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Issue 1,708: August 16, 2023
Top Stories
* New! Immunize.org's resources on vaccination-related fainting and anxiety, designed for healthcare personnel and the public. (#IZX1)
* Immunize.org’s screening checklists for vaccine contraindications now address vaccination-related fainting and anxiety (#IZX2)
* Two weeks remain in National Immunization Awareness Month; promote vaccination with these helpful resources for all ages (#IZX3)
* “Meningococcal ACWY Vaccine for Mature First Year College Students”: watch the 2-minute answer, part of the Ask the Experts Video Series on Facebook, LinkedIn, Twitter, YouTube, and Instagram (#IZX4)
* Immunize​.org's Influenza Vaccination Honor Roll for healthcare worker vaccination requirements now features 1,332 organizations, including one new facility (#IZX5)
* Spotlight: Check out Immunize​.org's companion websites (#IZX6)
* Vaccines in the news (#IZX7)


Immunize​.org Pages and Handouts
* Immunize​.org posts five updated 2023–2024 influenza season clinical resources for healthcare providers (#IZX8)
* Immunize​.org updates its "Ask the Experts" web page on vaccine storage and handling (#IZX9)


Featured Resources
* Organizing a new vaccination program? Use Immunize​.org’s Vaccinating Adults: A Step-by-Step Guide—free to download by chapter or in its entirety. (#IZX10)


Notable Publications
* “SARS-CoV-2 Infection and Death Rates among Maintenance Dialysis Patients during Delta and Early Omicron Waves—United States, June 30, 2021–September 27, 2022” published in MMWR (#IZX11)


Upcoming Events
* Virtual: CDC hosts COCA call "We Must Maintain Measles Elimination in the United States: Measles Clinical Presentation, Diagnosis, and Prevention" on August 17 at 2:00 p.m. (ET); CE credit offered (#IZX12)
* Virtual: Pfizer medical team hosts live webinar titled "New RSV Vaccine Recommendations for Older Adults: A 15-Minute Implementation Primer" August 16 and 17 (#IZX13)
* Virtual: NCIRD hosts webinar titled “Childhood and Adult Pneumococcal Recommendations” on August 23 at 12:00 p.m. (ET); CE credit offered (#IZX14)


Editorial Information (#Editorial)
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Top Stories
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New! Immunize​.org's resources on vaccination-related fainting and anxiety, designed for healthcare personnel and the public.
If you administer vaccinations, you can improve a recipient’s confidence in vaccines by acknowledging and addressing their anxiety. Anxiety about injections is common at all ages and contributes to vaccine hesitancy in those affected. Among some adolescents and adults, anxiety can trigger dizziness or fainting, risking fall-related injuries. Both the vaccinator and the vaccine recipient can take simple and effective steps to improve the recipient’s vaccination experience.

Thanks to support from CDC as part of its work to increase vaccine confidence, Immunize​.org now offers clinical tools for healthcare professionals and corresponding patient handouts on vaccination-related fainting and anxiety:
* Vaccination-Related Syncope: Information for Healthcare Personnel ([link removed])
* Fainting Related to Vaccination: What You Need to Know ([link removed]) ([link removed]) (for patients and parents)
* Addressing Vaccination Anxiety in Adolescents and Adults: Strategies for Healthcare Professionals ([link removed])
* Addressing Vaccination Anxiety in Adolescents and Adults: Strategies for Vaccine Recipients and Caregivers ([link removed])

These 1-page resources highlight major points and include key references. The resources for healthcare personnel are ideal for teaching huddles and short in-service trainings. They may also serve as the basis for quality-improvement efforts.
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This new suite of Immunize​.org clinical and patient resources will be completed in coming days with materials focused on the particular needs of children and infants and toddlers. Look for the announcement in IZ Express.

These resources are ideal to use in concert with Immunize​.org’s screening checklists for contraindications to vaccination, recently revised to include questions about vaccination anxiety and fainting. See the next story for details.

Related Links
* Immunize​.org: Improving the Vaccination Experience: Reducing Pain and Anxiety for Children and Adults ([link removed]) (2/28/23)
* Immunize​.org: Improving the Vaccination Experience: Accessible Vaccination for Neurodiverse People at Any Age on-demand ([link removed]) (12/13/22)
* Immunize​.org: Screening Checklist ([link removed]) main page (includes screening checklists with questions to screen for a history of fainting or feeling faint and for vaccination-related anxiety)
* Immunize​.org: Handouts for Patients and Staff ([link removed]) : Addressing Vaccination Anxiety ([link removed]) main page

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Immunize​.org’s screening checklists for vaccine contraindications now address vaccination-related fainting and anxiety

Vaccination anxiety and a history of syncope or presyncope related to injection are not contraindications or precautions to vaccination. However, both anxiety and fainting can adversely affect the vaccine recipient’s experience and increase vaccine hesitancy. You can take simple steps to prevent harmful syncope-related falls or to reassure patients if you are aware of these issues when assessing the recipient for vaccination. By addressing these issues consistently, you can help increase your patients’ confidence in vaccination.

