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IZ Express #1,707: Immunize.org summarizes August 3 ACIP meeting on nirsevimab, posts current state immunization requirement maps, and more
| From | Immunize.org <[email protected]> |
| Subject | IZ Express #1,707: Immunize.org summarizes August 3 ACIP meeting on nirsevimab, posts current state immunization requirement maps, and more |
| Date | August 9, 2023 10:31 AM |
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Issue 1,707: August 9, 2023
Top Stories
* Immunize.org summarizes ACIP’s August 3 meeting recommending nirsevimab for RSV prevention in infants and inclusion in Vaccines for Children program (#IZX1)
* New! Immunize.org updates its summaries of 2023 state immunization requirements for childcare, school, and college entry, including new summary maps. (#IZX2)
* August is National Immunization Awareness Month; promote vaccination with helpful resources for all ages (#IZX3)
* Review your COVID-19 resources with new version of Immunize.org’s “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools” (#IZX4)
* “Meningococcal ACWY Vaccine Schedule”: watch the 2-minute answer, part of the Ask the Experts Video Series on Facebook, LinkedIn, Twitter, YouTube, and Instagram (#IZX5)
* Vaccines in the news (#IZX6)
Immunize.org Pages and Handouts
* Immunize.org updates its “Ask the Experts” web page on polio vaccine (#IZX7)
* Recap: Immunize.org updated these clinic resources in June and July (#IZX8)
Vaccine Information Statements
* Recap: Vaccine Information Statements and translations released in June and July (#IZX9)
Featured Resources
* ACOG shares educational resources on maternal immunization for NIAM (#IZX10)
* ACOG offers training course, “Inform to Empower: Building COVID-19 Vaccine Confidence One Conversation at a Time," (#IZX11) for physicians and other obstetric care clinicians; CME offered (#IZX11)
Notable Publications
* “Vaccination Coverage among Adults in the United States, National Health Interview Survey, 2021” published by CDC (#IZX12)
* “Measles Outbreak—Central Ohio, 2022–2023” published in MMWR (#IZX13)
* “Safety Monitoring of Novavax COVID-19 Vaccine among Persons Aged ≥12 Years—United States, July 13, 2022–March 13, 2023” published in MMWR (#IZX14)
Global News
* WHO releases message from Director of Immunization, Vaccines, and Biologicals on the release of country vaccination estimates (#IZX15)
Editorial Information (#Editorial)
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Top Stories
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Immunize.org summarizes ACIP’s August 3 meeting recommending nirsevimab for RSV prevention in infants and inclusion in Vaccines for Children program
The Advisory Committee on Immunization Practices ([link removed]) (ACIP) met on August ([link removed]) 3 and recommended routine use of the monoclonal antibody product nirsevimab (trade name: Beyfortus, Sanofi) for the prevention of respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) in all infants younger than age 8 months during their first RSV season and in some children at high risk of severe disease during their second RSV season. Nirsevimab received FDA approval ([link removed]) on July 17. Presentation slides ([link removed]) are available online. Immediately after the meeting, CDC issued a media release ([link removed]) announcing the
director had adopted the ACIP recommendations, a step that initiates processes related to insurance coverage and implementation. Highlights of the meeting are provided below.
RSV Epidemiology
RSV is a common cause of respiratory illness and the leading cause of hospitalization of infants in the United States. Most (68%) infants are infected in the first year of life, and nearly all (97%) are infected by age 2 years. Of those infants with RSV infection, 2–3% require hospitalization, with an estimated 58,000–80,000 U.S. children younger than age 5 years hospitalized annually.
RSV infection typically causes mild upper respiratory symptoms, but can also cause bronchiolitis and pneumonia. Severe disease is most likely in very young infants and older infants born prematurely or with serious chronic diseases. Rates of severe disease are also 4–10 times greater in American Indian/Alaska Native (AI/AN) children than in the general population. Approximately 100–300 children younger than age 5 years die from RSV each year.
The RSV season typically occurs during October through March. The timing and severity of the season varies from year to year and between locations, particularly in areas outside the contiguous United States, such as Alaska, Hawaii, and overseas U.S. territories.
Nirsevimab Use
Nirsevimab is a long-acting monoclonal antibody product that provides passive immunization to the recipient for at least 150 days after administration. The pre-formed antibodies do not stimulate the immune system like an active immunization (vaccine). The rate of RSV-associated hospitalizations among recipients in clinical trials was 83% lower than among placebo recipients, and the rate of severe disease was 76% lower. Side effects were rare, with injection site reactions and rash reported in fewer than 1% of recipients.
Nirsevimab is administered intramuscularly (IM), with three dosing options based upon the child’s age and weight. Timing of nirsevimab administration is seasonal. Infants born during (or shortly before) the RSV season should be immunized within the first week of life (either before discharge from the delivery hospital or as an outpatient). Infants younger than 8 months of age who are born outside the season should receive nirsevimab shortly before, or early in, their first RSV season, and may be immunized when receiving other routine live or non-live vaccinations. Infants weighing less than 5 kg receive a 50 mg dose, and those weighing 5 or more kilograms receive a 100 mg dose.
ACIP separately recommended a 200 mg dose of nirsevimab (given as two 100 mg injections) for children age 8 through 19 months entering their second RSV season and at high risk of severe disease. Those recommended to receive nirsevimab in their second RSV season include those currently recommended by the American Academy of Pediatrics to receive palivizumab, a different monoclonal antibody that requires monthly administration. In addition, immunization was recommended for AI/AN children, who, as a population, are at high risk of hospitalization with RSV.
Nirsevimab is supplied in pre-filled 50 mg and 100 mg syringes that are stored at 2^o–8^oC, like refrigerated vaccines. The retail cost will be $495 per dose for 50 mg or 100 mg prefilled syringes. CDC will publish additional clinical considerations and professional educational materials in coming weeks.
Unique Implementation Considerations
The ACIP decision to include nirsevimab in the Vaccines for Children (VFC) program will facilitate access for all infants, regardless of insurance status. However, some implementation challenges remain because the product is not a traditional vaccine. Some jurisdictions may have different scope of practice regulations related to who is allowed to administer it. Seasonal administration will require planning and training. Payment issues will need to be addressed to facilitate its use in birthing hospitals. There may be issues to resolve in electronic health record system documentation and reporting to state immunization information systems.
ACIP Vote
ACIP made two separate and unanimous votes to recommend nirsevimab for two groups:
* Infants younger than age 8 months born during or entering their first RSV season should receive one dose (50 mg for infants weighing less than 5 kg, 100 mg for those 5 kg or more)
* Children age 8 months through 19 months who are at increased risk of severe RSV disease and entering their second RSV season – one dose (200 mg)
The Committee also unanimously approved including nirsevimab in the VFC program.
