Volume 19 – Number 2 May 2015 (Content current VACCINATE ADULTS! as of May 26) from the Immunization Action Coalition — www.immunize.org

New ACIP recommendations for HPV, influenza, What’s In This Issue MenB, typhoid, and yellow fever vaccines. Make New ACIP Recommendations...... 1 sure you’re up to date! Ask the Experts: CDC Answers Your Questions...... 1 An abundance of new guidance has recently been girls at age 11 or 12 years, with HPV vaccine use IAC’s Redesigned issued for the use of vaccines by the Centers for recommended for females through age 26 and for “Talking About Vaccines” Web Section...... 2 Disease Control and Prevention’s (CDC) Advisory males through age 21, as well as for men through Committee on Immunization Practices (ACIP) age 26 who are immunocompromised or who have Vaccine Highlights...... 4 in 2015 and more will be published soon. The gui- sex with men. For females, the 2-valent (2vHPV, Recommended U.S. Adult dance covers the use of 9-valent human papil- Cervarix, GlaxoSmithKline), 4-valent (4vHPV, Immunization Schedule...... 16 lomavirus vaccine (9vHPV, Gardasil 9, Merck); Gardasil, Merck), or 9-valent (9vHPV) HPV meningococcal serotype B vaccines (MenB: vaccines may be used. For males, either 4vHPV Guide to Contraindications and Precautions Bexsero, GlaxoSmithKline; Trumenba, Pfizer); or 9vHPV should be administered. Any recom- to Commonly Used Vaccines in Adults...... 9 influenza vaccines, typhoid vaccines (Typhim Vi, mended HPV vaccine, including 9vHPV, may be Vaccination Schedules for All Adults Sanofi Pasteur; Vivotif, PaxVax) and yellow fever used to complete a previously begun HPV vaccine and High-risk Adults...... 10 vaccine (YF, YF-VAX, Sanofi-Pasteur). series. Updated ACIP HPV recommendations are The following provides a brief summary of the available online at www.cdc.gov/mmwr/pdf/wk/ Vaccinations for Pregnant Women...... 11 recent changes voted upon at the February ACIP meet- mm6411.pdf, pages 300–304. Patient Handout: Protect Yourself from ing, as well as recommendations recently published Pneumococcal Disease...Get Vaccinated!...... 12 in Morbidity and Mortality Weekly Report (MMWR). Influenza vaccine Medical Management of Vaccine Reactions Human papillomavirus vaccine At its February meeting, ACIP voted to approve in Adults...... 13 its annual influenza vaccine recommendations for On March 27, MMWR published “Use of 9-Valent the 2015–2016 influenza season. The committee Handy VIS Reference Charts...... 14 Human Papillomavirus (HPV) Vaccine: Updated reaffirmed the need for annual influenza vac- The Vaccine Handbook: HPV Vaccination Recommendations of the ACIP.” cination for all people age 6 months and older. A Practical Guide for Clinicians...... 15 The new 9vHPV vaccine is recommended for Access a related CDC press release at www.cdc. use along with the other HPV vaccines already gov/media/releases/2015/s0226-acip.html. IAC’s Immunization Resources Order Form...... 18 recommended for use by ACIP. The recommen-

dations include HPV vaccination of all boys and Recommendations...continued on page 5 