You will now see two new screening questions on Immunize​.org’s screening checklists for vaccine contraindications:
* Have you [your child] ever felt dizzy or faint before, during, or after a shot?
* Are you [your child] anxious about getting a shot today?

Immunize​.org’s new resources related to vaccination anxiety and vaccination-related syncope (described in the story above) provide additional information about how you can help patients who answer “yes” to either of these questions.

Update your screening checklists today:
* Screening Checklist for Contraindications to HPV, MenACWY, MenB, and Tdap Vaccines for Teens ([link removed])
* Screening Checklist for Contraindications to Injectable Influenza Vaccination ([link removed])
* Screening Checklist for Contraindications to Vaccines for Adults ([link removed])
* Screening Checklist for Contraindications to Vaccines for Children and Teens ([link removed])

See all the Immunize​.org screening checklists by going to the Screening Checklists about Vaccine Contraindications and Precautions ([link removed]) main page.
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Related Links
* Immunize​.org: Screening Checklist ([link removed]) main page (showing language options)
* Immunize​.org: Handouts for Patients and Staff ([link removed]) main page

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Two weeks remain in National Immunization Awareness Month; promote vaccination with these helpful resources for all ages

August is National Immunization Awareness Month ([link removed]) (NIAM). This annual observance highlights 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.

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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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“Meningococcal ACWY Vaccine for Mature First Year College Students”: 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 channels make it easy for you to learn a little every day. This week, our featured episode from the Ask the Experts Video Series is Meningococcal ACWY Vaccine For Mature First Year College Students ([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.

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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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Immunize​.org’s Influenza Vaccination Honor Roll for healthcare worker vaccination requirements now features 1,332 organizations, including one new facility

Immunize​.org’s Influenza Vaccination Honor Roll ([link removed]) recognizes facilities that take a stand for patient safety by implementing policies for mandatory healthcare personnel influenza vaccination. There are now 1,332 organizations enrolled. Immunize​.org recently welcomed an additional healthcare organization.
* Care Resources PACE, Grand Rapids, MI

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Eligibility:
* Eligible organizations: Hospitals, long-term care facilities, medical practices, pharmacies, professional organizations, health departments, and other government entities
* Requirements:
+ Your policy must require influenza vaccination for all staff
+ The application ([link removed]) must describe measures to prevent transmission of influenza from unvaccinated personnel to patients (e.g., masking for the entire work shift)

Related Links
* Immunize​.org: list of Influenza Vaccination Honorees, all healthcare settings ([link removed]) , by state
* Immunize​.org: Long-Term Care/Assisted Living Influenza Vaccination Honorees ([link removed]) by state
* Immunize​.org: Influenza Vaccination Honor Roll program ([link removed]) , including:
+ Position statements ([link removed]) from professional societies and leading healthcare organizations in support of mandatory influenza vaccination
+ Application form for Influenza Vaccination Honor Roll ([link removed])
* Immunize​.org: Honor Roll for Patient Safety ([link removed]) web page

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Spotlight: Check out Immunize​.org's companion websites

On the Immunize​.org home page, you can link to several of our helpful companion websites.

Vaccine Information You Need at www.vaccineinformation.org ([link removed]) was launched by Immunize​.org in partnership with CDC to help inform the public. This website provides hundreds of valuable resources, including personal testimonies of suffering due to vaccine-preventable diseases, videos, public-service announcements, and educational materials from trusted organizations.

Information about the National Network of Immunization Coalitions, a project of Immunize​.org, can be found at www.immunizationcoalitions.org ([link removed]) . This website compiles information on more than 100 immunization coalitions and their topics of shared interest.

The National Adult and Influenza Immunization Summit (NAIIS) website at www.izsummitpartners.org ([link removed]) addresses practical immunization issues to improve coverage. With more than 900 members, NAIIS represents more than 130 public and private organizations. The NAIIS is led by members of the Summit Organizing Committee, including Immunize​.org, CDC, and other federal representatives.

MenACWY: You’re Not Done If You Give Just One at www.give2menacwy.org ([link removed]) supports a national campaign produced by Immunize​.org and Sanofi to improve protection from disease caused by meningococcal serogroups A, C, W, and Y. The site offers information for families and resources for providers to boost on-time delivery of both doses of the MenACWY vaccine.

