Immunization Works February 2014
Non-influenza Vaccination Coverage Among Adults in the United States, 2012: Vaccinations are recommended throughout life to prevent vaccine-preventable diseases. However, adult vaccination coverage remains low for most routinely recommended vaccines and well below Healthy People 2020 targets. In October 2013, the Advisory Committee on Immunization Practices (ACIP) approved the adult immunization schedule for 2014. With the exception of influenza vaccination, which is recommended for all adults each year, vaccinations recommended for adults target different populations based on age, health conditions, behavioral risk factors (e.g., injection drug use), occupation, travel, and other indications. To assess vaccination coverage among adults aged 19 years and older for selected vaccines, CDC analyzed data from the 2012 National Health Interview Survey (NHIS). The February 7 MMWR summarizes the results of that analysis by selected characteristics (age, race/ethnicity, and vaccination target criteria).
Influenza vaccination coverage estimates for the 2012–13 influenza season have been published separately. Compared with 2011, only modest increases occurred in Tdap vaccination among adults aged 19–64 years, herpes zoster vaccination among adults aged 60 years and older, and HPV vaccination among women aged 19–26 years; coverage among adults in the United States for the other vaccines did not improve. Racial/ethnic gaps in coverage persisted. Increases in vaccination coverage are needed to reduce the occurrence of vaccine-preventable diseases among adults. The Community Preventive Services Task Force and other authorities have recommended that health care providers incorporate vaccination needs assessment, recommendation, and offer of vaccination into routine clinical practice for adult patients.
Global Control and Regional Elimination of Measles, 2000–2012: In 2010, the World Health Assembly established three milestones toward global measles eradication to be reached by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged one year and older to more than 90% nationally and more than 80% in every district; 2) reduce and maintain annual measles incidence at fewer than five cases per million; and 3) reduce measles mortality by 95% from the 2000 estimate. After the adoption by member states of the South-East Asia Region (SEAR) of the goal of measles elimination by 2020, elimination goals have been set by member states of all six World Health Organization (WHO) regions; and reaching measles elimination in four WHO regions by 2015 is an objective of the Global Vaccine Action Plan (GVAP). The February 7 MMWR updates the previous report for 2000–2011 and describes progress toward global control and regional elimination of measles during 2000–2012. During this period, increases in routine MCV coverage, plus supplementary immunization activities (SIAs) reaching 145 million children in 2012, led to a 77% decrease worldwide in reported measles annual incidence, from 146 to 33 per million population, and a 78% decline in estimated annual measles deaths, from 562,400 to 122,000. Compared with a scenario of no vaccination, an estimated 13.8 million deaths were prevented by measles vaccination during 2000–2012. Achieving the 2015 targets and elimination goals will require countries and their partners to raise the visibility of measles elimination and make substantial and sustained additional investments in strengthening health systems.
CDC encourages organizations to content syndicate rather than copy a PDF version of the schedule onto their websites to share with visitors. Content syndication allows other organizations’ websites to mirror CDC web content, with immediate and automatic updates whenever changes are made on the CDC site. This helps ensure that all schedules are current across the Internet.
Recent Internet searches reveal hundreds of old copies of the schedules; please use this best practice to keep your website up to date. Follow the steps to display the schedules on your site.
Updated Hib and Td VISs: On February 4, CDC released updated Vaccine Information Statements (VISs) for Haemophilus influenzae type B (Hib) and tetanus, diphtheria (Td) vaccines. The updated Hib VIS replaces the 1998 version. The new Td VIS replaces the older Td/Tdap VIS, which had been temporarily pressed into service for Td alone. Because both VISs contain a change in the adverse events section (problems that can happen after any vaccine), it is advisable to begin using the updated VISs immediately.
CDC Press Release—Flu Hit Younger People Particularly Hard This Season: CDC reported in the February 21 MMWR that this influenza season was particularly hard on younger and middle-age adults. People age 18–64 represented 61 percent of all hospitalizations from influenza-up from the previous three seasons when this age group represented only about 35 percent of all such hospitalizations. Influenza deaths followed the same pattern; more deaths than usual occurred in this younger age group.
A second report in this week’s MMWR showed that influenza vaccination offered substantial protection against the flu this season, reducing a vaccinated person’s risk of having to go to the doctor for flu illness by about 60 percent across all ages. “Flu hospitalizations and deaths in younger and middle-aged adults is a sad and difficult reminder that flu can be serious for anyone, not just the very young and old; and that everyone should be vaccinated,” said CDC Director Tom Frieden, M.D., M.P.H. “The good news is that this season’s vaccine is doing its job, protecting people across all age groups.” Please visit the CDC newsroom web page for the full release.
