Immunization Works June 2016

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Live, Attenuated Influenza Vaccine (LAIV): The Advisory Committee on Immunization Practices (ACIP) met in Atlanta on June 22–23. Because of data indicating poor effectiveness of live, attenuated influenza vaccine (LAIV, FluMist) in children age 2 through 17 years of age during the past three influenza seasons, ACIP voted to recommend that LAIV should not be used in any setting during the 2016–17 influenza season. ACIP also voted to remove LAIV from the VFC program for the 2016–17 influenza season. Please read the CDC media statement for additional information.

New Webinar Series for Pink Book: This online series of 15 webinars provides an overview of vaccination principles, general recommendations, immunization strategies, and specific information about vaccine-preventable diseases and the vaccines that prevent them. Each webinar will explore a chapter from the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (the Pink Book). The webinars started on June 1 and will air live most Wednesdays from 12-1 p.m. EDT through September 21, 2016. Check the schedule for live webcasts, and view recordings at your convenience online at the Pink Book webinar web page.

You must register in advance for the live webinars. After registering, you will receive event access information via e-mail. Each webinar is limited to 1,500 participants so please log in early to secure a virtual “seat.” If a webinar is full or if you miss a live event, you can watch it at the Pink Book webinar web page. Webcasts will be posted within a few days after the live event.

Continuing Education (CE) credit will be available for each event.

Webinars will be aired via the Adobe Connect Webinar System. We recommend that you do a connection test in advance to verify that your computer meets all system requirements for the webinars. If you pass the three steps of the test, you are ready to participate. Audio will only be available through your computer speakers, so there will be no call-in phone number. Questions during the event can be submitted to our subject matter experts via a Question and Answer Pod, which will display when you join the event. Troubleshooting information to assist with meeting access and other issues will also be available.

47th National Immunization Conference (NIC)—It Takes a Community: CDC and NCIRD will host the 47th NIC September 13–15, 2016, at the Hilton Hotel in Atlanta, Georgia. The NIC brings together a wide variety of local, state, federal, and private-sector immunization partners to explore science, policy, education, and planning issues related to immunization and vaccine-preventable diseases.

The conference will have three plenary sessions, the Hilleman Lecture, 12 breakout sessions, exhibits, and posters, and will include the following topics:

Health and Risk Communication
Epidemiology and Surveillance
Immunization Information Systems (IIS)
Programmatic Issues
Adult Immunization
Child and Adolescent Immunization

Please visit the NIC web page for the agenda, registration, and additional information. Please contact the conference planning team if you have questions.

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Influenza Information

Influenza Activity in the U.S. during the 2015–16 Season and Composition of the 2016–17 Influenza Vaccine: During the 2015–16 U.S. influenza season (October 4, 2015–May 21, 2016), influenza activity was lower and peaked later compared with the previous three seasons (2014-15, 2013–14, and 2012-13). Activity remained low from October 2015 until late December 2015 and peaked in mid-March 2016. During the most recent 18 influenza seasons (including this season), only two other seasons have peaked in March (2011–12 and 2005–06). Overall influenza activity was moderate this season, with a lower percentage of outpatient visits for influenza-like illness (ILI), lower hospitalization rates, and a lower percentage of deaths attributed to pneumonia and influenza compared with the preceding three seasons. Influenza A(H1N1)pdm09 viruses predominated overall, but influenza A(H3N2) viruses were more commonly identified from October to early December, and influenza B viruses were more commonly identified from mid-April through mid-May. The majority of viruses have been similar to the components recommended for this season’s Northern Hemisphere influenza vaccine. The June 10 MMWR summarizes influenza activity in the U.S. during the 2015–16 influenza season and reports the vaccine virus components recommended for the 2016–17 Northern Hemisphere influenza vaccines.

Flu Season Update: Flu activity has peaked nationally for the 2015-16 flu season and is winding down. Influenza-like illness is below baseline. For the last 13 seasons, the average duration of a flu season by this measure has been 13 weeks, with a range of 1 week to 20 weeks. There is still some flu circulating, and it's important to note that flu viruses circulate at low levels, even over the summer. CDC recommends influenza vaccination as long as influenza viruses are circulating and vaccine is available. People who have not yet been vaccinated this season should be vaccinated if they are traveling to places where flu is circulating or if they will be congregating with people from areas where flu is circulating. CDC also recommends that patients suspected of having influenza who are at high risk or very sick should receive prompt treatment with influenza antiviral drugs without waiting for laboratory confirmation.

Influenza B viruses have been most common in the last few weeks; however, overall, H1N1 flu viruses have been most common this season. H1N1 flu viruses emerged in 2009 and caused a pandemic. They have circulated globally as seasonal flu viruses since that time, and have been associated with severe disease in some children, as well as in young and middle-aged adults. The good news is that all flu vaccines this season contained an influenza A (H1N1)pdm09 component.

