Immunization Works June 2020
June 29, 2020: Content on this page kept for historical reasons.
Top Stories
Maintaining Childhood Immunizations and Well-Child Care During COVID-19 Pandemic: Stay-at-home and shelter-in-place orders have resulted in declines in outpatient pediatric visits and fewer vaccine doses being administered, leaving children at risk for vaccine-preventable diseases. As states develop plans for reopening, health care providers are encouraged to work with families to keep or bring children up to date with their vaccinations. Primary care practices in communities affected by COVID-19 should continue to use strategies to separate well visits from sick visits. Examples might include:
- Scheduling sick visits and well-child visits during different times of the day
- Reducing crowding in waiting rooms by asking patients to remain outside (e.g., stay in their vehicles, if applicable) until they are called into the facility for their appointment, or setting up triage booths to screen patients safely
- Collaborating with health care providers in the community to identify separate locations for providing well visits for children
Health care providers should identify children who have missed well-child visits and/or recommended vaccinations and contact them to schedule in-person appointments, starting with newborns, infants up to 24 months, and young children and extending through adolescence. State-based immunization information systems and electronic health records may be able to support this work.
All newborns should be seen by a pediatric health care provider shortly after hospital discharge (3 to 5 days of age). Ideally, newborn visits should be done in person during the COVID-19 pandemic to evaluate infants for dehydration and jaundice, ensure all components of newborn screening were completed and appropriate confirmatory testing and follow-up are arranged, and evaluate mothers for postpartum depression. Developmental surveillance and early childhood screenings, including developmental and autism screening, should continue, along with referrals for early intervention services and further evaluation if concerns are identified. Please visit the COVID-19 web page for additional information.
Immunization Guidance during COVID–19: The COVID-19 pandemic has caused health care providers to change how they operate to continue providing essential services to patients. Ensuring that immunization services are maintained or reinitiated is essential for protecting individuals and communities from vaccine-preventable diseases and outbreaks and reducing the burden of respiratory illness during the upcoming influenza season.
CDC has issued “Interim Guidance for Immunization Services During the COVID-19 Pandemic” to help immunization providers in a variety of clinical settings plan for the safe administration of vaccines during the COVID-19 pandemic. This guidance will be updated as the COVID-19 pandemic evolves.
Highlights include:
- Considerations for routine administrations of all recommended vaccinations for children, adolescents, and adults, including pregnant women
- General practices for the safe delivery of vaccination services, including considerations for alternative vaccination sites
- Strategies for catch-up vaccinations
We encourage you to share this guidance widely.
Resources for Encouraging Vaccinations During the COVID-19 Pandemic: NCIRD has created a new web page for partners that features communication resources to encourage parents to stay up to date on routine vaccines during the COVID-19 pandemic. These resources include a web article, social media content, and social media graphics. Please consider sharing these resources on your social media platforms, newsletters, or other digital communication channels.
MMWR
Progress Toward Rubella Elimination in the Western Pacific Region, 2000–2019: Rubella is the leading vaccine-preventable cause of birth defects. Rubella typically manifests as a mild febrile rash illness; however, infection during pregnancy, particularly during the first trimester, can result in miscarriage, fetal death, or a constellation of malformations known as “congenital rubella syndrome” (CRS), commonly including one or more visual, auditory, or cardiac defects. In 2012, the Regional Committee of the World Health Organization (WHO) Western Pacific Region (WPR) committed to accelerate rubella control and, in 2017, resolved that all countries or areas (countries) in WPR should aim for rubella elimination as soon as possible. WPR countries are capitalizing on measles elimination activities, using a combined measles and rubella vaccine, case-based surveillance for febrile rash illness, and integrated diagnostic testing for measles and rubella. The June 19 MMWR summarizes progress toward rubella elimination and CRS prevention in WPR during 2000–2019. Coverage with a first dose of rubella-containing vaccine (RCV1) increased from 11% in 2000 to 96% in 2019. During 1970–2019, approximately 84 million persons were vaccinated through 62 supplementary immunization activities (SIAs) conducted in 27 countries. Reported rubella incidence increased from 35.5 to 71.3 cases per million population among reporting countries during 2000–2008, decreased to 2.1 in 2017, and then increased to 18.4 in 2019 as a result of outbreaks in China and Japan. Strong, sustainable immunization programs, closing of existing immunity gaps, and maintenance of high-quality surveillance to respond rapidly to and contain outbreaks are needed in every WPR country to achieve rubella elimination in the region.
