Immunization Works August 2013
National and State Vaccination Coverage Among Adolescents Aged 13–17 Years in 2012: At ages 11 through 12 years, the Advisory Committee on Immunization Practices (ACIP) recommends that preteens receive one dose of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine, one dose of meningococcal conjugate (MenACWY) vaccine, and three doses of human papillomavirus (HPV) vaccine. ACIP recommends administration of all age-appropriate vaccines during a single visit. ACIP also recommends that preteens and older adolescents receive an annual influenza vaccine as well as any overdue vaccines (e.g., varicella). To monitor vaccination coverage among persons aged 13–17 years, CDC analyzed data from the National Immunization Survey-Teen (NIS-Teen). The August 30, 2013 MMWR highlights the findings of that analysis. From 2011 to 2012, coverage increased for at least one Tdap vaccine dose (from 78.2% to 84.6%), at least one MenACWY vaccine dose (from 70.5% to 74.0%) and, among males, at least one HPV vaccine dose (from 8.3% to 20.8%). Among females, vaccination coverage estimates for each HPV vaccine series dose were similar in 2012 compared with 2011. Coverage varied substantially among states. Regarding Healthy People 2020 targets for adolescents, 36 states achieved targets for Tdap, 12 for MenACWY, and nine for varicella vaccine coverage. Large and increasing coverage differences between Tdap and other vaccines recommended for adolescents indicate that substantial missed opportunities remain for vaccinating teens, especially against HPV infection. Health care providers should administer recommended HPV and meningococcal vaccinations to boys and girls during the same visits when Tdap vaccine is given. In addition, whether for health problems or well-checks, providers, parents, and adolescents should use every health care visit as an opportunity to review adolescents’ immunization histories and ensure that every adolescent is fully vaccinated.
Vaccination Coverage Among Children in Kindergarten During the 2012–2013 School Year: State and local school vaccination requirements are implemented to maintain high vaccination coverage and minimize the risk from vaccine-preventable diseases. To assess school vaccination coverage and exemptions, CDC annually analyzes school vaccination coverage data from federally funded immunization programs. These awardees include 50 states and the District of Columbia (DC), five cities, and eight U.S.-affiliated jurisdictions. The August 2, 2013 MMWR summarizes vaccination coverage from 48 states and DC and exemption rates from 49 states and DC for children entering kindergarten for the 2012–2013 school year. Forty-eight states and DC reported vaccination coverage, with medians of 94.5% for two doses of measles, mumps, and rubella (MMR) vaccine; 95.1% for local requirements for diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccination; and 93.8% for two doses of varicella vaccine among awardees with a two-dose requirement. Forty-nine states and DC reported exemption rates, with the median total of 1.8%. Although school entry coverage for most awardees was at or near national Healthy People 2020 targets of maintaining 95% vaccination coverage levels for two doses of MMR vaccine, four doses of DTaP vaccine, and two doses of varicella vaccine, low vaccination and high exemption levels can cluster within communities, increasing the risk for disease. Reports to CDC are aggregated at the state level; however, local reporting of school vaccination coverage might be accessible by awardees. These local-level data can be used to create evidence-based health communication strategies to help parents understand the risks for vaccine-preventable diseases and the benefits of vaccinations to the health of their children and other kindergarteners.
Japanese Encephalitis Surveillance and Immunization in Asia and the Western Pacific: Japanese encephalitis (JE) virus is a leading cause of encephalitis in Asia, causing an estimated 67,900 JE cases annually. To control JE, the World Health Organization (WHO) recommends that JE vaccine be incorporated into immunization programs in all areas where JE is a public health problem. For many decades, progress mainly occurred in a small number of high-income Asian countries. Recently, prospects for control have improved with better disease burden awareness as a result of increased JE surveillance and wider availability of safe, effective vaccines. The August 23, 2013 MMWR summarizes the status of JE surveillance and immunization programs in 2012 in Asia and the Western Pacific. Data were obtained from the WHO/United Nations Children’s Fund (UNICEF) Joint Reporting Form (JRF), published literature, meeting reports, and websites. In 2012, 18 (75%) of the 24 countries with areas of JE virus transmission risk conducted at least some JE surveillance, and 11 (46%) had a JE immunization program. Further progress toward JE control requires increased awareness of disease burden at the national and regional levels, availability of WHO-prequalified pediatric JE vaccines, and international support for surveillance and vaccine introduction in countries with limited resources.
National Immunization Awareness Month: August was National Immunization Awareness Month (NIAM). The purpose of this observance was 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.
Manufacturers have begun shipping flu vaccines for the 2013–2014 season. Between 135 million and 139 million doses of vaccine are being produced. While some vaccine will be available in August, ample supplies should be available by September and October. Everyone six months of age and older should get a yearly flu vaccine, ideally by October. Please visit the CDC flu website for all the latest information and updates.
Resources and Information
Current Issues in Immunization Netconference: Immunization netconferences are live, one-hour presentations combining an online visual presentation 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, 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.
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.
Pertussis (Whooping Cough) Infographic in Spanish: Pregnant women now need a Tdap shot during every pregnancy to protect them from pertussis and pass some protection to their newborns. Learn the three best ways to protect babies from whooping cough in this new CDC pertussis infographic available in Spanish.
Redesigned CDC Websites
Vaccine Information Statements: Not only does this site have a new look, but you and your patients can now view mobile-friendly versions of the VISs. The redesigned VIS home page now includes at a glance the edition date for each VIS. Recently updated VISs include provider supplements (e.g., see PCV 13 VIS provider information and Tdap VIS provider information).
ACIP Recommendations: All vaccine-specific recommendations can now be found in one place including current, supplemental, and archived. Provisional recommendations are no longer being prepared and previous provisional recommendations have been incorporated into MMWR published recommendations.
New CDC Websites
Diphtheria Website: CDC’s diphtheria and diphtheria antitoxin content provides clinicians information on clinical features, medical management, preventive measures, and challenges of 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, kids, laboratorians, public health providers, and the general public. Patients can be referred to the “about” section to learn more about the disease and getting vaccinated.
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.
Calendar of Events
Current Issues in Vaccines Webinar, September 11, 2013, Dr. Paul Offit, Vaccine Education Center, Children’s Hospital of Philadelphia
20th Annual Immunize Georgia Conference, September 12, 2013, Pine Mountain, Georgia
Vaccines for Children Conference, September 25, 2013, American Academy of Pediatrics, New Jersey Chapter (registration is closed)
2013 Idaho Immunization Summit, September 30, 2013, Idaho Immunization Program
Got Your Shots? MDH Annual Immunization Conference, October 10–11, 2013, Minnesota Department of Health
Do the Right Thing—Kansas Immunization Conference [2 pages], October 15–17, 2013, Kansas Immunization Program
Annual Vaccine Renaissance Conference, October 16–18, 2013, Institute for Immunology and Informatics at University of Rhode Island
Annual Nevada Health Conference, October 28–30, 2013, Immunize Nevada
Louisiana Shots for Tots Conference, November 7–8, 2013, Louisiana Shots for Tots
Current Issues in Vaccines Webinar, November 13, 2013, Dr. Paul Offit, Vaccine Education Center, Children’s Hospital of Philadelphia
Clinical Vaccinology Course, November 15–17, 2013, National Foundation for Infectious Diseases (NFID), Cambridge, Massachusetts
26th Annual Infectious Diseases in Children Symposium, November 16–17, 2013, Infectious Diseases in Children
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