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Immunization Section Announcements

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    Florida Department of Health 

    Immunization Section 

    4052 Bald Cypress Way, Bin A11 

    Tallahassee, FL 32399-1719 

Stay Up-to-Date with the Immunization Section 

*Note: This page contains materials in the Portable Document Format (PDF). The free Adobe Reader may be required to view these files.

2017 Florida Immunization Summit

November 4, 2016—The Florida Department of Health Immunization Section would like to share with our partners and colleagues this announcement for the 2017 Florida Annual Immunization Summit. The summit is scheduled for February 2–4, 2017, at the Hilton St. Petersburg Bayfront Hotel in St. Petersburg, Florida.

This 3-day summit will focus on best practices to promote adolescent vaccines and eliminate vaccine-preventable diseases. The summit also aims to bring together health professionals, students, advocates, administrators, coalitions and community members for an in-depth discussion on adolescent vaccines.

Speakers and panels will discuss diversity in health care, immunization preparation for college, strategies to increase adolescent immunization rates and more.

Topics to be discussed include ACIP recommended adolescent vaccines:

  • Tetanus, diphtheria, acellular-pertussis (Tdap)
  • Meningococcal
  • Influenza
  • Human papillomavirus (HPV) as cancer prevention

To learn more and register, please visit:
www.srahec.org/fl-immunization-summit or stellared.learningexpressce.com/index.cfm?fa=view&eventID=6604


CDC Recommends Two HPV Shots for Younger Adolescents

October 21, 2016—The Department of Health Immunization Section would like to share information regarding the updated human papillomavirus (HPV) vaccine recommendation. The Centers for Disease Control and Prevention (CDC) now routinely recommends only two doses of HPV vaccine for 11 or 12 year olds to prevent HPV cancers. The Advisory Committee on Immunization Practices (ACIP) voted to recommend a 2-dose HPV vaccine schedule for young adolescents. CDC Director, Dr. Tom Frieden, approved the committee’s recommendations shortly after the vote. ACIP recommendations approved by the CDC Director become agency guidelines on the date published in the Morbidity and Mortality Weekly Report (MMWR).

This recommendation aims to make it easier for parents to protect their children by reducing the number of shots and trips to the doctor. HPV vaccination is an important cancer prevention tool and two doses of HPV vaccine will provide safe, effective and long-lasting protection when given at the recommended ages of 11 and 12 years. Some of the specifics of the recommendation include:

  • The first HPV vaccine dose is routinely recommended at 11–12 years old. The second dose of the vaccine should be administered 6 to 12 months after the first dose.
  • Teens and young adults who start the series at ages 15 through 26 years will continue to need three doses of HPV vaccine to protect against cancer-causing HPV infections.
  • Adolescents aged 9 through 14 years who have already received two doses of HPV vaccine less than 6 months apart, will require a third dose.
  • Three doses are recommended for people with weakened immune systems aged 9–26 years.

To view the entire press release, please visit: www.cdc.gov/media/releases/2016/p1020-hpv-shots.html.


Webinar on HPV Vaccine Recommendations Update

October 20, 2016—The Department of Health Immunization Section would like to share with its immunization partners the Centers for Disease Control and Prevention’s (CDC) webinar on recent changes to human papillomavirus (HPV) vaccine recommendations. The CDC Immunization Services Division will be hosting the webinar on Wednesday, October 26, 2016 from noon to 1:00 p.m. EST.

Dr. Lauri Markowitz of the National Center for Immunizations and Respiratory Diseases (NCIRD), Division of Viral Diseases, will be discussing the HPV vaccine recommendation changes that occurred during the October Advisory Committee on Immunization Practices (ACIP) meeting. Her presentation is entitled Recommendation for HPV Vaccination: 2016 Update.

The webinar will also be posted on CDC’s Current Issues in Immunization website after November 1st. CE credits will continue to be available for 30 days.

Registration is now open! Attendance is limited.


National Association of School Nurses Piloting Stats4Vax: Improving Teen Vaccination Rates

October 12, 2016—The Department of Health Immunization Section would like to share with our partners and colleagues information regarding a challenge unique to Florida High School Nurses. The National Association of School Nurses (NASN) is piloting Stats4Vax: Improving Teen Vaccination Rates One School Nurse at a Time to help improve teen vaccination rates—which are dismally low for some vaccines.

Vaccines are the best way to help protect teens against serious infectious diseases. However, millions of teens remain under-vaccinated against these diseases, particularly meningococcal meningitis and human papillomavirus (HPV), which both require a multi-dose vaccine series to help protect teens. Teen vaccination rates for flu are also low.

The focus of this challenge is to “uncover” and improve the vaccine uptake of those vaccines recommended for adolescents—these are the ones tracked by the Centers for Disease Control and Prevention (CDC).

Materials to help high school nurses promote vaccination are available on the NASN website. This unique challenge is an opportunity for high school nurses to improve vaccination rates over the course of a year. One winner will receive an all-expense paid trip to the NASN 2018 conference!

High school nurses must complete the entry form before October 31, 2016, in order to be eligible. School nurses must report the number of students in their high school who have received: HPV, Flu, Tdap, and/or Meningococcal vaccine at the time of form submission and then again at the end of the challenge, June 15, 2017.

For additional information please visit: www.nasn.org/ToolsResources/Immunizations/Stats4Vax or email: Stats4Vax@NASN.org.


PreteenVaxScene Webinar on Motivating Clinicians Through AFIX

October 3, 2016—We are pleased to share with our immunization partners and colleagues a #PreteenVaxScene webinar titled In Real Life: Using AFIX to Empower Clinicians to Increase HPV Vaccination Rates. The webinar is scheduled for Tuesday, October 11, 2016 at noon EST.

Mary Beth Koslap-Petraco DNP, PNP-BC, CPNP, FAANP will be sharing her evidence-based approach in conducting AFIX visits. Dr. Koslap-Petraco will share how she inspires clinicians daily to change how they practice and increase their HPV vaccination rates. Dr. Koslap-Petraco is the Coordinator of Child Health at the Suffolk County Department of Health Services in Suffolk County, New York and an HPV Vaccine Office Champion.

This webinar will be geared towards AFIX coordinators, AFIX program field staff, trainers of field staff, and immunization managers, as the presenter will share specific interventions that were used to increase HPV vaccination rates and were utilized during AFIX visits.

REGISTER NOW!

Florida Department of Health-Immunization Section Receives 2016 Vaccination Coverage Award

September 30, 2016—The Florida Department of Health (DOH) is pleased to announce the Immunization Section was the recipient of the Center for Disease Control and Prevention’s (CDC) Immunization Coverage Award. The award was presented to Immunization Section management team during the awards ceremony at the National Immunization Conference on September 13, 2016.

The DOH Immunization Program statewide has made great progress in the last year increasing immunization rates making Florida one of the best vaccinated states in the country. The Immunization Coverage Award: Most Improved Influenza Coverage Among Adults Aged 18 Years and Older,” was awarded in recognition of Florida’s outstanding accomplishment in achieving the most improved influenza vaccination coverage among adults aged 18 years and older from the 2012–2013 to 2015–2016 season.

Teamwork and dedication made this incredible honor possible. Congratulations to DOH’s Immunization Program and its immunizing providers statewide!

2016 NIC Award: Immunization Section

(Left to right) Montique Shepherd, MPA, CDC PHA; Beth Cox, DOH VFC Program Manager;Dearline Thomas-Brown, MPH, BSN, RN, DOH Executive Community Health Nursing Director;Tracey Andrews, CDC PHA; Nancy Messonnier, MD, CAPT, USPHS, Director, National Center for Immunization and Respiratory Diseases OID, CDC


Important Resources for Vaccine Conversations with Parents Policy Statements Issued by American Academy of Pediatrics

September 28, 2016—The Florida Department of Health-Immunization Section would like to share with our immunization partners and colleagues the policy statements and resources issued by the American Academy of Pediatrics (AAP). The AAP has published two new policy statements; “Countering Vaccine Hesitancy” and “Medical Versus Non-Medical Immunization Exemptions for Child Care and School Attendance,” for the September issue of Pediatrics. In light of these statements, we would like remind our partners and colleagues of some of the resources available on the AAP and the Centers for Disease Control and Prevention’s (CDC) websites to support clinicians in their vaccination efforts and conversations with parents.

To view resources, please visit:

AAP: Resource for Communicating with Families

CDC: Provider Resources for Vaccine Conversations with Parents


Training Opportunity: CDC Update—The Importance of Using AFIX, and Tools for Successful Visits

August 16, 2016—The Florida Department of Health-Immunization Section would like to share with our immunization partners the Centers for Disease and Prevention’s (CDC’s) Pre-Teen Vax Scene webinar. This training opportunity titled, “CDC Update—The Importance of Using Assessment, Feedback, Incentives and Exchange (AFIX) and Tools for Successful Visits,” webinar will be held on Thursday, September 8, 2016, at 3:00 p.m. EST.

To register for this webinar, please visit: cc.readytalk.com/registration/#/?meeting=bsougnj7vnxt&campaign=q6z7qhjoq1r8.

Hanan Awwad, CDC’s AFIX Lead, will discuss updates and showcase new AFIX materials intended to assist awardees in developing their AFIX program. He will also provide a brief overview of the importance of AFIX visits and how critical the AFIX conversation is in improving vaccination rates. This webinar is designed for AFIX coordinators, AFIX program field staff, trainers of field staff, and immunization managers. The department will share resources and tools available that can be used to make AFIX programs more responsive to the unique challenges posed by human papillomavirus (HPV) vaccination.


Vaccine Information Statement Update: Serogroup B Meningococcal (MenB)

August 11, 2016—The Florida Department of Health, Immunization Section, would like to share the Centers for Disease Control and Prevention's (CDC) updated Vaccine Information Statement (VIS) for Serogroup B Meningococcal (MenB) released 8/9/2016.

All previous versions/editions of the Serogroup B Meningococcal (MenB) vaccine VIS should be discarded. You must use the updated version/edition immediately.

This VIS reflects the latest recommendations and is available at:

The VIS is also available in a variety of translations by the Immunization Action Coalition (IAC), through a cooperative agreement with CDC. You may find these translations at: www.immunize.org/vis/vis_meningococcal_b.asp or immunize.org/vis/?f=9.

The Florida SHOTS system also provides an option to print the most current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly review the VIS being distributed by their staff. Please check for the current versions at: cdc.gov/vaccines/hcp/vis/current-vis.html.


Human Papillomavirus Assessment of Associated Cancers—United States, 2008–2012

July 27, 2016—The Florida Department of Health-Immunization Section would like to share with our immunization partners the Centers for Disease Control and Prevention’s (CDC) report on Human Papillomavirus Assessment of Associated Cancers—United States, 2008–2012, published in the Morbidity and Mortality Weekly Report, July 8, 2016/65(26); 661-666. To review the report in its entirety visit: www.cdc.gov/mmwr/volumes/65/wr/mm6526a1.htm?s_cid=mm6526a1_e.

Human papillomavirus (HPV) is a known cause for several cancers. Most HPV infections are asymptomatic and clear spontaneously, persistent infections with one of 13 oncogenic HPV types can progress to pre-cancer or cancer. To assess the incidence of HPV-associated cancers, the CDC analyzed 2008–2012 high-quality data from their National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results program.

Overall, an average of 38,793 HPV-associated cancers (11.7 per 100,000 persons) were diagnosed annually, including 23,000 (13.5) among females and 15,793 (9.7) among males. Of the 38,793 cancers that occurred each year in the United States at anatomic sites associated with HPV, approximately 30,700 can be attributed to HPV.

Ongoing surveillance for HPV-associated cancers using high-quality population-based registries is needed to monitor trends in cancer incidence that might result from increasing use of HPV vaccines and changes in cervical cancer screening practices. The Advisory Committee on Immunization Practices (ACIP) recommends routine vaccination with any of the available HPV vaccines. Recommendations include:

  • Use bivalent, quadrivalent or 9-valent for females
  • Use quadrivalent for males
  • Vaccinate at ages 11–12 years and through age 26 years for females and age 21 years for males, if they were not previously vaccinated

Vaccine Information Statement Update: Hepatitis A, Hepatitis B and Polio

July 26, 2016—The Florida Department of Health, Immunization Section, would like to share the Centers for Disease Control and Prevention's (CDC) updated Vaccine Information Statements (VISs) for Hepatitis A, Hepatitis B, and Polio released 7/20/2016.

All previous versions/editions of the Hepatitis A, Hepatitis B, and Polio vaccine VISs should be discarded. You must use the updated version/edition immediately. These three VISs reflect the latest recommendations and are available at:

The VISs are also available in a variety of translations. You may find these translations at: immunize.org/vis/?f=9. These are coordinated by the Immunization Action Coalition (IAC), through a cooperative agreement with CDC.

The Florida SHOTS system displays/provides an option to print the most current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly check the VIS being distributed by their staff. Check for the current versions at: cdc.gov/vaccines/hcp/vis/current-vis.html.


Newly Updated and Redesigned Vaccine Storage and Handling Toolkit Available

July 20, 2016—The Center for Disease Control and Prevention (CDC) announces a newly updated and redesigned Vaccine Storage and Handling Toolkit available online at: www.cdc.gov/vaccines/hcp/admin/storage/toolkit/storage-handling-toolkit.pdf.

The Vaccine Storage and Handling Toolkit reflects best practices for vaccine storage and handling from Advisory Committee on Immunization Practices (ACIP) recommendations, product information from vaccine manufacturers, and scientific studies.

Storage & Handling ToolkitThe newly designed toolkit helps health care providers find the information they need quickly and easily. The beginning chapters address the three main elements of an effective cold chain:

  • A well-trained staff
  • Reliable storage and temperature monitoring equipment
  • Accurate vaccine inventory management
  • Other chapters provide information on emergency management of vaccine and developing standard operating procedures for routine, and emergency storage and handling

The updated toolkit also reflects an adjustment in CDC’s guidance on the Fahrenheit temperature range for storing refrigerated vaccines. The new recommended Fahrenheit temperature range is 36° F – 46° F (previously 35° F – 46° F). The Celsius temperature range (2° C – 8° C) remains unchanged, as stated in all manufacturer package inserts for routinely recommended vaccines.


Training Opportunity: College Students and Meningococcal Disease: Are Students Protected?

July 19, 2016—We are pleased to share with our immunization partners the National Foundation for Infectious Diseases (NFID) webinar on “College Students and Meningococcal Disease: Are Students Protected?” This webinar is being presented on August 2, 2016 at 12 p.m. EST. To register for the webinar visit: cc.readytalk.com/registration/#/?meeting=ic4hp5spmhkg&campaign=ct55yzypjo0.

Presenters:

  • William Schaffner, MD, NFID Medical Director
  • Susan Even, MD, Executive Director, University of Missouri Student Health Center
  • Mary Ferris, MD, Student Health Executive Director, University of California, Santa Barbara, CA
  • Jillandra Rovaris, PhD, Director of Health and Counseling, Santa Clara University, Santa Clara, CA

Discussion:

  • The burden of meningococcal disease, immunization coverage rates, current recommendations for meningococcal vaccinations and an overview of recent cases on U.S. college campuses.
  • A panel of representatives from colleges that have experienced recent meningitis outbreaks will share their experiences, best practices, and lessons learned.

This webinar is supported by unrestricted educational grants from GlaxoSmithKline (GSK) and Pfizer Inc. NFID policies restrict funders from controlling program content. To review NFID policy please visit: www.nfid.org/info/grantspolicy.html.

The NFID offers a variety of professional education activities designed to provide practical knowledge, tools and resources led by key opinion leaders in infectious diseases. For more information about foundation and to review educational opportunities please visit: www.nfid.org/?utm_source=NFID+eMail+Subscription+2&utm_campaign=7316459b14-August+2016%3A+MenB&utm_medium=email&utm_term=0_39b4247b67-7316459b14-336170873.


Training Opportunity: Adolescent Immunization: “Where We Are Now and How We Can Do Better” Webinar

July 15, 2016—We are pleased to share with our immunization partners a webinar on adolescent immunization, “Where We Are Now and How We Can Do Better,” presented by William Atkins, MD, MPH, who serves as the Immunization Action Coalition’s associate director for immunization education. The webinar is scheduled for July 28, 2016, from noon–1 p.m. EST. To register for this webinar, please visit: cc.readytalk.com/registration/#/?meeting=ya6m9a54fbbl&campaign=crm9wgi6ofrq.

In 2005, the Advisory Committee on Immunization Practices (ACIP) made its first routine adolescent immunization recommendation for tetanus/diphtheria /acellular pertussis (Tdap) vaccine. Since that time several important vaccines have been added to the ACIP’s recommended immunization schedule for adolescents: Tdap, meningococcal ACWY, meningococcal B (a “category B” recommendation, meaning it is recommended for high risk individuals based on clinical decision making), human papillomavirus (HPV), and influenza. Data from the 2014 National Immunization Survey-Teen (NIS-Teen) indicated vaccine coverage for adolescents is relatively high for the single recommended dose of Tdap, however, for vaccines requiring more than one dose to complete the series remains far below desired coverage levels.

Dr. Atkinson’s presentation will cover the recommendations for each adolescent vaccine, provide strategies to improve coverage rates in this population, and offer available resources to assist immunization providers in their efforts to improve coverage rates.


Training Opportunity: Updates from June 2016 ACIP Meeting

June 30, 2016—The National Foundation for Infectious Diseases (NFID) is presenting a webinar on Updates from June 2016 ACIP Meeting. The presentation will cover updated recommendations for adult vaccination and discussion around votes taken regarding influenza, meningococcal, and cholera vaccines. The one-hour webinar will be presented on Thursday, July 7, 2016 at 12:00 p.m. EST.

For more information and to register, please visit: us2.campaign-archive2.com/?u=7dbf51a2fc5d9cc9dd52475dd&id=b8c9495ae4&e=5587afee93


National Immunization Awareness Month Events and Webinar Available

June 28, 2016—The Florida Department of Health’s Immunization Section is pleased to announce August is National Immunization Awareness Month (NIAM) sponsored by the National Public Health Information Coalition (NPHIC) and the Centers for Disease Control and Prevention’s (CDC) National Center for Immunization and Respiratory Diseases. NIAM was established to encourage people of all ages to make sure they are up to date on the vaccines recommended for them. Communities have continued to use the month each year to raise awareness about the important role vaccines play in preventing serious, sometimes deadly, diseases.

In preparation for NIAM’s observance, we are also sharing the NIAM Webinar as a training opportunity. The NIAM Webinar being offered is titled, “National Immunization Awareness Month: Strategies for Maximizing Digital Impact.” The webinar will highlight new digital and social media resources provided by the CDC. The Virtual Immunization Communication Network is providing the webinar on Wednesday, June 29, 2016 at 2 p.m. EST. 

Each week of NIAM focuses on a different stage of the lifespan:

  • Adults (Aug. 1–7)
  • Pregnant women (Aug. 8–14)
  • Babies and young children (Aug. 15–21)
  • Preteens and teens (Aug. 22–28)

CDC Immunization Resources Available: CDC has developed immunization materials our partners can use in local outreach and education efforts during NIAM and throughout the year. To learn more about NIAM activities, events, promotional materials, and educational resources visit: www.cdc.gov/vaccines/events/niam.html.


Centers for Disease Control and Prevention Announces 2016 ACIP Recommended Immunization Schedules are available in Spanish

June 16, 2016—We are pleased to share with our immunization partners the Centers for Disease Control and Prevention’s (CDC) announcement of the new 2016 ACIP Recommended Immunization Schedules are now available in Spanish. The schedule shows the recommended vaccines for those 7 to 18-years-old. The 2016 ACIP Recommended Immunization Schedules in Spanish is available at: www.cdc.gov/vaccines/schedules/easy-to-read/preteen-teen.html#spanish.


Centers for Disease Control and Prevention Announces Newly Redesigned Vaccines and Immunizations Website

June 3, 2016—We are pleased to share with our immunization partners the Centers for Disease Control and Prevention’s (CDC) newly redesigned Vaccines and Immunizations website which is now mobile-friendly. You can now use your cell phone or tablet to review the updated information at: www.cdc.gov/vaccines/index.html.

Features Include:

  • Schedules
  • Adult Vaccines
  • Health Care Providers/Professionals Resources
  • Immunization Managers Information Site
  • Specific Groups of People with Special Immunization Recommendations
  • Quick Links to Vaccine Related Information
  • News and Media Releases
  • Immunization Works Newsletters

The site navigation has been simplified and redundant or old pages have been removed. If you have bookmarks from your computer or have embedded CDC vaccine links within your web content, you may need to revise the links.

New Standards for Adult ImmunizationNew features and resources will be added throughout the year. Watch for updates.


2016–2017 Updated Immunization Flyers and Brochures Available

May 17, 2016—We are pleased to announce the 2016–2017 immunization flyers and brochures have been updated and are available on the Florida Department of Health’s (DOH) Immunization Section website: www.floridahealth.gov/programs-and-services/immunization/publications/index.html.

Every year the Centers for Disease Control and Prevention (CDC) announces immunization recommended schedules provided by the Advisory Committee on Immunization Practices (ACIP). In keeping up with the ACIP recommendations, DOH immunization flyers and brochures are updated annually to reflect the changes.

The DOH immunization brochures and flyers cover children, adolescent, and adult vaccines. The new 2016–2017 School Entry Immunization Requirements flyer is now available. Please check immunization information being disbursed in your clinic or practice to ensure the most updated materials are being given to your clients.

www.floridahealth.gov/programs-and-services/immunization/publications/_documents/16-17-schoolentry-eng.pdf

www.floridahealth.gov/programs-and-services/immunization/publications/_documents/7th-grade-requirements.pdf

www.floridahealth.gov/programs-and-services/immunization/publications/_documents/school-shots-english.pdf

www.floridahealth.gov/programs-and-services/immunization/publications/_documents/adolescent-shots.pdf

www.floridahealth.gov/programs-and-services/immunization/publications/_documents/teens-social.pdf

www.floridahealth.gov/programs-and-services/immunization/publications/_documents/vaccinate-graduate.pdf

The CDC recommends that all health care providers visit: www.cdc.gov/vaccines/schedules/index.html to read the complete advisory recommendations for important details and changes to last year's immunization schedules.


Hepatitis Awareness Month and Testing Day—May 2016

May 17, 2016—We are pleased to share with our immunization partners the 21st Hepatitis Awareness Month and the 5th observance of May 19, 2016 as National Hepatitis Testing Day in the United States. The Centers for Disease Control and Prevention (CDC) reports approximately 90 percent of U.S. deaths from viral hepatitis are caused by infection with hepatitis C virus (HCV). In 2013, for the first time, deaths associated with HCV infection surpassed the total number of deaths from 60 other nationally notifiable infectious diseases. Visit the viral hepatitis home page for more information: www.cdc.gov/hepatitis/hcv/index.htm.

Hepatitis Risk Assessment
The online Hepatitis Risk Assessment (www.cdc.gov/hepatitis/riskassessment/index.htm) is designed to determine an individual’s risk for viral hepatitis and asks questions based upon the CDC’s recommendations for testing and vaccination. The Hepatitis Risk Assessment allows individuals to answer questions privately, either in their home or in a health care setting, and print their recommendations to discuss with their doctor.

Hepatitis Testing Day – May 19, 2016
May 19 has been designated as a national “Hepatitis Testing Day” in the U.S., the CDC and others use Hepatitis Testing Day as an opportunity to remind health care providers and the public who should be tested for chronic viral hepatitis.

Chronic Hepatitis can lead to Liver Cancer
Unlike hepatitis A, which does not cause a long-term infection, hepatitis B and hepatitis C can become chronic, life-long infections. More than five million Americans are living with chronic hepatitis B or chronic hepatitis C in the U.S., but most do not know they are infected. Chronic hepatitis can cause serious liver problems, liver damage, cirrhosis, and liver cancer. People with chronic hepatitis B and hepatitis C have the greatest risk of liver cancer. More than 60 percent of liver cancer cases are associated with hepatitis B or C.

Vaccine-preventable: Hepatitis A and Hepatitis B
Hepatitis A and hepatitis B can both be prevented with vaccines. Cases of hepatitis A have dramatically declined in the U.S. over the last 20 years largely due to vaccination efforts. The hepatitis A vaccine is recommended for all children at one year of age and for adults who may be at increased risk. For more information, visit: www.cdc.gov/hepatitis/hav/afaq.htm. Unfortunately, many people became infected with hepatitis B before the hepatitis B vaccine was widely available. The hepatitis B vaccine is recommended for all infants at birth and for adults who may be at risk. Visit www.cdc.gov/hepatitis/hbv/bfaq.htm#bFAQ33 to learn more.


Training Opportunity: 2016 Pink Book Webinar Series

May 10, 2016—We are pleased to share with our immunization partners the Centers for Disease Control and Prevention’s (CDC) 2016 Pink Book Webinar Series. This online series of 15 webinars provides an overview of the principles of vaccination, general recommendations, immunization strategies for providers, and specific information about vaccine-preventable diseases and the vaccines that prevent them.

Each one-hour webinar explores a chapter from the 13th edition of “Epidemiology and Prevention of Vaccine-Preventable Diseases,” also known widely as “The Pink Book." The 13th edition of the Pink Book is available for free online or for purchase as a bound paperback book.

Audience: Immunization Providers, Physicians, Nurses, Nurse Practitioners, Pharmacists, Physician Assistants, DoD Paraprofessionals, Medical Students, state and local immunization programs, etc.

Register at: www.cdc.gov/vaccines/ed/webinar-epv/index.html. Join CDC weekly for “Pink Book Wednesdays” from Noon–1p.m., EDT, starting June 1, 2016. Continuing Education credits will be offered.

