Influenza
National Influenza Vaccination Week: This year’s National Influenza Vaccination Week (NIVW) is scheduled for December 2–8, 2018. NIVW is a national awareness week established in 2005 to highlight the importance of continuing flu vaccination through the holiday season and beyond.
Few people get vaccinated against flu after the end of November, but flu activity most commonly peaks in December or February and can last as late as May. CDC and its partners observe NIVW in December to remind people that even though the holiday season has begun, it is not too late to get a flu vaccine. As long as flu viruses are spreading and causing illness, vaccination should continue throughout the flu season to protect as many people as possible against flu. Even if you have already gotten sick with flu, you can still benefit from vaccination since flu vaccine protects against three or four different flu viruses (depending on which flu vaccine you get) and different flu viruses circulate over the course of a flu season.
Flu isn’t a “bad cold” and can result in serious health complications, such as pneumonia, bacterial infections, and hospitalizations. Flu can sometimes even lead to death. Anyone who gets sick with flu can pass it to someone at high risk of severe illness, which is why it’s important to protect yourself with a flu vaccine. Flu vaccination can keep you from getting sick with flu, prevent serious medical events associated with some chronic conditions, protect women during and after pregnancy, and save children’s lives. Flu vaccination also has been shown to reduce severity of illness in people who get vaccinated, but still get sick. Getting yourself vaccinated may also protect the people around you, including those most vulnerable to serious flu illness. Please visit the NIVW web page for additional information.
Flu Vaccine Webinar: Health care professionals can register for the #HowIRecommend Flu Vaccine Webinar, hosted by the Public Health Foundation (PHF) which will be held December 5, 2018, at 1 PM ET. This webinar will focus on exploring the severity and burden of last year’s flu season and why flu vaccine is so important and will offer tips on how to make stronger and more effective flu vaccine recommendations. Stay tuned for more activities taking place during National Influenza Vaccination Week.
2018–2019 Influenza Activity Update: Seasonal influenza activity was low in the U.S. during October, but began to increase slightly in November. Influenza A(H1N1) viruses were most commonly reported. CDC recommends that everyone 6 months and older get a flu vaccine as soon as possible. Because the peak month for influenza activity can range and influenza activity is expected to increase in the coming weeks, getting vaccinated now can still be protective.
CDC’s Influenza Division compiles and analyzes surveillance information on flu activity year-round in the U.S. This information is used to produce FluView, a weekly influenza surveillance report, and FluView Interactive, which allows for more in-depth exploration of influenza surveillance data. The most up-to-date influenza surveillance data in the U.S. for the 2018–19 flu season can be found in the current FluView.
New Influenza Antiviral Baloxavir Marboxil: Baloxavir marboxil (trade name Xofluza) is a new influenza antiviral drug approved by the U.S. Food and Drug Administration (FDA) on October 24, 2018, for the treatment of influenza in the U.S. There are now four approved and recommended influenza antiviral drugs for the 2018–19 season. Baloxavir is approved for the treatment of acute, uncomplicated flu in outpatients 12 years and older who have had flu symptoms for less than 2 days. CDC does not recommend use of baloxavir in pregnant women, breastfeeding mothers, or hospitalized patients. Randomized clinical trials show baloxavir shortened duration of flu symptoms by approximately one day compared with placebo, which is similar to oseltamivir. Learn more about available antiviral drugs at the influenza antiviral web page.
Estimated Burden of Influenza in the U.S. during the 2017–2018 Influenza Season: The burden of influenza in the U.S. can vary widely from season to season. It is determined by a number of factors, including the characteristics of circulating viruses, the timing of the season, population immunity to circulating viruses, how well flu vaccines are working, and how many people have gotten vaccinated. CDC uses modelling to estimate the numbers of influenza illnesses, medical visits, hospitalizations, and deaths in the U.S.
CDC estimates that during the 2017–18 season, there were about 49 million people getting sick with influenza, 22.7 million people going to a health care provider, 960,000 hospitalizations, and 79,000 deaths from influenza. The number of cases of influenza-associated illness that occurred last season was the highest since the 2009 H1N1 pandemic, when an estimated 60 million people were sick with influenza. These estimates demonstrate how severe influenza virus infection can be. Learn more about the disease burden of influenza at the disease burden web page.
Influenza Update Video: The recommendation for annual vaccination means that health care providers should remain up-to-date with their knowledge of influenza vaccination and practices. This web-on-demand video addresses frequently asked questions (FAQs) about influenza vaccine storage, handling, and administration recommendations, and best practices for the 2018-19 influenza season.
