Immunization Works June 2014
Vaccine Storage and Handling Education Resources: CDC has released new vaccine storage and handling resources to help all vaccine providers maintain the potency and viability of the nation’s vaccine supply. The resources are based on best practices and reflect the latest ACIP guidelines and manufacturer recommendations. CDC worked with the provider community on the content and design of these resources and, using audience research and instructional designers, crafted these resources to be clear for all audiences.
Updated Vaccine Storage and Handling Toolkit: From guidance to checklists to draft plans, this detailed document[4.3 MB, 109 pages] contains almost everything you need to know about vaccine storage and handling. The document was updated in June 2014.
Vaccine Storage and Handling Fact Sheets: The four storage and handling fact sheets illustrate best practices for both refrigerated and frozen vaccines. Written in plain language, they include assessments to reinforce key points. While the fact sheets are CDC-developed and branded, each contains an area where you can insert your organization’s logo.
On-Demand Training Video—Keys to Storing and Handling Your Vaccine Supply: The “Keys to Storing and Handling Your Vaccine Supply” on-demand training video highlights storage and handling recommendations and best practices to help providers protect their patients.
Vaccines are among the most powerful tools available to protect patient and public health. Proper storage and handling helps ensure vaccine potency. Vaccines are fragile, and storage and handling errors are costly. Reduced vaccine potency may leave patients unprotected from diseases such as pertussis, measles, and HPV.
Please visit the vaccine storage and handling resources web page for additional information and updates. Keep the vaccine storage and handling conversation going on Twitter @CDCIZLearn, and send your vaccine questions to email@example.com.
Use of MenACWY-CRM Vaccine in Children Age 2 through 23 Months at Increased Risk for Meningococcal Disease: During its October 2013 meeting, the Advisory Committee on Immunization Practices (ACIP) recommended use of a third meningococcal conjugate vaccine, MenACWY-CRM (Menveo, Novartis), as an additional option for vaccinating infants age 2 through 23 months at increased risk for meningococcal disease.
MenACWY-CRM is the first quadrivalent meningococcal conjugate vaccine licensed for use in children age 2 through 8 months. MenACWY-D (Menactra, Sanofi Pasteur) is recommended for use in children aged 9 through 23 months who are at increased risk for meningococcal disease, and Hib-MenCY-TT (MenHibrix, GlaxoSmithKline) is recommended for use in children aged 6 weeks through 18 months at increased risk.
The June 20 MMWR summarizes information on MenACWY-CRM administration in infants and provides recommendations for vaccine use in infants age 2 through 23 months who are at increased risk for meningococcal disease. Because the burden of meningococcal disease in infants is low in the U.S. and the majority of cases that do occur are caused by serogroup B, which is not included in any vaccine licensed in the U.S., only those infants who are at increased risk for meningococcal disease are recommended to receive a meningococcal vaccine.
Measles in the United States from January 1–May 23, 2014: Measles is a highly contagious, acute viral illness that can lead to serious complications and death. Although measles elimination (i.e., interruption of year-round endemic transmission) was declared in the U.S. in 2000, importations of measles cases from endemic areas of the world continue to occur, leading to secondary measles cases and outbreaks in the U.S., primarily among unvaccinated persons. To update national measles data in the U.S., CDC evaluated cases reported by states from January 1 through May 23, 2014. A total of 288 confirmed measles cases have been reported to CDC, surpassing the highest reported yearly total of measles cases since elimination (220 cases reported in 2011). Fifteen outbreaks accounted for 79% of cases reported, including the largest outbreak reported in the U.S. since elimination (138 cases and ongoing). The large number of cases this year emphasizes the need for healthcare providers to have a heightened awareness of the potential for measles in their communities and the importance of vaccination to prevent measles. Please read June 6 MMWR for the full report.
Progress Toward Measles Elimination in the Eastern Mediterranean Region, 2008–2012: In 1997, the 22 countries in the World Health Organization (WHO) Eastern Mediterranean Region (EMR) adopted a goal of measles elimination by 2010. To achieve this goal, the WHO Regional Office for the Eastern Mediterranean Region (EMRO) developed a four-pronged strategy:
- achieve more than 95% vaccination coverage of children with the first dose of measles-containing vaccine (MCV1) in every district of each country through routine immunization services,
- achieve more than 95% vaccination coverage with the second dose of measles-containing vaccine (MCV2) in every district of each country either through a routine 2-dose vaccination schedule or through supplementary immunization activities (SIAs),
- conduct high-quality, case-based surveillance in all countries, and
- provide optimal clinical case management, including supplementing diets with vitamin A.
