Immunization Announcements - Resources

Stay Up-to-Date with the Immunization Program

Training Opportunity

December 4, 2012 -- Current Issues in Immunization NetConference 2012 Session 4 is open for registration.

Date and Time: December 13, 2012, 12 noon - 1 pm Eastern

Speakers and Topics:

Gregory S Wallace, MD, MS, MPH: What's New in the Prevention of Measles, Rubella, Congenital Rubella Syndrome (CRS), and Mumps
Donna L. Weaver, RN, MN: Screening for Contraindications and Precautions

Updated Vaccine Resolutions

November 20, 2012 -- The Immunization Program is pleased to announce the release of three Vaccines for Children (VFC) Resolutions. VFC resolutions passed by the Advisory Committee on Immunization Practices (ACIP) form the basis for VFC program policies on vaccine availability and usage. VFC vaccine must be administered according to the guidelines outlined by the ACIP in the VFC resolutions. Resolutions for the following vaccines were updated in October 2012: Diphtheria, Tetanus, and Pertussis, Meningococcal, and Influenza.

Diphtheria, Tetanus, and Pertussis No. 10/12-1, VACCINES TO PREVENT DIPHTHERIA, TETANUS AND PERTUSSIS: Resolution 6/11-2 is repealed and replaced by this new resolution. Resolution No. 10/12-1 was adopted and became effective October 24, 2012. The purpose of this resolution is to revise the previous resolution to incorporate new recommendations regarding the vaccination of pregnant adolescents.
Meningococcal No. 10/12-2, VACCINES TO PREVENT MENINGOCOCCAL DISEASE. Resolution 6/11-1 is repealed and replaced by this new resolution. Resolution No. 10/12-2 was adopted and became effective October 24, 2012. The purpose of this resolution is to (1) update the eligible groups for meningococcal vaccination to include children aged 2 through 8 months of age at increased risk of meningococcal disease and to remove children with HIV infection, and to (2) update the recommended vaccine schedule to include another conjugated meningococcal vaccine schedule as an option.
Influenza

Resolution No. 10/12-3

National Influenza Vaccination Week is December 2-8, 2012

November 19, 2012 -- National Influenza Vaccination Week (NIVW) is a nationwide effort to remind everyone to highlight the importance of influenza vaccine. This year, NIVW will be observed from December 2-8. We encourage everyone who wishes to protect themselves and those around them from influenza to receive the flu vaccine as soon as possible, and to promote influenza vaccination at every opportunity.

Although we are optimistic, there is much room for increased vaccination coverage in our state, and we hope that this year, more people will be vaccinated than ever before. Vaccine is plentiful and available. The vaccine is safe and effective. In Florida, flu incidence usually peaks in February, but often peaks later. Make an extra effort this season to promote influenza vaccine until the supply is exhausted.

The Immunization Program has developed materials for this event and posted them for public download, use, and distribution from our publications website at NIVW Posters. Other materials and ideas for events are available at CDC NIVW Materials.

Training Opportunities

Current Issues in Immunization NetConference Special Vaccine Storage and Handling Webinar has been scheduled.

Date: November 29, 2012

Time: 12:00 noon to 1:00 pm (Eastern Time)

This is a limited registration event. Registration will close on November 28th or when the course is full. Please register early!

Speakers and Topics:

Dr. Chesley Richards, Director, Immunization Services Division, NCIRD: Impact and Importance of Proper Vaccine Storage and Handling

Patricia Beckenhaupt RN, MS, MPH, Public Health Analyst: Updated Vaccine Storage Recommendations

JoEllen Wolicki RN BSN, Nurse Educator: Storage and Handling Best Practices and Resources for Providers

On-demand replays and presentations will be available shortly after each event. Continuing education units are offered. Visit CDC Online Training for more information.

Families Fighting Flu Working Together to Protect Children Against the Flu Working Together to Protect Children Against the Flu has been scheduled.

Date: November 29, 2012

Time: 12:00 noon to 1:00 pm (Eastern Time)

As a mom or mom-to-be, it's important to stay informed and to always be prepared. To help, Families Fighting Flu (FFF) invites you to join an educational webinar to learn about protection from the flu for pregnant women, new moms, including those who are breastfeeding, and young children. Dr. Kevin Ault, professor, Department of Gynecology and Obstetrics at Emory University School of Medicine will be discussing what moms and moms-to-be should know and do to keep themselves and their families healthy during flu season. Julie Moise, a parent and FFF board member, will also share her personal story about her infant's battle with influenza and her involvement with FFF.

Question and answer session to follow speaker presentations.

Please, visit Families Fighting Flu for more information about influenza educational resources for parents and providers.

VIS News: Update to Multi Vaccine Information Statement

November 19, 2012 -- The updated Multi-Vaccine Information Statement (VIS) was posted on November 16, 2012 by the Centers for Disease Control and Prevention (CDC). This VIS presents the benefits and risks of six routine childhood vaccines. It also contains information about reporting an adverse reaction and the National Vaccine Injury Compensation Program, and how to get more information about vaccines and vaccine-preventable diseases. (Individual VISs are also available for these vaccines.)

Vaccine Information Statements are information sheets produced by the CDC that explain to vaccine recipients, their parents, or their legal representatives both the benefits and risks of a vaccine. Federal law requires that VIS be handed out when (before each dose) certain vaccinations are given.

Print-ready files can be found on the CDC website at Multi Vaccine VIS. Many Vaccine Information Statements are available in Spanish and other languages. See Immunization Action Coalition VIS.

The updated VIS has been integrated in the Florida State Health Online Tracking System (SHOTS), so registry users can access them electronically. Healthcare providers should periodically access the VIS electronically and print out a supply for routine distribution. If necessary, Immunization Program staff can FAX copies to providers without internet access.

