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Issue 1477: February 12, 2020

-TOP STORIES-
* MMWR publishes “Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger—United States, 2020"
* MMWR publishes "Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older—United States, 2020"
* CDC’s "Immunization Schedules" web section provides easy access to information and schedule-related resources
* MMWR publishes “Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak—United States, December 31, 2019–February 4, 2020”
* Early Release MMWR publishes “Persons Evaluated for 2019 Novel Coronavirus—United States, January 2020" on February 7
* MMWR publishes “Human Rabies—Utah, 2018”
* MMWR publishes “Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis, Inactivated Poliovirus, Haemophilus influenzae Type b Conjugate, and Hepatitis B Vaccine, and Guidance for Use in Infants”

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-TOP STORIES-
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MMWR publishes “Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger—United States, 2020”

On February 6, CDC published Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger—United States, 2020 ([link removed]) in MMWR (pages 130–132).

Each year, ACIP updates the immunization schedules to reflect current recommendations for licensed vaccines. In October 2019, ACIP voted to approve the recommended immunization schedules for 2020. The birth through 18 years recommended schedule has been approved by CDC, AAP, AAFP, and ACOG.

Changes in the 2020 child/adolescent immunization schedule include new or revised ACIP recommendations for hepatitis A vaccine, influenza vaccine, meningococcal B vaccine, and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine. Changes also include clarification of the recommendations for diphtheria and tetanus toxoids and acellular pertussis vaccine, Haemophilus influenzae type b vaccine, hepatitis B vaccine, meningococcal ACWY vaccine, and poliovirus vaccine.

The 2020 immunization child/adolescent schedule contains numerous, detailed recommendation changes. For all details regarding the content of the 2020 schedule, view the MMWR article ([link removed]).

You can also view these changes on CDC's Immunization Schedule Changes ([link removed]) web page.

Related Links
* MMWR: Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger—United States, 2020 ([link removed]) (PDF)
* MMWR: Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger—United States, 2020 ([link removed]) (HTML)
* Access the full-color 8-page PDF of the child/adolescent schedule ([link removed])
* Access the Child and Adolescent Schedule web page ([link removed]) on CDC's Immunization Schedules web section ([link removed])

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MMWR publishes “Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older—United States, 2020”

On February 6, CDC published Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older—United States, 2020 ([link removed]) (pages 133–135).

Each year, ACIP updates the immunization schedules to reflect current recommendations for licensed vaccines. In October 2019, ACIP voted to approve the recommended immunization schedules for 2020. The recommended schedule for adults has been approved by CDC, AAP, AAFP, ACOG, and ACNM.

Vaccine changes in the 2020 immunization schedule for adults aged 19 years and older include new or revised ACIP recommendations for hepatitis A vaccine, human papillomavirus vaccine, influenza vaccine, serogroup B meningococcal vaccine, pneumococcal vaccine, and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine. The MMWR article enumerates ([link removed]) the details and changes in these recommendations.

For all details regarding the changes in content and redesign of the 2020 adult schedule, view the MMWR article ([link removed]).

You can also view the changes in the adult schedule on CDC's Immunization Schedule Changes ([link removed]) web page.

Related Links
* MMWR: Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older—United States, 2020 ([link removed]) (PDF)
* MMWR: Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older—United States, 2020 ([link removed]) (HTML)
* Access the full-color 6-page PDF of the adult schedule ([link removed])
* Access the Adult Immunization Schedule ([link removed]) web page on CDC's Immunization Schedules ([link removed]) web section

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CDC’S “IMMUNIZATION SCHEDULES” WEB SECTION PROVIDES EASY ACCESS TO INFORMATION AND SCHEDULE-RELATED RESOURCES

CDC's Immunization Schedules ([link removed]) web section provides easy access to information and schedule-related resources for healthcare providers, parents, and other adults. The following web pages are included in this web section:
* Resources for Health Care Providers ([link removed])
* Child and Adolescent Immunization Schedule ([link removed]) web page, offering a variety of formats
* Adult Immunization Schedule ([link removed]) web page, offering a variety of formats
* Schedule Changes & Guidance ([link removed]) web page

Visit the CDC Immunization Schedules ([link removed]) web section to access the information you are seeking.

