Immunization Works January 2018

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MMWR
Influenza Information
Resources and Information
Calendar of Events

February 6, 2018: Content on this page kept for historical reasons.

MMWR

ACIP Recommendations for Use of Herpes Zoster Vaccines: On October 20, 2017, Zoster Vaccine Recombinant, Adjuvanted (Shingrix, GlaxoSmithKline [GSK], Research Triangle Park, NC), a 2-dose, subunit vaccine containing recombinant glycoprotein E in combination with a novel adjuvant (AS01B), was approved by the Food and Drug Administration for the prevention of herpes zoster in adults age 50 years and older. The vaccine consists of 2 doses (0.5 ml each), administered intramuscularly, 2–6 months apart. On October 25, 2017, the Advisory Committee on Immunization Practices (ACIP) recommended the recombinant zoster vaccine (RZV) for use in immunocompetent adults age 50 years and older. Please read the January 26 MMWR for the full report.

ACIP Recommendations for the Prevention of Hepatitis B Virus Infection in the U.S.: Hepatitis B virus (HBV) is transmitted via blood or sexual contact. Persons with chronic HBV infection are at increased risk for cirrhosis and liver cancer and require medical care. The January 12 MMWR updates and summarizes previously published recommendations from ACIP and CDC regarding the prevention of HBV infection in the U.S. ACIP recommends testing all pregnant women for hepatitis B surface antigen (HBsAg), and testing HBsAg-positive pregnant women for hepatitis B virus deoxyribonucleic acid (HBV DNA); administration of HepB vaccine and hepatitis B immune globulin (HBIG) for infants born to HBV-infected women within 12 hours of birth, followed by completion of the vaccine series and postvaccination serologic testing; universal hepatitis B vaccination within 24 hours of birth, followed by completion of the vaccine series; and vaccination of children and adolescents age 19 years or less who have not been vaccinated previously. ACIP recommends vaccination of adults at risk for HBV infection, including universal vaccination of adults in settings in which a high proportion have risk factors for HBV infection and vaccination of adults requesting protection from HBV without acknowledgment of a specific risk factor. These recommendations also provide CDC guidance for postexposure prophylaxis following occupational and other exposures. In addition this report briefly summarizes previously published American Association for the Study of Liver Diseases guidelines for maternal antiviral therapy to reduce perinatal HBV transmission.

ACIP Recommendations for use of a Third Dose of Mumps Virus—Containing Vaccine in Persons at Increased Risk for Mumps during an Outbreak: A substantial increase in the number of mumps outbreaks and outbreak-associated cases has occurred in the U.S. since late 2015. To address this public health problem, ACIP reviewed the available evidence and determined that a third dose of measles, mumps, rubella (MMR) vaccine is safe and effective at preventing mumps. During the October 2017 meeting, ACIP recommended a third dose of a mumps virus—containing vaccine for persons previously vaccinated with 2 doses who are identified by public health authorities as being part of a group or population at increased risk for acquiring mumps because of an outbreak. The purpose of the recommendation is to improve protection of persons in outbreak settings against mumps disease and mumps-related complications. The January 12 MMWR supplements the existing ACIP recommendations for mumps vaccination.

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Influenza Information

Flu Season Update: The 2017–18 flu season is well underway. Influenza A(H3N2) viruses are predominant but influenza A(H1N1) and influenza B viruses have been detected also. Influenza-like-illness (LI) activity has continuously increased since early November. As of the week ending January 19, all states but Hawaii are reporting widespread flu activity and 39 states plus New York City and Puerto Rico are experiencing “high” influenza activity. Influenza-like illness levels this season are now higher than what was seen during the peak of the 2012–13 and 2014–15 flu seasons; both also H3N2-predominant seasons that started early. Some severity indicators, including the overall hospitalization rate are now similar to what was seen during the peak of the 2014–15 season. Pneumonia and influenza reported deaths have been elevated for three weeks. Activity is expected to continue for several weeks.

With the sharp increase in influenza A(H3N2) activity in the U.S., CDC released a health advisory emphasizing the importance of its antiviral treatment recommendations this season. The December 27 health advisory published via CDC’s Health Alert Network (HAN) highlights the potential for influenza A(H3N2) virus-predominant seasons to be associated with more hospitalizations and deaths in persons age 65 years and older and young children compared with other age groups. On January 12, CDC hosted a press briefing giving an update on the latest FluView numbers. Dr. Brenda Fitzgerald and Dr. Dan Jernigan provided advice on preventing flu and information about what people can do to reduce the risk of flu or serious illness. Due to the spike in flu cases around the country, the January session of CDC Grand Rounds hosted “Public Health Response to Severe Influenza”. This Grand Rounds provided key and timely information for public health professionals on how to reduce the spread of seasonal flu in communities and adjust to spot shortages in antiviral drugs because of high influenza activity in some areas.

