IAC Express #948: Ask the Experts

[Guest guest]

> Date: Thu, 25 Aug 2011 14:04:18 -0500

> From: express@...

> express@...

> Subject: IAC Express #948: Ask the Experts

>

> IAC Express: Extra Edition

> Immunization news from the Immunization Action Coalition

>

> More than 44,000 subscribers read IAC Express.

> Subscribe to IAC Express and our other free publications at

> http://www.immunize.org/subscribe

>

> A web page version of this issue is available at

> http://www.immunize.org/express/issue948.asp

> ===========================================================

>

> Issue Number 948

> August 25, 2011

>

> CONTENTS OF THIS ISSUE

>

> 1. Read " Ask the Experts " Q & As about healthcare personnel

> vaccination

> -----------------------------------------------------------

>

> ABBREVIATIONS: AAFP, American Academy of Family Physicians;

> AAP, American Academy of Pediatrics; ACIP, Advisory

> Committee on Immunization Practices; AMA, American Medical

> Association; CDC, Centers for Disease Control and

> Prevention; FDA, Food and Drug Administration; IAC,

> Immunization Action Coalition; MMWR, Morbidity and Mortality

> Weekly Report; NCIRD, National Center for Immunization and

> Respiratory Diseases; NIVS, National Influenza Vaccine

> Summit; VIS, Vaccine Information Statement; VPD, vaccine-

> preventable disease; WHO, World Health Organization.

> -----------------------------------------------------------

>

> (1 of 1)

> August 25, 2011

> READ " ASK THE EXPERTS " Q & As ABOUT HEALTHCARE PERSONNEL

> VACCINATION

>

> Many readers of Needle Tips and Vaccinate Adults

> consistently rank " Ask the Experts " as their favorite

> feature in these publications. As a thank-you to our loyal

> IAC Express readers, we periodically publish Extra Editions

> with new " Ask the Experts " Q & As answered by CDC experts.

>

> IAC thanks nurse educator Donna L. Weaver, RN, MN, and

> medical epidemiologists T. Kroger, MD, MPH, and

> L. Atkinson, MD, MPH, National Center for

> Immunization and Respiratory Diseases, CDC, for answering

> the following questions.

>

> All the Q & As in this edition of IAC Express deal with

> vaccination issues related to healthcare personnel.

>

> We encourage you to reprint any of these Q & As in your own

> newsletters. Please credit the Immunization Action Coalition

> and the Centers for Disease Control and Prevention.

> Information about IAC's preferred citation style can be

> found at http://www.immunize.org/citeiac

>

> You can access more " Ask the Experts " Q & As in our online

> archive at http://www.immunize.org/askexperts

>

> Editor's note: Information about submitting a question to

> " Ask the Experts " is provided at the end of this Extra

> Edition.

>

> **************************

>

> Q: Which vaccines does ACIP specifically recommend that

> healthcare personnel (HCP) receive in order to work in a

> healthcare setting?

>

> A: ACIP recommends that all HCP be vaccinated with 2 doses

> of MMR vaccine (or have evidence of measles, mumps, and

> rubella immunity), annual influenza vaccination, 1 dose of

> Tdap (especially to protect against pertussis), 3 doses of

> hepatitis B vaccine for those who might be exposed to blood

> or body fluids at work, and 2 doses of varicella vaccine (or

> have evidence of varicella immunity). For definitions of

> evidence of immunity to mumps measles, rubella, and

> varicella, please refer to

>

http://www.cdc.gov/vaccines/recs/provisional/downloads/mmr-evidence-immunity-Aug\

2009-508.pdf

> (for MMR) and http://www.cdc.gov/mmwr/pdf/rr/rr5604.pdf

> (page 26, for varicella).

>

>

> Q: For which workers in healthcare settings does the

> Occupational Safety and Health Administration (OSHA) require

> that hepatitis B vaccine be provided?