MMWR
Global Routine Vaccination Coverage—2017: Endorsed by the World Health Assembly in 2012, the Global Vaccine Action Plan 2011–2020 (GVAP) calls on all countries to reach more than 90% national coverage with all vaccines in the country’s national immunization schedule by 2020. The November 16 MMWR updates previous reports and presents global, regional, and national vaccination coverage estimates and trends as of 2017. It also describes the number of infants surviving to age 1 year (surviving infants) who did not receive the third dose of diphtheria and tetanus toxoids and pertussis–containing vaccine (DTP3), a key indicator of immunization program performance, with a focus on the countries with the highest number of children who did not receive DTP3 in 2017. Based on the World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) estimates, global DTP3 coverage increased from 79% in 2007 to 84% in 2010, and has remained stable from 2010 to 2017 (84% to 85%). In 2017, among the 19.9 million children who did not receive DTP3 in the first year of life, 62% (12.4 million) lived in 10 countries. From 2007 to 2017, the number of children who had not received DTP3 decreased in five of these 10 countries and remained stable or increased in the other five. Similar to DTP3 coverage, global coverage with the first measles-containing vaccine dose (MCV1) increased from 80% in 2007 to 84% in 2010, and has remained stable from 2010 to 2017 (84% to 85%). Coverage with the third dose of polio vaccine (Pol3) has remained stable at 84%–85% since 2010. From 2007 to 2017, estimated global coverage with the second MCV dose (MCV2) increased from 33% to 67%, as did coverage with the completed series of rotavirus (2% to 28%), pneumococcal conjugate (PCV) (4% to 44%), rubella (26% to 52%), Haemophilus influenzae type b (Hib) (25% to 72%) and hepatitis B (HepB) (birth dose: 24% to 43%; 3-dose series: 63% to 84%) vaccines. Targeted, context-specific strategies are needed to reach and sustain high vaccination coverage, particularly in countries with the highest number of unvaccinated children.
Progress toward Poliomyelitis Eradication in Pakistan, January 2017–September 2018: Among the three wild poliovirus (WPV) serotypes, only WPV type 1 (WPV1) has been reported in polio cases or detected from environmental surveillance globally since 2012. Pakistan remains one of only three countries worldwide (the others are Afghanistan and Nigeria) that has never had interrupted WPV1 transmission. The November 9 MMWR documents Pakistan’s activities and progress toward polio eradication during January 2017–September 2018 and updates previous reports. In 2017, Pakistan reported eight WPV1 cases, a 60% decrease from 20 cases in 2016. As of September 18, 2018, four cases had been reported, compared with five cases at that time in 2017. Nonetheless, in 2018, WPV1 continues to be isolated regularly from environmental surveillance sites, primarily in the core reservoir areas of Karachi, Quetta, and Peshawar, signifying persistent transmission. Strategies to increase childhood immunity have included an intense schedule of supplemental immunization activities (SIAs), expanding and refining deployment of community-based vaccination implemented by community health workers recruited from the local community in reservoir areas, and strategic placement of permanent transit points where vaccination is provided to mobile populations. Interruption of WPV1 transmission will require further programmatic improvements throughout the country, with a focus on specific underperforming subdistricts in reservoir areas.
Update: Recommendations of the Advisory Committee on Immunization Practices (ACIP) for Use of Hepatitis A Vaccine for Postexposure Prophylaxis and for Preexposure Prophylaxis for International Travel: Postexposure prophylaxis (PEP) with hepatitis A (HepA) vaccine or immune globulin (IG) effectively prevents infection with hepatitis A virus (HAV) when administered within 2 weeks of exposure. Preexposure prophylaxis against HAV infection through the administration of HepA vaccine or IG provides protection for unvaccinated persons traveling to or working in countries that have high or intermediate HAV endemicity. The ACIP Hepatitis Vaccines Work Group conducted a systematic review of the evidence for administering vaccine for PEP to persons age 40 years and over, and reviewed the HepA vaccine efficacy and safety in infants and the benefits of protection against HAV before international travel. The February 21, 2018, ACIP recommendations update and supersede previous ACIP recommendations for HepA vaccine for PEP and for international travel. Current recommendations include that HepA vaccine should be administered to all persons age 12 months and older for PEP. In addition to HepA vaccine, IG may be administered to persons age 40 years and older depending on the provider’s risk assessment. ACIP also recommended that HepA vaccine be administered to infants aged 6–11 months traveling outside the U.S. when protection against HAV is recommended. The travel-related dose for infants age 6–11 months should not be counted toward the routine 2-dose series. The dosage of IG has been updated where applicable (0.1 mL/kg). HepA vaccine for PEP provides advantages over IG, including induction of active immunity, longer duration of protection, ease of administration, and greater acceptability and availability. Please read the November 2 MMWR for the full report.