2016 Training Schedule
Date Topic
June 1 Principles of Vaccination
June 8 General Recommendations: Part 1
June 15 General Recommendations: Part 2, and Vaccine Safety
June 29 Vaccine Storage & Handling and Administration
July 6 Immunization Strategies
July 13 Rotavirus and Hep A
July 20 DTaP /Tdap
July 27 Varicella/Zoster
Aug 3 Meningococcal Vaccines
Aug 10 Polio and Hib
Aug 17 Measles, Mumps, Rubella
Aug 24 Influenza
Aug 31 HPV
Sept 7 Hepatitis B
Sept 21 Pneumococcal Vaccines

Florida’s 2016 CDC Childhood Immunization Champion

April 22, 2016—In observance of National Infant Immunization Week (NIIW), the Florida Department of Health presented Dr. Julie DeCesare with the Centers for Disease Control and Prevention’s (CDC) Childhood Immunization Champion award on April 19, 2016 in Pensacola, FL. Dr. DeCesare has been named as Florida’s Immunization Champion for her outstanding efforts promoting and increasing the human papillomavirus (HPV) immunization rates in her community.

“We are thrilled that CDC has commended Dr. DeCesare for her commitment to ensuring that young people and their families understand the cancer prevention benefits of the HPV vaccine,” said Interim State Surgeon General Dr. Celeste Philip. “Her work at the local level with schools, hospitals and local health departments to ensure that all adolescents are protected has resulted in positive changes in her community.”

Dr. Julie DeCesare—Immunization Childhood ChampionDr. DeCesare is the OB/GYN Residency Director and Associate Professor at the Florida State University College of Medicine Pensacola satellite campus. She has been instrumental in developing a toolkit to promote education of young women regarding the HPV vaccination. The toolkit is available for download and has been distributed to hundreds of OB/GYNs throughout the state. She is currently conducting research on the attitudes regarding the HPV vaccine before and after receiving education on its benefits. Preliminary data suggests positive change from the educational program.

“Ensuring that every child is vaccinated on schedule is critical to protecting our children, schools, and communities from outbreaks of serious diseases,” said Dr. Amanda Cohn, a pediatrician at CDC and the Executive Secretary of the Advisory Committee on Immunization Practices. “We could not achieve our goal of protecting children without those committed individuals who promote immunizations at the state and local levels.”

CDC Childhood Immunization Champions were selected from a pool of health professionals, coalition members, community advocates, and other immunization leaders. State Immunization Programs coordinated the nomination process and submitted nominees to the CDC. One winner was selected in each of the participating states and the District of Columbia.

For profiles of other CDC Childhood Immunization Champion award winners, please visit www.cdc.gov/vaccines/events/niiw/champions/index.html. To learn more about Florida’s immunization efforts, visit our Immunization Section website.


Training Opportunity: You Call the Shots Offers New Rotavirus Module

April 20, 2016—We are pleased to share with our immunization partners the Centers for Disease Control and Prevention’s (CDC) You Call the Shots web-based training courses. The courses in You Call the Shots are updated regularly to include the latest guidelines and recommendations in vaccine practice.

The new Rotavirus module is now available with Continuing Education Units (CEUs) being offered for a limited time. To register for the CDC training course visit: www.cdc.gov/vaccines/ed/youcalltheshots.htm.

You Call the Shots is an interactive, web-based immunization training course. It consists of a series of modules that discuss vaccine-preventable diseases and explain the latest recommendations for vaccine use. Each module provides learning opportunities, self-test practice questions, reference and resource materials, and an extensive glossary.


TRAINING OPPORTUNITY: AFIX Program Strategies for Improving HPV Vaccination Rates in the Field

April 18, 2016—We are pleased to share with our immunization partners a webinar training presentation by the Centers for Disease Control and Prevention (CDC), Research Project Update: AFIX Program Strategies for Improving HPV Vaccination Rates in the Field. The Preteen VaxScene course is scheduled for May 19, 2016 at 1 p.m. EDT.

This webinar will be geared towards Assessment Feedback Incentives eXchange (AFIX) coordinators, AFIX program field staff, trainers of field staff, and immunization managers. Presenters will share strategies and tools they are using in an ongoing study to adapt AFIX to the unique challenges posed by Human papillomavirus (HPV) vaccination.

The update on this project will include discussion of how the study team is:

  • Using incentives, such as CMEs, to encourage vaccine providers to participate in AFIX
  • Using an Immunization Report Card to communicate the problem of low HPV vaccination coverage
  • Helping providers set measurable goals for HPV vaccination QI
  • Emphasize provider recommendations as a QI focus

Dr. Melissa Gilkey, Assistant Professor of Population Medicine at Harvard Medical School & Harvard Pilgrim Health Care Institute, will discuss the tools and strategies that were used by the participating AFIX programs for improving HPV vaccination rates in the field.

Chrystal Averette of the Washington Department of Health will share how, as part of this project, Washington State is implementing specific AFIX strategies in order to increase HPV vaccination rates.

To register for this event, please visit: cc.readytalk.com/cc/s/registrations/new?cid=hsx0yr705cpy


2016 Binational Immunization Resource Tool for Children from Birth Through 18 Years

April 18, 2016—We are pleased to share with our immunization partners the Center for Disease Control and Prevention’s (CDC) 2016 Binational Immunization Resource Tool for Children from Birth Through 18 Years. The binational immunization schedule provides a side-by-side presentation of recommended vaccines in Mexico and the United States, and helps health care professionals identify vaccines needed by children now in the U.S. who received some vaccines. The Binational Immunization Tool is available at: www.cdc.gov/vaccines/schedules/downloads/child/binational-schedule-pr.pdf.

2016 Binational Immunization ResourceThe CDC has a limited number of free Spanish language posters available for order. To view the current selection of posters please visit: www.cdc.gov/vaccines/events/niiw/promotional/print-materials/ads-posters.html#posters-spanish.


8th Annual Southwest Florida Immunization Workshop

April 15, 2016—We are pleased to share with our immunization partners the 8th Annual Southwest Florida Immunization Workshop, Vaccine Updates Including Adolescent Vaccines to be held May 19, 2016. Registration is at 8–9 a.m., with the workshop being held 9 a.m.–3:30 p.m., lunch included. The event will be held at State College of Florida at Lakewood Ranch, Sarasota. Preregistration is available at: www.planetreg.com/E171156173689.

Sponsors for the workshop include: Florida Department of Health (DOH), Partners Immunizing Toward Community Health (PITCH), Shots Across the Bay, Sarasota Memorial Health Care System, Suwannee River Area Health Education Center (AHEC), MedImmune, Pfizer, Merck, Sanofi Pasture and Walgreens.

Key Speakers and Presentation:

  • Dr. Schechtman, Florida American Academy of Pediatrics (AAP)
  • Dr. Susan Vadaparampil, Moffitt Cancer Center
  • JoEllen Wolicki, RN, BSN, Center for Disease Control and Prevention Nurse Educator

Presentation:

  • Keenan Farrar, Immunization Section Florida SHOTS Education Consultant
  • Michael Drennon, DOH-Sarasota Epidemiology Department
  • Carrie Harter, DOH-Manatee Epidemiology Department
  • Dearline Thomas-Brown, MPH, BSN, RN, DOH Immunization Section–Tallahassee
  • Samantha Staley and Andrea Peaten of PITCH will conduct a Human Papillomavirus exercise for everyone to participate in.

Activities:

  • Visit Vendor Displays
  • Tours of the state-of-the-art State College of Florida at Lakewood Ranch nursing simulation lab

Free CEUs and CMEs are being offered.


National Infant Immunization Week (NIIW) April 16–23, 2016

April 15, 2016—We are pleased to remind our immunization partners about the observance of National Infant Immunization Week (NIIW).

Since 1994, NIIW has been an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and to celebrate the achievements of immunization programs in promoting healthy communities throughout the United States. This year, NIIW is scheduled for April 16-23, 2016.

During the NIIW week, hundreds of communities across the United States will join in to celebrate the critical role vaccinations play in protecting our children, communities, and public health. Immunization is a shared responsibility. Families, health care professionals, and public health officials must work together to help protect the entire community.

It's easy to think of these as diseases of the past. But the truth is they still exist today. Unvaccinated children in the United States can—and do—get vaccine-preventable diseases. One example of the seriousness of vaccine-preventable diseases is the measles outbreaks in the last couple years resulting in an increase in the number of measles cases.

  • Through immunization, we can now protect infants and children from 14 vaccine-preventable diseases before age two.
  • Vaccines are among the most successful and cost-effective public health tools available for preventing disease and death. They not only help protect vaccinated individuals, but also help protect entire communities by preventing and reducing the spread of infectious diseases. Routine childhood immunization in one birth cohort prevents about 20 million cases of disease and about 42,000 deaths. It also saves about $13.5 billion in direct costs.

Children rely on adults to keep them safe and healthy. Those adults may be parents/guardians who keep a record of their child’s vaccinations and ask at each doctor appointment whether their child is up-to-date on immunizations. The adults may also be doctors, nurses, physician assistants, and other health care professionals who share scientifically-accurate, up-to-date information about vaccines with parents.

Additional Information, NIIW promotional and educational materials, as well as activities and event ideas can be found on the CDC resource site: cdc.gov/vaccines/events/niiw/index.html. You can continue to show your support for infant immunizations and NIIW by encouraging your community to join in.


Integrating Immunizations Into OB/GYN Practice

April 8, 2016—We are pleased to share with our immunization partners the American College of Obstetricians and Gynecologists (ACOG) publication, Committee Opinion, Number 661, April 2016. An article on Integrating Immunizations Into Practice was the focus of the Committee on Gynecologic Practice, Committee on Obstetric Practice and the Immunization Expert Work Group when discussing immunization against vaccine-preventable diseases for women’s primary and preventive health care.

The ACOG recommended that OB/GYNs should play a more prominent role in encouraging routine immunization in all patients; adults, pregnant women, and newborns. The obstetricians (OB) and gynecologists (GYN) can play a major role in reducing morbidity and mortality from a range of vaccine-preventable diseases including pertussis, influenza, human papillomavirus (HPV), and hepatitis. OB/GYNs should include immunizations as an integral part of their practice.

The ACOG has developed numerous resources, including a dedicated immunization website, Immunization for Women, www.immunizationforwomen.org/, to help equip OB/GYNs to become routine vaccinators. Many studies have shown that a recommendation from an OB/GYN or other health care provider for an immunization is one of the strongest influences on patient acceptance. While this is the first committee opinion specifically addressing the role of integrating immunizations into practice, ACOG has addressed the topic of immunization several times before in other committee opinions on the safety and efficacy of the Tetanus-Diphtheria-acellular Pertussis (Tdap) vaccine, the influenza vaccine, and the HPV vaccine.

The ACOG laid out a series of steps to better integrate immunization recommendations into their practice, including using electronic medical records to determine when a patient is due for her immunizations, as well as educating and immunizing health care personnel and staff so they can "lead by example" for their patients.

Download the ACOG Committee Opinion


Process for Designation as a Yellow Fever Vaccine Provider/Facility

April 7, 2016—The Immunization Section is sending this important announcement to notify our immunization partners regarding the application process for obtaining designation as a yellow fever vaccine provider/facility with requirements for both public and private medical facilities.

The Florida Department of Health–Immunization Section (Not Epidemiology) now certifies health care providers who meet the certification eligibility requirements to administer yellow fever vaccine. For more information: www.floridahealth.gov/programs-and-services/immunization/yellow-fever-vaccine-provider/index.html.

To become a certified Designated Yellow Fever Vaccine Provider/Facility, a provider MUST complete the following:

  1. Download, complete and submit the Yellow Fever Provider Application/Uniform Stamp Agreement
  2. Download, complete and submit the Yellow Fever Vaccination Center Agreement
  3. Submit proof of completion of the Centers for Disease Control and Prevention’s (CDC) Online Yellow Fever Course (Physician of Record as well as all designated medical staff) www.cdc.gov/travel-training/about-yellow-fever-vaccine.html
  4. Submit ALL forms and proof of CDC training via email, fax, or US mail per the information on the following website: www.floridahealth.gov/programs-and-services/immunization/yellow-fever-vaccine-provider/index.html.

Please note: If your Designated Yellow Fever Vaccine Provider changes, you MUST request a new yellow fever stamp with the new provider ID information.

  • When a yellow fever vaccine provider leaves their current position and a new provider is established, the new provider must request a new yellow fever vaccine stamp with the new provider’s ID information.
  • When a yellow fever vaccine provider relocates to a different medical establishment, the provider MUST submit a change of address and transfer the yellow fever vaccine to his new facility.

Training Opportunity: You Call the Shots Provides Updated Immunization Courses

April 1, 2016—We are pleased to share with our immunization partners the Centers for Disease Control and Prevention’s (CDC) You Call the Shots web-based training courses. The courses in You Call the Shots are updated regularly to include the latest guidelines and recommendations in vaccine practice. To review the updated training modules and register for the CDC training courses visit: www.cdc.gov/vaccines/ed/youcalltheshots.htm.

You Call the Shots is an interactive, web-based immunization training course. It consists of a series of modules that discuss vaccine-preventable diseases and explain the latest recommendations for vaccine use. Each module provides learning opportunities, self-test practice questions, reference and resource materials, and an extensive glossary.

Updated Courses

  • Meningococcal, February 2016
  • Pneumococcal, February 2016
  • Diphtheria, Tetanus, and acellular Pertussis (DTaP), March 2016
  • Hepatitis B, March 2016

**Continuing Education credits and Certificate of Participation are available.


Healthiest Nation 2030: Observing National Public Health Week April 4–10, 2016

April 1, 2016—We are pleased to share with our immunization partners this announcement on National Public Health Week, April 4–10, 2016. For 20 years, the American Public Health Association (APHA) champions the health of all people and communities and brings together communities across the United States to observe National Public Health Week as a time to recognize the contributions of public health and highlight issues that are important to improving our nation.

In observance of National Public Health Week, the University of Southern Florida’s College of Public Health (COPH) is hosting a variety of events throughout the month of April focusing on health issues, educational actives, and health screenings. Learn what you can do to create the healthiest nation in one generation by participating in an exciting array of scholarly, service, and research activities.

Highlights include:

  • A film screening of Someone You Love the HPV Epidemic
  • A Spring Fling Health Fair
  • A Food Drive to be held April 1–11, 2016

A COPH itinerary and flyer of the events taking place throughout the month can be downloaded below:

NPHM FlyerHPV Film Screening Flyer


Promote National Infant Immunization Week Using Social Media

April 1, 2016—We are pleased to share with our immunization partners an invitation to promote National Infant Immunization Week (NIIW), April 16–23, 2016, via social media. Promoting the NIIW is a great opportunity to raise awareness of the importance of childhood immunization. The Center for Disease Control and Prevention’s (CDC) National Center for Immunization and Respiratory Diseases (NCIRD) is inviting all their partners to spread the word about the value of immunization on social media using #NIIW during the observance week.

Join CDC’s NCIRD #NIIW Thunderclap campaign to support vaccination during NIIW. On April 18 at Noon EDT the #NIIW message will be released, all at once, thus creating a Thunderclap announcement that is heard far and wide. A thunderclap is a platform that uses the power of crowds to amplify a single important message across supporters’ social media channels.

Please, sign up now and help the CDC’s NCIRD reach a goal of 100 supporters. Instructions to sig up for the Thunderclap announcement have been listed for your convenience.

Thunderclap Instructions

  1. Go to www.thunderclap.it/projects/39318-support-childhood-vaccines.
  2. Choose a social media channel (Twitter, Facebook, or Tumblr) to share your support through.
  3. Note: Organizational Facebook pages cannot directly participate in a Thunderclap campaign, like personal profiles can. However, Facebook administrators can post a message with a link to the Thunderclap page and encourage fans to support the campaign.
  4. After you sign up, you can authorize Thunderclap to tell your friends and followers that you are supporting #NIIW.
  5. Invite others to sign up too!
  6. Watch on April 18 as the CDC’s NCIRD proclaims in unison support for infant immunization using #NIIW.
  7. If you have questions about Thunderclap, please email Brad Weisberg at lrt5@cdc.gov.

Immunization Action Coalition Publications

March 24, 2016—We are pleased to share with our immunization partners the Immunization Action Coalition’s (IAC) online publications, Needle Tips and Vaccinate Adults. These quarterly publications are a great resource for health professionals who provide services to children, teens, or adults.

Both quarterly publications feature a segment, Ask the Experts, which includes information provided by the Center for Disease Control and Prevention (CDC) experts who answer challenging and timely questions about vaccines and their administration. The publications focus on the latest vaccine news from the CDC and the Advisory Committee on Immunization Practices (ACIP).

The technical content for the online publications is reviewed by the CDC and contains ready-to-print materials to be copied and shared with staff and clients.

To subscribe to Needle Tips and Vaccinate Adults visit: www.immunize.org/subscribe/.

Download Vaccinate Adults Download Needle Tips


2016 National Adult and Influenza Immunization Summit Meeting—May 10–12, 2016

March 15, 2016—We are pleased to share with our immunization partners this announcement for the upcoming 2016 National Adult and Influenza Immunization Summit, “Making Vaccination Happen in a Changing Environment.” The event is being held at the Hyatt Regency Atlanta Hotel in Atlanta, GA, on May 10-12, 2016.

The National Adult and Influenza Immunization Summit (NAIIS) is dedicated to addressing and resolving adult and influenza immunization issues. The NAIIS consists of over 700 partners, representing more than 130 public and private organizations. Summit participants include a wide range of professionals from the health care industry, public health and private medical sectors, vaccine manufacturers and distributors, consumers, and others interested in stopping the transmission of vaccine-preventable diseases. Broad-based leadership of the NAIIS is conducted through the members of the Summit Organizing Committee (SOC).

To register for this summit please visit: www.izsummitpartners.org/summit/2016-naiis/ and use the password naiis2016. The registration site provides a draft agenda and hotel information. If you are interested in the federal government lodging rate, please email LaDora Woods (lwoods1@cdc.gov) for more information.

There will be three days packed with educational sessions. Highlights on the agenda include:

  • Vaccines and Insurance Coverage in the Era of the Affordable Care Act
  • The Use of Electronic Medical Records and Immunization Information System to Improve Adult Immunizations
  • Influenza Updates—2015–2016 Surveillance, Vaccine Coverage and Vaccine Effectiveness Update

National Immunization Conference 2016: It Takes a Community

March 14, 2016—We are pleased to share with our immunization partners the Centers for Disease Control and Prevention’s (CDC) and the CDC Foundation is hosting the National Immunization Conference September 13-15, 2016 at the Hilton Hotel, Atlanta, Georgia.

The three-day conference has three plenary sessions, 12 breakout sessions, various workshops, two immunization question and answer sessions, the Hilleman Lecture, and exhibits will highlight the 2016 conference.

Major Topics:

  • Ault Immunization
  • Immunization Information Systems
  • Programmatic Issues
  • Health and Risk Communications
  • Epidemiology and Surveillance
  • Childhood and Adolescent Immunization

For more information and to register for the conference visit : www.eventsforce.net/odyssey/frontend/reg/thome.csp?pageID=239&eventID=2&traceRedir=2&eventID=2.

Please note that while there is no charge to attend the conference and space is limited. It is recommended to register well in advance of the registration deadline of August 22, 2016, to guarantee availability.


Training Opportunity: 2016 Advisory Committee on Immunization Practices Recommended Immunization Schedules

March 10, 2016—We are pleased to share with our immunization partners the Centers for Disease Control and Prevention’s (CDC) 2016 Current Issues in Immunization NetConference (CIINC) being held March 16, 2016, Noon–1 p.m. (EST). For more information visit: www.cdc.gov/vaccines/ed/ciinc/.

The moderator for the NetConference will be Andrew Kroger, MD, MPH, Medical Officer, National Center for Immunization and Respiratory Diseases (NCIRD), CDC.

Speakers and Topics:

  • Update on 2016 Child/Adolescent Immunization Schedule
    Candice L. Robinson, MD, MPH, Communications and Education Branch, Immunization Services Division, NCIRD, CDC
  • Update on 2016 Adult Immunization Schedule
    David Kim, MD, Deputy Associate Director for Adult Immunization, Immunization Services Division, NCIRD, CDC

Training Opportunity: First Annual South Florida Immunization Workshop

March 10, 2016—The Immunization Section is pleased to announce the First Annual South Florida Immunization Workshop: Adolescent Health Challenges…Including HPV and Meningitis. The workshop is being held Saturday, March 12, 2016, 11 a.m.–5 p.m., at the Cohen Center on the Florida Gulf Coast University campus, Fort Myers, FL. The Immunization Coalitions for Collier and Lee Counties are hosting the event.

To register for the workshop visit: www.planetreg.com/e1216744673959. Visit vendor displays and enjoy a box lunch from 11 a.m.–12:30 p.m. The workshop will be held from 12:30–5 p.m. A workshop agenda has been attached for your convenience.

Featured Guest Speakers:

  • Lynn Bozof, President, National Meningitis Association
  • Dr. Tommy Schechtman, President, Florida American Academy of Pediatrics

Continuing physician and nursing education credit hours will be provided.


Kindergarten and Seventh Grade Immunization Status Report 2015–2016

February 29, 2016—Attached are the signed memorandum and results regarding the Kindergarten and Seventh Grade Immunization Status Report 2015–2016. Each October, all Florida public and private schools with a kindergarten and/or seventh grade are required to submit reports indicating the immunization status of their kindergarten and/or seventh-grade students.

The purpose of this report is to ensure compliance of section 1003.22, Florida Statutes and Florida Administrative Code Chapter 64D-3.046 regarding immunization. This report should also be used to identify those counties needing assistance in raising their immunization coverage levels among kindergarten and seventh-grade students to at least 95%.

View the K-7 2015–2016 Status Report


Administration Error Involving a Meningococcal Conjugate Vaccine—United States, March 1, 2010–September 22, 2015

February 26, 2016—The Immunizations Section is forwarding important information to our immunization partners provided by the Centers for Disease Control and Prevention (CDC). In the Morbidity and Mortality Weekly Report, February 19, 2016/65(6); 161–162, the Notes from the Field section focused on the article titled Administration Error Involving a Meningococcal Conjugate Vaccine—United States, March 1, 2010–September 22, 2015. To review the entire report, please visit: www.cdc.gov/mmwr/volumes/65/wr/mm6506a4.htm?s_cid=mm6506a4_e.

There were reports of only one component of Menveo being given to clients. Other reports noted the lyophilized MenA component was reconstituted in sterile water, saline, a different liquid vaccine (hepatitis B vaccine in two cases, and diphtheria-tetanus-acellular pertussis [DTaP] vaccine in one case), or an unspecified diluent.

Menveo is a meningococcal conjugate vaccine that is supplied in two vials that must be mixed before administration. The lyophilized MenA (freeze-dried) antigen must be reconstituted with the MenCYW-135 diluent. To administer the vaccine, the diluent is drawn into a syringe, and used to reconstitute the lyophilized MenA antigen. The antigen is mixed and then is administered by intramuscular injection. Failure to prepare Menveo as directed by the manufacturer’s instructions can lead to potential adverse reactions, lack of protection against the intended pathogens and vaccine failure.

Immunization providers need to follow the instructions provided with Menveo (including vaccine labeling, packaging, and product insert) regarding proper administration. Vaccines requiring reconstitution should only be reconstituted with the specific diluent supplied by the manufacturer for that vaccine. A recipient who has received an improperly prepared dose of Menveo needs to have the dose of meningococcal conjugate vaccine prepared and repeated according to manufacturer instructions. The repeat dose can be administered at any time.

The meningococcal conjugate vaccine is recommended for:

  • Adolescents preferably ages 11 to12-years-old with a booster at 16-years-old
  • People between the ages of 2 to 54-years-old who have certain immunosuppressive conditions

TRAINING OPPORTUNITY: Standing Orders for Adult Immunizations

February 24, 2016—The Immunization Section is pleased to announce Take a Stand workshops, Standing Orders for Adult Immunizations, a national adult immunization standing orders training initiative being offered in Orlando and Fort Lauderdale, Florida. Evidence has shown that the use of Standing Orders Programs (SOPs) in medical practices can improve immunization rates in the adult population. The use of SOPs are recommended by the Centers for Disease Control and Prevention (CDC) and by the United States Community Preventive Services Task Force. Information on the Take a Stand program has been attached for your convenience.

Take a Stand offers no-cost, interactive four-hour workshops led by experts in adult immunization. The SOPs authorize nurses, pharmacists, physician assistants, or medical assistants—when permitted under law—to assess a patient’s immunization status and then administer the needed vaccines according to the standing orders that have been pre-approved by a physician or another authorized provider.

Standing Orders for Adult Immunizations workshops are being offered at:

Orlando: April 12, 2016, 10 a.m.–2:30 p.m. (lunch included) at the Hyatt Regency, Orlando International Airport.

Fort Lauderdale: April 13, 2016, 10 a.m.–2:30 p.m. (lunch included) at the Riverside Hotel.

To register for a workshop visit: www.standingorders.org/. The initiative is supported and sponsored by the Immunization Action Coalition (IAC) and Pfizer.

  • The workshop will help implement and improve the use of standing orders in practices.
  • Practices will have access to follow-up support for standing order implementation from IAC for one year after the workshop.
  • The workshops are designed for clinicians, nurses, and clinic managers in medical practices that serve adults.

2016 Advisory Committee on Immunization Practices Recommended Immunization Schedules

February 5, 2016—We are pleased to share with our immunization partners the Centers for Disease Control and Prevention’s (CDC) 2016 immunization recommended schedules published in the Morbidity and Mortality Weekly Report, February 2, 2016/65(4); 1-2. The early released articles are: the Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years—United States, 2016 and the Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older—United States, 2016.

Each year, recommendations for routine use of vaccines in children, adolescents, and adults in the United States are developed by the Advisory Committee on Immunization Practices (ACIP). We recommend that all health care providers visit: www.cdc.gov/mmwr/index.html to read the complete advisory for important details and changes to last year's schedules.

View Child Schedule (0–18 Years)

View Adult Schedule (19+)


National Cancer Institute-Designated Cancer Centers Urge HPV Vaccination for the Prevention of Cancer

February 3, 2016—We are pleased to share the following information on the National Cancer Institute (NCI)-designating cancer centers to promote the use of Human Papillomavirus (HPV) vaccine. Today, cancer centers across the U.S. are releasing statements showing their support of HPV vaccine as cancer prevention.

