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Issue 1483: March 11, 2020

-TOP STORIES-
* Brand new! IAC’s laminated 2020 U.S. child/adolescent and adult immunization schedules—order copies for your exam rooms today!
* New Jersey updates its mandate for meningococcal vaccines in colleges and universities
* Huge milestone! IAC enrolls 500th hospital into its Hepatitis B Birth Dose Honor Roll!
* IAC Spotlight! IAC’s PowerPoint Slide Sets web page contains 13 presentations on a wide variety of immunization topics; available by request for your use
* CDC reports flu activity remains high, with elevated hospitalization rates among children and young adults; please continue vaccinating
* Not-to-miss immunization articles in the news
* Stay up to date on the latest coronavirus information from CDC and WHO

-IAC HANDOUTS-
* IAC updates both of its standing orders templates for administering MenACWY vaccine—one for children/teens and the other for adults
* IAC updates “Meningococcal ACWY Vaccine Recommendations by Age and Risk Factor”
* IAC updates a technical piece for healthcare professionals titled “Meningococcal B Vaccine: IAC Answers Your Questions”
* IAC updates its piece for the general public “Meningococcal: Questions and Answers—Information about the Disease and Vaccines”

-FEATURED RESOURCES-
* CDC updates recommendations in its “General Best Practice Guidelines for Immunization”
* CDC releases new patient handout “Talking to Pregnant Women About Vaccines”

-JOURNAL ARTICLES AND NEWSLETTERS-
* “Maximizing the Impact of, and Sustaining Standing Orders Protocols for Adult Immunization in Outpatient Clinics” published in American Journal of Infection Control
* “Combating Vaccine Hesitancy and Other 21st Century Social Determinants in the Global Fight Against Measles” published in Science Direct

-EDUCATION AND TRAINING-
* GSA's "Elevating Understanding of RSV in Older Adults" webinar to be held March 31


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-TOP STORIES-
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BRAND NEW! IAC’S LAMINATED 2020 U.S. CHILD/ADOLESCENT AND ADULT IMMUNIZATION SCHEDULES—ORDER COPIES FOR YOUR EXAM ROOMS TODAY!

IAC's laminated versions of the 2020 U.S. child/adolescent immunization schedule ([link removed]) and the 2020 U.S. adult immunization schedule ([link removed]) are available now.

These schedules are ideal for use in any busy healthcare setting where vaccinations are given. Their tough coating can be wiped down, and they’re durable enough to stand up to a year's worth of use.

The child/adolescent schedule is eight pages (i.e., four double-sided pages) and the adult schedule is six pages (i.e., three double-sided pages), but both schedules fold down to a convenient 8.5" x 11" size.

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With color coding for easy reading, our laminated schedules replicate the original CDC formatting, including the essential tables and notes.

PRICING
1–4 copies: $7.50 each
5–19 copies: $5.50 each
20–99 copies: $4.50 each
100–499 copies: $4.00 each
500–999 copies: $3.50 each

For quotes on customizing or placing orders of 1,000 copies or more, call 651-647-9009 or email [email protected] (mailto:[email protected])

Visit the Shop IAC: Laminated Schedules ([link removed]) web page for more information on the schedules, to view images of all the pages, to download the PDF order form ([link removed]), or to order online.

Related Links
* IAC’s Laminated Child/Adolescent Immunization Schedule ( ([link removed]) 0–18 years) web page
* IAC’s Laminated Adult Immunization Schedule ([link removed]) (19 and older) web page
* IAC’s Shop IAC ([link removed]) section on immunize.org
* IAC’s Laminated Schedules order form (PDF)([link removed])

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NEW JERSEY UPDATES ITS MANDATE FOR MENINGOCOCCAL VACCINES IN COLLEGES AND UNIVERSITIES

On January 13, 2020, New Jersey passed a law updating its mandate for college students to be immunized against meningococcal disease. The new mandate requires all incoming students attending New Jersey colleges or universities to receive meningococcal vaccines in accordance with recommendations of CDC’s Advisory Committee on Immunization Practices.

New Jersey has developed a guidance document ([link removed]) describing the broad requirement for meningococcal ACWY (MenACWY) vaccine and the targeted requirement for meningococcal serogroup B vaccine. Previously, only students residing in dormitories and attending four-year institutions were required to receive MenACWY vaccine.