>

> A: OSHA requires that hepatitis B vaccine be provided free

> of charge to HCP who have reasonably anticipated contact

> with blood or body fluids on the job. This requirement does

> not include HCP who would not be expected to have

> occupational risk, such as billing staff and general office

> workers. Employers must ensure that workers who decline

> hepatitis B vaccination sign a declination form. For a fact

> sheet about this OSHA requirement, go to:

> http://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact05.pdf

>

>

> Q: If an employee has 2 documented doses of MMR but has

> negative or equivocal titers for 1 or more of the antigens,

> what should we do? Same question if an employee has 2

> documented doses of varicella vaccine but tests negative.

>

> A: Actually, ACIP does not recommend testing for immunity in

> such situations. For measles, mumps, and rubella, ACIP

> considers 2 documented doses of MMR vaccine given on or

> after age 1 year and at least 28 days apart to be evidence

> of immunity for HCP. For varicella, ACIP considers 2

> documented doses of vaccine to be evidence of immunity for

> HCP as long as doses are given no earlier than age 12

> months, with at least 3 months between doses for children

> younger than age 13 years, or at least 4 weeks between doses

> for people age 13 years and older.

>

> Because of the limitations of serologic testing, tests for

> even properly vaccinated individuals will often come back as

> negative or equivocal, putting the employee health service

> in the difficult position of having to do something (e.g.,

> give additional doses, perform a follow-up titer).

>

> If a healthcare worker does not have any documented doses of

> MMR and/or varicella vaccine, he or she can (1) be tested

> for immunity or (2) just be given 2 doses of MMR and/or

> varicella at least 4 weeks apart. ACIP does not recommend

> serologic testing after vaccination.

>

> For more information on this topic, go to:

>

> IAC's " Ask the Experts " web section on MMR vaccination

> http://www.immunize.org/askexperts/experts_mmr.asp

>

> IAC's " Ask the Experts " web section on varicella vaccination

> http://www.immunize.org/askexperts/experts_var.asp

>

> ACIP recommendations on the prevention of measles, mumps,

> and rubella

> http://www.cdc.gov/mmwr/PDF/rr/rr4708.pdf (pages 18-20)

>

> ACIP recommendations on the prevention of varicella

> http://www.cdc.gov/mmwr/pdf/rr/rr5604.pdf (page 26)

>

>

> Q: How soon after a dose of Td can HCP receive a dose of

> Tdap?

>

> A: If they have not previously received Tdap, HCP in

> hospital, long-term care, and ambulatory care settings

> should receive a single dose of Tdap as soon as feasible and

> without regard to the dosing interval since the last Td

> dose. No minimum interval exists between receiving Td and

> Tdap.

>

>

> Q: Can Tdap be given to pregnant HCP?

>

> A: In June 2011, after studying new safety and efficacy

> data, ACIP voted to recommend that pregnant women who have

> never received the Tdap vaccine be vaccinated with Tdap

> during their third trimester or the second half of their

> second trimester (after 20 weeks gestation). ACIP made this

> recommendation in response to the continuing pertussis

> outbreak, with the goal of protecting newborns with maternal

> antibodies and decreasing the risk of transmission from

> mother to infant after birth. If the vaccine is not given

> during pregnancy, it should be given immediately post-

> partum.

>

> To view ACIP's provisional recommendation for use of Tdap in

> pregnant women, go to:

> http://www.cdc.gov/vaccines/recs/provisional

>

>

> Q: Can pregnant healthcare personnel administer live-virus

> vaccines?

>

> A: A pregnant staff member may administer any vaccine except

> smallpox vaccine.

>

>

> Q: Why is it so important to vaccinate HCP against

> influenza?

>

> A: Because HCP provide care to patients at high risk for

> complications of influenza, achieving high rates of

> vaccination among HCP will reduce disease burden and

> healthcare costs.

>

> Influenza is readily transmitted for 24 hours before a

> person develops influenza symptoms. That means symptom-free

> unvaccinated HCP can transmit influenza virus to patients

> before developing symptoms and electing to stay home as a

> way to prevent transmission.

>

>

> Q: Why does CDC recommend that we consider obtaining a

> signed declination from HCP who refuse influenza

> vaccination?

