaccine (aIIV3) will be available in trivalent formulations.

Updates to the recommendations described in this report reflect discussions during public meetings of ACIP held on October 25, 2017; February 21, 2018; and June 20, 2018. New and updated information in this report includes the following four items. First, vaccine viruses included in the 2018–19 U.S. trivalent influenza vaccines will be an A/Michigan/45/2015 (H1N1)pdm09–like virus, an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus, and a B/Colorado/06/2017–like virus (Victoria lineage). Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage). Second, recommendations for the use of LAIV4 (FluMist Quadrivalent) have been updated. Following two seasons (2016–17 and 2017–18) during which ACIP recommended that LAIV4 not be used, for the 2018–19 season, vaccination providers may choose to administer any licensed, age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). LAIV4 is an option for those for whom it is appropriate. Third, persons with a history of egg allergy of any severity may receive any licensed, recommended, and age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). Additional recommendations concerning vaccination of egg-allergic persons are discussed. Finally, information on recent licensures and labeling changes is discussed, including expansion of the age indication for Afluria Quadrivalent (IIV4) from ≥18 years to ≥5 years and expansion of the age indication for Fluarix Quadrivalent (IIV4), previously licensed for ≥3 years, to ≥6 months.

This report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2018–19 season in the United States. A Background Document containing further information and a brief summary of these recommendations are available at

These recommendations apply to U.S.-licensed influenza vaccines used within Food and Drug Administration–licensed indications. Updates and other information are available at CDC’s influenza website ( Vaccination and healthcare providers should check CDC’s influenza website periodically for additional information.

View Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season in PDF format. It is also available in HTML format.

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CDC releases updated VISs for DTaP and MenACWY vaccines

On August 24, CDC released revised Vaccine information Statements (VISs) for DTaP and MenACWY vaccines. 

The new DTaP VIS reflects ACIP recommendation changes with regard to contraindications and precautions for vaccination. 

The new MenACWY VIS removes reference to the meningococcal polysaccharide vaccine (MPSV4) which is no longer available in the United States. Otherwise, changes to this VIS are minimal.

CDC encourages providers to begin using these VISs immediately; however, stocks of the previous editions may be used until gone.

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CDC issues report on vaccination coverage among adolescents age 13–17 years in the U.S. in 2017; more adolescents up to date on HPV vaccination

CDC published National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years—United States, 2017 the August 24 issue of MMWR (pages 909–917). The first paragraph is reprinted below.

The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination of persons aged 11–12 years with human papillomavirus (HPV) vaccine, quadrivalent meningococcal conjugate vaccine (MenACWY), and tetanus and reduced diphtheria toxoids and acellular pertussis vaccine (Tdap). A booster dose of MenACWY is recommended at age 16 years, and catch-up vaccination is recommended for hepatitis B vaccine (HepB), measles, mumps, and rubella vaccine (MMR), and varicella vaccine (VAR) for adolescents whose childhood vaccinations are not up to date (UTD). ACIP also recommends that clinicians may administer a serogroup B meningococcal vaccine (MenB) series to adolescents and young adults aged 16–23 years, with a preferred age of 16–18 years. To estimate U.S. adolescent vaccination coverage, CDC analyzed data from the 2017 National Immunization Survey–Teen (NIS-Teen) for 20,949 adolescents aged 13–17 years. During 2016–2017, coverage increased for ≥1 dose of HPV vaccine (from 60.4% to 65.5%), ≥1 dose of MenACWY (82.2% to 85.1%), and ≥2 doses of MenACWY (39.1% to 44.3%). Coverage with Tdap remained stable at 88.7%. In 2017, 48.6% of adolescents were UTD with the HPV vaccine series (HPV UTD) compared with 43.4% in 2016. On-time vaccination (receipt of ≥2 or ≥3 doses of HPV vaccine by age 13 years) also increased. As in 2016, ≥1-dose HPV vaccination coverage was lower among adolescents living in nonmetropolitan statistical areas (MSAs) (59.3%) than among those living in MSA principal cities (70.1%). Although HPV vaccination initiation remains lower than coverage with MenACWY and Tdap, HPV vaccination coverage has increased an average of 5.1 percentage points annually since 2013, indicating that continued efforts to target unvaccinated teens and eliminate missed vaccination opportunities might lead to HPV vaccination coverage levels comparable to those of other routinely recommended adolescent vaccines.

On August 23, CDC posted a related press release titled More U.S. adolescents up to date on HPV vaccination.

CDC has also developed a free continuing education course based on this report. 

