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IZ Express #1,690: Immunize.org summarizes simplified ACIP recs for COVID-19 vaccines, and more
| From | Immunize.org <[email protected]> |
| Subject | IZ Express #1,690: Immunize.org summarizes simplified ACIP recs for COVID-19 vaccines, and more |
| Date | April 26, 2023 11:01 AM |
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Issue 1,690: April 26, 2023
Top Stories
* Immunize.org summarizes ACIP’s April 19, 2023, meeting to discuss simpler bivalent mRNA COVID-19 vaccine recommendations and increased flexibility for people at higher risk
* "The Association of Reported Experiences of Racial and Ethnic Discrimination in Health Care with COVID-19 Vaccination Status and Intent—United States, April 22, 2021–November 26, 2022” published in MMWR
* May is Hepatitis Awareness Month; encourage hepatitis B vaccination of all adults through age 59 years with these resources
* National Infant Immunization Week is here! Before the week ends, use CDC's 2023 digital media toolkit to spread the word.
* Spotlight: Immunize.org resources focused on the history of vaccines
* Vaccines in the news
Immunize.org Pages and Handouts
* Immunize.org updates its resource for healthcare providers titled “Meningococcal B Vaccine Recommendations by Age and Risk Factor”
* Immunize.org updates “Talking about Vaccines: Responding to Parents” web page
Featured Resources
* Meningitis B Action Project offers multiple educational materials for parents, students, and healthcare professionals, including videos
* Supplies are going fast! Get your laminated versions of CDC’s 2023 immunization schedules now.
* Immunize.org's elegant "Vaccines Save Lives" black enamel pins make thoughtful tokens of thanks for hard-working colleagues
* New resources available for organizations supporting refugee, immigrant, and migrant communities before and after the end of the public health emergency
Notable Publications
* Public Health Agency of Canada publishes "NACI Recommendations on Repeated Seasonal Influenza Vaccination" (#IZ13)
Upcoming Events
* Virtual: American College Health Association offers fourth in five-part webinar series, Facts or Fakes? Promoting Health Literacy Skills with Your Students; CE available
------------------------------------------------------------
Top Stories
------------------------------------------------------------
Immunize.org summarizes ACIP’s April 19, 2023, meeting to discuss simpler bivalent mRNA COVID-19 vaccine recommendations and increased flexibility for people at higher risk
The Advisory Committee on Immunization Practices (ACIP) ([link removed]) met on April 19, 2023 ([link removed]), to review FDA’s April 18 amendments to the emergency use authorizations (EUAs) for use of bivalent mRNA COVID-19 vaccines ([link removed]). The amendments further simplify U.S. COVID-19 vaccine recommendations and provide additional flexibility for people at higher risk of COVID-19 complications. No votes were taken, but members were generally supportive of the changes. After the meeting, CDC released a media statement ([link removed]) recommending use of these vaccines as authorized by FDA.
CDC’s statement enacts the following changes to COVID-19 vaccine recommendations:
* Bivalent mRNA COVID-19 vaccines are authorized for all recommended doses for people age 6 months and older
* Monovalent mRNA vaccines are no longer authorized for use in the United States
* Previously unvaccinated people age 6 years and older, and those in that age group who have not received a bivalent mRNA COVID-19 vaccine, are considered fully vaccinated following a single bivalent dose
* Children age 6 months through 5 years should receive a primary series of at least two doses (with at least one bivalent dose), but the total number of doses needed is determined by the formulation used and the number of previous doses. CDC is developing support materials to assist providers with these determinations.
* Adults age 65 years and older who have received a bivalent mRNA vaccine dose have the option to receive a second bivalent mRNA dose at least 4 months after their most recent dose
* Individuals with immunocompromise who received a bivalent mRNA vaccine dose have the option to receive a second bivalent mRNA vaccine dose at least 2 months after their most recent dose, and subsequent doses at the discretion of their healthcare provider
+ Due to lack of data, FDA did not extend this authorization to children younger than age 5 who received Pfizer-BioNTech COVID-19 vaccination
* No changes were made to the recommendations for use of monovalent Novavax and Janssen (Johnson & Johnson) COVID-19 vaccines
During the meeting, ACIP also received COVID-19 vaccine program updates, discussed vaccine safety and efficacy, and reviewed implementation issues related to the updated bivalent vaccine authorizations. Presentation slides ([link removed]) are available online. The sections below outline additional key points.
Next steps for implementation of revised CDC guidance
* The elimination of monovalent mRNA vaccine options reduces the number of mRNA COVID-19 vaccine products from 11 to 5
* Clinicians should download and use the four new FDA EUA Fact Sheets that reflect these changes
* CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States ([link removed]) should be reviewed for specific guidance
* CDC will issue additional clinic tools to assist providers in coming weeks, especially for children age 6 months through 5 years, whose new interim recommendations are particularly complex
* CDC will host a Clinician Outreach and Communication Activity (COCA) ([link removed]) webinar on these changes on May 11
Current vaccine uptake and safety
* The bivalent vaccines demonstrate very good effectiveness against severe disease outcomes
* Only 16.7% of eligible people in the United States have received a bivalent vaccine
* CDC continues to monitor the statistical signal suggesting a possible increased risk for ischemic stroke following receipt of Pfizer-BioNTech COVID-19 bivalent vaccine ([link removed]). The signal has diminished over time, which is reassuring. Recommendations for use of the vaccine are unchanged.
End of the Public Health Emergency (PHE) for COVID-19
* The COVID-19 PHE ends on May 11, 2023
* All government-purchased COVID-19 vaccine doses will continue to be distributed and administered free of charge at least through summer 2023
* After COVID-19 vaccines become commercially available in the fall, most recipients will have access to vaccination with no out-of-pocket costs. The Vaccines for Children program, commercial insurance, Medicaid, and Medicare will cover the cost of these vaccines.
