ACOG's Influenza Season Newsletter

Visit our 2017-2018 Influenza Season page for more information such as current vaccination rates, flu distribution updates, flu vaccine composition and more!

This page is updated monthly with ACOG’s new monthly influenza season newsletter. 

 

September Immunization Newsletter

Information for the 2017-18 Influenza Season

The American College of Obstetricians and Gynecologists (ACOG) and the Centers of Disease Control and Prevention (CDC) strongly recommend all persons six months and older receive an annual flu shot. This is particularly important for pregnant women, who are at increased risk of severe disease and hospitalization related to influenza.

The composition of U.S. flu vaccines is reviewed annually and updated to match flu viruses expected to circulate. Flu vaccines protect against the three or four viruses that research suggests will be most common.

For 2017-2018, three-component vaccines contain:

  • an A/Michigan/45/2015 (H1N1)pdm09-like virus 
  • an A/Hong Kong/4801/2014 (H3N2)-like virus
  • a B/Brisbane/60/2008-like (B/Victoria lineage) virus

Four-component vaccines contain the same three strains as three-component vaccines, along with an additional B strain (B/Phuket/3073/2013-like (B/Yamagata lineage) virus.)

View CDC’s website for the primary changes and updates to the recommendations.

View CDC’s Frequently Asked Flu Questions 2017-2018 Influenza Season.

CDC's 2017-2018 Flu Season Campaign Toolkit

CDC’s seasonal flu vaccination campaign materials are available to assist partners in communicating about the importance of vaccination. This digital toolkit includes details on events/activities, sample social media and newsletter content, graphics, web assets, and media prep material. This material is downloadable, shareable, and some of the material is customizable.

National Influenza Vaccination Week (NIVW), December 3-9, 2017, focuses on highlighting the importance of influenza vaccination.

ACOG Responds to Article on Potential Link Between Flu Shot and Miscarriage Early in Pregnancy 

Association of spontaneous abortion with receipt of inactivated influenza vaccine containing H1N1 pdm09 in 2010-11 and 2011-12 was published September 2017. 

View Dr. Haywood Brown, president of the American College of Obstetricians and Gynecologists (ACOG), statement on the safety of the influenza vaccine during pregnancy. 

CDC’s Flu Vaccination and Possible Safety Signal Fact Sheet contains information about influenza and influenza vaccination during pregnancy and provides guidance on how to address concerns that patients may have about influenza vaccination. 

Updated! ACOG Tdap Immunization Toolkit

Visit ACOG’s Immunization for Women website to access ACOG’s Tdap Immunization Toolkit, which includes:

ACOG Influenza Vaccination during Pregnancy Toolkit

Visit ACOG’s Immunization for Women website to access ACOG’s Influenza Immunization During Pregnancy Toolkit, which includes:

Zika Virus Update

NEW! ACOG and SMFM recently revised their Practice Advisory on Zika Virus. Critical updates are below.

  • should continue to consult CDC’s World Map of Areas with Risk of Zika when assessing patients. In many countries the epidemic is over, however Zika is still likely to be endemic in various regions of the Americas.
  • New data on currently available IgM tests shows that IgM antibodies persist for at least four months following acute infection, thus making it difficult to determine if IgM detected during pregnancy represents an infection that is recent (during pregnancy) or one that occurred before pregnancy. IgM can also persist for a prolonged period of time potentially making timing of infection with subsequent pregnancies difficult to determine.
  • The number of false positive Zika tests has risen as the prevalence of Zika has decreased, and this compounds some of the limitations of the IgM test.
  • CDC no longer recommends routine Zika virus testing for asymptomatic pregnant women with possible Zika exposure that is not ongoing*. However, testing of asymptomatic pregnant women without ongoing* possible exposure should be considered using shared decision making. See more in the Assessment and Testing section.
  • Some jurisdictions (e.g. those at increased risk for local transmission) will continue to recommend Zika testing for asymptomatic pregnant women due to increased risks of transmission. Therefore, obstetric providers should check regularly with their state and local health departments for information on testing asymptomatic pregnant women without ongoing* possible exposure.
  • The CDC now recommends concurrent IgM and NAT testing for symptomatic pregnant women with possible Zika exposure up to 12 weeks after symptom onset. Ideally, testing should be performed as soon as possible after symptoms begin. Revised testing Figure 1 & Figure 2 can be found in the Assessment and Testing module.

*Ongoing exposure is defined as currently living in or frequent travel (e.g. daily or weekly) to areas with Zika virus transmission

Regardless of location, providers should evaluate all pregnant women in the United States for possible Zika virus exposure during each prenatal care visit. This evaluation should include an assessment of signs and symptoms of Zika virus disease (e.g. acute onset of fever, rash, arthralgia, conjunctivitis), a travel history, and a woman’s sexual partner’s potential exposure. 

Please Note: Some states will continue testing asymptomatic pregnant women. Please check with your state and local health department for recommendations in your area.

View CDC’s MMWR, Update: Interim Guidance for Healthcare Providers Caring for Pregnant Women and Possible Zika Virus Exposure – United States, July 2017.

View CDC’s New and Updated Clinician and Patient Resources which incorporates the new guidance!

Access ACOG’s Zika Toolkit online! The toolkit includes ACOG’s Patient Education Zika virus infographic (also available in Spanish) and video (also available in Spanish), and additional links for ob-gyns.

Visit ACOG’s Zika Virus Updates page for up-to-date information and resources. 

Are your patients traveling to visit friends or family in areas with Zika?