The Centers for Disease Control and Prevention report that each year in the U.S., 27,000 men and women are diagnosed with an HPV-related cancer. Many of these HPV-related cancers are preventable using HPV vaccine. Unfortunately, HPV vaccination rates across the U.S. remain low. The NCI recognizes these low rates as a serious public health threat and is compelled to issue a call to action.

Take action now!


National Infant Immunization Week Update and Planning Webinar

January 26, 2016—We are pleased to remind our immunization partners about the upcoming observance of National Infant Immunization Week (NIIW) April 16–23, 2016. This annual observance is to promote the benefits of immunizations and to improve the health of children two years old or younger. Since 1994, local and state health departments, national immunization partners, health care professionals, community leaders from across the United States, and the Centers for Disease Control and Prevention (CDC) have worked together through NIIW to highlight the positive impact of vaccination on the lives of infants and children, and to call attention to immunization achievements.

To prepare for NIIW 2016 sign up for the “Planning Kick Off” webinar on February 4, 2016, at 2 p.m. (EST.) Learn about resources and planning efforts that will highlight national projects and complement state and local efforts. Register Today!

Topics:

  • Overview of NIIW goals and purpose
  • Key dates and resources for the CDC Childhood Immunization Champion Award
  • Highlight CDC materials available for use in planning and conducting your NIIW events
  • NIIW success stories from program and coalition colleagues at the state level

Presenters:

  • Dave McCormick, Director of the Indiana Immunization Division, Indiana Immunization Program Manager
  • Lisa Robertson, Executive Director, Indiana Immunization Coalition
  • Jill Woodard, Northrop Grumman Health Research Associate working at the National Center for Immunization and Respiratory Diseases at the CDC as a contractor

Please review the following websites for more information on NIIW:


2016 Childhood Immunization Champion Award Program

January 8, 2016—The Centers for Disease Control and Prevention (CDC) and the CDC Foundation is proud to present the fifth Annual Childhood Immunization Champion Award Program. The award honors those who are doing an exemplary job or going above and beyond to promote or foster childhood immunizations in their communities. Awards will be announced April 16-23, 2016 in conjunction with the observance of National Infant Immunization Week (NIIW).

Immunization Champions can include coalition members, parents, health care professionals (e.g., physicians, nurses, physicians’ assistants, nurse practitioners, medical assistants, etc.), and other immunization leaders who meet the award criteria. Immunization program managers, state and federal government employees of health agencies, individuals who have been affiliated with and/or employed by pharmaceutical companies and those who have already received the award are not eligible to apply.

When nominating and selecting a Champion, immunization programs should base their nominations on meeting one or more of the following criteria:

Leadership: The candidate is considered an authority on immunization in their community, medical system, or individual practice. Activities may include acting as a spokesperson, trainer, mentor, or educator.

Collaboration: The candidate has worked to build support for and increase immunization rates in infants and young children. Activities may include establishing or strengthening partnerships, coalitions, committees, working groups, or other.

Innovation: The candidate has used creative or innovative strategies to promote immunization or address challenges to immunization in their practice, community, state, or region. Activities may include either new strategies or adapting existing strategies in new ways such as for reaching under-immunized populations.

Advocacy: The candidate is active in advancing policies and best practices to support immunization in infants and young children in their community, state, or region. Activities may include providing legislative testimony or promoting, analyzing, or evaluating policies.

Eligibility information and nominating forms have been attached for your convenience. Please submit ALL nomination packets to Immunization@FloridaHealth.gov, by January 29, 2015.

Download Immunization Champion Information and Nomination Form


You have the Power To Prevent Cancer!

January 8, 2016—DOH is Proud to Partner with the 2016 Florida Immunization Campaign #BeHPVFreeFL.

2016 Immunization Summit LogoFlorida has one of the highest cervical cancer rates in the country and yet, our HPV vaccination rates are among the lowest with only 29% completion rate for girls and 18% completion rate for boys. Now is the time to turn this around, prevent cancer through HPV vaccination and save lives.

As part of this Campaign, a 2-Day Immunization Summit for healthcare professionals will take place in St. Petersburg on Feb 11th & 12th.

This is a wonderful opportunity for all Pediatric Physicians, Medical Staff, Community Health Centers, County Health Department employees, School Staff, Medical and Nursing Students, and Residents to learn current recommendations for the HPV vaccine, tools for talking to parents, strategies for improving HPV vaccination rates, the critical role that health professionals play, as well as a chance to share best practices and network with peers.

Thank you for your support in helping to make the 2016 Florida Immunization Summit a success! You have the Power To Prevent Cancer!

2016 Immunization Summit Registration: #BeHPVFreeFL

Download #BeHPVFreeFL Newsletter.


Immunization Champions, Advocates, and Mentors Program Academy

December 22, 2015—We would like to share with our immunization partners the Immunization Champions, Advocates, and Mentors Program (ICAMP) Academy, sponsored by the Gerontological Society of America (GSA). This program will prepare health care providers to become an Immunization Champion for your organization. The GSA wants to support your efforts to improve the quality of care for the adult population you serve as well as to improve your organization’s performance on immunization quality metrics.

Health care providers including physicians, nurses, pharmacists, physician assistants, and nurse practitioners will have the unique opportunity to attend the 1½-day multidisciplinary program, at four locations in 2016:

  • February 15-16 in Los Angeles, CA
  • March 28-29 in Atlanta, GA
  • May 16-17 in Washington, DC
  • June 20-21 in Phoenix, AZ

All expenses and program fees for participants are fully covered by GSA. We invite you to apply for this innovative program. Applications will be evaluated and a limited number of participants will be chosen by GSA’s National Adult Vaccination Program multidisciplinary workgroup.

For additional information and to apply for the program visit: www.navp.org.

Application deadline dates are: January 3, 2016 for February 15-16, 2016 in Los Angeles; January 31, 2016 for March 28-29, 2016 in Atlanta; March 13, 2016 for May 16-17, 2016 in Washington, DC, and April 3, 2016 for the June 20-21, 2016 academy in Phoenix. Apply now as space is limited.

The ICAMP Academy’s agenda has been designed by experts who have achieved success in improving immunization rates in their practices and communities. The ICAMP Academy will provide you with insights on how to efficiently implement the National Vaccine Advisory Committee’s Standards for Adult Immunization Practice through the use of practical tools and sharing of best practices.

Potential benefits for you and your organization include:

  • Improved performance on immunization quality metrics.
  • Increased satisfaction with the healthcare provider–patient immunization dialogue.
  • Improved overall knowledge base regarding adult immunization standards.
  • Learning from and developing relationships with the ICAMP Academy’s multidisciplinary participants and experts.
  • Learning about best practices that have proven to increase adult immunization rates.

Training Opportunity: Join Voices for Vaccines Conference Call Discussing the HPV Vaccination

December 22, 2015—The Immunization Section is pleased to announce a training presentation sponsored by Join Voices for Vaccines (VFV) featuring Dr. Nathan Boonstra, who will discuss “HPV Vaccination” during a conference call to be held on January 7 at 1p.m. (ET). Dr. Boonstra will talk about the problem of low HPV vaccine uptake and how providers, parents, and public health professionals can work together to better protect children and communities against this common and potentially deadly virus.

Dr. Boonstra is an attending pediatrician at Blank Children's Hospital in Des Moines. He has spoken extensively to physicians and parent groups about vaccines, including the HPV vaccine in particular. When he isn't attending to patients or promoting prevention, you can find Dr. Boonstra at his blog at PedsGeekMD.

Voices for Vaccines is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters. VFV invites everyone who appreciates vaccines to become a member of their organization. Please spread the word to your friends and colleagues to register for the conference call and to join VFV! To register for the conference call send an email to: info@voicesforvaccines.org.


TRAINING OPPORTUNITY: Taming Conversations Around HPV Vaccine and Other Immunizations in Social Media

December 21, 2015—The Immunization Section is pleased to announce four training presentations by the Centers for Disease Control and Prevention (CDC). In observance of Cervical Health Awareness Month in January 2016, the CDC Adolescent Immunization Communications Team is presenting the “Taming Conversations Around HPV Vaccine and Other Immunizations in Social Media” webinar series.

There will be weekly presentations addressing various aspects of engaging with negative comments or safety concerns on social media platforms. Discussion will be mostly focused on the HPV vaccine, and the unique challenges that comes with it. Each webinar will offer perspectives from experts in immunization, vaccine safety, vaccine acceptance, and social media.

Please register for one or more of the webinars listed below using the following links:


National Influenza Vaccination Week (NIVW) is December 6–12, 2015

December 4, 2015—We would like to remind our immunization partners about the upcoming observance of National Influenza Vaccination Week (NIVW). NIVW is an annual observance to highlight the importance of continuing influenza vaccination though the holiday season and beyond. This year NIVW is scheduled for December 6–12, 2015.

  • Flu vaccination activity drops after the end of November. The Centers for Disease Control and Prevention (CDC) and partners want to remind the public that even though the holiday season is upon us it is not too late to get a flu vaccine. As long as flu viruses are spreading and causing illness vaccination can provide protection against the flu.
  • The CDC recommends a yearly flu vaccine for everyone six-months of age and older as the first and most important step in protecting against influenza virus. Flu vaccine is the best tool to help prevent or reduce missed work, serious illnesses, doctor’s visits, hospitalization, and even death.

A goal of NIVW is to communicate the importance of flu vaccination for people who are at high- risk for developing flu-related complications:

  • Young children
  • Pregnant women
  • People with certain chronic health conditions
  • People 65-years of age and older

A full list of “People at High-Risk of Developing Flu-Related Complications” is available at: www.cdc.gov/flu/about/disease/high_risk.htm.

There are many choices available for flu vaccine, both in terms of where to get vaccinated and which vaccine to get. Millions of doses of influenza vaccine have been administered to people safely for decades. The holiday season will be much more enjoyable if you protect yourself, your family, and community against the flu.

Please visit the CDC resource site at: www.cdc.gov/flu/nivw/ to obtain educational and promotional materials to encourage community participation for NIVW activities.


Pneumococcal Vaccination Coverage Among Persons ≥65 years—United States, 2013

December 1, 2015—We are pleased to share the following Science Direct Publication, Vaccine, with our immunization partners. In the October 13, 2015; Vol. 33, Issue 42, pgs. 5503–5506; Vaccine has published the following article, Pneumococcal Vaccination Coverage Among Persons ≥65 years—United States, 2013, as reported by Alissa C. O’Halloran, Peng-jun Lu and Tamara Pilishvili. The report, in its entirety, has been attached for your convenience. Dowload the O'Halloran Report.

Invasive pneumococcal is a disease causing serious illness in the United States for adults 65-years and older. In 1997 the Advisory Committee on Immunization Practices (ACIP) first recommended the use of 23–valent pneumococcal polysaccharide vaccine (PPSV23). In 2014 the ACIP added 13–valent pneumococcal conjugate vaccine (PCV13) to be used in a series with PPSV23.

Healthy People 2020 set a goal of 90 percent for adults’ 65–years and older to receive the pneumococcal vaccines. The 2013 National Health Interview Survey (NHIS) estimated the national pneumococcal vaccination coverage was at 59 percent for adults’ 65–years and older. From 2005–2013 a Behavioral Risk Factor Surveillance System (BRFSS) was used to examine national and state-specific pneumococcal vaccine information for adults’ 65–years and older. The survey included racial and ethnic groups.

Survey Results:

  • The overall pneumococcal vaccine average rate was 69.5 percent
  • Non-Hispanic whites had a pneumococcal vaccine average rate of 71.2 percent
  • Racial/ethnic groups combined had a pneumococcal vaccine average rate of 61.5 percent
  • Oregon had the highest pneumococcal vaccine rate of 75 percent
  • New Jersey had the lowest pneumococcal vaccine rate of 61.9 percent
  • Florida had a pneumococcal vaccine rate of 66.2 percent

This article indicated the pneumococcal vaccination coverage has increased since 1997. There is still work to do to reach the Healthy People 2020 goal of 90 percent, especially for racial/ethnic groups, whose pneumococcal immunization rate was almost ten (10) percent below the non-Hispanic whites. These results indicate that racial/ethnic disparities exist.

It is important that health care providers and hospitals continue their efforts to immunize adults with pneumococcal vaccines. Missed opportunities are occurring during hospital stays and annual doctor visits. Health care providers are encouraged to follow the ACIP recommendation to administer needed vaccines to clients and to document vaccines administered. When vaccines are not available please refer the client to a local facility that provides vaccines.


Vaccine Information Statement Update: Pneumococcal Conjugate and Multiple Vaccines

November 30, 2015—The Florida Department of Health, Immunization Section, would like to share the Centers for Disease Control and Prevention (CDC) updated Vaccine Information Statements (VIS) for pneumococcal conjugate vaccine (PCV13) and multiple vaccines (DTaP, Hib, hepatitis B, polio, PCV13) released on November 5, 2015.

All previous versions/editions of the pneumococcal conjugate and multiple vaccines VIS’s should be discarded. You must use the updated version/edition immediately. These two VISs reflect the latest recommendations and format are available at: www.cdc.gov/vaccines/hcp/vis/vis-statements/pcv13.html and www.cdc.gov/vaccines/hcp/vis/vis-statements/multi.html.

The VIS’s are also available in a variety of translations. You may find these translations at: immunize.org/vis/?f=9. These are coordinated by the Immunization Action Coalition (IAC), through a cooperative agreement with CDC.

The Florida SHOTS system displays/provides an option to print the most current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly check the VIS being distributed by their staff. Check for the current versions at: cdc.gov/vaccines/hcp/vis/current-vis.html.


Immunization-related Mobile Applications for Health Care Professionals and Consumers

November 24, 2015—Looking for immunization-related applications (apps) for your mobile device? Look no further. We are pleased to share the following immunization-related mobile applications for health care professionals, community partners and consumers.

The “Apps for Immunization” is a listing of DOH approved immunization-related applications (apps) from trusted sources such as Centers for Disease Control and Prevention (CDC) and American Academy of Pediatrics (AAP) made available through iTunes. These mobile apps give health care professionals and consumers 24/7 access to vital health information including current immunization news, scientific publications, and disease prevention tips. Materials embodied in these apps provide health care professionals and parents with quick access on the latest vaccine recommendations and immunization schedules on their smartphone devices. Content produced on these apps are automatically updated to reflect the most up-to-date information with the ability to share articles through various social media networks. With excellent user ratings, these immunization-related resources will help with protecting the health of the general public and contribute to increasing immunization levels and decreasing vaccine-preventable diseases in Florida. To connect with these DOH approved apps, use the following link: www.floridahealth.gov/programs-and-services/immunization/iphone-mobile-apps/index.html.


Human Papillomavirus Vaccination Coverage Among Female Adolescents in Managed Care Plans—United States, 2013

November 2, 2015—We are pleased to share the following report with our immunization partners from the MMWR publication October 30, 2015/64(42); 1185–1189, the Centers for Disease Control and Prevention (CDC) published the Human Papillomavirus Vaccination Coverage Among Female Adolescents in Managed Care Plans—United States, 2013. To review the entire report and data visit: www.cdc.gov/mmwr/preview/mmwrhtml/mm6442a1.htm?s_cid=mm6442a1_e.

In the United States there are 79 million people infected with the Human papillomavirus (HPV), with approximately 14 million new cases being diagnosed each year. There are approximately 27,000 cancer cases attributed to HPV annually. HPV vaccination is an effective primary prevention strategy that can reduce many of the HPV infections that lead to cancer and is routinely recommended for adolescents aged 11–12 years.

To determine whether the recommended HPV vaccination series is currently being administered to adolescents with health insurance, CDC and the National Committee for Quality Assurance (NCQA) assessed 2013 data from the Healthcare Effectiveness Data and Information Set (HEDIS). The HEDIS HPV vaccine for female adolescents performance measure evaluates the proportion of female adolescent members in commercial and Medicaid health plans who receive the recommended 3-dose HPV vaccination series by age 13 years.

There were 367 commercial plans and 153 Medicaid plans submitted to the HEDIS HPV vaccination measure data, representing a total of 626,318 female adolescent plan members, aged 13 years, eligible for the measure. Approximately 31% of the U.S. female population aged 13 years.

Results:

  • Commercial plans provided 3 doses of HPV vaccine to a median of 12% of female adolescent members by age 13 years.
  • Medicaid plans reported significantly higher rates of 3-dose HPV coverage compared with commercial plans, with a median of 19% of female adolescents receiving 3 doses.

Most female adolescents in commercial and Medicaid health plans are not receiving the recommended doses of HPV vaccine by age 13 years. The HEDIS HPV vaccination measure was publicly reported for the first time in 2013, approximately seven years after the quadrivalent HPV vaccine was licensed in the United States and recommended by the Advisory Committee on Immunization Practices (ACIP) for use in female adolescents, allowing health care providers time to adapt to the recommendations. Despite this, results from this study indicate that health plans are performing poorly overall with regard to HPV vaccination rates in female adolescents aged 13 years.

Studies have identified that clinicians are less likely to make a strong recommendation for HPV vaccination for adolescents aged 11-12 years compared with older adolescents. Because a clinician recommendation greatly influences parental acceptance, the CDC has developed resources to help clinicians respond to parents' questions and communicate strong, clear HPV vaccination recommendations. The HPV clinician resources are available at: www.cdc.gov/hpv.

Improving HPV vaccination coverage among female adolescents and understanding how the highest-performing health plans support HPV vaccination are needed. Knowledge of barriers and attitudes of clinicians or family members that might contribute to low vaccination coverage, and incentives that might contribute to differences in vaccination coverage between Medicaid and commercial plans, are needed. Characterizing the strategies and best practices used by higher performing plans will be important for improving HPV vaccination coverage in the United States. Increasing delivery of HPV vaccination at the recommended ages of 11 or 12 years, before most adolescents are exposed to the virus, can ensure adolescents are protected against HPV infections and associated cancers.


Use of Serogroup B Meningococcal Vaccines in Adolescents and Young Adults: Recommendations of the Advisory Committee on Immunization Practices, 2015

October 26, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the October 23, 2015/64(41); 1171–1176, the Centers for Disease Control and Prevention published the Use of Serogroup B Meningococcal Vaccines in Adolescents and Young Adults: Recommendations of the Advisory Committee on Immunization Practices, 2015. The review the article and data visit: www.cdc.gov/mmwr/preview/mmwrhtml/mm6441a3.htm?s_cid=mm6441a3_e.

The Advisory Committee on Immunization Practices recommended that adolescents and young adults aged 16–23 years may be vaccinated with a serogroup B meningococcal (MenB) vaccine to provide short-term protection against most strains of serogroup B meningococcal disease.

It is estimated that approximately 15 to 29 cases and two to five deaths could be prevented annually with a routine adolescent MenB vaccination program. A recommendation for college students only is estimated to prevent approximately nine cases and one death annually.

Guidance for Use

  • The preferred age for MenB vaccination is 16–18 years.
  • The two MenB vaccines are not interchangeable; the same vaccine product must be used for all doses. MenB vaccine should either be administered as a 3-dose series of MenB-FHbp or a 2-dose series of MenB-4C.
  • MenB-FHbp or MenB-4C may be administered at the same time as other vaccines recommended for this age, but at a different anatomic site, if feasible.

People at risk:

  • A serogroup B meningococcal disease outbreak
  • Anyone whose spleen is damaged or has been removed
  • Anyone with a rare immune system condition called “persistent complement component deficiency”
  • Anyone taking a drug called eculizumab (also called Soliris®)
  • Microbiologists who routinely work with N. meningitidis isolates

People who should not get the serogroup B meningococcal vaccines include: Those who have severe or life-threatening allergies. Women who are pregnant or breastfeeding. If a person is ill they should be advised to come back when they feel better.

The new Serogroup B Meningococcal Vaccine Information Statement is located at: www.cdc.gov/vaccines/hcp/vis/vis-statements/mening-serogroup.html.


Update: Shortened Interval for Post-vaccination Serologic Testing of Infants Born to Hepatitis B-Infected Mothers

October 16, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the October 9, 2015 / 64(39); 1118–20 article, the Centers for Disease Control and Prevention (CDC) published, “Update: Shortened Interval for Post-vaccination Serologic Testing of Infants Born to Hepatitis B-Infected Mothers.” You can read the article in its entirety at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6439a6.htm?s_cid=mm6439a6_e.

The CDC recommends a shortened interval for post-vaccination serologic testing (PVST) of infants born to hepatitis B virus (HBV) positive mothers to minimize the possibility for unnecessary revaccination. An estimated 25,000 infants are born to HBV-positive mothers each year in the United States. However, post-exposure prophylaxis (PEP) is highly effective in preventing perinatal HBV transmission; only one percent of infants receiving PEP develop infection. Infants born to HBV-infected mothers should receive hepatitis B vaccine (consisting of a 3– or 4–dose series) and hepatitis B immune globulin within 12 hours of birth to prevent perinatal HBV transmission.

In order to determine whether the infant requires revaccination, PVST was previously recommended at age 9–18 months. Because new evidence suggests that hepatitis B antibody levels decline following vaccination, the CDC now recommends that PVST take place earlier—at age 9–12 months, or 1–2 months after the final dose of the hepatitis B vaccine series—in order to ensure antibodies are detected.

Benefits to the shortened interval include a reduction in the time that non-responders are at risk for transmission from close contacts with HBV infection, opportunity for prompt revaccination when needed, and conservation of public health resources. Additionally, the authors note that a shortened interval might increase adherence with recommendations for timely completion of PVST.


Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus Vaccine and Guidance for Use as a Booster Dose

September 14, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the September 4, 2015/64(34); 948-949, the Centers for Disease Control and Prevention published the Licensure of a Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed and Inactivated Poliovirus Vaccine and Guidance for Use as a Booster Dose. To read the entire article visit: www.cdc.gov/mmwr/preview/mmwrhtml/mm6434a5.htm?s_cid=mm6434a5_e.

On March 24, 2015, the Food and Drug Administration licensed an additional combined diphtheria and tetanus toxoids and acellular pertussis adsorbed (DTaP) and inactivated poliovirus (IPV) vaccine (DTaP-IPV) (Quadracel, Sanofi Pasteur Inc.). Quadracel is the second DTaP-IPV vaccine to be licensed for use among children aged 4 through 6 years in the United States. Quadracel is approved for administration as a fifth dose in the DTaP series and as a fourth or fifth dose in the IPV series in children aged 4 through 6 years who have received 4 doses of DTaP-IPV-Hib (Pentacel, Sanofi Pasteur) and/or DTaP (Daptacel, Sanofi Pasteur) vaccine.

This report summarizes the indications for Quadracel vaccine and provides guidance from the Advisory Committee on Immunization Practices (ACIP) for its use. Feedback from ACIP liaison organizations, ACIP endorsed the licensed indications for this vaccine. Both licensed DTaP-IPV vaccine formulations are included in the federal Vaccines for Children Program.

Indications and Guidance for Use
Quadracel is indicated for use as the fifth dose of DTaP and fourth or fifth dose of IPV in children aged 4 through 6 years who received DTaP-IPV-Hib (Pentacel) and/or DTaP (Daptacel) vaccine as the first 4 doses. This vaccine should not be administered to children aged <4 years or ≥7 years. If Quadracel vaccine is inadvertently administered before age 4 years for an earlier dose of the DTaP and/or IPV series and if minimum interval requirements have been met, the dose may be counted as valid for the DTaP and/or IPV series and does not need to be repeated. Note that the final dose in the IPV series must be administered at age ≥4 years regardless of the number of previous doses, and with a minimum interval of 6 months from the previous dose. Therefore, a dose of Quadracel vaccine administered before the fourth birthday cannot be counted as a valid final dose of IPV. Data are limited on the safety and immunogenicity of interchanging DTaP vaccines from different manufacturers.

Recommendation
ACIP recommends that, whenever feasible, the same manufacturer's DTaP vaccines should be used for each dose in the series. However, vaccination should not be deferred because the type of DTaP vaccine previously administered is unavailable or unknown.


Intervals between PCV13 and PPSV23 Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

September 14, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the September 4, 2015/64(34); 944-947, the Centers for Disease Control and Prevention published the Intervals between PCV13 and PPSV23 Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP).To read the entire article visit: www.cdc.gov/mmwr/preview/mmwrhtml/mm6434a4.htm?s_cid=mm6434a4_e.

On June 25, 2015, ACIP changed the recommended interval between PCV13 followed by PPSV23 (PCV13–PPSV23 sequence) from 6–12 months to ≥1 year for immunocompetent adults aged ≥65 years. Recommended intervals for all other age and risk groups remain unchanged. The report outlines the rationale for this change and summarizes the evidence considered by ACIP to make this recommendation.

Article Summary:

  • In August 2014, ACIP recommended routine use of a dose of PCV13 followed by a dose of PPSV23 6–12 months later among immunocompetent adults aged ≥65 years. Adults aged ≥65 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear implants are recommended to receive PCV13 first, followed by PPSV23 ≥8 weeks later. ACIP also recommended that all adults aged ≥65 years who already received PPSV23 should receive a dose of PCV13 ≥1 year after receipt of PPSV23 (PPSV23–PCV13 sequence). The difference in the recommended interval depending on the order in which the two vaccines were given added significant complexity to the recommendation and created implementation challenges for this age group. To simplify the recommendations, ACIP reviewed existing data to evaluate potential areas for harmonization of recommended dosing intervals. Specifically, ACIP assessed whether available evidence would support changing the recommended interval for the PCV13–PPSV23 sequence for immunocompetent adults aged ≥65 years from 6–12 months to ≥1 year and thus be harmonized with the recommended interval for the PPSV23–PCV13 sequence in the same age group.
  • For immunocompetent adults aged ≥65 years who have not previously received pneumococcal vaccine, ACIP makes the following recommendation for intervals between PCV13 followed by PPSV23: A dose of PPSV23 should be given ≥1 year following a dose of PCV13. The two vaccines should not be co-administered. If a dose of PPSV23 is inadvertently given earlier than the recommended interval, the dose need not be repeated.
  • The recommended intervals between PCV13 and PPSV23 for persons aged ≥2 years with medical indications to receive both vaccines remain unchanged. PPSV23 is recommended to be given ≥8 weeks after PCV13 for children and adults aged ≥19 years with certain underlying medical conditions (including adults aged ≥65 years with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants).
  • The studies among HIV-positive adults evaluating the immune response to PPSV23 administered 4 or 8 weeks after PCV7 showed statistically significant increases in antibody levels compared with response to PPSV23 alone. The currently recommended 8-week interval minimizes the risk window for invasive pneumococcal disease caused by serotypes unique to PPSV23 in these highly vulnerable groups.