Are healthcare personnel at risk of occupa- HPV vaccine tional infection with HPV? Ask the Occupational infection with HPV is possible. Which types of HPV are most likely Some HPV-associated conditions (including ano- to cause disease? genital and oral warts, anogenital intraepithelial Experts Of the annual average of 26,900 HPV-related can- neoplasias, and recurrent respiratory papilloma- The Immunization Action Coalition extends thanks cers in the United States, approximately 64% are tosis) are treated with laser or electrosurgical to our experts, medical officer Andrew T. Kroger, attributable to HPV 16 or 18 (65% for females; 63% procedures that could produce airborne particles. MD, MPH, and nurse educator Donna L. Weaver, for males; approximately 21,300 cases annually), These procedures should be performed in an RN, MN, both with the National Center for Immu- which are included in all three HPV vaccines. Ap- appropriately ventilated room using standard nization and Respiratory Diseases at the Centers proximately 10% are attributable to HPV types 31, precautions and local exhaust ventilation. Workers for Disease Control and Prevention (CDC). 33, 45, 52, and 58 (14% for females; 4% for males; in HPV research laboratories who handle wild- approximately 3,400 cases annually), which are type virus or “quasi virions” might be at risk of included in the 9-valent HPV vaccine. HPV type acquiring HPV from occupational exposures. In Stay current with FREE subscriptions 16, 18, 31, 33, 45, 52, or 58 account for about 81% The Immunization Action Coalition’s of cervical cancers in the United States. Ask the Experts...continued on page 22  2 periodicals, Vaccinate Adults and Approximately 50% of cervical precancers Needle Tips, and our email news (CIN2 or greater) are caused by HPV 16 or 18 and service, IAC Express, are packed 25% by HPV 31, 33, 45, 52, or 58. HPV 6 or 11 Immunization questions? with up-to-date information. cause 90% of anogenital warts (condylomata) and Email [email protected] Subscribe to all 3 free publications in most cases of recurrent respiratory papillomatosis.  Call your state health department one place. It’s simple! Go to More information about HPV and HPV-related   (phone numbers at cancers is available in the 2014 HPV ACIP state- www.immunize.org/subscribe www.immunize.org/coordinators) ment at www.cdc.gov/mmwr/pdf/rr/rr6305.pdf. Recommendations...continued from page 1 No preference was stated on the use of one MenB Typhi (i.e., microbiologists/laboratory workers and vaccine over the other. intimate contacts of documented chronic carriers). Meningococcal B vaccine ACIP delayed its discussion about the use of MenB vaccine in adolescents and college students Yellow fever vaccine Also in February, ACIP voted that a series of either until the June meeting. of the recently licensed MenB vaccines should ACIP voted to recommend that a single dose of be administered to people 10 years of age and Typhoid vaccine yellow fever (YF) vaccine provides long-lasting older who are at increased risk of meningococcal protection and is adequate for most travelers. disease. These individuals include: On March 27, CDC published “Updated Recom- ACIP also stated that additional doses of YF • People with persistent complement component mendations for the Use of Typhoid Vaccine – ACIP, vaccine may be indicated for certain populations. deficiencies, including inherited or chronic U.S., 2015” in MMWR (www.cdc.gov/mmwr/pdf/ A booster dose of YF vaccine may be considered deficiencies in C3, C5-9, properdin, factor D, wk/mm6411.pdf, pages 305–308). for travelers who received their last dose at least factor H, or taking eculizumab; These revised ACIP recommendations include 10 years previously and who will be in a higher- • People with anatomic or functional asplenia, updated information on the two currently available risk setting based on season, location, activities, including sickle cell disease; typhoid vaccines and on vaccine safety. Routine and duration of their travel. For more details, see • Microbiologists routinely exposed to isolates of typhoid vaccination is not recommended in the IAC’s ACIP meeting summary in “Technically Neisseria meningitidis; and U.S. The vaccine is recommended for international Speaking,” April 2015, www.immunize.org/ • People identified to be at increased risk because travelers to specific areas, as well as for those technically-speaking/20150401.asp. of a meningococcal B outbreak. who are routinely exposed to Salmonella serotype

Apply for IAC’s Influenza Vaccination Honor Roll Join more than 500 healthcare Laminated U.S. settings already honored! Immunization Schedules

Purchase IAC’s laminated versions of the 2015 U.S. immunization schedules for children (0–18 years old) and This honor roll recognizes health- adults. Both are laminated care settings that have implemented and washable for heavy-duty mandatory vaccination policies for use, complete with essential healthcare personnel (HCP). footnotes, and printed in To find the healthcare settings listed color for easy reading. by state, visit www.immunize.org/ honor-roll/influenza-mandates/ honorees.asp More information and discount pricing options are available online To read position statements sup- at www.immunize.org/laminated- porting mandatory HCP vaccination schedules or see the order form from leading healthcare organizations on page 24. and professional medical societies or to apply, visit www.immunize.org/ honor-roll/influenza-mandates

Vaccinate Adults! • May 2015 • Immunization Action Coalition • (651) 647-9009 • www.immunize.org • www.vaccineinformation.org 5