Interim Estimates of 2013–14 Seasonal Influenza Vaccine Effectiveness in the United States: In the United States, annual vaccination against seasonal influenza is recommended for all persons older than six months. Each season since 2004–05, CDC has estimated the effectiveness of seasonal influenza vaccine to prevent influenza-associated, medically attended acute respiratory illness (ARI). The February 21 MMWR uses data from 2,319 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness (Flu VE) Network during December 2, 2013–January 23, 2014, to estimate an interim adjusted effectiveness of seasonal influenza vaccine for preventing laboratory-confirmed influenza virus infection associated with medically attended ARI. During this period, overall vaccine effectiveness (VE) (adjusted for study site, age, sex, race/ethnicity, self-rated health, and days from illness onset to enrollment) against influenza A and B virus infection associated with medically attended ARI was 61%. The influenza A (H1N1)pdm09 (pH1N1) virus that emerged to cause a pandemic in 2009 accounted for 98% of influenza viruses detected. VE was estimated to be 62% against pH1N1 virus infections and was similar across age groups. As of February 8, 2014, influenza activity remained elevated in the United States, the proportion of persons seeing their health care provider for influenza-like illness was lower than in early January but remained above the national baseline, and activity still might be increasing in some parts of the country. CDC and the ACIP routinely recommend that annual influenza vaccination efforts continue as long as influenza viruses are circulating. Persons aged six months and older who have not yet been vaccinated this season should be vaccinated. Antiviral medications are an important second line of defense to treat influenza illness and should be used as recommended among suspected or confirmed influenza patients, regardless of patient vaccination status. Early antiviral treatment is recommended for persons with suspected influenza with severe or progressive illness (e.g., hospitalized persons) and those at high risk for complications from influenza, no matter how severe the illness.
Influenza Activity Update in the United States: Influenza activity in the United States began to increase in mid-November and remained elevated through February 8, 2014. During that time, influenza A (H1N1)pdm09 (pH1N1) viruses predominated overall, while few B and A (H3N2) viruses were detected. The February 21 MMWR summarizes influenza activity in the United States during September 29, 2013–February 8, 2014, and updates the previous summary.
Influenza-Associated Intensive Care Unit Admissions and Deaths in California: The California Department of Public Health (CDPH) conducts surveillance on severe influenza illness among California residents younger than 65 years of age. Severe cases are defined as those resulting in admission to an intensive care unit (ICU) or death; reporting of ICU cases is voluntary, and reporting of fatal cases is mandatory. The February 21 MMWR describes the epidemiologic, laboratory, and clinical characteristics of ICU and fatal influenza cases with symptom onset on or after September 29, 2013, and reported by January 18, 2014 of the 2013–14 influenza season. At the time of this report, local health jurisdictions (LHJs) in California had reported 94 deaths and 311 ICU admissions of patients with a positive influenza test result. The 405 reports of severe cases (i.e., fatal and ICU cases combined) were more than in any season since the 2009 pandemic caused by the influenza A (H1N1)pdm09 (pH1N1) virus.
Flu Season Resources: Are you promoting flu vaccination this season? CDC provides a variety of free materials for all audiences, including print, audio/video, social media tools, and web tools. This season CDC has added new flu promotional materials for grassroots outreach to health-disparate populations. Order these resources and more at the free resources web page; it’s one-stop shopping for up-to-date flu information!
Also, check out our flu partner website, where partners are entering activities into the calendar of events for the 2013–14 flu season. Submit your flu prevention activities/events and see what others are planning now.
You can also visit CDC’s main flu website to access relevant Q&As; learn more about the most recent ACIP recommendations; keep up with national and international flu activity, surveillance, and vaccine coverage data; or view information tailored specifically for health care professionals.
Health Map Vaccine Finder: Need help finding flu vaccine? The Health Map Vaccine Finder helps consumers find flu vaccine within their communities.
Health care providers can register their locations on this site, which now shows availability for more than 38,000 locations. Spread the word to immunization providers about how they can register.
Flu-related questions and information requests (including web content syndication or how to receive updates via subscription) should be directed to CDC at firstname.lastname@example.org.
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 next netconference is scheduled for March 12, 2014. The topics will be Updates on Childhood and Adolescent Immunization Schedules and Updates on Adult Immunization Recommendations and Standards for Adult Immunizations. Please visit the netconference web page for additional information and archived webcasts of past presentations.
