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					Vaccine Highlights                                                                                           Subscribe to IAC Express!
Recommendations, schedules, and more                                                                           www.immunize.org/subscribe
Editor’s note: The information in Vaccine High-       Control of Influenza in Children, 2010–2011.”
lights is current as of January 3, 2011.              To read the statement, go to http://pediatrics.
                                                      aappublications.org/cgi/reprint/peds.2010-2216v1.
    CDC news                                          On Sept. 17, CDC published “Prevention Strategies
CDC will publish the annually updated Recom-          for Seasonal Influenza in Healthcare Settings.” This                                        Get weekly
mended Adult Immunization Schedule in MMWR            guidance continues to emphasize the importance
                                                      of a comprehensive influenza prevention strategy
                                                                                                                                                   updates on
on February 4, 2011, and the Recommended
Immunization Schedule for Children and Ado-           that can be applied across the entire spectrum of                                              vaccine
                                                      healthcare settings. It supersedes previous CDC
lescents in MMWR on February 11, 2011. For
the past few years, both schedules have been          guidance for both seasonal influenza and the In-                                            information
published in MMWR in January. The move to a           terim Guidance on Infection Control Measures for                                                while
February publication date is expected to be per-      2009 H1N1 Influenza in Healthcare Settings. To
manent, beginning in 2011. The reason is to allow     access the guidance, go to www.cdc.gov/flu/pdf/                                                it’s still
time to update the immunization schedules with        infectioncontrol_seasonalflu_ICU2010.pdf.                                                       news!
recommendations that ACIP makes at its annual         On Sept. 15, CDC published a “Dear Colleague”
late-October meeting.                                 letter; signed by representatives of 10 organiza-
                                                      tions, the letter urges healthcare providers to rec-
    Influenza vaccine news                            ommend influenza vaccination to their pregnant                All the news we publish in
                                                      and postpartum patients this season. To access the        “Vaccine Highlights” will be sent by
Policy Statements Issued for Mandatory                letter, go to www.cdc.gov/flu/pdf/influenza_and_           email to you every Monday. Free!
Healthcare Worker Influenza Vaccination               pregnancy_letter.pdf.                                               To sign up, visit
The following professional societies have re-
cently published mandatory influenza vaccination      On Sept. 27, the Dear Abby column published a             www.immunize.org/subscribe
policies for healthcare workers. To obtain copies     letter from Dr. Deborah Wexler, executive direc-
of these policy statements, click on the URLs be-     tor of the Immunization Action Coalition. The              At the same time, you’ll be able to
low.                                                  letter urges everyone 6 months and older to get               sign up to receive other free
• American Academy of Pediatrics (AAP):               vaccinated against influenza this year. To read                     IAC publications!
  http://pediatrics.aappublications.org/cgi/          the letter in Dear Abby’s column, along with
  content/abstract/peds.2010-2376v1                   Abby’s comments, go to www.uexpress.com/
• American College of Physicians (ACP): www.          dearabby/?uc_full_date=20100927.
  acponline.org/clinical_information/resources/                                                              Current VISs and dates
  adult_immunization/flu_hcw.pdf                       Pneumococcal vaccine news                             The use of most Vaccine Information State-
• Infectious Diseases Society of America (ISDA):                                                             ments (VISs) is mandated by federal law.
  www.idsociety.org/redirector.aspx?id=15413          On Dec. 10, MMWR published “Prevention of
                                                      Pneumococcal Disease Among Infants and Chil-           Listed below are the dates of the most cur-
• Society for Healthcare Epidemiology of Amer-                                                               rent VISs. Check your stock of VISs against
  ica (SHEA): www.journals.uchicago.edu/doi/          dren—Use of 13-Valent Pneumococcal Con-
                                                      jugate Vaccine and 23-Valent Pneumococcal              this list. If you have outdated VISs, print cur-
  full/10.1086/656558                                                                                        rent ones from IAC’s website at www.immu-
                                                      Polysaccharide Vaccine.” To read the recom-
   To read about nearly 100 healthcare settings                                                              nize.org/vis. You’ll find VISs in more than
                                                      mendations, go to www.cdc.gov/mmwr/PDF/rr/
across the nation that have implemented manda-                                                               30 languages.
                                                      rr5911.pdf.
tory influenza vaccination for healthcare workers,                                                           DTaP/DT/DTP.... 5/17/07           MMR ................3/13/08
visit the Immunization Action Coalition’s Honor       IAC has created a table that explains how to use       Hepatitis A ....... 3/21/06       MMRV ..............5/21/10
Roll for Patient Safety at www.immunize.org/          PCV13 to catch up children who have fallen             Hepatitis B ...... 7/18/07        PCV ...................4/16/10
honor-roll.                                           behind on their PCV7 doses. It is available            Hib ................ 12/16/98     PPSV ............... 10/6/09
                                                      at www.immunize.org/catg.d/p2016.pdf. In               HPV (Cervarix) ... 3/30/10        Polio .................. 1/1/00
On Oct. 29, CDC published a large-print version
                                                      addition, IAC has a standing orders protocol for       HPV (Gardasil) .... 3/30/10       Rabies ............. 10/6/09
of the 2010–11 VIS for trivalent inactivated
                                                      administering PCV vaccine to children. Find it at      Influenza (LAIV) ...8/10/10       Rotavirus .......... 12/6/10
influenza vaccine (TIV; injectable). The intent is
                                                      www.immunize.org/catg.d/p3086.pdf.                     Influenza (TIV) ....8/10/10       Shingles ........... 10/6/09
to make it easier for people with reduced vision or
visual acuity to read the VIS. To access it, go to    On Sept. 3, CDC published “Updated Recom-              Japanese encephalitis             Td/Tdap ......... 11/18/08
www.immunize.org/vis/flu_inactive_large_print.pdf.    mendations for Prevention of Invasive Pneu-                Ixiaro ...............3/1/10  Typhoid ............ 5/19/04
  To obtain hundreds of additional VISs in dozens     mococcal Disease Among Adults Using the                    JE VAX............3/1/10      Varicella .......... 3/13/08
of languages, visit www.immunize.org/vis.             23-Valent Pneumococcal Polysaccharide Vac-             Meningococcal...1/28/08           Yellow fever .... 11/9/04
                                                      cine (PPSV23).” To read the updated recom-                            Multi-vaccine VIS ......9/18/08
In the October issue of Pediatrics, the American                                                                            (for 6 vaccines given to infants/children:
                                                      mendations, go to www.cdc.gov/mmwr/PDF/wk/                            DTaP, IPV, Hib, HepB, PCV, RV)
Academy of Pediatrics (AAP) published “Policy
Statement—Recommendations for Prevention and
                                                      mm5934.pdf and see pages 1102–06.                                                                                    
                                                                                                                                                     (continued on page 5)