The updated NJ mandate will take effect on June 15, 2020.

IAC updated its MenACWY Vaccine Mandates for Colleges and Universities ([link removed]) web page to include the new NJ MenACWY mandate.

Related Link
* IAC’s State Laws and Mandates by Vaccine ([link removed]) web section contains tables and maps for 13 routinely recommended vaccines. The tables and maps contain information on state immunization requirements for child care, Pre-K, schools, and colleges/universities.

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HUGE MILESTONE! IAC ENROLLS 500TH HOSPITAL INTO ITS HEPATITIS B BIRTH DOSE HONOR ROLL!

On February 28, Immunization Action Coalition enrolled the St. Joseph's Hospital-South, Riverview, FL (with a birth dose coverage rate of 92%), as the 500th birthing institution into its Hepatitis B Birth Dose Honor Roll. ([link removed])

The Hepatitis B Birth Dose Honor Roll was launched in 2013 and is a key part of IAC’s major initiative urging the nation’s hospitals to Give Birth to the End of Hep B. ([link removed]) Hospitals and birthing centers are recognized for attaining high coverage rates for administering hepatitis B vaccine at birth. To be included in the Hepatitis B Birth Dose Honor Roll, a birthing institution must have:
(1) reported a coverage rate of 90 percent or greater, over a 12-month period, for administering hepatitis B vaccine before hospital discharge to all newborns (including those whose parents refuse vaccination), and (2) implemented specific written policies, procedures, and protocols to protect all newborns from hepatitis B virus infection prior to hospital discharge.

IAC urges qualifying birthing institutions to apply for the Honor Roll ([link removed]).

Honorees are awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IAC Express’s approximately 52,000 readers.

Please visit the Hepatitis B Birth Dose Honor Roll ([link removed]) ([link removed]) web page that lists these institutions and their exceptional efforts to protect infants from perinatal hepatitis B transmission.

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IAC SPOTLIGHT! IAC’S POWERPOINT SLIDE SETS WEB PAGE CONTAINS 13 PRESENTATIONS ON A WIDE VARIETY OF IMMUNIZATION TOPICS; AVAILABLE BY REQUEST FOR YOUR USE

IAC's PowerPoint Slide Sets ([link removed]) web page on immunize.org contains 13 presentations on a variety of immunization topics. These slides are available for your use "as is" or you can modify them to suit your organization's needs. Some of the slide sets include speaker’s notes. Currently the 13 slide sets are available for viewing online in a 6-slide-per-page handout format. The titles and links to the handout-formatted slides are listed below.
* Adolescent Immunization Update and the 16-Year-Old Platform ([link removed])
* Common Immunization Myths and Misconceptions ([link removed])
* Current Issues in Influenza ([link removed])
* Give Birth to the End of Hep B: What Hospitals Need to Do to Protect Newborns ([link removed])
* How to Implement Standing Orders in Your Practice ([link removed])
* The Importance of Minimum Ages and Intervals in the Vaccine Schedule ([link removed])
* A Photo Collection of Vaccine-Preventable Diseases ([link removed])
* Quick Answers to Tough Questions ([link removed])
* Resources to Help Immunization Providers PREVENT Vaccination Errors ([link removed])
* Strategies to Increase Enrollment in IAC's Hepatitis B Birth Dose Honor Roll ([link removed])
* To Err Is Human; Not to Err Is Better! Vaccination Errors and How to Prevent Them ([link removed])
* What Are Standing Orders Protocols? Making a Difference in Adult Immunization Rates ([link removed])
* Why Adult Immunization Matters ([link removed])

To request any of the PowerPoint format slide sets, go to IAC's PowerPoint Slide Sets web page ([link removed]). Just below the presentation's title and description, click on "Request the PowerPoint slide set" and an email request form for the PowerPoint presentation will appear. Complete the form and hit “send.” Once you have submitted your request, we will send you the presentation and, when available, the speaker’s notes. You can edit and use the slides as you see fit. If you change the slides in any way, please acknowledge that the slide set was adapted from the Immunization Action Coalition.

Visit the IAC's PowerPoint Slide Sets web page ([link removed]) on immunize.org to access and begin utilizing these valuable slide sets today!