Remind them to protect themselves and loved ones from mosquito bites and sexual transmission of Zika. Refer them to CDC’s Zika Travel Information page to learn what they need to know before, during and after their travel.

 

August Immunization Newsletter

Information for the 2017-18 Influenza Season

The American College of Obstetricians and Gynecologists (ACOG) and the Centers of Disease Control and Prevention (CDC) strongly recommend all persons six months and older receive an annual flu shot. This is particularly important for pregnant women, who are at increased risk of severe disease and hospitalization related to influenza.

The composition of U.S. flu vaccines is reviewed annually and updated to match flu viruses expected to circulate. Flu vaccines protect against the three or four viruses that research suggests will be most common. 

For 2017-2018, three-component vaccines contain:

  • an A/Michigan/45/2015 (H1N1)pdm09-like virus 
  • an A/Hong Kong/4801/2014 (H3N2)-like virus
  • a B/Brisbane/60/2008-like (B/Victoria lineage) virus

Four-component vaccines contain the same three strains as three-component vaccines, along with an additional B strain (B/Phuket/3073/2013-like (B/Yamagata lineage) virus.)

For information on How Influenza (Flu) Vaccines Are Made visit CDC's website

Preparing for Flu Season

It is important to start preparing your practice and yourself for the 2017-2018 Flu Season. The below resources will assist you in achieving proper storage, handling, and administration of vaccines.

  • The Vaccine Storage and Handling Toolkit reflects best practices for vaccine storage and handling from Advisory Committee on Immunization Practices (ACIP) recommendations, product information from vaccine manufacturers, and scientific studies.
  • You Call the Shots: Vaccine Storage and Handling Module is an interactive, web-based module which provides learning opportunities, self-test practice questions, reference and resource materials, and an extensive glossary. Continuing education or a certificate of completion is available.
  • August Immunization Newsletter
  • CDC’s Vaccine Administration Protocols webpage contains information regarding contraindications, dosage, route, site, minimal ages and intervals, managing vaccine reactions, standing orders, and recommendations and guidelines.
  • Safety Monitoring: Some influenza vaccine manufacturers maintain pregnancy registries to monitor the safety of their products when used in pregnant women. Please check your flu products’ package insert for registry information.

Immunization Champion Spotlight: Richard Bardowell, MD

Dr. Richard Bardowell leads a solo ob-gyn practice in Burbank, California. Until recently, Dr. Bardowell did not administer immunizations within his office due to concerns regarding ordering, cost, and documentation. Instead he referred his pregnant patients to the local pharmacy for any needed vaccines. However, in the past two years, Dr. Bardowell has been able to offer both influenza and Tdap vaccinations in his office. The following steps were taken to reach this achievement.

  1. 1. The team researched the lowest prices for vaccines, obtained a vaccine-grade refrigerator, and learned proper vaccine storage and handling practices.
    2. Increased patients’ overall awareness of immunizations by routinely screening patients for needed immunizations and increasing the immunization-focused education materials around the office.
    3. Enrolled his practice into the California Immunization Registry (CAIR), which helped his practice communicate with other providers and the state about his patients’ vaccine status.
Dr. Bardowell and his team researched options for vaccine purchasing and were able to make a profit on both influenza and Tdap immunizations. They used a group purchasing organization to receive the lowest cost possible. View the Immunization for Women website for resources on managing costs and purchasing options.

Dr. Bardowell states, “I hope that all OB providers will realize the importance of antenatal immunization and will begin offering immunizations in their office.”

 

Updated! Vaccinations for Pregnant Women

ACOG recently endorsed the updated Vaccination for Pregnant Women document which was created by the Immunization Action Coalition (IAC).

View the document here!

Upcoming Events

Click here to check out upcoming immunization events including webinars and conference calls!

ACOG Influenza Vaccination during Pregnancy tool kit

Visit ACOG’s Immunization for Women website to access ACOG’s Influenza Immunization During Pregnancy Toolkit, which includes:

Zika Virus Update

NEW! View CDC’s MMWR, Update: Interim Guidance for Healthcare Providers Caring for Pregnant Women and Possible Zika Virus Exposure – United States, July 2017. CDC is committed to ensuring that its guidance is based on the most current available evidence and has been updated to incorporate what has been learned over the past year and reduce misinterpretation of Zika test results for pregnant women. CDC’s updated interim guidance presents the updated recommendations in two algorithms – one for pregnant women with Zika symptoms and one for pregnant women without Zika symptoms*.

View CDC’s New and Updated Clinician and Patient Resources which incorporates the new guidance!

Access ACOG’s Zika Toolkit online! The toolkit includes ACOG’s Patient Education Zika virus infographic (also available in Spanish) and video (also available in Spanish), and additional links for ob-gyns.

Access the most recent ACOG and SMFM Practice Advisory on Zika Virus.

Visit ACOG’s Zika Virus Updates page for up-to-date information and resources. 

Are your patients traveling to visit friends or family in areas with Zika?

Remind them to protect themselves and loved ones from mosquito bites and sexual transmission of Zika. Refer them to CDC’s Zika Travel Information page to learn what they need to know before, during and after their travel.

*Please Note: Some states will continue testing asymptomatic pregnant women. Please check with your state and local health department for recommendations in your area.