>

> A: Some studies have shown an increase in HCP influenza

> vaccine acceptance when decliners are required to sign such

> a statement. In addition, such statements can help a

> vaccination program assess the reasons for declination and

> plan future educational efforts.

>

> You can find links to sample influenza vaccination

> declination forms in the resources section at the end of the

> Q & As.

>

>

> Q: Please tell me which professional associations have

> endorsed mandatory influenza vaccination for healthcare

> workers and have created policy statements.

>

> A: The following professional associations have issued

> policy statements supporting mandatory healthcare worker

> influenza vaccination:

>

> * American Academy of Pediatrics

>

http://pediatrics.aappublications.org/content/early/2010/09/13/peds.2010-2376.ab\

stract

>

> * American Medical Directors Association

> http://www.amda.com/governance/resolutions/J11.cfm

>

> * American Pharmacists Association

>

http://www.pharmacist.com/AM/Template.cfm?Section=House_of_Delegates & TEMPLATE=/C\

M/ContentDisplay.cfm & CONTENTID=25910

>

> * American Public Health Association

> http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1410

>

> * Association for Professionals in Infection Control and

> Epidemiology

>

http://www.apic.org/Content/NavigationMenu/PracticeGuidance/Topics/Influenza/API\

C_Position_Paper_Influenza_11_7_08final_revised.pdf

>

> * Infectious Diseases Society of America

> http://www.idsociety.org/redirector.aspx?id=15413

>

> * Society for Healthcare Epidemiology of America

> http://www.jstor.org/stable/10.1086/656558

>

> You can find additional information about mandatory

> influenza vaccination for HCP including a list of more than

> 100 healthcare settings that have implemented mandatory

> vaccination programs. Access IAC's Honor Roll for Patient

> Safety web section at http://www.immunize.org/honor-roll

>

>

> USEFUL RESOURCES

>

> From CDC/ACIP

>

> Immunization of Health-Care Workers: Recommendations of the

> Advisory Committee on Immunization Practices and the

> Hospital Infection Control Practices Advisory Committee

> (1997)

> http://www.cdc.gov/mmwr/PDF/rr/rr4618.pdf

>

> Influenza Vaccination of Health-Care Personnel (2006)

> http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5502a1.htm

>

> ACIP recommendations for all vaccines, including MMR,

> varicella, influenza, Tdap, and hepatitis B

> http://www.cdc.gov/vaccines/pubs/ACIP-list.htm

>

>

> From IAC

>

> IAC provides links to all ACIP recommendations

> chronologically and by disease at

> http://www.immunize.org/acip

>

> Healthcare Personnel Vaccination Recommendations

> http://www.immunize.org/catg.d/p2017.pdf

>

> Hepatitis B and the Healthcare Worker

> http://www.immunize.org/catg.d/p2109.pdf

>

> Screening Questionnaire for Injectable Influenza Vaccination

> (English)

> http://www.immunize.org/catg.d/p4066.pdf

>

> Screening Questionnaire for Injectable Influenza Vaccination

> (Spanish)

> http://www.immunize.org/catg.d/p4066-01.pdf

>

> Screening Questionnaire for Intranasal Influenza Vaccination

> (English)

> http://www.immunize.org/catg.d/p4067.pdf

>

> Screening Questionnaire for Intranasal Influenza Vaccination

> (Spanish)

> http://www.immunize.org/catg.d/p4067-01.pdf

>

> Declination of Influenza Vaccination (English)

> http://www.immunize.org/catg.d/p4068.pdf

>

> Declination of Influenza Vaccination (Spanish)

> http://www.immunize.org/catg.d/p4068-01.pdf

>

> Sample standing orders for most vaccines, including all

> those recommended for HCP, can be accessed at

> http://www.immunize.org/standing-orders

>

> Visit IAC's Honor Roll for Patient Safety to view stellar

> examples of influenza vaccination mandates in healthcare

> settings at http://www.immunize.org/honor-roll

>

> ===========================================================

> HOW TO SUBMIT A QUESTION TO " ASK THE EXPERTS "

> IAC works with CDC to compile new " Ask the Experts " Q & As for

> our publications based on commonly asked questions. We also

> consider the need to provide information about new vaccines

> and recommendations. Most of the questions are thus a

> composite of several inquiries.