World Pneumonia Day is November 12, 2012

November 8, 2012 -- In the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report on November 9, 2012, the announcement for World Pneumonia Day (November 12) was published. Pneumonia is the leading killer of young children around the world, causing approximately 20% of all child deaths. For countries to reach United Nations Millennium Development Goal 4 of reducing child mortality by two thirds (from 1990 levels) by 2015, interventions to prevent pneumonia deaths need to be implemented. Illness and deaths from pneumonia can be reduced with the use of Streptococcus pneumoniae (pneumococcus), Haemophilus influenzae type b (Hib), influenza, and measles vaccines; antimicrobial treatments; and exclusive breast feeding of young infants, among other strategies.

The fourth annual World Pneumonia Day is being observed November 12, 2012, to raise awareness about pneumonia's toll and to promote interventions to protect against, treat, and prevent the disease globally. Activities are being promoted by a coalition of more than 140 community-based organizations, academic institutions, government agencies, and foundations

November is National Diabetes Month

November 2, 2012 -- November is National Diabetes Month. In 2010, nearly 26 million persons in the United States had diabetes, and an estimated 79 million adults had prediabetes. Persons with diabetes can take steps to control the disease and prevent complications, and those with prediabetes can prevent or delay the onset of type 2 diabetes through weight loss and physical activity.

Diabetes can occur at any age. To address the burden of diabetes among U.S. youths, CDC and the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health support the SEARCH for Diabetes in Youth study. The study provides estimates of the incidence and prevalence of diabetes in young persons in the United States.

Persons with diabetes might be exposed to bloodborne viruses through contaminated equipment. Insulin pens and similar devices for delivery of diabetes medications are meant for one person only and should never be shared. New resources include print materials to raise awareness about the basics of injection safety. Because adults with diabetes are at increased risk for developing kidney disease, CDC also is launching the National Chronic Kidney Disease Surveillance System to monitor chronic kidney disease trends in the United States.

World Polio Day is October 24

October 19, 2012 -- World Polio Day (October 24) was established by Rotary International over a decade ago to commemorate the birth of Jonas Salk, who led the first team to develop a vaccine against poliomyelitis. Use of this inactivated poliovirus vaccine and subsequent widespread use of the oral poliovirus vaccine developed by Albert Sabin led to establishment of the Global Polio Eradication Initiative (GPEI) in 1988. Since then, GPEI has reduced polio worldwide by 99%; however, in 2012, transmission of indigenous wild poliovirus has continued uninterrupted in three countries (Nigeria, Afghanistan, and Pakistan). In April 2012, the World Health Assembly declared the completion of polio eradication a programmatic emergency for global public health.

Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine for Adults with Immunocompromising Conditions: Recommendations of the Advisory Committee on Immunization Practices (ACIP)

October 19, 2012 -- On June 20, 2012, the Advisory Committee on Immunization Practices (ACIP) published Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine for Adults with Immunocompromising Conditions: Recommendations of the Advisory Committee on Immunization Practices (ACIP) recommending routine use of 13-valent pneumococcal conjugate vaccine (PCV13; Prevnar 13, Wyeth Pharmaceuticals, Inc., a subsidiary of Pfizer, Inc.) for adults aged â¥19 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid (CSF) leaks, or cochlear implants. PCV13 should be administered to eligible adults in addition to the 23-valent pneumococcal polysaccharide vaccine (PPSV23; Pneumovax 23, Merck & Co. Inc.), the vaccine currently recommended for these groups of adults. The evidence for the benefits and risk of PCV13 vaccination of adults with immunocompromising conditions was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework and designated as a Category A recommendation. This report outlines the new ACIP recommendations for PCV13 use; explains the recommendations for the use of PCV13 and PPSV23 among adults with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants; and summarizes the evidence considered by ACIP to make its recommendations.

National and State Vaccination Coverage Among: Children in Kindergarten and Adolescents Aged 13–17 Years — United States, 2011

September 4, 2012 -- The Florida Department of Health Immunization Program announces two pertinent Centers for Disease Control and Prevention (CDC), Morbidity and Mortality Weekly Report (MMWR) publications.

Vaccination Coverage Among Children in Kindergarten — United States, 2011–12 School Year; August 24, 2012 / 61(33);647-652

To identify areas of undervaccination for vaccine-preventable diseases, state and local health departments monitor compliance with school immunization requirements using annual school vaccination assessment reports, supported as a CDC immunization funding objective for the 64 grantees, including the 50 states, the District of Columbia (DC), five cities, and eight other reporting areas. The CDC also monitors progress toward meeting Healthy People 2020 objectives for the vaccination of children entering kindergarten. Although statewide levels of vaccination coverage are at or very near target levels, locally low vaccination coverage for extremely transmissible diseases such as measles remains a threat to health. This report summarizes vaccination coverage, exemption rates, and reporting methods from the 2011-2012 school year kindergarten vaccination assessments.

National and State Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2011: August 31, 2012 / 61(34);671-677

Since 2005, the Advisory Committee on Immunization Practices (ACIP) has expanded the routine adolescent vaccination schedule with administration of the following vaccines at 11 or 12 years of age: meningococcal conjugate (MenACWY); tetanus-diphtheria-pertussis (Tdap); human papillomavirus (HPV); and influenza. The CDC analyzed data from the National Immunization Survey-Teen (NIS-Teen). This report summarizes the results of that assessment. Adolescent vaccination coverage increased from 2006 to 2011, although the rate of increase differed by vaccine.

Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) United States, 2012-13 Influenza Season

August 17, 2012 -- The Centers for Disease Control and Prevention (CDC) published Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) — United States, 2012–13 Influenza Season Morbidity and Mortality Weekly Report (MMWR) August 17, 2012 / 61(32);613-618. (Influenza Vaccines)

Important Pediatric Vaccine Supply Update

August 14, 2012 -- The Department of Health's Immunization Program would like to inform you that Sanofi Pasteur has extended its temporary order allocations for Pentacel® (diphtheria-tetanus-pertussis [DTaP], inactivated poliovirus [IPV], and Haemophilus influenzae type b [Hib]vaccine) through the first quarter of 2013. (Pentacel® Update)

Training Opportunity: Clinical Vaccinology Course

August 7, 2012 -- The Florida Department of Health Immunization Program would like to bring the following educational opportunity to your attention.

