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Top Stories
Immunize.org Pages and Handouts
Vaccine Information Statements
Featured Resources
Global News
Upcoming Events
Top Stories
The Advisory Committee on Immunization Practices (ACIP) met on September 12 to review FDA’s September 11 action approving and authorizing the 2023–2024 formula (“updated”) mRNA COVID-19 vaccines. Bivalent COVID-19 vaccines are no longer authorized and should no longer be used; at this time, the recommendations for Novavax COVID-19 vaccine are unchanged. ACIP voted (13–1) to recommend use of the 2023–2024 (monovalent, XBB-containing) COVID-19 vaccines for all individuals age 6 months and older, in accordance with the terms of FDA licensure or emergency use authorization (EUA). Although this recommendation currently applies only to Pfizer-BioNTech and Moderna mRNA vaccines, it also will apply to a 2023–2024 updated Novavax COVID-19 vaccine if it receives FDA authorization. Presentation slides from the meeting are available online, and meeting highlights are provided below. Following the meeting, the CDC director officially accepted the recommendations in a media statement.
Current Epidemiology of SARS-CoV-2 More than 90% of currently circulating viruses in the United States are of XBB lineage, the strain selected in June for the 2023–2024 COVID-19 vaccine formulation. Recently, SARS-CoV-2 BA.2.86 lineage viruses also have been detected at low levels in the United States. There are currently an estimated 17,000 or more COVID-related hospitalizations each week. Hospitalizations have increased in all age groups since mid-July, 2023, with highest rates seen in infants younger than age 6 months and older adults. While 4 out of 5 adults age 65 years and older hospitalized with COVID-19 had at least 3 underlying medical conditions, more than half of children younger than age 5 years hospitalized with COVID-19 in the first half of 2023 were in a normal state of health at baseline with no underlying medical conditions. Most children and adults hospitalized for COVID-19 during 2023 were unvaccinated or had not received an updated bivalent booster. CDC presented updated information on the prevalence of post-COVID conditions (“Long COVID”) in previously infected individuals. A wide range of physical and mental health consequences may continue or develop at least 4 weeks after initial COVID-19 illness. The prevalence of ongoing symptoms lasting at least 3 months after COVID-19 varies by age, with between 2.3 and 4.7 percent of all adults in one nationally representative survey currently reporting symptoms consistent with Long COVID. Almost 1 in 4 adults with Long COVID reported significant activity limitations. A growing body of evidence indicates that COVID-19 vaccination reduces the risk of Long COVID among children and adults. Evidence presented to ACIP demonstrated that people of any age and health status have some measurable risk of severe illness following SARS-CoV-2 infection; in addition, conditions that increase the risk of severe illness are widespread (e.g., 70% of U.S. adults are overweight or obese). The uncertain future of COVID-19 epidemiology combined with the well-understood, reassuring safety profile of available vaccines favor a cautious, broad recommendation for vaccination at this time, despite the relatively short (a few months) duration of enhanced protection from hospitalization. The risk-benefit balance favors vaccination for all age groups and the economic cost-benefit balance is in line with other routine vaccines in all groups. Vaccine products ACIP recommended the use of 2023–2024 updated COVID-19 vaccines in accordance with their FDA licensure or emergency use authorization (EUA). By not specifying brands of 2023–2024 COVID-19 vaccines in its recommendation, this recommendation may apply to any 2023–2024 COVID-19 vaccine authorized or approved by FDA in the future (e.g., the 2023–2024 formulation of the Novavax adjuvanted protein subunit vaccine, which is currently under evaluation for an EUA by FDA). Additional information on each product is shown below under “Related Links.” Age 12 years and older (vaccines have full FDA licensure)
Recommended schedule for updated 2023–2024 COVID-19 vaccines Most individuals age 5 years and older
Individuals who are moderately to severely immunocompromised
Representatives from Pfizer-BioNTech, Moderna, and Novavax presented available data on their updated 2023–2024 formulations of COVID-19 vaccine. Information from clinical trials or preclinical data indicate the updated vaccines are expected to provide cross-protection against the newer circulating SARS-CoV-2 viruses in the BA.2.86 lineage. Extensive vaccine safety surveillance continues to indicate COVID-19 vaccines are safe and effective. Benefits continue to outweigh risk in the age groups for which risk of myocarditis is highest (males age 12 through 39 years). For example, the risk of adverse cardiac outcomes was 1.8–5.6 times higher after SARS-CoV-2 infection than after mRNA COVID-19 vaccination among males age 12 through 17 years. The strain change made in the 2023–2024 updated formulation is not expected to alter the safety profile of the vaccines. Projected public interest in COVID-19 vaccination A survey of more than 4,000 American adults conducted in August indicated approximately 42% definitely or probably would get the updated vaccine. Confidence in vaccine safety is higher for influenza and other routine