Future discussions
ACIP members noted that a maternal vaccination for RSV designed to protect newborns is being considered for licensure by FDA. If a maternal RSV vaccine is licensed and recommended, ACIP will revisit the nirsevimab recommendations and adjust them as necessary.
The next scheduled ACIP meeting will be held on October 25–27, although additional emergency meetings may be announced prior to 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 meetings
* CDC media release: CDC Recommends a Powerful New Tool to Protect Infants from the Leading Cause of Hospitalization ([link removed]) (8/3/23)
* CDC: ACIP Meeting Recommendations – August 2023 ([link removed]) web page
* CDC: ACIP Presentation Slides ([link removed]) : August 3, 2023 Meeting web page
* CDC:[link removed] Syncytial Virus Infection: For Healthcare Providers ([link removed] ) web page
* CDC: RSV Surveillance & Research ([link removed]) main page
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New! Immunize.org updates its summaries of 2023 state immunization requirements for childcare, school, and college entry, including new summary maps.
Childcare and school requirements for vaccination vary by state and are critical to making childcare facilities and schools a safe and healthy learning environment for everyone. In the spring of 2023, Immunize.org surveyed all state immunization program managers to update its detailed data tables on state vaccine-specific requirements for childcare, school, and college students. Based on information provided or confirmed by immunization managers, Immunize.org updated its State Requirements by Vaccine ([link removed]) main page and each of its pages detailing vaccine-specific requirements by state for childcare, K-12, and post-secondary education settings. In addition, new and improved state maps were produced to visually represent vaccine-specific requirements and state policies related to exemptions. These maps are ideal for use in presentations by policymakers, healthcare professionals, and advocates.
[link removed]
Below are links to each of the vaccine-specific requirement pages and the exemptions page:
* DTaP: Childcare and Elementary School ([link removed])
* HepA: Childcare and School (Kindergarten–Grade 12) ([link removed])
* HepB: Childcare and School (Kindergarten–Grade 12) ([link removed])
* HepB: College/University ([link removed])
* Hib: Childcare ([link removed])
* HPV: Secondary School ([link removed])
* Influenza: Childcare and Pre-K ([link removed])
* MenACWY: Secondary School ([link removed])
* MenACWY: College/University ([link removed])
* MMR: Childcare and School (Kindergarten–Grade 12) ([link removed])
* Pneumo (PCV): Childcare ([link removed])
* Polio: Childcare and Elementary School ([link removed])
* Rotavirus: Childcare ([link removed])
* Tdap: Secondary School ([link removed])
* Varicella: Childcare and School (Kindergarten–Grade 12) ([link removed])
* COVID-19: Childcare and School ([link removed])
* Exemptions Permitted for State Childcare and School Immunization Requirements ([link removed])
Related Links
* Immunize.org: State Requirements by Vaccine ([link removed]) main page
* Immunize.org: State Exemptions ([link removed]) main page
* Immunize.org: State Health Departments ([link removed]) main page
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August is National Immunization Awareness Month; promote vaccination with helpful resources for all ages
August is National Immunization Awareness Month ([link removed]) (NIAM). This annual observance highlights the efforts to protect people of all ages against vaccine-preventable diseases through on-time vaccination. This year, NIAM serves as a focal point to get back on track with routine vaccines.
NIAM is a good time to remind healthcare providers that they are still the most trusted source of vaccine information for parents and patients. Encourage patients to schedule appointments to ensure they are up to date on annual exams and recommended vaccines.
[link removed]
CDC’s NIAM web page includes two toolkits, one for reaching healthcare professionals ([link removed]) and the other for reaching parents and patients ([link removed]) . Each includes key messages, sample social media content, and educational resources. CDC encourages its partners to share these messages and resources throughout August using the hashtag #ivax2protect.
Related Links
* CDC: Toolkit for Reaching Healthcare Professionals ([link removed]) main page
* CDC: Toolkit for Reaching Parents and Patients ([link removed]) main page
* NFID: National Immunization Awareness Month Resource Round-Up ([link removed]) main page
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Review your COVID-19 resources with new version of Immunize.org’s “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools”
Immunize.org reviews and updates the Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools ([link removed]) at least monthly, prominently indicating when it was last revised at the top of the page. Changes on the August 1 update include weblinks to new versions of:
* COVID-19 ACIP recommendations
* Pfizer-BioNTech Emergency Use Authorization (EUA) for Healthcare Providers
* COVID-19 Vaccination Recommendations infographics (2 versions: for people with or without immunocompromise)
* “At-A-Glance” summaries for Pfizer-BioNTech and Moderna COVID-19 vaccines
* Vaccine Storage and Handling Guidance websites (CDC is no longer publishing individual vaccine storage and handling PDFs)
All COVID-19 vaccination providers should review the checklist regularly and download the latest CDC schedule and standing order documents. The checklist is posted on Immunize.org's Vaccines: COVID-19 ([link removed]) main page to help practices stay up to date.
[link removed]
Related Links
* Immunize.org: Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools ([link removed]) (PDF)
* Immunize.org: Vaccines: COVID-19 ([link removed]) main page
* Immunize.org: Ask the Experts: COVID-19 ([link removed]) web page
* CDC: Interim Clinical Considerations ([link removed]) main page summarizing use of COVID-19 vaccines in the United States
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“Meningococcal ACWY Vaccine Schedule”: watch the 2-minute answer, part of the Ask the Experts Video Series on Facebook, LinkedIn, Twitter, YouTube, and Instagram
Immunize.org’s social media program highlights our educational resources for today’s vaccinators. This week, our featured episode from the Ask the Experts Video Series is Meningococcal ACWY Vaccine Schedule ([link removed]) . This is available on our YouTube channel ([link removed]) , along with our full collection of quick video answers to popular Ask the Experts ([link removed]) questions.
[link removed]
Our social media channels feature our most popular printable resources, our Ask the Experts Video Series, and announcements important to frontline vaccinators. Like, follow, and share Immunize.org’s social media accounts. Encourage colleagues and others interested in vaccination to do likewise:
* Facebook at ImmunizeOrg ([link removed])
* Instagram at ImmunizeOrg ([link removed])
* LinkedIn at Immunize.org ([link removed])
* Twitter at ImmunizeOrg ([link removed])
* YouTube at ImmunizeOrg ([link removed])
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Vaccines in the news
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* KFF: Headed Back to School in 2023: A Look at Children’s Routine Vaccination Trends ([link removed]) (7/31/23)
* Healio: Immunization Awareness Month: Vaccine Developments You May Have Missed in 2023 ([link removed]) (7/30/23)
* Johns Hopkins: What’s in Store for the Upcoming Respiratory Virus Season? ([link removed]) (7/28/23)
* AARP: Lost Your COVID-19 Vaccine Card? Here's How to Get It Back ([link removed]) (7/26/23)
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Immunize.org Pages and Handouts
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Immunize.org updates its “Ask the Experts” web page on polio vaccine
Immunize.org's popular Ask the Experts: Polio ([link removed]) web page was updated to reflect new ACIP recommendations for adult vaccinations in June 2023. ACIP now recommends that all U.S. adults who are known or reasonably suspected of being unvaccinated or incompletely vaccinated against polio should receive a primary series of polio vaccine. Take this opportunity to refresh your polio vaccine knowledge by reviewing the questions and answers.