The National Foundation for Infectious Diseases (NFID) will be hosting the Clinical Vaccinology Course, scheduled for November 2-4, 2012 at the Hyatt Regency in Miami, Florida. This 2 1/2 day program of courses focuses on updated recommendations for vaccinations across the lifespan and innovative and practical strategies for ensuring timely and appropriate vaccination. Target audience includes physicians (family, internists, pediatricians, and infectious disease specialists); nurses; nurse practitioners; physician assistants; pharmacists; vaccine program administrators; federal, state, and local public health professionals; and other healthcare professionals interested in clinical aspects of vaccine delivery.

Collaborating partner organizations to date include: American Academy of Pediatrics, American College Health Association, American Medical Association, American Pharmacists Association, Centers for Disease Control and Prevention, National Community Pharmacists Association, Society for Adolescent Health and Medicine, Society of Infectious Diseases Pharmacists

Continuing education units will be offered for physicians, nurses, and pharmacists.

August is National Immunization Awareness Month

August 2, 2012 -- The Immunization Program is pleased to announce this year's observance of National Immunization Awareness Month in August.

National Immunization Awareness Month (NIAM) is the perfect time to promote immunizations and remind family, friends, and coworkers to get caught up on their shots. Immunizations aren't just for babies and young kids. We all need shots to help protect us from serious diseases and illness. Like eating healthy food, exercising and getting regular physicals, vaccines are important to your overall health. Vaccines are one of the most convenient, simplest and safest preventive care measures available.

An NIAM toolkit is available, and the Immunization Program has materials on our publications website.

Training Opportunity: Influenza Outlook: Strategies and Plans for the 2012-13 Flu Season

July 3, 2012 -- Mark your calendar and register today for the next VICNetwork (Virtual Immunization Communication Network) webinar scheduled for Wednesday July 25, 2012 at 2:00 pm ET.

Influenza Vaccine Information Statements (VIS) Update

July 3, 2012 -- Influenza Vaccine Information Statements (VIS), dated July 2, 2012, for the 2012-2013 flu season are available from the Centers for Disease Control and Prevention (CDC).

Utilizing the Vaccine Adverse Event Reporting System (VAERS)

July 3, 2012 -- The Bureau of Immunization would like to remind our immunization providers of the process for reporting adverse events following administration of any vaccines. The Vaccine Adverse Event Report System (VAERS) is a national vaccine safety surveillance program co-sponsored by the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA). VAERS is a post-marketing safety surveillance program, collecting information about adverse events (possible side effects) that occur after the administration of vaccines licensed for use in the U.S.

Healthcare providers should report any adverse event that occurs after the administration of a vaccine licensed in the U.S. You may report adverse events even if you are unsure whether a vaccine caused them.

The National Childhood Vaccine Injury Act (NCVIA) requires healthcare providers to report:

Any adverse event listed by the vaccine manufacturer as a contraindication to further doses of the vaccine.
Any adverse event listed in the VAERS Table of Reportable Events Following Vaccination that occurs within the specified time period after vaccination.

Anyone can file a VAERS report, including healthcare providers, manufacturers, and vaccine recipients. VAERS reports may be submitted by mail, fax or online.

Visit the VAERS Report an Adverse Event web page for more information. Please review the online help for data entry before entering reports using the online system. Prior to submitting the report electronically to VAERS, please print an additional copy of the report and fax it to the VAERS coordinator in the Bureau of Immunization at (850) 922-4195, with a cover sheet marked confidential.

Florida Department of Health Announces New Section Administrator

-Charles Alexander remains a leader at DOH and in his field of Immunizations-

June 20, 2012 -- TALLAHASSEE - Florida Department of Health's (DOH) Deputy Secretary of Health Dr. Steven Harris today announced Charles Alexander, as Section Administrator for the Division of Disease Control's newly created Section of Immunization, effective immediately. As leader of the Section of Immunization, Mr. Alexander will oversee statewide objectives and activities for the Department and County Health Departments (CHD).

"With over 35 years in public health, Charles Alexander is a state leader in immunizations," said Dr. Harris. "His appointment demonstrates the high esteem in which he is held with the Department."

Since 2001, Mr. Alexander has served as the Chief of the Bureau of Immunizations and with this appointment he remains a leader in his field. He facilitated the expansion of Florida's SHOTS (State Health Online Tracking System) Program, the Florida Vaccines for Children Program, and the Florida Early Childhood Immunization Initiative.

Mr. Alexander received a Bachelor of Science degree from McMurry College in Abilene, Texas. His career began in the Venereal Disease Program with the Centers for Disease Control and Prevention (CDC) in 1965. Mr. Alexander has also worked for public health programs in Tennessee, California, Connecticut, New York, Missouri, Wisconsin and Virginia.

The Florida Department of Health's mission is to protect and promote the health of all residents and visitors in the state through organized state and community efforts, including cooperative agreements with counties. For more information, visit the Florida Department of Health's website.

Clarification: 2012-2013 Immunization Update for Schools and Childcare Facilities

May 17, 2012 -- The Bureau of Immunization would like to provide further clarification of the Polio and Varicella vaccine requirements provided in the 2012-2013 Immunization Update (See Below) that was distributed on Wednesday, May 16, 2012.

Polio vaccine requirement:

Effective for the 2012-2013 school year, there must be documentation of at least one dose of polio vaccine administered on or after the 4th birthday for students entering Kindergarten only. The polio requirement is 4 doses, with the following exceptions:
- If 4th dose administered prior to 4th birthday, a 5th dose is required
- If 3rd dose is administered after 4th birthday, a 4th dose is not required

Varicella vaccine intervals in accordance with the Advisory Committee on Immunization Practices (ACIP) are:

Minimum interval between varicella vaccine doses is 3 months for children 12 months through 12 years of age. However, if the 2nd dose is inadvertently given at least 4 weeks after the 1st dose, the 2nd does not need to be repeated.
Minimum interval between varicella vaccine doses is 4 weeks for persons beginning the varicella series on or after the 13th birthday.