 

July Immunization Newsletter

Flu Activity Update

For the 2016-2017 season, influenza-like-illness was at or above baseline for 17 consecutive weeks with activity peaking nationally in February. For the last 15 seasons, the average duration of a flu season by this measure has been 13 weeks, with a range from one week to 20 weeks. Influenza surveillance in the U.S. is available at FluView

Information for the 2017-18 Influenza Season

The more people who get vaccinated, the more people will be protected from flu, including older people, very young children, pregnant women and people with certain health conditions who are more vulnerable to serious flu complications. The composition of U.S. flu vaccines is reviewed annually and updated to match flu viruses expected to circulate. Flu vaccines protect against the three or four viruses that research suggests will be most common.

For 2017-2018, three-component vaccines are recommended to contain:

  • an A/Michigan/45/2015 (H1N1)pdm09-like virus *
  • an A/Hong Kong/4801/2014 (H3N2)-like virus
  • a B/Brisbane/60/2008-like (B/Victoria lineage) virus

Four-component vaccines, which protect against a second lineage of B viruses, are recommended to be produced using the same viruses recommended for the trivalent vaccines, as well as a B/Phuket/3073/2013-like (B/Yamagata lineage) virus.

For information on How Influenza (Flu) Vaccines Are Made visit CDC's website

National Vaccine Injury Compensation Program 

Recommended vaccines, including influenza vaccine, can occasionally be associated with side effects, but most are rare and mild. In very rare cases, a vaccine can cause a serious problem, such as a severe allergic reaction. In these instances, the National Vaccine Injury Compensation Program (VICP) may provide financial compensation to individuals who file a petition and are found to have been injured by a VICP-covered vaccine. Please visit the U.S. Department of Health and Human Services website for more information.

NEW Vaccine Adverse Event Reporting System (VAERS) 2.0 Website and Ways to Report to VAERS

VAERS 2.0 includes a new reporting form and a new website that allows you to easily submit a VAERS report electronically, access VAERS data, and learn more about how CDC and FDA monitor the safety of vaccines. 

There are two ways to report an adverse event following vaccination to VAERS:

  1. Use the online reporting tool
  2. Complete a writable VAERS PDF form and upload it onto the new VAERS website

Immunization Champion Spotlight: Brenna Hughes, MD Duke University Medical Center

Dr. Brenna Hughes and the team at Duke University Medical Center in Durham North Carolina are committed to implementing standing orders for vaccinations. The Duke University Medical Center wishes to encourage and support other practices to utilize standing orders. They suggest the following steps used successfully at Brown University’s Women & Infants Hospital as well.

  1. Leverage the CMS measure for standing orders to gain buy-in from leadership and prioritize this in your IT department
  2. Pass a policy supporting the use of standing orders through nursing leadership and quality committees.
  3. To reduce the need for buy-in from a large number of nurses and physicians, one nurse champion can shepherd the order through the policy process and one physician can be designated to sign off on the order.
  4. Utilize physician leadership as the standing orders signature, while maintaining the order within the pharmacy.
  5. The nursing staff ensure safety by referring to a checklist.

Through this process, Duke University Medical Center has maintained high immunization rates in pregnant women. Helpful resources to implement standing orders can be found at the Immunization Action Coalition’s webpage.

August is National Immunization Awareness Month!

National Immunization Awareness Month (NIAM) is an annual observance held in August to highlight the importance of vaccination for people of all ages. It is also a great opportunity to draw awareness to immunization in your own practice!

Accordingly, we urge providers to bring NIAM to the attention of your patients and your staff. For ob-gyn providers, there are two themed weeks in particular that you may wish to highlight:

  • August 7-13 Pregnant Women: Protect yourself and pass protection on to your baby.
  • August 14-20 Adults: Vaccines are not just for kids.

You can download the full NIAM toolkit, broken down by the weekly themes, to access resources to help you promote NIAM. The toolkit includes vaccine information and FAQs that can be printed as handouts or highlighted on your website. It also includes sample tweets and Facebook posts you can use to promote NIAM via social media. Additionally, you are able to download a variety of images for printing as posters or flyers, or for posting to your website or social media account.

Save the Date for ACOG's upcoming webinars 

National Immunization Awareness Month (NIAM) is an annual observance held in August to highlight the importance of vaccination for people of all ages. ACOG is participating by hosting two webinars during the month of August.

  • August 7, 2017 12:00PM (ET) Best Practices to Improve Maternal Immunization Register here!
  • August 17, 2017 1200PM (ET) Don’t Wait, Vaccinate! Tips and Resources for Communicating with Adult Patients about Vaccination Register here!

ACOG Influenza Vaccination during Pregnancy tool kit

Visit ACOG’s Immunization for Women website to access ACOG’s Influenza Immunization During Pregnancy Toolkit, which includes:

Zika Virus Update

NEW! View CDC’s MMWR, Update: Interim Guidance for Healthcare Providers Caring for Pregnant Women and Possible Zika Virus Exposure – United States, July 2017. CDC is committed to ensuring that its guidance is based on the most current available evidence and has been updated to incorporate what has been learned over the past year and reduce misinterpretation of Zika test results for pregnant women. CDC’s updated interim guidance presents the updated recommendations in two algorithms – one for pregnant women with Zika symptoms and one for pregnant women without Zika symptoms.

Access ACOG’s Zika Toolkit online! The toolkit includes ACOG’s Patient Education Zika virus infographic (also available in Spanish) and video (also available in Spanish), and additional links for ob-gyns.

Access the most recent ACOG and SMFM Practice Advisory on Zika Virus.

Visit ACOG’s Zika Virus Updates page for up-to-date information and resources. 

Are your patients traveling to visit friends or family in areas with Zika?

