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Immunization Works July 2013

Immunization Works July 2013 Newsletter


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National Immunization Awareness Month: August is National Immunization Awareness Month (NIAM). The purpose of this observance is to highlight the importance of immunizations which is one of the top public health accomplishments of the 20th Century. The National Public Health Information Coalition (NPHIC) in collaboration with a team from the National Center for Immunization and Respiratory Diseases (NCIRD) has developed various immunization resources, logos, and a communication toolkit.

The toolkit is designed to help public information officers and immunization program managers work together to communicate about the importance of immunizations. NPHIC urges the entire public health community to put the toolkit’s sample tweets, Facebook posts, articles and other materials to good use.

The toolkit is structured to highlight the importance of immunizations for a different population each week of the month:

  • Week 1: Off to college (young adults)
  • Week 2: Back to school (children)
  • Week 3: Not just for kids (adults)
  • Week 4: A healthy start (babies and pregnant women)

Human Papillomavirus Vaccination Coverage Among Adolescent Girls From 2007-2012, and Postlicensure Vaccine Safety Monitoring From 2006-2013: Since mid-2006, the Advisory Committee on Immunization Practices (ACIP) has recommended routine vaccination of adolescent girls at ages 11 or 12 years with three doses of human papillomavirus (HPV) vaccine. Two HPV vaccines are currently available in the United States. Both the quadrivalent (HPV4) and bivalent (HPV2) vaccines protect against HPV types 16 and 18, which cause 70% of cervical cancers and the majority of other HPV-associated cancers; HPV4 also protects against HPV types 6 and 11, which cause 90% of genital warts. The July 26, 2013 MMWR summarizes national HPV vaccination coverage levels among adolescent girls aged 13-17 years from the 2007-2012 National Immunization Survey-Teen (NIS-Teen) and national postlicensure vaccine safety monitoring. Although vaccination coverage with more than one dose of any HPV vaccine increased from 25.1% in 2007 to 53.0% in 2011, coverage in 2012 (53.8%) was similar to 2011. If HPV vaccine had been administered during health care visits when another vaccine was administered, vaccination coverage for more than one dose could have reached 92.6%. Safety monitoring data continue to indicate that HPV4 is safe. Despite availability of safe and effective vaccines and ample opportunities for vaccine delivery in health care settings, HPV vaccination coverage among adolescent girls failed to increase from 2011 to 2012.

We are asking partners for your help in spreading the word about HPV. Here are a couple easy things you can do:

Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Children Aged 6-18 Years With Immunocompromising Conditions: On February 20, 2013, the ACIP recommended routine use of 13-valent pneumococcal conjugate vaccine (PCV13; Prevnar 13, Wyeth Pharmaceuticals, Inc., a subsidiary of Pfizer, Inc.) for children aged 6-18 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear implants who have not previously received PCV13. PCV13 should be administered to these children regardless of whether they received the 7-valent pneumococcal conjugate vaccine (PCV7) or the 23-valent pneumococcal polysaccharide vaccine (PPSV23). Recommendations for PPSV23 use for children in this age group remain unchanged. The evidence for the benefits and risks associated with PCV13 vaccination of children with immunocompromising conditions was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. This recommendation reflects a policy change from permissive and off-label recommendation of PCV13 in the pediatric immunocompromised population to a category A recommendation. The June 28, 2013 MMWR summarizes the evidence considered by ACIP to make this recommendation and reviews the recommendations for use of PCV13 and PPSV23 for children aged 6-18 years.

Updated Recommendations for Use of VariZIG in the United States: In December 2012, the Food and Drug Administration (FDA) approved VariZIG, a varicella zoster immune globulin preparation (Cangene Corporation, Winnipeg, Canada) for use in the United States for postexposure prophylaxis of varicella for persons at high risk for severe disease who lack evidence of immunity to varicella and for whom varicella vaccine is contraindicated. Previously available under an investigational new drug (IND) expanded access protocol, VariZIG, a purified immune globulin preparation made from human plasma containing high levels of anti-varicella-zoster virus antibodies (immunoglobulin G), is the only varicella zoster immune globulin preparation currently available in the United States. VariZIG is now approved for administration as soon as possible following varicella-zoster virus exposure, ideally within 96 hours (4 days) for greatest effectiveness. CDC recommends administration of VariZIG as soon as possible after exposure to the varicella-zoster virus and within 10 days. CDC also has revised the patient groups recommended by the ACIP to receive VariZIG by extending the period of eligibility for previously recommended premature infants from exposures to varicella-zoster virus during the neonatal period to exposures that occur during the entire period for which they require hospital care for their prematurity. The CDC recommendations for VariZIG use are now harmonized with the American Academy of Pediatrics (AAP) recommendations. The July 19, 2013 MMWR summarizes data on the timing of administration of varicella zoster immune globulin in relation to exposure to varicella-zoster virus and provides the CDC updated recommendations for use of VariZIG that replace the 2007 ACIP recommendations.

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Influenza Information

2013-2014 Influenza Vaccine Information Statements (VIS): The inactivated influenza VIS and the live, intranasal influenza VIS are now available. These VISs are available online, as PDFs, as RTFs (for electronic systems), and on mobile devices. Provider Guidelines for the influenza vaccine VISs will be available soon.