>

> You can email your question about vaccines or immunization

> to IAC at admin@... As we receive hundreds of

> emails each month, we cannot guarantee that we will print

> your specific question in the " Ask the Experts " feature.

> However, you will get an answer. To see if your question has

> already been answered, you can first check the " Ask the

> Experts " online archive at

> http://www.immunize.org/askexperts

>

> You can also email CDC's immunization experts directly at

> nipinfo@... There is no charge for this service.

>

> If you have a question about IAC materials or services,

> email admininfo@...

>

> Please forward these " Ask the Experts " Q & As to your co-

> workers and suggest they subscribe to IAC Express at

> http://www.immunize.org/subscribe

>

> ===========================================================

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> this issue of IAC Express or selected articles. When you do

> so, please add a note that the Immunization Action Coalition

> is the source of the material and provide a link to

> http://www.immunize.org/express/issue948.asp

>

> Editor: Deborah L. Wexler, MD (deborah@...)

> Managing Editor: Dale (dale@...)

> Associate Editor: A. , DDS, MPH

> (tanderson@...)

> Editorial and Operations Assistant: Janelle Tangonan

> (janelle@...)

> ISSN: 1526-1786

>

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> from the National Center for Immunization and Respiratory

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> CDC. IAC Express is also supported by educational grants

> from the following companies: Baxter Healthcare Corp.; CSL

> Biotherapies; GlaxoKline; MedImmune, Inc.; Merck Sharp

> & Dohme Corp.; Novartis Vaccines; Ortho Clinical

> Diagnostics, Inc.; Pfizer, Inc.; and sanofi pasteur.

>

>

[Guest guest]

> Date: Thu, 25 Aug 2011 14:04:18 -0500

> From: express@...

> express@...

> Subject: IAC Express #948: Ask the Experts

>

> IAC Express: Extra Edition

> Immunization news from the Immunization Action Coalition

>

> More than 44,000 subscribers read IAC Express.

> Subscribe to IAC Express and our other free publications at

> http://www.immunize.org/subscribe

>

> A web page version of this issue is available at

> http://www.immunize.org/express/issue948.asp

> ===========================================================

>

> Issue Number 948

> August 25, 2011

>

> CONTENTS OF THIS ISSUE

>

> 1. Read " Ask the Experts " Q & As about healthcare personnel

> vaccination

> -----------------------------------------------------------

>

> ABBREVIATIONS: AAFP, American Academy of Family Physicians;

> AAP, American Academy of Pediatrics; ACIP, Advisory

> Committee on Immunization Practices; AMA, American Medical

> Association; CDC, Centers for Disease Control and

> Prevention; FDA, Food and Drug Administration; IAC,

> Immunization Action Coalition; MMWR, Morbidity and Mortality

> Weekly Report; NCIRD, National Center for Immunization and

> Respiratory Diseases; NIVS, National Influenza Vaccine

> Summit; VIS, Vaccine Information Statement; VPD, vaccine-

> preventable disease; WHO, World Health Organization.

> -----------------------------------------------------------

>

> (1 of 1)

> August 25, 2011

> READ " ASK THE EXPERTS " Q & As ABOUT HEALTHCARE PERSONNEL

> VACCINATION

>

> Many readers of Needle Tips and Vaccinate Adults

> consistently rank " Ask the Experts " as their favorite

> feature in these publications. As a thank-you to our loyal

> IAC Express readers, we periodically publish Extra Editions

> with new " Ask the Experts " Q & As answered by CDC experts.

>

> IAC thanks nurse educator Donna L. Weaver, RN, MN, and

> medical epidemiologists T. Kroger, MD, MPH, and

> L. Atkinson, MD, MPH, National Center for

> Immunization and Respiratory Diseases, CDC, for answering

> the following questions.

>

> All the Q & As in this edition of IAC Express deal with

> vaccination issues related to healthcare personnel.

