Immunization Works January 2015
2015 Immunization Schedules: Every year, the Advisory Committee on Immunization Practices (ACIP) develops recommendations for routine use of vaccines in children, adolescents, and adults. When adopted by the CDC Director they become official CDC/HHS policy. In early 2015, MMWR will publish a summary of schedule changes. The 2015 figures, footnotes, and tables will be published on the CDC website.
The 2015 child and adolescent schedule is set to be released on January 26, and the adult schedule is set to be released on February 3. Until then, the 2014 schedules will remain on the website.
CDC encourages organizations to syndicate content rather than copy a PDF version of the schedule onto their websites to share with visitors. Content syndication allows other organizations’ websites to mirror CDC web content, with automatic updates whenever changes are made on the CDC site. This helps ensure that all schedules are current across the Internet. See how to display the schedules on your site.
Updates to the Overseas Immunization Program for U.S.-bound Refugees: Refugees being resettled in the U.S., unlike immigrants seeking residency, have not been subject to immunization requirements. Without immunization, refugee communities overseas and in the U.S. are vulnerable to outbreaks of vaccine-preventable diseases that can disrupt the resettlement process and require costly public health responses. CDC's Division of Global Migration and Quarantine has regulatory authority to prevent communicable disease importation among the approximately 70,000 refugees resettled in the U.S. each year.
Historically, logistical challenges prevented overseas routine vaccination of refugees scheduled for resettlement in the U.S. However, in December 2012, CDC began implementation of an overseas program that resulted in the routine vaccination of U.S.-bound refugees in six countries: Thailand and Nepal (initiated December 2012), Malaysia and Kenya (initiated September 2013), Ethiopia (initiated November 2013), and Uganda (initiated August 2014). Refugees vaccinated through this program began arriving in the U.S. in 2013. The program covers approximately 50% of refugees who arrive in the U.S. annually and likely will be expanded to include countries from which other refugees originate. Please read the January 15 MMWR for the full report.
Flu Update: Flu activity is high across most of the country, causing flu illnesses, hospitalizations, and deaths. Flu season will probably continue for several weeks. Influenza antiviral drugs can treat flu illness and should be used to treat people who are very sick or who are at high risk of serious flu complications and have flu symptoms. Early antiviral treatment works best; however, starting them later still can be helpful, especially if the sick person has a high-risk health condition or is very sick from the flu. So far, most of the influenza A (H3N2) viruses causing illness this season are different from the H3N2 component of 2014-15 influenza vaccine. Nonetheless, this season’s vaccine still will prevent some illnesses, will reduce hospitalizations and deaths, and will protect against other flu viruses which may spread later this season.
CDC Health Update Regarding Treatment of Patients with Influenza with Antiviral Medications: CDC issued a Health Alert Network (HAN) update on January 9, 2015, to remind clinicians that influenza should be high on their list of possible diagnoses for ill patients because influenza activity is elevated nationwide. The HAN advised clinicians that all hospitalized patients and all high-risk patients (either hospitalized or outpatient) with suspected influenza should be treated as soon as possible with one of three available influenza antiviral medications. This should be done without waiting for confirmatory influenza testing. Although antiviral drugs work best when given early, therapeutic benefit has been observed even when treatment is initiated later. Please read the full HANfor more information.
CDC Telebriefing - Update on the 2014-15 Flu Season: On January 9, 2015, CDC held a telebriefing to provide an update on influenza activity in the U.S. and review the agency’s antiviral treatment recommendations. Key takeaways from this telebriefing include:
- H3N2 viruses continue to be predominant this season and flu is widespread in almost all of the country.
- Key flu indicators suggest this season is a bad one for people 65 years and older. Hospitalization rates in this age group are rising.
- Most of the H3N2 viruses this season differ from the H3N2 virus that is included in this season’s vaccine.
- CDC still urges people to get vaccinated despite drifted H3N2 viruses. Vaccination still may offer some protection and, therefore, reduce severe outcomes such as hospitalization and death.
- All hospitalized and high-risk patients with suspected influenza should be treated as soon as possible with one of three available influenza antiviral medications.
- Do not wait for confirmatory testing; consider possible benefits of treating flu even after two days of symptom onset. Although antiviral medications work best when given early, therapeutic benefit has been observed even when treatment is initiated later.
A full audio recording and transcript of the telebriefing can be found on the CDC Newsroom website.
Resources on Antiviral Medications: In addition to the Health Advisory Network Update, please read Influenza Antiviral Medications: Summary for Clinicians (for healthcare providers) and What You Should Know about Flu Antiviral Drugs (for the public) for more information.
Early Estimates of Seasonal Influenza Vaccine Effectiveness (VE): Early estimates indicate that influenza vaccines provided limited protection against influenza viruses circulating during the first part of the 2014-15 season, which were mainly influenza A (H3N2) viruses. Data so far this season indicate that influenza vaccination reduced a vaccinated person’s risk of having to go to the doctor for flu illness by about 23% across all ages. Most of the influenza A (H3N2) viruses differ from the H3N2 component of 2014-15 influenza vaccine. This season’s vaccine will still prevent some illnesses and reduce hospitalizations and deaths, despite offering reduced protection. For example, one modeling study suggests that among people 65 and older, vaccine effectiveness of only 10% during a severe season still would prevent about 13,000 hospitalizations. Also, the vaccine will protect against viruses that may circulate later in the season. Please read the January 15 MMWR for the full report. CDC will continue to monitor VE throughout the season and will share final VE estimates at the end of the season. The final, adjusted VE estimates for the 2014-15 influenza vaccine are likely to be somewhat different from the interim estimates for a number of reasons, including adjustments for additional potential confounders, such as chronic medical conditions in patients, which are not available for interim estimates. VE estimates also could change as more patient data become available, or if changes occur in the circulating influenza viruses during the remainder of this season.