National, State, and Selected Local Area Vaccination Coverage Among Children

September 4, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the August 28, 2015/64(33); 889–896 issue, the Centers for Disease Control and Prevention (CDC) published the National, State, and Selected Local Area Vaccination Coverage Among Children Aged 19–35 Months—United States, 2014. You can read the article in its entirety at: cdc.gov/mmwr/preview/mmwrhtml/mm6433a1.htm?s_cid=mm6433a1_e.

The National Immunization Survey (NIS) has monitored vaccination coverage among U.S. children aged 19–35 months since 1994. The report presents national, regional, state, and selected local area vaccination coverage estimates for children born from January 2011 through May 2013, based on data from the 2014 NIS. For most vaccinations, there was no significant change in coverage between 2013 and 2014. The exception was hepatitis A vaccine for which increases were observed. Also, the rotavirus coverage for children living below the poverty level was 14.1% lower than children at or above the poverty level.

  • National coverage among children aged 19–35 months estimates indicate that the Healthy People 2020 target* of 90% was met for ≥3 doses of poliovirus vaccine (93.3%), ≥1 dose of measles, mumps, and rubella vaccine (MMR) (91.5%), ≥3 doses of hepatitis B vaccine (HepB) (91.6%), and ≥1 dose of varicella vaccine (91.0%). Coverage was below target for ≥4 doses of diphtheria, tetanus, and acellular pertussis vaccine (DTaP), the full series of Haemophilus influenzae type b (Hib) vaccine, hepatitis B (HepB) birth dose,† ≥4 doses pneumococcal conjugate vaccine (PCV), ≥2 doses of HepA, the full series of rotavirus vaccine, and the combined vaccine series.
  • Florida estimated vaccination coverage with selected individual vaccines and a combined vaccine series* among children aged 19–35 months:
Vaccine Dosage Percentages
MMR ≥1 91.2%
DTaP ≥4 86.2%
HepB ≥3 94.9%
HepB Birth 53.2%
Hep A ≥2 54.9%
Rotavirus ≥2 or ≥3 67.9%
Combined Series   72.7%

The combined (4:3:1:3*:3:1:4) vaccine series includes ≥4 doses of DTaP, ≥3 doses of poliovirus vaccine, ≥1 dose of measles-containing vaccine, full series of Hib vaccine (≥3 or ≥4 doses, depending on product type), ≥3 doses of HepB, ≥1 dose of varicella vaccine, and ≥4 doses of PCV.

The 2014 data indicate that coverage remains consistently high for most vaccinations, although variation by poverty status and geographic area was observed. For some vaccines and population subgroups, improvement in coverage is necessary to achieve optimal protection. For all vaccines, maintaining high coverage is critical to sustain progress in reducing the impact of vaccine-preventable diseases.


Vaccination Coverage Among Children in Kindergarten—United States, 2014–2015 School Year

September 4, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the August 28, 2015/64(33); 897–904 issue, the Centers for Disease Control and Prevention (CDC) published Vaccination Coverage Among Children in Kindergarten—United States, 2014–2015 School Year. You can read the article in its entirety at: cdc.gov/mmwr/preview/mmwrhtml/mm6433a2.htm?s_cid=mm6433a2_e.

The CDC analyzes school vaccination data collected by federally funded state, local, and territorial immunization programs in order to monitor state and national vaccination coverage and exemption levels among children attending kindergarten.

School vaccination regulations provide an opportunity for children who are behind on vaccination in infancy to be vaccinated by school entry. For example, the kindergartners covered in this report were born during 2009–2011.

This report describes vaccination coverage estimates in 49 states and the District of Columbia (DC) and vaccination exemption estimates in 46 states and DC that reported the number of children with at least one exemption among kindergartners during the 2014–2015 school year. The median vaccination coverage was used to assess progress toward the national Healthy People 2020 target of ≥95% vaccination coverage for kindergartners.

National: Median vaccination coverage was 94.0% for 2 doses of measles, mumps, and rubella (MMR) vaccine; 94.2% for the local requirements for diphtheria, tetanus, and acellular pertussis vaccine (DTaP); and 93.6% for 2 doses of varicella vaccine among the 39 states and DC with a 2-dose requirement. The median percentage of any exemptions was 1.7%.

Florida: The Florida kindergarten vaccine coverage rates for MMR, DTaP, and varicella was equal to or greater than 93.3%. Florida’s kindergarten population consisted of 228,982 students.

Although statewide vaccination coverage among kindergartners was high during the 2014–2015 school year, geographic pockets of low vaccination coverage and high exemption levels can place children at risk for vaccine-preventable diseases. Appropriate school vaccination coverage assessments can help immunization programs identify clusters of low coverage and develop partnerships with schools and communities to ensure that children are protected from vaccine-preventable diseases.


TRAINING OPPORTUNITY: HPV Vaccination Quality Improvement Projects and Implementation Science Working Together, For the Win! (#FTW)

August 31, 2015—The Immunization Section is pleased to announce a webinar training presentation by the Centers for Disease Control and Prevention (CDC), on Friday, September 18, 2015, at 11 a.m. ET. The webinar will feature “HPV Vaccination Quality Improvement Projects and Implementation Science Working Together, For the Win! (#FTW).”

Guest speakers for this webinar series features:

  • Dr. Brian Mittman, PhD will provide a brief introduction about Implementation Science theory and principles, and an overview of considerations influencing physician behavior and making practice-level changes.
  • Dr. Alix Casler, MD, FAAP will summarize her practice’s quality improvement project to increase HPV vaccination rates. Dr. Casler will discuss their multi-level approach and experience integrating changes in a large pediatric office.
  • Kia Redwine, Clinical Management Consultant will present on a collaborative quality Improvement project between WellStar Health System and the Georgia Department of Public Health to increase HPV vaccination rates. Ms. Redwine will highlight the variety of interventions that that were incorporated and lessons learned from her perspective.

To register online please visit: cc.readytalk.com/cc/s/registrations/new?cid=6j2gnrfysvp8.


TRAINING OPPORTUNITY: HPV 101—An Overview of HPV Vaccination

August 19, 2015—The Immunization Section is pleased to announce training opportunities provided by the Inter-Tribal Council of Michigan's National Native Network. The Indian Health Services (IHS) Clinical Support Center presents a webinar series: Cancer Risk Reduction in Indian Country. The topic for this series is: HPV 101—An Overview of HPV Vaccination, to be presented August 25, 2015 at 3:00 p.m. EST.

To register visit: attendee.gotowebinar.com/register/8424162691211665154. Space is limited. After registering, you will receive a confirmation email containing information about joining the webinar. Please review the system requirements.

Course Objectives:

  • Recognize the importance of HPV vaccination for cancer prevention and the rationale for vaccinating at ages 11 or 12 years.
  • Identify barriers to vaccination to provide useful and compelling information that encourages providers to support and recommend vaccination as a means of cancer prevention.
  • Effectively communicate information to parents in making an informed decision about HPV vaccination.

Continuing Education Units: This webinar is designated 1.0 contact hour for nurses. To obtain a certificate of continuing education, you must be registered for the course, participate in the webinar in its entirety and submit a completed post-webinar survey. The post-webinar survey will be emailed to you after the completion of the course. Certificates will be mailed to participants within four weeks by the IHS Clinical Support Center.

Accreditation: The IHS Clinical Support Center is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The IHS Clinical Support Center designates this live activity for 1 hour of AMA PRA Category 1 Credit™ for each hour of participation. Physicians should claim only the credit commensurate with the extent of their participation.


Vaccine Information Statement Update: Influenza 2015–2016

August 11, 2015—The Florida Department of Health, Immunization Section, would like to share the Centers for Disease Control and Prevention (CDC) updated Vaccine Information Statement (VIS) for influenza vaccines—both Inactivated Influenza Vaccines (IIV), and Live Attenuated Influenza Vaccines (LAIV) released on August 7, 2015.

All previous versions/editions of the Influenza VISs should be discarded. You must use the updated version/edition immediately. These two VISs reflect the latest recommendations and format are available at: www.cdc.gov/vaccines/hcp/vis/vis-statements/flu.html and www.cdc.gov/vaccines/hcp/vis/vis-statements/flulive.html.

The VIS’s are also available in a variety of translations. You may find these translations at: immunize.org/vis/?f=9. These are coordinated by the Immunization Action Coalition (IAC), through a cooperative agreement with CDC.

The Florida SHOTS system displays/provides an option to print the most current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly check the VIS being distributed by their staff. Check for the current versions at: cdc.gov/vaccines/hcp/vis/current-vis.html.


Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2015–2016 Influenza Season

August 10, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the August 7, 2015/64(30); 784-792 issue, the Centers for Disease Control and Prevention (CDC) published Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2015–2016 Influenza Season. You can read the article in its entirety at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a3.htm?s_cid=mm6430a3_e.

This report updates the 2015–2016 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines. People ages six-months and older should receive influenza vaccine annually. Influenza vaccination should not be delayed to procure a specific vaccine preparation if an appropriate one is already available.

The 2015–2016 ACIP Influenza Vaccination Recommendations

The committee recommends the trivalent formulation influenza vaccines for the U.S. 2015–2016 influenza season contain the following:

  • A/California/7/2009 (H1N1)-like virus
  • A/Switzerland/9715293/2013 (H3N2)-like virus
  • B/Phuket/3073/2013-like (Yamagata lineage) virus

The ACIP recommends the quadrivalent influenza vaccines will contain the above three strains and an additional B strain:

  • B/Brisbane/60/2008-like (Victoria lineage) virus

For healthy children ages two-years to eight-years-old, who have no contraindications or precautions, either LAIV or IIV is an appropriate option. No preference is expressed for LAIV or IIV for people ages two-years to 49-years-old for whom either vaccine is appropriate. An age-appropriate formulation of vaccine should be used.

LAIV should not be used in the following populations:

  • People under the age of two and older than 49-years of age
  • People with contraindications listed in the package insert
  • Children who are two through 17-years of age, who are receiving aspirin or aspirin-containing products
  • People who have experienced severe allergic reactions to the vaccine or any of its components, or to a previous dose of any influenza vaccine
  • Pregnant women
  • Immunocompromised people
  • People with an egg allergy history
  • Children, two- to four-years-old, who have asthma or who have had a wheezing episode noted in the medical record within the past 12 months
  • People who have taken influenza antiviral medications within the previous 48 hours

The ACIP Recommendations for Influenza Vaccination of People with an Egg Allergy History

People with a history of egg allergy who have experienced only hives after exposure to egg should receive influenza vaccine. Because relatively few data are available for use of LAIV in this setting, IIV or trivalent recombinant influenza vaccine (RIV3) should be used. RIV3 may be used for people 18-years and older who have no other contraindications. However, IIV (egg- or cell culture-based) may also be used, with the following additional safety measures:

  • Vaccine should be administered by a health care provider who is familiar with the potential manifestations of egg allergy
  • Vaccine recipients should be observed for at least 30 minutes for signs of a reaction after administration of each vaccine dose.

National, Regional, State and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years—United States, 2014

August 6, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the July 31, 2015/64(29); 784-792 issue, the Centers for Disease Control and Prevention (CDC) published the National, Regional, State and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years—United States, 2014. You can read the article in its entirety at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6429a3.htm?s_cid=mm6429a3_e.

The Advisory Committee on Immunization Practices (ACIP) recommends routine immunizations for adolescents aged 11–12 years for protection against diseases like pertussis, meningococcal disease, and human papillomavirus (HPV) associated cancers. To assess vaccination coverage among adolescents, CDC analyzed data collected regarding 20,827 adolescents through the 2014 National Immunization Survey–Teen (NIS-Teen).

  • National coverage among adolescents aged 13–17 years from 2013 to 2014, increased for all routinely recommended vaccines: from 84.7% to 87.6% for tetanus-diphtheria-acellular pertussis (Tdap) vaccine dose, from 76.6% to 79.3% for meningococcal conjugate (MenACWY) vaccine dose, from 56.7% to 60.0% and from 33.6% to 41.7% for HPV vaccine dose among females and males, respectively.
  • Florida coverage among adolescents aged 13–17 years from 2013 to 2014, increased for most routinely recommended vaccines: from 84.8% to 90.7% for tetanus-diphtheria-acellular pertussis (Tdap) vaccine dose, from 72.3% to 72.2% for meningococcal conjugate (MenACWY) vaccine dose, from 49.7% to 57.2% and from 27.8% to 41% for HPV vaccine dose among females and males, respectively.

Despite overall progress in vaccination coverage among adolescents, HPV vaccination coverage continues to lag behind Tdap and MenACWY coverage at state and national levels. Differences in coverage estimates by vaccine indicate many missed opportunities for simultaneous administration of HPV with Tdap or MenACWY. Routinely recommending HPV vaccination at ages 11–12 years during the same visit and with the same emphasis used for other vaccines is critical. NIS-Teen summary is available at: www.cdc.gov/vaccines/who/teens/vaccination-coverage.html.


August is National Immunization Awareness Month

August 6, 2015—The Centers for Disease Control and Prevention (CDC), the leader in the fight of infectious diseases, deems August National Immunization Awareness Month (NIAM). This event highlights the necessity of immunizations to combat vaccine-preventable diseases and improving coverage levels for people of all ages.

Activities to raise awareness about immunization will focus on encouraging people to protect their health by being immunized. Different age groups have different immunization needs. This includes: pregnant women, babies, children, teens, young adults and adults. Although the needs vary the outcome is the same—to protect each individual from vaccine-preventable diseases.

Look for NIAM activities hosted in your community. The websites presented below provide comprehensive immunization information for all age groups.

Ready For School
From the beginning of child care, to graduation from high school and on to college, Florida requires certain vaccines to be administered before students can attend. Healthy children to young adults can get sick from vaccine-preventable diseases. For back to school immunizations visit: www.nphic.org/niam-readyforschool.

Born With Protection
Women who are pregnant or planning a pregnancy will want to be up-to-date on routine adult vaccines. Sharing this information with a pre-conception and prenatal health care professional will help determine which vaccines are needed during pregnancy. Immunization recommendations for pregnant women can be found at: www.nphic.org/niam-pregnantwomen.

Birth to Age 6
Through immunization, infants can be protected from 14 vaccine-preventable diseases before age two. Starting at birth up to two years old, infants should receive all their baby shots. Parents should encourage their health care provider to give all age-appropriate shots at every visit. After age two, children are still recommended to receive a yearly flu vaccine and are due for additional vaccines between ages 4–6. Immunizations help keep children safe from disease and cut down on sick visits. Immunization requirements for infants and children are available at: www.nphic.org/niam-birthto6.

Preteens & Teens
Preteens and teens need vaccines because they are at greater risk for certain diseases. Students participating in public or private school campus-based activities are required to have age-appropriate vaccines with the proper documentation on file at the school. To find out more about preteen/teen vaccines visit: www.nphic.org/niam-preteensteens.

Adults
Vaccinations are recommended throughout life to prevent vaccine-preventable diseases. Many adults are unaware of the need for vaccinations after high school or college. Adult vaccination coverage is low. Research shows that adult patients are willing to get a vaccine when it is recommended by their provider, according to the Standards for Adult Immunization Practice. It is recommended providers screen adult patients to determine vaccines needs and administer the vaccine or refer the patient to a provider who is able to vaccinate. For more information on adult vaccinations please visit: www.nphic.org/niam-adults.


Additional Guidance Online for Providers Regarding 9-Valent HPV Vaccine Use Among Persons Who Previously Received HPV Vaccination

July 31, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the July 31, 2015/64(29); 806 issue, the Centers for Disease Control and Prevention (CDC) published the Announcement: Additional Guidance Online for Providers Regarding 9-Valent HPV Vaccine Use Among Persons Who Previously Received HPV Vaccination. You can read the article in its entirety at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6429a9.htm?s_cid=mm6429a9_e.

A 9-valent human papillomavirus (HPV) vaccine (Gardasil 9, Merck and Co., Inc.) was licensed for use in females and males in the United States in December 2014. This is the third HPV vaccine licensed by the Food and Drug Administration; the other vaccines are the bivalent HPV vaccine, licensed for use in females, and the quadrivalent HPV vaccine, licensed for use in females and males.

In February 2015, the Advisory Committee on Immunization Practices (ACIP) recommended 9-valent HPV vaccine as one of three HPV vaccines that can be used for routine vaccination of females and one of two HPV vaccines for routine vaccination of males. ACIP recommendations were published in a March 2015 report. Additional information has been posted on the CDC website to provide guidance on issues that were not addressed in the March report but are likely to arise during the transition to 9-valent HPV vaccine, including questions about use of 9-valent HPV vaccine among persons who previously received bivalent or quadrivalent HPV vaccine. For more information visit: www.cdc.gov/vaccines/who/teens/downloads/9vHPV-guidance.pdf.


TRAINING OPPORTUNITY: "You Call the Shots" HPV, Polio, and Hepatitis A Training Updates

July 8, 2015—The Immunization Section is pleased to announce training opportunities presented by the Centers for Disease Control and Prevention (CDC), "You Call the Shots" HPV, Polio, and Hepatitis A Training Updates.

The HPV, Polio, and Hepatitis A vaccine training modules are the latest updates to the "You Call the Shots" (YCTS) Web-based training series. The CDC updated YCTS to include the latest guidelines and recommendations in vaccine practice. The HPV training now includes the latest information on the 9-valent HPV vaccine. In addition to the HPV, Polio, and Hepatitis A modules, Influenza, MMR, General Recommendations on Immunization, VFC, and Storage and Handling modules have all been updated as of July 1, 2015. Please note: The Immunization Section makes every attempt to provide training on a variety of subjects/issues, without endorsement, for those interested in immunizations.

To register for the CDC web-based trainings modules visit: www.cdc.gov/vaccines/ed/youcalltheshots.htm.

Continuing Education Units (CEU’s) will also be offered:(www.cdc.gov/vaccines/ed/ciinc/ceinfo.htm).


Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015

June 22, 2015—We are pleased to share this yellow fever vaccine information with our immunization partners.

The Advisory Committee on Immunization Practices (ACIP) recommendation for use of yellow fever vaccine booster doses was published in the Morbidity and Mortality Weekly Report (MMWR) as Yellow Fever Vaccine Booster Doses: Recommendations of the Advisory Committee on Immunization Practices, 2015; June 19, 2015 / 64(23); 647-650. The official MMWR report is available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6423a5.htm?s_cid=mm6423a5_e.

On February 26, 2015, the ACIP voted that a single primary dose of yellow fever vaccine provides long-lasting protection and is adequate for most travelers. ACIP has also approved recommendations for at-risk laboratory personnel and certain travelers to receive additional doses of yellow fever vaccine.

Due to the fact that no specific yellow fever treatment exists, prevention through vaccination is critical. With the administration of more than 540 million doses of yellow fever vaccine only 23 vaccine failures have been identified.

The evidence for benefits and risks associated with yellow fever vaccine booster doses was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. This report summarizes the evidence considered by ACIP and provides the updated recommendations for yellow fever vaccine booster doses.

Recent yellow fever changes:

  • In April 2013, the World Health Organization (WHO) Strategic Advisory Group of Experts on Immunization concluded that a single primary dose of yellow fever vaccine is sufficient to confer sustained immunity and lifelong protection against yellow fever disease, and that a booster dose is not needed.
  • In May 2014, the World Health Assembly adopted the recommendation to remove the 10-year booster dose requirement from the International Health Regulations by June 2016.
  • The advisory group noted that future studies and surveillance data should be used to identify specific risk groups, such as persons infected with human immunodeficiency virus (HIV) or infants, who might benefit from a booster dose.

Yellow Fever Vaccine Booster Dose Recommendations:

  • Pregnant women
  • Hematopoietic stem cell transplant recipients
  • HIV-infected persons
  • Additional doses may be given to certain groups believed to be at increased risk for yellow fever disease either because of their location and duration of travel or because of more consistent exposure to virulent virus, like laboratory workers.

TRAINING OPPORTUNITY: June Advisory Committee on Immunization Practices (ACIP) Meeting Update/Opportunities for Summer HPV Vaccination: National Immunization Awareness Month (NIAM) and Beating the Back-to-School Rush

June 10, 2015—The Immunization Section is pleased to announce a training presentation by the Centers for Disease Control and Prevention (CDC), Friday, June 26, 2015 at 12:00 p.m. ET featuring “June ACIP Meeting Update/Opportunities for Summer HPV Vaccination: NIAM and Beating the Back-to-School Rush.”

Guest speakers for this webinar series features:

  • Cindy Weinbaum, MD, MPH, Acting Executive Secretary of the ACIP, will provide an overview of ACIP draft agenda topics: Policy options, evidence, and considerations for routine use of MenB vaccines in adolescents; an overview of 9-valent HPV vaccination for persons who have completed an HPV vaccination series, cost-effectiveness, as well as GRADE and proposed guidance for use of 9vHPV vaccine; updates to the Child/Adolescent Immunization Schedule.
  • Ian Branam, Health Communication Specialist, TEKsystems Inc. from NCIRD’s Health Communication Science Office (HCSO), will discuss plans and activities for National Immunization Awareness Month (NIAM) to help promote immunizations throughout the month of August.
  • Jill Roark, MPH, Health Communication Specialist, NCIRD HCSO, will present ideas for Beating the Back-to-School Rush, including ideas to help parents and clinicians to take advantage of early summer break for vaccinations.

To register online please visit: attendee.gotowebinar.com/register/6017466976921946370.


Influenza Activity—United States, 2014–2015 Season and Composition of the 2015–2016 Influenza Vaccine

June 9, 2015—The Food and Drug Administration's (FDA) Vaccines and Related Biological Products Advisory Committee (VRBPAC) recommendations for the influenza vaccine for the 2015–2016 U.S. influenza season. The advisory committee reviewed and evaluated the surveillance data of recent influenza isolates and serological responses to 2014–2015 vaccines, and the availability of candidate strains and reagents. Their recommendations were published in the Morbidity and Mortality Weekly Report (MMWR) as Influenza Activity—United States, 2014–2015 Season and Composition of the 2015–2016 Influenza Vaccine June 5, 2015 / 64(21);583-590 available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6421a5.htm?s_cid=mm6421a5_e.

This report summarizes influenza activity in the U.S. during the 2014–2015 influenza season (September 28, 2014– May 23, 2015) as of June 5, 2015, and includes recommendations for the components of the 2015–2016 Northern Hemisphere influenza vaccine.

During the 2014–2015 influenza season in the U.S., influenza activity increased through November and December before peaking in late December. Influenza A (H3N2) viruses predominated, and the prevalence of influenza B viruses increased late in the season. This influenza season, similar to previous influenza A (H3N2)–predominant seasons, was moderately severe with overall high levels of outpatient illness and influenza-associated hospitalization, especially for adults aged ?5 years. The majority of circulating influenza A (H3N2) viruses were different from the influenza A (H3N2) component of the 2014–2015 Northern Hemisphere seasonal vaccines, and the predominance of these drifted viruses resulted in reduced vaccine effectiveness.

The vaccine recommendations were based on several factors, including global influenza virologic and epidemiologic surveillance, genetic characterization, antigenic characterization, antiviral resistance and the candidate vaccine viruses that are available for production.

The committee recommended that the influenza trivalent vaccines for the U.S. 2015-2016 influenza season contain the following:

  • A/California/7/2009 (H1N1)pdm09-like virus
  • A/Switzerland/9715293/2013 (H3N2)-like virus
  • B/Phuket/3073/2013-like (B/Yamagata lineage) virus

The committee also recommended that quadrivalent influenza vaccines contain the above three strains and the following additional B strain:

  • B/Brisbane/60/2008-like (B/Victoria lineage) virus

An annual influenza vaccination is recommended for all persons aged 6 months and older. Immunization providers should consult the FDA–approved prescribing information for 2015–2016 influenza vaccines and the 2015–2016 Advisory Committee on Immunization Practices influenza recommendation statement for the most current information concerning indications, contraindications, and precautions.


Tetanus, Diphtheria, Pertussis Vaccination Coverage Before, During, and After Pregnancy—16 States and New York City, 2011

May 22, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the May 22, 2015/64(19); 522–526 issue, the Centers for Disease Control and Prevention (CDC) published Tetanus, Diphtheria, Pertussis Vaccination Coverage Before, During, and After Pregnancy—16 States and New York City, 2011. To review statistics and individual state coverage rates you can read the article in its entirety at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6419a4.htm?s_cid=mm6419a4_e.

In June 2011, the Advisory Committee on Immunizations Practices (ACIP) recommended one dose of tetanus, diphtheria, and acellular pertussis (Tdap) vaccine during pregnancy for women who had not received Tdap previously. In 2012, ACIP expanded the 2011 recommendation, advising pregnant women to be vaccinated with Tdap during each pregnancy to provide maternal antibodies for each infant. The optimal time for vaccination is at 27–36 weeks' gestation as recommended by ACIP.

In response to ACIP's Tdap recommendation for pregnant women in 2011, CDC added a supplemental question to the Pregnancy Risk Assessment Monitoring System (PRAMS) survey to determine women's Tdap vaccination status before, during, or after their most recent delivery.

Among 16 states and New York City participating in the Pregnancy Risk Assessment Monitoring System supplemental data collection, the median proportion of women with recent live-births during September–December 2011 who reported receiving Tdap vaccination before pregnancy was 13.9 percent, during pregnancy was 9.8 percent, and after delivery was 30.9 percent. These results can provide a baseline for evaluating implementation of the current recommendations for Tdap vaccination for pregnant women.

Infants have substantially higher rates of pertussis and the largest burden of pertussis-related deaths. Maternal vaccination with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine protects infants from pertussis. Efforts to promote and educate pregnant women and their providers on the importance of Tdap vaccination during pregnancy are needed to increase coverage of Tdap among pregnant women to protect mothers and their infants from pertussis.