Remind them to protect themselves and loved ones from mosquito bites and sexual transmission of Zika. Refer them to CDC’s Zika Travel Information page to learn what they need to know before, during and after their travel.

 


June: Start Planning for the 2017-18 Flu Season

Flu Activity Update

Influenza activity is low in the United States after being at or above baseline for 17 weeks during the 2016-17 flu season. The May 14-20, 2017 FluView was the final full influenza surveillance report for the 2016-2017 U.S. flu season. Influenza surveillance in the U.S. will continue through the summer months with condensed reports available at FluView

Information for the 2017-18 Influenza Season

There’s not much down time between flu seasons, and it’s time to start planning for next year! The composition of U.S. flu vaccines is reviewed annually and updated to match circulating flu viruses. Flu vaccines protect against the three or four viruses that research suggests will be most common. For 2017-2018, three-component vaccines are recommended to contain:

  • an A/Michigan/45/2015 (H1N1)pdm09-like virus *
  • an A/Hong Kong/4801/2014 (H3N2)-like virus
  • a B/Brisbane/60/2008-like (B/Victoria lineage) virus

Four-component vaccines, which protect against a second lineage of B viruses, are recommended to be produced using the same viruses recommended for the trivalent vaccines, as well as a B/Phuket/3073/2013-like (B/Yamagata lineage) virus.

* This is a new strain for the H1N1 virus, and the first time the A/California/7/2009(H1N1) is not used since the pandemic. The other strains for influenza A (H3N2) and B viruses are the same as the ones used in the 2016-2017 vaccines.

For information on How Influenza (Flu) Vaccines Are Made visit CDC's website

Immunization Champion Spotlight: Lois Ramondett, MD MD Anderson Cancer Center

Dr. Lois Ramondetta and her team at MD Anderson Cancer Center in Houston Texas are committed to increasing HPV vaccination rates among employees and their families. The MD Anderson Cancer Center HPV Moonshot wishes to encourage and support employees to be community leaders when it comes to cancer prevention. They have taken the following key steps:

  1. Surveyed MD Anderson employees to estimate vaccination rates and to gauge educational needs surrounding the HPV vaccine. 
  2. Published educational materials and informational articles in employee newsletter.
  3. Created a website with information on the importance of HPV vaccination.
  4. Provided presentations throughout the organization to educate employees about HPV and the importance of the HPV vaccine.
  5. Started a monthly weekend HPV vaccination clinic for employees and their vaccine eligible dependents. This clinic was started in July 2016 and to date, the clinic has vaccinated 87 unique patients of which 42 have completed the series. 

Save the Date for ACOG’s upcoming webinars

National Immunization Awareness Month (NIAM) is an annual observance held in August to highlight the importance of vaccination for people of all ages. ACOG is participating by hosting two webinars during the month of August.

  • August 7, 2017 12:00PM (ET) Best Practices to Improve Maternal Immunization
  • August 17, 2017 1200PM (ET) Don’t Wait, Vaccinate! Tips and Resources for Communicating with Adult Patients about Vaccination
Registration coming soon!

ACOG Influenza Vaccination during Pregnancy tool kit

Visit ACOG’s Immunization for Women website to access ACOG’s Influenza Immunization During Pregnancy Toolkit, which includes:

Zika Virus Update

Access ACOG’s Zika Toolkit online! The toolkit includes ACOG’s Patient Education Zika virus infographic (also available in Spanish) and video (also available in Spanish), CDC’s Zika Screening tool and additional links for ob-gyns.

Access the most recent ACOG and SMFM Practice Advisory on Zika Virus.

CDC’s Vital Signs Report on Zika Virus shows that in 2016 10% of babies born to mothers with confirmed Zika Virus infection had some Zika-related birth defects. Almost every state in the U.S. has reported a case of a pregnant woman with potential Zika Virus infection. Many of these potential cases are due to travel. It is important that every pregnant woman in the U.S. be screened and assessed for possible Zika virus exposure at each prenatal visit. Pregnant women should not travel to any area where there is a risk of Zika virus infection. 

CDC's MMWR“Pregnancy Outcomes Following Zika Virus Infection during Pregnancy in the U.S. Territories, January 15, 2016-April 25, 2017,” provides new information on 2,549 cases of pregnant women with possible Zika virus infection who completed their pregnancies in the U.S. territories. 

  • Nearly 1,508 women had confirmed Zika virus infection, and 5% of their fetuses and infants had birth defects potentially associated with Zika virus infection.
  • Eight percent with confirmed infection in the first trimester had fetuses or infants with birth defects, compared to 5% and 4% in the second and third trimesters, respectively
  • Of the 2,464 live-born infants, 59% had testing reported for Zika virus infection, 52% were reported to have received head imaging and 79% had a reported hearing screening at birth.

This report is the first from the US territories to provide results of an analysis of data reported to the Zika pregnancy and infant registries. Also, this report represents the largest number of completed pregnancies with laboratory confirmation of Zika virus infection to date. 

Visit ACOG’s Zika Virus Updates page for up-to-date information and resources.  

Are your patients traveling to visit friends or family in areas with Zika?

Remind them to protect themselves and loved ones from mosquito bites and sexual transmission of Zika. Refer them to CDC’s Zika Travel Information page to learn what they need to know before, during and after their travel.

 

May: Start Planning for the 2017-18 Flu Season

Flu Activity Update

Flu activity in the U.S. is declining, and most states are now experiencing minimal activity. Pregnant women should still be offered the influenza vaccine until the end of the flu season: May 2017.