Continuing Flu Vaccination Efforts for the 2014-15 Flu Season: A variety of resources are available, including print, audio/video, social media tools, and web tools. This season CDC added new flu promotional materials for grassroots outreach to health-disparate populations. You can order these free resources and more at the CDC flu free resources web page; it’s one-stop shopping for up-to-date flu information!
Check out our partner website, where partners have been entering activities into the calendar of events for the 2014-15 flu season. Submit your flu prevention activities/events and see what others are planning now.
You also can visit CDC’s main flu website to access relevant Q&As, keep up with national andinternational flu activity, surveillance, and vaccine coverage data, or view information tailored specifically for healthcare professionals. Flu-related questions and information requests (including web content syndication or to receive updates via subscription) should be directed to CDC email@example.com.
Health Map Vaccine Finder: Need help finding flu vaccine? The Health Map Vaccine Finder helps consumers locate flu vaccine within their communities.
Healthcare providers can register their location on this site, which now shows availability for over 38,000 locations. Spread the word to immunization providers about how they can register on this site.
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. Please visit the netconference web page for additional information and archived webcasts.
Y ou 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 new Measles, Mumps, and Rubella (MMR) module was added and the Vaccines for Children (VFC) and Vaccine Storage and Handling modules recently have been updated. Please visit You Call the Shots for additional information and other modules. Continuing Education (CE) credit is available for viewing a module and completing an evaluation.
ACIP Meeting: The next ACIP meeting will be February 25-26, 2015. Please visit the ACIP meeting web page for agendas, presentation slides, meeting minutes, archived video broadcasts, and additional information.
Cervical Cancer Awareness Month Resources: January is Cervical Cancer Awareness Month. This is a great time to promote HPV vaccination to prevent cervical cancer, as well as partner with local, state, or national cancer organizations in educating parents and clinicians on the importance of HPV vaccination. To assist you in your promotional efforts, CDC has updated its ready-to-publish (matte) articles and features for you to use during the month.
Here are some simple things you can do to promote cervical cancer prevention this month:
Additionally, even though males aren’t directly affected by cervical cancer, HPV vaccination is still important to protect them from a number of cancers caused by HPV. We encourage you to share our “HPV Vaccine for Boys” feature on your social media platforms to encourage parents to get their boysand girls vaccinated against cancers caused by HPV.
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 to download materials.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, 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 healthcare 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 may need to sign up and log in as a member to view the videos. 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, including the updatedParents Guide to Childhood Immunizationsand flu campaign materials, are available.
Clinical Decision Support for Immunizations: In December 2014, the Clinical Decision Support for Immunizations (CDSi) project expert panel met again to discuss how to incorporate both adult vaccines and special immunization considerations for groups with at-risk conditions into the CDSi Logic Specification for ACIP recommendations and supporting resources. This panel consists of professionals from the IIS programs and vendors, EHR-focused organizations, the Indian Health Service, the Veterans Administration, the American College of Physicians, and the American Academy of Family Practitioners. At the three-day meeting, the team of 15 panelists collaborated in the development of 153 test cases across 17 vaccine groups and 135 ACIP-defined conditions. By creating test cases and practicing real-world examples, the panelists positioned the project to develop final deliverables to be used by implementers across the nation. The updated CDSi Logic Specification and supporting resources will be available to the immunization community by summer 2015.
2014 Kaafee Billah Award: Congratulations to Lee Hampton (CGH), Ruth Link-Gelles (NCIRD), Mark Messonnier (NCIRD), Fangjun Zhou (NCIRD), Matthew Moore (NCIRD) and Charles Stoecker (Tulane University School of Public Health and Tropical Medicine). Their paper, “Cost-Effectiveness of Using 2 vs 3 Primary Doses of 13-valent Pneumococcal Conjugate Vaccine,” published in Pediatrics, August 2013, won CDC’s 2014 Kaafee Billah Memorial Award in Economics Research.
Using a modeling technique following a hypothetical birth cohort of children, the authors estimated that changing the U.S. 13-valent pneumococcal conjugate vaccine (PCV13) pediatric schedule from 3 to 2 primary doses while keeping a booster dose would result in net savings of $421 million annually. Although this change might lead to moderate increases in pneumococcal disease, especially otitis media and pneumonia, sizable societal cost savings could be expected from removing the PCV13 primary series third dose. The additional illnesses could be prevented through modest increases in coverage. These findings illustrate that examining the cost-effectiveness of alternate vaccine dosages may be worthwhile when the vaccine has a high cost per dose and differences in effectiveness may be small.
The 2014 Kaafee Billah Award was presented at a ceremony in December 2014. The award has been presented by the Health Economics Research Group annually since 2008. The award recognizes outstanding published scientific contributions in economic research at CDC that apply economic methods, theories, and knowledge to analyze a public health problem. The Billah Award is named after former CDC economist Kaafee Billah, PhD (1967-2006), and is the first CDC award to honor contributions in the field of economics.
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
National Vaccine Advisory Committee (NVAC) Meeting, February 10-11, 2015, Washington, D.C.
Spring Clinical Vaccinology Course, (National Foundation for Infectious Diseases), March 13-15, 2015, Denver, CO
Epidemiology and Prevention of Vaccine-Preventable Diseases, March 17-18, 2015, Piscataway, NJ
Annual Conference on Vaccine Research, (National Foundation for Infectious Diseases), April 13-15, 2015, Bethesda, MD
National Infant Immunization Week (NIIW), April 18-25, 2015, Nationwide
California Immunization Coalition Summit, April 26-27, 2015, Riverside, CA
National Adult and Influenza Immunization Summit Meeting, May 12-14, Atlanta, GA