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CDC reports on trends in HPV-associated cancers in the United States

CDC published Trends in Human Papillomavirus–Associated Cancers—United States, 1999–2015 in the August 24 issue of MMWR (pages 918–924). A summary made available to the press is reprinted below.

HPV-associated cancers are rising, according to a new CDC study. HPV can cause cervical cancer as well as some oropharyngeal, vulvar, vaginal, penile, and anal cancers. From 1999 to 2015, the number of HPV-associated cancers increased from 30,000 to over 43,000 annually. Most of the increase was in oropharyngeal and anal cancer in men and women. This is likely due to increased HPV exposure over the past few decades. From other reports, we know that over 90 percent of cancers likely caused by HPV can be prevented by HPV vaccine. Meanwhile, cervical cancer rates continue to decline because of screening and early detection. Screening finds cervical precancers so they can be treated before becoming cancer. There is no recommended screening for other HPV-associated cancers.

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FDA works to mitigate shortages of EpiPen by extending expiration date for specific lots of medication

Regional supply disruptions and manufacturing issues have contributed to the self-injectable epinephrine product EpiPen's limited availability in certain areas in the United States.

On August 21, FDA announced an additional action to help mitigate the shortage—extending the expiration date of specific lots of 0.3 milligram EpiPen products. A section of a related press release is reprinted below.

The U.S. Food and Drug Administration today took additional action to mitigate shortages of EpiPen (epinephrine) auto-injector by extending the expiration date of specific lots of 0.3 milligram products marketed by Mylan by four months beyond the labeled expiration date. This change beyond the approved 20-month shelf life is based on stability data provided by Mylan and reviewed by the FDA. To help ensure patient safety, these products, which already have been dispensed to patients, should have been—and should continue to be—stored as labeled.

While product is currently available, multiple factors, including regional supply disruptions and manufacturer issues, have contributed to EpiPen’s limited availability in certain areas in the U.S. The FDA continues to work closely with Mylan on EpiPen production and supply, and also has been in contact with the other manufacturers of epinephrine auto-injectors, including Adrenaclick and Auvi-Q, regarding their supply as the school year begins since this is historically accompanied by increased product demand. The agency also recently approved the first generic version of EpiPen.
Mylan also has established a customer service number, which we have posted on the FDA's website, to help pharmacies and patients locate EpiPens if necessary. Information on supply information of other approved epinephrine autoinjector products can also be found on the agency’s website.

Read the complete press release: FDA In Brief: FDA takes additional action to mitigate shortages of EpiPen by extending expiration date for specific lots of medication.

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IAC Spotlight! Visit IAC's website for information about immunization coalitions and nonprofits 

For many years, IAC has coordinated the Immunization Coalitions Network, a project which allows immunization coalitions and nonprofits to communicate with each other. As part of this effort, in May 2016, IAC launched a new website, This website is intended to be a one-stop shop for learning about immunization coalitions, their locations, missions, activities, newsletters, and how to engage with them. The site promotes the activities of immunization organizations, offers resources of importance to the network, and provides a searchable online database of local, state, regional, national, and international immunization coalitions. Interested supporters of immunization can find contacts, resources, ideas, and volunteer opportunities.

This website currently lists 131 immunization-related coalitions and nonprofit organizations, as well as other resources such as archived newsletters and webinars. If you are an immunization coalition director or nonprofit leader whose organization is not listed here, please contact for more information.

Check out the immunization coalitions' information and resources at

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IAC enrolls five new birthing institutions into its Hepatitis B Birth Dose Honor Roll; fourteen previously honored institutions qualify for additional years' honors

The Immunization Action Coalition (IAC) is pleased to announce that five new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.

  • Berger Health System, Circleville, OH (99%)
  • McLaren Bay Region, Bay City, MI (94%)
  • Munson Healthcare, Grayling, MI (90%)
  • St. Clair Hospital, Pittsburgh, PA (90%)
  • Westmoreland Hospital, Greensburg, PA (91%)

The following eight institutions are being recognized for a second year:

  • Christiana Care Health System, Newark, DE (94%)
  • Hiawatha Community Hospital, Hiawatha, KS (91%)
  • Lakeland Medical Center, St. Joseph, MI (92%)
  • McLaren Central Michigan, Mt. Pleasant, MI (92%)
  • McLaren Bay Region, Bay City, MI (95%)
  • OSF St. Francis Hospital and Medical Group, Escanaba, MI (91%)
  • Spectrum Health Pennock, Hastings, MI (91%)
  • South Coast Global Medical Center, Santa Ana, CA (98%)

The following three institutions are being recognized for a third year:

  • McLaren Bay Region, Bay City, MI (95%)
  • Mercy Hospital Washington, Washington, MO (93%)
  • St. Rose Hospital, Hayward, CA (98%)

In addition, the following four institutions are being recognized for a fourth year:

  • Lakeland Community Hospital, Niles, MI (90%)
  • McLaren Bay Region, Bay City, MI (94%)
  • MidMichigan Health–Midland, Midland, MI (92%)
  • University Medical Center of Southern Nevada, Las Vegas, NV (98%)

Finally, the following institution is being recognized for a fifth year:

  • Arkansas Valley Regional Medical Center, La Junta, CO (91%)

Note: One of these institutions qualified for four 12-month periods at one time.

The Honor Roll now includes 417 birthing institutions from 40 states, Puerto Rico, Guam, and an overseas U.S. military base. Ninety-six institutions have qualified for two years, 46 institutions have qualified three times, 22 institutions have qualified four times, seven institutions have qualified five times, one institution has qualified six times, and one institution has qualified seven times.

The Honor Roll is a key part of IAC’s major initiative urging the nation’s hospitals to Give birth to the end of Hep B. Hospitals and birthing centers are recognized for attaining high coverage rates for administering hepatitis B vaccine at birth and meeting specific additional criteria. The initiative urges qualifying healthcare organizations to apply for the Hepatitis B Birth Dose Honor Roll online.

To be included in the Hepatitis B Birth Dose Honor Roll, a birthing institution must have: (1) reported a coverage rate of 90 percent or greater, over a 12-month period, for administering hepatitis B vaccine before hospital discharge to all newborns, including those whose parents refuse vaccination, and (2) implemented specific written policies, procedures, and protocols to protect all newborns from hepatitis B virus infection prior to hospital discharge.

Honorees are also awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IAC Express’s approximately 50,000 readers.

Please visit the Hepatitis B Birth Dose Honor Roll web page that lists these institutions and their exceptional efforts to protect infants from perinatal hepatitis B transmission.

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IAC posts seven updated translations of its 1-page vaccination schedule for patients titled “Vaccinations for Adults—You’re never too old to get vaccinated!”

IAC recently posted seven updated translations of its 1-page vaccination schedule for patients titled “Vaccinations for Adults—You’re never too old to get vaccinated!”

Access the English-language version.

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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 posts seven updated Spanish translations of its 1-page adult vaccination schedules for patients with HIV or hepatitis C infection; with heart or lung disease, diabetes, or anatomic or functional asplenia; and for men who have sex with men

IAC has posted updated Spanish translations of its seven 1-page adult vaccination schedules for patients in various risk groups: HIV, hepatitis C, diabetes, heart disease, lung disease, men who have sex with men, and adults without a spleen.

The English-language and Spanish-language versions are listed below.

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Reader alert: IAC's Spanish translations of "Questions Frequently Asked about Hepatitis B" and "Protect Yourself Against Hepatitis A and Hepatitis B: A Guide for Gay and Bisexual Men" were delayed in posting following last week's IAC Express

Last week's IAC Express included an announcement that the Spanish translations of "Questions Frequently Asked about Hepatitis B" and "Protect Yourself Against Hepatitis A and Hepatitis B: A Guide for Gay and Bisexual Men" had been updated. Unfortunately, there was a delay in posting the revised pieces, and they were not actually available until about 11:30 a.m. CT last Wednesday.

If you downloaded either of these pieces the morning of August 22, please download them again to ensure you have the most recent version. After you open the link, it also might be prudent to "refresh" the page to make sure you aren't accessing the older version which might be cached in your computer or network if you opened it last week.

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World Health Organization reports that more than 41,000 people in European region have been infected with measles in the first half of 2018

On August 20, the World Health Organization (WHO) published Measles cases hit record high in the European Region. Selections from the report are reprinted below.

Over 41,000 children and adults in the WHO European Region have been infected with measles in the first 6 months of 2018. The total number for this period far exceeds the 12-month totals reported for every other year this decade. So far, the highest annual total for measles cases between 2010 and 2017 was 23,927 for 2017, and the lowest was 5,273 for 2016. Monthly country reports also indicate that at least 37 people have died due to measles so far this year....

Seven countries in the Region have seen over 1,000 infections in children and adults this year (France, Georgia, Greece, Italy, the Russian Federation, Serbia, and Ukraine). Ukraine has been the hardest hit, with over 23,000 people affected; this accounts for over half of the regional total. Measles-related deaths have been reported in all of these countries, with Serbia reporting the highest number of 14....