You Call the Shots Modules: You Call the Shots is a web-based training course developed through the Project to Enhance Immunization Content in Nursing Education and Training. The Influenza, Vaccine Storage and Handling, and Vaccines for Children (VFC) modules have recently been updated and are now available. Please visit You Call the Shots for additional information and other modules. Continuing Education (CE) credit is available for viewing a module and completing an evaluation.
ACIP Meeting: The next ACIP meeting will be held February 26–27, 2014. Please visit the ACIP meeting web page for the agenda, presentation slides, meeting minutes, archived video broadcasts, and additional information.
New Spanish Language HPV Vaccination Materials: Are you looking for Spanish language materials to better promote awareness of HPV vaccine or educate your community? CDC has created new radio public service announcements that are now available for download. Most of these items can be customized with “tagging” to help identify your organization for local exposure.
There are also several new HPV vaccination posters available in both English and Spanish.
CDC Named Finalist in Prestigious Award Competition: CDC, in collaboration with Kid Risk, Inc., has been named one of six finalist organizations to compete for the 2014 INFORMS Franz Edelman Prize. Now in its 43rd year, the Edelman Award is the world’s most prestigious recognition for excellence in applying analytics and operations research projects to transform companies, entire industries and people’s lives.
On March 30, Dr. Mark Pallansch, director, Division of Viral Diseases; Dr. Stephen Cochi, senior advisor to the director, Global Immunization Division; and Dr. Steven Wassilak, team lead for science, innovation and research, Polio Response, Emergency Operations Center; will present with Kid Risk, Inc. and colleagues, Dr. Kimberly Thompson and Dr. Radboud Duintjer Tebbens, on their project: “Using Integrated Analytical Models to Support Global Health Policies to Manage Vaccine Preventable Diseases: Polio Eradication and Beyond.”
Finalists are chosen on the merits of how analytics methodologies were applied to solve problems, reduce costs, or otherwise improve results in real-world environments. The 2014 Edelman Award winner will be announced at the Edelman Gala on March 31 in Boston. The winner will receive a $10,000 honorarium.
Rotavirus Vaccine Introduction in Africa: Rotavirus is the leading cause of severe diarrhea among children worldwide. Each year, it causes more than 450,000 deaths in children younger than five years of age. Over half of those deaths occur among African children. Two rotavirus vaccines are now available to help prevent severe rotavirus disease among children and are poised to have an incredible impact in African countries. A new supplement to the Pediatric Infectious Disease Journal that was released in January, 2014, highlights the importance of surveillance efforts to monitor rotavirus disease burden as African countries prepare to introduce the vaccines. Articles included in the supplement discuss rotavirus disease burden and rotavirus strain diversity in Africa, as well as provide baseline data on intussusception, a rare adverse event that has been associated with rotavirus vaccines. As the rotavirus vaccines are introduced throughout Africa in the coming years, these studies, along with ongoing surveillance efforts, will provide critical data that can be used to evaluate the impact of the vaccines.
Adult Immunization Materials: Adult resource materials are available for order from the Public Health Foundation, including a new prescription pad with a checklist health care providers can use to counsel patients about which vaccines are right for them. Each sheet on the pad lists 17 possible vaccinations and serves as a convenient resource for patients and providers.
Also visit CDC’s Adult Vaccination Information for Health Care and Public Health Professionals, which has various materials available for download to educate and encourage adult patients to get vaccinated. The resources, along with the new Vaccines for Adults website provide 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, including recently released commentaries titled Considerations for Antimicrobial Prophylaxis After Exposure to Pertussis, featuring Lara Misegades (DBD/MVPDB) and Antibiotics for Acute Otitis Media, featuring Lauri Hicks (DBD/RDB). You may need to sign up and log in as a member to view the videos. Registration is free.
Immunization Resources: NCIRD publications are available for ordering at CDC-INFO on Demand. You can search for immunization publications by using the “Programs” drop down menu (Immunization and Vaccines) or you can search by “Title.” Numerous items, including the Parents Guide to Childhood Immunizations and flu campaign materials, are available for ordering. The 2014 immunization schedules will be available in late March.
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
9th International Symposium on Pneumococci and Pneumococcal Diseases (ISPPD), March 9–13, 2014, Hyderabad, India
2014 Spring Clinical Vaccinology Course, March 21–23, 2014, Seattle, WA
New Hampshire Immunization Conference, March 26, 2014, Manchester, NH
National Infant Immunization Week (NIIW), April 26–May 3, 2014, nationwide
17th Annual Conference on Vaccine Research, April 28–30, 2014, Bethesda, MD
2014 National Adult and Influenza Immunization Summit, May 12–15, 2014, Atlanta, GA
Pennsylvania Immunization Conference, June 19, 2014, Wyomissing, PA
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