So far, surveillance data show that the flu viruses currently circulating, including H1N1 viruses, remain similar to the vaccine virus components. How similar circulating viruses are to the vaccine viruses is one factor that influences how well the flu vaccine works each year. In February, CDC reported that this season’s vaccine was 60% effective in preventing medically attended influenza. Flu vaccines are made to protect against the three or four flu viruses (depending on which vaccine you get) that research suggests will be most common during the upcoming season.

Remember that it takes 2 weeks after vaccination for protection to begin. Protecting yourself from flu also protects the people around you who may be more vulnerable to serious flu illness. Pregnant women, babies, and people with asthma, for example, can suffer more serious flu illness and other complications. If you haven’t been vaccinated yet, you should get a flu vaccine now to protect yourself, your family, your colleagues, and your community against influenza.

Flu vaccines are offered by many doctor’s offices, clinics, health departments, pharmacies, health centers, and urgent care centers, as well as by many employers and schools, so you can get vaccinated even if you don’t have a regular doctor or nurse. Find a place near you to get flu and other recommended vaccines.

Antiviral drugs for treatment of flu illness serve as a second line of defense against the flu. Antiviral drugs can lessen symptoms and shorten the time that a patient is sick. They can also prevent serious flu complications. CDC recommends that people who are very sick with flu, or people who are at high risk of flu complications, should be treated as quickly as possible with flu antiviral drugs. Antiviral treatment works best when started early (within 2 days of getting sick). However, starting treatment later can still be helpful, especially if the person has a high-risk condition or is very sick from flu.

The three prescription antiviral medications recommended for treatment of influenza are oral oseltamivir (Tamiflu), inhaled zanamivir (Relenza), and intravenous peramivir (Rapivab). These drugs are chemically-related antiviral medications, known as neuraminidase inhibitors, that work against activity of both influenza A and B viruses. Decisions about starting antiviral treatment should not wait for test results or laboratory confirmation of influenza.

For more information about how serious flu can be and the benefits of flu vaccination, talk to your doctor or other health care professional, visit the CDC influenza website, or call 1-800-CDC-INFO.

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Resources and Information

Epidemiology and Prevention of Vaccine-Preventable Diseases, 13th Edition (the Pink Book): CDC, NCIRD, and the Public Health Foundation (PHF) are pleased to announce that the book, Epidemiology and Prevention of Vaccine-Preventable Diseases, 13th Edition, is available. The Pink Book provides public health and health care professionals with the most comprehensive information on vaccines and vaccine-preventable diseases. The Pink Book is available for purchase from the PHF Learning Resource Center, and the chapters and appendices can be viewed/downloaded from the NCIRD vaccines site.

Current Issues in Immunization Netconferences: Immunization netconferences are live, one-hour events combining an online visual presentationwith 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. The next netconference will be November 9, 2016. Please visit the netconference web page for the archived webcasts, upcoming netconferences, and additional information.

You Call the Shots Modules: You Call the Shots is a web-based training course developed through the Project to Enhance Immunization Content in Nursing Education and Training. Several updated modules are now available, including Rotavirus and Hepatitis B. Please visit the You Call the Shots web page for additional information and other modules. Continuing Education (CE) credit is available for viewing a module and completing an evaluation.

ACIP Meeting: The most recent ACIP meeting was held June 22–23, 2016. Topics for the June meeting included cholera, meningococcal vaccine, influenza, the child/adolescent immunization schedule, hepatitis, vaccine supply, respiratory syncytial virus (RSV), maternal pertussis vaccine safety, poliovirus laboratory containment, and human papillomavirus (HPV). Votes were scheduled for recommendations for cholera and meningococcal vaccines and the VFC program. The meeting minutes will be posted soon. The next ACIP meeting will be held October 19-20, 2016. Please visit the ACIP meeting web page for agendas, presentation slides, meeting minutes, and archived video broadcasts.

Measles Resources: CDC aims to continue increasing awareness of measles among individuals and families and to encourage MMR vaccination. To support disease prevention and vaccination education efforts, CDC has developed a variety of measles and vaccination resources, including fact sheets, podcasts, and matte articles. There are also infographics available in English and Spanish.

CDC and Medscape: This special series of commentaries, part of a collaboration between CDC and Medscape, is designed to deliver CDC's authoritative guidance directly to Medscape's physicians, nurses, pharmacists, and other health care providers. In this series, CDC experts offer video commentaries on current topics important to practicing clinicians. NCIRD has contributed to a variety of commentaries. You may need to sign up and log in as a member to view the commentaries. Registration is free.

Immunization Resources: Publications are available for ordering at CDC-INFO on Demand. You can search for immunization publications by using the “Programs” drop-down menu and selecting “Immunization and Vaccines,” or you can search by “Title.” Numerous items are available, including the 2016 immunization schedules, the Parents’ Guide to Childhood Immunizations, and various campaign materials.

CDC Job Openings: CDC is committed to recruiting and hiring qualified candidates for a wide range of immunization and other positions. Researchers, medical officers, epidemiologists, and other specialists are often needed to fill positions within CDC. For a current listing, including international opportunities, please visit CDC’s employment web page.

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