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The Children's Hospital of Philadelphia

Vaccine Update for Healthcare Providers

February 2013

This newsletter is meant to keep you up to date on issues related to vaccines quickly and easily. We welcome your comments and questions; please email us at vacinfo@email.chop.edu.

VEC Announcements: Pertussis: What you should know and March 13 Vaccine Education webinar

Pertussis: What you should know
The previously titled “Tdap: What you should know” has been updated and revised to focus more on pertussis and pertussis vaccines for different age groups. “Pertussis: What you should know” is now available online in English and Spanish or for order in pads of 50 sheets.

March 13 Vaccine Education webinar
Registration is now open for the upcoming Vaccine Education webinar co-sponsored by the PA Chapter, American Academy of Pediatrics. The webinar, supported by the Thomas F. McNair Scott Endowed Research and Lectureship Fund, will be presented by Dr. Paul Offit on March 13, 2013, from noon to 1 p.m. ET. Topics will include:

  • Pertussis: Are vaccine-resistant strains emerging?
  • Influenza: Conceptually different vaccines will be available for 2013-2014
  • HibMenCY: One component routinely recommended for all infants, the other for high-risk infants; what to do?
  • Pneumococcal vaccine: Update to PCV-13 recommendation

To register, go to http://vaccine.chop.edu/webinars.

News and Views: IOM reviews safety of childhood vaccine schedule

Charlotte A. Moser, Assistant Director, and Paul A. Offit, Director, Vaccine Education Center at The Children’s Hospital of Philadelphia 

Historically, the Institute of Medicine (IOM) has convened groups to review a variety of vaccine-related issues, including vaccine safety concerns. In each case a committee of experts was charged with offering “independent, objective, evidence-based advice” meant to inform the direction of policy and provide a viewpoint based on the compendium of existing information for the public and private sectors. Most recently, the IOM turned its attention to concerns about the safety of the childhood immunization schedule. The resulting report, “The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies,” was released on January 16, 2013. 

Read a summary of the report and how to apply it in practice»

In the Journals: Pertactin-negative variants of Bordatella pertussis in the U.S.

Paul A. Offit, MD, Director, Vaccine Education Center at The Children’s Hospital of Philadelphia

On February 7, 2013, the New England Journal of Medicine published an article titled, “Pertactin-Negative Variants of Bordetella pertussis in the United States” (Queenan AM, Cassiday PK, Evangelista A. N Engl J Med. 2013 Feb 7;368(6):583-4). In this report, researchers at St. Christopher’s Hospital for Children in Philadelphia examined 12 isolates of B. pertussis obtained from children admitted to their hospital. They found that 11 of the 12 isolates no longer contained pertactin, a structural protein associated with bacterial virulence. Two of the three DTaP vaccines used in the United States (ACEL-IMUNE® and Infanrix®) contain pertactin. Also, both Tdap vaccines, Boostrix® and Adacel®, contain pertactin. It is possible that these pertactin-negative isolates are the result of selective pressure exerted by widespread vaccination with pertactin-containing vaccines.

Read more about these findings in the context of what is already known»

Technically Speaking: CDC’s 2013 immunization schedules and IAC’s easy-to-use summaries of CDC’s vaccination recommendations — now available for your office

Deborah L. Wexler, MD, Executive Director, Immunization Action Coalition

Early each year, CDC publishes updated versions of the recommended U.S. immunization schedules to reflect changes that occurred throughout the previous year. This year, for the first time, schedules for children, teens and adults were all published simultaneously. If you have not seen them, consult the January 28, 2013 supplement issue of Morbidity and Mortality Weekly (MMWR). Although the updates for 2013 were not vast, it is important that your office staff, as immunization providers, is aware of the updates and implement appropriate procedural changes if necessary. 

To make your job easier, the Immunization Action Coalition (IAC) has designed two user-friendly documents that summarize guidance in the current CDC recommendations: Summary of Recommendations for Child/Teen Immunization and Summary of Recommendations for Adult Immunization.

Read more about what these two resources offer»

From the Media — Barbara Walters had chickenpox + non-influenza vaccination coverage among adults = more work needed surrounding adult immunizations

Much vaccine media over the last few weeks has been related to the publication of the article about pertactin-negative pertussis strains (see “In the Journals”) and influenza disease rates; however, this month’s media report focuses on something that didn’t receive as much coverage — adult immunization needs. 

Review summary data table and find out about helpful resources related to adult immunizations»

On the Calendar

Registration is now open for the National Adult Immunization Summit and Influenza Summits; the AAP is holding a 2D Vaccine Barcode Pilot’s Educational Forum, and World Meningitis Day will be held on April 24. Learn more about these and other upcoming meetings and events. 

Check the calendar»

On the Bookshelf: Books for kids

Charlotte A. Moser, Assistant Director, Vaccine Education Center at The Children’s Hospital of Philadelphia

Do you need books for the waiting room? Wondering about good titles to donate to your local library? Need to get gifts for any kids? If so, read on to find some books for the younger crowd that will also help them better understand the spread of diseases and gain an understanding of vaccines.

Read more»

Resources: Resources for parents, and immunization quality improvement study seeks participants

Resources for parents
The Immunization Action Coalition (IAC) recently transformed its website for the public and the Centers for Disease Control and Preventions (CDC) made some infographics available:

  • IAC’s website transformation – www.vaccineinformation.org is the web site that IAC maintains for the public. Although this website has been available for several years, it has recently undergone renovations to improve navigation and refresh its appearance. Information is now organized into sections based on age. The website continues to offer an extensive selection of personal stories, videos and disease-specific information and resources. If you’ve not done so already, take a moment to check it out!
  • CDC Infographics – If you have had parents question whether vaccines have been tested for safety, the CDC’s new infogaphic may be helpful. Titled “The Journey of Your Child’s Vaccine,” the graphic shows three major phases of vaccine development:
    • How a new vaccine is developed, approved and manufactured
    • How a vaccine is added to the U.S. recommended immunization schedule
    • How a vaccine’s safety continues to be monitored

If you haven’t seen it, check it out or review the accompanying text document.

The CDC also has a new pertussis-specific infographic titled “Protect Babies from Whooping Cough.” The infographic highlights the need for pregnant moms to get vaccinated, describes the concept of cocooning, points out when babies and young children need to get pertussis-containing vaccines, and guides parents as to where to get the vaccine. The infographic and accompanying text document are available for sharing.

Immunization quality improvement study seeks participants
The American Academy of Pediatrics and Children’s National Medical Center recently started recruitment for a new study referred to as “Comparison of Immunization Quality Improvement Dissemination Strategies” or “CIzQIDS.” The randomized trial is seeking primary care practice teams interested in improving care and sharing what they learned with other participants.

Participating practices will be divided into two groups, half in a pay for performance intervention and half in a quality improvement technical support intervention. To qualify, practices must have a baseline immunization rate for 3- to 18-month-old patients of 79 percent or lower; however, practices are encouraged to apply even if they are unsure of their rates as the study team anticipates most practices will qualify. To learn more or listen to an informational recording, visit the AAP’s web page. To see if you are qualified, complete the screening survey.

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Founded in 1855, The Children’s Hospital of Philadelphia is the birthplace of pediatric medicine in America. Throughout its history, a passionate spirit of innovation has driven this renowned institution to pursue scientific discovery, establish the highest standards of patient care, train future leaders in pediatrics, and advocate for children’s health. A haven of hope for children and families worldwide, CHOP is a nonprofit charitable organization that relies on the generous support of its donors to continue to set the global standard for pediatric care. For more information, visit http://www.chop.edu.

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