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CDC REPORTS FLU ACTIVITY REMAINS HIGH, WITH ELEVATED HOSPITALIZATION RATES AMONG CHILDREN AND YOUNG ADULTS; PLEASE CONTINUE VACCINATING

Seasonal influenza activity in the United States remains high but has decreased over the past three weeks. According to CDC's Weekly U.S. Influenza Surveillance Report, FluView ([link removed]), rates of hospitalization among school-aged children and young adults are higher at this time than in recent seasons. Hospitalization rates among children 0–4 years old are the highest CDC has on record at this point in a season, surpassing rates reported during the second wave of the 2009 H1N1 pandemic.

Forty-eight states and Puerto Rico reported widespread activity, with Oregon and Hawaii reporting regional activity.

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A total of 136 influenza-associated pediatric deaths have been reported for the 2019–20 season. Eleven influenza-associated pediatric deaths that occurred during the 2019–20 flu season were reported between weeks 51 and 9 (the weeks ending December 21, 2019, and February 29, 2020).

Influenza vaccination is recommended for everyone 6 months of age and older, so please continue to vaccinate all your patients in this age range. If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to a clinic or pharmacy that provides vaccines or to the HealthMap Vaccine Finder ([link removed]) to locate influenza vaccination services near them.

Related Links:
* CDC's Seasonal Flu web section ([link removed])
* CDC's FluView web section ([link removed])
* CDC's Free Resources related to influenza ([link removed])
* IAC's Influenza Educational Materials ([link removed]) , ([link removed]) free and ready to print
* IAC’s Ask the Experts: Influenza ([link removed]) web page
* IAC’s Vaccines: Influenza ([link removed]) web page
* National Adult and Influenza Immunization Summit ([link removed]) website
* The Summit Buzz: ([link removed]) Newsletter of the National Adult and Influenza Immunization Summit (NAIIS)
* Influenza Vaccine Availability Tracking System—IVATS: ([link removed]) a resource for healthcare settings looking to purchase influenza vaccine (made available from NAIIS)

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NOT-TO-MISS IMMUNIZATION ARTICLES IN THE NEWS

Three articles that appeared in the media recently are particularly compelling in conveying the potential risks of vaccine-preventable diseases and the importance of vaccination.
* HCP Live: Flu Cases Near 30 Million in the US, CDC Reports ([link removed]) (2/28/20)
* Portland [ME] Press Herald: "No" Vote—to Keep State’s New Vaccine Law—Wins by Overwhelming Margin ([link removed]) (3/3/20)
* CT Post: Senate Leaders: Whose "Dark Money" is Funding Vaccine Opponents? ([link removed])

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STAY UP TO DATE ON THE LATEST CORONAVIRUS INFORMATION FROM CDC AND WHO

CDC and WHO are closely monitoring outbreaks of respiratory illness caused by a novel coronavirus (COVID-19) ([link removed]). Be sure to check the resources below for the latest information, and stay in touch with your state health department.

Related Links:
* CDC Coronavirus Disease 2019 (COVID-19) ([link removed]) main page, which links to CDC’s Situation Summary ([link removed]) web page and Latest News ([link removed]) web page
* WHO Coronavirus Disease (COVID-19) Outbreak ([link removed]) main page, which links to WHO’s Situation Reports ([link removed]) web page
* Coronavirus COVID-19 Global Cases by Johns Hopkins CSSE ([link removed]) web page

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-IAC HANDOUTS-
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IAC UPDATES BOTH OF ITS STANDING ORDERS TEMPLATES FOR ADMINISTERING MENACWY VACCINE—ONE FOR CHILDREN/TEENS AND THE OTHER FOR ADULTS

IAS has updated both of its standing orders templates for administering the MenACWY vaccine: Standing Orders for Administering Meningococcal ACWY Vaccine to Children and Teens ([link removed]) and Standing Orders for Administering Meningococcal ACWY Vaccine to Adults ([link removed]) . A small edit was made to both templates in section #1 to add a second complement inhibitor (ravulizumab, Ultomiris; Alexion), which blocks terminal complement activation and may increase risk of encapsulated bacterial infections.