Florida’s 2015 CDC Childhood Immunization Champion

May 6, 2015—The Immunization Section is pleased to announce Dr. Greg Howard Savel, MD, FAAP and Pediatrician, was selected as the 2015 CDC Childhood Immunization Champion for Florida. This award is sponsored by the Centers for Disease Control and Prevention (CDC), the National Center for Immunization and Respiratory Diseases (NCIRD) and the CDC Foundation. This award is given annually to recognize individuals who make a significant contribution toward improving public health through their work in childhood immunization.

Dr. Greg Savel remembers the parents of the three children who died from vaccine-preventable diseases (chicken pox and measles) during his residency at Tampa General Hospital. Since that time, over 25 years ago, he has been committed to educating parents on the importance of immunization.

Dr. Savel is a pediatrician at Myrtle Avenue Pediatrics in Clearwater, Florida. He is an immunization leader in Pinellas County and he is an expert on addressing vaccine hesitancy among parents of infants and young children. Dr. Savel is the principal pediatrician on immunization within Pinellas County hospitals. He speaks with patients and trains staff regularly on various vaccine topics. As Chair of the Pinellas Immunization Team for Community Health (PITCH), he has collaborated with over 40 community organizations and coalitions and forged strong community partnerships to support vaccination of children from newborns to two-years-old.

Dr. Savel’s advocacy for childhood immunization has helped yield positive results. The vaccination rate for two-year-old children in the community has increased from 75 percent to 81.9 percent. Within the Pinellas community health department, the vaccination rate for two-year-old children was 99 percent, and the vaccination rate for one-year-old children increased from 90 percent to 97 percent in large part, due to his dedication.

For his many efforts to increase immunization rates through community partnerships, Dr. Savel is Florida’s CDC Childhood Immunization Champion. Visit the CDC Childhood Immunization Champion website at: www.cdc.gov/vaccines/events/niiw/champions/profiles-2015.html for information on Dr. Savel and other state champions.

Please join the Immunization Section in congratulating Dr. Savel.


May is Hepatitis Awareness Month

May 4, 2015—During May, The Florida Department of Health, the Centers for Disease Control and Prevention (CDC), and its public health partners work to shed light on this hidden epidemic by raising awareness and promoting screening of pregnant women for hepatitis B surface antigen (HBsAg) to protect Florida from Perinatal Hepatitis B transmission. Viral hepatitis is a major global health threat and affects over 4.4 million Americans. Hepatitis Awareness information is available at: www.cdc.gov/hepatitis/HepAwarenessMonth.htm.

Know the ABCs of Hepatitis
Hepatitis A does not cause a long-term infection but Hepatitis B and Hepatitis C can become chronic, life-long infections. Americans are living with chronic Hepatitis B or chronic Hepatitis C in the United States, but most do not know they are infected. Chronic viral hepatitis can lead to serious liver problems including liver cancer. Every year, approximately 15,000 Americans die from liver cancer or chronic liver disease associated with viral hepatitis.

Some population groups are disproportionately affected by viral hepatitis-related liver cancer. The number of new cases of liver cancer is highest in Asian and Pacific Islanders and is increasing among African Americans, baby boomers born (1945-1965) and men.

Hepatitis Testing Day—May 19th
May 19th has been designated as a national “Hepatitis Testing Day” in the United States. The CDC will use the second annual Hepatitis Testing Day on May 19, 2015 as an opportunity to remind health care providers and the public who should be tested for chronic viral hepatitis. Find a testing event near you or help build testing resources by registering your testing day event at: npin.cdc.gov/htd/HTD.aspx.

Hepatitis Risk Assessment and Overview
The online Hepatitis Risk Assessment is designed to determine an individual’s risk for viral hepatitis and asks questions based upon CDC’s recommendations for testing and vaccination. The Hepatitis Risk Assessment allows individuals to answer questions privately, either in their home or in a health care setting. You can take the risk assessment at: www.cdc.gov/knowmorehepatitis/hra.htm.

Vaccine Preventable
Hepatitis A and Hepatitis B can both be prevented with vaccines. The Hepatitis A vaccine is recommended for all children at one year of age and for adults who may be at risk. The Hepatitis B vaccine is recommended for all infants at birth and adults who may be at risk.


Vaccine Information Statement Updates: Rotavirus

April 24, 2015—The Florida Department of Health, Immunization Section, would like to share the Centers for Disease Control and Prevention (CDC) updated Vaccine Information Statement (VIS) for Rotavirus released on April 16, 2015.

Rotavirus causes diarrhea, vomiting and fever mostly in babies and young children. The diarrhea can be severe, and lead to dehydration. Before rotavirus vaccine, rotavirus disease was a common and serious health problem for children in the United States. Almost all children had at least one rotavirus infection before their fifth birthday. Infants should get their first rotavirus vaccine by two months of age.

Babies who should not get rotavirus vaccine include:

  • A baby who has a severe allergy to any part of the rotavirus vaccine
  • Babies with "severe combined immunodeficiency" (SCID)

Check with baby’s doctor if the baby’s immune system is weakened because of:

  • HIV/AIDS, or any other disease that affects the immune system
  • Treatment with drugs such as steroids
  • Cancer or cancer treatment with x-rays or drugs

All previous versions/editions of the Rotavirus VIS should be discarded. You must use the updated version/edition immediately. This VIS reflects the latest recommendations and format. The updated Rotavirus VIS is available at: www.cdc.gov/vaccines/hcp/vis/index.html.

The VIS’s are also available in a variety of translations. You may find these translations at: immunize.org/vis/?f=9. These are coordinated by the Immunization Action Coalition (IAC) through a cooperative agreement with the Centers for Disease Control and Prevention.

The Florida SHOTS system displays/provides an option to print the most current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly check the VIS being distributed by their staff. Check for the current versions at: cdc.gov/vaccines/hcp/vis/current-vis.html.


Use of 9-Valent Human Papillomavirus (HPV) Vaccine: Update HPV Vaccination Recommendations of the Advisory Committee on Immunization Practices

April 24, 2015—The Florida Department of Health, Immunization Section, would like to share the Centers for Disease Control and Prevention (CDC) article: Use of 9-Valent Human Papillomavirus (HPV) Vaccine: Updated HPV Vaccination Recommendations of the Advisory Committee on Immunization Practices. The article was published in the Morbidity and Mortality Weekly Report (MMWR) March 27, 2015/64(11); 300-304. The article is available in its entirety at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6411a3.htm?s_cid=mm6411a3_e.

In February 2015, the Advisory Committee on Immunization Practices (ACIP) recommended 9-valent human papillomavirus (HPV) vaccine (9vHPV) as one of three HPV vaccines that can be used for routine vaccination. The Food and Drug Administration approved 9vHPV in December 2014.

HPV is associated with cervical, vulvar, and vaginal cancer in females, penile cancer in males, and anal cancer and oropharyngeal cancer in both females and males. The burden of HPV infection also includes cervical pre-cancers. The majority of all HPV-associated cancers are caused by HPV 16 or 18, types targeted by 2vHPV, 4vHPV and 9vHPV.

The new ACIP recommendations for use of HPV Vaccines:

  • 9vHPV, 4vHPV or 2vHPV can be used for routine vaccination of females aged 11 or 12 years and females through age 26 years who have not been vaccinated previously or who have not completed the 3-dose series.
  • 9vHPV or 4vHPV can be used for routine vaccination of males aged 11 or 12 years and males through age 21 years who have not been vaccinated previously or who have not completed the 3-dose series.
  • 9vHPV or 4vHPV vaccination for men who have sex with men and immunocompromised persons (including those with HIV infection) through age 26 years if not vaccinated previously.

New Vaccine Information Statement: HPV (Human Papillomavirus) Gardasil®-9

The new HPV (Human Papillomavirus) Gardasil®-9 Vaccine Information Statement (VIS) is available at: www.cdc.gov/vaccines/hcp/vis/vis-statements/hpv-gardasil-9.html.The VIS’s are also available in a variety of translations. You may find these translations at: immunize.org/vis/?f=9. These are coordinated by the Immunization Action Coalition (IAC), through a cooperative agreement with the Centers for Disease Control and Prevention.

The Florida SHOTS system displays/provides an option to print the most current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly check the VIS being distributed by their staff. Check for the current versions at: cdc.gov/vaccines/hcp/vis/current-vis.html.


Vaccine Information Statement Updates: Haemophilus Influenzae type b (Hib)

April 9, 2015—The Florida Department of Health, Immunization Section, would like to share the Centers for Disease Control and Prevention (CDC) updated Vaccine Information Statement (VIS) for Haemophilus Influenzae type b (Hib) released on April 2, 2015.

The Hib vaccine protects infants from diseases caused by the Haemophilus influenzae type bacteria. Before the vaccine, Hib disease was the leading cause of bacterial meningitis and a common cause of other invasive diseases including: epiglottitis, pneumonia, septic arthritis, cellulitis, purulent pericarditis, and bacteremia among U.S. children under five years of age. Meningitis is an infection of the lining of the brain and spinal cord often leading to brain damage, deafness and death. Hib disease is uncommon in adults and in children over age 5 years. Persons with certain immuno-compromising conditions are considered at increased risk for invasive Hib disease; these conditions might include:

  • Functional or anatomic asplenia
  • HIV infection
  • Immunoglobulin deficiency including immunoglobulin G2 subclass deficiency
  • Early component complement deficiency
  • Receipt of a hematopoietic stem cell transplant
  • Receipt of chemotherapy or radiation therapy for malignant neoplasms

All previous versions/editions of the Hib VIS should be discarded. You must use the updated version/edition immediately. This VIS reflects the latest recommendations and format. The updated Hib VIS is available at: www.cdc.gov/vaccines/hcp/vis/index.html.

The VIS’s are also available in a variety of translations. You may find these translations at: immunize.org/vis/?f=9. These are coordinated by the Immunization Action Coalition (IAC), through a cooperative agreement with the Centers for Disease Control and Prevention.

The Florida SHOTS system displays/provides an option to print the most current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly check the VIS being distributed by their staff. Check for the current versions at: cdc.gov/vaccines/hcp/vis/current-vis.html.


Vaccine Information Statement Update: Tdap and Td

April 2, 2015—The Florida Department of Health, Immunization Section would like to share the Centers for Disease Control and Prevention (CDC) updated Vaccine Information Statements (VIS’) for Tetanus, diphtheria, pertussis (Tdap) and Tetanus, diphtheria (Td), February 24, 2015.

The Tdap vaccine can protect adolescents and adults from tetanus, diphtheria, and acellular pertussis. One dose of Tdap is routinely given at age 11 or 12. Adults who did not get a Tdap at that age should receive one as soon as possible.

Tdap is especially important for health care professionals and anyone having close contact with an infant younger than 12 months of age. It is also recommended that pregnant women get a dose of Tdap during the third semester of every pregnancy to protect their newborn from pertussis. Infants are most at risk for severe, life-threatening complications from pertussis.

The Td VIS was also updated. Td protects against tetanus and diphtheria, but not pertussis. A Td booster should be given every 10 years and should also be given, after five years if a severe cut, puncture would, or burn should happen, to prevent the development of tetanus infection. For more information regarding either Tdap or Td, check with your primary care provider. Tdap or Td may safely be given at the same time as other vaccines.

All previous versions/editions of the Tdap and Td VISs should be discarded. You must use the updated version/edition immediately. These VIS’ reflects the latest recommendations and format. The updated Tdap and Td VISs are available at: http://www.cdc.gov/vaccines/hcp/vis/index.html.

The VIS’ are also available in a variety of translations. You may find these translations at: immunize.org/vis/?f=9. These are coordinated by the Immunization Action Coalition (IAC), through a cooperative agreement with the Centers for Disease Control and Prevention.

The Florida SHOTS system displays/provides an option to print the most current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly check the VIS being distributed by their staff. Check for the current versions at: cdc.gov/vaccines/hcp/vis/current-vis.html.


TRAINING OPPORTUNITY: HPV Vaccine Recommendation Update Webinar

March 30, 2015—The Immunization Section is pleased to announce a training presentation by the Centers for Disease Control and Prevention (CDC), “HPV Vaccine Recommendation Update Webinar” on Friday, April 3, 2015, 11:00 a.m.–noon (EDT).

CDC’s Dr. Lauri Markowitz will provide an update on HPV vaccine recommendations and a review of the HPV vaccine session from last month’s meeting of the Advisory Committee on Immunization Practices (ACIP). The ACIP voted on use of 9-valent HPV vaccine.

Shannon Stokley will be available to answer questions regarding programmatic implications and Jill Roark will also be available to respond to communications-related questions.

Note: The Immunization Section makes every attempt to provide training on a variety of subjects/issues, without endorsement, for those interested in immunizations.


National Infant Immunization Week (NIIW) is April 18–24, 2015

March 24, 2015—We are pleased to remind our immunization partners about the upcoming observance of National Infant Immunization Week (NIIW).

Since 1994, NIIW has been an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and to celebrate the achievements of immunization programs in promoting healthy communities throughout the United States. This year, NIIW is scheduled for April 18–24, 2015.

During the NIIW week in April, hundreds of communities across the United States will join in to celebrate the critical role vaccination plays in protecting our children, communities, and public health. Immunization is a shared responsibility. Families, health care professionals, and public health officials must work together to help protect the entire community.

It's easy to think of these as diseases of the past. But the truth is they still exist today. Unvaccinated children in the United States can—and do—still get some of these diseases. One example of the seriousness of vaccine-preventable diseases is the most recent measles outbreaks resulting in an increase in the number of measles cases. In 2014, 644 people in the U.S. were reported as having measles. This is the largest number of cases in the U.S. since measles was eliminated in 2000. In the past three months, January 1 to March 13, 2015, 176 people from 17 states and the District of Columbia were reported to have measles.

  • Through immunization, we can now protect infants and children from 14 vaccine-preventable diseases before age two.
  • Vaccines are among the most successful and cost-effective public health tools available for preventing disease and death. They not only help protect vaccinated individuals, but also help protect entire communities by preventing and reducing the spread of infectious diseases. Among children born during 1994–2013, vaccination will prevent an estimated 322 million illnesses, 21 million hospitalizations, and 732,000 deaths over the course of their lifetimes.

Children rely on adults to keep them safe and healthy. Those adults may be parents/guardians who keep a record of their child’s vaccinations and ask at each doctor appointment whether their child is up-to-date on immunizations. The adults may also be doctors, nurses, physician assistants, and other healthcare professionals who share scientifically-accurate, up-to-date information about vaccines with parents.

Additional Information, NIIW promotional and educational materials, as well as activities and event ideas can be found on the CDC resource site: cdc.gov/vaccines/events/niiw/index.html. You can continue to show your support for infant immunizations and NIIW by encouraging your community to join in.


Training Opportunity—Immunization Update: Addressing Vaccine Hesitancy

March 13, 2015—The Immunization Section is pleased to forward the attached announcement for an Annual Program update on “Immunization Update: Addressing Vaccine Hesitancy,” scheduled for March 26, 2015, 5:00 p.m.–8:30 p.m. The program update will be held at Bethesda Health, 2815 S. Seacrest Boulevard, Boynton Beach, FL 33435.

Sponsored by: Palm Beach County Immunization Coalition, Bethesda Memorial Hospital, and the Florida Department of Health in Palm Beach County.

To register by phone: (561) 840-4568.

Agenda Topics:

  • Vaccine for Children Requirements Update
  • Group Activity “Community Immunity”
  • Dinner and a Movie, “The Invisible Threat”
  • Panel Discussions

Alina Alonso, MD will be the moderator for the evening. Guest speakers presenting at the program update are: Tommy Schechtman, MD, Pediatrician for Pediatric Partners; Chad Sanborn, MD, Pediatric Infectious Disease Physician; Sharon Fox, MD, Pediatrician for Palm Beach Pediatrics and Colette Chiacchiero, Operation Management Consultant for the Florida Department of Health, Immunization Section.

Continuing education credits (CEUs) will be offered.

Please note: The Immunization Section makes every attempt to provide training on a variety of subjects/issues, without endorsement, for those interested in immunizations.

Immunization Annual Program Update Agenda: Addressing Vaccine Hestiancy


Advisory Committee on Immunization Practices Recommended Immunization Schedules

February 27, 2015—We are pleased to share the attached pdf versions of the CDC MMWR publication with our immunization partners. In the February 6, 2015/64(04); 91-94, the Centers for Disease Control and Prevention published the Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years—United States, 2015 and Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older—United States, 2015.

Each year, recommendations for routine use of vaccines in children, adolescents, and adults in the United States are developed by the Advisory Committee on Immunization Practices (ACIP). We recommend that all healthcare providers visit: www.cdc.gov/mmwr/preview/mmwrhtml/mm6404a5.htm to read the complete advisory for important details and changes to last year's schedules.


Advisory Committee on Immunization Practices Recommended Immunization Schedules

February 10, 2015—We are pleased to share the following MMWR publication with our immunization partners. In the February 6, 2015/64(04); 91–94, the Centers for Disease Control and Prevention published the Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years—United States, 2015 and Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older—United States, 2015.

Each year, recommendations for routine use of vaccines in children, adolescents, and adults in the United States are developed by the Advisory Committee on Immunization Practices (ACIP). We recommend that all healthcare providers visit: cdc.gov/mmwr/index2015.html to read the complete article for important details and changes to last year's schedules.

Changes to the Immunization Schedules for Persons Aged 0 Through 18 Years:

  • Several new references were added, including the 2015 immunization schedules (cdc.gov/vaccines/schedules) for vaccination recommendations for persons aged ≥19 years.
  • Figure 1, "Recommended Immunization Schedule for Persons Aged 0 through 18 Years":
    • Highlights the recommendations for influenza vaccination for children 1) for live attenuated influenza vaccine, which may only be administered beginning at age 2 years, and 2) for children aged 6 months through 8 years, who need 2 doses of influenza vaccine in the first year vaccinated, and in subsequent years only require 1 dose of vaccine.
    • Pages 4 through 6 contain combined footnotes for each vaccine related to routine vaccination, catch-up vaccination,§ and vaccination of persons with high-risk medical conditions or under special circumstances.
    • The meningococcal conjugate vaccine footnote was revised to more clearly present recommendations for use of MenACWY-CRM, MenACWY-D, and Hib-MenCY-TT in children aged 2 months and older with anatomic or functional asplenia, or with persistent complement deficiencies.
    • A purple bar was added for measles-mumps-rubella (MMR) vaccine for children aged 6–11 months, denoting the recommendation to vaccinate such children if they will travel or live abroad.
  • Standardized formatting used for footnotes for each vaccine to reflect the number of vaccine doses in a particular series.
    • Footnotes organized to reflect vaccine recommendations for each high-risk condition.
    • The diphtheria/tetanus/acellular pertussis (DTaP) vaccine footnote has language added.
    • Influenza vaccine footnotes updated to reflect revised contraindications for LAIV.
    • Pneumococcal vaccine footnote updated to provide clearer guidance for vaccination of persons with high-risk conditions.
  • Figure 2, Catch-Up Immunization Schedule:
    • Haemophilus influenzae type b (Hib) conjugate vaccine, pneumococcal conjugate vaccine, tetanus, diphtheria, and acellular pertussis (Tdap) vaccine and varicella vaccine catch-up schedules updated to provide more clarity. Minimum ages were noted as "not-applicable" for children aged 7 years and older for hepatitis A and B, polio, meningococcal, MMR, and varicella vaccines.
  • The CDC has developed "job-aids" with detailed scenarios by age group and previous doses of vaccine received. The job-aids are available at cdc.gov/vaccines/schedules/hcp/child-adolescent.html.

Changes to the Immunization Schedules for Adults aged 19 Years or Older:

  • Figure 1, the recommended adult immunization schedule by vaccine and age group, has been revised to designate PCV13 for adults aged 65 years or older as "recommended" (from the previous "recommended if some other risk is present"). Figure 2, showing vaccines that might be indicated for adults on the basis of medical and other indications, is unchanged.
  • The footnotes for pneumococcal vaccination have been revised to provide algorithmic, patient-based guidance for the health care provider to arrive at appropriate vaccination decisions for individual patients.
  • The footnote for influenza vaccination has been updated to indicate that adults aged 18 years or older (changed from adults aged 18 through 49 years) can receive recombinant influenza vaccine. (The upper age limit for LAIV remains 49 years.) A list of currently available influenza vaccines is available at: cdc.gov/flu/protect/vaccine/vaccines.htm.

Contraindications and Precautions Table

  • The contraindications and precautions table was updated to include has been revised to update the section on LAIV to reflect the changes in the ACIP recommendations for the 2014–2015 influenza season.

Details on these updates and information on other vaccines recommended for adults are available under Adult Immunization Schedule, United States, 2015 at: cdc.gov/vaccines/schedules and in the Annals of Internal Medicine. The full ACIP recommendations for each vaccine are not included in the schedule because of space limitations but are available at: cdc.gov/vaccines/hcp/acip-recs/index.html.


Deadline Approaching for Nominees: 2015 Childhood Immunization Champion Award Program

February 10, 2015—The deadline is fast approaching to recognize individuals for their outstanding work in improving immunization services for children. Please submit your nominees for the 2015 Childhood Immunization Champion Award by Friday, February 13, 2015.

The Centers for Disease Control and Prevention (CDC) is proud to present the Third Annual Childhood Immunization Champion Award Program. This annual award recognizes individuals who make a significant contribution toward improving public health in their communities through their work in childhood immunization. Let's take this opportunity to garner some accolades for the great immunization partners in our state.

Please submit your nominations to the Immunization Section at Immunization@FLHealth.gov by Friday, February 13, 2015. Information and nominating forms are available on the CDC webpage at: www.cdc.gov/vaccines/events/niiw/champions/downloads/nomination.pdf. Please promote this important opportunity to colleagues, members, coalitions, and partners who provide immunizations or who have an interest in recognizing a colleague.


Deadline Approaching for Nominees: 2015 Childhood Immunization Champion Award Program

January 29, 2015—The deadline is fast approaching to recognize individuals for their outstanding work in improving immunization services for children. Please submit your nominees for the 2015 Childhood Immunization Champion Award to the Immunization Section by Friday, February 13, 2015.

The Centers for Disease Control and Prevention (CDC) is proud to present the Third Annual Childhood Immunization Champion Award Program. This annual award recognizes individuals who make a significant contribution toward improving public health in their communities through their work in childhood immunization. Let's take this opportunity to garner some accolades for the great immunization partners in our state. Each year, up to one CDC Immunization Champion from each of the 50 U.S. states, 8 U.S. Territories and Freely Associated States, and the District of Columbia will be honored during National Infant Immunization Week (NIIW), April 18-25, 2015.

Award Criteria
The Champion Award is intended to recognize individuals who are working at the local level. It honors those who are doing an exemplary job or going above and beyond to promote or foster childhood immunizations in their communities. The nomination and selection of a local Champion should be based on meeting one or more of the following criteria:

  • Leadership: The candidate is considered an authority on immunization in their community, medical system, or individual practice. Activities may include acting as a spokesperson, trainer, mentor, or educator.
  • Collaboration: The candidate has worked to build support for and increase immunization rates in infants and young children. Activities may include establishing or strengthening partnerships, coalitions, committees, working groups, or other.
  • Innovation: The candidate has used creative or innovative strategies to promote immunization or address challenges to immunization in their practice, community, state, or region. Activities may include either new strategies or adapting existing strategies in new ways such as for reaching under-immunized populations.
  • Advocacy: The candidate is active in advancing policies and best practices to support immunization in infants and young children in their community, state, or region. Activities may include providing legislative testimony or promoting, analyzing, or evaluating policies.

Eligibility
Champions can include coalition members, parents, health care professionals (e.g., physicians, nurses, physicians’ assistants, nurse practitioners, medical assistants, etc.), and other immunization leaders who meet the award criteria. Immunization program managers, state and federal government employees of health agencies, individuals who have been affiliated with and/or employed by pharmaceutical companies and those who have already received the award are not eligible to apply (for details, see page 3 of nomination packet:
www.cdc.gov/vaccines/events/niiw/champions/downloads/nomination.pdf.

Please submit your nominations to the Immunization Section at Immunization@FLHealth.gov by Friday, February 13, 2015. Information and nominating forms are available on the CDC webpage at: www.cdc.gov/vaccines/events/niiw/champions/downloads/nomination.pdf.


TRAINING OPPORTUNITY: “You Call The Shots” New Training Modules Available

January 26, 2015—The Immunization Section is pleased to announce new training modules were added to the Centers for Disease Control and Prevention (CDC) web-based training course titled, “You Call the Shots.” A module was added about Measles, Mumps, and Rubella (MMR) and two other modules titled, "Vaccines for Children" and "Vaccine Storage and Handling," were also updated (see links below).

CEUs will be offered using the CIINC link: (www.cdc.gov/vaccines/ed/ciinc/ceinfo.htm).

Note: The Immunization Section makes every attempt to provide training on a variety of subjects/issues, without endorsement, for those interested in immunizations.


2014 Survey of Immunization Levels in Two-Year-Old Children

December 30, 2014—The memorandum and report regarding the 2014 Survey of Immunization Levels in Two-Year-Old Children has been released. The Immunization Section conducted an annual immunization survey of 1,740 randomly selected two-year-old children born in Florida. This survey provides estimated immunization levels for 20 selected counties as well as statewide data. The 2014 statewide coverage rate for the basic 4:3:1:3:3:1 (four DTaP, three polio, one MMR, three Hib, three Hepatitis B, and one Varicella) series is 85.6%. Coverage levels for the 20 largest counties ranged from 70.15% to 94.74%.

Florida’s childhood immunization service delivery is approximately 75% privatized (see Enclosures 3 and 4). County health departments (CHDs) should focus on the key areas identified in the memorandum, in order to reach the current state immunization coverage goal of 90 percent for the 4:3:1:3:3:1 series.

If you have any questions concerning this report, please contact our survey and assessment consultant, Ms. Amy Wilson, at (850) 245-4444, ext. 2395.


National Influenza Vaccination Week (NIVW) is December 7–13, 2014

November 21, 2014—We are pleased to remind our immunization partners about the upcoming observance of National Influenza Vaccination Week (NIVW).