[link removed]
Immunize.org’s Ask the Experts ([link removed]) main page leads you to 30 web pages on various topics with more than 1,200 common or challenging questions and answers about vaccines and their administration. Immunize.org’s team of experts includes Kelly L. Moore, MD, MPH (team lead), Carolyn B. Bridges, MD, FACP, and Iyabode Beysolow, MD, MPH.
Related Links
* Immunize.org: Ask the Experts ([link removed]) main page with more than 1,200 questions and answers
* Immunize.org: Ask the Experts: Polio ([link removed]) web page
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Recap: Immunize.org updated these clinic resources in June and July
IZ Express regularly summarizes Immunize.org’s new and updated educational materials and web pages. All Immunize.org materials are free to distribute. In recent weeks, Immunize.org updated these helpful materials:
Immunize.org Materials for Clinicians
* Vaccines with Diluents: How to Use Them ([link removed])
* Need Help Responding to Vaccine-Hesitant Parents? ([link removed])
* Before You Vaccinate Adults, Consider Their "H-A-L-O"! ([link removed])
* Steps to Implementing Standing Orders for Immunization in Your Practice Setting ([link removed])
* Standing Orders for Administering:
+ Haemophilus influenzae Type B Vaccine to Adults ([link removed])
+ Human Papillomavirus Vaccine to Adults ([link removed])
+ Meningococcal B Vaccine to Adolescents and Adults ([link removed])
* Birthing Mothers, Newborns, and Hepatitis B vaccination:
+ Labor & Delivery HBsAg Admission Checklist for Birthing Mother ([link removed])
+ Guidance for Developing Admission Orders in Labor & Delivery and Newborn Units to Prevent Hepatitis B Virus Transmission ([link removed])
+ Sample Text for Developing Admission Orders in Newborn Units for the Hepatitis B Vaccine Birth Dose ([link removed])
Immunize.org Printable Materials for Patients
* After the Shots . . . What to Do If Your Child Has Discomfort ([link removed])
+ Translations: Spanish ([link removed]) , Arabic ([link removed]) , Chinese–Simplified ([link removed]) , French ([link removed]) , Korean ([link removed]) , Russian, ([link removed]) and Vietnamese ([link removed])
* Vaccinations for Infants and Children, Age 0–10 Years ([link removed])
+ Translations: Spanish ([link removed]) , Arabic ([link removed]) , Chinese–Simplified ([link removed]) , French ([link removed]) , Korean ([link removed]) , Russian, ([link removed]) and Vietnamese ([link removed])
* Vaccinations for Preteens and Teens ([link removed])
+ Translations: Spanish ([link removed]) , Arabic ([link removed]) , Chinese–Simplified ([link removed]) , French ([link removed]) , Korean ([link removed]) , Russian, ([link removed]) and Vietnamese ([link removed])
* Adult Immunization: Importance of Staying Up to Date with Vaccines ([link removed])
* Vaccinations for Adults ([link removed])
* Vaccinations for Adults with Chronic Liver Disease or Infection ([link removed])
* Vaccinations for Adults with Diabetes ([link removed])
* Vaccinations for Adults with Heart Disease ([link removed])
* Vaccinations for Adults with HIV Infection ([link removed])
* Vaccinations for Adults with Lung Disease ([link removed])
* Vaccinations for Adults without a Spleen ([link removed])
* Vaccinations for Men Who Have Sex with Men ([link removed])
* Questions and Answers: Information about the Disease and Vaccines
+ Diphtheria ([link removed])
+ Pertussis (Whooping Cough) ([link removed])
+ Tetanus ([link removed])
* Evidence Shows Vaccines Unrelated to Autism ([link removed])
Immunize.org Web Pages
* Vaccines: Mpox ([link removed])
* Vaccine Timeline ([link removed])
* Ask the Experts:
+ Combination Vaccines ([link removed])
+ Documenting Vaccination ([link removed])
+ Hepatitis A ([link removed])
+ Measles, Mumps, and Rubella ([link removed])
+ Meningococcal ACWY ([link removed])
+ Meningococcal B ([link removed])
+ Rotavirus ([link removed])
+ Scheduling Vaccines ([link removed])
Related Links
* Immunize.org: Handouts ([link removed]) main page to see educational materials sorted by category
* Immunize.org: Ask the Experts ([link removed]) main page to access more than 1,200 questions answered by Immunize.org experts
* Immunize.org: Clinic Tools ([link removed]) main page and its eight subtopics
* Immunize.org: Educational Materials for Patients and Staff ([link removed]) —an alphabetical list of more than 240 ready-to-print staff educational materials and patient handouts
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Vaccine Information Statements
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Recap: Vaccine Information Statements and translations released in June and July
IZ Express regularly provides readers with information about new and updated Vaccine Information Statements (VISs) and their translations.
On July 24, CDC released an updated interim VIS for Multi Pediatric Vaccines (Your Child's First Vaccines) ([link removed]) and a new VIS for Respiratory Syncytial Virus (RSV) Vaccine ([link removed]) for adults.
As a result of these VIS releases, two handouts related to VISs were updated:
* Dates of Current Vaccine Information Statements (VISs) ([link removed])
* You Must Provide Patients with Vaccine Information Statements (VISs) – It's Federal Law! ([link removed])
On May 12, CDC released interim VISs for Hepatitis B Vaccine ([link removed]) and Pneumococcal Conjugate (PCV) Vaccine ([link removed]) , and Immunize.org provided eight translations for each.
