CIENCIASMEDICASNEWS: Immunization Works December 2017 Newsletter

Immunization Works December 2017 Newsletter | CDC

MMWR

Introduction of Inactivated Poliovirus Vaccine and Impact on Vaccine-Associated Paralytic Poliomyelitis in Beijing, China, 2014–2016: When included in a sequential polio vaccination schedule, inactivated polio vaccine (IPV) reduces the risk for vaccine-associated paralytic poliomyelitis (VAPP), a rare adverse event associated with receipt of oral poliovirus vaccine (OPV). During January 2014, the World Health Organization (WHO) recommended introduction of at least 1 IPV dose into routine immunization schedules in OPV-using countries. The Polio Eradication and Endgame Strategic Plan 2013–20 recommended completion of IPV introduction in 2015 and globally synchronized withdrawal of OPV type 2 in 2016. Introduction of 1 dose of IPV into Beijing’s Expanded Program on Immunization (EPI) on December 5, 2014, represented China’s first province-wide IPV introduction. Coverage with the first dose of polio vaccine was maintained from 96.2% to 96.9%, similar to coverage with the first dose of diphtheria and tetanus toxoids and pertussis vaccine (DTP) (96.5%–97.2%). The polio vaccine dropout rate (the percentage of children who received the first dose of polio vaccine but failed to complete the series) was 1.0% in 2015 and 0.4% in 2016. The use of 3 doses of private-sector IPV per child decreased from 18.1% in 2014 to 17.4% in 2015 and to 14.8% in 2016. No cases of VAPP were identified during 2014–16. Successful introduction of IPV into the public-sector EPI program was attributed to comprehensive planning, preparation, implementation, robust surveillance for adverse events after immunization (AEFI), and monitoring of vaccination coverage. This evaluation provided information that helped contribute to the expansion of IPV use in China and in other OPV-using countries. Please read the December 15 MMWR for the full report.

Fractional-Dose Inactivated Poliovirus Vaccine Campaign in the Sindh Province, Pakistan, 2016: Following the declaration of eradication of wild poliovirus (WPV) type 2 in September 2015, trivalent oral poliovirus vaccine (tOPV) was withdrawn globally to reduce the risk for type 2 vaccine-derived poliovirus (VDPV2) transmission. All countries implemented a synchronized switch to bivalent OPV (type 1 and 3) in April 2016. Any isolation of VDPV2 after the switch is to be treated as a potential public health emergency and might indicate the need for supplementary immunization activities. On August 9, 2016, VDPV2 was isolated from a sewage sample taken from an environmental surveillance site in Hyderabad, Sindh province, Pakistan. Possible vaccination activities in response to VDPV2 isolation include the use of injectable, inactivated polio vaccine (IPV), which poses no risk for vaccine-derived poliovirus transmission. Fractional-dose, intradermal IPV (fIPV), one-fifth of the standard intramuscular dose, has been developed to more efficiently manage limited IPV supplies. fIPV has been shown in some studies to be noninferior to full-dose IPV and was used successfully in response to a similar detection of a single VDPV2 isolate from sewage in India. Injectable fIPV was used for response activities in Hyderabad and three neighboring districts. The December 1 MMWR describes the findings of an assessment of preparatory activities and subsequent implementation of the fIPV campaign. Despite achieving high coverage (more than 80%), several operational challenges were noted. The lessons learned from this campaign could help to guide the planning and implementation of future fIPV vaccination activities.

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Influenza

Influenza Vaccination Update: On December 7, 2017, CDC released early-season flu vaccination coverage estimates for the 2017–18 influenza season on CDC’s FluVaxView website. There are three reports on 2017–18 early-season flu vaccination coverage estimates:

Flu vaccination coverage among the general population
Flu vaccination coverage among health care personnel
Flu vaccination coverage among pregnant women

Based on data collected through early November 2017, influenza vaccination uptake in the U.S. was similar to this time last season overall for adults and children. Thirty-nine percent of children age 6 months through 17 years and 39% of adults age 18 years and older received an influenza vaccination by early November. Although overall flu vaccination estimates among adults and children were similar to early estimates from last season, adults 18-49 years had a decrease of 4 percentage points and Hispanic adults had a decrease of 8 percentage points compared to the same time point last influenza season. The most common place of vaccination among both adults and children as of early November 2017 was a doctor’s office (children 65%, adults 35%). Other common places of influenza vaccination reported by adults included pharmacies/stores (28%) and workplaces (17%). See the online report for many more estimates, further methodological details and limitations, and recommendations.