Resources and Information
The Journey of Your Child’s Vaccine Video: Learn about the journey of a childhood vaccine’s development, from lab testing through safety monitoring. This video explains the three phases of clinical trials, vaccine licensing and manufacturing, how a vaccine is added to the U.S. recommended immunization schedule, and how FDA and CDC continue to monitor vaccine safety after the public begins using the vaccine.
Epidemiology and Prevention of Vaccine-Preventable Diseases, 13th Edition (the Pink Book): Published by CDC, NCIRD, and the Public Health Foundation (PHF), the Pink Book provides health care professionals with the most comprehensive information available on vaccines and vaccine-preventable diseases. The Pink Book is available for purchase from the PHF Learning Resource Center, and the chapters and appendices can be viewed or downloaded from the NCIRD vaccines site.
2018 Webinar Series for Pink Book: This 2018 online series of 15 webinars, which concluded on October 3, 2018, provides an overview of vaccination principles, general recommendations, immunization strategies, and specific information about vaccine-preventable diseases and the vaccines that prevent them. Each webinar explored a chapter from the 13th edition of the Pink Book. All of the recordings can be viewed online at the Pink Book webinar web page. Continuing Education (CE) is available for each webinar.
“Keys to Storing and Handling Your Vaccine Supply” Video: Two of the most important safeguards for the nation’s vaccine supply are proper storage and handling. A new 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 Administration e-Learn: An e-Learn on vaccine administration is now available. Proper vaccine administration is critical for ensuring that vaccines are both safe and effective. Vaccine administration errors happen more often than you might think. Of the average 36,000 reports received annually by the Vaccine Adverse Event Reporting System (VAERS), about 1,500 are directly related to administration error.
Some of the most common vaccine administration errors include:
- Not following the recommended immunization schedule
- Administering improperly stored or expired vaccine and/or diluent
- Administering the wrong vaccine—confusing look-alike or sound-alike vaccines such as DTaP/Tdap or administering products outside age indications
The e-Learn is a free, interactive, online educational program that serves as a useful introductory course or a great refresher on vaccine administration. The self-paced e-Learn provides comprehensive training, using videos, job aids, and other resources to accommodate a variety of learning styles, and offers a certificate of completion and/or Continuing Education (CE) for those that complete the training.
For more information, please contact nipinfo@cdc.gov.
Current Issues in Immunization NetConferences: Immunization netconferences are live, one-hour events combining an online visual presentation with simultaneous audio via telephone conference call, along with a live question-and-answer session. Registration, Internet access, and a separate phone line are needed to participate. The next netconference is scheduled for November 28, 2018, and the topic will be Hepatitis A Guidelines. Please visit the netconference web page for additional information and to view archived webcasts.
HPV Video: Immunization providers play a critical role in getting parents to accept HPV vaccination for their children. A new video, titled “You Are the Key to HPV Cancer Prevention,” provides up-to-date information on HPV infection/disease, HPV vaccine, and ways to successfully communicate with parents about HPV vaccination. HPV vaccination is cancer prevention. While most U.S. adolescents are starting the HPV vaccine series, less than half have finished the series. Every year that adolescents aren’t vaccinated is another year they are left unprotected against cancer-causing infections. Continuing Education (CE) is available.
You Call the Shots Modules: You Call the Shots is a web-based training course developed through the Project to Enhance Immunization Content in Nursing Education and Training. The Vaccine Administration module has recently been updated and is now available. 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.
Measles and Mumps Resources: CDC aims to continue increasing awareness of measles and mumps among individuals and families and to encourage MMR vaccination. To support disease prevention and vaccination educational efforts, CDC has developed a variety of measles and mumps resources, including fact sheets, podcasts, and matte articles. Some of the measles graphics are also available in Spanish.
CDC and Medscape: This special series of commentaries, part of a collaboration between CDC and Medscape, is designed to deliver CDC’s authoritative guidance directly to Medscape’s physicians, nurses, pharmacists, and other health care providers. In this series, CDC experts offer video commentaries on current topics important to practicing clinicians. NCIRD has contributed to a variety of commentaries. You will need to sign up and log in as a member to view the commentaries and registration is free.
Immunization Resources: Various publications are available for ordering at CDC-INFO On Demand. You can search for immunization publications by using the “Programs” drop-down menu and selecting “Immunization and Vaccines,” or you can search by “Title.” Numerous items are available for ordering, including the 2018 recommended immunization schedules.
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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