* A new federal “Bridge Access Program ([link removed])” is intended to maintain COVID-19 vaccine access for uninsured adults
* The Public Readiness and Emergency Preparedness (PREP) Act providing immunity from liability ([link removed]) for medical countermeasures against COVID-19 will be extended through December 2024. This revised declaration will provide liability protection for pharmacy professionals to administer COVID-19 and seasonal influenza vaccines to people age 3 years or older.
Future recommendations
* In June 2023, the virus strain or strains to be included in COVID-19 vaccine anticipated to be distributed in fall 2023 will be selected
* ACIP members and CDC staff highlighted the need for further changes to recommendations for younger children, including immunocompromised children, and the need to consider recommending vaccination during each pregnancy
The next scheduled ACIP meeting will be held on June 21–22, 2023, although additional emergency meetings may be announced before that time. Information about past and future ACIP meetings ([link removed]) may be found on the ACIP website.
Related Links
* ACIP main page ([link removed]) for content from previous meetings, as well as information about future settings
* CDC: ACIP Presentation Slides ([link removed]) : April 19 Meeting web page
* FDA: Fact Sheets for Bivalent COVID-19 mRNA Vaccine
+ Pfizer-BioNTech
o Healthcare providers ([link removed]) (4/18/2023)
o Recipients and caregivers ([link removed]) (4/18/2023)
+ Moderna
o Healthcare providers ([link removed]) (4/18/2023)
o Recipients and caregivers ([link removed]) (4/18/2023)
* CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States ([link removed])
* CDC: (media statement) CDC Simplifies COVID-19 Vaccine Recommendations, Allows Older Adults and Immunocompromised Adults to Get Second Dose of the Updated Vaccine ([link removed])
* HHS: Fact Sheet: HHS Announces Intent to Amend the Declaration under the PREP Act for Medical Countermeasures against COVID-19 ([link removed])
------------------------------------------------------------
"The Association of Reported Experiences of Racial and Ethnic Discrimination in Health Care with COVID-19 Vaccination Status and Intent—United States, April 22, 2021–November 26, 2022” published in MMWR
CDC published The Association of Reported Experiences of Racial and Ethnic Discrimination in Health Care with COVID-19 Vaccination Status and Intent—United States, April 22, 2021–November 26, 2022 ([link removed]) in the April 21 issue of MMWR ([link removed]). A portion of the summary appears below.
Adults reporting experiences of racial and ethnic discrimination in health care had a significantly higher prevalence of being unvaccinated against COVID-19 overall and among most racial and ethnic groups. . . .
Strategies to address inequitable experiences (discrimination) include increasing awareness by health care providers of patients’ potential negative health care experiences and known historical mistreatment and incorporating this sensitivity into their patient interactions. This action might foster patient trust, improve adherence to recommended health interventions, and reduce some COVID-19–related health disparities.
Access the MMWR article in HTML ([link removed]) or PDF ([link removed]).
Related Link
* MMWR's main page ([link removed]) provides access to MMWR Weekly and its companion publications
------------------------------------------------------------
May is Hepatitis Awareness Month; encourage hepatitis B vaccination of all adults through age 59 years with these resources
May is Hepatitis Awareness Month ([link removed].) across the United States, and May 19 marks National Hepatitis Testing Day ([link removed]) . Help shed light on the burden of viral hepatitis and encourage testing and vaccination according to CDC recommendations. Key facts:
* Several viruses cause hepatitis. The most common types are hepatitis A, hepatitis B, and hepatitis C.
* Chronic hepatitis B and hepatitis C are the leading causes of liver cancer in the United States
* Both hepatitis A and hepatitis B are preventable with safe and effective vaccines
CDC published Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices—United States, 2022 ([link removed]) on April 1 in MMWR. Hepatitis B vaccination is now recommended by CDC as shown:
* All adults age 19 through 59 years and adults age 60 years and older with risk factors for hepatitis B infection should be vaccinated against hepatitis B
* Adults age 60 years and older without known risk factors may also receive HepB
CDC continues to recommend routine hepatitis B vaccination for all infants and catch-up vaccination of children and teens younger than age 19 years.
Spread the word with graphics and posts on social media to promote Hepatitis Awareness Month and National Hepatitis Testing Day. CDC's social media toolkit is posted on its Hepatitis Awareness Month ([link removed].) web page.
Related Links
* MMWR: Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices—United States, 2022 ([link removed]) (4/1/22)
* CDC: Viral Hepatitis: Awareness Month ([link removed].) web page
* CDC: Viral Hepatitis: Hepatitis B Vaccination of Adults ([link removed]) web page
* Hepatitis B Foundation: May Is Hepatitis Awareness Month ([link removed]) web page
* Immunize.org: Standing Orders for Administering Hepatitis B Vaccine to Adults ([link removed]) (PDF)
* Immunize.org: Vaccines: Hepatitis A ([link removed]) web page
* Immunize.org: Vaccines: Hepatitis B ([link removed]) web page
* Immunize.org: Ask the Experts: Hepatitis B ([link removed]) web page
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National Infant Immunization Week is here! Before the week ends, use CDC's 2022 digital media toolkit to spread the word.
National Infant Immunization Week ([link removed]) (NIIW), April 24–30, highlights the importance of protecting infants from vaccine-preventable diseases and celebrates the achievements of immunization partners. Completing the recommended vaccinations by age 2 years is the best way to protect young children from 15 potentially life-threatening diseases. After the disruptions of three pandemic years, these messages are more important than ever for families to hear.