Multistate Mumps Outbreak Originating from Asymptomatic Transmission at a Nebraska Wedding: In August 2019, 30 attendees at a Nebraska wedding developed mumps after being exposed to one asymptomatic index patient who was fully vaccinated according to ACIP recommendations, resulting in a multistate outbreak. A public health investigation and response revealed epidemiologic links that extended from the index patient through secondary, tertiary, and quaternary patients and culminated in a measles-mumps-rubella (MMR) booster vaccination campaign in the local community where approximately half of the patients resided. Please read the June 5 MMWR for the full report.
Resources and Information
Epidemiology and Prevention of Vaccine-Preventable Diseases, (the Pink Book) 2020 Video Series: CDC is offering a series of weekly one-hour web-on-demand videos that will provide an overview of vaccination principles, general best practices, immunization strategies, and specific information about vaccine-preventable diseases and the vaccines that prevent them. Each video will include updated information from recent Advisory Committee on Immunization Practices (ACIP) meetings and votes. The series will start on July 1, 2020, and a new video will be released most Wednesdays through October 14, 2020. This year, because of limited staff availability during the ongoing COVID-19 response, the series will be prerecorded rather than live events. Questions about the material presented can be submitted to nipinfo@cdc.gov. Please visit the Pink Book video series page for the schedule and additional information. Continuing Education (CE) will be available for each event.
Pediatrics Perspectives: An article in Pediatrics Perspectives titled “A Call to Action: Strengthening Vaccine Confidence in the United States” has been published online. In 2000, measles was declared eliminated in the U.S.; however, the sustained transmission of almost 12 months (2018–2019), nearly led to the loss of the U.S.’s elimination status. A significant contributor to this consequence was widespread vaccine hesitancy—the delay in acceptance or the refusal of vaccination despite availability of vaccination services. To protect our nation, we must empower families in all communities and across generations, to feel confident in the decision to vaccinate. The prevalence of misinformation presents continued challenges. CDC’s Vaccinate with Confidence framework encourages communities and organizations at all levels to focus on protecting communities, empowering families, and stopping myths to increase coverage of vaccine-preventable diseases.
American Academy of Pediatrics (AAP): Through the State Immunization and Strategy Action Team Initiative, the AAP will support a virtual learning collaborative focused on improving human papillomavirus (HPV) and pediatric influenza vaccination in rural and underserved areas where vaccination rates are low and engage key partners that pertain to immunization, rural health, and/or underserved populations. The purpose of the collaborative is to support state teams in developing and implementing a plan to reach rural and underserved populations with immunization strategies. The collaborative will kick off with virtual team meetings in September 2020 and include virtual meetings through July 2021. Applications are open to AAP chapters, health departments, immunization coalitions, health care systems, and other organizations working to address rural and underserved populations. The application and support letters are due by July 27, 2020. The application can be viewed here and contact Melissa Ponce for additional information.
Acute Flaccid Myelitis (AFM) Webinar: In preparation for a possible AFM outbreak in 2020, CDC wants to make sure clinicians can promptly recognize AFM symptoms, appropriately manage patients, and report suspected cases. NCIRD’s Division of Viral Diseases is hosting a webinar, titled “Acute Flaccid Myelitis: What Health Care Providers Need to Know in 2020,” on July 8, 2020. AFM is a serious neurologic condition that affects mostly children. Please visit the AFM webinar web page for additional information and registration.
Vaccine Administration e-Learn: An e-Learn on vaccine administration is now available. Proper vaccine administration is critical for ensuring that vaccines are both safe and effective. Vaccine administration errors happen more often than you might think. Of the average 36,000 reports received annually by the Vaccine Adverse Event Reporting System (VAERS), about 1,500 are directly related to administration error. Some of the most common vaccine administration errors include:
- Not following the recommended immunization schedule
- Administering improperly stored or expired vaccine and/or diluent
- Administering the wrong vaccine—confusing look-alike or sound-alike vaccines such as DTaP/Tdap or administering products outside age indications
The e-Learn is a free, interactive, online educational program that serves as a useful introductory course or a great refresher on vaccine administration. The self-paced e-Learn provides comprehensive training, using videos, job aids, and other resources to accommodate a variety of learning styles. A certificate of completion and/or Continuing Education (CE) is available for those that complete the training.