>

> We encourage you to reprint any of these Q & As in your own

> newsletters. Please credit the Immunization Action Coalition

> and the Centers for Disease Control and Prevention.

> Information about IAC's preferred citation style can be

> found at http://www.immunize.org/citeiac

>

> You can access more " Ask the Experts " Q & As in our online

> archive at http://www.immunize.org/askexperts

>

> Editor's note: Information about submitting a question to

> " Ask the Experts " is provided at the end of this Extra

> Edition.

>

> **************************

>

> Q: Which vaccines does ACIP specifically recommend that

> healthcare personnel (HCP) receive in order to work in a

> healthcare setting?

>

> A: ACIP recommends that all HCP be vaccinated with 2 doses

> of MMR vaccine (or have evidence of measles, mumps, and

> rubella immunity), annual influenza vaccination, 1 dose of

> Tdap (especially to protect against pertussis), 3 doses of

> hepatitis B vaccine for those who might be exposed to blood

> or body fluids at work, and 2 doses of varicella vaccine (or

> have evidence of varicella immunity). For definitions of

> evidence of immunity to mumps measles, rubella, and

> varicella, please refer to

>

http://www.cdc.gov/vaccines/recs/provisional/downloads/mmr-evidence-immunity-Aug\

2009-508.pdf

> (for MMR) and http://www.cdc.gov/mmwr/pdf/rr/rr5604.pdf

> (page 26, for varicella).

>

>

> Q: For which workers in healthcare settings does the

> Occupational Safety and Health Administration (OSHA) require

> that hepatitis B vaccine be provided?

>

> A: OSHA requires that hepatitis B vaccine be provided free

> of charge to HCP who have reasonably anticipated contact

> with blood or body fluids on the job. This requirement does

> not include HCP who would not be expected to have

> occupational risk, such as billing staff and general office

> workers. Employers must ensure that workers who decline

> hepatitis B vaccination sign a declination form. For a fact

> sheet about this OSHA requirement, go to:

> http://www.osha.gov/OshDoc/data_BloodborneFacts/bbfact05.pdf

>

>

> Q: If an employee has 2 documented doses of MMR but has

> negative or equivocal titers for 1 or more of the antigens,

> what should we do? Same question if an employee has 2

> documented doses of varicella vaccine but tests negative.

>

> A: Actually, ACIP does not recommend testing for immunity in

> such situations. For measles, mumps, and rubella, ACIP

> considers 2 documented doses of MMR vaccine given on or

> after age 1 year and at least 28 days apart to be evidence

> of immunity for HCP. For varicella, ACIP considers 2

> documented doses of vaccine to be evidence of immunity for

> HCP as long as doses are given no earlier than age 12

> months, with at least 3 months between doses for children

> younger than age 13 years, or at least 4 weeks between doses

> for people age 13 years and older.

>

> Because of the limitations of serologic testing, tests for

> even properly vaccinated individuals will often come back as

> negative or equivocal, putting the employee health service

> in the difficult position of having to do something (e.g.,

> give additional doses, perform a follow-up titer).

>

> If a healthcare worker does not have any documented doses of

> MMR and/or varicella vaccine, he or she can (1) be tested

> for immunity or (2) just be given 2 doses of MMR and/or

> varicella at least 4 weeks apart. ACIP does not recommend

> serologic testing after vaccination.

>

> For more information on this topic, go to:

>

> IAC's " Ask the Experts " web section on MMR vaccination

> http://www.immunize.org/askexperts/experts_mmr.asp

>

> IAC's " Ask the Experts " web section on varicella vaccination

> http://www.immunize.org/askexperts/experts_var.asp

>

> ACIP recommendations on the prevention of measles, mumps,

> and rubella

> http://www.cdc.gov/mmwr/PDF/rr/rr4708.pdf (pages 18-20)

>

> ACIP recommendations on the prevention of varicella

> http://www.cdc.gov/mmwr/pdf/rr/rr5604.pdf (page 26)

>

>

> Q: How soon after a dose of Td can HCP receive a dose of

> Tdap?