Before this week is over, use CDC's 2023 NIIW Digital Media Toolkit ([link removed]) for your NIIW activities. The toolkit includes updated English and Spanish logos, sample social media content, social graphics, and key messages. Please share your posts using the hashtag #ivax2protect.
Related Links
* CDC: National Infant Immunization Week ([link removed]) main page
* CDC: 2023 NIIW Digital Media Toolkit ([link removed]) main page
* Immunize.org: Parent Handouts ([link removed]) main page
------------------------------------------------------------
Spotlight: Immunize.org resources focused on the history of vaccines
In this week’s Spotlight, we summarize resources at Immunize.org that focus on the history of vaccines.
Vaccine Timeline ([link removed]) main page lists historic dates and events related to vaccines and immunization. From Edward Jenner’s first smallpox vaccination in 1796 to COVID-19 vaccines, this chart highlights scientific discoveries and technologies that led to rapid advances in virology, molecular biology, and vaccinology.
Immunize.org YouTube channel ([link removed]) contains public service announcements encouraging vaccination. Compiled by vaccine expert Capt. William L. Atkinson, MD, MPH, USPHS (retired), this collection spans more than 50 years.
History through Film ([link removed]) main page highlights Protecting Health: Saving Lives, the documentary that covers the history of the Immunization Action Coalition (now Immunize.org) from 1990 to 2020. Hosted by Sam Waterston, the 30-minute film was produced by Visionaries, Inc. for broadcast on more than 100 local PBS stations nationwide.
Publications Archive ([link removed]) links to past issues of Immunize.org publications, describing the contemporary vaccine-practice issues of the time: Needle Tips, Vaccinate Adults!, Vaccinate Women, and IZ Express (formerly IAC Express).
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Vaccines in the news
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* STAT: RSV Vaccine Approval Should Be a Top Priority for the FDA ([link removed]) (Opinion) (4/19/23)
* Washington Post: Why Reports of Period Weirdness after COVID Shots Were Ignored ([link removed]) (Opinion) (4/18/23)
* New York Times: Biden Administration Will Fund Program to Keep COVID Vaccines Free for the Uninsured ([link removed]) (4/18/23)
* Reuters: U.S. Spending $5 Billion to Speed Up Development of New COVID Vaccines ([link removed]) (4/11/23)
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Immunize.org Pages and Handouts
------------------------------------------------------------
Immunize.org updates its resource for healthcare providers titled “Meningococcal B Vaccine Recommendations by Age and Risk Factor”
Immunize.org updated its chart for healthcare providers, Meningococcal B Vaccine Recommendations by Age and Risk Factor ([link removed]). Minor text changes enhance comprehension. A QR code now links to the online version of the document.
Test Yourself: A 10-year-old patient with sickle cell disease presents for vaccination. You give MenB today. Based on the brand of MenB available in your setting, when would you schedule the second dose? Find the right answer in this chart.
Related Links
* Immunize.org: Handouts: Q&As: Diseases and Vaccines ([link removed]) web page
* Immunize.org: Handouts: Meningococcal B ([link removed]) web page
* Immunize.org: Handouts for Patients and Staff ([link removed]) web page, where you can sort materials by topic, vaccine, or language
* Immunize.org: Educational Materials for Patients and Staff ([link removed])—an alphabetical list of more than 300 ready-to-print staff educational materials and patient handouts
------------------------------------------------------------
Immunize.org updates “Talking about Vaccines: Responding to Parents” web page
Immunize.org updated its Talking about Vaccines: Responding to Parents ([link removed]) main page. This page leads to many resources from Immunize.org, CDC, and others to help healthcare professionals communicate with parents and patients about important vaccine topics. Changes include updated CDC, AAP, and other resources.
Related Link
* Immunize.org: Talking about Vaccines ([link removed]) main page
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Featured Resources
------------------------------------------------------------
Meningitis B Action Project offers multiple educational materials for parents, students, and healthcare professionals, including videos
The Meningitis B Action Project ([link removed]), a joint initiative by the Kimberly Coffey Foundation and the Emily Stillman Foundation, offers a wide range of MenB educational materials and videos ([link removed]) for parents, students, and healthcare professionals, including recently added Spanish translations ([link removed]).
Meningitis B Action Project co-founders, Patti Wukovits and Alicia Stillman, recently joined the Ambiguously Blind podcast ([link removed]), hosted by bacterial meningitis survivor John Grimes. In the podcast, they discuss their experience with meningitis advocacy in honor and memory of each of their daughters, Kimberly Coffey and Emily Stillman, who lost their lives to meningitis B before the MenB vaccine was available in the United States.
The work of the Meningitis B Action Project was recently highlighted in Contemporary Pediatrics ([link removed]-). The article emphasized the role pediatric and adolescent practitioners play in preventing meningococcal meningitis.
Related Links
* Meningitis B Action Project ([link removed]) web page
* Immunize.org: Handouts: Meningococcal B ([link removed]) web page
* Immunze.org: Ask the Experts: Meningococcal B ([link removed]) web page
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Supplies are going fast! Get your laminated versions of CDC’s 2023 immunization schedules now.
Immunize.org's laminated versions of the 2023 U.S. child and adolescent immunization schedule ([link removed]) and the 2023 U.S. adult immunization schedule ([link removed]) are in stock, but supplies are getting low. Order while supplies last.
While the schedules are available online from CDC at no cost, Immunize.org’s laminated schedules are ideal for use in any busy healthcare setting. Their tough coating can be wiped down, and they’re durable enough to stand up to a year of use.
