Immunization - Vaccine Updates
(Last updated 10/14/2014)
CDC releases supplemental information for healthcare providers to accompany the 2014–15 influenza VISs
On October 3, CDC posted Provider Information: Influenza VISs on its website as a PDF document. These provider guidelines supplement the 2014–15 influenza VISs and summarize relevant ACIP recommendations; include more detailed information about indications, schedules, and precautions; and contain other information giving providers a quick reference to help address common patient questions.
CDC publishes ACIP recommendations for use of PCV13 and PPSV23 vaccines in adults age 65 and older
CDC published Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine Among Adults Aged ≥65 Years: Recommendations of the Advisory Committee on Immunization Practices (ACIP) in the September 19 issue of MMWR (pages 822–825). A portion of the "ACIP Recommendations for PCV13 and PPSV23 Use" section is reprinted below.
ACIP Recommendations for PCV13 and PPSV23 Use
Both PCV13 and PPSV23 should be administered routinely in series to all adults aged ≥65 years.
Pneumococcal vaccine-naïve persons. Adults aged ≥65 years who have not previously received pneumococcal vaccine or whose previous vaccination history is unknown should receive a dose of PCV13 first, followed by a dose of PPSV23. The dose of PPSV23 should be given 6–12 months after a dose of PCV13. If PPSV23 cannot be given during this time window, the dose of PPSV23 should be given during the next visit. The two vaccines should not be coadministered, and the minimum acceptable interval between PCV13 and PPSV23 is 8 weeks.
Previous vaccination with PPSV23. Adults aged ≥65 years who have previously received ≥1 doses of PPSV23 also should receive a dose of PCV13 if they have not yet received it. A dose of PCV13 should be given ≥1 year after receipt of the most recent PPSV23 dose. For those for whom an additional dose of PPSV23 is indicated, this subsequent PPSV23 dose should be given 6–12 months after PCV13 and ≥5 years after the most recent dose of PPSV23.
Potential Time-Limited Utility of Routine PCV13 Use Among Adults ≥65 Years. The recommendations for routine PCV13 use among adults aged ≥65 years will be reevaluated in 2018 and revised as needed.
ACIP recommendations for routine use of PCV13 in adults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid leak, or cochlear implants remain unchanged.
CDC publishes 2014–15 influenza vaccination recommendations in MMWR
CDC published Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP)—United States, 2014–15 Influenza Season in the August 15 issue of MMWR. The first paragraph of the report is reprinted below.
This report updates the 2013 recommendations by the Advisory Committee on Immunization Practices (ACIP) regarding use of seasonal influenza vaccines. Updated information for the 2014–15 influenza season includes 1) antigenic composition of U.S. seasonal influenza vaccines; 2) vaccine dose considerations for children aged 6 months through 8 years; and 3) a preference for the use, when immediately available, of live attenuated influenza vaccine (LAIV) for healthy children aged 2 through 8 years, to be implemented as feasible for the 2014–15 season but not later than the 2015–16 season. Information regarding issues related to influenza vaccination not addressed in this report is available in the 2013 ACIP seasonal influenza recommendations…
The report includes the preferential recommendation to use LAIV in healthy children 2 through 8 years of age when the nasal spray flu vaccine is immediately available and if the child has no contraindications or precautions to that vaccine. However, if the nasal spray vaccine is not immediately available, children in this age group should get the flu shot (IIV). Vaccination should not be delayed to obtain the nasal spray flu vaccine.
The complete article with 2014-15 influenza vaccination recommendations can be found at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6332a3.htm .
2014-15 Influenza Vaccine Information Statements Now Available
On August 19, CDC issued two new influenza Vaccine Information Statements (VISs) for use during the 2014–15 influenza season. The VIS for inactivated influenza vaccine (IIV) is intended for use with all non-live virus formulations—trivalent, quadrivalent, cell-culture, recombinant, intradermal, and high-dose. The VIS for live attenuated intranasal influenza vaccine (LAIV) is intended for use when administering nasal-spray vaccine.
Recommendations for Influenza Vaccination, Persons with Egg Allergy and Use of Antivirals
The most current information for health care professionals regarding influenza vaccine recommendations (including persons with egg allergy), vaccine supply, and recommendations for using antiviral agents for influenza can be found on the CDC website at www.cdc.gov/flu/professionals/.
CDC updates its Vaccine Storage & Handling Toolkit
In May, CDC released an updated version of its Vaccine Storage & Handling Toolkit, originally published online in 2012. The toolkit is based on the recommendations of the Advisory Committee on Immunization Practices (ACIP), equipment manufacturers' product information, and studies from the National Institute for Scientific Technology. Here's a direct link to the updated PDF document.
The toolkit outlines best practice strategies and recommendations on the following topics:
- Points to consider in selecting, maintaining, and using vaccine storage units and thermometers
- Consistent maintenance of the cold chain
- Routine storage and handling practices
- Inventory management
- Emergency procedures for protecting vaccine inventories
On the toolkit web page, you'll also find related resources such as training materials, slide sets, and other helpful items.