Health Alert Network - Update on Variant Influenza Virus (H3N2v): The first cases of influenza A (H3N2) variant (H3N2v) virus infection this year were reported in June 2013. These cases were associated with exposure to swine at an agricultural fair prior to illness onset. H3N2v viruses with the matrix (M) gene from the 2009 H1N1 pandemic virus were first detected in people in 2011 and were responsible for a multi-state outbreak in the summer of 2012 that resulted in 306 cases, including 16 hospitalizations and one fatality. Genetic sequencing by CDC has confirmed that H3N2v viruses isolated in June 2013 are nearly identical to those detected during the summer of 2012. Most cases of H3N2v identified during 2012 were associated with exposure to pigs at agricultural fairs. Agricultural fairs take place across the United States every year, primarily during the summer months and into early fall. Many fairs have swine barns, where pigs from different places come in close contact with each other and with people. These venues may allow spread of influenza viruses both among pigs and between pigs and people. Data indicate that infected pigs may spread influenza viruses even if they are not symptomatic (e.g., coughing and/or sneezing). Although instances of limited person-to-person spread of this virus have been identified in the past, sustained or community-wide transmission of H3N2v has not occurred. Please visit the July 5, 2013 HAN advisory for the entire article.

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Meetings and Conferences

ACIP Meeting: The most recent ACIP meeting was held June 19-20, 2013, in Atlanta, Georgia. Please visit the ACIP meeting web page for presentation slides, meeting minutes, archived video broadcasts, and additional information. The next ACIP meeting will be held on October 23-24, 2013.

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Resources and Information

Current Issues in Immunization Netconference: Immunization Netconferences are live, one-hour presentations combining an online visualpresentation with simultaneous audio via telephone conference call and a live question and answer session. Internet access and a separate phone line are needed to participate. The most recent netconference was on July 25, 2013. Lisa Grohskopf was the speaker and the topic was Influenza Vaccine Recommendations. Please visit the netconference web page for on-demand replays and additional information.

You Call the Shots Modules: This is a web-based training course that was developed through the Project to Enhance Immunization Content in Nursing Education and Training. The Hepatitis A module, Vaccine Storage and Handling, and Vaccines for Children (VFC) modules have been added within the past few months. Please visit the You Call the Shots web page for additional information. Continuing Education (CE) credit is also available.

New Antibiotic Stewardship Curriculum for Medical Students: With support from CDC, Wake Forest School of Medicine has developed a curriculum for medical students, which focuses on antibiotic resistance, prudent antibiotic use, and common respiratory tract infections. Please visit the Get Smart web page for additional information.

New CDC Websites

  • Diphtheria Website: CDC's diphtheria and diphtheria antitoxin content provides clinicians information on clinical features, medical management, preventive measures, and challenges with this disease.
  • Pneumococcal Website: CDC's pneumococcal disease content provides clinicians with information about the bacteria, risk factors, transmission, clinical features, prevention, diagnosis, management guidelines, and more.

These user-friendly disease websites also provide information for parents, general public, kids, laboratorians, and public health providers. Patients can be referred to the "about" section to learn more about the disease and getting vaccinated.

Redesigned CDC Websites

Adult Vaccine Finder Now Available: If you are interested in letting the public know about vaccines offered at your practice or clinic, please visit the HealthMap Vaccine Finder. The site already includes more than 54,000 locations that provide flu shots and has provided this information to 500,000 users from the general public. The site has been expanded to include 10 additional adult vaccines. You can also register your location on this website.

Adult Immunization Materials: Resource materials are available for order from the Public Health Foundation. Health care providers may find the new prescription pads very helpful. The pad is actually a checklist health care providers can use to counsel patients about which vaccines are right for them. Each sheet lists 17 possible vaccinations and serves as a convenient resource for patients and providers.

Also visit the CDC Vaccines for Adult Patients resource web page, which has various materials available for download to educate and encourage adult patients to get vaccinated. The resources are part of a new vaccines for adults website providing general information on adult vaccination. Targeted groups include young adults (19-26 years), pregnant women, adults with special health conditions, and older adults (60 years and older).

CDC and Medscape Videos: This special series of commentaries is part of a collaboration between CDC and Medscape and is designed to deliver CDC's authoritative guidance directly to Medscape's physicians, nurses, pharmacists, and other health care providers. In this series, experts from CDC offer video commentaries on the current topics important to practicing clinicians. NCIRD has contributed to a variety of commentaries. You will need to sign up as a member to view the videos.

Immunization Resources: Please visit the NCIRD publications ordering form for the latest immunization publications. Copies of the Surveillance of Vaccine-Preventable Diseases DVD, the Parents Guide to Childhood Immunizations, and the 2013 immunization schedules are available for ordering.

CDC Job Openings: CDC is committed to recruiting and hiring qualified candidates for a wide range of immunization and other positions. Researchers, Medical Officers, Epidemiologists, and other specialists are often needed to fill positions within CDC. For a current listing, including international opportunities, please visit CDC’s employment web page.


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