has been refreshed! Take a tour.
Issue 1420: April 10, 2019








Available now! IAC’s sturdy laminated versions of the 2019 U.S. child/adolescent immunization schedule and the 2019 U.S. adult immunization schedule—order them for your exam rooms today! Bulk purchase prices available.

IAC's laminated versions of the 2019 U.S. child/adolescent immunization schedule and the 2019 U.S. adult immunization schedule are available now. These schedules are covered with a tough coating you can wipe down; they will stand up to a year's worth of use in every area of your healthcare setting where immunizations are given. The child/adolescent schedule is eight pages (i.e., four double-sided pages) and the adult schedule is six pages (i.e., three double-sided pages). Both schedules 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. They come complete with essential tables and notes, and they replicate the newly designed CDC schedule format.

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.

Related Links

Back to top

Total U.S. measles cases for 2019 climb to 465 this week—largest weekly increase in case numbers this year

On April 8, CDC posted its latest updated number of 2019 measles cases in the U.S. on its Measles Cases and Outbreaks web page, now increased to 465 cases across 19 states (as of April 4). This number reflects an increase of 78 cases over the previous week's total of 387, with the outbreaks now including four additional states. The current total surpasses the 12-month total number of measles cases of 372 in 2018, and it is the second-greatest number of cases reported in the U.S. in one year since measles was eliminated in 2000. 

The states that have reported cases to CDC are Arizona, California, Colorado, Connecticut, Florida, Georgia, Illinois, Indiana, Kentucky, Massachusetts, Michigan, Missouri, Nevada, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington. CDC reports its total measles cases for the year every Monday morning.

Access additional information about U.S. measles cases in 2019 on CDC's Measles Cases and Outbreaks web page.

Related Links

Back to top

March's Technically Speaking column by IAC executive director Dr. Deborah Wexler is titled "With Measles 'Breaking Out' All Over the United States, Here Are Some Good Educational Resources"

Technically Speaking is a monthly column written by IAC executive director Dr. Deborah Wexler for Vaccine Update for Healthcare Providers, a monthly e-newsletter from the Children's Hospital of Philadelphia (CHOP). The column covers practical topics in immunization, such as vaccine administration, immunization scheduling, vaccine storage and handling, and vaccine recommendations.

March's column is titled With Measles "Breaking Out" All Over the United States, Here Are Some Good Educational Resources and is reprinted below.

With Measles "Breaking Out" All Over the United States, Here Are Some Good Educational Resources
Published March 2019

According to the Centers for Disease Control and Prevention (CDC), 228 cases of measles have been confirmed so far this year (as of March 7) in 12 states, including California, Colorado, Connecticut, Georgia, Illinois, Kentucky, New Hampshire, New Jersey, New York, Oregon, Texas, and Washington. With additional cases anticipated, we unfortunately may surpass the 2018 total of 372 reported cases within the first half of 2019.

Measles frequently comes into the U.S. from travelers who contract the disease abroad and bring it into the U.S. This highly communicable virus then spreads in communities with pockets of unvaccinated people.

Whether you live in a state where measles has already occurred or if you simply want to be prepared, the resources below will help you protect your patients from measles.

Centers for Disease Control and Prevention

Immunization Action Coalition

Vaccine Education Center at Children's Hospital of Philadelphia

American Academy of Pediatrics

Back to top

Dr. Paul Offit responds to mumps outbreaks with Medscape commentary titled "What Will It Take to Eradicate Mumps?"

Dr. Paul Offit, director of the Vaccine Education Center at the Children's Hospital of Philadelphia, presented a Medscape video commentary in response to the recent mumps outbreaks at Temple University and two other universities in the Philadelphia area. The commentary, published April 4, is titled What Will It Take to Eradicate Mumps? In the video he explains why mumps, unlike the measles and rubella components of the MMR vaccine, has never been eliminated. The following is an excerpt from the transcript's concluding paragraphs.

... Last year we had about 6,000 cases of mumps in the United States. Many were associated with college outbreaks, because that's about 10 years after the second dose.

The recommendation from the Centers for Disease Control and Prevention is to get a third dose of mumps vaccine if you are on a college campus or in a setting where there is an outbreak. We may be moving toward a third dose recommendation anyway, if these outbreaks continue among 16- to 18-year-olds....

View the video (2:55 minutes) and commentary transcript.

Back to top

Reminder! National Infant Immunization Week is April 27–May 4; many resources available to help you plan activities

National Infant Immunization Week (NIIW) is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and to celebrate the achievements of immunization programs and their partners in promoting healthy communities. NIIW will be held this year on April 27–May 4.

Visit CDC's updated NIIW website to find promotional and educational materials to help you plan your NIIW activities including those in the 2019 Digital Media Toolkit, and tailor them to the needs of your community. If you're looking for planning ideas and tools, you can access guidance on CDC's Planning Your NIIW web page.

CDC would like to hear from organizations planning a 2018 NIIW activity. Please complete the NIIW Activity Form so others can learn what you're doing to educate and inspire parents and providers to protect infants and toddlers from vaccine-preventable diseases.