* Length: Each schedule with appendices is 12 pages
* Size: Standard 8.5” X 11” booklet format
* Full Color: With color coding for easy reading, our laminated schedules replicate the original CDC formatting, including the essential tables and notes
* Bonus: The adult schedule includes Immunize.org’s popular 1-page handout summarizing the dose, route, and needle length recommendations for all vaccines and recipients
Pricing for Each Schedule
$10.00: 1 copy
$9.50 each: 2–4 copies
$8.50 each: 5–19 copies
$7.50 each: 20–99 copies
$6.00 each: 100–499 copies
$5.00 each: 500–999 copies
$4.00 each: 1,000–1,999 copies
$3.25 each: 2,000+ copies
Visit Shop Immunize.org: Laminated Schedules ([link removed]) to view images of each page and order today!
For additional information, call 651-647-9009 or email [email protected].
Related Links
* Immunize.org: Laminated Child and Adolescent Immunization Schedules (0–18 years) ([link removed]) web page
* Immunize.org: Laminated Adult Immunization Schedules (19 and older) ([link removed]) web page
* Immunize.org: Shop Immunize.org ([link removed]) main page
* CDC: Immunization Schedules ([link removed])
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Immunize.org's elegant "Vaccines Save Lives" black enamel pins make thoughtful tokens of thanks for hard-working colleagues
Immunize.org’s elegantly designed “Vaccines Save Lives” pins ([link removed]) are meaningful gifts for people who care about vaccination. The pin makes a refined statement in hard black enamel with gold lettering and edges, measuring 1.125" x 0.75".
[link removed]
The pin features a stick-through-post with the back covered by a round rubber cap that holds the pin securely. A gold metal spring-lock clasp is also provided.
Wear these pins on clothing, ([link removed]) uniforms, and white coats to show that you value vaccines.
Click here for "Vaccines Save Lives" pin pricing and ordering information. ([link removed])
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New resources available for organizations supporting refugee, immigrant, and migrant communities before and after the end of the public health emergency
The National Resource Center for Refugees, Immigrants, and Migrants (NRC-RIM) released a collection of materials ([link removed]) to help organizations supporting refugee, immigrant and migrant (RIM) communities before and after the end of the COVID-19 public health emergency.
* Materials for communities include fact sheets, social media assets, a cost table, and descriptions of promising practices to improve health in RIM communities
* Many of these materials are customizable; organizations may add their own logos
* Resources were translated into Amharic, Arabic, Burmese, Dari, French, Karen, Kinyarwanda, Nepali, Pashto, Portuguese, Rohingya, Russian, Spanish, Somali, Swahili (Congolese), Swahili (East Africa), Tigrinya, and Ukrainian
* Audio resources in Dari, Pashto, and Rohingya are coming soon
Related Links
* NRC-RIM ([link removed]) main page
* NRC-RIM: End of the Public Health Emergency ([link removed]) web page
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Notable Publications
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Public Health Agency of Canada publishes "NACI Recommendations on Repeated Seasonal Influenza Vaccination"
In the April 2023 issue, Children's Health and COVID-19 published Advisory Committee Statement: Summary of the National Advisory Committee on Immunization (NACI) Statement—Recommendation on Repeated Seasonal Influenza Vaccination ([link removed]) . NACI addressed the question of whether annual influenza vaccination might result in diminished benefits over time. They concluded that evidence supports the benefit of annual influenza immunization. NACI is the Canadian counterpart of the CDC’s ACIP. The conclusions section appears below.
Overall, NACI concluded that there is evidence to recommend annual influenza vaccination, irrespective of whether an individual received the seasonal influenza vaccine in previous seasons. It is neither currently feasible nor warranted to modify existing annual influenza vaccination programs to account for potential negative or positive interference. NACI continues to strongly recommend that seasonal influenza vaccine should be offered annually to everyone six months of age and older who does not have contraindications to the vaccine, irrespective of previous seasons' influenza vaccination status.
------------------------------------------------------------
Upcoming Events
------------------------------------------------------------
Virtual: American College Health Association offers fourth in five-part webinar series, Facts or Fakes? Promoting Health Literacy Skills with Your Students; CE available
The American College Health Association (ACHA) is offering a free, five-part webinar series, Facts or Fakes? Promoting Health Literacy Skills with Your Students ([link removed]) . This five-part webinar series provides tools to help students and others navigate misinformation, disinformation, and the infodemic. Webinars include:
* January 10 – "Health Literacy 101" (available on-demand ([link removed]) )
* February 21 – "Digital Wellbeing and Mental Health: Helping Me Is Helping We" (available on-demand ([link removed]) )
* March 7 – "Debunking Fake News" (available on-demand ([link removed]) )
* April 18 – "Confronting Misinformation in Our Circles of Influence" (available on-demand ([link removed]) )
* May 9 – "Managing the Infodemic: Getting Started"
The May 9 session airs 12:00–1:00 p.m. (ET). Up to 5 hours of credit are available for CNE, CME, and CHES, and 1.0 CE is available for counselors for session 2.
Register for the free webinars ([link removed]).
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For more upcoming events, visit our Calendar of Events ([link removed]).
Editorial Information
Editor-in-Chief
Kelly L. Moore, MD, MPH
Managing Editor
John D. Grabenstein, RPh, PhD
Associate Editor
Sharon G. Humiston, MD, MPH
Writer/Publication Coordinator
Taryn Chapman, MS
Courtnay Londo, MA
Style and Copy Editor
Marian Deegan, JD
Web Edition Managers
Arkady Shakhnovich
Jermaine Royes
Contributing Writer
Laurel H. Wood, MPA
Technical Reviewer
Kayla Ohlde
About IZ Express
Immunize.org welcomes redistribution of this issue of IZ Express or selected articles. When you do so, please add a note that Immunize.org is the source of the material and provide a link to this issue ([link removed]).