As of early November 2017, 36% of pregnant women reported being vaccinated. Health care personnel play a key role in increasing flu vaccination coverage among all patients, including pregnant women. Pregnant women who reported receiving a clinician recommendation for and an offer of flu vaccination had higher vaccination coverage (52%) compared with women who reported receiving a recommendation for but no offer of vaccination (26%) or women who reported receiving no recommendation (6%). The top three reasons reported for receiving a flu vaccination were 1) to protect their baby from flu (41%), 2) to protect themselves from flu (24%), and 3) because their health care professional recommended it (15%), similar to the top three reasons reported last year. A strong recommendation with an offer of vaccination can help improve vaccination uptake, especially for the pregnant women who were not vaccinated but intended to get vaccinated.

Influenza can be a serious disease that can lead to hospitalization and sometimes even death. Anyone can get very sick from the flu, including people who are otherwise healthy. As of early November 2017, 68% of health care personnel (HCP) had received a flu vaccine this season. This is similar to coverage estimates at the same time last season (69%). HCP can get flu from patients and coworkers who are sick with flu. HCP can spread flu to others even if they don’t feel sick. By getting vaccinated, health care workers help protect themselves, their families at home, and their patients.

CDC also released an influenza activity update in the weekly MMWR. According to the update, flu activity in the U.S. began to increase in early November and continued to increase throughout the month. So far, influenza A(H3N2) viruses have been predominant in the U.S. In the past, H3N2-predominant seasons have been associated with greater severity, especially among young children and older adults. Flu is difficult to predict. It’s not yet possible to say how severe the season will be or what viruses will predominate.

Thank You for Participating in National Influenza Vaccination Week (NIVW) 2017: NIVW was held December 3–9, 2017. CDC would like to thank all partners for participating in NIVW activities and for continuing to promote flu vaccination. The success of NIVW relies on the involvement of our partners at all levels, and we appreciate your hard work!

Highlights of NIVW events and activities:

On Monday, December 4, CDC kicked off NIVW with the #UnitedAgainstFlu Twitter chat, hosted by the American Hospital Association (@ahahospitals), and the #FightFluChat Twitter chat, hosted by NFID, Wendy Sue Swanson, MD, MBE, of Seattle Children’s, and CDC. Experts addressed commonly asked questions about flu and flu vaccination and spread the word about the importance of getting a flu shot.
Throughout NIVW, CDC featured profiles of CDC flu fighters and flu fighter partners whose work contributes to flu prevention in the U.S. and around the world.

Again, thank you to all of our partners for contributing to the success of NIVW 2017!

Continuing Flu Vaccination Efforts for the 2017–2018 Flu Season: Flu activity is expected to increase in the coming weeks. While seasonal flu outbreaks can happen as early as October, influenza activity has peaked between December and February about 75% of the time in the past 30 years, and significant flu activity can occur as late as May. This means that vaccination after November would still offer substantial protection during most seasons. As long as flu activity is ongoing, it’s not too late to get vaccinated, even in January or later. Remember, it takes about two weeks after vaccination for the immune system to fully respond and for these antibodies to provide protection, making now the perfect time to be vaccinated.

Continue to fight flu this season. Stay up to date on the latest flu information from CDC by following @CDCFlu on Twitter and signing up for CDC’s weekly Influenza Newsletter.

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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, 13th 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 Center , 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 Now Available: A new 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), 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.

CEB Receives FGDLA 5-Star Award: The Federal Government Distance Learning Association (FGDLA) recognized Immunization Services Division’s Communication and Education Branch (CEB) for demonstrating leadership and best practices in the development and application of proven distance learning technologies and/or video production supporting distance learning in the federal government. FGDLA is a professional association formed to promote the development and application of distance learning in the federal government. The association encourages the application of all forms of distance learning media, as well as embracing innovative methods in integrating instructional technologies to meet the training and education needs of the federal government. Membership includes individuals employed by various federal government agencies. FGDLA is a chapter of the U.S. Distance Learning Association.

Vaccine Administration e-Learn Receives Digital Health Award: The Vaccine Administration e-Learn developed by the Immunization Services Division’s Communication and Education Branch received a Merit Award in the Government/Health Professionals/ Medical Education Web-based category. The Digital Health Awards competition is held twice each year in the spring and fall. The program is organized by the Health Information Resource Center (HIRC), a national clearinghouse for professionals who work in health fields.

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.

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 influenza module has recently been updated and is 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 Resources: CDC aims to continue increasing awareness of measles 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 vaccination resources, including fact sheets, podcasts, and matte articles. There are also infographics available in English and Spanish.

CDC and Medscape: 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 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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