To track flu activity in your area, see the CDC’s weekly flu report 

Information for the 2017-18 Influenza Season

There’s not much downtime between flu seasons, and it’s time to start planning for next year!  The composition of U.S. flu vaccines is reviewed annually and updated to match circulating flu viruses. Flu vaccines protect against the three or four viruses that research suggests will be most common. For 2017-2018, three-component vaccines are recommended to contain:

  • an A/Michigan/45/2015 (H1N1)pdm09-like virus *
  • an A/Hong Kong/4801/2014 (H3N2)-like virus
  • a B/Brisbane/60/2008-like (B/Victoria lineage) virus

Four-component vaccines, which protect against a second lineage of B viruses, are recommended to be produced using the same viruses recommended for the trivalent vaccines, as well as a B/Phuket/3073/2013-like (B/Yamagata lineage) virus.

* This is a new strain for the H1N1 virus, and the first time the A/California/7/2009(H1N1) is not used since the pandemic. The other strains for influenza A (H3N2) and B viruses are the same as the ones used in the 2016-2017 vaccines.

Immunization Champion Spotlight: Harborview Medical Center. Seattle, Washington

Dr. Linda O’Neal Eckert and her team at Harborview Medical Center in Seattle Washington are committed to protecting mothers and babies from vaccine preventable diseases like flu and pertussis. They have successfully made immunizations a part of their office culture by taking a few simple, key steps:

  1. Offering an educational seminar on value of vaccines to cultural case workers and clinic staff
  2. Every Aug/Sept Dr. Eckert gives an in-service to nursing and clinic staff over lunch highlighting the importance of flu vaccines
  3. Using standing orders for flu vaccine
  4. Posting a sign on the front desk when people check in that reads: “Flu vaccine available and strongly recommended”.
  5. Hanging signs in bathroom: “Help prevent your baby from getting the flu or whooping cough”
  6. Staff have to “opt out” of flu vaccine and Tdap vaccine. Those who opt out have to watch an educational video and sign a paper

As a result of these steps, Dr. Eckert’s office has rates of influenza and Tdap vaccination as high as 75% and 80% respectively.

ACOG Influenza Vaccination during Pregnancy tool kit

Visit ACOG’s Immunization for Women website to access ACOG’s Influenza Immunization During Pregnancy Toolkit, which includes:

Zika Virus Update

Access ACOG’s Zika Toolkit online! The toolkit includes ACOG’s Patient Education Zika virus infographic (also available in Spanish) and video (also available in Spanish), CDC’s Zika Screening tool and additional links for ob-gyns.

Access the most recent ACOG and SMFM Practice Advisory on Zika Virus.

CDC’s Vital Signs Report on Zika Virus shows that in 2016 10% of babies born to mothers with confirmed Zika Virus infection had some Zika-related birth defects. Almost every state in the U.S. has reported a case of a pregnant woman with potential Zika Virus infection. Many of these potential cases are due to travel. It is important that every pregnant woman in the U.S. be screened and assessed for possible Zika virus exposure at each prenatal visit. Pregnant women should not travel to any area where there is a risk of Zika virus infection. 

Visit ACOG’s Zika Virus Updates page for up-to-date information and resources.  

Are your patients traveling to visit friends or family in areas with Zika?

Remind them to protect themselves and loved ones from mosquito bites and sexual transmission of Zika. Refer them to CDC’s Zika Travel Information page to learn what they need to know before, during and after their travel.

 

April: Influenza Updates

Flu Activity Update

Flu activity in the U.S. is declining, and most states are now experiencing low to minimal activity. Women who are or will be pregnant during the flu season (through May 2017) should be offered the flu vaccine if they have not already received it.

To track flu activity in your area, see the CDC’s weekly flu report 

Information for the 2017-18 Influenza Season

There are many flu viruses and they are constantly changing. The composition of U.S. flu vaccines is reviewed annually and updated to match circulating flu viruses. Flu vaccines protect against the three or four viruses that research suggests will be most common. For 2017-2018, three-component vaccines are recommended to contain:

  • an A/Michigan/45/2015 (H1N1)pdm09-like virus *
  • an A/Hong Kong/4801/2014 (H3N2)-like virus
  • a B/Brisbane/60/2008-like (B/Victoria lineage) virus

Four-component vaccines, which protect against a second lineage of B viruses, are recommended to be produced using the same viruses recommended for the trivalent vaccines, as well as a B/Phuket/3073/2013-like (B/Yamagata lineage) virus.

* This is a new strain for the H1N1 virus, and the first time the A/California/7/2009(H1N1) is not used since the pandemic. The other strains for influenza A (H3N2) and B viruses are the same as the ones used in the 2016-2017 vaccines.

National Infant Immunization Week is April 22-29

National Infant Immunization Week (NIIW) is an annual observance to highlight the importance of protecting infants from vaccine-preventable diseases and celebrate the achievements of immunization programs and their partners in promoting healthy communities.

Since 1994, hundreds of communities across the United States have joined together to celebrate the critical role vaccination plays in protecting our children, communities, and public health.

Learn more about NIIW

ACOG Section Spotlight: Mississippi’s Give Me a Shot Campaign

Give Me a Shot is a web-based public health campaign designed to garner public support for pro-vaccine advocacy and to provide public and government leaders with accurate, evidence-based information on the benefits of immunization and the role policy plays in protecting Mississippians from vaccine-preventable disease.

Find more information about the Give Me a Shot campaign on ACOG’s Immunization for Women website.