Hepatitis B Vaccine (view in English ([link removed]) ):
* Arabic ([link removed])
* Bengali ([link removed])
* Chinese–Simplified ([link removed])
* Haitian Creole ([link removed])
* Portuguese ([link removed])
* Russian ([link removed])
* Spanish PDF ([link removed]) and RTF ([link removed])
* Vietnamese ([link removed])
Pneumococcal Conjugate Vaccine (view in English ([link removed]) ):
* Arabic ([link removed])
* Bengali ([link removed])
* Chinese–Simplified ([link removed])
* Haitian Creole ([link removed])
* Portuguese ([link removed])
* Russian ([link removed])
* Spanish PDF ([link removed]) and RTF ([link removed])
* Vietnamese ([link removed])
Related Links
* Immunize.org: Vaccine Information Statements ([link removed]) main page for VISs in 47 languages
* CDC: What's New with VISs ([link removed]) web page
* CDC: Current VISs ([link removed]) web page
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Featured Resources
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ACOG shares educational resources on maternal immunization for NIAM
For National Immunization Awareness Month (NIAM), the American College of Obstetricians and Gynecologists (ACOG) is highlighting the importance of maternal immunization with a searchable list of educational resources. ([link removed][Vaccines])
They offer:
* Infographics ([link removed][Vaccines]&f:@patientportalcontenttype=[Infographic]) (9 in English, 4 in Spanish)
* FAQ web pages ([link removed][Vaccines]&f:@patientportalcontenttype=[FAQs]) (all 7 in English)
* Expert views ([link removed][Vaccines]&f:@patientportalcontenttype=[Expert%20View]) (8 for adults, 1 for teens)
* Videos ([link removed][Vaccines]&f:@patientportalcontenttype=[Video]) (4 in English, 1 in Spanish)
[link removed]
These resources can be effective tools for sharing accessible, evidence-based information on COVID-19, Tdap, and influenza vaccination during pregnancy. The suite also includes information on HPV, mpox, and other adult vaccines. Please share these resources with your networks.
View ACOG's resources ([link removed][Vaccines]) .
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ACOG offers training course, “Inform to Empower: Building COVID-19 Vaccine Confidence One Conversation at a Time,” for physicians and other obstetric care clinicians; CME offered
The American College of Obstetricians and Gynecologists (ACOG) offers Inform to Empower: Building COVID-19 Vaccine Confidence One Conversation at a Time ([link removed]) , a free training course intended to teach physicians and other obstetric care clinicians about the importance of increasing patients' vaccine confidence and techniques to increase vaccination demand in practice.
[link removed]
The course offers a maximum of 1.5 CME credits.
Access the course ([link removed]) .
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Notable Publications
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“Vaccination Coverage among Adults in the United States, National Health Interview Survey, 2021” published by CDC
On July 19, CDC published Vaccination Coverage among Adults in the United States, National Health Interview Survey, 2021 ([link removed]) . The conclusion section appears below.
Coverage increased for influenza and herpes zoster vaccination in recent years. Disparities in vaccination coverage by race and ethnicity were seen for all vaccines assessed. Increasing the proportion of adults who receive recommended vaccines and ensuring equitable access to, and uptake of recommended vaccines is a high-priority public health issue.
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“Measles Outbreak—Central Ohio, 2022–2023” published in MMWR
CDC published Measles Outbreak—Central Ohio, 2022–2023 ([link removed]) on August 4 in MMWR. Our analysis of Notes from the Field is summarized below.
* Although the United States has maintained measles elimination since 2000, measles outbreaks continue to occur in countries around the world. Thus, there is always a risk of measles importation that could affect undervaccinated communities.
* In November 2022, two 2-year-old children were admitted to the same hospital in Ohio for suspected measles infection, so public health officials launched an investigation
* A total of 85 people in central Ohio tested positive for measles
* This outbreak was characterized by young median patient age (1 year), low rates of MMR vaccination, and high rates of respiratory coinfection (e.g., respiratory syncytial virus [RSV]), with twice the hospitalization rate reported among previous U.S. measles cases
* Two-dose MMR vaccination coverage among children entering kindergarten in Ohio during the 2021–22 school year (i.e., before the outbreak) was 5% lower than the national coverage estimate of 93%
* Healthcare facilities, clinicians, and childcare centers serving undervaccinated populations should remain on high alert for measles and emphasize the importance of timely MMR vaccination
[link removed]
Access the MMWR article in HTML ([link removed]) or PDF ([link removed]) .
Related Links
* MMWR's main page ([link removed]) provides access to the MMWR family of publications
* CDC: Measles (Rubeola): For Healthcare Providers ([link removed]) main page
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“Safety Monitoring of Novavax COVID-19 Vaccine among Persons Aged ≥12 Years—United States, July 13, 2022–March 13, 2023” published in MMWR
CDC published Safety Monitoring of Novavax COVID-19 Vaccine among Persons Aged ≥12 Years—United States, July 13, 2022–March 13, 2023 ([link removed]) on August 4 in MMWR. Our analysis of Notes from the Field is summarized below.
* Novavax COVID-19 vaccine ([link removed]) is authorized and recommended as
+ A primary 2-dose monovalent vaccination series in people age 12 and older
+ A monovalent booster dose in people age 18 and older who are unable or unwilling to receive an mRNA COVID-19 bivalent vaccine
* To assess the safety of the Novavax COVID-19 vaccine among individuals age 12 years and older, CDC reviewed reports made to the Vaccine Adverse Event Reporting System ([link removed]) (VAERS) from July 13, 2022, to March 13, 2023
* No unexpected safety concerns were identified. The most commonly reported adverse events were nonserious and included reports of dizziness, fatigue, and headache.
* This review underscores the safety of the Novavax COVID-19 vaccine
* It’s important to stay up to date with COVID-19 vaccines to prevent severe illness
Access the MMWR article in HTML ([link removed]) or PDF ([link removed]) .
Related Links
* MMWR's main page ([link removed]) provides access to the MMWR family of publications
* CDC: Stay Up to Date with COVID-19 Vaccines ([link removed]) main page
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Global News
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WHO releases message from Director of Immunization, Vaccines, and Biologicals on the release of country vaccination estimates
On July 31, the World Health Organization (WHO) released Message by the Director of the Department of Immunization, Vaccines and Biologicals at WHO—July 2023 ([link removed]) . A portion of the article appears below.
The WHO/UNICEF estimates of national immunization coverage ([link removed]) (WUENIC) for 2022 were released on 18 July. . . .
The WUENIC findings are encouraging: some immunization services have begun to recover after the disruptions caused by COVID-19 – meaning that immunization services reached 4 million more children than in 2021. Despite this overall improvement, the recovery has been uneven across countries, across vaccines, and across age groups. Even with evidence of a recovery underway in 2022, more than 20 million children still missed out on one or more vaccines last year, and over 14 million missed out entirely. These numbers are higher than in 2019, the year before the pandemic hit. . . .
Most concerningly is that as a group, low-income countries are not yet showing signs of immunization recovery. For these countries, measles vaccine coverage has continued to backslide in 2022, raising the alarm even further for immediate action. We must catch-up, restore, and strengthen all national immunization programs to ensure that all children, no matter where they are, have access to and receive the life-saving vaccines which are their right.
The WUENIC-2022 release of country estimates coincided with the halfway mark for the Big Catch-Up ([link removed]) , underscoring the need for sustained action to strive for catch-up, equitable recovery and strengthening for the remainder of the year and beyond.