Related Links:
* IAC's Handouts: Meningococcal ACWY Vaccine ([link removed]) web page
* View more than 300 ready-to-print IAC Educational Materials for Patients and Staff ([link removed])
* IAC's Handouts for Patients and Staff ([link removed]) sorted by topic

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IAC UPDATES “MENINGOCOCCAL ACWY VACCINE RECOMMENDATIONS BY AGE AND RISK FACTOR”

IAC recently updated Meningococcal ACWY Vaccine Recommendations by Age and Risk Factor. ([link removed]) A small edit was made in footnote #9 to add a second complement inhibitor (ravulizumab, Ultomiris; Alexion), which blocks terminal complement activation and may increase risk of encapsulated bacterial infections.

Related Links:
* IAC's Handouts: Meningococcal ACWY Vaccine ([link removed]) web page
* View more than 300 ready-to-print IAC Educational Materials for Patients and Staff ([link removed])
* IAC's Handouts for Patients and Staff ([link removed]) sorted by topic

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IAC UPDATES A TECHNICAL PIECE FOR HEALTHCARE PROFESSIONALS TITLED “MENINGOCOCCAL B VACCINE: IAC ANSWERS YOUR QUESTIONS”

IAC updated Meningococcal B Vaccine: IAC Answers Your Questions ([link removed]), a technical piece with information about shared clinical decision making, MenB booster doses for patients at increased risk, and to add a second complement inhibitor (ravulizumab, Ultomiris; Alexion), which blocks terminal complement activation and may increase risk of encapsulated bacterial infections.

Related Links:
* IAC's Handouts: Meningococcal B Vaccine ([link removed]) web page
* View more than 300 ready-to-print IAC Educational Materials for Patients and Staff ([link removed])
* IAC's Handouts for Patients and Staff ([link removed]) sorted by topic

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IAC UPDATES ITS PIECE FOR THE GENERAL PUBLIC “MENINGOCOCCAL: QUESTIONS AND ANSWERS—INFORMATION ABOUT THE DISEASE AND VACCINES”

IAC has updated Meningococcal: Questions and Answers—Information about the Disease and Vaccines ([link removed]). Changes were made to reflect the updated ACIP recommendation to use shared clinical decision-making for patients ages 16 through 23 years, to incorporate the recommendations for booster doses for patients at increased risk, to add a second complement inhibitor (ravulizumab, Ultomiris; Alexion), which blocks terminal complement activation and may increase risk of encapsulated bacterial infections.

Related Links:
* IAC's Handouts: Meningococcal ACWY Vaccine ([link removed]) web page
* IAC's Handouts: Meningococcal B Vaccine ([link removed]) web page
* View more than 300 ready-to-print IAC Educational Materials for Patients and Staff ([link removed])
* IAC's Handouts for Patients and Staff ([link removed]) sorted by topic

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-FEATURED RESOURCES-
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CDC UPDATES RECOMMENDATIONS IN ITS “GENERAL BEST PRACTICE GUIDELINES FOR IMMUNIZATION”
CDC has recently updated its General Best Practice Guidelines for Immunization ([link removed]) with several changes. The General Best Practice Guidelines’ List of Errata/Updates ([link removed]) web page provides a list of all errata and updates that have been made and the dates the changes were made. The list is updated whenever it is determined changes are necessary.

The page numbers correspond to the version in PDF format ([link removed]) .
* Page 23: The recommendation was changed to allow providers to administer a dose of live, injectable vaccine, even if the interval after an antibody-containing blood product is not complete, to induce active protection. Even so, the dose should not count toward needed doses and should be repeated. Serology is no longer recommended to ascertain whether the dose provided protection.
* Page 39 (Table 3-5 Footnotes): The specific source material for understanding antibody quantities in antibody products is now listed. Also listed is the process for determining how to calculate the interval between antibody product and live, injectable vaccine, based on the quantity of antibody in the product.
* Page 55 (Table 4-1): A footnote is placed after HPV vaccine to clarify that HPV vaccine is not recommended during pregnancy.
* Page 115: For response to out-of-range temperature readings, if a non-live vaccine is administered and then found out to have been stored at a deviated temperature, the dose should be repeated and does not need to wait an interval from the invalid dose. An exception to this rule is zoster recombinant vaccine (RZV, Shingrix; GSK), which is a non-live vaccine; such an RZV dose needs to be repeated and does need to wait 4 weeks after the invalid dose.