>

> A: If they have not previously received Tdap, HCP in

> hospital, long-term care, and ambulatory care settings

> should receive a single dose of Tdap as soon as feasible and

> without regard to the dosing interval since the last Td

> dose. No minimum interval exists between receiving Td and

> Tdap.

>

>

> Q: Can Tdap be given to pregnant HCP?

>

> A: In June 2011, after studying new safety and efficacy

> data, ACIP voted to recommend that pregnant women who have

> never received the Tdap vaccine be vaccinated with Tdap

> during their third trimester or the second half of their

> second trimester (after 20 weeks gestation). ACIP made this

> recommendation in response to the continuing pertussis

> outbreak, with the goal of protecting newborns with maternal

> antibodies and decreasing the risk of transmission from

> mother to infant after birth. If the vaccine is not given

> during pregnancy, it should be given immediately post-

> partum.

>

> To view ACIP's provisional recommendation for use of Tdap in

> pregnant women, go to:

> http://www.cdc.gov/vaccines/recs/provisional

>

>

> Q: Can pregnant healthcare personnel administer live-virus

> vaccines?

>

> A: A pregnant staff member may administer any vaccine except

> smallpox vaccine.

>

>

> Q: Why is it so important to vaccinate HCP against

> influenza?

>

> A: Because HCP provide care to patients at high risk for

> complications of influenza, achieving high rates of

> vaccination among HCP will reduce disease burden and

> healthcare costs.

>

> Influenza is readily transmitted for 24 hours before a

> person develops influenza symptoms. That means symptom-free

> unvaccinated HCP can transmit influenza virus to patients

> before developing symptoms and electing to stay home as a

> way to prevent transmission.

>

>

> Q: Why does CDC recommend that we consider obtaining a

> signed declination from HCP who refuse influenza

> vaccination?

>

> A: Some studies have shown an increase in HCP influenza

> vaccine acceptance when decliners are required to sign such

> a statement. In addition, such statements can help a

> vaccination program assess the reasons for declination and

> plan future educational efforts.

>

> You can find links to sample influenza vaccination

> declination forms in the resources section at the end of the

> Q & As.

>

>

> Q: Please tell me which professional associations have

> endorsed mandatory influenza vaccination for healthcare

> workers and have created policy statements.

>

> A: The following professional associations have issued

> policy statements supporting mandatory healthcare worker

> influenza vaccination:

>

> * American Academy of Pediatrics

>

http://pediatrics.aappublications.org/content/early/2010/09/13/peds.2010-2376.ab\

stract

>

> * American Medical Directors Association

> http://www.amda.com/governance/resolutions/J11.cfm

>

> * American Pharmacists Association

>

http://www.pharmacist.com/AM/Template.cfm?Section=House_of_Delegates & TEMPLATE=/C\

M/ContentDisplay.cfm & CONTENTID=25910

>

> * American Public Health Association

> http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1410

>

> * Association for Professionals in Infection Control and

> Epidemiology

>

http://www.apic.org/Content/NavigationMenu/PracticeGuidance/Topics/Influenza/API\

C_Position_Paper_Influenza_11_7_08final_revised.pdf

>

> * Infectious Diseases Society of America

> http://www.idsociety.org/redirector.aspx?id=15413

>

> * Society for Healthcare Epidemiology of America

> http://www.jstor.org/stable/10.1086/656558

>

> You can find additional information about mandatory

> influenza vaccination for HCP including a list of more than

> 100 healthcare settings that have implemented mandatory

> vaccination programs. Access IAC's Honor Roll for Patient

> Safety web section at http://www.immunize.org/honor-roll

>

>

> USEFUL RESOURCES

>

> From CDC/ACIP

>

> Immunization of Health-Care Workers: Recommendations of the

> Advisory Committee on Immunization Practices and the

> Hospital Infection Control Practices Advisory Committee

> (1997)

> http://www.cdc.gov/mmwr/PDF/rr/rr4618.pdf

>

> Influenza Vaccination of Health-Care Personnel (2006)