Related Link
* WHO: Analysis and Insights: WHO/UNICEF Estimates of National Immunization Coverage ([link removed]) main page
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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 1,707: August 9, 2023
Top Stories
* Immunize.org summarizes ACIP’s August 3 meeting recommending nirsevimab for RSV prevention in infants and inclusion in Vaccines for Children program (#IZX1)
* New! Immunize.org updates its summaries of 2023 state immunization requirements for childcare, school, and college entry, including new summary maps. (#IZX2)
* August is National Immunization Awareness Month; promote vaccination with helpful resources for all ages (#IZX3)
* Review your COVID-19 resources with new version of Immunize.org’s “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools” (#IZX4)
* “Meningococcal ACWY Vaccine Schedule”: watch the 2-minute answer, part of the Ask the Experts Video Series on Facebook, LinkedIn, Twitter, YouTube, and Instagram (#IZX5)
* Vaccines in the news (#IZX6)
Immunize.org Pages and Handouts
* Immunize.org updates its “Ask the Experts” web page on polio vaccine (#IZX7)
* Recap: Immunize.org updated these clinic resources in June and July (#IZX8)
Vaccine Information Statements
* Recap: Vaccine Information Statements and translations released in June and July (#IZX9)
Featured Resources
* ACOG shares educational resources on maternal immunization for NIAM (#IZX10)
* ACOG offers training course, “Inform to Empower: Building COVID-19 Vaccine Confidence One Conversation at a Time," (#IZX11) for physicians and other obstetric care clinicians; CME offered (#IZX11)
Notable Publications
* “Vaccination Coverage among Adults in the United States, National Health Interview Survey, 2021” published by CDC (#IZX12)
* “Measles Outbreak—Central Ohio, 2022–2023” published in MMWR (#IZX13)
* “Safety Monitoring of Novavax COVID-19 Vaccine among Persons Aged ≥12 Years—United States, July 13, 2022–March 13, 2023” published in MMWR (#IZX14)
Global News
* WHO releases message from Director of Immunization, Vaccines, and Biologicals on the release of country vaccination estimates (#IZX15)
Editorial Information (#Editorial)
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Top Stories
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Immunize.org summarizes ACIP’s August 3 meeting recommending nirsevimab for RSV prevention in infants and inclusion in Vaccines for Children program
The Advisory Committee on Immunization Practices ([link removed]) (ACIP) met on August ([link removed]) 3 and recommended routine use of the monoclonal antibody product nirsevimab (trade name: Beyfortus, Sanofi) for the prevention of respiratory syncytial virus (RSV) lower respiratory tract infection (LRTI) in all infants younger than age 8 months during their first RSV season and in some children at high risk of severe disease during their second RSV season. Nirsevimab received FDA approval ([link removed]) on July 17. Presentation slides ([link removed]) are available online. Immediately after the meeting, CDC issued a media release ([link removed]) announcing the
director had adopted the ACIP recommendations, a step that initiates processes related to insurance coverage and implementation. Highlights of the meeting are provided below.
RSV Epidemiology
RSV is a common cause of respiratory illness and the leading cause of hospitalization of infants in the United States. Most (68%) infants are infected in the first year of life, and nearly all (97%) are infected by age 2 years. Of those infants with RSV infection, 2–3% require hospitalization, with an estimated 58,000–80,000 U.S. children younger than age 5 years hospitalized annually.
RSV infection typically causes mild upper respiratory symptoms, but can also cause bronchiolitis and pneumonia. Severe disease is most likely in very young infants and older infants born prematurely or with serious chronic diseases. Rates of severe disease are also 4–10 times greater in American Indian/Alaska Native (AI/AN) children than in the general population. Approximately 100–300 children younger than age 5 years die from RSV each year.
The RSV season typically occurs during October through March. The timing and severity of the season varies from year to year and between locations, particularly in areas outside the contiguous United States, such as Alaska, Hawaii, and overseas U.S. territories.
Nirsevimab Use
Nirsevimab is a long-acting monoclonal antibody product that provides passive immunization to the recipient for at least 150 days after administration. The pre-formed antibodies do not stimulate the immune system like an active immunization (vaccine). The rate of RSV-associated hospitalizations among recipients in clinical trials was 83% lower than among placebo recipients, and the rate of severe disease was 76% lower. Side effects were rare, with injection site reactions and rash reported in fewer than 1% of recipients.
Nirsevimab is administered intramuscularly (IM), with three dosing options based upon the child’s age and weight. Timing of nirsevimab administration is seasonal. Infants born during (or shortly before) the RSV season should be immunized within the first week of life (either before discharge from the delivery hospital or as an outpatient). Infants younger than 8 months of age who are born outside the season should receive nirsevimab shortly before, or early in, their first RSV season, and may be immunized when receiving other routine live or non-live vaccinations. Infants weighing less than 5 kg receive a 50 mg dose, and those weighing 5 or more kilograms receive a 100 mg dose.
ACIP separately recommended a 200 mg dose of nirsevimab (given as two 100 mg injections) for children age 8 through 19 months entering their second RSV season and at high risk of severe disease. Those recommended to receive nirsevimab in their second RSV season include those currently recommended by the American Academy of Pediatrics to receive palivizumab, a different monoclonal antibody that requires monthly administration. In addition, immunization was recommended for AI/AN children, who, as a population, are at high risk of hospitalization with RSV.
Nirsevimab is supplied in pre-filled 50 mg and 100 mg syringes that are stored at 2^o–8^oC, like refrigerated vaccines. The retail cost will be $495 per dose for 50 mg or 100 mg prefilled syringes. CDC will publish additional clinical considerations and professional educational materials in coming weeks.
Unique Implementation Considerations
The ACIP decision to include nirsevimab in the Vaccines for Children (VFC) program will facilitate access for all infants, regardless of insurance status. However, some implementation challenges remain because the product is not a traditional vaccine. Some jurisdictions may have different scope of practice regulations related to who is allowed to administer it. Seasonal administration will require planning and training. Payment issues will need to be addressed to facilitate its use in birthing hospitals. There may be issues to resolve in electronic health record system documentation and reporting to state immunization information systems.
ACIP Vote
ACIP made two separate and unanimous votes to recommend nirsevimab for two groups:
* Infants younger than age 8 months born during or entering their first RSV season should receive one dose (50 mg for infants weighing less than 5 kg, 100 mg for those 5 kg or more)
* Children age 8 months through 19 months who are at increased risk of severe RSV disease and entering their second RSV season – one dose (200 mg)
The Committee also unanimously approved including nirsevimab in the VFC program.
Future discussions
ACIP members noted that a maternal vaccination for RSV designed to protect newborns is being considered for licensure by FDA. If a maternal RSV vaccine is licensed and recommended, ACIP will revisit the nirsevimab recommendations and adjust them as necessary.