Related Links
* CDC's General Best Practice Guidelines’ List of Errata/Updates ([link removed]) web page
* Download General Best Practice Guidelines for Immunization ([link removed]) as a PDF document (195 pages, 1.05 MB)
* Access General Best Practice Guidelines for Immunization ([link removed]) section of the CDC's website for the HTML version

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CDC RELEASES NEW PATIENT HANDOUT “TALKING TO PREGNANT WOMEN ABOUT VACCINES”

CDC released a new handout for patients titled Talking to Pregnant Women About Vaccines ([link removed]) to help answer common questions about the use of vaccines during pregnancy.

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It’s part of CDC’s Toolkit for Prenatal Care Providers ([link removed]) which is designed to help ob-gyns, family physicians, and nurse midwives increase rates of maternal immunization.

Related Links
* CDC's Pregnancy and Vaccination Resources for Provider Education ([link removed]) web page
* IAC's Handouts: Pregnancy and Vaccination ([link removed]) web page

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-JOURNAL ARTICLES AND NEWSLETTERS-
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“Maximizing the Impact of, and Sustaining Standing Orders Protocols for Adult Immunization in Outpatient Clinics” published in American Journal of Infection Control

American Journal of Infection Control published Maximizing the Impact of, and Sustaining Standing Orders Protocols for Adult Immunization in Outpatient Clinics ([link removed](19)30740-0/fulltext) , by Tan LJ, et al., in its March issue. The conclusion is reprinted below.

SOPs may provide a good starting point for increasing adult immunization coverage rates. Using additional interventions, quality-based metrics, or incentives could lead to sustained adult immunization prioritization.

Access the full article in PDF format ([link removed](19)30740-0/pdf) .

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“Combating Vaccine Hesitancy and Other 21st Century Social Determinants in the Global Fight Against Measles” published in Science Direct

Science Direct published Combating Vaccine Hesitancy and Other 21st Century Social Determinants in the Global Fight Against Measles ([link removed]) by Hotez PJ, et al., in its April issue. Key portions of the abstract are reprinted below.

Measles transmission due to sharp declines in measles-mumps-rubella (MMR) vaccination coverage is now widespread among nations that previously saw impressive public health gains including Philippines, DR Congo, Madagascar, Samoa, many in Europe, and the United States and Venezuela in the Americas. Key determinants include the interruption of vaccine health systems due to war, conflict, and political instability; food insecurity and urbanization; and an increasingly globalized vaccine hesitancy or antivaccine movement. Vaccine hesitancy is partly responsible for over 100 000 measles cases in Europe in 2019, and the re-emergence of measles to the United States almost twenty years after it was eliminated. Three major elements currently comprise the American antivaccine movement, including a media empire, a political arm, and deliberate predatory behavior.

Access the full article in PDF format. ([link removed])

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-EDUCATION AND TRAINING-
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GSA's "Elevating Understanding of RSV in Older Adults" webinar to be held March 31

Mark your calendar for Gerontological Society of America's Elevating Understanding of RSV in Older Adults ([link removed]) webinar on March 31 at 12:00 p.m. (ET). Scroll down the GSA web page for details.

Respiratory syncytial virus, or RSV, causes 177,000 hospitalizations and 14,000 deaths in older adults each year. In this 1-hour webinar, experts will share what is known about the prevalence, incidence, and impact of RSV in older adults.

There is no charge for this webinar. To register, you will need to follow the registration instructions ([link removed]) and create a free account.

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Video of the Week
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Can I Still Get HPV Vaccine If I'm Older? In this Talking about Vaccines video, Dr. Paul Offit, pediatric infectious disease specialist at Children's Hospital of Philadelphia, discusses the use of HPV vaccine in adults. Although it's best to vaccinate at 11 to 12 years of age, CDC says the vaccine may also be given to adults ages 27 to 45 based on shared decision-making with their clinician.
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])
John D. Grabenstein, RPh, PhD (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])

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

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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]) .

IAC Express is supported in part by Grant No.
6NH23IP922550 from the National Center for Immunization and Respiratory Diseases, CDC.

IAC Express Disclaimer ([link removed])
ISSN: 1526-1786
Our mailing address is
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