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MMWR publishes “Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak—United States, December 31, 2019–February 4, 2020”

CDC published Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak—United States, December 31, 2019–February 4, 2020 ([link removed]) in the February 7 issue of MMWR (pages 140–146). The article's "Summary" box content is reprinted below.

What is already known about this topic?

In December 2019, an outbreak of acute respiratory illness caused by a novel coronavirus (2019-nCoV) was detected in mainland China. Cases have been reported in 26 additional locations, including the United States.

What is added by this report?

Nine of the first 11 U.S. 2019-nCoV patients were exposed in Wuhan, China. CDC expects more U.S. cases.

What are the implications for public health practice?

CDC, multiple other federal agencies, state and local health departments, and other partners are implementing aggressive measures to substantially slow U.S. transmission of 2019-nCoV, including identification of U.S. cases and contacts and managing travelers arriving from mainland China to the United States. Interim guidance is available at [link removed] ([link removed] ) and will be updated as more information becomes available.

Access the MMWR article in HTML format. ([link removed])

Related Links
* Access the MMWR article ([link removed]) ([link removed]) in PDF format
* MMWR main page ([link removed]) provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements
* Visit CDC’s 2019 Novel Coronavirus ([link removed]) main page
* Access CDC's 2019 Novel Coronavirus Situation Summary ([link removed]) web page
* CDC’s 2019 Novel Coronavirus Information for Healthcare Professionals ([link removed]) web page
* Visit WHO’s Novel Coronavirus ([link removed]) main page
* WHO's Novel Coronavirus (2019-nCoV) Technical Guidance ([link removed]) web page

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Early Release MMWR publishes “Persons Evaluated for 2019 Novel Coronavirus—United States, January 2020” on February 7

CDC published Persons Evaluated for 2019 Novel Coronavirus—United States, January 2020 ([link removed]) (pages 1–5) as an early release in February 7 MMWR. The article's "Summary" box content is reprinted below.

What is already known about this topic?

During a 2020 outbreak of novel coronavirus (2019-nCoV) infection, CDC provided consultation to public health officials and health care providers evaluating persons at risk for 2019-nCoV infection.

What is added by this report?

During January 2020, CDC responded to clinical inquiries regarding approximately 650 persons in the United States and tested 210 for 2019-nCoV, one fifth of whom reported no recent travel-related risk but had close contact with a 2019-nCoV patient or a person under investigation for 2019-nCoV in the United States.

What are the implications for public health practice?

Health care providers should remain vigilant regarding possible 2019-nCoV exposure not only among returning travelers, but also among persons in close contact with 2019-nCoV patients in the United States.

Access the complete report:
* In PDF format ([link removed])
* In HTML format ([link removed])

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MMWR publishes “Human Rabies—Utah, 2018”

CDC published Human Rabies—Utah, 2018 ([link removed]) in the February 7 issue of MMWR (pages 121–124). The summary provided to the press is reprinted below.

Human rabies is preventable by early recognition of potential exposures and receipt of postexposure prophylaxis (PEP). Bats are the main source of rabies in the United States. Delayed recognition of a human rabies case in Utah resulted in the possible exposure of 279 people, including 242 health care workers. Exposures were evaluated through an online tool that provided a rapid exposure assessment with minimal personnel time; 74 (31%) potentially exposed health care workers and 30 family and community members received PEP. To prevent human rabies cases and reduce the number of possible secondary exposures and the subsequent need for administering PEP if a case occurs, it is essential to educate the general public about the risk of rabies from bat exposure and to advise health care providers to consider rabies in the differential diagnosis of unexplained neurologic symptoms.

Access the complete report:
* In PDF format ([link removed])
* In HTML format ([link removed])

Related Links
* MMWR Weekly, February 7, 2020 ([link removed]) , ([link removed]) in PDF format
* MMWR main page ([link removed]) provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements

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MMWR publishes “Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis, Inactivated Poliovirus, Haemophilus influenzae Type b Conjugate, and Hepatitis B Vaccine, and Guidance for Use in Infants”

CDC published Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis, Inactivated Poliovirus, Haemophilus influenzae Type b Conjugate, and Hepatitis B Vaccine, and Guidance for Use in Infants ([link removed]) in the February 7 issue of MMWR (pages 136–139). The summary provided to the press is reprinted below.