IZ Express is supported in part by Grant No. 1NH23IP922654 from the National Center for Immunization and Respiratory Diseases, CDC. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.
IZ Express Disclaimer ([link removed])
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Issue 1,690: April 26, 2023
Top Stories
* Immunize.org summarizes ACIP’s April 19, 2023, meeting to discuss simpler bivalent mRNA COVID-19 vaccine recommendations and increased flexibility for people at higher risk
* "The Association of Reported Experiences of Racial and Ethnic Discrimination in Health Care with COVID-19 Vaccination Status and Intent—United States, April 22, 2021–November 26, 2022” published in MMWR
* May is Hepatitis Awareness Month; encourage hepatitis B vaccination of all adults through age 59 years with these resources
* National Infant Immunization Week is here! Before the week ends, use CDC's 2023 digital media toolkit to spread the word.
* Spotlight: Immunize.org resources focused on the history of vaccines
* Vaccines in the news
Immunize.org Pages and Handouts
* Immunize.org updates its resource for healthcare providers titled “Meningococcal B Vaccine Recommendations by Age and Risk Factor”
* Immunize.org updates “Talking about Vaccines: Responding to Parents” web page
Featured Resources
* Meningitis B Action Project offers multiple educational materials for parents, students, and healthcare professionals, including videos
* Supplies are going fast! Get your laminated versions of CDC’s 2023 immunization schedules now.
* Immunize.org's elegant "Vaccines Save Lives" black enamel pins make thoughtful tokens of thanks for hard-working colleagues
* New resources available for organizations supporting refugee, immigrant, and migrant communities before and after the end of the public health emergency
Notable Publications
* Public Health Agency of Canada publishes "NACI Recommendations on Repeated Seasonal Influenza Vaccination" (#IZ13)
Upcoming Events
* Virtual: American College Health Association offers fourth in five-part webinar series, Facts or Fakes? Promoting Health Literacy Skills with Your Students; CE available
------------------------------------------------------------
Top Stories
------------------------------------------------------------
Immunize.org summarizes ACIP’s April 19, 2023, meeting to discuss simpler bivalent mRNA COVID-19 vaccine recommendations and increased flexibility for people at higher risk
The Advisory Committee on Immunization Practices (ACIP) ([link removed]) met on April 19, 2023 ([link removed]), to review FDA’s April 18 amendments to the emergency use authorizations (EUAs) for use of bivalent mRNA COVID-19 vaccines ([link removed]). The amendments further simplify U.S. COVID-19 vaccine recommendations and provide additional flexibility for people at higher risk of COVID-19 complications. No votes were taken, but members were generally supportive of the changes. After the meeting, CDC released a media statement ([link removed]) recommending use of these vaccines as authorized by FDA.
CDC’s statement enacts the following changes to COVID-19 vaccine recommendations:
* Bivalent mRNA COVID-19 vaccines are authorized for all recommended doses for people age 6 months and older
* Monovalent mRNA vaccines are no longer authorized for use in the United States
* Previously unvaccinated people age 6 years and older, and those in that age group who have not received a bivalent mRNA COVID-19 vaccine, are considered fully vaccinated following a single bivalent dose
* Children age 6 months through 5 years should receive a primary series of at least two doses (with at least one bivalent dose), but the total number of doses needed is determined by the formulation used and the number of previous doses. CDC is developing support materials to assist providers with these determinations.
* Adults age 65 years and older who have received a bivalent mRNA vaccine dose have the option to receive a second bivalent mRNA dose at least 4 months after their most recent dose
* Individuals with immunocompromise who received a bivalent mRNA vaccine dose have the option to receive a second bivalent mRNA vaccine dose at least 2 months after their most recent dose, and subsequent doses at the discretion of their healthcare provider
+ Due to lack of data, FDA did not extend this authorization to children younger than age 5 who received Pfizer-BioNTech COVID-19 vaccination
* No changes were made to the recommendations for use of monovalent Novavax and Janssen (Johnson & Johnson) COVID-19 vaccines
During the meeting, ACIP also received COVID-19 vaccine program updates, discussed vaccine safety and efficacy, and reviewed implementation issues related to the updated bivalent vaccine authorizations. Presentation slides ([link removed]) are available online. The sections below outline additional key points.
Next steps for implementation of revised CDC guidance
* The elimination of monovalent mRNA vaccine options reduces the number of mRNA COVID-19 vaccine products from 11 to 5
* Clinicians should download and use the four new FDA EUA Fact Sheets that reflect these changes
* CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States ([link removed]) should be reviewed for specific guidance
* CDC will issue additional clinic tools to assist providers in coming weeks, especially for children age 6 months through 5 years, whose new interim recommendations are particularly complex
* CDC will host a Clinician Outreach and Communication Activity (COCA) ([link removed]) webinar on these changes on May 11
Current vaccine uptake and safety
* The bivalent vaccines demonstrate very good effectiveness against severe disease outcomes
* Only 16.7% of eligible people in the United States have received a bivalent vaccine
* CDC continues to monitor the statistical signal suggesting a possible increased risk for ischemic stroke following receipt of Pfizer-BioNTech COVID-19 bivalent vaccine ([link removed]). The signal has diminished over time, which is reassuring. Recommendations for use of the vaccine are unchanged.
End of the Public Health Emergency (PHE) for COVID-19
* The COVID-19 PHE ends on May 11, 2023
* All government-purchased COVID-19 vaccine doses will continue to be distributed and administered free of charge at least through summer 2023
* After COVID-19 vaccines become commercially available in the fall, most recipients will have access to vaccination with no out-of-pocket costs. The Vaccines for Children program, commercial insurance, Medicaid, and Medicare will cover the cost of these vaccines.
