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Immunization Healthcare

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The Defense Health Agency Immunization Healthcare Branch (DHA-IHB) supports all Department of Defense (DoD) immunization programs and provides clinical consultative services, educational support, and training resources for the entire DoD family. To learn more, visit our:

What's New

The following documents have been updated within the past 30 days:

Document What's changed Date Posted 

As of October 1, 2018, the AskIHB secure communication web portal for clinical assistance is no longer available.  The Immunization Healthcare Branch will continue to provide 24/7 clinical support through the Immunization Healthcare Support Center at (877) GET-VACC (438- 8222), Option 1, or DSN 761-4245.

Current Issues in Vaccines webinar This November 14 webinar will discuss the latest influenza vaccine updates, the impact of pneumococcal conjugate vaccine (PCV13), and the possible expanded recommendation for human papillomavirus (HPV) vaccine. November 5, 2018
Notice of Precautionary Handling Instructions for Certain EpiPen Auto-Injectors A notice that some EpiPen® 0.3 mg and EpiPen Jr® 0.15 mg Auto-Injectors, and their authorized generic versions, may not easily slide out of their carrier tube, which could delay or potentially prevent use of the device during an emergency. November 5, 2018
Updates from October 2018 ACIP Meeting 
This November 6 webinar will discuss updates from the October 2018 Advisory Committee on Immunization Practices (ACIP) meeting, including current U.S. vaccination recommendations for adults, adolescents, and children.
October 31, 2018
MMQC-18-2500 Current Yellow Fever Vaccine Inventory - Suspense 10 November 2018 All immunization sites are to report their inventory of yellow fever vaccine, even if they have on-hand zero balance, by November 10, 2018. October 30, 2018
Anthrax Infections and Anthrax Vaccine Information paper updated to remove information regarding the Anthrax Vaccine in Pregnancy Registry. October 26, 2018

When Pregnancy Is Discovered After Anthrax Vaccination

Information paper updated to reflect that new enrollment in the Anthrax Vaccine in Pregnancy registry has been discontinued. October 26, 2018
Update: Influenza Activity — United States and Worldwide, May 20–October 13, 2018

In the United States, reported influenza activity was low in all regions, typical for this time of year. Fourteen influenza variant virus infections were reported in the U.S., and most were associated with exposure to swine.

October 26, 2018
Update on Vaccine-Derived Polioviruses — Worldwide, January 2017–June 2018

Vaccine-derived polioviruses (VDPVs) can circulate in settings of low population immunity or during outbreaks. After the 2016 synchronized switch from trivalent oral poliovirus vaccine (OPV) (types 1, 2, and 3) to bivalent OPV (types 1 and 3), new circulating VDPV outbreaks were detected in five countries.

October 26, 2018

Measles Outbreak in a Highly Vaccinated Population — Israel, July–August 2017

During July and August 2017, nine measles cases occurred among vaccinated Israeli soldiers. The primary patient had recently traveled to Europe. All other cases occurred in his direct contacts. All patients had mild illness; no tertiary cases occurred.

October 26, 2018
Japanese Encephalitis and Japanese Encephalitis Vaccine
A DHA-IHB information paper updated to include the recently licensed accelerated Japanese Encephalitis vaccination schedule for people at prolonged risk for infection. October 25, 2018
ProQuad package insert The prescribing information for ProQuad measles-mumps-rubella-varicella (MMRV) vaccine has been updated to clarify some information from Post-Marketing Experience.
October 25, 2018
Influenza Vaccine Product List and Age Groups 2018-19 An updated list to reflect the new FDA-licensed age range for Afluria influenza vaccine.  October 24, 2018
Summer may be gone, but West Nile Virus remains a threat Taking steps to prevent mosquito bites can be the best way to reduce risk of West Nile Virus infection and other mosquito-borne illnesses.
October 24, 2018

Mumps Outbreak in a Marshallese Community — Denver Metropolitan Area, Colorado, 2016–2017

An outbreak of 47 mumps cases occurred in the Denver metropolitan area, mostly among members of a Marshallese community. Public health response included early active surveillance, public education, and prompt implementation of MMR vaccination clinics.

October 23, 2018

Vaccination Coverage for Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2017–18 School Year

Immunization programs conduct annual kindergarten vaccination assessments to monitor school-entry vaccination coverage for all state-required vaccines. Median vaccination coverage was 94.3% for 2 doses of measles, mumps, and rubella vaccine; 95.1% for the state-required number of doses of diphtheria and tetanus toxoids and acellular pertussis vaccine; and 93.8% for 2 doses of varicella vaccine.

October 23, 2018

Vaccination Coverage Among Children Aged 19–35 Months — United States, 2017

The Advisory Committee on Immunization Practices recommends routine vaccination by age 24 months against 14 potentially serious illnesses. In 2017, coverage with most recommended vaccines among children aged 19–35 months remained stable and high but was lower in more rural areas and among uninsured or Medicaid-insured children.