Although significant progress was made toward measles elimination in the EMR during 1997–2007, the measles elimination goal was not reached by the target date of 2010, and the date was revised to 2015. The June 13 MMWR updates previous reports and summarizes the progress made toward measles elimination in EMR during 2008–2012. From 2008 to 2012, large outbreaks occurred in countries with a high incidence of measles, and reported annual measles cases in EMR increased from 12,186 to 36,456. To achieve measles elimination in EMR, efforts are needed to increase 2-dose vaccination coverage, especially in countries with high incidence of measles and in conflict-affected countries, and to implement innovative strategies to reach populations at high risk in areas with poor access to vaccination services or with civil strife.
National Immunization Conference—United States Immunization in a Time of Change (NIC-USITC): CDC, the Task Force for Global Health, and the CDC Foundation will host the NIC-USITC September 29–30, 2014, at the Crowne Plaza Ravinia in Atlanta, Georgia.
This two-day conference with four plenary sessions, 18 breakout sessions, two immunization Q&A sessions, and the Hilleman Lecture will highlight the following major topics:
- Immunization communications with partners and the general public
- Issues related to the immunization of adults
- Current status of vaccine-preventable diseases in the United States
- Global immunization
- HPV vaccine communication, science, and safety
- Advances in information technology
- Improving vaccine management and accountability
- Quality improvement in vaccine programs
Please note this conference will be limited to approximately 800 people.
Influenza Activity in the United States During the 2013–14 Season and Composition of the 2014–15 Influenza Vaccines: During the 2013–14 influenza season in the U.S., influenza activity increased through November and December before peaking in late December. Influenza A (H1N1)pdm09 (pH1N1) viruses predominated overall, but influenza B viruses and, to a lesser extent, influenza A (H3N2) viruses also were reported in the U.S. This influenza season was the first since the 2009 pH1N1 pandemic in which pH1N1 viruses predominated, and was characterized overall by lower levels of outpatient illness and mortality than influenza A (H3N2)-predominant seasons, but higher rates of hospitalization among adults aged 50–64 years compared with recent years.
The Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee has determined that the 2014–15 influenza vaccines used in the U.S. have the same antigenic composition as those used in 2013–14. The trivalent vaccines should contain an A/California/7/2009-like (2009 H1N1) virus, an A/Texas/50/2012-like (H3N2) virus, and a B/Massachusetts/2/2012-like (B/Yamagata lineage) virus. The committee also recommended that quadrivalent vaccines contain a B/Brisbane/60/2008-like (B/Victoria lineage) virus. These recommendations were based on global influenza virus surveillance data related to epidemiology, antigenic and genetic characteristics, serologic responses to 2013–14 seasonal vaccines, and the availability of candidate vaccine viruses and reagents.
Please read the June 6 MMWR for the full report.
Modeling Influenza Vaccine Administration: CDC is seeking input from state immunization programs to better understand vaccine administration capacity at the state level and improve pandemic influenza vaccine planning. Improving influenza vaccination coverage is a key goal of pandemic planning, as vaccination remains the most effective method to prevent flu-related illness, hospitalization, and death. In order to improve pandemic influenza vaccination coverage, planners could benefit from understanding current vaccine administration capacity and identifying ways to maximize that capacity in the event of a pandemic. To that end, we developed a computer simulation model to predict influenza vaccination capacities. The model explores the use of community pharmacists administering vaccines to increase vaccination capacity. By changing inputs in the preliminary model, we predicted how many adults and children could be vaccinated each week by non-pharmacy vaccine provider sites (hospitals, doctors’ offices, clinics, health departments, workplaces, and schools) and retail pharmacies. We also forecasted the time required to achieve 80% vaccination coverage for one dose. Preliminary results indicated the inclusion of community pharmacists administering vaccines could increase weekly vaccination capacity as much as 50% and reduce the time to reach 80% vaccination coverage by approximately eight weeks.
The model currently provides national capacity estimates. With new input from state partners, however, it could prove useful for state pandemic planners. We recently began comparing model results with estimates developed by immunization program staff from selected states to generate meaningful vaccine administration capacity estimates for each state to inform pandemic planning activities. We are currently seeking additional state partners for this project. In addition to potentially improving pandemic preparedness at the state and local level, work on this project would also count toward activities related to Section 317 program preparedness requirements. If you are interested, we welcome your expertise to help us refine model inputs and improve our final results. Please contact Dr. Joy Schwerzmann for more information.
