Immunization Works July 2014
Human Papillomavirus Vaccination Coverage Among Adolescents, 2007–2013, and Postlicensure Vaccine Safety Monitoring, 2006–2014, in the United States: Since mid–2006, a licensed human papillomavirus (HPV) vaccine has been available and recommended by the Advisory Committee on Immunization Practices (ACIP) for routine vaccination of adolescent girls at ages 11 or 12 years. Two vaccines that protect against HPV infection are currently available in the U.S. Both the quadrivalent (HPV4) and bivalent (HPV2) vaccines protect against HPV types 16 and 18, which cause 70% of cervical cancers; HPV4 also protects against HPV types 6 and 11, which cause 90% of genital warts. In 2011, the ACIP also recommended HPV4 for the routine vaccination of adolescent boys at ages 11 or 12 years. HPV vaccines can be safely co-administered with other routinely recommended vaccines, and ACIP recommends administration of all age-appropriate vaccines during a single visit. To assess progress with HPV vaccination coverage among adolescents aged 13–17 years, characterize adherence to recommendations for HPV vaccination by the 13th birthday, and describe HPV vaccine adverse event reports received postlicensure, CDC analyzed data from the 2007–2013 National Immunization Survey-Teen (NIS-Teen) and national postlicensure vaccine safety data among females and males. Vaccination coverage with more than one dose of any HPV vaccine increased significantly from 53.8% (2012) to 57.3% (2013) among adolescent girls and from 20.8% (2012) to 34.6% (2013) among adolescent boys. Receipt of more than one dose of HPV among girls by age 13 years increased with each birth cohort; however, missed vaccination opportunities were common. Had HPV vaccine been administered to adolescent girls born in 2000 during healthcare visits when they received another vaccine, vaccination coverage for more than one dose by age 13 years for this cohort could have reached 91.3%. Postlicensure monitoring data continue to indicate that HPV4 is safe. Improving practice patterns so that clinicians use every opportunity to recommend HPV vaccines and address questions from parents can help realize reductions in vaccine-preventable infections and cancers caused by HPV. Please read the July 25 MMWR for the full report.
National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years in the United States, 2013: The ACIP recommends that adolescents routinely receive one dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine, two doses of meningococcal conjugate (MenACWY) vaccine, and three doses of HPV vaccine. ACIP also recommends administration of “catch-up” vaccinations, such as measles, mumps, and rubella (MMR), hepatitis B, and varicella, and, for all persons aged six months and older, an annual influenza vaccination. ACIP recommends administration of all age-appropriate vaccines during a single visit. To assess vaccination coverage among adolescents aged 13–17 years, CDC analyzed data from the 2013 National Immunization Survey-Teen (NIS-Teen). The July 25 MMWR summarizes the results of that analysis, which show that from 2012 to 2013, coverage increased for each of the vaccines routinely recommended for adolescents: from 84.6% to 86.0% for more than one Tdap dose; from 74.0% to 77.8% for more than one MenACWY dose; from 53.8% to 57.3% for more than one HPV dose among females, and from 20.8% to 34.6% for more than one HPV dose among males. Coverage varied by state and local jurisdictions and by U.S. HHS region. Healthy People 2020 vaccination targets for adolescents aged 13–15 years were reached in 42 states for more than one Tdap dose, 18 for more than one MenACWY dose, and 11 for more than two varicella doses. No state met the target for more than three HPV doses. Use of patient reminder and recall systems, immunization information systems, coverage assessment and feedback to clinicians, clinician reminders, standing orders, and other interventions can help make use of every healthcare visit to ensure that adolescents are fully protected from vaccine-preventable infections and cancers, especially when such interventions are coupled with clinicians’ vaccination recommendations.
National Immunization Awareness Month (NIAM): NIAM is an annual observance to highlight the value of immunization across the lifespan. Activities focus on encouraging people of all ages to protect their health and the health of their loved ones by getting immunized against vaccine-preventable diseases. The recent measles outbreaks in the U.S. underscore the importance of high vaccination coverage levels to protect our nation’s health. NIAM is an opportunity to raise awareness about the benefits of immunization.
This year, the National Public Health Information Coalition (NPHIC) is coordinating NIAM activities across the country. NPHIC has collaborated with CDC’s National Center for Immunization and Respiratory Diseases (NCIRD) to develop a communication tool kit with key messages, FAQs, sample media materials, social media messages, and other resources to help you celebrate NIAM and promote vaccination. The tool kit also contains specific information for each of the month’s weekly themes: babies and pregnant women (August 3–9), children, preteens, and teens (August 10–16), young adults (August 17–23), and adults (August 24–30). Share your plans for NIAM by completing this online form and see what other organizations have planned.