65+ Flu Defense at www.influenza-defense.org ([link removed]) is a public health service produced by Immunize​.org and Seqirus. The website offers tools and resources to help protect patients 65 and older, each of whom are at greater risk of influenza complications.
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Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* CNN: States Gear Up for This Fall’s Triple Threat of Respiratory Viruses: COVID-19, Flu, and RSV ([link removed]) (8/10/23)
* Infectious Disease Special Edition: Pediatricians: We Need Infrastructure to Provide Nirsevimab ([link removed] ) (8/8/23)
* Medical Express: How to Increase Acceptance of an RSV Vaccine? Explain the FDA’s Vaccine Approval Process ([link removed]) (8/8/23)
* STAT: Community Health Workers, Experts in the In-Between, Fight for Their Place in the System ([link removed] ) (8/7/23)
* Washington Post: All It Takes to Avert a Tripledemic Is a Simple Message ([link removed] ) (8/6/23)
* The Hill: Childhood Vaccinations Falter Ahead of Crucial Fall Season ([link removed] ) (8/6/23)
* Forbes: COVID Cases Are on the Rise—Here’s What You Need to Know ([link removed] ) (8/3/23)

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Immunize​.org Pages and Handouts
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Immunize​.org posts five updated 2023–2024 influenza season clinical resources for healthcare providers

Immunize​.org updated five of its influenza-related clinical resources for healthcare providers. The revised materials are listed below.

Influenza Vaccine Products for the 2023-2024 Influenza Season ([link removed]) was reviewed and updated for the 2023–2024 influenza season; however, the manufacturers, products, indications, and codes remain the same as the 2022–2023 season.
[link removed]

Revisions for Standing Orders for Administering Influenza Vaccine to Adults ([link removed]) and to Standing Orders for Administering Influenza Vaccine to Children and Teens ([link removed]) include an expanded footnote describing clinical considerations for coadministration of influenza vaccines with other recommended vaccines. They include an explanatory note on ACIP’s 2023 recommendation that egg allergy of any severity is no longer a consideration when giving influenza vaccines. People with egg allergy of any severity may receive any appropriate influenza vaccine without any additional safety measures beyond those needed for recipients of any vaccine.

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Similarly, Screening Checklist for Contraindications to Injectable Influenza Vaccination (IIV) ([link removed]) and to Screening Checklist for Contraindications to Live Attenuated Intranasal Influenza Vaccination ([link removed]) reflect ACIP's updated recommendations that people with egg allergy may receive any appropriate influenza vaccine without any additional safety measures. Note the slight name change to remove "Inactivated" and substitute the more inclusive term, "Injectable." As with all of Immunize​.org’s screening checklists for injectable vaccines, questions related to anxiety and fainting were added to the IIV checklist.

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Related Links
* Immunize​.org: Vaccines: Influenza ([link removed]) main page
* Immunize​.org: Standing Orders Templates for Administering Vaccines ([link removed]) main page
* Immunize​.org: Screening for Vaccine Contraindications and Precautions ([link removed]) main page
* Immunize​.org: Handouts for Patients and Staff ([link removed]) main page, where you can sort materials by topic, vaccine, or language
* Immunize​.org: Educational Materials for Patients and Staff ([link removed]) —an alphabetical listing of more than 230 ready-to-print staff educational materials and patient handouts

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Immunize​.org updates its "Ask the Experts" web page on vaccine storage and handling

Immunize​.org's popular Ask the Experts: Storage and Handling ([link removed]) web page was updated to reflect the new NSF/ANSI 456 voluntary certification for vaccine storage equipment. Those seeking to purchase reliable refrigerators or freezers for vaccine storage may now look for this NSF certification as an indication that the unit model has been tested and shown to maintain consistent proper vaccine storage under a wide range of normal clinic use conditions. The answers on this page also were also updated with current hyperlinks and COVID-19 information.

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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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Featured Resources
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Organizing a new vaccination program? Use Immunize​.org’s Vaccinating Adults: A Step-by-Step Guide—free to download by chapter or in its entirety.

Download Immunize​.org’s free 142-page book on adult vaccination to help build your program and train your team: Vaccinating Adults: A Step-by-Step Guide (Guide) ([link removed]) .

[link removed]

This thorough "how to" guide on adult vaccination provides easy-to-use, practical information covering all essential activities. It helps vaccine providers enhance their existing adult vaccination services or introduce them into any clinical setting.

The Guide is available to download/print either by chapter or in its entirety free at www.immunize.org/guide ([link removed]) . The National Vaccine Program Office and CDC both supported the development of the Guide and provided early technical review.

The Guide is a valuable resource to assist providers in increasing adult vaccination rates. Be sure to get a copy today!

Please note: this guide was produced in 2017, before the COVID-19 era, and reflects the recommendations of that time.