The next scheduled ACIP meeting will be held on October 25–27, although additional emergency meetings may be announced prior to 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 meetings
* CDC media release: CDC Recommends a Powerful New Tool to Protect Infants from the Leading Cause of Hospitalization ([link removed]) (8/3/23)
* CDC: ACIP Meeting Recommendations – August 2023 ([link removed]) web page
* CDC: ACIP Presentation Slides ([link removed]) : August 3, 2023 Meeting web page
* CDC:[link removed] Syncytial Virus Infection: For Healthcare Providers ([link removed] ) web page
* CDC: RSV Surveillance & Research ([link removed]) main page
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New! Immunize.org updates its summaries of 2023 state immunization requirements for childcare, school, and college entry, including new summary maps.
Childcare and school requirements for vaccination vary by state and are critical to making childcare facilities and schools a safe and healthy learning environment for everyone. In the spring of 2023, Immunize.org surveyed all state immunization program managers to update its detailed data tables on state vaccine-specific requirements for childcare, school, and college students. Based on information provided or confirmed by immunization managers, Immunize.org updated its State Requirements by Vaccine ([link removed]) main page and each of its pages detailing vaccine-specific requirements by state for childcare, K-12, and post-secondary education settings. In addition, new and improved state maps were produced to visually represent vaccine-specific requirements and state policies related to exemptions. These maps are ideal for use in presentations by policymakers, healthcare professionals, and advocates.
[link removed]
Below are links to each of the vaccine-specific requirement pages and the exemptions page:
* DTaP: Childcare and Elementary School ([link removed])
* HepA: Childcare and School (Kindergarten–Grade 12) ([link removed])
* HepB: Childcare and School (Kindergarten–Grade 12) ([link removed])
* HepB: College/University ([link removed])
* Hib: Childcare ([link removed])
* HPV: Secondary School ([link removed])
* Influenza: Childcare and Pre-K ([link removed])
* MenACWY: Secondary School ([link removed])
* MenACWY: College/University ([link removed])
* MMR: Childcare and School (Kindergarten–Grade 12) ([link removed])
* Pneumo (PCV): Childcare ([link removed])
* Polio: Childcare and Elementary School ([link removed])
* Rotavirus: Childcare ([link removed])
* Tdap: Secondary School ([link removed])
* Varicella: Childcare and School (Kindergarten–Grade 12) ([link removed])
* COVID-19: Childcare and School ([link removed])
* Exemptions Permitted for State Childcare and School Immunization Requirements ([link removed])
Related Links
* Immunize.org: State Requirements by Vaccine ([link removed]) main page
* Immunize.org: State Exemptions ([link removed]) main page
* Immunize.org: State Health Departments ([link removed]) main page
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August is National Immunization Awareness Month; promote vaccination with helpful resources for all ages
August is National Immunization Awareness Month ([link removed]) (NIAM). This annual observance highlights the efforts to protect people of all ages against vaccine-preventable diseases through on-time vaccination. This year, NIAM serves as a focal point to get back on track with routine vaccines.
NIAM is a good time to remind healthcare providers that they are still the most trusted source of vaccine information for parents and patients. Encourage patients to schedule appointments to ensure they are up to date on annual exams and recommended vaccines.
[link removed]
CDC’s NIAM web page includes two toolkits, one for reaching healthcare professionals ([link removed]) and the other for reaching parents and patients ([link removed]) . Each includes key messages, sample social media content, and educational resources. CDC encourages its partners to share these messages and resources throughout August using the hashtag #ivax2protect.
Related Links
* CDC: Toolkit for Reaching Healthcare Professionals ([link removed]) main page
* CDC: Toolkit for Reaching Parents and Patients ([link removed]) main page
* NFID: National Immunization Awareness Month Resource Round-Up ([link removed]) main page
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Review your COVID-19 resources with new version of Immunize.org’s “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools”
Immunize.org reviews and updates the Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools ([link removed]) at least monthly, prominently indicating when it was last revised at the top of the page. Changes on the August 1 update include weblinks to new versions of:
* COVID-19 ACIP recommendations
* Pfizer-BioNTech Emergency Use Authorization (EUA) for Healthcare Providers
* COVID-19 Vaccination Recommendations infographics (2 versions: for people with or without immunocompromise)
* “At-A-Glance” summaries for Pfizer-BioNTech and Moderna COVID-19 vaccines
* Vaccine Storage and Handling Guidance websites (CDC is no longer publishing individual vaccine storage and handling PDFs)
All COVID-19 vaccination providers should review the checklist regularly and download the latest CDC schedule and standing order documents. The checklist is posted on Immunize.org's Vaccines: COVID-19 ([link removed]) main page to help practices stay up to date.
[link removed]
Related Links
* Immunize.org: Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools ([link removed]) (PDF)
* Immunize.org: Vaccines: COVID-19 ([link removed]) main page
* Immunize.org: Ask the Experts: COVID-19 ([link removed]) web page
* CDC: Interim Clinical Considerations ([link removed]) main page summarizing use of COVID-19 vaccines in the United States
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“Meningococcal ACWY Vaccine Schedule”: watch the 2-minute answer, part of the Ask the Experts Video Series on Facebook, LinkedIn, Twitter, YouTube, and Instagram
Immunize.org’s social media program highlights our educational resources for today’s vaccinators. This week, our featured episode from the Ask the Experts Video Series is Meningococcal ACWY Vaccine Schedule ([link removed]) . This is available on our YouTube channel ([link removed]) , along with our full collection of quick video answers to popular Ask the Experts ([link removed]) questions.
[link removed]
Our social media channels feature our most popular printable resources, our Ask the Experts Video Series, and announcements important to frontline vaccinators. Like, follow, and share Immunize.org’s social media accounts. Encourage colleagues and others interested in vaccination to do likewise:
* Facebook at ImmunizeOrg ([link removed])
* Instagram at ImmunizeOrg ([link removed])
* LinkedIn at Immunize.org ([link removed])
* Twitter at ImmunizeOrg ([link removed])
* YouTube at ImmunizeOrg ([link removed])
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Vaccines in the news
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* KFF: Headed Back to School in 2023: A Look at Children’s Routine Vaccination Trends ([link removed]) (7/31/23)
* Healio: Immunization Awareness Month: Vaccine Developments You May Have Missed in 2023 ([link removed]) (7/30/23)
* Johns Hopkins: What’s in Store for the Upcoming Respiratory Virus Season? ([link removed]) (7/28/23)
* AARP: Lost Your COVID-19 Vaccine Card? Here's How to Get It Back ([link removed]) (7/26/23)
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Immunize.org Pages and Handouts
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Immunize.org updates its “Ask the Experts” web page on polio vaccine
Immunize.org's popular Ask the Experts: Polio ([link removed]) web page was updated to reflect new ACIP recommendations for adult vaccinations in June 2023. ACIP now recommends that all U.S. adults who are known or reasonably suspected of being unvaccinated or incompletely vaccinated against polio should receive a primary series of polio vaccine. Take this opportunity to refresh your polio vaccine knowledge by reviewing the questions and answers.