A new combination vaccine to prevent diphtheria, tetanus, whooping cough, polio, Haemophilus influenzae type b (Hib) disease, and hepatitis B has been licensed, but won’t be available before 2021. In late 2018, the Food and Drug Administration licensed a new combination vaccine that protects against six diseases. In June 2019, the Advisory Committee on Immunization Practices voted to include this vaccine, known as Vaxelis, in the federal Vaccines for Children Program. Vaxelis provides protection against diphtheria, tetanus, whooping cough, polio, Haemophilus influenzae type b (Hib) disease, and hepatitis B. This vaccine is licensed for use in children 6 weeks through 4 years old and is indicated for use in infants at ages 2, 4, and 6 months. Although licensed, the manufacturer has stated that the vaccine will not be commercially available in the United States before 2021.

Access the complete report:
* In PDF format ([link removed])
* In HTML format ([link removed])

Related Links
* MMWR Weekly, February 7, 2020 ([link removed]) , ([link removed]) in PDF format
* MMWR main page ([link removed]) provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements


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Video of the Week
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Brian Shares His Flu Story: Brian had genetic chronic obstructive pulmonary disease, which resulted in his needing a double lung transplant. He knows that he is at increased risk for flu complications because of his chronic disease, so he takes precautions to stay healthy and always gets a flu shot. (Source: American Lung Association)
Visit the VOTW archive ([link removed])
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Follow Us
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Technically Speaking
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Read Dr. Wexler's column for the Vaccine Education Center's monthly newsletter, Vaccine Update

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Vaccinating Adults:
A Step-by-Step Guide
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IAC's 142-page book available for free download ([link removed]) .

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Calendar of Events
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Conferences, meetings, and training opportunities

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Patient Record Cards
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Record cards for patients -- child & teen ([link removed]) , adult ([link removed]) , and lifetime ([link removed]) -- are printed on durable paper and sized to fit in a wallet when folded

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DVD: Immunization Techniques
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Every practice should have this award winning, "how-to" training video

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Protect Newborns Guidebook

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Comprehensive guide Hepatitis B: What Hospitals Need to Do to Protect Newborns ([link removed])

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Editorial Information

Editor
Deborah L. Wexler, MD (mailto:[email protected])

Associate Editors
Carolyn Bridges, MD, MPH (mailto:[email protected])
Sharon Humiston, MD, MPH (mailto:[email protected])

Consulting Editors
Taryn Chapman, MS (mailto:[email protected])
Marian Deegan, JD (mailto:[email protected])
Courtnay Londo, MA (mailto:[email protected])
Jane Myers, MA, EdM (mailto:[email protected])

Assistant Managing Editor
Liv Augusta Anderson, MPP (mailto:[email protected])

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Abbreviations
AAFP: American Academy of Family Physicians
AAP: American Academy of Pediatrics
ACIP: Advisory Committee on Immunization Practices
CDC: Centers for Disease Control and Prevention
FDA: Food and Drug Administration
IAC: Immunization Action Coalition
MMWR: Morbidity and Mortality Weekly Report
NCIRD: National Center for Immunization and Respiratory Diseases
VIS: Vaccine Information Statement
WHO: World Health Organization

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About IAC Express
The Immunization Action Coalition welcomes redistribution of this issue of IAC Express or selected articles. When you do so, please add a note that the Immunization Action Coalition is the source of the material and provide a link to this issue. ([link removed])

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IAC Express is supported in part by Grant No.
6NH23IP922550 from the National Center for Immunization and Respiratory Diseases, CDC. Its contents are solely the responsibility of IAC and do not necessarily represent the official views of CDC. IAC Express is also supported by educational grants from the following companies: AstraZeneca, Inc.; Merck Sharp & Dohme Corp.; Pfizer, Inc.; and Sanofi Pasteur.

IAC Express Disclaimer ([link removed])
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