The vaccine intervals are referenced in the Centers for Disease Control and Prevention immunization schedules.

2012-2013 Immunization Update for Schools and Childcare Facilities

May 16, 2012 -- The Florida Department of Health (DOH), Bureau of Immunization would like to remind all immunization partners of the childcare facilities and school immunization requirements for the 2012-2013 school year. Documentation for required immunizations is mandatory for all students entering, attending, or transferring into a Florida school in grades pre-Kindergarten (K) through 12 as detailed in the Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes, effective July 2011 and incorporated by reference in Chapter 64D-3.046, Florida Administrative Code. The Guidelines, located at the Bureau of Immunization website, provide technical assistance to healthcare providers, schools, childcare facility operators, family daycare home operators, school health personnel, and county health department personnel, and are only updated when there are any legislative changes to childcare and/or school requirements.

A flyer summarizing the school immunization requirements is available in English, Spanish, and Haitian Creole.

We encourage individuals not to wait for the school rush. There is no time like the present to update children's immunizations and provide them with the required documentation for school. Many healthcare providers and families have begun the process to get ready for the new school year. Immunizations should be updated at each encounter, including annual physicals, interim check-ups or sport physicals.

The following information summarizes the latest updates.

Childcare Facilities

Effective January 1, 2012, pneumococcal conjugate vaccine (age-appropriate number of doses) is now required for all children 2 through 59 months of age.

Grades K through 12

Effective for the 2012-2013 school year, there must be documentation of at least one dose of polio vaccine administered on or after the 4th birthday. The requirement is 4 doses, with the following exceptions:
- If 4th dose administered prior to 4th birthday, a 5th dose is required
- If 3rd dose is administered after 4th birthday, a 4th dose is not required
One dose of varicella vaccine is required for grades 5 through 11 (or healthcare provider's documentation of evidence of disease)
Two doses of varicella vaccine is required for grades K through 4 (or healthcare provider's documentation of evidence of disease)
Tetanus-diphtheria-pertussis (Tdap) vaccine is required for grades 7 through 10

There is some confusion regarding Part B: Temporary Medical Exemptions (TMEs). The Form DH 680, Florida Certification of Immunization, provides a selection for either Code 1 (K through 12) or Code 8 (7th Grade requirement). A number of healthcare providers have been providing kindergarten students who meet all kindergarten requirements with a TME extending until the student is due to enter 7th grade.

A TME should be completed only if a child is not fully immunized for their current school grade, based on the proper spacing of vaccines. The expiration date should coincide with the date that the child is due to receive his/her next immunization based on the catch-up schedule. For example, a kindergarten student receives a dose of varicella vaccine the day prior to entering school and is required to receive a second dose of varicella vaccine as required for school attendance. A TME is issued for the child to return in a minimum of four weeks to receive the second dose of varicella vaccine. The improper issuance of TMEs has a negative effect on the overall compliance rates when assessing each county's coverage for school immunizations.

Providers should select Part A, Code 1, for children who have completed the requirements for Kindergarten. TMEs must not be issued for children complete for Kindergarten.
Providers should enter Part A, Code 8, for students entering grades 7 through 10 and who have completed the Tdap requirement.

Form DH 681, Religious Exemption from Immunization, can be accessed by county health departments through the immunization registry, the Florida SHOTS™ (Florida State Health Online Tracking System). Form DH 681 will no longer be available from the Distribution Center once the current inventory is depleted. Please contact the Florida SHOTS™ staff at (877) 888-SHOT (7468) if you have questions regarding the electronic Form DH 681.

The table below may assist providers in determining the phase-in grade schedule for Tdap and varicella vaccine requirements.

Phase–In Schedule for Tdap* and Varicella Vaccines** for 2012/2013 through 2020/2021 School Years

School Year/ Grades	2012/ 2013 Grades	2013/ 2014 Grades	2014/ 2015 Grades	2015/ 2016 Grades	2016/ 2017 Grades	2017/ 2018 Grades	2018/ 2019 Grades	2019/ 2020 Grades	2020/ 2021 Grades
1 Varicella	5-11	6-12
2 Varicella	K-4	K-5	K-6	K-7	K-8	K-9	K-10	K-11	K-12
Tdap	7-10	7-11	7-12	7-12	7-12	7-12	7-12	7-12	7-12

*Tetanus/Diphtheria/Pertussis vaccine

**Or documentation of evidence of disease

Guidance for Immunization Providers During the 2012 Pentacel® and Daptacel® Shortage

May 14, 2012 -- We are pleased to share Guidance for Vaccinating Children During the 2012 Pentacel® and Daptacel® Shortage which was provided to our offices by the Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD) on May 11, 2012. (Guidance During Shortage)

May is Older Americans Month

May 1, 2012 -- In May, we recognize Older Americans Month — a tradition dating back to 1963 — to honor the many contributions of our nation's older citizens. This year's theme "Never Too Old to Play" encourages older Americans to stay active in their own lives and in their communities. Older Americans are living longer and are more active than ever before. With the aging of the baby boomer generation — the largest in America's history — our senior population is expected to number 72.1 million by 2030. This increase will present all of us with tremendous opportunities, as well as, new challenges.

We know that preventing disease before it starts helps people live longer, healthier lives. The new healthcare law is giving older Americans greater control over their own health by providing many free preventive services in Medicare such as flu shots, mammograms, and an annual wellness visit so seniors can spend more time with their doctors. In 2011, more than 32.5 million seniors took advantage of one or more preventive services covered without cost-sharing.

Immunizations across the lifespan are a simple means of protecting the health of older Americans. Vaccines recommended for adults include: tetanus-diphtheria-pertussis (Tdap), measeles-mumps-rubella (MMR), influenza, pneumococcal, herpes zoster (shingles), hepatitis A, hepatitis B, and meningococcal. We encourage all Older Americans and those who serve them to check their immunization status and take the steps necessary to maximize their protection against vaccine-preventable diseases. Older Americans are a crucial element in the effort to cocoon the newborns in their families.