[link removed]
Immunize.org’s Ask the Experts ([link removed]) main page leads you to 30 web pages on various topics with more than 1,200 common or challenging questions and answers about vaccines and their administration. Immunize.org’s team of experts includes Kelly L. Moore, MD, MPH (team lead), Carolyn B. Bridges, MD, FACP, and Iyabode Beysolow, MD, MPH.
Related Links
* Immunize.org: Ask the Experts ([link removed]) main page with more than 1,200 questions and answers
* Immunize.org: Ask the Experts: Polio ([link removed]) web page
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Recap: Immunize.org updated these clinic resources in June and July
IZ Express regularly summarizes Immunize.org’s new and updated educational materials and web pages. All Immunize.org materials are free to distribute. In recent weeks, Immunize.org updated these helpful materials:
Immunize.org Materials for Clinicians
* Vaccines with Diluents: How to Use Them ([link removed])
* Need Help Responding to Vaccine-Hesitant Parents? ([link removed])
* Before You Vaccinate Adults, Consider Their "H-A-L-O"! ([link removed])
* Steps to Implementing Standing Orders for Immunization in Your Practice Setting ([link removed])
* Standing Orders for Administering:
+ Haemophilus influenzae Type B Vaccine to Adults ([link removed])
+ Human Papillomavirus Vaccine to Adults ([link removed])
+ Meningococcal B Vaccine to Adolescents and Adults ([link removed])
* Birthing Mothers, Newborns, and Hepatitis B vaccination:
+ Labor & Delivery HBsAg Admission Checklist for Birthing Mother ([link removed])
+ Guidance for Developing Admission Orders in Labor & Delivery and Newborn Units to Prevent Hepatitis B Virus Transmission ([link removed])
+ Sample Text for Developing Admission Orders in Newborn Units for the Hepatitis B Vaccine Birth Dose ([link removed])
Immunize.org Printable Materials for Patients
* After the Shots . . . What to Do If Your Child Has Discomfort ([link removed])
+ Translations: Spanish ([link removed]) , Arabic ([link removed]) , Chinese–Simplified ([link removed]) , French ([link removed]) , Korean ([link removed]) , Russian, ([link removed]) and Vietnamese ([link removed])
* Vaccinations for Infants and Children, Age 0–10 Years ([link removed])
+ Translations: Spanish ([link removed]) , Arabic ([link removed]) , Chinese–Simplified ([link removed]) , French ([link removed]) , Korean ([link removed]) , Russian, ([link removed]) and Vietnamese ([link removed])
* Vaccinations for Preteens and Teens ([link removed])
+ Translations: Spanish ([link removed]) , Arabic ([link removed]) , Chinese–Simplified ([link removed]) , French ([link removed]) , Korean ([link removed]) , Russian, ([link removed]) and Vietnamese ([link removed])
* Adult Immunization: Importance of Staying Up to Date with Vaccines ([link removed])
* Vaccinations for Adults ([link removed])
* Vaccinations for Adults with Chronic Liver Disease or Infection ([link removed])
* Vaccinations for Adults with Diabetes ([link removed])
* Vaccinations for Adults with Heart Disease ([link removed])
* Vaccinations for Adults with HIV Infection ([link removed])
* Vaccinations for Adults with Lung Disease ([link removed])
* Vaccinations for Adults without a Spleen ([link removed])
* Vaccinations for Men Who Have Sex with Men ([link removed])
* Questions and Answers: Information about the Disease and Vaccines
+ Diphtheria ([link removed])
+ Pertussis (Whooping Cough) ([link removed])
+ Tetanus ([link removed])
* Evidence Shows Vaccines Unrelated to Autism ([link removed])
Immunize.org Web Pages
* Vaccines: Mpox ([link removed])
* Vaccine Timeline ([link removed])
* Ask the Experts:
+ Combination Vaccines ([link removed])
+ Documenting Vaccination ([link removed])
+ Hepatitis A ([link removed])
+ Measles, Mumps, and Rubella ([link removed])
+ Meningococcal ACWY ([link removed])
+ Meningococcal B ([link removed])
+ Rotavirus ([link removed])
+ Scheduling Vaccines ([link removed])
Related Links
* Immunize.org: Handouts ([link removed]) main page to see educational materials sorted by category
* Immunize.org: Ask the Experts ([link removed]) main page to access more than 1,200 questions answered by Immunize.org experts
* Immunize.org: Clinic Tools ([link removed]) main page and its eight subtopics
* Immunize.org: Educational Materials for Patients and Staff ([link removed]) —an alphabetical list of more than 240 ready-to-print staff educational materials and patient handouts
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Vaccine Information Statements
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Recap: Vaccine Information Statements and translations released in June and July
IZ Express regularly provides readers with information about new and updated Vaccine Information Statements (VISs) and their translations.
On July 24, CDC released an updated interim VIS for Multi Pediatric Vaccines (Your Child's First Vaccines) ([link removed]) and a new VIS for Respiratory Syncytial Virus (RSV) Vaccine ([link removed]) for adults.
As a result of these VIS releases, two handouts related to VISs were updated:
* Dates of Current Vaccine Information Statements (VISs) ([link removed])
* You Must Provide Patients with Vaccine Information Statements (VISs) – It's Federal Law! ([link removed])
On May 12, CDC released interim VISs for Hepatitis B Vaccine ([link removed]) and Pneumococcal Conjugate (PCV) Vaccine ([link removed]) , and Immunize.org provided eight translations for each.