October 23, 2018

Notes from the Field: Rubella Infection in an Unvaccinated Pregnant Woman — Johnson County, Kansas, December 2017

An unvaccinated patient tested positive for rubella infection while pregnant, after her unvaccinated brother returned home from a rubella-endemic part of the world. Rubella infection in pregnancy can result in miscarriage, stillbirth, or congenital rubella syndrome (CRS). The patient, under care for a high-risk pregnancy, eventually delivered a full-term, apparently normal, infant.

October 23, 2018

Varivax package insert

The prescribing information for Varivax chickenpox vaccine has been updated to clarify some information from Post-Marketing Experience.

October 23, 2018
Pneumococcal Vaccines: Strategies to Increase Adult Immunization Rates  This October 30, 2018 webinar will discuss the importance of pneumococcal vaccines in adults, with a focus on strategies for determining which pneumococcal vaccine to give to whom and when. October 22, 2018
Afluria Quadrivalent package insert Updated prescribing information for Afluria quadrivalent influenza vaccine, to include the expansion of the age indication to everyone 6 months and older. October 18, 2018
Smallpox Vaccine and Contact Transmission Avoidance This information paper describes precautions to be taken by household or other close contacts of those who recently received smallpox vaccine.
October 18, 2018
Hepatitis B Vaccine Information Statement (VIS) Updates to add the available option of a 2-dose schedule. October 16, 2018
Immunization Tool Kit 9th Edition (2018) The Immunization Tool Kit (ITK) is a practical reference that facilitates and enhances the global delivery of quality immunization healthcare to Department of Defense (DoD) beneficiaries and employees. It is based on national recommendations, evidenced-based, peer-reviewed published medical literature, and clinical practice guidelines. The printed version of the new ITK is underway, and will be announced when available.
October 16, 2018
FDA Approval for Afluria Age Expansion The Food and Drug Administration (FDA) has extended the age indication for Afluria quadrivalent and trivalent influenza vaccine for use in persons ages 6 to 59 months. October 11, 2018
Gardasil 9 package insert

The human papillomavirus (HPV) vaccine has been approved by the FDA for use in women and men up to 45 years of age.

October 9, 2018

IXIARO package insert

The FDA has approved an alternate, compressed primary Japanese encephalitis vaccination schedule for those at prolonged high risk.

October 9, 2018

Menveo package insert

Updates information associated with altered immunocompetence in recipients of a certain blood-disorder treatment.

October 9, 2018

Vision

A premier, responsive, patient centered organization promoting excellence in immunization health care practice and policy for service members and beneficiaries.

Mission

Support Force Health Protection and Readiness, and the Military Health System (MHS) by developing and promoting programs and services that enhance immunization effectiveness, safety, and acceptability. Provide evidence based solutions that improve immunization health care through policy implementation guidance, strategic communication, education, training, and clinical services worldwide.

Immunization Resources

Joint Regulation screenshot   Storage and Handling 2017 cover     
Best Practices Immunization Cover  CDC Pink Book cover   Yellow Book 2018

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Immunization Tool Kit 9th Edition

Publication
10/25/2018

A practical reference that facilitates and enhances the global delivery of quality immunization healthcare to Department of Defense (DoD) beneficiaries and employees. The Defense Health Agency Immunization Healthcare Branch (DHA-IHB) publishes the Immunization Tool Kit based on national recommendations, evidenced-based, peer-reviewed published medical ...

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WRAIR begins Phase 1 clinical trial of Marburg vaccine

Article
10/19/2018
The WRAIR study evaluates the VRC-MARADC087-00-VP vaccine, developed by the Vaccine Research Center of the National Institute of Allergy and Infectious Diseases, National Institutes of Health. (U.S. Army file photo)

WRAIR recently administered the first vaccine in a Phase 1 clinical trial to evaluate the safety and immunogenicity of a Marburg vaccine

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Vaccination Coverage for Selected Vaccines and Exemption Rates Among Children in Kindergarten — United States, 2017–18 School Year

Report
10/12/2018

Immunization programs conduct annual kindergarten vaccination assessments to monitor school-entry vaccination coverage for all state-required vaccines. Median vaccination coverage was 94.3% for 2 doses of measles, mumps, and rubella vaccine; 95.1% for the state-required number of doses of diphtheria and tetanus toxoids and acellular pertussis vaccine; and 93.8% for 2 doses of varicella vaccine.

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Vaccination Coverage Among Children Aged 19–35 Months — United States, 2017

Report
10/12/2018

The Advisory Committee on Immunization Practices recommends routine vaccination by age 24 months against 14 potentially serious illnesses. In 2017, coverage with most recommended vaccines among children aged 19–35 months remained stable and high but was lower in more rural areas and among uninsured or Medicaid-insured children.