* A new federal “Bridge Access Program ([link removed])” is intended to maintain COVID-19 vaccine access for uninsured adults
* The Public Readiness and Emergency Preparedness (PREP) Act providing immunity from liability ([link removed]) for medical countermeasures against COVID-19 will be extended through December 2024. This revised declaration will provide liability protection for pharmacy professionals to administer COVID-19 and seasonal influenza vaccines to people age 3 years or older.
Future recommendations
* In June 2023, the virus strain or strains to be included in COVID-19 vaccine anticipated to be distributed in fall 2023 will be selected
* ACIP members and CDC staff highlighted the need for further changes to recommendations for younger children, including immunocompromised children, and the need to consider recommending vaccination during each pregnancy
The next scheduled ACIP meeting will be held on June 21–22, 2023, although additional emergency meetings may be announced before that time. Information about past and future ACIP meetings ([link removed]) may be found on the ACIP website.
Related Links
* ACIP main page ([link removed]) for content from previous meetings, as well as information about future settings
* CDC: ACIP Presentation Slides ([link removed]) : April 19 Meeting web page
* FDA: Fact Sheets for Bivalent COVID-19 mRNA Vaccine
+ Pfizer-BioNTech
o Healthcare providers ([link removed]) (4/18/2023)
o Recipients and caregivers ([link removed]) (4/18/2023)
+ Moderna
o Healthcare providers ([link removed]) (4/18/2023)
o Recipients and caregivers ([link removed]) (4/18/2023)
* CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States ([link removed])
* CDC: (media statement) CDC Simplifies COVID-19 Vaccine Recommendations, Allows Older Adults and Immunocompromised Adults to Get Second Dose of the Updated Vaccine ([link removed])
* HHS: Fact Sheet: HHS Announces Intent to Amend the Declaration under the PREP Act for Medical Countermeasures against COVID-19 ([link removed])
------------------------------------------------------------
"The Association of Reported Experiences of Racial and Ethnic Discrimination in Health Care with COVID-19 Vaccination Status and Intent—United States, April 22, 2021–November 26, 2022” published in MMWR
CDC published The Association of Reported Experiences of Racial and Ethnic Discrimination in Health Care with COVID-19 Vaccination Status and Intent—United States, April 22, 2021–November 26, 2022 ([link removed]) in the April 21 issue of MMWR ([link removed]). A portion of the summary appears below.
Adults reporting experiences of racial and ethnic discrimination in health care had a significantly higher prevalence of being unvaccinated against COVID-19 overall and among most racial and ethnic groups. . . .
Strategies to address inequitable experiences (discrimination) include increasing awareness by health care providers of patients’ potential negative health care experiences and known historical mistreatment and incorporating this sensitivity into their patient interactions. This action might foster patient trust, improve adherence to recommended health interventions, and reduce some COVID-19–related health disparities.
Access the MMWR article in HTML ([link removed]) or PDF ([link removed]).
Related Link
* MMWR's main page ([link removed]) provides access to MMWR Weekly and its companion publications
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May is Hepatitis Awareness Month; encourage hepatitis B vaccination of all adults through age 59 years with these resources
May is Hepatitis Awareness Month ([link removed].) across the United States, and May 19 marks National Hepatitis Testing Day ([link removed]) . Help shed light on the burden of viral hepatitis and encourage testing and vaccination according to CDC recommendations. Key facts:
* Several viruses cause hepatitis. The most common types are hepatitis A, hepatitis B, and hepatitis C.
* Chronic hepatitis B and hepatitis C are the leading causes of liver cancer in the United States
* Both hepatitis A and hepatitis B are preventable with safe and effective vaccines
CDC published Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices—United States, 2022 ([link removed]) on April 1 in MMWR. Hepatitis B vaccination is now recommended by CDC as shown:
* All adults age 19 through 59 years and adults age 60 years and older with risk factors for hepatitis B infection should be vaccinated against hepatitis B
* Adults age 60 years and older without known risk factors may also receive HepB
CDC continues to recommend routine hepatitis B vaccination for all infants and catch-up vaccination of children and teens younger than age 19 years.
Spread the word with graphics and posts on social media to promote Hepatitis Awareness Month and National Hepatitis Testing Day. CDC's social media toolkit is posted on its Hepatitis Awareness Month ([link removed].) web page.
Related Links
* MMWR: Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices—United States, 2022 ([link removed]) (4/1/22)
* CDC: Viral Hepatitis: Awareness Month ([link removed].) web page
* CDC: Viral Hepatitis: Hepatitis B Vaccination of Adults ([link removed]) web page
* Hepatitis B Foundation: May Is Hepatitis Awareness Month ([link removed]) web page
* Immunize.org: Standing Orders for Administering Hepatitis B Vaccine to Adults ([link removed]) (PDF)
* Immunize.org: Vaccines: Hepatitis A ([link removed]) web page
* Immunize.org: Vaccines: Hepatitis B ([link removed]) web page
* Immunize.org: Ask the Experts: Hepatitis B ([link removed]) web page
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National Infant Immunization Week is here! Before the week ends, use CDC's 2022 digital media toolkit to spread the word.
National Infant Immunization Week ([link removed]) (NIIW), April 24–30, highlights the importance of protecting infants from vaccine-preventable diseases and celebrates the achievements of immunization partners. Completing the recommended vaccinations by age 2 years is the best way to protect young children from 15 potentially life-threatening diseases. After the disruptions of three pandemic years, these messages are more important than ever for families to hear.