Please visit our adults web site and the Centers for Disease Control and Prevention's (CDC) for information about adult immunization recommendations.

To learn more about Older Americans Month visit the Administration on Aging's web site.

Vaccine Information Statement (VIS) Update - Measles-Mumps-Rubella (MMR)

May 1, 2012 -- The Centers for Disease Control and Prevention (CDC) has published a new MMR vaccine information statement (VIS). (MMR VIS)

Bureau of Immunization Launches the New www.ImmunizeFlorida.org

April 25, 2012 -- The Bureau of Immunization is pleased to unveil an innovative update to our website to help parents and other consumers in Florida learn about the most effective way to protect themselves and their children from vaccine-preventable disease. ImmunizeFlorida.org brings together the best resources on vaccine and immunizations to provide consumers with easy-to-understand health information specifically for their needs.

The new site makes it easy for parents to locate vaccine recommendations, immunization requirements for school or child care, and current information on specific vaccines. Adults will find important advice on their continuing immunization needs and travel vaccines. Healthcare providers will be able to find all the resources they need to provide timely and correct immunization services to their patients.

We urge everyone to visit the new site and learn more about how vaccines can protect the health of each family member as well as the entire state.

Important: Supply Delays for Pentacel® Vaccine

April 25, 2012 -- On April 20, 2012, Sanofi Pasteur notified the Centers for Disease Control and Prevention (CDC) of a temporary delay in their supply of Pentacel®. (Vaccine Supply Delay)

Announcing Florida's Childhood Immunization Champion Award Winner

April 24, 2012 -- The Bureau of Immunization is proud to announce that Parker Small, MD, has been selected as the first Centers for Disease Control and Prevention (CDC) Childhood Immunization Champion for the state of Florida. The CDC and the CDC Foundation launched this new annual awards program to honor immunization champions across the 50 U.S. and the District of Columbia during National Infant Immunization Week (April 21-28, 2012). Dr. Small was nominated and selected from a pool of healthcare professionals, coalition members, parents, and other immunization leaders as having made a significant contribution to public health in Florida through his work in children's immunization.

In an effort to increase vaccine rates among middle and elementary school students, Dr. Small served as the driving force behind the Alachua County, Florida, school-located influenza vaccination (SLIV) program. This program received national recognition as a model for community participation and high immunization rates. Through collaborative efforts, the program immunized 25% of the county's public and private preschool, elementary, and middle school students.

Young children rely on the champions in their lives to keep them safe and healthy. Champions may be parents who keep a record of their child's vaccinations and ask at each doctor appointment whether their child is up-to-date on immunizations. Champions may also be doctors, nurses, physician assistants, and other healthcare professionals who share scientifically-accurate, up-to-date information about vaccines with parents. Families, healthcare professionals, and public health officials must work together to help protect our children by making sure they are vaccinated according to the Advisory Committee on Immunization Practices (ACIP) recommended schedule. Dr. Small is an inspiration to all of us who care passionately about children's health in Florida, and we are pleased and honored to congratulate him on this well-deserved award.

To read Dr. Small's profile, and to learn more about the award, please visit on the CDC's Childhood Immunization Champion Award program website.

Immunization Update -- VariZIG™ for Post-exposure Prophylaxis of Varicella Disease

April 10, 2012 -- In May 2011, the Food and Drug Administration (FDA) approved an extended period for administering VariZIG™. (Post-exposure Prophylaxis)

Immunization Update -- Pneumococcal Conjugate Vaccine

April 10, 2012 -- The Bureau of Immunization would like to review the recommendations for the pneumococcal conjugate vaccine as detailed in the Recommended Immunization Schedule for Persons Aged 0 through 6 years—United States, 2012 and the Prevention of Pneumococcal Disease Among Infants and Children --- Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine; Morbidity and Mortality Weekly Report (MMRW); Recommendations and Reports; December 10, 2012 / 59(RR11);1-18. (Pneumococcal Conjugate Vaccine)

National Infant Immunization Week 2012 - April 21-28

April 9, 2012 -- We are pleased to announce this year's observance of National Infant Immunization Week (NIIW). We encourage all our immunization partners to promote the protection of children through timely immunization.

NIIW is an annual observance to promote the benefits of immunizations and to improve the health of children two years of age or younger. Since 1994, local and state health departments, national immunization partners, healthcare professionals, community leaders from across the U.S., and the Centers for Disease Control and Prevention (CDC) have worked together through NIIW to highlight the positive impact of vaccination on the lives of infants and children, and to call attention to immunization achievements. Please visit the CDC web-pages dedicated to this worldwide event.

This year's NIIW, set for April 21-28, 2012, will be celebrated as part of the first World Immunization Week (WIW), an initiative of the World Health Organization (WHO). During WIW, all six WHO regions, including more than 180 Member States, territories, and areas, will simultaneously promote immunization, advance equity in the use of vaccines and universal access to vaccination services, and enable cooperation on cross-border immunization activities in April 2012.

As part of WIW, NIIW will be held in conjunction with the Pan American Health Organization's (PAHO) Vaccination Week in the Americas (VWA). Communities across the U.S. and Western hemisphere will participate in awareness and education events, planned in conjunction with state and local health departments, PAHO, and the United States-Mexico Border Health Commission in sites along the U.S.-Mexican border.

See what is already planned, and add your event to this year's listing. When you visit the activities page, you will see a Florida location has posted their event on these nationally accessed pages.

More information, educational resources, and promotional materials can be accessed from the CDC page.