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Say ‘Shoo’ to the flu with TRICARE

Article
9/26/2018
Amanda LaFountain, a licensed practical nurse, administers the flu shot to a Soldier. (U.S. Army photo by Staff Sgt. Marshall Metzger)

Flu viruses are serious, contagious viruses that can lead to hospitalization or even death

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General Best Practice Guidelines for Immunization

Publication
7/18/2018

The Centers for Disease Control and Prevention (CDC) recommends routine vaccination to prevent 17 vaccine-preventable diseases that occur in infants, children, adolescents, or adults. This report provides information for clinicians and other health care providers about concerns that commonly arise when vaccinating persons of various ages.

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Advice for healthy older adults: Get the new shingles vaccine

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3/29/2018
Navy Petty Officer 3rd Class Luis Echevarria draws up the new vaccine for shingles at Naval Hospital Jacksonville, Florida.  Shingrix is recommended for healthy adults 50 and older even if they’ve already had shingles or received the previous shingles vaccine. (U.S. Navy photo by Petty Officer 1st Class Jacob Sippel)

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Immunization University and Project Immune Readiness Certificate Retrieval Instructions

Publication
2/14/2018

This document provides instructions for students to retrieve their certificates for Immunization University and Project Immune Readiness courses

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Army Medicine in thick of war on antibiotic-resistant bacteria

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2/2/2018
This strain of antibiotic-resistant Staphylococcus aureus bacteria is magnified 50,000 times.

The Centers for Disease Control and Prevention calls antibiotic resistance one of the world's most pressing public health problems

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Antibiotics not the answer for common cold

Article
12/21/2017
Antibiotics should only be used to treat bacterial infections, not viral infections as they will not work against upper respiratory illnesses caused by viruses. (U.S. Air Force photo by Airman 1st Class Kenna Jackson)

Antibiotics should only be used to treat bacterial infections, not viral infections

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Immunization Healthcare Branch outreach initiatives

Article
12/6/2017
Navy Lt. Jessica Miller, a certified nurse midwife in Naval Hospital Jacksonville’s pregnancy Integrated Practice Unit, assesses a patient. A key education initiative for the Defense Health Agency Immunization Healthcare Branch involved outreach to new parents or soon-to-be parents to address any questions or concerns they have about vaccines recommended during pregnancy, infancy or childhood. (U.S. Navy photo by Jacob Sippel)

A key education initiative for the Defense Health Agency Immunization Healthcare Branch involved outreach to new parents or soon-to-be parents

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Surveillance Snapshot: Influenza Immunization among U.S. Armed Forces Healthcare Workers, August 2012 – April 2017

Infographic
10/31/2017
Did you know …?  During the 2016 – 2017 influenza season, each of the three services attained greater than 94% compliance among healthcare personnel. The U.S. Advisory Committee on Immunization Practices recommends that all healthcare personnel be vaccinated against influenza to protect themselves and their patients. The Joint Commission requires that healthcare organizations have influenza vaccination programs for practitioners and staff, and that they work toward the goal of 90 percent receipt of influenza vaccine. This snapshot of a five-year surveillance period (August 2012 – April 2017) shows  that the active component healthcare personnel of the Army, Navy, and Air Force has exceeded the percentage compliance with influenza immunization requirement in each year. •	Line graph showing the percentage of healthcare specialists and officers with records of influenza vacation by influenza year (1 August through 30 April) and service, active, U.S. Armed Forces, August 2012 – April 2017 displays. Access the full snapshot in MSMR Vol. 24 No. 10 October 2017 at Health.mil/MSMR There are two photos featured on the infographic: 1.	A service member being vaccinated with the flu vaccine displays  2.	A photo of vaccine administrators shows.

This snapshot of a five-year surveillance period (August 2012 – April 2017) details influenza immunization compliance among the active component healthcare personnel of the Army, Navy, and Air Force.

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Don’t give flu a fighting chance; get the flu shot

Article
10/10/2017
Navy Hospital Corpsman 3rd Class Gerich Curtom (left), administers a flu shot to Builder 2nd Class Charles Scheck at Naval Air Station North Island’s medical clinic. There are many different strains of flu virus, and they can often mutate quickly, presenting a challenge in keeping everyone healthy and maintaining optimal immunity, and making it necessary to get immunized annually. (U.S. Navy photo by Mass Communication Specialist 1st Class Sean P. Lenahan)

Influenza presents a disease threat almost every year, and annual immunization continues to be the best way to avoid that threat

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National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2016

Report
8/25/2017

CDC provides up-to-date estimated immunization rates among teens using the latest recommended immunization schedules.

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Immunizations provide the ounce of prevention delivering the pound of cure

Article
8/1/2017
Air Force Col. Tonya Rans, chief, Immunization Healthcare Branch, Defense Health Agency.

Air Force Col. Tonya Rans, chief, Immunization Healthcare Branch at the Defense Health Agency, explains how vaccinations are an important preventive health tool.

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