Related Links
* Vaccinating Adults: A Step-by-Step Guide ([link removed]) main page, permitting download of entire Guide (142 pages, PDF) ([link removed])
* View the table of contents and individual chapters (PDF):
+ Table of Contents ([link removed])
+ Step 1: Getting Started ([link removed])
+ Step 2: Setting Up for Vaccination Services ([link removed])
+ Step 3: Vaccine Storage and Handling ([link removed])
+ Step 4: Deciding Whom to Vaccinate ([link removed])
+ Step 5: Administering Vaccines ([link removed])
+ Step 6: Documentation and Related Issues ([link removed])
+ Step 7A: Financial Considerations ([link removed])
+ Step 7B: How to Bill for Adult Immunizations ([link removed])
* Immunize​.org’s educational materials (handouts) on adult immunization ([link removed])

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Notable Publications
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“SARS-CoV-2 Infection and Death Rates among Maintenance Dialysis Patients during Delta and Early Omicron Waves—United States, June 30, 2021–September 27, 2022” published in MMWR

CDC published SARS-CoV-2 Infection and Death Rates among Maintenance Dialysis Patients during Delta and Early Omicron Waves—United States, June 30, 2021–September 27, 2022 ([link removed]) on August 11 in MMWR. A portion of the summary appears below.

Patients receiving maintenance dialysis are at increased risk for complications related to SARS-CoV-2 infection, including death. . . .

During June 30, 2021–September 27, 2022, rates of SARS-CoV-2 infection and COVID-19–related death were higher among maintenance dialysis patients compared with rates in the U.S. population. These higher infection rates were attenuated by vaccination. . . .

Patients receiving maintenance dialysis benefit from staying up to date with recommended COVID-19 vaccination. Continued efforts to mitigate transmission of respiratory viruses in dialysis facilities are warranted.

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Access the MMWR article in HTML ([link removed]) or PDF ([link removed]) .

Related Link
* MMWR's main page ([link removed]) provides access to the MMWR family of publications

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Upcoming Events
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Virtual: CDC hosts COCA call "We Must Maintain Measles Elimination in the United States: Measles Clinical Presentation, Diagnosis, and Prevention" on August 17 at 2:00 p.m. (ET); CE credit offered

CDC will host a Clinician Outreach and Communication Activity (COCA) call titled We Must Maintain Measles Elimination in the United States: Measles Clinical Presentation, Diagnosis, and Prevention ([link removed]) , 2:00–3:00 p.m. (ET) on August 17. During this COCA call, presenters will discuss the history of measles in the United States, review clinical presentation and diagnosis of measles infection, review how to report suspected cases to public health agencies, and outline recommendations for measles vaccination in the United States.

A recording of the presentation will be archived for viewing on the COCA call webpage ([link removed]) a few hours after the live event ends.

Free continuing-education credit will be offered for this COCA call.

Registration is not required.

Link for the August 17 call ([link removed]) .

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Virtual: Pfizer medical team hosts live webinar titled "New RSV Vaccine Recommendations for Older Adults: A 15-Minute Implementation Primer" August 16 and 17

Two new RSV vaccines were recently licensed and recommended by ACIP for use in adults age 60 years or older after shared clinical decision-making (a discussion of the individual patient’s risks and benefits): Arexvy (GSK) and Abrysvo (Pfizer). The Pfizer Vaccines Medical Affairs team is hosting a live webinar, New RSV Vaccine Recommendations for Older Adults: A 15-Minute Implementation Primer ([link removed] RSV Vaccine Recommendations for Older Adults: A 15-Minute Implementation Primer) , multiple times throughout the day on August 16 and 17. The webinar offers healthcare provider briefings on the RSV older adult vaccine. Topics include:
* RSV burden of disease
* ACIP recommendations and clinical considerations
* Preparation and administration for Pfizer's RSV vaccine
* Question and answer session

Continuing education credit is not offered for this event.

View times and join the sessions ([link removed]) .

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Virtual: NCIRD hosts webinar titled “Childhood and Adult Pneumococcal Recommendations” on August 23 at 12:00 p.m. (ET); CE credit offered

The Immunization Services Division (ISD) in the National Center for Immunization and Respiratory Diseases (NCIRD) will host a webinar in their Current Issues in Immunization Webinar (CIIW) Series titled Childhood and Adult Pneumococcal Recommendations ([link removed]) , 12:00–1:00 p.m. (ET) on August 23. During the webinar, Miwako Kobayashi, MD, MPH, Division of Bacterial Diseases, NCIRD, will give updates on childhood and adult pneumococcal recommendations.

Registration is not needed, but participation is limited. Continuing education credit is available.

A recording will be available following the webinar. View archived CIIW videos ([link removed]) .

Join the event directly ([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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