National Influenza Vaccination Week is an annual observance to highlight the importance of continuing influenza vaccination though the holiday season and beyond. This year NIVW is scheduled for December 7–13, 2014.

  • Flu vaccination activity drops after the end of November. The CDC and partners want to remind the public that even through the holiday season is upon us it’s not too late to get a flu vaccine. As long as flu viruses are spreading and causing illness vaccination can provide protection against the flu.
  • CDC Recommends a yearly flu vaccine for everyone 6-months of age and older as the first and most important step in protecting against influenza disease.

A goal of NIVW is to communicate the importance of flu vaccination for people who are at high risk for developing flu-related complications: Young children, pregnant women, people with certain chronic health conditions and people 65-years and older. A full list of “People at High Risk of Developing Flu-Related Complications” is available at: www.cdc.gov/flu/about/disease/high_risk.htm.

There are many choices available for flu vaccine, both in terms of where to get vaccinated and what vaccine to get. Millions of doses of influenza vaccine have been administered to people safely for decades. Once vaccinated people can enjoy their holiday season knowing they protected themselves and their loved ones against the flu.

Please visit the CDC resource site at: www.cdc.gov/flu/nivw/ to obtain educational and promotional materials to encourage community participation for NIVW activities.


Influenza Vaccine Update

November 10, 2014—We are pleased to share the following influenza update from the Centers for Disease Control and Prevention (CDC). At the October 2014 ACIP meeting, information was presented which indicated that there was no measurable effectiveness of the 2013-14 live attenuated influenza vaccine (LAIV) against the influenza A (H1N1) strain. However, the LAIV has been shown to be effective against influenza A (H3N2) and influenza B strains in the past. Both CDC and the American Academy of Pediatrics have issued updates regarding the use of LAIV and inactivated influenza vaccine for the 2014-15 season. Links to both statements are below.
  1. Surveillance shows that there is substantially more circulation of influenza A (H3N2) and B viruses and very little circulating H1N1 so far;
  2. LAIV has been shown to offer good protection against influenza A (H3N2) and influenza B viruses in the past;
  3. LAIV may offer better protection than IIV against antigenically drifted viruses that may circulate this season; and,
  4. Vaccine providers have received their vaccine for the 2014-2015 season and have likely administered a good proportion of it; ACIP and CDC have not changed the current influenza vaccination recommendations.

People who have not been vaccinated yet this season should get vaccinated now. Parents should seek to get their children immunized with whatever vaccine is immediately available and indicated. Influenza vaccination should not be delayed to procure a specific vaccine preparation. The HealthMap Vaccine Finder can be used to locate vaccine.

The CDC update can be found at: www.cdc.gov/flu/news/nasal-spray-effectiveness.htm

The AAP statement can be found at: aapnews.aappublications.org/content/early/2014/11/06/aapnews.20141106-1


Vaccine Information Statement Update: Multiple-Vaccines

October 27, 2014—The Centers for Disease Control and Prevention has updated the Vaccine Information Statement (VIS) for multiple-vaccines. The multi-vaccine VIS may be used in place of the individual VISs for DTaP, Hib, Hepatitis B, Polio, and PCV13 when two or more of these vaccines are administered during the same visit. It may be used for infants through children four through six years of age receiving their routine vaccines.

This VIS no longer includes rotavirus vaccine, because its unique recommendations aren't easily harmonized with those for other infant vaccines. The individual rotavirus VIS should be used. Remaining stocks of the previous edition of the multi-vaccine VIS should be discarded, and this edition should be used immediately.

This VIS reflects the latest recommendations, and new VIS format. The pediatric multi-vaccine vaccine information statement has recently been updated and is available at: www.cdc.gov/vaccines/hcp/vis/vis-statements/multi.html.

Translations of most VISs are available in a variety of languages. Foreign language translations of VISs (www.immunize.org/vis/?f=9) are coordinated by the Immunization Action Coalition (IAC), through a cooperative agreement with the Centers for Disease Control and Prevention.

The Florida SHOTS system will print the current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly check the VIS being distributed by their staff. Check for the current versions at: www.cdc.gov/vaccines/hcp/vis/current-vis.html.

Please distribute this important information to colleagues, members, coalitions, and partners who provide or have an interest in immunizations. Please place this information prominently on your website.


Vaccination Coverage Among Children in Kindergarten–United States, 2013–2014 School Year

October 20, 2014—We are pleased to share the following MMWR publication with our immunization partners. In the October 17, 2014/63(41); 931–920 issue, the Centers for Disease Control and Prevention (CDC) published Vaccination Coverage Among Children in Kindergarten—United States, 2013-2014 School Year. To review statistics and individual state coverage rates you can read the article in its entirety at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6341a1.htm?s_cid=mm6341a1_e.

State and local vaccination requirements for school entry are implemented to maintain high vaccination coverage and protect school children from vaccine-preventable diseases. Each year, to assess state and national vaccination coverage and exemption levels among kindergartners, CDC analyzes school vaccination data collected by federally funded state, local, and territorial immunization programs. This report describes vaccination coverage in 49 states and the District of Columbia (DC) and vaccination exemption rates in 46 states and DC for children enrolled in kindergarten during the 2013–2014 school year.

Federally funded immunization programs assess vaccination coverage among children entering kindergarten each school year. Health departments, school nurses, or school personnel assess the vaccination and exemption status, as defined by state and local school requirements, of a census or sample of kindergartners enrolled in public and private schools. Among the 49 states and DC reporting vaccination coverage data, 42 used their immunization information system (IIS) as at least one source of data for their school assessment.

Immunization programs having access to school vaccination coverage and exemption rates can identify areas where children are more vulnerable to vaccine-preventable diseases. Health promotion efforts in these local areas can be used to help parents understand the risks for vaccine-preventable diseases and the protection that vaccinations provide to their children.


Training Opportunity: ACIP Recommendations for Use of Pneumococcal Vaccines among Adults 65 Years of Age or Older and Improving Awareness and Use of Vaccines Recommended for Adults

October 15, 2014—The Immunization Section is pleased to announce a “Current Issues in Immunization” NetConference featuring “ACIP Recommendations for Use of Pneumococcal Vaccines Among Adults 65 Years of Age or Older” and “Improving Awareness and Use of Vaccines Recommended for Adults.” The NetConference is scheduled for October 23, 2014 at Noon (EDT) and is presented by the National Center for Immunization and Respiratory Diseases Division, Centers for Disease Control and Prevention (CDC).

This is a limited registration event. Registration will close on October 22 or when the course is full. To register logon to: www2.cdc.gov/vaccines/ed/ciinc/.

Dr. Raymond Strikas will moderate the NetConference featuring:

  • ACIP Recommendations for Use of Pneumococcal Vaccines Among Adults 65 years of age or older Tamara Pilishvili, MPH, Epidemiologist and CDC Lead for ACIP Pneumococcal Vaccines Work Group, DBD, NCIRD, CDC
  • Improving Awareness and Use of Vaccines Recommended for Adults Carolyn B. Bridges, MD, FACP, CAPT USPHS, Associate Director for Adult Immunizations, ISD, NCIRD, CDC

"Current Issues in Immunization" is a series of NetConferences which features live, one hour presentations that combine an online visual presentation with simultaneous audio via telephone conference call followed by a live question and answer session. Internet access and a separate phone line are needed to participate. On-demand replays and presentations are made available shortly after each event.

There will be CEUs offered (www.cdc.gov/vaccines/ed/ciinc/ceinfo.htm) and this presentation will be archived (www.cdc.gov/vaccines/ed/ciinc/#archived) for review at a later date.


Vaccine Information Statements (VIS) Update

October 10, 2014—The Provider Information document for the 2014–2015 influenza VISs is now available. This document is accessible along with both flu VISs. It summarizes selected information and recommendations for this year’s influenza vaccines, and may be used to answer patients’ questions and clarify information.

The Florida SHOTS system will print the current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly check the VIS being distributed by their staff. Check for the current versions at: www.cdc.gov/vaccines/hcp/vis/current-vis.html.

Please distribute this important information to colleagues, members, coalitions, and partners who provide or have an interest in immunizations. Please place this information prominently on your website.


Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged ≥65 Years: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

September 25, 2014—We are pleased to share the following MMWR publication with our immunization partners. In the September 19, 2014/63(37); 822–825 issue, the Centers for Disease Control and Prevention (CDC) published the Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged ≥65 Years: Recommendations of the Advisory Committee on Immunization Practices (ACIP).

The CDC released a new recommendation for the use of pneumococcal vaccines among adults. Adults 65 years or older are recommended to get the pneumococcal conjugate vaccine PVC13 and the pneumococcal polysaccharide vaccine PPSV23.

As part of the new recommendation, adults 65 years of age or older who have not previously received any pneumococcal vaccines or whose previous vaccination history is unknown should receive a dose of PVC13 first, followed 6–12 months later by a dose of PPSV23. Adults 65 years of age or older who have previously received PPSV23 should receive PCV13 at least one year since their most recent dose of PPSV23.

It is also important to remember that pneumococcal vaccines are also recommended for adults 19 years or older with certain health conditions and lifestyles. For more information on pneumococcal vaccination visit: www.cdc.gov/vaccines/vpd-vac/pneumo/default.htm.


Measles Outbreak in an Unvaccinated Family and a Possibly Associated International Traveler–Orange County, Florida, December 2012–January 2013 and Assessment of Varicella Surveillance and Outbreak Control Practices–United States, 2012

September 22, 2014—We are pleased to share the following Morbidity and Mortality Weekly Report (MMWR) publications with our immunization partners. In the September 12, 2014 / 63(36); 781–784 issue, the Centers for Disease Control and Prevention published Measles Outbreak in an Unvaccinated Family and a Possibly Associated International Traveler–Orange County, Florida, December 2012–January 2013. Also published in the September 12, 2014 / 63(36); 785–788 issue is Assessment of Varicella Surveillance and Outbreak Control Practices–United States, 2012. This article is available in its entirety at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6336a2.htm?s_cid=mm6336a2_e.

Measles Outbreak in an Unvaccinated Family and a Possibly Associated International Traveler–Orange County, Florida, December 2012–January 2013

The Florida Department of Health in Orange County (FDOH-Orange) was notified by a child care facility on January 11, 2013, that a parent had reported that an attendee and three siblings were ill with measles. All four siblings were unvaccinated for measles and had no travel history outside of Orange County during the periods when they likely had been exposed. A fifth, possibly associated case was later reported in a Brazilian citizen who had become ill while vacationing in Florida. The outbreak investigation was conducted at multiple community settings in Orange County. Sources of measles exposure can be difficult to identify for every measles case. Reporting a confirmed or suspected case immediately to public health authorities is critical to limit the spread of measles.

Assessment of Varicella Surveillance and Outbreak Control Practices–United States, 2012

Case-based varicella (chickenpox) surveillance is important for monitoring the impact of the varicella vaccination program. In 2002, the Council of State and Territorial Epidemiologists (CSTE) recommended that all states move toward case-based varicella surveillance by 2005; in 2003, varicella was made nationally notifiable. To ease the transition to case-based reporting, CSTE and CDC recommended starting with sentinel site or outbreak surveillance and then moving to statewide case-based surveillance when feasible. To gauge progress in varicella surveillance, in 2012 CDC and CSTE developed a survey for assessing varicella surveillance practices. As the varicella vaccination program matures and more cases occur among vaccinated persons, laboratory confirmation is increasingly necessary. Considerable progress has been made in national varicella surveillance, and national data are now used to monitor trends in varicella incidence.


TRAINING OPPORTUNITY: Hepatitis B Provider Knowledge and Screening Practices Webinar

September 22, 2014—The Immunization Section is pleased to announce the Hepatitis B Provider Knowledge and Screening Practices webinar featuring speakers from the U.S. Department of Health and Human Services (HHS), Centers for Disease Control and Prevention and Hep B United partners. The webinar is scheduled for September 30, 2014 from 3–4 p.m. (EDT).

Hepatitis B affects up to two million Americans—yet the disease is often overlooked and largely underdiagnosed. Additionally, studies have shown that knowledge about chronic viral hepatitis among health care providers is generally poor. This interactive session will focus on health care provider knowledge and screening for hepatitis B.

Register for the Hepatitis B webinar at: bit.ly/Wc53iW.

Kate Moraras, MPH, Senior Program Director, Hepatitis B Foundation Director and Hep B United, will moderate the webinar and introduce guest speakers:

  • John Ward, MD, Director, Viral Hepatitis Program, Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, HHS Centers for Disease Control and Prevention
  • Camilla Graham, MD, MPH, Co-Director, Viral Hepatitis Center, Division of Infectious Diseases, Beth Israel Deaconess Medical Center
  • Chrissy M. Cheung, MPH, Hepatitis B Prevention Coordinator, Santa Clara County Public Health Department

No CEUs or CMEs are available for this program. This webinar will be archived and available two weeks after the live presentation.

Note: The Immunization Section makes every attempt to provide training on a variety of subjects/issues, without endorsement, for those interested in immunizations.


Expansion of Adult Vaccine Availability Through the Immunization Section

September 16, 2014—The Immunization Section is pleased to announce the expansion in the availability of select federally supplied adult vaccines for uninsured and underinsured clients served at county health departments effective October 1, 2014. The Immunization Section will provide county health departments with the opportunity to order the following vaccines to serve a limited number of uninsured and underinsured adult clients:

  • Human papillomavirus (HPV) vaccine–Available for uninsured and underinsured clients 19 through 26 years of age
  • Meningococcal conjugate vaccine (MCV4)–Available for uninsured and underinsured clients (age 19 and older)
  • Tetanus-diphtheria- acellular pertussis (Tdap) Vaccine–Available for uninsured and underinsured clients (age 19 and older)
  • Pneumococcal conjugate vaccine (PCV 13) and pneumococcal polysaccharide vaccine (PPSV)–Available for uninsured and underinsured high-risk clients (age 19 and older)
  • Varicella Vaccine–Available for outbreak control for all exposed persons, regardless of financial status

Changes include the availability of Tdap vaccine for all adults age 19 and older and the inclusion of PCV13 vaccine for high-risk adults and MCV4 for age 19 and older.

Vaccine will continue to be ordered, received and administered through the Florida State Health Online Tracking System (SHOTS) utilizing the program component (PC) 17–adult vaccines. Coordination and collaboration with HMS will allow CHDs to pull these services from Florida SHOTS to HMS.

All vaccine will be distributed by the McKesson Distribution Center and will be received just as the pediatric PC01 is received but utilizing PC17 instead.

Since these vaccines are purchased with federal funds county health departments may bill the client only for the administration of the vaccine. Billing for the vaccine is prohibited. Quantities of vaccine are limited based on the availability of funds; therefore, a county health department may not receive all the vaccine initially requested.


Training Opportunity: Accelerating HPV Vaccine Uptake: What is Working and Why

September 16, 2014—The Immunization Section is pleased to announce the National Cancer Institute (NCI) Research to Reality’s Cyber-Seminar Series on Accelerating HPV Vaccine Uptake: What is Working and Why. The webinar is scheduled for September 23, 2014, 2:00 p.m. (EDT).

Human papillomaviruses (HPV) cause most cases of cervical cancer and large proportions of vaginal, vulvar, anal, penile, and oropharyngeal cancers. HPV vaccines could dramatically reduce the incidence of HPV-associated cancers and other conditions among both females and males, but the uptake of vaccines has fallen short of target levels. The September NCI Research to Reality cyber-seminar will present key goals and high priority research interventions to increase HPV vaccine uptake. The webinar highlights promising interventions that through a variety of strategies have created substantive changes in accelerating HPV vaccine uptake.

To register logon to: cyberseminar.cancercontrolplanet.org/register.aspx?ID=51.

This webinar will be archived (researchtoreality.cancer.gov/cyber-seminars/accelerating-hpv-vaccine-uptake-what-working-and-why) for review at a late date. No CEUs are available for this program.


TRAINING OPPORTUNITY: Influenza and Chronic Medical Conditions: How Risk Adds to Risk in the Older Adult

September 5, 2014—The Immunization Section is pleased to announce a web-based educational program Influenza and Chronic Medical Conditions: How Risk Adds to Risk in the Older Adult sponsored by Sanofi-Pasteur.

The webcast will be moderated by William Schaffner, MD, Professor of Preventive Medicine, Department of Health Policy, and Professor of Medicine, Division of Infectious Diseases at Vanderbilt University School of Medicine in Nashville, Tennessee.

  • The presentation explores ways in which influenza and comorbidities such as heart disease, lung disease, and diabetes interact to increase the risks of influenza-related complications, hospitalization, and death.
  • The presentation stresses how important it is for health care providers to identify and immunize patients at high risk of influenza, especially older adults who are likely to have one or more comorbid conditions.
  • The program reviews why the use of vaccines that generate a higher immune response may be important to help prevent influenza infection and its potentially life-threatening complications in older adults.

The 1–hour program includes a formal presentation and a question and answer session. The webcast is offered on the following dates: September 16, 2014 at 2:00 p.m. (EDT) and September 25, 2014 at noon (EDT).

Please confirm your participation and indicate which date you prefer by visiting the Influenza and Chronic Medical Conditions Registration page. We thank you for your consideration and your interest in disease prevention and look forward to your participation.

No CEUs or CMEs are available for this program.

Note: The Immunization Section makes every attempt to provide training on a variety of subjects/issues, without endorsement, for those interested in immunizations.


National, State, and Selected Local Area Vaccination Coverage Among Children Aged 19–35 Months—United States, 2013 and Human Papillomavirus Vaccination: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

September 2, 2014—We are pleased to share the following Morbidity and Mortality Weekly Report (MMWR) publications with our immunization partners. In the August 29, 2014/63(34); 741-748 issue, the Centers for Disease Control and Prevention published the National, State and Selected Local Area Vaccination Coverage Among Children Aged 19-35 Months—United States, 2013. Also published in the August 29, 2014/63 No. RR-5; 1-30 issue are Human Papillomavirus Vaccination: Recommendations of the Advisory Committee on Immunization Practices (ACIP). This article is available in its entirety at: www.cdc.gov/mmwr/preview/mmwrhtml/rr6305a1.htm?s_cid=rr6305a1_e.

Vaccination Coverage Among Children—In the United States, among children born during 1994–2013, vaccination will prevent an estimated 322 million illnesses, 21 million hospitalizations, and 732,000 deaths during their lifetimes. Since 1994, the National Immunization Survey (NIS) has monitored vaccination coverage among children aged 19–35 months in the United States. This report describes national, regional, state, and selected local area vaccination coverage estimates for children born January 2010–May 2012, based on results from the 2013 NIS. The national average for the combined 4:3:1:3:3:1:4 childhood series is 70.4%. Florida’s rate is 70.0%. The combined (4:3:1:3*:3:1:4) vaccine series includes ≥4 doses of diphtheria, tetanus and acellular pertussis (DTaP), ≥3 doses of poliovirus vaccine, ≥1 dose of measles-containing vaccine, full series of Hib vaccine (≥3 or ≥4 doses, depending on product type), ≥3 doses of Hepatitis B, ≥1 dose of varicella vaccine, and ≥4 doses of pneumococcal conjugate vaccine.

Human Papillomavirus Vaccination—This report summarizes the epidemiology of human papillomavirus (HPV) and associated diseases, describes the licensed HPV vaccines, provides updated information on vaccines from clinical trials and post-licensure safety studies and compiles recommendations from CDC’s Advisory Committee on Immunization Practices (ACIP) for use of HPV vaccines.


Vaccine Information Statement Update: Influenza 2014–2015

August 21, 2014—Updated Vaccine Information Statement (VIS) for influenza vaccines—for both Inactivated Influenza Vaccines (IIV), and Live Attenuated Influenza Vaccines (LAIV) were posted by the Centers for Disease Control and Prevention. These VISs reflect the latest recommendations, and new VIS format.

These VIS are attached for your reference and can be found online at: www.cdc.gov/vaccines/hcp/vis/vis-statements/flu.html and www.cdc.gov/vaccines/hcp/vis/vis-statements/flulive.html.

Translations of most VISs are available in a variety of languages. Foreign language translations of VISs (www.immunize.org/vis/?f=9) are coordinated by the Immunization Action Coalition (IAC), through a cooperative agreement with the Centers for Disease Control and Prevention.

The Florida SHOTS system will print the current VIS for participants, so this transition should be seamless. We encourage ALL providers to regularly check the VIS being distributed by their staff. Check for the current versions at: www.cdc.gov/vaccines/hcp/vis/current-vis.html.

Please distribute this important information to colleagues, members, coalitions, and partners who provide or have an interest in immunizations. Please place this information prominently on your website.


Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2014–2015

August 18, 2014—On August 15, 2014 the Centers for Disease Control and Prevention published Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)—United States, 2014–2015 Influenza Season Morbidity and Mortality Weekly Report (MMWR) August 15, 2014 / 63(32); 691–697. To read the entire document visit: www.cdc.gov/mmwr/preview/mmwrhtml/mm6332a3.htm?s_cid=mm6332a3_e.

Routine annual influenza vaccination is recommended for all persons aged ≥6 months.

For the 2014–2015 influenza season:

Vaccine virus strains included in the 2014–2015 U.S. Trivalent influenza vaccines will contain hemagglutinin (HA) derived from an A/California/7/2009 (H1N1)-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like (Yamagata lineage) virus. Quadrivalent influenza vaccines will contain these antigens, and also a B/Brisbane/60/2008-like (Victoria lineage) virus.

When immediately available, LAIV should be used for healthy children aged 2 through 8 years who have no contraindications or precautions (Category A). If LAIV is not immediately available, IIV should be used. Vaccination should not be delayed to procure LAIV.

LAIV should not be used in the following populations:

  • Persons aged <2 years or >49 years;
  • Those with contraindications listed in the package insert
  • Children aged 2 through 17 years who are receiving aspirin or aspirin-containing products; Persons who have experienced severe allergic reactions to the vaccine or any of its components, or to a previous dose of any influenza vaccine;
  • Pregnant women;
  • Immunosuppressed persons;
  • Persons with a history of egg allergy;
  • Children aged 2 through 4 years who have asthma or who have had a wheezing episode noted in the medical record within the past 12 months, or for whom parents report that a health care provider stated that they had wheezing or asthma within the last 12 months;
  • Persons who have taken influenza antiviral medications within the previous 48 hours;
  • Persons of any age with asthma might be at increased risk for wheezing after administration of LAIV.

Influenza Vaccination of Persons with a History of Egg Allergy

Persons with a history of egg allergy who have experienced only hives after exposure to egg should receive influenza vaccine. IIV or trivalent recombinant influenza vaccine (RIV3) should be used. RIV3 may be used for persons aged 18 through 49 years who have no other contraindications. However, IIV (egg- or cell-culture based) may also be used.

Other influenza vaccine recommendations pertaining to persons with egg allergies are listed in the publication.

The Immunization Section supports the ACIP recommendations that health care workers and those who have contact with vulnerable persons be vaccinated, not only to protect themselves, but also for those to whom they serve and care. Anyone who wants protection from influenza should be vaccinated, and health care providers should recommend vaccination at every opportunity to all eligible persons. Health care providers should offer influenza vaccine as soon as it becomes available and should continue to offer it throughout the influenza season (i.e., as long as influenza viruses are circulating in the community).

The CDC and the Immunization Section have developed influenza educational materials found online at www.cdc.gov/flu/ and www.floridahealth.gov/programs-and-services/prevention/flu-prevention/index.html.


Utilizing the Vaccine Adverse Event Reporting System (VAERS)

August 14, 2014—The Immunization Section would like to remind our immunization providers of the process for reporting adverse events following administration of any vaccines. The Vaccine Adverse Event Report System (VAERS) is a national vaccine safety surveillance program co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS is a post-marketing safety surveillance program, collecting information about adverse events (possible side effects) that occur after the administration of vaccines licensed for use in the United States.

Health care providers should report any adverse event that occurs after the administration of a vaccine licensed in the United States. You may report adverse events even if you are unsure whether a vaccine caused them.

The National Childhood Vaccine Injury Act (NCVIA) requires health care providers to report:

Anyone can file a VAERS report, including health care providers, manufacturers, and vaccine recipients. VAERS reports may be submitted by mail, fax or online.

The VAERS Web submission site is located at vaers.hhs.gov/esub/step1. Please review the online help for data entry before entering reports using the online system. Prior to submitting the report electronically to VAERS, please print an additional copy of the report and fax it to the VAERS coordinator in the Immunization Section at 850-922-4195, following the current security and confidentiality protocols. County health departments should refer to DOHP 350-5-14 available on the department's intranet.


TRAINING OPPORTUNITY: Vaccine Update for Health Care Providers

August 7, 2014—The Immunization Section is pleased to announce the Vaccine Education Center at the Children’s Hospital of Philadelphia is hosting a “Current Issues in Vaccines” webinar covering information from the Advisory Committee on Immunization Practices (ACIP) June meeting. The webinar is scheduled for September 10, 2014 at Noon (EST).

Topics of discussion include:

  • Yellow fever vaccine: Can one dose last a lifetime?
  • Influenza vaccine: Is LAIV better than IIV?
  • HPV vaccine: Are two doses as good as three?
  • HPV vaccine: New 9-valent vaccine
  • Vaccine safety: Febrile seizures
  • PCV 13: What about adults?
  • Measles: Update on recent outbreak

Dr. Paul Offit, MD will present the webinar. Dr. Offit is the Director of the Vaccine Education Center for the Division of Infectious Diseases at the Children’s Hospital of Philadelphia. He is also a Professor of Pediatrics and Maurice Hilleman Professor of Vaccinology at the University of Pennsylvania School of Medicine.

Each “Current Issues in Vaccines” webinar presents topics being addressed by the ACIP, covered by the media or asked by parents. Each presentation will be 40 to 45 minutes, followed by 15 to 20 minutes of audience questions.

The “Current Issues in Vaccines” webinars are co-sponsored by the Pennsylvania Chapter, American Academy of Pediatrics, and are supported by the Thomas F. McNair Scott Endowed Research and Lectureship Fund.

There will be CEU offered and this presentation will be archived.

Note: The Immunization Section makes every attempt to provide training on a variety of subjects/issues, without endorsement, for those interested in immunizations.