4    NEEDLE TIPS • January 2011 • Immunization Action Coalition • (651) 647-9009 • www.immunize.org • www.vaccineinformation.org
                                                                                                    Vaccine Highlights . . . continued from page 4


                                                     On Nov. 17, CDC released “2009 Adult                   tetanus with and without pertussis are presented
  Rotavirus vaccine news                             Vaccination Coverage, National Health Interview        overall and by selected characteristics (i.e.,
On Dec. 6, CDC published an updated edition of       Survey (NHIS).”        Estimates of vaccination        age, vaccination target group status, and race/
the interim VIS for rotavirus vaccine. It includes   coverage for hepatitis A, hepatitis B, herpes zoster   ethnicity). To access the key findings and other
information about a possible increased risk of       (shingles), human papillomavirus, influenza            information from the NHIS survey, go to www.
intussusception among vaccine recipients and re-     (2008–09 season), pneumococcal disease, and            cdc.gov/vaccines/stats-surv/nhis/2009-nhis.htm.
vised wording on porcine circovirus, along with
several minor changes.
  Because the updated edition of the VIS refers                 New Handouts from the Immunization Action Coalition in 2010
to a potential adverse event not mentioned in the              IAC developed the following handouts for healthcare professional staff and/or the
previous edition, CDC recommends that only the                           general public. Download, print, and distribute them freely.
updated edition be used starting immediately. To
access the VIS, go to www.immunize.org/vis/            • Evidence shows vaccines unrelated to autism        • Vaccines with diluents: How to use them
vis_rotavirus.asp.                                       www.immunize.org/catg.d/p4028.pdf                    www.immunize.org/catg.d/p3040.pdf

                                                       • Personal belief exemptions for vaccination         • Recommendations for pneumococcal vaccine
                                                                                                              use in children
 Vaccine coverage 2009                                   put people at risk. Examine the evidence
                                                                                                              www.immunize.org/catg.d/p2016.pdf
                                                         for yourself
On Sept. 17, CDC published “National, State, and         www.immunize.org/catg.d/p2069.pdf                  • Sample text for admission orders for hepa-
Local Area Vaccination Coverage Among Chil-                                                                   titis B vaccine birth dose in newborn nursery
dren Aged 19–35 Months—United States, 2009”            • Need help responding to vaccine-hesitant par-        www.immunize.org/catg.d/p2131.pdf
in MMWR, Vol. 59 (36). The National Immuni-              ents? Science-based materials are available
zation Survey (NIS) provides vaccination cover-          from these respected organizations                 Don’t miss Slide Set of Vaccine-Preventable Diseases
age estimates for children ages 19–35 months for         www.immunize.org/catg.d/p2070.pdf                  www.immunize.org/resources/res_powerpoint.asp
each of the 50 states and 17 selected urban areas.
To access the NIS report, go to www.cdc.gov/           To access all IAC’s handouts (more than 250), go to www.immunize.org/handouts
mmwr/preview/mmwrhtml/mm5936a2.htm.