Related Links

Back to top

Influenza activity decreased this week but remains elevated; CDC reports an estimate of up to 50,900 influenza-related deaths so far this season

According to CDC, influenza activity decreased in the U.S. but remains elevated in the period ending March 30. The proportion of outpatient visits for influenza-like illness decreased from 3.8% in the previous week to 3.2%, which is above the national baseline of 2.2%. CDC estimates that flu has caused as many as 38.1 million flu illnesses, 549,000 hospitalizations, and 50,900 deaths so far this season. 

CDC has reported 5 additional influenza-associated pediatric deaths this season, for a total of 82. Last season, there was a record-setting number of pediatric deaths in the U.S. (185). 

CDC stated in its Weekly U.S. Influenza Surveillance Report, FluView, that during the week ending March 29 the geographic spread of influenza in 33 states and Puerto Rico was reported as widespread; 15 states reported regional activity; the District of Columbia and one state reported local activity; and the U.S. Virgin Islands and Guam did not report.

Influenza vaccination is recommended for everyone six months of age and older. If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to a clinic or pharmacy that provides vaccines or to the HealthMap Vaccine Finder to locate sites near their workplaces or homes that offer influenza vaccination services.

Following is a list of resources related to influenza disease and vaccination for healthcare professionals and the public:

Back to top

IAC Spotlight! IAC's “Clinic Tools: Scheduling Vaccines” web page contains a wide variety of educational materials to help you vaccinate your patients on schedule and “catch-up” those who are behind

IAC's Clinic Tools: Scheduling Vaccines web page on contains numerous resources from IAC and IAC partners that will help you vaccinate your patients on schedule and "catch-up" patients who are behind.

When you visit the Clinic Tools: Scheduling Vaccines web page, you will find in the left-hand column a list of IAC's educational materials related to scheduling vaccines according to ACIP recommendations. In this list, you'll also find links to materials for healthcare professionals and their patients, including detailed vaccine recommendations, schedules to give to patients, standing orders templates for vaccine administration, Vaccine Information Statements, "Ask the Experts" Q&As on scheduling vaccinations, and other helpful IAC tools. In the right-hand column, you will find resources from CDC, including links to the U.S. immunization schedules and the Department of Health and Human Services information related to scheduling vaccines.
To easily locate this web page from anywhere on, go to the light blue band of tabs across the top and select the "Clinic Tools" tab (third from the left), and then from the drop-down menu select "Scheduling Vaccines."

Visit the Clinic Tools: Scheduling Vaccines web page.

Related Links

Back to top


Global spread of measles surging, with widespread outbreaks in 10 countries

UNICEF issued a press release on March 1 titled Alarming Global Surge of Measles Cases a Growing Threat to Children—UNICEF. The article states that in 2018, 74% of the total increase in measles cases occurred in ten countries, 98 countries reported more cases in 2018 than in 2017, and other countries that once were free of measles experienced measles cases again.

According to the press release, the following countries had the highest increases in measles cases when comparing 2017 and 2018. 

  • Ukraine: 30,338
  • Philippines: 13,192
  • Brazil: 10,262
  • Yemen: 6,641
  • Venezuela: 4,916
  • Serbia: 4,355
  • Madagascar: 4,307
  • Sudan: 3,496
  • Thailand: 2,758
  • France: 2,269

Read the complete article, Alarming Global Surge of Measles Cases a Growing Threat to Children—UNICEF,  to learn more about the actions that UNICEF and its partners have been taking to fight the global spread of measles.

Related Links

Back to top

Following a cyclone in Mozambique, 1,500 cases of cholera have occurred; WHO, UNICEF, and partners begin cholera vaccination campaign with 900,000 doses 

Following a cyclone in mid-March that devastated Beira, Mozambique, the area experienced a widespread cholera outbreak of almost 1,500 reported cases. On April 3, WHO announced the beginning of an oral cholera vaccine campaign to respond to the outbreak. Almost 900,000 doses of the vaccine, funded by Gavi, the Vaccine Alliance, arrived in Mozambique on April 3 for the campaign. WHO, UNICEF, the International Federation of Red Cross and Red Crescent Societies, as well as Médecins sans Frontieres (Doctors without Borders) are working with the International Coordinating Group and the Ministry of Health to carry out the vaccination effort. 

View a brief video posted by VOA (Voice of America) featuring cyclone survivors at a vaccination site in Beira: Mozambique's Cyclone Survivors Face Rising Threat of Cholera.

Related Links

Back to top

CDC and WHO report on “Tracking Progress Toward Polio Eradication—Worldwide, 2017–2018” in this week’s MMWR and Weekly Epidemiological Record, respectively  

CDC published Progress Toward Poliomyelitis Eradication—Afghanistan, January 2014–August 2015 in the April 5 issue of MMWR (pages 1166–1170). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Progress Towards Poliomyelitis Eradication: Afghanistan, January 2014–August 2015. A media summary of the MMWR article is reprinted below.

