Wisconsin Immunization Program Update
Monday, December 19, 2016
The following is an update from the Wisconsin Department of Health Services and the Division of Public Health.
HPV Two Dose Schedule
The CDC recently revised the Human Papillomavirus (HPV) vaccination recommendation from a three (3) dose series to a two (2) dose series for 9 through 14 year-olds. The MMWR published on December 15, 2016 has the two dose schedule for HPV. You can find it at: https://www.cdc.gov/mmwr/volumes/65/wr/mm6549a5.htms_cid=mm6549a5_e The Wisconsin Immunization Program (WIP) is currently working on implementing these changes to the Policies and Procedures Manual for local health departments and the Wisconsin Immunization Registry (WIR). WIP anticipates the changes to be completed by early 2017.
In the meantime, WIR will continue to forecast HPV on the existing three dose schedule. If your clinic has adjusted its policy and implemented the new two dose scheduling, keep in mind that WIR is not currently forecasting the two dose schedule for those individuals who start the series before their 15th birthday.
HPV vaccination is an important cancer prevention tool and the CDC continues to recommend that most children get the vaccine at age 11 or 12. Two doses of HPV vaccine will provide safe, effective and long-lasting protection when given at the recommended ages. CDC recommends that teens and young adults who start the series at ages 15 through 26 years will continue to need three doses of HPV vaccine. For more information on the vaccine recommendation, please visit the CDC website: https://www.cdc.gov/media/releases/2016/p1020-hpv-shots.html.
Mumps Update: Increase in cases and guidance for testing
Since November 15, 2016, 7 new cases of PCR-confirmed mumps have been reported among Wisconsin residents. The cases were reported from five different Wisconsin counties. The median age of these patients is 22 years (range: 18 to 32 years). Two are students at UW-Platteville, one is a student at an out of state university where there is an ongoing mumps outbreak, and one had a history of international travel.
- PCR is the preferred diagnostic test for mumps. Buccal swabs for PCR testing should be collected as soon as possible after symptom onset (ideally within 3 days of the onset of parotitis onset, but not more than 9 days after onset). Information on proper technique for collecting a buccal swab can be found on the CDC website: http://www.cdc.gov/mumps/lab/detection-mumps.html.
- The Wisconsin Division of Public Health requests that all samples collected from suspect cases of mumps be sent to the Wisconsin State Lab of Hygiene (WSLH) for testing. Specific guidance for the submission of the samples to the WSLH can be found at: http://www.slh.wisc.edu/mumps-testing-guidance/. The WSLH Customer Service phone number is 800-862-1013.
- In addition, the WSLH is requesting that two swabs are collected from individuals suspected of having mumps: a buccal swab for mumps testing and a nasopharyngeal swab for influenza and respiratory testing. See the following memo for more information: https://www.dhs.wisconsin.gov/influenza/testing-parotitis.pdf.
Meningococcal B Outbreak
Three cases of meningococcal disease, serogroup B occurred on the University of Wisconsin, Madison campus this past October. In response, the university, in partnership with the state health department and the Centers for Disease Control and Prevention, offered MenB vaccine to all UW Madison undergraduates; nearly 21,000 students were vaccinated at seven mass vaccination clinics held on campus.
As this is a multi-dose series, students are being asked to schedule an appointment with their home health care provider or retail pharmacy during the next two months to complete the series (students received the vaccine brand Bexsero, which is a two dose series). Immunizations, including meningococcal B vaccine, are fully covered by most health insurance plans.
If it is not possible for the student to get the vaccine at home, or if the student does not have coverage for this vaccine through health insurance, the vaccine is available at UHS at no cost by making an appointment. Alternately, uninsured UW-Madison students may receive the vaccine at their local health department.
Students have a record of their vaccination in their MyUHS account and students with Wisconsin addresses also have their MenB vaccine information from the university in the WIR.
Providers are being encouraged to reach out to their affected patients, and ensure that they have Bexsero on hand. If providers are having difficulty obtaining the vaccine in a timely manner, they can contact Don Johnston at GSK for assistance at: firstname.lastname@example.org.
Tdap Vaccination during Pregnancy
Are pregnant women in Wisconsin receiving the Tdap vaccine?
Since 2013, all pregnant women are recommended to receive Tdap vaccine during every pregnancy, ideally between 27-36 weeks gestation, to prevent pertussis among their newborn infants. The Wisconsin Immunization Program recently evaluated Tdap vaccination rates among pregnant women by linking information in the Wisconsin Immunization Registry to records of Wisconsin live births during 2015. Ninety-one percent of women with a live birth during 2015 had records in the Wisconsin Immunization Registry. Among these women, 71% received Tdap during pregnancy and 91% of these women received Tdap during the recommended time. This brief report describes Tdap vaccination rates among pregnant women in Wisconsin during 2015 and identifies subpopulations with lower vaccination rates during pregnancy. Please also view other information in the “Pregnant women” section on our Immunization
Data page: https://www.dhs.wisconsin.gov/immunization/data.htm
Brief report: https://www.dhs.wisconsin.gov/publications/p01696.pdf