TRAINING OPPORTUNITY: “Vaccine Confidence”
The Key to Communicating With Parents of Pediatric Patients

August 6, 2014—The Immunization Section is pleased to announce a webcast presented by Sanofi Pasteur Inc., and facilitated by PRI Healthcare Solutions, “Vaccine Confidence” The Key to Communication With Parents of Pediatric Patients. Joseph Domachowske, MD, will moderate the educational webcast on the concept of vaccine confidence and the pivotal role health care professionals can play in ensuring children are fully immunized in a timely manner.

The program will highlight strategies for overcoming vaccine hesitancy and building vaccine confidence among parents of pediatric patients. Considering the recent outbreaks of vaccine-preventable diseases such as pertussis and measles, and the impact of non-medical exemptions on immunization coverage rates, confident approaches to communication about vaccines are needed more than ever.

The program will be available once a week for a 2-week period: August 7, 2014 at noon and August 12, 2014 at 3:00 p.m. (EDT)

To register logon to: vaccineconfidence2014.prihcs.com/access.html

For additional details about this program, as well as information on how to participate, please refer to the attachment.

No CEUs or CMEs are available for this program.

Note: The Immunization Section makes every attempt to provide training on a variety of subjects/issues, without endorsement, for those interested in immunizations.


TRAINING OPPORTUNITY: Benefits and Safety of 4-Strain Live, Attenuated Influenza Vaccine

August 5, 2014—The Immunization Section is pleased to announce a MedImmune, National Flu Immunization Webinar ”Benefits and Safety of 4-Strain Live, Attenuated Influenza Vaccine.” Presentation schedules and presenters are listed below.

August 13, 2014: Dr. Henry Wojtczak, Pediatric Pulmonology, Department of Pediatrics, Naval Medical Center will present the webinar at noon (EST), August 13, 2014. The courses will be one hour with a question and answer session to follow. RSVP required by August 7, 2014.

August 20, 2014: Dr. William Michael Brown Pediatrics, Bayfront Health, St. Petersburg will present the webinar at 3 p.m. (EST), August 20,2014. The courses will be one hour with a question and answer session to follow. RSVP required by August 14, 2014.

To register online please visit: medimmuneprograms.webex.com/mw0401l/mywebex/default.do?siteurl=medimmuneprograms.

If you have any questions or want to know if the webinar is being archived please contact: MedImmuneSpeakers@Insyght.com

No CEUs are available for this program.

Note: The Immunization Section makes every attempt to provide training on a variety of subjects/issues, without endorsement, for those interested in immunizations.


Important: Interim Recommendations for the Use of Pneumococcal and Influenza Vaccines Among Unaccompanied Children

July 31, 2014—We are pleased to share the following vaccine information with our immunization partners. The Centers for Disease Control and Prevention (CDC) has provided updated interim recommendations for the use of pneumococcal and influenza vaccines among unaccompanied children transitioning through the large processing centers and the Department of Defense (DoD) facilities receiving these children.

Thousands of children from Central America are currently sheltered and cared for at U.S. government facilities. From July 10, 2014 through July 24, 2014, seven cases of severe pneumococcal pneumonia have been identified among unaccompanied children. There is also an increased risk of influenza among these children. H1N1 and influenza B have been detected in several children.

To address the outbreaks of pneumococcal pneumonia and the increased risk of influenza transmission, interim recommendations are outlined below:

Pneumococcal vaccine

  • All unaccompanied children, regardless of their point of entry or pathway to Office of Refugee Resettlement shelters, should receive a single dose of PCV13 as soon as possible after apprehension. Those currently in shelters should be vaccinated as soon as feasible.

Influenza vaccine

  • For children who are staying in large processing centers (such as Nogales or McAllen) for sufficient time to receive vaccinations, vaccinate using the 2013–2014 influenza vaccines.
  • Children in DoD facilities (such as Lackland, Ft. Sill, and Ventura) who did not receive influenza vaccine prior to arrival should be vaccinated using the 2013–2014 vaccine.
  • For children in other facilities, vaccinate using the 2014–2015 influenza vaccine when available, unless there is evidence of influenza activity or severe respiratory illness, in which case 2013–2014 vaccine may be used if 2014–2015 vaccine is not yet available.
  • Once the 2014–2015 vaccines are available, vaccinate all children 6 months of age or older using the 2014–2015 influenza vaccine formulation.
  • It should be noted that the Food and Drug Administration has created a pathway to extend the expiry dates of specific formulations of 2013–14 vaccines. Eligible vaccines would be IIV formulations for which 12– or 18–month stability data are available. Doses of 2013–2014 influenza vaccine with this extended expiration date may be ordered through the Immunization Section. Only doses ordered through the Immunization Section will have the extended expiration date and leftover vaccines from the 2013–2014 season should not be used.

Vaccine Information Statement Updates

July 31, 2014—The Immunization Section is taking this opportunity to update our immunization partners regarding Vaccine Information Statements (VISs).

A Vaccine Information Statement (VIS) is a one-page (two-sided) information sheet, produced by CDC. VISs inform vaccine recipients—or their parents or legal representatives—about the benefits and risks of a vaccine.

Federal law requires that VISs be handed out whenever (before each dose) certain vaccinations are given. It is a requirement of the National Childhood Vaccine Injury Act (NCVIA) of 1986. VISs are worded so they may be used by adults as well as children. An exception is the DTaP VIS, since DTaP is not licensed for adults. There are separate VISs for adult Td and Tdap vaccines. Apart from legal requirements, it is good practice to give the appropriate VIS every time any vaccine is administered, to anyone of any age.

The NCVIA requires providers to supplement the VISs with "visual presentations" or oral "explanations" as needed. If patients are unable to read the VISs, it is up to the provider to ensure that they have that information. VISs can be read to these patients, or videotapes can be used as supplements. At least one CD-ROM is being produced on which users can hear the VISs read. The VISs available on CDC's website are compatible with screen reader devices.

A VIS with a date several years old is not necessarily out of date. VISs are not updated annually or on any other routine schedule. An updated VIS with a new date is posted when there is a change in recommendations. Providers can check weekly for VIS updates at www.immunize.org/new/vis.asp or www.cdc.gov/vaccines/hcp/vis/what-is-new.html. VIS is NOT an informed consent form. People sometimes use the term “informed consent” loosely when referring to VISs. But even when vaccine information materials had tear-off sheets for parents to sign, they were not technically informed consent forms. The signature was simply to confirm that the "Duty to Warn" clause in the vaccine contract was being fulfilled.

There is no Federal or state requirements for informed consent for administration of vaccines. VISs are written to fulfill the information requirements of the NCVIA. But, because they cover both benefits and risks associated with vaccinations, they provide enough information that anyone reading them should be adequately informed. This consent is generally considered included in the "Consent to treat" which patients grant to providers early on. Vaccine would be covered under the general "consent to treat", just as any other treatment or medication. Section 743.0645, Florida Statutes defines who can consent to ordinary medical care and treatment, which includes immunization for a minor. Visit archive.flsenate.gov/Statutes/Index.cfm?App_mode=Display_Index&Title_Request=XLIII#TitleXLIII.

This is a listing of VISs and the dates they were issued. Vaccines covered by the NCVIA are in bold.

Adenovirus 6/11/14
Anthrax 3/10/10
DTaP 5/17/07
Hib 2/4/14
Hepatitis A 10/25/11
Hepatitis B 2/2/12
HPV-Cervarix 5/3/11
HPV-Gardasil 5/17/13
Influenza 7/26/13
Japanese Encephalitis 1/24/14
MMR 4/20/12
MMRV 5/21/10
Meningococcal 10/14/11
PCV13 2/27/13
PPSV 10/6/09
Polio 11/8/11
Rabies 10/6/09
Rotavirus 8/26/13
Shingles 10/6/09
Td 2/4/14
Tdap 5/9/13
Typhoid 5/29/12
Varicella (Chickenpox) 3/13/08
Yellow fever 3/30/11

The Multi-Vaccine Information Statement is being temporarily removed from circulation while being updated. In the meantime please use the individual VISs when vaccinating children with DTaP, Hib, Hepatitis B, PCV13, Polio and Rotavirus vaccines. An updated edition is expected by mid-2014.

Providers (both public and private) have certain responsibilities with respect to these information statements. Today, there are more ways to obtain VISs electronically than there have been in the past, and providers have found innovative ways to comply with the VIS law while conserving paper—all of which have led to confusion about exactly what a provider's responsibilities are regarding use of VISs. Detailed recommendations for using vaccines are available from the manufacturers' package inserts, Advisory Committee on Immunization Practices (ACIP) statements on specific vaccines, and the American Academy of Pediatrics Red Book. ACIP statements for all recommended childhood vaccines can be viewed, downloaded, and printed from this web site: www.cdc.gov/vaccines/hcp/acip-recs/index.html.

Consult the Vaccine Adverse Event Reporting System (VAERS) site for guidance on how to obtain and complete a VAERS form at: vaers.hhs.gov/index or call 1-800-822-7967.

Within the context of the NCVIA mandate, and given the variety of ways a VIS can now be offered, note the following instructions:

  1. Always offer the patient or parent a copy of the appropriate VIS to read during the immunization visit, and a copy (either paper or electronic) to take home. Always offer the patient an opportunity to ask questions. Note: When a combination vaccine is administered for which there is not a consolidated VIS, give the patient the individual VISs for each component.
  2. It is acceptable to make a VIS available to be read before the immunization visit (e.g., by giving the patient or parent a copy to take home during a prior visit, or telling them how to download or view a copy from the internet). We encourage this when possible. These patients must still be offered a copy to read during the immunization visit, as a reminder, and a copy to take home.
  3. The patient may be offered a permanent (e.g., laminated) copy of the VIS to read during the immunization visit (instead of their own paper copy), or may be directed to the appropriate VIS on an office computer. Note: Check the CDC's VIS website periodically to ensure that the office copies you are using are the current editions.
  4. Always encourage the patient to take a copy of each appropriate VIS home when they leave the office. This is because some information (e.g., the routine schedule, or how to recognize or report an adverse event) can be useful later. Offer the patient a paper copy, or of they prefer to download the VIS onto a mobile device, direct them to CDC's patient VIS download webpage, www.cdc.gov/vaccines/hcp/vis/index.html , during the visit.
  5. As needed, supplement VISs orally, with visual presentations, with additional printed material, or in any other way that will help recipients understand the disease and vaccine.
  6. Record the required information on the patient's medical record or on a permanent office log (the record should be both permanent and accessible):
    • The edition date of the VIS (found on the back in either the left or right bottom corner). Note: When multiple VISs are given for a combination vaccine, record the individual edition dates.
    • The date the VIS is provided (i.e., the date of the visit when the vaccine is administered).
    • The name, address (office address) and title of the person who administers the vaccine.
    • The date the vaccine is administered.
    • The vaccine manufacturer and lot number.

Providers May Also

  • Add a practice’s name, address, or phone number to an existing VIS. If the publication date is cut off during downloading, add the date.

Providers Should Not

  • Change a VIS or make your own VIS. The law requires providers to use those developed by CDC.

VIS is available from:

  • CDC's Vaccines & Immunizations site: www.cdc.gov/vaccines/hcp/vis/index.html. VISs in different languages can be found at: www.immunize.org/vis/.
  • Participants in the Florida State Health Online Tracking System (Florida SHOTS) can access the current VIS through the program. These can be printed as needed, avoiding the need to carry a stock of VIS for each type of antigen administered.

TRAINING OPPORTUNITY: “Are You Ready for Flu?”
CDC’s Recommendations and Communication Plans for the 2014-2015 Influenza Season

July 28, 2014—The Immunization Section is pleased to announce a Virtual Immunization Communication (VIC) Network webinar, “Are You Ready for Flu?” The webinar is scheduled for August 13, 2014 at 2 p.m. (EDT). The presentation will include the Centers for Disease Control and Prevention’s (CDC) recommendations and communication plans for the 2014–2015 influenza season.

"Are You Ready for Flu?" webinar will provide an overview of the 2014–2015 influenza season and information about this year’s flu vaccine communication campaign plan for the general public along with new materials that will assist with reaching Hispanic, African American and American Indian/Alaska Native populations.

Objectives:

  • Influenza vaccination recommendations, formulations and supply 2014–2015 flu season;
  • Key communication considerations and planned strategies for the 2014–2015 flu season;
  • Grassroots approaches for effectively reaching disparate population with flu vaccination messages.

To register logon to: nphic-cic.webex.com/mw0401l/mywebex/default.do?siteurl=nphic-cic.

Speakers:

  • Joseph Bresee, MD, FAAP, chief of the Epidemiology and Prevention Branch in the CDC’s Influenza Division.
  • Cindy Fowler is a health communication specialist in the Health Communication Science Office for the National Center for Immunization and Respiratory Diseases at CDC.
  • Carlos Velazquez, MA, has been in the health field for more than 20 years. He is currently overseeing the CDC's communications initiative for grassroots social marketing to promote influenza immunization to disparate populations.

The VIC Network is a nationwide “virtual immunization community” of health educators, public health communicators and others who promote immunizations to exchange and share resources and materials and the best practices. This presentation will be archived (http://www.vicnetwork.org/) for review at a later date. No CEUs are available for this program.


National, Regional, State and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years—United States, 2013

July 28, 2014—We are pleased to share the following MMWR publication with our immunization partners. In the July 25, 2014/63(29); 625-33 issue, the Centers for Disease Control and Prevention published the National, Regional, State and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–7 Years – United States, 2013. You can read the article in its entirety at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6329a4.htm.

  • The Advisory Committee on Immunization Practices (ACIP) recommends that adolescents routinely receive 1 dose of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine, 2 doses of meningococcal conjugate (MenACWY) vaccine, and 3 doses of human papillomavirus (HPV) vaccine.
  • To assess vaccination coverage among adolescents aged 13–17 years, CDC analyzed data from the 2013 National Immunization Survey-Teen (NIS-Teen). This report summarizes the results of that analysis, which show that from 2012 to 2013, coverage increased for each of the vaccines routinely recommended for adolescents: from 84.6% to 86.0% for ? Tdap dose; from 74.0% to 77.8% for ? MenACWY dose; from 53.8% to 57.3% for ? HPV dose among females, and from 20.8% to 34.6% for ? HPV dose among males.
  • Coverage varied by state and local jurisdictions and by U.S. Department of Health and Human Services (HHS) region. Healthy People 2020 vaccination targets for adolescents aged 13–15 years (4) were reached in 42 states for ? Tdap dose, 18 for ? MenACWY dose, and 11 for ? varicella doses. No state met the target for ? HPV dose

The latest vaccination coverage estimates for adolescents show only small increase for HPV vaccine. CDC officials announced that the number of girls and boys aged 13–17 years receiving human papillomavirus (HPV) vaccine remains unacceptably low. NIS-Teen summary is available at: www.cdc.gov/vaccines/who/teens/vaccination-coverage.html.

Teen vaccine related information has been attachment for your convenience:

  • Vaccine Chart for Adolescents 13–17 Coverage
  • CDC Press Release: Safe and effective vaccine that prevents cancer continues to be underutilized. Latest vaccination coverage estimates for adolescents show only small increase for HPV vaccine
  • HPV Cancer Prevention flyer

Use of MenACWY-CRM Vaccine in Children Aged 2 Through 23 Months at Increased Risk for Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices, 2013

July 18, 2014—We are pleased to share the following vaccine report with our immunization partners. The Centers for Disease Control and prevention (CDC) features articles on vaccinations in the Morbidity and Mortality Weekly Report (MMWR) Volume 63(24); 527–530. This report is available at: www.cdc.gov/mmwr/preview/mmwrhtml/mm6324a2.htm on June 20, 2014.

The Advisory Committee on Immunization Practices (ACIP) at the October 2013 meeting recommended use of a third meningococcal conjugate vaccine, MenACWY-CRM (Menveo, Novartis), as an additional option for vaccinating infants aged 2 through 23 months at increased risk for meningococcal disease.

MenACWY-CRM is the first quadrivalent meningococcal conjugate vaccine licensed for use in children aged 2 through 8 months. MenACWY-D (Menactra, Sanofi Pasteur) is recommended for use in children aged 9 through 23 months who are at increased risk for meningococcal disease, and Hib-MenCY-TT (MenHibrix, GlaxoSmithKline) is recommended for use in children aged 6 weeks through 18 months at increased risk.

Infants at increased risk for meningococcal disease are:

  • Infants with persistent complement component deficiencies (C3, C5–C9, properdin, factor D, and factor H),
  • Infants with functional or anatomic asplenia (including sickle cell disease),
  • Healthy infants in communities with a meningococcal disease outbreak for which vaccination is recommended, and
  • Infants traveling to or residing in areas where meningococcal disease is hyperendemic or epidemic.

Routine vaccination against meningococcal disease is not recommended for children aged 2 months through 10 years.


August is National Immunization Awareness Month (NIAM)

July 11, 2014—The Centers for Disease Control and Prevention (CDC), the leader in the fight of infectious diseases, deems August National Immunization Awareness Month (NIAM). This event highlights the necessity of immunizations to combat vaccine-preventable diseases and improving coverage levels for people of all ages.

Activities to raise awareness about immunization will focus on encouraging people to protect their health by being immunized. Different age groups have different immunization needs. This includes: pregnant women, babies, children, teens, young adults and adults. Although the needs vary the outcome is the same, to protect each individual from vaccine-preventable diseases.

In August look for National Immunization Awareness Month activities hosted in your community.

  • A Healthy Start (Aug. 3–9)
    Pregnant women: Women who are pregnant or planning a pregnancy, vaccination needs are determined by age, lifestyle, medical conditions and previous vaccinations. An accurate record of immunizations is important. Infants can be protected from 14 vaccine-preventable diseases before age two. Starting at birth up to two years-old, infants should receive all their baby shots.
  • Back to School (Aug. 10–16)
    Children/Teens: From the beginning of child care to the completion of high school, Florida requires certain vaccines to be administered before children can attend. Students participating in public or private school campus-based activities are required to have age-appropriate vaccines with the proper documentation on file at the school.
  • Off to the Future (Aug. 17–23)
    Young Adults: Some vaccines may be recommended for adults because of a particular job or school-related requirements, health conditions, lifestyle or other factors. For example, some states require students entering colleges and universities to be vaccinated against certain diseases like meningitis due to increased risk among college students living in residential housing.
  • Not Just for Kids (Aug. 24–30)
    Adults: Vaccinations are recommended throughout life to prevent vaccine-preventable diseases. Many adults are unaware of the need for vaccinations after high school or college. Adult vaccina¬tion coverage is low. Research shows that adult patients are willing to get a vaccine when it is recommended by their provider, according to the Adult Immunization Standards of Practice.

2014–2015 Immunization Requirement Update for Schools and Childcare Facilities

June 25, 2014—The Immunization Section would like to remind all immunization partners of the childcare facilities and school immunization requirements for the 2014–2015 school year. Documentation for required immunizations is mandatory for all students entering, attending, or transferring into a Florida school in grades pre-Kindergarten through 12 as detailed in the Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes, effective March 2013 and incorporated by reference in Rule 64D-3.046, Florida Administrative Code. The Guidelines, located at the Immunization Section website at: www.immunizeflorida.org/schoolguide.pdf, provide technical assistance to health care providers, schools, childcare facility operators, family daycare home operators, school health personnel, and county health department personnel, and are updated when there are changes to immunization recommendations impacting childcare and/or school requirements. There have been no changes to childcare requirements.

There is no time like the present to update children’s immunizations and provide them with the required documentation for school. Many health care providers and families have already begun the process to get ready for the new school year. Immunizations should be updated at each encounter, including annual physicals, interim check-ups or sport physicals.

Reminders and updates to school requirements for the 2014–2015 school year include:

Grades K through 12:

  • Effective since the 2011–2012 school year, there must be documentation of at least one dose of polio vaccine administered on or after the 4th birthday for students entering Kindergarten only. The polio requirement is 4 doses, with the following exceptions:
    • If a 4th dose is administered prior to the 4th birthday, a 5th dose is required.
    • If a 3rd dose is administered after the 4th birthday, a 4th dose is not required.
  • Varicella vaccine:
    • One dose is required for grades 7 through 12 (or health care provider's documentation of evidence of disease).
    • Two doses (appropriately spaced) are required for grades K through 6 (or health care provider's documentation of evidence of disease).
  • Tdap (tetanus/diphtheria/pertussis) vaccine is required prior to entering grades 7 through 12.

The flyer link below, containing the phase-in schedule, may assist providers in determining the phase-in grade schedule for Tdap and varicella vaccine requirements.

www.floridahealth.gov/programs-and-services/immunization/publications/_documents/phase-in-schedule.pdf

The 2014–2015 school flyer link is also below for your reference and is available at the Immunization Section website at:

www.floridahealth.gov/programs-and-services/immunization/publications/_documents/2014-15-school-entry-eng.pdf

As a reminder, to complete the Florida Certification of Immunization (Form DH 680) meeting all kindergarten requirements, you select Part A: Complete with either Code 1 (K through 12) or Code 8 (7th Grade requirement). A number of health care providers have provided kindergarten students who meet all kindergarten requirements with Part B: Temporary Medical Exemptions (TMEs) extending until the student is due to enter 7th grade.

A TME should be completed only if a child is not fully immunized for their current school grade, based on the proper spacing of vaccines. The expiration date should coincide with the date that the child is due to receive his/her next immunization, plus 15 days, based on the catch-up schedule. For example: a kindergarten student receives a dose of varicella vaccine the day prior to entering school and is required to receive a second dose of varicella vaccine as required for school attendance. A TME is issued for the child to return in a minimum of three months, to receive the second dose of varicella vaccine.

  • Providers should select Part A, Code 1, for children who have completed the immunization requirements for Kindergarten. TMEs must not be issued for children complete for Kindergarten.
  • Providers should enter Part A, Code 8, for students entering grades 7 through 12 and who have completed the Tdap requirement.

The improper issuance of TMEs has a negative effect on the overall compliance rates when assessing each county’s coverage for school immunizations.

Form DH 681, Religious Exemption from Immunization, should only be accessed by county health departments through the immunization registry, the Florida State Health Online Tracking System (SHOTS). Please contact the Florida SHOTS staff at 1-877-888-SHOT (7468) if you have questions regarding the electronic Form DH 681.


Sanofi Pasteur Pentacel® Packaging Change

June 19, 2014—The Immunization Section is pleased to share the following information from Sanofi Pasteur regarding their change of cap color for the Pentacel® vaccines. The half-moon colored cap is being replaced with a solid blue colored cap. There is no change to the product itself or to the NDC, so nothing will need to be changed when ordering Pentacel®

This change is effective with all new Pentacel® vaccines. Providers may still receive the previous half-moon colored caps as the solid blue colored caps are being phased into the market. This means that providers may have both the new packaging and the old in their storage units during this brief transition time.

Sanofi Pasteur document announcing the Pentacel® cap color packaging change.


Influenza Activity—United States, 2013–2014 Season and Composition of the 2014–2015 Influenza Vaccine

June 17, 2014—We are pleased to share this influenza vaccine composition information with our immunization partners.

FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) met in Silver Spring, Maryland, on February 28, 2014, to select the influenza viruses for the composition of the influenza vaccine for the 2014–2015 U.S. influenza season. During the meeting, the advisory committee reviewed and evaluated the surveillance data related to epidemiology and antigenic characteristics of recent influenza isolates, serological responses to 2013–2014 vaccines, and the availability of candidate strains and reagents. Their recommendations were published in the Morbidity and Mortality Weekly Report (MMWR) as Influenza Activity—United States, 2013–2014 Season and Composition of the 2014–2015 Influenza Vaccine June 6, 2014 / 63(22);483–490 available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a2.htm?s_cid=mm6322a2_w.

This report summarizes influenza activity in the United States during the 2013–2014 influenza season (September 29, 2013–May 17, 2014) as of June 6, 2014, and includes recommendations for the components of the 2014–2015 Northern Hemisphere influenza vaccine.

This influenza season was the first since the 2009 pH1N1 pandemic in which pH1N1 viruses predominated and was characterized overall by lower levels of outpatient illness and mortality than influenza A (H3N2)–predominant seasons, but higher rates of hospitalization among adults aged 50–64 years compared with recent years.

During the 2013–2014 influenza season in the United States, influenza activity increased through November and December before peaking in late December. Influenza A (H1N1)pdm09 (pH1N1) viruses predominated overall, but influenza B viruses and, to a lesser extent, influenza A (H3N2) viruses also were reported in the United States.

The committee recommended that the trivalent formulation influenza vaccines for the U.S. 2014–2015 influenza season contain the following:

  • A/California/7/2009-like (2009 H1N1) virus
  • A/Texas/50/2012-like (H3N2) virus
  • B/Massachusetts/2/2012-like (B/Yamagata lineage) virus

The committee also recommended that quadrivalent influenza vaccines contain the above three strains and the following additional B strain:

  • B/Brisbane/60/2008-like (B/Victoria lineage) virus

An annual influenza vaccination is recommended for all persons aged ≥6 months. Immunization providers should consult Food and Drug Administration-approved prescribing information for 2014–2015 influenza vaccines and the 2014–2015 Advisory Committee on Immunization Practices influenza recommendation statement for the most current information concerning indications, contraindications, and precautions.


Measles—United States, January 1–May 23, 2014

June 3, 2014—We are pleased to share the report “Measles—United States, January 1–May 23, 2014.” Measles is a highly contagious, acute viral illness that can lead to serious complications and death. The disease was declared eliminated in the United States in 2000. In 2014, 288 cases have been reported to the CDC. The patients range from 2-weeks-old to 65-years-old. No deaths have been reported. The report is published in the Morbidity and Mortality Weekly Report, volume 63 (Early Release); 1–4, written by Paul A. Gastañaduy, MD, Susan B. Redd, Amy Parker Fiebelkorn, MSN, et al.

The report focuses on measles outbreaks in relation to age, location and importations. The majority of the cases are associated with importations from at least 18 countries. Most of the cases reported have been in persons who were unvaccinated. Health care providers are urged to remind persons who plan to travel internationally to get vaccinated.

To read the report in its entirety visit: www.cdc.gov/mmwr/preview/mmwrhtml/mm63e0529a1.htm?s_cid=mm63e0529a1_e.