Advisory Committee on Immunization Practices (ACIP): Provisional Tdap Recommendations

March 23, 2012 -- On February 22, 2012, the ACIP voted to recommend tetanus toxoid-reduced diphtheria toxoid-acellular pertussis vaccine (Tdap) for adults aged 65 years and older. (Provisional Tdap Recommendations)

Vaccine Information Statement (VIS) - Human Papillomavirus (HPV) Vaccine

February 24, 2012 -- On February 22, 2012, a new Vaccine Information Statement (Interim) was posted for the Human Papillomavirus (HPV) vaccine, Gardasil®. (New HPV VIS)

Recommended Immunization Schedules for Persons 0 Through 18 Years of Age — United States, 2012

February 16, 2012 -- On February 9, 2012, the Centers for Disease Control and Prevention published the approved Recommended Immunization Schedules for Persons 0 Through 18 Years of Age — United States, 2012 in the Morbidity and Mortality Weekly Report (MMRW) February 10, 2012 / 61(05);1-4. We are pleased to bring this year's childhood immunization schedule to the attention of our immunization partners.

The article is presented for your review below.

Each year, the Advisory Committee on Immunization Practices (ACIP) publishes immunization schedules for persons 0 through 18 years of age. These schedules summarize recommendations for currently licensed vaccines for children 0 through 6 years of age, 7 through 18 years of age, and catch-up immunization for persons 4 months through 6 years of age, and include recommendations in effect as of December 23, 2011.

Vaccination providers are being advised to use all three schedules and their respective footnotes together and not separately.

A parent-friendly schedule for children and adolescents is available online.

Changes to the previous schedules include the following:

Recommended immunization schedule for persons 0 through 6 years of age:

Quadrivalent meningococcal conjugate vaccine (MCV4) purple bar has been extended to reflect licensure of MCV4-D (Menactra) use in children as young as 9 months of age.
A wording change has been introduced in the hepatitis A (HepA) vaccine yellow bar; wording now states, "Dose 1." A new yellow and purple bar has been added to reflect HepA vaccine recommendations for children 2 years of age and older.
Guidance is provided for administration of hepatitis B (HepB) vaccine in infants with birthweights less than 2,000 grams and 2,000 grams or more. Clarification is provided for doses after administration of the birth dose of HepB vaccine.
Rotavirus (RV) vaccine footnotes have been condensed.
Haemophilus influenzae type b (Hib) conjugate vaccine footnotes have been condensed, and use of HiberixÂ® for the booster (final) dose has been clarified. Guidance for use of Hib vaccine in persons 5 years of age and older in the catch-up schedule has been updated.
Pneumococcal vaccine footnotes have been condensed.
Guidance is provided for use of measles-mumps-rubella (MMR) vaccine in infants 6 through 11 months of age. Footnotes in the catch-up schedule have been condensed.
HepA vaccine footnotes have been updated to clarify that the second dose of HepA vaccine should be administered 6 to 18 months after dose 1.
MCV4 footnotes have been updated to reflect recent recommendations published in the MMWR.
Influenza vaccine footnotes have been updated to provide guidance on live, attenuated influenza vaccine (LAIV) contraindications.
Influenza vaccine footnotes also have been updated to clarify dosing for children aged 6 months through 8 years for the 2011-2012 and 2012-2013 seasons.

Recommended immunization schedule for persons 7 through 18 years of age:

Updated to include number of doses for each vaccine.
Information regarding the recommended age (16 years) for the booster dose of MCV4 has been added.
Tdap vaccine recommendations for children 7 through 10 years of age have been updated.
Human papillomavirus (HPV) vaccine footnotes have been updated to include routine recommendations for vaccination of males.
Varicella (VAR) vaccine footnotes have been condensed.
Inactivated poliovirus vaccine (IPV) footnotes have been updated to include upper age limit for routine vaccination. IPV footnotes in the catch-up schedule have been condensed, and relevant wording added to the catch-up schedule.

Catch-up immunization schedule for persons 4 months through 18 years of age who start late or who are more than 1 month behind:

HepA vaccine and HepB vaccine footnotes have been removed. Relevant wording has been added to the schedule.
MCV4 vaccine has been added along with corresponding footnotes.

The recommended immunization schedules for persons 0 through 18 years of age and the catch-up immunization schedule for 2012 are approved by the ACIP, the American Academy of Pediatrics, and the American Academy of Family Physicians.

The National Childhood Vaccine Injury Act requires healthcare providers to provide parents/guardians or patients with copies of Vaccine Information Statements before administering each dose of the vaccines listed in the schedules.

Distribution of Standard Vaccine Temperature Logs

February 10, 2012 -- The Bureau of Immunization is pleased to share with our immunization partners the availability of a standard vaccine temperature log for use in monitoring temperatures in vaccine storage units. We feel these new temperature logs emphasize the importance of protecting your investments, both in those you serve, and in the vaccines you administer. Recalling and revaccinating children can be inconvenient, time-consuming and costly, often leaving them underprotected for some time. Replacing a compromised vaccine supply is definitely costly. Vaccine accountability and storage and handling issues are always an opportunity for quality control. This tool will assist providers in protecting their vaccine inventory.

The Bureau has printed a set of Vaccine Temperature Logs and distributed them statewide to all providers currently enrolled in our Vaccines for Children (VFC) Program. Each provider on our VFC Program mailing list with a valid address should be receiving a 6 months supply of logs for the refrigerator and freezer. These logs are designed such that each sheet can be used to document AM and PM readings for 15 days for a single storage unit. They should be arriving soon, if not already.

There are several reasons why we believe these will be useful:

The standardized form will decrease occurrence of temperature excursions without immediate action. We have noted that many providers are still using columnar-style log sheets. This chart format clearly identifies out-of-range temperatures, minimizing misinterpretation by staff. Temperature readings are entered by hand, and users are prompted to take action when the temperature is outside acceptable vaccine storage temperature ranges.

The standardized form increases ease of identifying out-of-range temperatures. Review of temperature excursion events from the past several years indicates that the overwhelming majority occur in offices where columnar temperature logs are in use. The temperature chart makes noting out-of-range temperatures simpler by eliminating a need to scan a list. Excursion time endpoints are clear on the chart.