Ask the Experts . . . continued from page 1
months after the Tdap dose given at age 11 years.    11–12-year-old visit. (The Td dose for 11–12-          in subsequent years) to allow time to update the im-
After that, the child needs a booster dose of Td     year-olds was replaced by Tdap in 2006.) Current       munization schedules with recommendations that
every 10 years. An easy way to determine how to      data now indicate that the protection provided by      ACIP makes at its annual late-October meeting.
catch-up a child is to consult “Recommended Im-      MCV4 wanes within 5 years following vaccina-
                                                                                                            When we have to give multiple injections, can
munization Schedules for Persons Aged 0 Through      tion. For this reason, in October 2010, ACIP voted
                                                                                                            we give two in the same limb?
18 Years, U.S.” The schedule is approved by CDC,     to recommend an MCV4 vaccine booster dose to
                                                                                                            If a patient requires more than one vaccine, ACIP
AAP, and AAFP and is released early in each          provide continuing protection during the peak years
                                                                                                            and AAP consistently recommend administering all
calendar year. It includes a catch-up schedule for   of vulnerability.
                                                                                                            needed vaccines during a single office visit (unless
children who have fallen behind (see www.cdc.
                                                     We recently vaccinated an asplenic 65-year-            there are contraindications or precautions). If you
gov/vaccines/recs/schedules/child-schedule.htm).     old man against Neisseria meningitidis;                have the option of giving the vaccines in different
                                                     unfortunately, we gave him MCV4, which isn’t           anatomic sites, do so. If you need to give multiple
 Meningococcal vaccines                              licensed for people older than 55. Should we           injections in the same limb, separate two intra-
                                                     now give him a dose of meningococcal poly-
I understand that ACIP recently voted to
                                                                                                            muscular injections by 1 inch or more in the body
                                                     saccharide vaccine (MPSV4; Menomune)?
recommend administering a routine booster                                                                   of the muscle, if possible, to reduce the likelihood
                                                     No. Though giving MCV4 to a 65-year-old is
dose of quadrivalent meningococcal conju-                                                                   of local reactions overlapping. Likewise, separate
                                                     off-label and a vaccine administration error, there
gate vaccine (MCV4) to all teens. Can you tell                                                              two subcutaneous injections by 1 inch or more in
                                                     is no need to repeat the dose. The error should be
me more?                                                                                                    the fatty tissue.
                                                     documented in the medical record, and the patient
At its October 2010 meeting, ACIP voted to recom-
                                                     should be informed. Make sure staff are trained so     You recently published a Q&A about cleaning
mend that providers administer the initial dose of
                                                     this error is not repeated. MCV4 is not approved       the vaccine vial stopper with an alcohol wipe
MCV4 to all adolescents at age 11–12 years with                                                             after removing the protective cap from a vac-
                                                     by FDA for people 56 years and older. People this
a booster dose at age 16 years.
                                                     age should receive meningococcal polysaccharide
                                                                                                                                            (continued on page 18)
Why did ACIP vote to recommend a routine             vaccine (MPSV4).
booster dose of MCV4 for adolescents age 16
years and older?
In October 2005, ACIP recommended routine
                                                      General vaccine questions
MCV4 vaccination for all adolescents at ages         When will the 2011 recommended immuniza-                       Needle Tips correction policy
11–12 years to protect them from meningococcal       tion schedules for children, adolescents, and             If you find an error, please notify us immediately by
disease as older teens. The peak age for menin-      adults be published?                                      sending an email message to admin@immunize.org.
gococcal disease is 16–21 years. In 2005, ACIP       The publication of these schedules in CDC’s               We publish notification of significant errors in our
reasoned that higher MCV4 vaccination rates                                                                    email announcement service, IAC Express. Be sure
                                                     MMWR is expected in early February 2011. Pub-
                                                                                                               you’re signed up for this service. To subscribe, visit
could be achieved if administering the dose were     lication of the annual schedules has been moved to        www.immunize.org/subscribe.
coupled with giving the Td booster dose at the       February this year (and probably will continue to be

NEEDLE TIPS • January 2011 • Immunization Action Coalition • (651) 647-9009 • www.immunize.org • www.vaccineinformation.org                                             5

				
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