TRAINING OPPORTUNITY: “Why Measles Matters” NetConference

May 20, 2014—The Immunization Section is pleased to announce a “Current Issues in Immunization” NetConference on “Why Measles Matters.” The presentation is scheduled for May 22, 2014 at 3 p.m. (EDT). The Centers for Disease Control and Prevention’s (CDC) Gregory S. Wallace, MD, MS, MPH, will discuss this highly contagious disease as well as the importance of ongoing immunization efforts.

Measles is an acute viral illness that can lead to severe complications and death. Measles was declared eliminated from the United States (the absence of continuous disease transmission for more than 12 months) in 2000. The United States highlights the importance of ensuring age-appropriate vaccination for international travelers and maintaining high vaccination coverage, as well as the need for heightened awareness among healthcare providers regarding the possibility of measles.

"Current Issues in Immunization" is a series of NetConferences which features live, one hour presentations that combine an online visual presentation with simultaneous audio via telephone conference call followed by a live question and answer session. Internet access and a separate phone line are needed to participate. On-demand replays and presentations are made available shortly after each event.

There will be CEU offered (www.cdc.gov/vaccines/ed/ciinc/ceinfo.htm) and this presentation will be archived (www.cdc.gov/vaccines/ed/ciinc/#archived) for review at a later date.


Important: Increase in Reported Measles Cases–United States 2014

May 19, 2014—The National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention is requesting all immunization programs share the following information with all health care providers and infection control specialists:

This year, the United States is having more reported cases of measles than usual. Many health care providers in the United States have never seen a patient with measles and may not recognize the signs and symptoms. Health care providers need to be more alert than ever to the possibility of measles.

Health care providers should consider measles in patients who:

  • Present with febrile rash illness and clinically compatible measles symptoms [cough, coryza (or runny nose) or conjunctivitis (pink eye)].
  • Recently traveled internationally or were exposed to someone who recently traveled.
  • Have not been vaccinated against measles.

Health care providers should also consider measles when evaluating patients for other febrile rash illnesses, including Dengue and Kawasaki’s Disease.

If you suspect measles, do the following immediately:

  1. Promptly isolate patients to avoid disease transmission.
  2. Immediately report the suspect measles case to their health department.
  3. Obtain specimens for testing from patients with suspected measles, including viral specimens.

Additional guidance for health care providers can be found at: www.cdc.gov/measles/hcp/index.html. Also, see CDC’s measles surveillance guidance: www.cdc.gov/vaccines/pubs/surv-manual/chpt07-measles.html.

Section 381.0031(1,2), Florida Statutes provides that “Any practitioner, licensed in Florida to practice medicine, osteopathic medicine, chiropractic, naturopathy, or veterinary medicine, who diagnoses or suspects the existence of a disease of public health significance shall immediately report the fact to the Department of Health.” The FDOH county health departments serve as the Department's representative in this reporting requirement. For contact information for the local county health departments, please visit: www.floridahealth.gov/programs-and-services/county-health-departments/find-a-county-health-department/county-health-departments/CHDlisting.html.


Advisory Committee on Immunization Practices Makes Changes in the Binational Immunization Schedule

We are pleased to share the following information with our immunization partners. The Advisory Committee on Immunization Practices (ACIP) reviews the recommended immunization schedules each year to ensure that the schedule reflects current recommendations for licensed vaccines. The Binational Immunization Schedule which includes the immunization schedule for Mexico can assist providers in interpreting immunization records for children entering the United States from Mexico. This information will assist providers in determining the completeness of these children’s immunization records.

To review the Binational immunization resource tool for children from birth through 18 years, visit: www.cdc.gov/vaccines/schedules/downloads/child/binational-schedule-pr.pdf


Food and Drug Administration Expands the Age for Adacel®

May 5, 2014—We are pleased to inform you that the Food and Drug Administration (FDA) has expanded the approved age indication of Adacel® (Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine Adsorbed) (Tdap) for active booster immunization for the prevention of tetanus, diphtheria, and pertussis as a single dose in persons 10 through 64 years of age. Attached is the customer letter from Sanofi-Pasteur for your reference.

With a rise in reported pertussis incidences, this approval also provides an additional opportunity to administer the vaccine to a younger age group to help prevent this highly contagious disease.

Adacel® vaccine was originally licensed by the FDA in June 2005 as the first booster to address pertussis protection for both adolescents and adults 11 through 64 years of age.

Adacel® Age Indication Customer Letter


Florida’s 2014 CDC Childhood Immunization Champion

May 1, 2014—The Immunization Section is pleased to announce that David Berman, MD, has been selected as the 2014 CDC Childhood Immunization Champion for Florida. This award is sponsored by the Centers for Disease Control and Prevention (CDC), the National Center for Immunization and Respiratory Diseases (NCIRD), and the CDC Foundation. This award is given annually to recognize individuals who make a significant contribution toward improving public health through their work in childhood immunization.

Dr. Berman is a Pediatric Infectious Diseases Specialist at All Children’s Hospital in St. Petersburg, Florida. He has volunteered his time to work with the Florida Chapter of the American Academy of Pediatrics (AAP) to promote vaccine advocacy in the State of Florida. Working with other colleagues in Florida, the Florida Chapter of the AAP secured a vaccine hesitancy education grant to educate physicians the community about the safety and effectiveness of vaccines. Dr. Berman has also partnered locally with the Florida Department of Health in Pinellas County to use a portion of the grant to develop a community team called “PITCH” (The Pinellas Immunization Team for Community Health) to improve childhood immunization rates in Pinellas County children 0-2 years of age. Dr. Berman also reached out to the film producer of “Invisible Threat,” an immunization documentary produced by high school students from San Diego County, California while garnering endorsement of the film by All Children’s Hospital, Johns Hopkins Pediatrics and Epidemiology, the Florida Chapter of the AAP , and the Resident, Fellow and Medical Student Section of the AAP. Each of these groups endorsed the film. Dr. Berman along with his community colleagues are now using the film in an outreach project in Pinellas County to educate community members about immunizations with plans to promote the campaign throughout Florida.

Dr. Berman’s efforts to collaborate with community partners to ensure children are immunized and providers are educated on the importance of immunizing makes him Florida’s CDC Childhood Immunization Champion. Visit the CDC Childhood Immunization Champion website at www.cdc.gov/vaccines/events/niiw/champions/profiles-2014.html for additional information on Dr. Berman and other state champions.

Please join the Immunization Section in congratulating Dr. Berman.


2014 National Adult and Influenza Immunization Summit Meeting—May 13–15, 2014

April 4, 2014—The Immunization Section is pleased to share information regarding the 2014 National Adult and Influenza Immunization Summit Meeting. The 2014 face-to-face annual meeting of the National Adult and Influenza Immunization Summit will be held in Atlanta, Georgia, at the Hyatt Regency hotel on May 13–15, 2014.

The National Adult and Influenza Immunization Summit (NAIIS) was founded by the American Medical Association (AMA) and the Centers for Disease Control and Prevention (CDC). Currently the NAIIS is led by the Immunization Action Coalition (IAC), the CDC, and the National Vaccine Program Office (NVPO). The NAIIS is dedicated to addressing and resolving adult and influenza immunization issues.

The NAIIS now consists of over 400 partners, representing more than 100 public and private organizations. Summit participants include a wide range of professionals from the healthcare industry, public health and private medical sectors, vaccine manufacturers and distributors, consumers, and others interested in stopping the transmission of vaccine-preventable diseases.

To learn more regarding the Summit, how to join, or information on the face-to-face meeting, go to www.izsummitpartners.org/.


Sanofi Pasteur ActHIB Packaging Change

The Immunization Section would like to make you aware of this important information from Sanofi Pasteur regarding their changing the packaging for ActHIB. The new packaging will establish new NDCs and lot numbers for the inner components of the vaccine packages, as well as modifying the carton to incorporate dividers between each of the vials and diluent to prevent movement within the box. Currently, the NDC is only on the outer carton, the new packaging will now have NDC numbers for the outer carton, vaccine vial, and diluent. It is important to note, that with any vaccine products with multiple NDCs for different pieces or components that the only NDC that can be used to order, to report inventory, or to submit vaccine returns is the one that is listed on the CDC contract, this is the number listed on the outer carton. Sanofi Pasteur will maintain the current NDC on the outer carton of the new packaging for ActHIB, so nothing will need to be changed when ordering ActHIB.

Currently, it is estimated that the new packaging will be distributed in the private sector in mid to late April, which will be before public supplies. This means there will be a brief period of time that providers may have both the new packaging and the old in their storage units.

Click the link below to view a copy of the letter that Sanofi Pasteur will be using to announce the ActHIB NDC, lot number and packaging change. If you have any question regarding the packaging change, please call the Sanofi Pasteur Support Services at 1-800-VACCINE (1-800-822-2463).

Letter from Sanofi Pasteur Regarding Packaging Change


National Infant Immunization Week (NIIW) is April 26–May 3, 2014

April 1, 2014—NIIW is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and to celebrate the achievements of immunization programs in promoting healthy communities throughout the United States. This year, NIIW is scheduled to be held April 26–May 3, 2014.

During the last week in April and the first week of May, hundreds of communities across the United States will join those in countries around the world to celebrate the critical role vaccination plays in protecting our children, communities, and public health. NIIW will be celebrated this year simultaneously with World Immunization Week, an initiative of the World Health Organization.

Immunization is a shared responsibility. Families, healthcare professionals, and public health officials must work together to help protect the entire community.

Children rely on adults to keep them safe and healthy. Those adults may be parents/guardians who keep a record of their child’s vaccinations and ask at each doctor appointment whether their child is up-to-date on immunizations. The adults may also be doctors, nurses, physician assistants, and other healthcare professionals who share scientifically-accurate, up-to-date information about vaccines with parents.

It's easy to think of these as diseases of the past. But the truth is they still exist. Children in the United States can—and do—still get some of these diseases. One example of the seriousness of vaccine-preventable diseases is an increase in measles cases or outbreaks that were reported in 2013. Data from 2013 showed a higher than normal number of measles cases nationally and in individual states, including an outbreak of 58 cases in New York City that was the largest reported outbreak of measles in the U.S. since 1996.

Please, visit the CDC resource site for this observance, www.cdc.gov/vaccines/events/niiw/overview.html, for educational and promotional materials to encourage community participation and enthusiasm for your NIIW activities.


Vaccine Information Statement Update: Multi-Vaccine

March 7, 2014—We are pleased to share this VIS update news with our immunization partners. The pediatric Multi-Vaccine VIS is being temporarily removed from service so it can be updated to reflect current ACIP recommendations. An updated edition should be available by mid-2014. Do Not Use 11/16/12 edition of the Multi-Vaccine VIS. Use the individual VISs when DTaP, Hib, Hepatitis B, Polio, PCV13 and/or Rotavirus vaccines are administered. By federal law, all vaccine providers must give patients, or their parents or legal representatives, the appropriate Vaccine Information Statement (VIS) whenever a vaccination is given.


Prevention and Control of Haemophilus influenzae
Type b Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Two-Dose Varicella Vaccination Coverage Among Children Aged 7 years–Six Sentinel Sites, United States, 2006–2012

February 28, 2014—We are pleased to share the following articles with our immunization partners. The Centers for Disease Control and Prevention (CDC) features articles on vaccinations in the Morbidity and Mortality Weekly Report (MMWR) Volume 63, No. RR-1 and No.8, February 28, 2014. This report is available at www.cdc.gov/mmwr/.

Haemophilus influenzae–This report compiles and summarizes all recommendations from CDC's ACIP regarding prevention and control of Haemophilus influenzae type b (Hib) disease in the United States.

This report does not contain any new recommendations; it is intended for use by clinicians, public health officials, vaccination providers, and immunization program personnel as a resource. ACIP recommends routine vaccination with a licensed conjugate Hib vaccine for infants aged 2 through 6 months (2 or 3 doses, depending on vaccine product) with a booster dose at age 12 through 15 months. ACIP also recommends vaccination for certain persons at increased risk for Hib disease (i.e., persons who have early component complement deficiencies, immunoglobulin deficiency, anatomic or functional asplenia, or HIV infection; recipients of hematopoietic stem cell transplant; and recipients of chemotherapy or radiation therapy for malignant neoplasms). This report summarizes current information on Hib epidemiology in the United States and describes Hib vaccines licensed for use in the United States. Guidelines for antimicrobial chemoprophylaxis of contacts of persons with Hib disease also are provided.

Two-Dose Varicella–In 2007, the ACIP recommended a routine second dose of varicella vaccine for children at age 4–6 years. Data on the number of states with 1-dose and 2-dose varicella vaccine elementary school entry requirements at the start of the school year were obtained from state immunization websites for 2007 and 2012. By 2012, thirty-six states require two doses of varicella vaccine for school entry.


Adult Immunization Standards of Practice

February 28, 2014—We are pleased to share the Adult Immunization Standards of Practice published in the February 20th Public Health Reports with our immunization partners. The Standards lay out the roles and responsibilities of major stakeholders involved in vaccinating adults. The Association of Immunization Managers (AIM) supports the Adult Immunization Standards of Practice. Also, attached is the Morbidity and Mortality Weekly Report, volume 63, number 5, titled Noninfluenza Vaccination Coverage Among Adults—United States, 2012, documenting adult immunization coverage levels.

Research shows that adult patients are willing to get a vaccine when it is recommended by their provider. We encourage you to adopt the Adult Immunization Standards of Practice in your own practice to increase uptake of adult vaccines.

The Adult Immunization Standards of Practice guidance document describes the four steps that every provider should take to encourage their adult patients to get vaccinated:

NVAC: Standards for Adult Immunization Practice

CDC MMWR Weekly Report


Palm Beach County Immunization Workshop

February 25, 2014—We are pleased to share the following training event with our immunization partners.  Please see the flyer below for event detail.

On March 13th, the Palm Beach County Childhood and Adult Coalition will present "Vaccines:  Protect, Promote, Prevent." The event will take place Thursday, March 13, 2013 at the Bethesda Memorial Hospital Conference Room, 2815 South Seacrest Boulevard, Boynton Beach, from 5:30–8:30 pm. CEUs and CMEs are offered for this event.  RSVP by Thursday, March 6, 2014 by calling 561-840-4568.

Palm Beach County Immunization Workshop Flyer


Vaccine Information Statement Updates: Hib and Td

February 11, 2014—We are pleased to share this VIS update news with our immunization partners.

An updated VIS for Hib (Haemophilus Influenzae type b) and Td (Tetanus, Diphtheria) were posted at www.cdc.gov/vaccines/hcp/vis/index.html on February 4, 2014. Because both VISs contain a change in the adverse events section, the new VIS should be used beginning immediately. An accompanying Provider Information Sheet will be posted soon. By federal law, all vaccine providers must give patients, or their parents or legal representatives, the appropriate Vaccine Information Statement (VIS) whenever a vaccination is given.

Users of the Florida SHOTS immunization registry will automatically access this updated VIS when they print VIS from within the system.


Noninfluenza Vaccination Coverage Among Adults—United States, 2012

February 7, 2014—We are pleased to share the following article with our immunization partners. The Centers for Disease Control and Prevention (CDC) features an article on adult vaccinations in the Morbidity and Mortality Weekly Report (MMWR) Volume 63, No.5, February 7, 2014. This report is available at www.cdc.gov/mmwr/.

Vaccinations are recommended throughout life to prevent vaccine-preventable diseases and their sequelae. Adult vaccination coverage, however, remains low for most routinely recommended vaccines and well below Healthy People 2020 targets. To assess vaccination coverage among adults aged ≥19 years for selected vaccines, CDC analyzed data from the 2012 National Health Interview Survey (NHIS). This report summarizes the results of that analysis.


Deadline is Approaching for Nominees: 2014 Childhood Immunization Champion Award Program

February 5, 2014—The deadline is fast approaching to recognize individuals for their outstanding work in improving immunization services for children. Please submit your nominees for the 2014 Childhood Immunization Champion Award to Laura Rutledge, RN by Friday, February 14, 2014.

The Centers for Disease Control and Prevention (CDC) is proud to present the Third Annual Childhood Immunization Champion Award Program. This annual award recognizes individuals who make a significant contribution toward improving public health in their communities through their work in childhood immunization. Let's take this opportunity to garner some accolades for the great immunization partners in our state. Each year, up to one CDC Immunization Champion from each of the 50 U.S. states, 8 U.S. Territories and Freely Associated States, and the District of Columbia will be honored during National Infant Immunization Week (NIIW), April 26–May 3, 2014.

Award Criteria

The Champion Award is intended to recognize individuals who are working at the local level. It honors those who are doing an exemplary job or going above and beyond to promote or foster childhood immunizations in their communities. The nomination and selection of a local Champion should be based on meeting one or more of the following criteria:

Eligibility

Champions can include coalition members, parents, health care professionals (e.g., physicians, nurses, physicians’ assistants, nurse practitioners, medical assistants, etc.), and other immunization leaders who meet the award criteria. Immunization program managers, state and federal government employees of health agencies, individuals who have been affiliated with and/or employed by pharmaceutical companies and those who have already received the award are not eligible to apply.


Advisory Committee on Immunization Practices Recommended Immunization Schedules

February 4, 2014—We are pleased to share the following MMWR publication with our immunization partners. In the February 3, 2014/63 (Early Release), the Centers for Disease Control and Prevention published the Advisory Committee on Immunization Practices Recommended Immunization Schedules for Persons Aged 0 Through 18 Years — United States, 2014 and Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older — United States, 2014. 

Each year, recommendations for routine use of vaccines in children, adolescents, and adults in the United States are developed by the Advisory Committee on Immunization Practices (ACIP).  We recommend that all healthcare providers visit http://www.cdc.gov/mmwr/ to read the article for important details and changes to last year's schedules.

Changes to the Immunization Schedules for Persons Aged 0 Through 18 Years:

Changes to the Immunization Schedules for Adults aged 19 Years or Older: 

Footnotes

Contraindications and precautions table


Training Opportunities: Immunization Updates

January 30, 2014—The Immunization Section is pleased to share the following training opportunities from GlaxoSmithKline (GSK) and Merck Medical Forums.

Please see GSK attachment for registration requirements, speakers and times.  Programs are available on the following dates:

Please see Merck attachment for registration requirements and speaker information.  The program is scheduled for:  February 6, 2014, 1 PM Central/2 PM Eastern.

No CMEs or CEUs are available for these programs. 

Note:  The Immunization Section makes every attempt to provide training on a variety of subjects/issues, without endorsement, for those interested in immunizations. 


National Infant Immunization Week Webinar

January 22, 2014—The Immunization Section is pleased to share the National Center for Immunization and Respiratory Diseases (NCIRD) at the Centers for Disease Control and Prevention webinar in preparation for National Infant Immunization Week (NIIW) 2014. NIIW is set for April 26–May 3, 2014. This year’s theme is Harnessing National Infant Immunization Week (NIIW) 2014 to Increase the Reach and Impact of Your Program Long-Term.

This webinar is scheduled for Tuesday, February 11 at 1 PM EST, the webinar will cover:

This free webinar requires pre-registration. To register, go to 2014 NIIW Webinar Registration and (Depending upon your computer, you may have to depress the CTRL key while clicking the link).

Once you are registered, you will receive a confirmation email with instructions for joining the session.


Training Opportunity: You Call the Shots

January 23, 2014—The Florida Immunization Section is pleased to share new training courses from the Centers for Disease Control and Prevention’s (CDC) You Call the Shots. You Call the Shots is an interactive, web-based immunization training course. It consists of a series of modules that discuss vaccine-preventable diseases and explains the latest recommendations for vaccine use. Each module provides learning opportunities, self-test practice questions, reference and resource materials and an extensive glossary. Modules ten and sixteen are updated and information is available below.

These free courses are available on the CDC’s Vaccine and Immunizations website at: www.cdc.gov/vaccines/ed/youcalltheshots.htm.

These courses are intended for nurses, nursing students, medical assistants, pharmacists and other health professionals who provide immunizations. Continuing education credit is available for the individual modules to physicians, nurses, health educators, and pharmacists.

Module Ten: Immunization: You Call the Shots–Storage and Handling—2014

OBJECTIVES:

Module Sixteen: Immunization: You Call the Shots–Vaccines for Children (VFC) Program—2014

OBJECTIVES:


Increase in Influenza-like Illness in Pregnant Women

December 20, 2013—The Immunization Section would like to share this important information with colleagues regarding reports of severe influenza illness in pregnant women.

In recent weeks, the Florida Department of Health has received reports of severe influenza illness, including hospitalizations requiring ICU care, among pregnant women. None of these pregnant women experiencing severe complications had received the 2013–2014 influenza vaccine. Via review of emergency department chief complaint data in ESSENCE-FL, the Bureau of Epidemiology has also seen an increase in recent weeks of the number of pregnant women presenting for care to emergency departments for influenza chief complaints. 

Please see letter below signed by Anna Likos, MD, MPH, Director and State Epidemiologist, Division of Disease Control and Health Protection, for providers encouraging them to vaccinate pregnant women for influenza. County health department epidemiology programs have assisted in distributing this information in their communities with a special focus on the obstetrics community as well as pharmacies and other locations that administer vaccine to pregnant women.

Influenza Letter from Dr. Anna Likos, MD, MPH


Merck Issues Recall of Gardasil Vaccine

December 20, 2013—The Immunization Section would like to make you aware of a voluntary recall of Gardasil Vaccine being communicated on December 20, 2013 by Merck to their customers via the attached letter, which provides instructions about the recall. Gardasil vaccine was distributed in both the public and private sectors.

This recall affects one lot of Gardasil vaccine (NDC 00006-4045-41; Lot # J007354). Merck is communicating with customers who received this lot number on Friday, December 20, 2013 via the attached documents, which provide instructions on the recall. If you do not receive communication from Merck, your vaccine is not involved in the recall. This voluntary recall is being conducted due to the potential for a limited number of vials in this lot to contain glass particles. Information about the details of the recall is included in the attached documents. Patients who received this lot number do not need to be revaccinated.

Distribution of this lot by CDC’s centralized distributor (McKesson Distribution Center) for the Vaccines for Children (VFC) Program occurred during the first two weeks of October 2013. VFC Program providers may review the “Transaction History” in the Florida State Health Online Tracking System (SHOTS) to determine if your office received this lot number.

Merck will be providing credit/replacement differently depending on whether the vaccine was privately purchased versus distributed through the VFC Program ordering and distribution mechanism:

Since providers will not be receiving replacement doses directly from Merck, VFC Program providers should order VFC Program vaccines their normal process to make up for any doses lost due to the recall.

Questions about this recall should be directed to Merck National Service Center: 1-800-672-6372, Select Prompt #2, then Prompt #3 (Monday to Friday 8:00 AM to 7:00 PM EST).


Novartis Meningococcal Vaccine Recall

December 12, 2013—The Immunization Section would like to make you aware of a Meningococcal vaccine voluntary recall being communicated on December 2, 2013 by Novartis Vaccines to their customers via the attached letter, which provides instructions about the recall.

This precautionary and voluntary action is being taken following observation of higher-than-specified levels of residual moisture within the lyophilized Men A component vial of Menveo  (NDC #46028-0208-01 , lot # M12115).  Fortunately, this recall does not present any safety concerns or a need to revaccinate and there are no associated supply issues.

The vaccine in the recalled lot was distributed only in the private sector, and Novartis is working directly with the customers who purchased the vaccine regarding the recall.

Questions about this recall should be directed to Novartis Vaccines Customer Service at 1-877-683-4732 (select option #3).

US Menveo Voluntary Recall


Meningococcal Vaccine Recommendations

November 21, 2013—The Immunization Section is pleased to provide an immunization update on meningococcal vaccine recommendations.  This information was originally published in the Morbidity and Mortality Weekly Report (MMWR). Prevention and Control of Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP) (62(RR02);1–22) which was published on March 21, 2013 and is available online at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6202a1.htm?s_cid=rr6202a1_w.  The Vaccines for Children (VFC) resolution is available at http://www.cdc.gov/vaccines/programs/vfc/downloads/resolutions/02-13-2-hib.pdf.  

ACIP recommends meningococcal vaccination for the following groups:

Two quadrivalent meningococcal polysaccharide-protein conjugate vaccines that provide protection against meningococcal serogroups A, C, W, and Y are licensed in the United States for use among persons as noted:

Quadrivalent meningococcal polysaccharide vaccine is the only vaccine licensed for use among persons aged ≥56 years.

A bivalent meningococcal polysaccharide protein conjugate vaccine that provides protection against meningococcal serogroups C and Y along with Haemophilus influenzae type b (Hib) is licensed for use in children aged 6 weeks through 18 months.

Both quadrivalent meningococcal conjugate vaccines and the bivalent meningococcal conjugate vaccine are available through the VFC Program. 

There is limited supply of Hib-MenCY-TT (Menhibrix) as this vaccine should only be used for high-risk children.  Refer to Table 7 in the above mentioned MMWR publication. 


Surveillance of Influenza Vaccination Coverage

October 25, 2013—The Centers for Disease Control and Prevention published Surveillance of Influenza Vaccination Coverage—United States, 2007–08 Through 2011–12 Influenza Seasons—Surveillance Studies in the Morbidity and Mortality Weekly Report (MMWR) October 25, 2013 / 62(ss04):1–29.  Visit http://www.cdc.gov/mmwr/ to read the entire document.

Seasonal influenza is associated with substantial morbidity and mortality in the United States. Rates for serious illness and death are higher among adults aged ≥65 years, children aged <2 years, pregnant women, and persons of any age who have medical conditions that place them at increased risk for influenza complications. The economic impact of influenza illness is substantial. Substantial improvement in annual influenza vaccination of recommended groups is needed to reduce the health effects of influenza and reach Healthy People 2020 targets.

The Immunization Section supports the Advisory Committee on Immunization Practices (ACIP) recommendation of routine annual influenza vaccination of all persons aged 6 months and older.  Health care providers should recommend vaccination at every opportunity to all eligible persons.  Health care providers should offer influenza vaccine as soon as it becomes available and should continue to offered it throughout the influenza season (i.e., as long as influenza viruses are circulating in the community).