Flu Season Resources: CDC provides a variety of free materials for all audiences, including print, audio/video, social media tools, and web tools. CDC has added new flu promotional materials for grassroots outreach to health-disparate populations. Order these resources and more at the free flu resources web page; it’s one-stop shopping for up-to-date flu information!
Also, check out our flu partner website, where partners enter activities into the calendar of events for the flu season. Submit your flu prevention activities/events and see what others have submitted.
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 healthcare providers.
Health Map Vaccine Finder: Help consumers find flu vaccine within their communities by referring them to the Health Map Vaccine Finder.
Healthcare 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 how to mirror CDC Web content on your site 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 July 30, 2014. Please visit the netconference web page for additional information and archived webcasts.
ACIP Meeting: Please visit the ACIP meeting web page for agendas, presentation slides, meeting minutes, archived video broadcasts, and additional information on the June 25–26 meeting, as well as upcoming meetings.
National Immunization Awareness Month: August is National Immunization Awareness Month (NIAM), which will provide an opportunity to raise awareness of the importance of immunization and the need for improving national vaccination coverage levels. The National Public Health Information Coalition, in collaboration with CDC, has developed a National Immunization Awareness Month Communication Toolkit that includes key messages, vaccine information, sample news releases and articles, sample social media messages, and links to web resources from CDC and other organizations.
Vaccines for Preteens and Teens: CDC understands that a strong recommendation for HPV vaccine from a healthcare provider can make an impact on vaccination rates, but we know there can be some challenges with messaging. To remedy these challenges, CDC has developed two new CME courses to assist doctors, nurses, and other healthcare providers in effectively speaking with patients and their parents about HPV vaccine.
- Continuing Education Opportunity: You Are the Key to HPV Cancer Prevention: This is a web-on-demand video which is approximately one hour in length. It was posted for CE credit on February 26, 2014, and CE credit is available until February 26, 2016. Credit is available for immunization providers, including physicians, nurses, nurse practitioners, pharmacists, physician’s assistants, DoD paraprofessionals, medical students, etc.
- COMING SOON: Medscape CME—How to Make the Recommendation:
This CME activity is for pediatricians, family physicians, nurses, and other healthcare providers who care for adolescent patients in their practice or clinic. The goal of the CME is to enhance decision-making skills and knowledge, building both confidence and competence in the care of adolescent patients. Included in this CME are Skill-building Video Vignettes, custom-developed videos illustrating provider-patient encounters that demonstrate educational gaps that cannot be as effectively achieved with text alone, such as clinician/patient communication.
Adult Immunization Materials: Adult resource materials are available for order from the Public Health Foundation, including a new prescription pad with a checklist healthcare 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 Healthcare 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 healthcare providers. In this series, experts from CDC offer video commentaries on the current topics important to practicing clinicians. You may need to sign up and log in as a member to view the videos. Registration is free.
CDC Announcement: The Community Preventive Services Task Force recently posted new information on its website—Increasing Appropriate Vaccination: Immunization Information Systems (IIS).
Upcoming Webinar: Please join the American College of Obstetricians and Gynecologists (ACOG) for a webinar, “The Immunization Business and Clinical Strategies for Ob-Gyn Practices” on July 30, 2014, from noon-1pm EST. Topics covered will include coding/billing procedures, vaccine purchasing strategies, storage and handling, and state immunization registries. You will need to register for this webinar, which is sponsored by ACOG’s Immunization Program in collaboration with the American Academy of Pediatrics (AAP).
Immunization Resources: Publications are available for ordering at CDC-INFO on Demand. You can search for immunization publications by using the “Programs” drop-down menu and selecting “Immunization and Vaccines,” or you can search by “Title.” Numerous items, including the 2014 printed and laminated immunization schedules, the Parents Guide to Childhood Immunizations, and flu campaign materials, can be ordered.
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
Montana Two-Day Epidemiology and Prevention of Vaccine-Preventable Diseases Course (VPD), July 14–16, 2014, Billings, MT
Colorado Two-Day Epidemiology and Prevention of Vaccine-Preventable Diseases Course (VPD), July 30–31, 2014, Breckenridge, CO
Immunization Business and Clinical Strategies for Ob-gyn Practices, July 30, 2014, webinar
Nevada Two-Day Epidemiology and Prevention of Vaccine-Preventable Diseases Course (VPD), October 20–22, 2014, Reno, NV
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