> http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5502a1.htm

>

> ACIP recommendations for all vaccines, including MMR,

> varicella, influenza, Tdap, and hepatitis B

> http://www.cdc.gov/vaccines/pubs/ACIP-list.htm

>

>

> From IAC

>

> IAC provides links to all ACIP recommendations

> chronologically and by disease at

> http://www.immunize.org/acip

>

> Healthcare Personnel Vaccination Recommendations

> http://www.immunize.org/catg.d/p2017.pdf

>

> Hepatitis B and the Healthcare Worker

> http://www.immunize.org/catg.d/p2109.pdf

>

> Screening Questionnaire for Injectable Influenza Vaccination

> (English)

> http://www.immunize.org/catg.d/p4066.pdf

>

> Screening Questionnaire for Injectable Influenza Vaccination

> (Spanish)

> http://www.immunize.org/catg.d/p4066-01.pdf

>

> Screening Questionnaire for Intranasal Influenza Vaccination

> (English)

> http://www.immunize.org/catg.d/p4067.pdf

>

> Screening Questionnaire for Intranasal Influenza Vaccination

> (Spanish)

> http://www.immunize.org/catg.d/p4067-01.pdf

>

> Declination of Influenza Vaccination (English)

> http://www.immunize.org/catg.d/p4068.pdf

>

> Declination of Influenza Vaccination (Spanish)

> http://www.immunize.org/catg.d/p4068-01.pdf

>

> Sample standing orders for most vaccines, including all

> those recommended for HCP, can be accessed at

> http://www.immunize.org/standing-orders

>

> Visit IAC's Honor Roll for Patient Safety to view stellar

> examples of influenza vaccination mandates in healthcare

> settings at http://www.immunize.org/honor-roll

>

> ===========================================================

> HOW TO SUBMIT A QUESTION TO " ASK THE EXPERTS "

> IAC works with CDC to compile new " Ask the Experts " Q & As for

> our publications based on commonly asked questions. We also

> consider the need to provide information about new vaccines

> and recommendations. Most of the questions are thus a

> composite of several inquiries.

>

> You can email your question about vaccines or immunization

> to IAC at admin@... As we receive hundreds of

> emails each month, we cannot guarantee that we will print

> your specific question in the " Ask the Experts " feature.

> However, you will get an answer. To see if your question has

> already been answered, you can first check the " Ask the

> Experts " online archive at

> http://www.immunize.org/askexperts

>

> You can also email CDC's immunization experts directly at

> nipinfo@... There is no charge for this service.

>

> If you have a question about IAC materials or services,

> email admininfo@...

>

> Please forward these " Ask the Experts " Q & As to your co-

> workers and suggest they subscribe to IAC Express at

> http://www.immunize.org/subscribe

>

> ===========================================================

> The Immunization Action Coalition welcomes redistribution of

> this issue of IAC Express or selected articles. When you do

> so, please add a note that the Immunization Action Coalition

> is the source of the material and provide a link to

> http://www.immunize.org/express/issue948.asp

>

> Editor: Deborah L. Wexler, MD (deborah@...)

> Managing Editor: Dale (dale@...)

> Associate Editor: A. , DDS, MPH

> (tanderson@...)

> Editorial and Operations Assistant: Janelle Tangonan

> (janelle@...)

> ISSN: 1526-1786

>

> To subscribe to IAC Express, as well as to view past issues,

> please visit http://www.immunize.org/express

>

> To update your contact information, please send an email

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> If you have trouble receiving or displaying IAC Express

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>

> IAC Express is supported in part by Grant No. 5U38IP000290

> from the National Center for Immunization and Respiratory

> Diseases, CDC. Its contents are solely the responsibility of

> IAC and do not necessarily represent the official views of

> CDC. IAC Express is also supported by educational grants

> from the following companies: Baxter Healthcare Corp.; CSL

> Biotherapies; GlaxoKline; MedImmune, Inc.; Merck Sharp

> & Dohme Corp.; Novartis Vaccines; Ortho Clinical

> Diagnostics, Inc.; Pfizer, Inc.; and sanofi pasteur.

>

>