While immunization coverage with 2 doses of measles-containing vaccine increased from 88% of eligible children in the Region in 2016 to 90% in 2017, large disparities at the local level persist: some communities report over 95% coverage, and others below 70%.

WHO is working closely with Member States currently facing outbreaks to implement response measures, including enhanced routine and supplemental immunization as well as heightened surveillance to quickly detect cases. WHO is also working with other countries to attain the 95% threshold....

Read the complete article: Measles cases hit record high in the European Region.

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WHO summarizes the 2017–18 influenza season in the northern hemisphere in this week's Weekly Epidemiological Record

The World Health Organization (WHO) published Review of the 2017–2018 influenza season in the northern hemisphere in the August 24 issue of its Weekly Epidemiological Record. A selection from the article is reprinted below.

In the North American subregion (Canada and the United States of America [USA]), the timing of this season was generally similar to that of previous seasons. Influenza activity started to increase in mid-November 2017 and peaked in late January and early February of 2018.

Activity began to decrease in late February, but remained high through March—longer than in previous seasons. Influenza activity was near inter-seasonal levels only by early to mid-May. Influenza A(H3N2) viruses predominated in the North American subregion (Canada and the USA) during this season, but influenza B viruses were also seen throughout the season at higher levels than the typical end-of-season circulation.

Influenza A viruses accounted for 57% and 68–71% and influenza B viruses for 43% and 29–32% of influenza-positive samples in Canada and the USA, respectively, with subnational variations in proportions.

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New partnership to bring 8 million vaccines to remote areas of Liberia, Uganda, and Kenya

A new partnership between Gavi, the Vaccine Alliance; the Audacious Project; Last Mile Health, and Living Goods aims to bring vaccination services to remote areas of Liberia, Uganda, and Kenya. A section of a related August 15 press release is reprinted below.

The new partnership will provide a combined U.S. $18 million to Last Mile Health and Living Goods' Audacious Project to boost the number of community health workers and integrate immunisation information and data-capture into their daily routines. The new funding will help give over 8 million people access to vaccines, while the partnership as a whole aims to deploy 50,000 community health workers to serve 34 million people by 2021.

The health workers will be equipped with smartphones that can capture the immunisation status of every child in real time with a time-stamped GPS identifier, send automated vaccination reminders by SMS and use real-time data to help pinpoint and close immunisation gaps. This system enables governments to optimise the performance of thousands of far-flung health workers in real time.

Read the complete press release: New initiative to bring vaccination to over 8 million people across Africa.

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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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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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Study found that physicians have significant gaps in knowledge about MenB disease and MenB vaccine

The August issue of Pediatrics includes an article titled Adoption of Serogroup B Meningococcal Vaccine Recommendations by Allison Kempe, et al. The abstract is reprinted below.

In 2015, the Advisory Committee on Immunization Practices recommended that 16- to 23-year-olds may be vaccinated with the serogroup B meningococcal (MenB) vaccine on the basis of individual clinical decision-making (Category B). We assessed the following among U.S. pediatricians and family physicians (FPs): (1) practices regarding MenB vaccine delivery, (2) factors influencing a decision to recommend the MenB vaccine, and (3) factors associated with discussing the MenB vaccine.

We surveyed a nationally representative sample of pediatricians and FPs via e-mail and Internet from October 2016 to December 2016.

The response rate was 72% (660 of 916). During routine visits, 51% of pediatricians and 31% of FPs reported always or often discussing MenB vaccine. Among those who discussed often or always, 91% recommended vaccination; among those who never or rarely discussed, 11% recommended. We found that 73% of pediatricians and 41% of FPs currently administered the MenB vaccine. Although many providers reported not knowing about factors influencing recommendation decisions, MenB disease outbreaks (89%), disease incidence (62%), and effectiveness (52%), safety (48%), and duration of protection of MenB vaccine (39%) increased the likelihood of recommendation, whereas the Category B recommendation (45%) decreased likelihood. Those somewhat or not at all aware of the MenB vaccine (risk ratio 0.32 [95% confidence interval 0.25–0.41]) and those practicing in a health maintenance organization (0.39 [0.18–0.87]) were less likely, whereas those aware of disease outbreaks in their state (1.25 [1.08–1.45]) were more likely to discuss MenB vaccine.

Primary care physicians have significant gaps in knowledge about MenB disease and the MenB vaccine, and this appears to be a major driver of the decision not to discuss the vaccines.

Access the complete article in HTML format (includes a helpful video): Adoption of Serogroup B Meningococcal Vaccine Recommendations.