Poliovirus outbreaks are primarily detected by surveillance for acute flaccid paralysis (AFP) among children under 15 years old and testing stool specimens for wild poliovirus (WPV) and vaccine-derived polioviruses (VDPVs). A new CDC report finds that the majority of the high-priority countries evaluated for polio surveillance have met their national AFP surveillance targets, but there was substantial subnational variation in surveillance performance. The report presents 2017–2018 poliovirus surveillance data, with focus on 31 countries in endemic and polio-free World Health Organization regions identified as surveillance-high-priority countries due to “high risk of poliovirus transmission and limited capacity to adequately address those risks.” These surveillance systems need continued strengthening through monitoring, supervision, and improvements in specimen collection and transport to provide sufficient evidence for interruption of poliovirus circulation.

Related Links

Back to top

WHO reports on “Epidemic Meningitis Control in Countries in the African Meningitis Belt, 2018" in this week's Weekly Epidemiological Record

WHO published Epidemic Meningitis Control in Countries in the African Meningitis Belt, 2018 in the April 5 issue of its Weekly Epidemiological Record (pages 179–188). The first two paragraphs are reprinted below.


The main pathogen responsible for epidemic bacterial meningitis is
Neisseria meningitidis (N.m.). Of the 12 subtypes or serogroups of N.m. identified, 6 (N.m. A, B, C, W, X and Y) are recognized as the main causes of disease and epidemics. Meningococcal meningitis cases occur worldwide; however, large, recurring epidemics affect an extensive region of sub-Saharan Africa known as the “meningitis belt”, which comprises 26 countries, from Senegal in the west to Ethiopia in the east. Outbreaks caused by Streptococcus pneumoniae (Spn) have also been reported in the region, although they are less frequent and less extensive.

Meningococcal A Conjugate Vaccine Mass Preventive Campaigns

Before 2010, serogroup A was responsible for the large majority of epidemics. Starting in 2010, a meningococcal A conjugate vaccine (MACV) was introduced progressively into epidemic-prone areas in countries of the African meningitis belt through mass preventive vaccination campaigns. This has dramatically reduced the number of
N.m. A cases and eliminated N.m. A epidemics in these areas.

Read the complete report: Epidemic "Meningitis Control in Countries in the African Meningitis Belt, 2018.

Back to top


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!

Related Links

Back to top


Study published in the BMJ finds routine HPV vaccination of girls aged 12–13 led to dramatic reduction of preinvasive cervical disease

The BMJ (British Medical Journal) recently published Prevalence of Cervical Disease at Age 20 after Immunisation with Bivalent HPV Vaccine at Age 12–13 in Scotland: Retrospective Population Study, by T. Palmer, et al. The abstract's "Conclusions" section is reprinted below.


Routine vaccination of girls aged 12–13 years with the bivalent HPV vaccine in Scotland has led to a dramatic reduction in preinvasive cervical disease. Evidence of clinically relevant herd protection is apparent in unvaccinated women. These data are consistent with the reduced prevalence of high risk HPV in Scotland. The bivalent vaccine is confirmed as being highly effective vaccine and should greatly reduce the incidence of cervical cancer. The findings will need to be considered by cervical cancer prevention programmes worldwide.

Access the full study: Prevalence of Cervical Disease at Age 20 after Immunisation with Bivalent HPV Vaccine at Age 12–13 in Scotland: Retrospective Population Study.

Access the BMJ editorials titled The Remarkable Impact of Bivalent HPV Vaccine in Scotland, published in the same issue:

Back to top


CDC updates "You Call the Shots" module on MMR; free CE credit available

CDC recently updated the MMR module of its web-based training course "You Call the Shots," a program for all immunization providers. The program includes 18 modules on immunization topics (e.g., DTaP, Hepatitis A, Influenza, Vaccine Storage and Handling, Vaccines for Children).

Continuing education credit is available for a variety of healthcare professionals by viewing a module and completing an evaluation. 

Participants can access information about obtaining CE credit from the You Call the Shots main page.

Related Link

Back to top

Registration is open for the Epidemiology & Prevention of Vaccine-Preventable Diseases ("The Pink Book") course in Atlanta, May 28–30

CDC faculty from its National Center for Immunization and Respiratory Diseases will present "The Pink Book" course, a comprehensive review of immunization principles, as well as vaccine-preventable diseases and the recommended vaccines to prevent them, in Atlanta, GA, May 28–30. This 2.5-day continuing education opportunity, which will feature the most up-to-date immunization information from the ACIP, will be free of charge. 

The course is designed for anyone seeking the most comprehensive and current knowledge of immunization, including physicians, nurses, medical assistants, pharmacists, immunization providers, program managers, and nursing and medical students. 

Access additional details about the course, materials, and accommodations.

Registration information.  

Related Link

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
Immunization Action Coalition
2550 University Avenue West, Suite 415 North
Saint Paul, MN 55114

Copyright (C) 2019 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

This page was updated on .