Hepatitis B Vaccine (view in English ([link removed]) ):
* Arabic ([link removed])
* Bengali ([link removed])
* Chinese–Simplified ([link removed])
* Haitian Creole ([link removed])
* Portuguese ([link removed])
* Russian ([link removed])
* Spanish PDF ([link removed]) and RTF ([link removed])
* Vietnamese ([link removed])
Pneumococcal Conjugate Vaccine (view in English ([link removed]) ):
* Arabic ([link removed])
* Bengali ([link removed])
* Chinese–Simplified ([link removed])
* Haitian Creole ([link removed])
* Portuguese ([link removed])
* Russian ([link removed])
* Spanish PDF ([link removed]) and RTF ([link removed])
* Vietnamese ([link removed])
Related Links
* Immunize.org: Vaccine Information Statements ([link removed]) main page for VISs in 47 languages
* CDC: What's New with VISs ([link removed]) web page
* CDC: Current VISs ([link removed]) web page
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Featured Resources
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ACOG shares educational resources on maternal immunization for NIAM
For National Immunization Awareness Month (NIAM), the American College of Obstetricians and Gynecologists (ACOG) is highlighting the importance of maternal immunization with a searchable list of educational resources. ([link removed][Vaccines])
They offer:
* Infographics ([link removed][Vaccines]&f:@patientportalcontenttype=[Infographic]) (9 in English, 4 in Spanish)
* FAQ web pages ([link removed][Vaccines]&f:@patientportalcontenttype=[FAQs]) (all 7 in English)
* Expert views ([link removed][Vaccines]&f:@patientportalcontenttype=[Expert%20View]) (8 for adults, 1 for teens)
* Videos ([link removed][Vaccines]&f:@patientportalcontenttype=[Video]) (4 in English, 1 in Spanish)
[link removed]
These resources can be effective tools for sharing accessible, evidence-based information on COVID-19, Tdap, and influenza vaccination during pregnancy. The suite also includes information on HPV, mpox, and other adult vaccines. Please share these resources with your networks.
View ACOG's resources ([link removed][Vaccines]) .
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ACOG offers training course, “Inform to Empower: Building COVID-19 Vaccine Confidence One Conversation at a Time,” for physicians and other obstetric care clinicians; CME offered
The American College of Obstetricians and Gynecologists (ACOG) offers Inform to Empower: Building COVID-19 Vaccine Confidence One Conversation at a Time ([link removed]) , a free training course intended to teach physicians and other obstetric care clinicians about the importance of increasing patients' vaccine confidence and techniques to increase vaccination demand in practice.
[link removed]
The course offers a maximum of 1.5 CME credits.
Access the course ([link removed]) .
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Notable Publications
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“Vaccination Coverage among Adults in the United States, National Health Interview Survey, 2021” published by CDC
On July 19, CDC published Vaccination Coverage among Adults in the United States, National Health Interview Survey, 2021 ([link removed]) . The conclusion section appears below.
Coverage increased for influenza and herpes zoster vaccination in recent years. Disparities in vaccination coverage by race and ethnicity were seen for all vaccines assessed. Increasing the proportion of adults who receive recommended vaccines and ensuring equitable access to, and uptake of recommended vaccines is a high-priority public health issue.
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“Measles Outbreak—Central Ohio, 2022–2023” published in MMWR
CDC published Measles Outbreak—Central Ohio, 2022–2023 ([link removed]) on August 4 in MMWR. Our analysis of Notes from the Field is summarized below.
* Although the United States has maintained measles elimination since 2000, measles outbreaks continue to occur in countries around the world. Thus, there is always a risk of measles importation that could affect undervaccinated communities.
* In November 2022, two 2-year-old children were admitted to the same hospital in Ohio for suspected measles infection, so public health officials launched an investigation
* A total of 85 people in central Ohio tested positive for measles
* This outbreak was characterized by young median patient age (1 year), low rates of MMR vaccination, and high rates of respiratory coinfection (e.g., respiratory syncytial virus [RSV]), with twice the hospitalization rate reported among previous U.S. measles cases
* Two-dose MMR vaccination coverage among children entering kindergarten in Ohio during the 2021–22 school year (i.e., before the outbreak) was 5% lower than the national coverage estimate of 93%
* Healthcare facilities, clinicians, and childcare centers serving undervaccinated populations should remain on high alert for measles and emphasize the importance of timely MMR vaccination
[link removed]
Access the MMWR article in HTML ([link removed]) or PDF ([link removed]) .
Related Links
* MMWR's main page ([link removed]) provides access to the MMWR family of publications
* CDC: Measles (Rubeola): For Healthcare Providers ([link removed]) main page
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“Safety Monitoring of Novavax COVID-19 Vaccine among Persons Aged ≥12 Years—United States, July 13, 2022–March 13, 2023” published in MMWR
CDC published Safety Monitoring of Novavax COVID-19 Vaccine among Persons Aged ≥12 Years—United States, July 13, 2022–March 13, 2023 ([link removed]) on August 4 in MMWR. Our analysis of Notes from the Field is summarized below.
* Novavax COVID-19 vaccine ([link removed]) is authorized and recommended as
+ A primary 2-dose monovalent vaccination series in people age 12 and older
+ A monovalent booster dose in people age 18 and older who are unable or unwilling to receive an mRNA COVID-19 bivalent vaccine
* To assess the safety of the Novavax COVID-19 vaccine among individuals age 12 years and older, CDC reviewed reports made to the Vaccine Adverse Event Reporting System ([link removed]) (VAERS) from July 13, 2022, to March 13, 2023
* No unexpected safety concerns were identified. The most commonly reported adverse events were nonserious and included reports of dizziness, fatigue, and headache.
* This review underscores the safety of the Novavax COVID-19 vaccine
* It’s important to stay up to date with COVID-19 vaccines to prevent severe illness
Access the MMWR article in HTML ([link removed]) or PDF ([link removed]) .
Related Links
* MMWR's main page ([link removed]) provides access to the MMWR family of publications
* CDC: Stay Up to Date with COVID-19 Vaccines ([link removed]) main page
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Global News
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WHO releases message from Director of Immunization, Vaccines, and Biologicals on the release of country vaccination estimates
On July 31, the World Health Organization (WHO) released Message by the Director of the Department of Immunization, Vaccines and Biologicals at WHO—July 2023 ([link removed]) . A portion of the article appears below.
The WHO/UNICEF estimates of national immunization coverage ([link removed]) (WUENIC) for 2022 were released on 18 July. . . .
The WUENIC findings are encouraging: some immunization services have begun to recover after the disruptions caused by COVID-19 – meaning that immunization services reached 4 million more children than in 2021. Despite this overall improvement, the recovery has been uneven across countries, across vaccines, and across age groups. Even with evidence of a recovery underway in 2022, more than 20 million children still missed out on one or more vaccines last year, and over 14 million missed out entirely. These numbers are higher than in 2019, the year before the pandemic hit. . . .
Most concerningly is that as a group, low-income countries are not yet showing signs of immunization recovery. For these countries, measles vaccine coverage has continued to backslide in 2022, raising the alarm even further for immediate action. We must catch-up, restore, and strengthen all national immunization programs to ensure that all children, no matter where they are, have access to and receive the life-saving vaccines which are their right.
The WUENIC-2022 release of country estimates coincided with the halfway mark for the Big Catch-Up ([link removed]) , underscoring the need for sustained action to strive for catch-up, equitable recovery and strengthening for the remainder of the year and beyond.
Related Link
* WHO: Analysis and Insights: WHO/UNICEF Estimates of National Immunization Coverage ([link removed]) main page
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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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