Visit ACOG’s Immunization for Women website to access ACOG’s Influenza Immunization During Pregnancy Toolkit, which includes:

Zika Virus Update

Access ACOG’s Zika Toolkit online! The toolkit includes ACOG’s Patient Education Zika virus infographic (also available in Spanish) and video (also available in Spanish), CDC’s Zika Screening tool and additional links for ob-gyns.

Access the most recent ACOG and SMFM Practice Advisory on Zika Virus.

NEW: CDC’s Vital Signs Report on Zika Virus shows that in 2016 10% of babies born to mothers with confirmed Zika Virus infection had some Zika-related birth defects. Almost every state in the U.S. has reported a case of a pregnant woman with potential Zika Virus infection. Many of these potential cases are due to travel. It is important that every pregnant woman in the U.S. be screened and assessed for possible Zika virus exposure at each prenatal visit.

NEW: ACOG’s Zika Virus Practice Advisory is now available in Spanish

Visit ACOG’s Zika Virus Updates page for up-to-date information and resources.  

Are your patients traveling to visit friends or family in areas with Zika?

Remind them to protect themselves and loved ones from mosquito bites and sexual transmission of Zika. Refer them to CDC’s Zika Travel Information page to learn what they need to know before, during and after their travel.


March: Flu Activity is Peaking. It's Not Too Late to Vaccinate!

Flu Activity Increasing Across the Country

It's not too late to vaccinate! Flu activity is elevated across the country. Outpatient visits for influenza-like-illness are above the national baseline. Activity is expected to continue during the coming weeks. To date, influenza A (H3N2) viruses have predominated overall, but influenza A (H1N1)pdm09 and influenza B viruses have also been identified. See the full MMWR report update on influenza activity in the United States

The best way to protect yourself and your patients, especially pregnant women and their infants during the flu season, is vaccination. Influenza vaccination is recommended also for people who have already had the flu, to provide protection against other circulating strains as the influenza epidemic progresses. 

To track flu activity in your area, see the CDC's weekly flu report

Assessing and Treating Influenza-like-Illness

  • ACOG & SMFM's Algorithm for the assessment and treatment of pregnant women with influenza-like-illness
  • Antiviral Agents for the Treatment and Chemoprophylaxis of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
  • A recent large multinational register study published in BMJ found no increased risks of adverse neonatal outcomes or congenital malformations associated with exposure to neuraminidase inhibitors during embryo-fetal life. The results support previously reported findings that the use of neuraminidase inhibitors is not associated with increased risks of adverse fetal or neonatal outcomes.

Interim Estimates of Influenza Vaccine Effectiveness

On February 16, 2017 the CDC published an MMWR with the interim estimates of influenza vaccine effectiveness (VE) for the 2016-17 flu season. The report was based on 3,144 children and adults enrolled in the U.S. Influenza Vaccine Effectiveness Network (U.S. Flu VE Network) during November 28, 2016 - February 4, 2017. During this period, overall vaccine effectiveness (VE) against influenza A and influenza B virus infection associated with medically attended Acute Respiratory Illness was 48%. These interim VE estimates indicate that influenza vaccination reduced the risk for outpatient medical visits by almost half. This VE is consistent with VE expected in the early part of the annual influenza epidemic. VE assessment will continue throughout the season.

Visit ACOG's Immunization for Women website to access ACOG's Influenza Immunization During Pregnancy Toolkit, which includes:

Zika Virus Update

Access ACOG’s Zika Toolkit online! The toolkit includes ACOG’s Patient Education Zika virus infographic (also available in Spanish) and video (also available in Spanish), CDC’s Zika Screening tool and additional links for ob-gyns.

Access the most recent ACOG and SMFM Practice Advisory on Zika Virus.

NEW! ACOG's Zika Virus Practice Advisory is now available in Spanish.

Visit ACOG’s Zika Virus Updates page for up-to-date information and resources.  

Are your patients traveling to visit friends or family in areas with Zika?

Remind them to protect themselves and loved ones from mosquito bites and sexual transmission of Zika. Refer them to CDC’s Zika Travel Information page to learn what they need to know before, during and after their travel.

 

December: Protect Patients from Flu & Zika this Holiday Season

Zika Virus Update

NEW! Access ACOG’s Zika Toolkit online! The toolkit includes ACOG’s Patient Education Zika virus infographic (also available in Spanish) and video (also available in Spanish), CDC’s Zika Screening tool and additional links for ob-gyns.

Access the most recent ACOG and SMFM Practice Advisory on Zika Virus.

Visit ACOG’s Zika Virus Updates page for up-to-date information and resources.  

Are your patients traveling to visit friends or family in areas with Zika?

Remind them to protect themselves and loved ones from mosquito bites and sexual transmission of Zika. Refer them to CDC’s Zika Travel Information page to learn what they need to know before, during and after their travel.

National Influenza Vaccination Week: December 4-10, 2016

It’s not too late to vaccinate! With flu activity increasing and family and friends planning gatherings for the holidays, now is a great time to remind your patients to get a flu vaccine. Receiving a flu vaccine can protect your patients and their loved ones against this potentially serious disease.

ACOG recommends that all Ob-gyns recommend and offer flu vaccine to all their patients, especially pregnant patients who are at increased risk of serious illness due to seasonal influenza. As a reminder, pregnant patients should always receive inactivated flu vaccine. See ACOG’s Influenza Immunization During Pregnancy Committee Opinion for additional information and share CDC’s Pregnant? Get a Flu Shot! Webpage with your patients.