Before this week is over, use CDC's 2023 NIIW Digital Media Toolkit ([link removed]) for your NIIW activities. The toolkit includes updated English and Spanish logos, sample social media content, social graphics, and key messages. Please share your posts using the hashtag #ivax2protect.
Related Links
* CDC: National Infant Immunization Week ([link removed]) main page
* CDC: 2023 NIIW Digital Media Toolkit ([link removed]) main page
* Immunize.org: Parent Handouts ([link removed]) main page
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Spotlight: Immunize.org resources focused on the history of vaccines
In this week’s Spotlight, we summarize resources at Immunize.org that focus on the history of vaccines.
Vaccine Timeline ([link removed]) main page lists historic dates and events related to vaccines and immunization. From Edward Jenner’s first smallpox vaccination in 1796 to COVID-19 vaccines, this chart highlights scientific discoveries and technologies that led to rapid advances in virology, molecular biology, and vaccinology.
Immunize.org YouTube channel ([link removed]) contains public service announcements encouraging vaccination. Compiled by vaccine expert Capt. William L. Atkinson, MD, MPH, USPHS (retired), this collection spans more than 50 years.
History through Film ([link removed]) main page highlights Protecting Health: Saving Lives, the documentary that covers the history of the Immunization Action Coalition (now Immunize.org) from 1990 to 2020. Hosted by Sam Waterston, the 30-minute film was produced by Visionaries, Inc. for broadcast on more than 100 local PBS stations nationwide.
Publications Archive ([link removed]) links to past issues of Immunize.org publications, describing the contemporary vaccine-practice issues of the time: Needle Tips, Vaccinate Adults!, Vaccinate Women, and IZ Express (formerly IAC Express).
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Vaccines in the news
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* STAT: RSV Vaccine Approval Should Be a Top Priority for the FDA ([link removed]) (Opinion) (4/19/23)
* Washington Post: Why Reports of Period Weirdness after COVID Shots Were Ignored ([link removed]) (Opinion) (4/18/23)
* New York Times: Biden Administration Will Fund Program to Keep COVID Vaccines Free for the Uninsured ([link removed]) (4/18/23)
* Reuters: U.S. Spending $5 Billion to Speed Up Development of New COVID Vaccines ([link removed]) (4/11/23)
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Immunize.org Pages and Handouts
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Immunize.org updates its resource for healthcare providers titled “Meningococcal B Vaccine Recommendations by Age and Risk Factor”
Immunize.org updated its chart for healthcare providers, Meningococcal B Vaccine Recommendations by Age and Risk Factor ([link removed]). Minor text changes enhance comprehension. A QR code now links to the online version of the document.
Test Yourself: A 10-year-old patient with sickle cell disease presents for vaccination. You give MenB today. Based on the brand of MenB available in your setting, when would you schedule the second dose? Find the right answer in this chart.
Related Links
* Immunize.org: Handouts: Q&As: Diseases and Vaccines ([link removed]) web page
* Immunize.org: Handouts: Meningococcal B ([link removed]) web page
* Immunize.org: Handouts for Patients and Staff ([link removed]) web page, where you can sort materials by topic, vaccine, or language
* Immunize.org: Educational Materials for Patients and Staff ([link removed])—an alphabetical list of more than 300 ready-to-print staff educational materials and patient handouts
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Immunize.org updates “Talking about Vaccines: Responding to Parents” web page
Immunize.org updated its Talking about Vaccines: Responding to Parents ([link removed]) main page. This page leads to many resources from Immunize.org, CDC, and others to help healthcare professionals communicate with parents and patients about important vaccine topics. Changes include updated CDC, AAP, and other resources.
Related Link
* Immunize.org: Talking about Vaccines ([link removed]) main page
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Featured Resources
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Meningitis B Action Project offers multiple educational materials for parents, students, and healthcare professionals, including videos
The Meningitis B Action Project ([link removed]), a joint initiative by the Kimberly Coffey Foundation and the Emily Stillman Foundation, offers a wide range of MenB educational materials and videos ([link removed]) for parents, students, and healthcare professionals, including recently added Spanish translations ([link removed]).
Meningitis B Action Project co-founders, Patti Wukovits and Alicia Stillman, recently joined the Ambiguously Blind podcast ([link removed]), hosted by bacterial meningitis survivor John Grimes. In the podcast, they discuss their experience with meningitis advocacy in honor and memory of each of their daughters, Kimberly Coffey and Emily Stillman, who lost their lives to meningitis B before the MenB vaccine was available in the United States.
The work of the Meningitis B Action Project was recently highlighted in Contemporary Pediatrics ([link removed]-). The article emphasized the role pediatric and adolescent practitioners play in preventing meningococcal meningitis.
Related Links
* Meningitis B Action Project ([link removed]) web page
* Immunize.org: Handouts: Meningococcal B ([link removed]) web page
* Immunze.org: Ask the Experts: Meningococcal B ([link removed]) web page
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Supplies are going fast! Get your laminated versions of CDC’s 2023 immunization schedules now.
Immunize.org's laminated versions of the 2023 U.S. child and adolescent immunization schedule ([link removed]) and the 2023 U.S. adult immunization schedule ([link removed]) are in stock, but supplies are getting low. Order while supplies last.
While the schedules are available online from CDC at no cost, Immunize.org’s laminated schedules are ideal for use in any busy healthcare setting. Their tough coating can be wiped down, and they’re durable enough to stand up to a year of use.