Access the complete article in PDF format: Adoption of Serogroup B Meningococcal Vaccine Recommendations.

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Study in Pediatrics did not find increased risk of primary ovarian insufficiency after HPV, Tdap, inactivated influenza, or MenACWY vaccination

The August issue of Pediatrics includes an article titled Primary Ovarian Insufficiency and Adolescent Vaccination by Allison L. Naleway, et al. The Conclusions section of the abstract is reprinted below.

We did not find a statistically significant elevated risk of POI after HPV, Tdap, II, or MenACWY vaccination in this population-based retrospective cohort study. These findings should lessen concern about POI risk after adolescent vaccination.

Access the complete abstract online: Primary Ovarian Insufficiency and Adolescent Vaccination.

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CDC reports on mumps outbreak in Alaska

CDC published Notes from the Field: Mumps Outbreak — Alaska, May 2017–July 2018 in the August 24 issue of MMWR (pages 940–941). Sections of this report are reprinted below.

In May 2017, the Alaska Section of Epidemiology (SOE) was notified of an Anchorage resident with laboratory-confirmed mumps who reported exposure to an out-of-state visitor with mumps-like symptoms. Another seven laboratory-confirmed cases were reported in late July and August; all were in Anchorage residents, mostly in persons who self-identified as Native Hawaiian or other Pacific Islander (NH/PI)....

On November 15, with 56 confirmed and probable mumps cases identified (including 82% among NH/PI, who represent 4.8% of the Anchorage population), SOE recommended a third dose of MMR vaccine (MMR3) for persons at increased risk for acquiring mumps... Despite this recommendation, cases continued to occur among persons at increased risk and among persons without documented epidemiologic links to other cases. Consequently, on December 28, 2017, when 138 cases had been reported, the MMR3 recommendation was expanded to all Anchorage residents. On February 22, 2018, with 247 cases reported, and cases continuing and occurring statewide among persons with indeterminate epidemiologic links and no history of in-state or out-of-state travel, the recommendation was extended to all 737,080 Alaska residents....

As of July 31, 2018, the outbreak is ongoing, with 391 confirmed and probable cases reported...

Compared with mumps outbreaks in discrete populations such as universities where the population at risk is well defined, community outbreaks pose unique challenges. Following updated Advisory Committee on Immunization Practice recommendations, a third MMR dose was recommended for persons at increased risk for acquiring mumps as defined by the epidemiologic data. However, as the outbreak evolved, it became more difficult to determine who was at increased risk. Group-specific MMR3 recommendations were challenging for clinicians to implement when faced with uncertainty about whether their patients participated in group settings where mumps was circulating. In response, SOE implemented a stepwise expansion of its MMR3 recommendation that eventually included all Alaskans. Evaluation of Alaska’s response to the mumps outbreak, including the impact of MMR3 recommendations on MMR uptake, is ongoing. Disseminating information through social media, working with community groups, and vaccination clinics have been important in raising awareness and increasing vaccine uptake.

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CDC offers new Medscape CME activity: "Making the Case: Championing for HPV Cancer Prevention in Your Practice"

CDC has developed a new opportunity to obtain CME credit by completing a course online on Medscape. Modeled on an interactive grand rounds approach, this new CME features cases with two adolescent patients designed to educate clinicians about current HPV vaccine recommendations, best practices for effectively recommending and addressing questions about HPV vaccination with parents of age-appropriate boys and girls, and strategies to foster team-wide collaboration for HPV vaccination in their practice.

Access Making the Case: Championing for HPV Cancer Prevention in Your Practice. If you are not a registered user on Medscape, you can register for free and get unlimited access to all continuing education activities and other Medscape features.

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Reminder: Vaccine Education Center's "Current Issues in Vaccines" webinar with Dr. Paul Offit to be held September 5

Reminder: the Vaccine Education Center (VEC) at Children's Hospital of Philadelphia will present a 1-hour webinar, beginning at 12:00 noon (ET) on September 5. Part of its Current Issues in Vaccines series, the webinar will feature Paul Offit, MD, director of VEC. Dr. Offit's topics for this webinar will be:
  • Do vaccines cause autoimmune diseases?
  • Influenza vaccine: How well did it work last year?
  • Efforts to make a more effective influenza vaccine

Free continuing education credits (CME, CEU, and CPE) will be available for both the live and archived events. 

Registration is required. Access more information.

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Weekly CDC webinar series on "The Pink Book" chapter topics continues September 5 with "Hepatitis B"; 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 September 5 webinar will cover "Hepatitis B" 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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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 DisclaimerISSN 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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