CIENCIASMEDICASNEWS: Immunization Works Newsletters

May 31, 2018: Content on this page kept for historical reasons.

MMWR

Progress Toward Measles Elimination in the Western Pacific Region, 2013–2017: In 2005, the Regional Committee for the World Health Organization (WHO) Western Pacific Region (WPR) established a goal for measles elimination by 2012. To achieve this goal, the 37 WPR countries and areas implemented the recommended strategies in the WPR Plan of Action for Measles Elimination and the Field Guidelines for Measles Elimination. The strategies include 1) achieving and maintaining more than 95% coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services and supplementary immunization activities (SIAs), when required; 2) conducting high-quality case-based measles surveillance, including timely and accurate testing of specimens to confirm or discard suspected cases and detect measles virus for genotyping and molecular analysis; and 3) establishing and maintaining measles outbreak preparedness to ensure rapid response and appropriate case management. The May 4 MMWR updates the previous report and describes progress toward measles elimination in WPR during 2013–17. During 2013–16, estimated regional coverage with the first MCV dose (MCV1) decreased from 97% to 96%, and coverage with the routine second MCV dose (MCV2) increased from 91% to 93%. Eighteen (50%) countries achieved more than 95% MCV1 coverage in 2016. Seven (39%) of 18 nationwide SIAs during 2013–17 reported achieving more than 95% administrative coverage. After a record low of 5.9 cases per million population in 2012, measles incidence increased during 2013–16 to a high of 68.9 in 2014 because of outbreaks in the Philippines and Vietnam, as well as increased incidence in China, and then declined to 5.2 in 2017. To achieve measles elimination in WPR, additional measures are needed to strengthen immunization programs to achieve high population immunity, maintain high-quality surveillance for rapid case detection and confirmation, and ensure outbreak preparedness and prompt response to contain outbreaks.

Progress Toward Worldwide Polio Eradication, January 2016–March 2018: In 1988, when an estimated 350,000 cases of poliomyelitis occurred in 125 countries, the World Health Assembly resolved to eradicate polio globally. Transmission of wild poliovirus (WPV) continues uninterrupted in only three countries (Afghanistan, Nigeria, and Pakistan), and among the three serotypes, WPV type 1 (WPV1) remains the only confirmed circulating type. The May 11 MMWR describes global progress toward polio eradication during January 2016–March 2018, and updates previous reports. In 2017, 22 WPV1 cases were reported, a 41% decrease from the 37 WPV1 cases reported in 2016. As of April 24, 2018, eight WPV1 cases have been reported (seven in Afghanistan and one in Pakistan), compared with five cases during the same period in 2017. In Pakistan, continuing WPV1 transmission has been confirmed in multiple areas in 2018 by isolation from wastewater samples. In Nigeria, ongoing endemic WPV1 transmission was confirmed in 2016; although WPV was not detected in 2017 or in 2018 to date, limitations in access for vaccination and surveillance in insurgent-held areas in northeastern Nigeria might permit continued undetected poliovirus transmission. Substantial progress toward polio eradication has continued in recent years; however, interruption of WPV transmission will require overcoming remaining challenges to reaching and vaccinating every missed child. Until poliovirus eradication is achieved, all countries must remain vigilant by maintaining high population immunity and sensitive poliovirus surveillance.

Vaccination Coverage Among Children Age 2 Years in the U.S. Affiliated Pacific Islands, April–October, 2016: Vaccine-preventable diseases (VPDs) cause substantial morbidity and mortality in the U.S. Affiliated Pacific Islands (USAPIs). CDC collaborates with USAPI immunization programs to monitor vaccination coverage. In 2016, USAPI immunization programs and CDC piloted a method for estimating up-to-date vaccination status among children age 2 years using medical record abstraction to ascertain regional vaccination coverage. Geographic differences in vaccination coverage between main and outer islands were assessed for two jurisdictions where data were adequate. Completion of the recommended series of each vaccine was less than 90% in all jurisdictions except Palau. Coverage with the recommended 6-vaccine series (4:3:1:3:3:4) ranged from 19.5% (Chuuk) to 69.1% (Palau). Coverage was lower in the outer islands than in the main islands for most vaccines, with differences ranging from 0.9–66.8 percentage points. Medical record abstraction enabled rapid vaccination coverage assessment and timely dissemination of results to inform programmatic decision-making. Effectively monitoring vaccination coverage, coupled with implementation of data-driven interventions, is essential to maintain protection from VPD outbreaks in the region and the mainland U.S. Please read the May 24 MMWR for the full report.