- More vaccine storage and handling resources from CDC
- CDC's new training video: Keys to Storing and Handling Your Vaccine Supply
- IAC's Clinic Resources: Storage & Handling
Ohio Pharmacists May Administer MMR Vaccine Effective June 9, 2014
As of June 9, 2014, trained Ohio pharmacists are able to administer measles, mumps and rubella (MMR) vaccine to persons 18 years of age and older. Pharmacists who administer the vaccine must meet the training requirements of Ohio Board of Pharmacy Rule 4729-5-36, and work under a physician-established protocol. For pharmacists who have completed a board-approved immunization training program and whose training did not include measles, mumps and rubella vaccine, OPA’s home-study CE article Immunizations for Measles, Mumps, Rubella is approved as a supplemental course.
For pharmacists who have completed a board-approved immunization training program and whose training did not include measles, mumps and rubella vaccine, OPA’s home-study CE article Immunizations for Measles, Mumps, Rubella is approved as a supplemental course.
To order this Home-Study CE, Click Here
Zoster Prescription Requirement Ends May 22:
Update Your Protocol
As of May 22, 2014, trained Ohio pharmacists are able to administer Zostavax (herpes zoster vaccine) without a prescription. The patient receiving the vaccine must meet the age criteria listed in the FDA-approved labeling. Pharmacists who administer the vaccine must meet the training requirements of Ohio Board of Pharmacy Rule 4729-5-36, and work under a physician-established protocol.
Guidance document on this rule change can be found at http://pharmacy.ohio.gov/Documents/LawsRules/RuleChanges/Guidance%20Document%20for%20Pharmacist%20Administration%20of%20Zostavax%20%28Herpes%20Zoster%20Vaccine%29.pdf
Pharmacists currently administering Zostavax need to update their protocol to delete the requirements for a patient-specific prescription and administration of the vaccine within 30 days of issuance of the prescription.
For pharmacists who have completed a board-approved immunization training program and whose training did not include zoster vaccine, OPA’s home-study CE article Immunizations for Selected Vaccine-Preventable Diseases in Adults is approved as a supplemental course.
To order this Home-Study CE, Click Here
HealthMap Vaccine Finder
HealthMap Vaccine Finder (http://flushot.healthmap.org) is a free, online service where users can search for locations offering flu vaccines, as well as other adult vaccines. This service partners with clinics, pharmacies, and health departments to provide accurate and up-to-date information about receiving the flu vaccine.
In 2012, Google passed the baton to HealthMap when it retired Google Flu Vaccine Finder. If you previously provided data to Google Flu Vaccine Finder and would like to still be included in the list of vaccine providers, you will need to register and upload your location data to HealthMap.
Draft Immunization Protocols
OPA annually drafts adult immunization protocols in compliance with the Ohio State Board of Pharmacy’s rules. Updated protocols for 2014 are now available. Use the following link to purchase the protocol package: Immunization Protocol Package form
IAC's screening checklists for vaccines have been updated
Immunization Action Coalition (IAC) recently updated and renamed the following checklists for vaccine contraindications.
- Screening Checklist for Contraindications to Inactivated Injectable Influenza Vaccination, (formerly titled "Screening Questionnaire for Inactivated Injectable Influenza Vaccination")
- Screening Checklist for Contraindications to Live Attenuated Intranasal Influenza Vaccination (formerly titled "Screening Questionnaire for Live Attenuated Intranasal Influenza Vaccination")
- Screening Checklist for Contraindications to Vaccines for Adults (formerly titled "Screening Questionnaire for Adult Immunization")
- Vaccine Information Statements (VISs)
The latest VISs can be obtained from the Centers for Disease Control and Prevention at www.cdc.gov/vaccines/pubs/vis/default.htm.
VISs are not updated annually or on any other routine schedule. An updated VIS with a new date is posted when there is a change in recommendations.
- The Quick Reference Information: Medicare Immunization Billing chart is now available in hardcopy or as a download from the Medicare Learning Network. This chart gives Medicare fee-for-service physicians, providers, suppliers, and other health care professionals quick information to assist with filing claims for influenza, Pneumococcal Polysaccharide (PPV), and Hepatitis B (HBV) vaccines and their administration. To download, view and print the chart, click on the following link:
- Medicaid Payment for Influenza Vaccine Administration at the Pharmacy
Medicaid will pay pharmacies for administration of seasonal influenza vaccine for dates of service October 1 through May 31 each year. Payment for influenza vaccine administration will be made to pharmacies only for Medicaid consumers who do not reside in a long-term care facility (LTCF). The updated ODJFS flu shot document with complete details for this year will be available here.
- Summary of Recommendations for Adult Immunization
This summary provided by the Immunization Action Coalition was updated in March 2014 and can be found at http://www.immunize.org/catg.d/p2011.pdf
- Links to the Ohio Revised Code and the Ohio Administrative Code for the sections that cover immunizations by pharmacists:
Adult immunizations (ORC 4729.41)
Definitions (OAC 4729-5-01)
Pharmacy intern professional functions (OAC 4729-5-08)
Record keeping (OAC 4729-5-27)
Course requirements in the administration of immunizations (OAC 4729-5-36)
Protocols for the administration of immunizations (OAC 4729-5-37)
Immunization administration (OAC 4729-5-38)
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