* Length: Each schedule with appendices is 12 pages
* Size: Standard 8.5” X 11” booklet format
* Full Color: With color coding for easy reading, our laminated schedules replicate the original CDC formatting, including the essential tables and notes
* Bonus: The adult schedule includes Immunize.org’s popular 1-page handout summarizing the dose, route, and needle length recommendations for all vaccines and recipients
Pricing for Each Schedule
$10.00: 1 copy
$9.50 each: 2–4 copies
$8.50 each: 5–19 copies
$7.50 each: 20–99 copies
$6.00 each: 100–499 copies
$5.00 each: 500–999 copies
$4.00 each: 1,000–1,999 copies
$3.25 each: 2,000+ copies
Visit Shop Immunize.org: Laminated Schedules ([link removed]) to view images of each page and order today!
For additional information, call 651-647-9009 or email [email protected].
Related Links
* Immunize.org: Laminated Child and Adolescent Immunization Schedules (0–18 years) ([link removed]) web page
* Immunize.org: Laminated Adult Immunization Schedules (19 and older) ([link removed]) web page
* Immunize.org: Shop Immunize.org ([link removed]) main page
* CDC: Immunization Schedules ([link removed])
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Immunize.org's elegant "Vaccines Save Lives" black enamel pins make thoughtful tokens of thanks for hard-working colleagues
Immunize.org’s elegantly designed “Vaccines Save Lives” pins ([link removed]) are meaningful gifts for people who care about vaccination. The pin makes a refined statement in hard black enamel with gold lettering and edges, measuring 1.125" x 0.75".
[link removed]
The pin features a stick-through-post with the back covered by a round rubber cap that holds the pin securely. A gold metal spring-lock clasp is also provided.
Wear these pins on clothing, ([link removed]) uniforms, and white coats to show that you value vaccines.
Click here for "Vaccines Save Lives" pin pricing and ordering information. ([link removed])
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New resources available for organizations supporting refugee, immigrant, and migrant communities before and after the end of the public health emergency
The National Resource Center for Refugees, Immigrants, and Migrants (NRC-RIM) released a collection of materials ([link removed]) to help organizations supporting refugee, immigrant and migrant (RIM) communities before and after the end of the COVID-19 public health emergency.
* Materials for communities include fact sheets, social media assets, a cost table, and descriptions of promising practices to improve health in RIM communities
* Many of these materials are customizable; organizations may add their own logos
* Resources were translated into Amharic, Arabic, Burmese, Dari, French, Karen, Kinyarwanda, Nepali, Pashto, Portuguese, Rohingya, Russian, Spanish, Somali, Swahili (Congolese), Swahili (East Africa), Tigrinya, and Ukrainian
* Audio resources in Dari, Pashto, and Rohingya are coming soon
Related Links
* NRC-RIM ([link removed]) main page
* NRC-RIM: End of the Public Health Emergency ([link removed]) web page
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Notable Publications
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Public Health Agency of Canada publishes "NACI Recommendations on Repeated Seasonal Influenza Vaccination"
In the April 2023 issue, Children's Health and COVID-19 published Advisory Committee Statement: Summary of the National Advisory Committee on Immunization (NACI) Statement—Recommendation on Repeated Seasonal Influenza Vaccination ([link removed]) . NACI addressed the question of whether annual influenza vaccination might result in diminished benefits over time. They concluded that evidence supports the benefit of annual influenza immunization. NACI is the Canadian counterpart of the CDC’s ACIP. The conclusions section appears below.
Overall, NACI concluded that there is evidence to recommend annual influenza vaccination, irrespective of whether an individual received the seasonal influenza vaccine in previous seasons. It is neither currently feasible nor warranted to modify existing annual influenza vaccination programs to account for potential negative or positive interference. NACI continues to strongly recommend that seasonal influenza vaccine should be offered annually to everyone six months of age and older who does not have contraindications to the vaccine, irrespective of previous seasons' influenza vaccination status.
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Upcoming Events
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Virtual: American College Health Association offers fourth in five-part webinar series, Facts or Fakes? Promoting Health Literacy Skills with Your Students; CE available
The American College Health Association (ACHA) is offering a free, five-part webinar series, Facts or Fakes? Promoting Health Literacy Skills with Your Students ([link removed]) . This five-part webinar series provides tools to help students and others navigate misinformation, disinformation, and the infodemic. Webinars include:
* January 10 – "Health Literacy 101" (available on-demand ([link removed]) )
* February 21 – "Digital Wellbeing and Mental Health: Helping Me Is Helping We" (available on-demand ([link removed]) )
* March 7 – "Debunking Fake News" (available on-demand ([link removed]) )
* April 18 – "Confronting Misinformation in Our Circles of Influence" (available on-demand ([link removed]) )
* May 9 – "Managing the Infodemic: Getting Started"
The May 9 session airs 12:00–1:00 p.m. (ET). Up to 5 hours of credit are available for CNE, CME, and CHES, and 1.0 CE is available for counselors for session 2.
Register for the free webinars ([link removed]).
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For more upcoming events, visit our Calendar of Events ([link removed]).
Editorial Information
Editor-in-Chief
Kelly L. Moore, MD, MPH
Managing Editor
John D. Grabenstein, RPh, PhD
Associate Editor
Sharon G. Humiston, MD, MPH
Writer/Publication Coordinator
Taryn Chapman, MS
Courtnay Londo, MA
Style and Copy Editor
Marian Deegan, JD
Web Edition Managers
Arkady Shakhnovich
Jermaine Royes
Contributing Writer
Laurel H. Wood, MPA
Technical Reviewer
Kayla Ohlde
About IZ Express
Immunize.org welcomes redistribution of this issue of IZ Express or selected articles. When you do so, please add a note that Immunize.org is the source of the material and provide a link to this issue ([link removed]).
IZ Express is supported in part by Grant No. 1NH23IP922654 from the National Center for Immunization and Respiratory Diseases, CDC. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.
IZ Express Disclaimer ([link removed])
ISSN: 2771-8085
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