The standardized form increases the efficiency of Bureau Field Staff time by providers during office visits. Reducing the variance in forms allows field staff to interpret the data provided more quickly, thereby increasing the efficiency of the time they spend in each provider's office. Working with multiple forms requires field staff to use additional time to interpret data. Less time interpreting temperature charts means more time spent providing training, technical assistance and improving coverage rates.

We strongly recommend that each provider begin using these standardized forms. Additional copies can be printed using the pdf file located on the VFC Program Forms webpage.

Childhood Immunization Champion Award

February 7, 2012 -- The Centers for Disease Control and Prevention (CDC) would like to introduce the Childhood Immunization Champion Award, a new annual award to recognize individuals who make a significant contribution toward improving public health in their communities through their work in childhood immunization. We realize that each of you has an Immunization Champion in your midst. Let's take the opportunity to garner some accolades for the great immunization partners in our state. One CDC Immunization Champion from each of the 50 states and the District of Columbia will be honored during National Infant Immunization Week (NIIW), April 21-28, 2012.

Nominations are due to Laura Rutledge, Executive Community Health Nursing Director, Bureau of Immunization, by February 20, 2012 at the email listed below. Note: Please disregard the Due Date of February 10 on the application. (Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.)
Immunization@doh.state.fl.us

Included at the CDC's Childhood Immunization Champion Award webpage, are various resources you can use to promote this new award program and solicit nominations for deserving Champions from your community. These resources include a one page flyer, posting information for Facebook and Twitter, a web link, a newsletter notice and the award logo. For more information, contact Helen Fox Fields at hfields@immunizationmanagers.org.

Award Criteria

A CDC Childhood Immunization Champion is an individual who meets one or more of the following criteria:

Has provided community leadership on immunization issues and collaborated with others to build support for increasing immunization rates among infants and young children.
Has used creative and/or innovative strategies to promote infant and young child immunization and meet unique immunization challenges within their community, state or region, including, for example, reaching hard-to-reach or under-immunized populations.
Has been a visible immunization champion in a community and/or medical system by acting as a spokesperson, advocate, and/or educator.
Has been an advocate for immunization policy advancements.

Eligibility

Champions can include healthcare professionals (e.g., physicians, nurses, physicians' assistants, nurse practitioners, medical assistants, etc.), coalition members, parents, and other immunization leaders who meet the award criteria. State immunization program managers, state and federal government employees of health agencies, and individuals who have been affiliated with and/or employed by pharmaceutical companies are not eligible to apply (see page 6 of the nomination packet for more details). It is important to consider who the employer is when determining eligibility. If an individual's salary is paid directly by a health agency within the state or federal government, they would be considered a state or federal government.

Recommended Adult Immunization Schedule — United States, 2012

February 6, 2012 -- The Bureau of Immunization is pleased to notify our partners of the release of the Recommended Adult Immunization Schedule — United States, 2012, in the Morbidity and Mortality Weekly Report (MMWR) February 3, 2012/61(04);1-7. The recommended immunization schedules for adults is approved by the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics, and the American Academy of Family Physicians.

Each year, the ACIP reviews the recommended Adult Immunization Schedule to ensure that the schedule reflects current recommendations for the licensed vaccines. The primary changes include:

A new footnote to links for the full ACIP vaccine recommendations and where to find additional information on specific vaccine recommendations for travelers.
Table summarizing precautions and contraindications was added.
Tetanus-diphtheria-pertussis (Tdap) and tetanus-diphtheria (Td) vaccines - Footnote for updated to indicate:
- Tdap vaccine is recommended for all persons who are close contacts of infants younger than 12 months of age (e.g., parents, grandparents, and childcare providers) and who have not received Tdap previously.
- Tdap vaccine is recommended for pregnant women during later pregnancy (>20 weeks gestation).
- Other adults who are close contacts of children younger than 12 months of age continue to be recommended to receive a one-time dose of Tdap vaccine.
Human papillomavirus (HPV) vaccine - Footnote updated to include routine vaccination of males 11-12 years of age, with catch-up vaccination recommended for males 13-21 years of age. Also now recommended for previously unvaccinated males 22-26 years of age who are immunocompromised, or who test positive for human immunodeficiency virus (HIV) infection, or who have sex with men.
Hepatitis B vaccine - Footnote updated to include the recommendation to vaccinate adults younger than 60 years of age who have diabetes, as soon as possible after diabetes is diagnosed. Also now recommended at the discretion of the treating clinician for adults with diabetes who are 60 years of age or older based on a patient's likely need for assisted blood glucose monitoring, likelihood of acquiring hepatitis B, and likelihood of immune response to vaccination.
Zoster vaccine â Notes recently approved by FDA for administration to persons 50 years of age and older; however, the ACIP continues to recommend that vaccination begin at 60 years of age.
Influenza vaccine - Footnote revised to specify age indications for the different licensed formulations of trivalent inactivated influenza vaccine (TIV).
Measles-mumps-rubella (MMR) vaccine - Footnote simplified to focus only on routine use of this vaccine in adults. Readers referred to the ACIP's MMR and healthcare personnel recommendations regarding the use of MMR vaccine in outbreak settings.
Meningococcal conjugate vaccine (MCV4) and meningococcal polysaccharide vaccine (MPSV4) - Specific information added for specific age and risk groups.

The National Childhood Vaccine Injury Act requires healthcare providers to provide parents/guardians or patients with copies of Vaccine Information Statements (VIS) before administering each dose of the vaccines listed in the schedules.

Immunization Update

January 29, 2012 -- As a result of considerable interest being expressed in the following issues, the Bureau of Immunization would like to provide the following questions and answers (Q&A) to all County Health Departments (CHDs). We hope this information will be useful in implementing the new polio requirement for kindergarten students and completing the Form DH 681, Religious Exemption from Immunization.