Visit the NIAM website to access these resources and learn more.
Vaccine Storage and Handling Education Resources: CDC has released vaccine storage and handling resources to help 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 toolkit was updated in June 2014.
Vaccine Storage and Handling Fact Sheets: 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 firstname.lastname@example.org.
Interim CDC Guidance for Polio Vaccination for Travel to and from Countries Affected by Wild Poliovirus: In the prevaccine era, infection with wild poliovirus (WPV) was common worldwide, with seasonal peaks and epidemics in the summer and fall in temperate areas. The incidence of poliomyelitis in the U. S. declined rapidly after the licensure of inactivated polio vaccine (IPV) in 1955 and live oral polio vaccine (OPV) in the 1960s. The last cases of indigenously acquired WPV in the U. S. occurred in 1979, the last WPV case in a U.S. resident traveling abroad occurred in 1986, and the last WPV imported case was in 1993. Since 2000, the U. S. has exclusively used IPV, resulting in prevention of 8–10 vaccine-associated paralytic poliomyelitis cases annually.
The July 11 MMWR provides an update on CDC policy for polio vaccination of travelers for health protection. It also provides additional interim guidance for physicians whose U.S. resident patients will travel to or reside in affected countries longer than four weeks. Evidence of polio vaccination (with IPV or OPV) within 12 months of travel might be required for those patients when they depart from countries with active poliovirus transmission. This interim guidance is to ensure compliance with WHO International Health Regulations temporary recommendations for countries designated as “polio-infected” to reduce the risk for exportation of WPV from those countries.
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 that this conference will be limited to approximately 800 people.
Flu Season Resources: CDC provides a variety of free materials for all audiences, including print, audio/video, social media tools, and web tools. This includes 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 share ideas with others.
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 email@example.com.
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.
CDC Twitter Chat—Vaccinating Teens and Preteens: On Monday, July 28, from 3–4 p.m. EST, @CDCizlearn will host a Twitter #vaxchat with healthcare providers, state/local health departments, health organizations, and medical associations on vaccinating teens and preteens. In this peer-to-peer conversation, we’ll identify barriers, relay strategies, and share resources on how to better serve patients and their families.
The chat will follow CDC’s July 24 release of new data on vaccine coverage for U.S. teens. Let’s take this opportunity as a healthcare community to discuss how to overcome obstacles and increase the number of preteens and teens protected from vaccine-preventable diseases.
Please RSVP at http://twtup.com/CDCteenvax and use the hashtag #vaxchat to participate.
Follow @CDCizlearn on Twitter for immunization news, education, and recommendations across the lifespan.
NVAC Global Immunizations Report: Global immunization programs have considerable impact on reducing child mortality and improving the lives of people everywhere. Public Health Reports is pleased to publish this special supplement [4.7 MB, 91 pages] presenting a comprehensive report from the National Vaccine Advisory Committee (NVAC) on the contributions of HHS toward global immunizations. The NVAC provides recommendations and highlights priority areas for HHS to enhance U.S. efforts toward preventing vaccine-preventable diseases worldwide. The analysis provided in the report is intended to build awareness and support for HHS activities as they contribute overall to our national global health goals, and highlight areas for potential collaboration with global partners.
Public Health Vaccinology Course: You are invited to attend a Public Health Vaccinology Course on September 3–4, 2014, in Atlanta, Georgia. The course, sponsored by NCIRD, will focus on: the biologic basis of vaccine development; vaccine licensure and recommendations; specific vaccines and vaccine-preventable diseases; immunization program implementation; vaccine hesitancy and risk communication; vaccine safety issues; global vaccines; and maternal immunization. Space is limited, so early registration is recommended. Continuing Medical Education (CME) will be available for the course.
ACIP Meeting: Please visit the ACIP meeting web page for agendas, presentation slides, meeting minutes, archived video broadcasts, and additional information. The next ACIP meeting will be October 29–30, 2014. ACIP will also host a webinar, “Use of Pneumococcal Vaccines in Adults” on August 13. Please visit the ACIP web page for additional information.
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 one-hour web-on-demand video. It was posted for CE credit on February 26, 2014, and CE credit is available until February 26, 2016 for immunization providers, including physicians, nurses, nurse practitioners, pharmacists, physician’s assistants, DoD paraprofessionals, medical students, etc.
- Medscape CME—Framing the Conversation with Parents about the HPV Vaccine: This new 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 this activity is to educate clinicians on the importance of the HPV vaccine for children approaching adolescence and to provide strategies to educate parents about the importance of the vaccine for their child’s well-being. (You may need to sign up and log in as a member to participate.)
Adult Immunization Materials: Adult resource materials are available for order from the Public Health Foundation, including a 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 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.
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 12–1 p.m. 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
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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