“Keys to Storing and Handling Your Vaccine Supply” Video: Two of the most important safeguards for the nation’s vaccine supply are proper vaccine storage and handling. An updated web-on-demand video, titled “Keys to Storing and Handling Your Vaccine Supply,” is designed to decrease vaccine storage and handling errors by demonstrating recommended best practices and addressing frequently asked questions. Continuing Education (CE) is available.
Vaccine Storage and Handling Toolkit: The Vaccine Storage and Handling Toolkit is a comprehensive guide that reflects best practices for vaccine storage and handling from ACIP recommendations, product information from vaccine manufacturers, and scientific studies.
Current Issues in Immunization Webinars: These webinars, held several times during the year, are designed to provide clinicians with the most up-to-date information on immunizations. The webinars are live, one-hour events combining an online visual presentation with simultaneous audio via telephone conference call, along with a live question-and-answer session. Registration, Internet access, and a separate phone line are needed to participate. View the webinar web page for upcoming and archived webinars and additional information.
You Call the Shots Modules: You Call the Shots is a series of interactive, web-based training courses developed through the Project to Enhance Immunization Content in Nursing Education and Training. These courses are ideal for medical or nursing students, new vaccination providers, or seasoned health care providers seeking a review. The “Rotavirus,” “DTaP,” and “Tdap” modules have recently been updated. Please visit the You Call the Shots web page to view all the modules. Continuing Education (CE) is available for viewing a module and completing an evaluation.
Vaccines for Children (VFC) Program Fact Sheet and Feature Article: Parents may not be aware that their children are eligible for free vaccines through the VFC program. This updated one-page handout for parents of children age 0–18 years is easy to print and share. CDC has also updated its VFC feature article. Please consider sharing via your social media channels.
Updated: Healthy Pregnancy Tips Videos: CDC has created 60–second, 30–second and 6–second versions of the “Healthy Pregnancy Tips” video. These YouTube videos explain why vaccines are an important part of every pregnancy. Please consider sharing with pregnant women via your social media channels.
“Talking to Pregnant Women about Vaccines” Handout: Vaccines are an important part of a healthy pregnancy and pregnant women may have questions or concerns about side effects, safety, and vaccine effectiveness. Addressing their questions and concerns about vaccines in plain and understandable language is key. CDC created the “Talking to Pregnant Women about Vaccines” handout for prenatal care providers to help address commonly asked questions about vaccines during pregnancy.
Redesigned HPV Vaccine Website for Health Care Professionals: As part of its effort to optimize digital content for use on multiple devices, CDC has redesigned the HPV vaccine website for health care professionals. The new website includes HPV cancer statistics, continuing education resources, tips for answering parents’ questions, and more. It also features a new page on HPV vaccine safety and effectiveness data, which outlines the key data that health care professionals need to know as they address questions from parents. Please share this new resource with colleagues or members of your health care professional association.
CDC and Medscape: This special series of commentaries, part of a collaboration between CDC and Medscape, is designed to deliver CDC’s authoritative guidance directly to Medscape’s physicians, nurses, pharmacists, and other health care providers. In this series, CDC experts offer video commentaries on current topics important to practicing clinicians. NCIRD has contributed to a variety of commentaries. You will need to sign up and log in as a member to view the commentaries and registration is free.
Immunization Resources: Various publications are available for ordering at CDC-INFO On Demand. You can search for immunization publications by using the “Programs” drop-down menu and selecting “Immunization and Vaccines,” or you can search by “Title.” Free hard copies of the 2020 recommended immunization schedules are now available for ordering.
CDC Job Openings: CDC is committed to recruiting and hiring qualified candidates for a wide range of immunization and other positions. Researchers, medical officers, epidemiologists, and other specialists are often needed to fill positions within CDC. For a current listing, including international opportunities, please visit CDC’s employment web page.
Calendar of Events
Vaccine Summit Ohio, American Public Health Association, October 5–7, 2020, Columbus, OH
ACIP Meeting, October 28–29, 2020, Atlanta, GA