1. When will the new requirement for the polio (IPV) vaccine series be required for entry into kindergarten?

Effective for the 2012/2013 school year, the final dose of the IPV vaccine must be administered on or after the student's 4th birthday for entry into kindergarten. The effective date for the new IPV requirement is changed to the 2012/2013 school year due to the lengthy delay in finalizing the Rule (Chapter 64D-3.046, Florida Administrative Code [FAC]) change.
A 5th dose is required If the 4th dose was administered prior to the 4th birthday.
A 4th dose is not necessary if the 3rd dose was administered on or after the 4th birthday.
Students in grades 1 through 12 do not have to be recalled if all 4 polio doses were administered prior to 4th birthday. This requirement applies only to students entering kindergarten, effective for school year 2012/2013.

2. What is the process for providing parents/guardians with a Form DH 681, Religious Exemption from Immunization?

The CHD will provide a Form DH 681 to a parent/guardian, if requested due to their objection to immunizations for religious tenets or practices.
The electronically signed Form DH 681 can be accessed by the CHD in Florida SHOTS (Florida State Health Online Tracking System), printed and signed by the parent/guardian to take to the school.
The CHD can/should point out the specific language on the Form DH 681 (while the parent is signing the form) and also referenced in Section 1003.22, Florida Statute (FS) that: children identified as not being immunized against any communicable disease that is present in a Florida school, preschool or childcare facility shall be temporarily excluded for a time specified by the CHD director or administrator.
No other information or procedures should be requested of the parent/guardian for obtaining the Form DH 681.
The authority for this process is referenced in the following: Section 1003.22, FS; Chapter 64D-3.046, FAC, and the Immunization Guidelines Florida Schools, Childcare Facilities and Family Daycare Homes, Effective July 2011.

Immunization Update - Clarification

February 6, 2012 -- The Bureau of Immunization would like to provide further detail/clarification to the January 19, 2012 Immunization Update regarding the process for the provision of the Form DH 681, Religious Exemption from Immunization to parents and/or guardians.

The County Health Department (CHD) will provide a Form DH 681 to a parent/guardian, if requested in writing because immunizations are in conflict with their religious tenets or practices. Note that the Form DH 681 is a request in writing and the parent need not supply any additional information as proof of their religious tenets or practices.
The Form DH 681 is accessed by the CHD in Florida SHOTS.
The electronically certified/signed Form DH 681 represents the parent's (or guardian's) affirmation that a religious conflict exists and that they understand that: children identified as not being immunized against any communicable disease that is present in a Florida school, preschool or childcare facility shall be temporarily excluded for a time specified by the CHD director or administrator.
The Form DH 681, once electronically certified/signed, will be part of the child's electronic immunization record and accessible to the child's healthcare provider in Florida SHOTS. While the healthcare provider may access, view and print the Form DH 681, only CHDs may issue or rescind the form.
The parent's or guardian's name will be printed on the electronic signature line.
No other information or procedures should be requested of the parent/guardian for obtaining the Form DH 681.
The authority for this process is referenced in the following: Chapter 1003.22, FS; Chapter 64D-3.046, FAC, and the Immunization Guidelines Florida Schools, Childcare Facilities and Family Daycare Homes, Effective July 2011.

Please contact the Florida SHOTS staff at (877) 888-SHOT (7468) if you have questions regarding the electronic Form DH 681.

Vaccine Information Statement (VIS) - Tdap

January 25, 2012 -- On January 24, 2012, the Centers for Disease Control and Prevention (CDC) published a new Vaccine Information Statement (VIS) that can be used for both tetanus-diphtheria-pertussis (Tdap) and tetanus-diphtheria (Td) vaccines. (Tdap VIS)

Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes

January 11, 2012 -- The Bureau of Immunization is pleased to announce the final release of the revised Immunization Guidelines for Florida Schools, Childcare Facilities, and Family Daycare Homes, Effective July 2011, and incorporated by reference in amended Chapter 64D-3.046, Florida Administrative Code, which became effective December 29, 2011.

The guidelines, which provide technical assistance to healthcare providers, schools, childcare facility operators, family daycare home operators, school health personnel, and County Health Department (CHD) personnel, are only updated when there are any legislative changes to childcare and/or school requirements.

Updates and clarifications to school and childcare requirements include:

Effective January 1, 2012, pneumococcal conjugate vaccine (age-appropriate doses) is now required for all children 2 to 59 months of age attending childcare facilities.
The DH Form 680, Florida Certification of Immunization, has also been updated with minor revisions. The updated DH Form 680 provides a selection for either Code 1 (K to 12) or Code 8 (7th Grade requirement). Providers should select Part A Code1 for children who have completed the requirements for Kindergarten. Providers should enter Part A Code 8 for students who have completed the requirements for and are entering grade 7. Please note: Providers should not complete Part B (Temporary Medical Exemption) if a student entering Kindergarten has completed the Kindergarten requirements.
Effective 2012/2013 school year: there must be documentation of at least one dose of polio vaccine administered on or after the 4th birthday. The requirement is 4 doses with the following exceptions:
- If 4th dose administered prior to 4th birthday a 5th dose is required.
- If 3rd dose is administered after the 4th birthday a 4th dose is not required.
The DH 681 Form, Religious Exemption from Immunization, can be accessed by CHDs through the Florida SHOTS (Florida State Health Online Tracking System). The DH 681 will no longer be available from the Department of Health Distribution Center (once supplies are gone). Please contact the Florida SHOTS staff at (877) 888-SHOT (7468) if you have questions regarding the electronic DH 681.

Meningococcal Vaccine Information Statement Available in Haitian Creole.

January 10, 2012 -- The Immunization Action Coalition (IAC) recently posted the updated Meningococcal Vaccine Information Statements (VIS) in Haitian Creole. (Haitian Creole VIS)

Bureau of Immunization Online Training Series

January 10, 2012 -- The Bureau of Immunization film module webinar series is now available for CME/CE credits. (Online Training Series)

Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males

January 6, 2012 -- In the December 23, 2011, Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention published Recommendations on the Use of Quadrivalent Human Papillomavirus Vaccine in Males — Advisory Committee on Immunization Practices (ACIP), 2011. (HPV Recommendations for Males)

Immunization Program Announcements