While flu vaccination is the most important way to prevent influenza, antiviral drugs are the most important way to treat influenza infection. Studies have shown that early treatment with a flu antiviral drug can shorten the duration of fever and illness symptoms, and can reduce the risk of serious flu complications. All influenza viruses collected and tested to date this flu season have been sensitive to the recommended antiviral drugs oseltamivir, zanamivir, and peramivir.

For more information on the 2017–18 flu season activity update, follow the Flu Activity and Surveillance on FluView.

Take 3 Actions to Fight Flu: Influenza is a contagious disease that can be serious. CDC recommends the following actions to protect yourself and others from flu.

Take flu antiviral drugs if your doctor prescribes them. People who are at high risk for influenza complications should contact a health care professional promptly if they get flu symptoms, even if they have been vaccinated this season. If you get sick with flu, antiviral drugs can be used to treat your illness. CDC recommends rapid treatment of seriously ill and high risk flu patients with antiviral drugs. It is very important that antiviral drugs are used early to treat hospitalized patients, people with severe flu illness, and people who are at high risk of serious flu complications based on their age or health.
Take every day preventive actions to help stop the spread of germs. If possible, try to avoid close contact with sick people. If you do get sick, limit contact with others as much as possible to keep from infecting them. Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand rub. Also, clean and disinfect surfaces and objects that may be contaminated with germs like flu. Avoid touching your eyes, nose or mouth because germs spread this way. Cover mouth and nose with a tissue when you cough or sneeze.
If you have not gotten a flu vaccine yet this season, get vaccinated now—it’s not too late! As long as flu viruses are circulating, vaccination should continue throughout flu season, even in January or later. Everyone 6 months of age and older is recommended to get vaccinated against flu every year, with rare exceptions. With many more weeks of flu activity expected for this flu season, there is still time to get vaccinated if you haven’t already done so. As long as flu viruses are circulating, vaccination can protect you against flu.

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Resources and Information

ACIP Meeting: The Advisory Committee on Immunization Practices (ACIP) comprises medical and public health experts who develop recommendations for the use of vaccines in the U.S. The recommendations stand as public health guidance for the safe use of vaccines and related biological products. ACIP meetings are held quarterly, and the next meeting will be February 21–22, 2018. Please visit the ACIP meeting web page for additional information, including presentation slides and agendas.

Epidemiology and Prevention of Vaccine-Preventable Diseases, 13^th Edition (the Pink Book): Published by CDC, NCIRD, and the Public Health Foundation (PHF), the Pink Book provides health care professionals with the most comprehensive information available on vaccines and vaccine-preventable diseases. The Pink Book is available for purchase from the PHF Learning Resource CenterExternal, and the chapters and appendices can be viewed/downloaded from the NCIRD vaccines site.

Webinar Series for Pink Book: This online series of 15 webinars provides an overview of vaccination principles, general recommendations, immunization strategies, and specific information about vaccine-preventable diseases and the vaccines that prevent them. Each webinar explored a chapter from the 13th edition of the Pink Book. The webinars started on June 14 and finished on October 11, 2017. All of the recordings can be viewed online at the Pink Book webinar web page. Continuing Education (CE) is available for each webinar.

Vaccine Administration e-Learn: An e-Learn on vaccine administration is now available. Proper vaccine administration is critical for ensuring that vaccines are both safe and effective. Vaccine administration errors happen more often than you might think. Of the average 36,000 reports received annually by the Vaccine Adverse Event Reporting System (VAERS)External, about 1,500 are directly related to administration error.

Some of the most common vaccine administration errors include:

Not following the recommended immunization schedule
Administering improperly stored or expired vaccine and/or diluent
Administering the wrong vaccine—confusing look-alike or sound-alike vaccines such as DTaP/Tdap or administering products outside age indications

The e-Learn is a free, interactive, online educational program that serves as a useful introductory course or a great refresher on vaccine administration. The self-paced e-Learn provides comprehensive training, using videos, job aids, and other resources to accommodate a variety of learning styles, and offers a certificate of completion and/or Continuing Education (CE) for those that complete the training.

For more information, please contact nipinfo@cdc.gov.

Current Issues in Immunization NetConferences: Immunization netconferences are live, one-hour events combining an online visual presentation with simultaneous audio via telephone conference call, along with a live question-and-answer session. Registration, Internet access, and a separate phone line are needed to participate. Please visit the netconference web page for information on upcoming netconferences and to view archived webcasts. The next netconference is scheduled for March 21, 2018.

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 Vaccine Storage and Handling and Vaccines for Children (VFC) modules have recently been updated and are now available. Please visit the You Call the Shots web page for additional information and other modules. Continuing Education (CE) is available for viewing a module and completing an evaluation.

Measles and Mumps Resources: CDC aims to continue increasing awareness of measles and mumps among individuals and families and to encourage MMR vaccination. To support disease prevention and vaccination educational efforts, CDC has developed a variety of measles and mumps resources, including fact sheets, podcasts, and matte articles. Some of the measles graphics are also available in Spanish.

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

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 are available for ordering, including the Parents’ Guide to Childhood Immunizations and various campaign materials.

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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