If your office does not administer flu vaccine, refer your patients to HealthMap Vaccine Finder to find a flu vaccine near them.

Key Messages to share with your patients

  • Flu vaccination can reduce flu illnesses, doctor visits, pneumonia, need for antibiotics, missed work and school due to flu, as well as prevent flu-related hospitalizations.
  • Flu vaccination also may make your illness milder if you do get sick.
  • Getting vaccinated yourself also protects people around you, including those who are more vulnerable to serious flu illness, like babies and young children, older people, and people with certain chronic health conditions.
  • While seasonal flu outbreaks can happen as early as October, flu activity is usually highest between December and February, though activity can last as late as May.
  • As long as flu activity is ongoing, it’s not too late to get vaccinated!

View all NIVW Key Messages from CDC at: https://www.cdc.gov/flu/nivw/nivw-key-points.htm

Additional information and resources for NIVW can be found at: https://www.cdc.gov/flu/nivw/

Visit ACOG’s Immunization for Women website to access ACOG’s Influenza Immunization During Pregnancy Toolkit, which includes:

 
New Evidence Reinforcing Flu Vaccine Safety

The article Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder, published online 11/28/16 detailed a retrospective cohort study of maternal influenza vaccination, maternal influenza infection, and autism. The study found no association between maternal influenza infection or maternal influenza vaccination and autism.


Ousseny Zerbo, PhD1; Yinge Qian, MS1; Cathleen Yoshida, MA1; et al. Association Between Influenza Infection and Vaccination During Pregnancy and Risk of Autism Spectrum Disorder. JAMA Pediatr. Published online Nov 28, 2016. doi:10.1001/jamapediatrics.2016.3609

 

October: Zika Virus Guidance, Flu Season & HPV Vaccination Updates

Zika Virus Update

ACOG and SMFM revised sections of their Practice Advisory on Zika Virus October 18, 2016 including updates pertaining to travel restrictions, reproductive counseling, testing, and postnatal management.  

Pregnant women should consider postponing travel to all areas of Miami-Dade County, FL. Pregnant women should specifically avoid travel to the identified 4.5-square-mile area of Miami Beach and one-square-mile area in Little River located in Miami-Dade County.

The Texas Department of State Health Services issued a media release reminding pregnant women who cross the border with Mexico that Zika virus testing is available to them and encourages them to discuss testing with their health care providers.

Visit ACOG’s Zika Virus Updates for up-to-date information and resources.  


Prepare for Flu Season!

Flu season is upon us and ob-gyns should start to vaccinate as soon as vaccine is available.

According to the FluView report for the week ending October 15, 2016, flu activity is low overall in the continental United States, with only Guam reporting widespread flu activity. Influenza A (H3) viruses were most commonly reported during week 41. While the timing of influenza activity varies and is unpredictable, flu activity often begins to increase in October. CDC recommends that everyone 6 months of age and older get an annual flu vaccine before the end of October, if possible.

As stated in the October 1 Dear Colleague letter from the CDC:

As a health care provider, you know the value of prevention and its benefits on your patients’ health. Influenza vaccine has been shown to reduce the overall risk of flu-associated illness, medical visits and flu-related complications, including hospitalizations.. Vaccination is especially important for people with certain underlying medical conditions, pregnant women, the very young, and the elderly.

Click here for the full Dear Colleague letter from the CDC.


Immunization Webinar

The ACOG webinar Integrating Immunization in the Ob-Gyn Practice: Practical Tips and Resources is now available online. In this free webinar, Dr. Linda Eckert provides practical tips and resources for incorporating immunizations into routine practice. Current recommendations for Tdap, hepatitis B, influenza, zoster and pneumococcal vaccinations for pregnant and non-pregnant patients are reviewed and common patient concerns and misconceptions are addressed. Brief immunization-related patient scenarios are also presented.


ACOG Flu Season Resources:
 

Continuing Medical Education Opportunities

New Immunization Maintenance of Certification Part IV Modules
now available from ABOG
ACOG Immunization and Practice staff helped develop MOC Part IV Modules on pneumococcal and zoster vaccines for ABOG’s consideration to enhance ob-gyns’ immunization knowledge and practice.

CDC NetConference on Vaccines in Pregnancy

Vaccines recommended during pregnancy have a strong record of safety and effectiveness, yet low rates of vaccination persist. Health care providers can play a pivotal role in this issue. On Wednesday, Nov. 9, 12-1 ET join maternal vaccination safety experts for the next Current Issues in Immunization NetConference—Vaccines during Pregnancy: A Strong Record of Safety.
Free continuing education is available, but attendance is limited! To register, visit: http://bit.ly/2enAINN


HPV Vaccination Schedule Update

On October 19th CDC recommended that 11- to 12-year-olds receive two doses of HPV vaccine at least six months apart rather than the previously recommended three doses to protect against cancers caused by human papillomavirus (HPV) infections. Teens and young adults who start the series later, at ages 15 through 26 years, will continue to need three doses of HPV vaccine to protect against cancer-causing HPV infection. This 2-dose schedule for young adolescents was voted on at the October Advisory Committee on Immunization Practices (ACIP) meeting and CDC Director Frieden approved the committee’s recommendations shortly after the vote. ACIP recommendations approved by the CDC Director become agency guidelines on the date published in the Morbidity and Mortality Weekly Report (MMWR). Click here to read the full CDC press release. ACOG is reviewing its clinical guidance for possible updates in light of these new CDC/ACIP recommendations.