Notes from the Field: Vaccine Administration Errors Involving Recombinant Zoster Vaccine: During the first four months of RZV (Shingrix), monitoring (October 20, 2017–February 20, 2018), VAERS received a total of 155 reports, of which 13 (8%) documented an administration error, some with more than one type of error. Vaccine providers may be confusing administration procedures and storage requirements between the older ZVL (Zostavax) vaccine and the newly licensed RZV. Prior experience indicates that reports of administration errors are highest shortly after licensure and recommendation, likely due to lack of familiarity with a new vaccine. To prevent RZV administration errors, vaccine providers should be aware of prescribing information, storage requirements, preparation guidelines, and ACIP recommendations for herpes zoster vaccines. Please read the May 24 MMWR for the full report.

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Influenza

Flu Season Update: According to the FluView report for the week ending May 19, 2018, influenza activity has continued to decrease and remained below national baseline for five consecutive weeks. Though influenza A(H3N2) viruses remain predominate this season overall, since early March, influenza B viruses have been more frequently reported than influenza A viruses. Only pediatric deaths are nationally notifiable; 169 flu-associated deaths in children had been reported to CDC as of May 19.

For more information on the 2017–18 flu season activity update and vaccine effectiveness, see FluView: the Weekly U.S. Influenza Surveillance Report.

Flu Vaccine Benefits from 2016–2017 Season: Flu vaccination prevented an estimated 5.3 million influenza illnesses, 2.6 million influenza-associated medical visits, and 85,000 influenza-associated hospitalizations during the 2016–17 flu season. A CDC report underscores the benefits of the current vaccination program, but also highlights areas where improvements in vaccine uptake and vaccine effectiveness could deliver even greater benefits to the public’s health. In the U.S., overall vaccine uptake has been relatively stable at around 47%, but there are differences in uptake between different age groups. Younger children and older adults generally have higher vaccine uptake. If vaccination coverage improved to 70% for all age groups, another 1.9 million illnesses, 822,000 medical visits, and 17,300 hospitalizations could have been prevented during the 2016–17 flu season. Please read the CDC vaccine benefits report for more information.

Remembering the 1918 Influenza Pandemic: One hundred years ago, a flu pandemic swept the world. Five hundred million people were infected, and at least 50 million people died. An estimated 675,000 Americans lost their lives in one of the deadliest disease outbreaks in recent history. World War I was raging at the same time, and troop movements contributed to the spread of flu. To commemorate the centenary of the devastating 1918 flu pandemic, the David J. Sencer CDC Museum has launched an exhibition, Remembering: The 1918 Influenza Pandemic. The exhibit features a video, “CDC Mission: Pandemic Preparedness,” highlighted on the museum’s main video screen. The video includes comments from CDC’s pandemic flu fighters, discussing the impact of the 1918 flu pandemic, what has been learned about flu in the past 100 years, and how flu viruses continue to pose a serious public health threat.
The exhibition also includes a photo gallery stationed in the lobby of the museum. The gallery presents photographs of military personnel, medical staff, Red Cross workers, and civilians impacted by influenza, capturing the desperate times of the pandemic.

Stop by the museum to get a better understanding of the 1918 flu pandemic, and how science has evolved and informs our future preparedness for seasonal and pandemic flu outbreaks.

Please visit the CDC 1918 flu commemoration page for more information.

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Resources and Information

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.

Vaccine Administration e-Learn: An 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.

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. The next netconference is scheduled for July 24, 2018.

New HPV Video: Immunization providers play a critical role in getting parents to accept HPV vaccination for their children. A new video, titled “You Are the Key to HPV Cancer Prevention” provides up-to-date information on HPV infection/disease, HPV vaccine, and ways to successfully communicate with parents about HPV vaccination. HPV vaccination is cancer prevention. While most U.S. adolescents are starting the HPV vaccine series, less than half have finished the series. Every year that adolescents aren’t vaccinated is another year they are left unprotected against cancer-causing infections. Continuing Education (CE) is available.

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. Please visit the You Call the Shots web page to view the modules. Continuing Education (CE) is available for viewing a module and completing an evaluation.

ACIP Meeting: The Advisory Committee on Immunization Practices (ACIP) comprises medical and public health experts who develop recommendations for the routine use of vaccines for children, adolescents, and adults in the U.S. The recommendations stand as public health guidance for the safe use of vaccines and related biological products. After ACIP votes on vaccine recommendations, CDC reviews the recommendations and, if approved, provides necessary guidance on implementing the recommendations. ACIP meetings are held quarterly. The next meeting is scheduled for June 20–21. Please visit the ACIP meeting web page for agendas, presentation slides, meeting minutes, and archived video broadcasts.

Measles and Mumps Resources: CDC aims to continue increasing awareness of measles and mumps 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 mumps resources, including fact sheets, podcasts, and matte articles. Some of the measles graphics are also available in 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: Various 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. The 2018 Recommended Immunization Schedules are also available for ordering.

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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