September: Prepare for Flu Season

Flu season is upon us and ob-gyns should start to vaccinate as soon as vaccine is available.

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) and the American College of Obstetricians and Gynecologists (ACOG) recommend that all adults, including pregnant women receive an annual influenza vaccine.

Updates for the 2016-17 Flu Season:

  • Interim recommendation that LAIV4 (nasal spray vaccine) should not be used this season due to concerns about its effectiveness
  • Egg-allergic recipients no longer need to be observed for 30 minutes post-vaccination, except if it is a severe form (see below). Providers should consider observing all patients for 15 minutes after vaccination to decrease the risk for injury should they experience syncope.
  • Persons with a history of severe allergic reaction (hypersensitivity reaction more severe than hives alone) to egg should be vaccinated in an inpatient or outpatient medical setting under the supervision of a health care provider who is able to recognize and manage severe allergic conditions.

For more information, read the MMWR “Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2016–17 Influenza Season” published August 26, 2016.

ACOG Flu Season Resources:

  • FAQ Tear Pads for Patients Concerning Flu Vaccination During Pregnancy

“Time to Think About Your Baby’s Vaccines”

Dr. Messonnier, Director of the National Center for Immunization and Respiratory Diseases wrote an article for your pregnant patients titled “Time to Think About Your Baby’s Vaccines.” The article highlights the importance of vaccines during pregnancy and suggests that pregnant women find a pediatric provider to learn more about infant immunizations before their baby arrives.

Share this article with your pregnant patients by adding the link to your website or sending it out in your regular communication channels: http://immunizationforwomen.org/yourbabysvaccines

 

August is National Immunization Awareness Month!

During August, we celebrate National Immunization Awareness Month (NIAM) and highlight the importance of vaccination for people of all ages. This is the perfect time to remind your pregnant patients to start learning about the safe, proven disease protection that vaccines will provide to their babies once they are born.  Encourage them to find and meet with a pediatric provider before their baby is born, so they can get information about vaccines that their newborn will need in the first months of life and ask any questions they may have.  You can also refer them to CDC’s newly redesigned website for parents, which contains credible information about vaccines, vaccine-preventable diseases, how to make shots less stressful, vaccine safety, and more.

NIAM is also a great reminder to make a strong recommendation for flu and whooping cough vaccines during pregnancy.  Women can get the flu shot at any time during their pregnancy, and even though it’s not flu season yet, you can let your pregnant patients know that you recommend they get the vaccine as soon as it becomes available.  Pregnant women should also get a dose of Tdap during their pregnancies “ideally between 27-36 weeks of pregnancy” to pass some whooping cough protection on to their babies.  Women who are thinking of conceiving also may need some vaccines.  For example, they should make sure they are up to date on their measles-mumps-rubella (MMR) vaccine.  This one is important because rubella is a contagious disease that can be very dangerous during pregnancy.  In fact, it can cause a miscarriage or serious birth defects.  The best protection against rubella is MMR vaccine, but pregnant women need to get it at least four weeks before getting pregnant.  Visit CDC’s new website with tips for how to talk with pregnant patients about vaccines

You can also refer women to CDC’s new website about pregnancy and vaccination which features a new quiz on Vaccines for Pregnant Women. Help your patients learn more about the vaccines they need during pregnancy by sharing this link on your website or social media accounts: http://go.usa.gov/xx6Ah

NIAM is sponsored by the National Public Health Information Coalition, in collaboration with the Centers for Disease Control and Prevention. Visit the NIAM website for more information about how to observe this important month in your practice.  

Pregnancy & Flu Vaccine

ACOG’s Committee Opinion 608: Influenza Vaccination During Pregnancy recommends that all adults receive an annual influenza vaccine. It is particularly important that women who are or will be pregnant during influenza season receive an inactivated influenza vaccine as soon as it is available.

To learn more visit:
2016-2017 Flu Season &
Flu & Pregnancy

A recent study published in the Lancet, concluded that “Trivalent inactivated influenza vaccine elicited robust antibody responses and women and their infants were significantly protected against laboratory-confirmed influenza.”

Strategies for Health care providers for making a strong vaccine referral to pregnant women.

ACOG Resources Available:

 ACOG has a limited supply of the following resources available, free of charge. If you are interested in receiving a copy please email Immunization@acog.org.

 

ACIP Vote on LAIV Recommendation for 2016- 2017:

CDC’s Advisory Committee on Immunization Practices (ACIP) voted in favor of an interim recommendation that live attenuated influenza vaccine (LAIV), also known as the “nasal spray” flu vaccine, should not be used during the 2016-2017 flu season. ACIP continues to recommend annual flu vaccination, with either the inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV) for everyone 6 months and older. The ACIP vote follows data showing poor or relatively lower effectiveness of LAIV from 2013 through 2016. For more information, see the CDC Media Statement and Medscape Article

The 2016-2017 Influenza Vaccine Composition:

The FDA endorsed the WHO-recommended vaccine viruses for use in all U.S. seasonal flu vaccines for the 2016-2017 flu season. It was recommended that trivalent vaccines for use in the 2016-2017 influenza season (Northern Hemisphere winter) contain the following:

  • an A/California/7/2009 (H1N1) pdm09-like virus;
  • an A/Hong Kong/4801/2014 (H3N2)-like virus;
  • a B/Brisbane/60/2008-like virus (B/Victoria lineage).

 It was recommended that quadrivalent vaccines contain the above three viruses and a B/Phuket/3073/2013-like virus (B/Yamagata lineage).

 
 

Updated 8/18/17

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