adult vaccines than for COVID-19 vaccine. A survey conducted in June 2023 showed the impact of a healthcare provider’s recommendation: about 9 out of 10 adults who reported that their healthcare provider recommended COVID-19 vaccination had been vaccinated, while only about 2 out of 3 adults who reported that no healthcare provider had recommended COVID-19 vaccination to them had been vaccinated anyway. Transition to routine vaccine purchase and billing With the exception of uninsured adults, all other vaccine recipients will receive the 2023–2024 formulation of COVID-19 vaccines as they do other routine vaccines. The retail price of these vaccines is in the range of $120–$130/dose, but the cost will be fully covered by most private insurance plans, Medicaid and Medicare, and eligible children will have access through the Vaccines for Children (VFC) program. CPT codes have been updated for billing purposes. CDC has established a temporary Bridge Access Program to cover the cost of vaccine for adults who are uninsured or underinsured. The Bridge Access Program will be available through the end of 2024 in designated pharmacies, federally qualified health centers, and public health departments. Information about dose availability, including availability of doses through the Bridge Access Program for uninsured and underinsured adults, is available at www.vaccines.gov. The next ACIP meeting will be held on Friday, September 22, when the committee will consider recommendations for the use of maternal RSV vaccine during pregnancy for the prevention of severe RSV disease in infants. Information about past and future ACIP meetings may be found on the ACIP website. Related Links
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CDC updated their Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States on September 15. This guidance provides important details on use of COVID-19 vaccines. All healthcare professionals administering or counseling patients on COVID-19 vaccination should review all changes on the web page.
View the CDC’s Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States web page.
HHS launches Bridge Access Program to provide COVID-19 vaccines at no cost for uninsured and underinsured adults
On September 14, CDC issued a press release announcing the launch of the federal Bridge Access Program, a program to sustain broad access to COVID-19 vaccines at no cost to millions of uninsured and underinsured adults. A portion of the press release appears below. The Bridge Access Program is temporary and scheduled to end in December 2024. A longer-term solution is the Vaccines for Adults (VFA) program, proposed in both the FY 2023 and 2024 Presidential Budgets, which would cover all recommended vaccinations at no cost for uninsured adults. This proposal has not yet been enacted into law. COVID-19 vaccines remain free for most Americans through their health insurance plans—or through the Vaccines for Children (VFC) program, which provides recommended vaccines and immunizations at no cost to about half of the nation’s children. Vaccination remains the best available protection against the most severe outcomes of COVID-19, including hospitalization and death.
Immunize.org's popular Ask the Experts: Influenza web page was updated for the 2023–24 influenza season. Answers have been updated with current information on the burden of influenza disease, current season vaccines, and information about routine vaccine administration for people with egg allergies. Related Links
“MenACWY Given at Age 10. Revaccinate at 11, or Not?”: watch the 1-minute answer, part of the Ask the Experts Video Series on Facebook, LinkedIn, X (Twitter), YouTube, and Instagram Immunize.org's social media channels make it easy for you to learn a little more every day. This week, our featured episode from the Ask the Experts Video Series is MenACWY Given at Age 10. Revaccinate at 11, or Not? This is available on our YouTube channel, along with our full collection of quick video answers to popular Ask the Experts questions. Like, follow, and share Immunize.org’s social media accounts and encourage colleagues and others interested in vaccination to do likewise:
Spotlight: Immunize.org's resources focused on communication between healthcare personnel and patients or caregivers
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
Immunize.org Pages and Handouts
Immunize.org updates the 2023–24 influenza vaccination standing orders templates—one for adults and one for children and teens
Immunize.org revised the wording of the two current (2023–24) standing orders templates for influenza based upon questions from readers. The new wording is intended to make it more explicit that the ACIP and CDC do not consider egg allergy a contraindication or precaution to the use of any influenza vaccine. No additional safety measures are necessary when administering any influenza vaccine to a person with egg allergy of any severity beyond standard practices for safe vaccine administration. The note is now clearly placed under the subheading, “Not a contraindication or a precaution.” In addition, the phrase, “live virus” was inadvertently missing from the statement on the routine 4-week interval recommended between live attenuated influenza vaccine and other injectable live virus vaccines not administered on the same day. The two standing order templates include both injectable and intranasal influenza vaccines:
  Please replace previous versions of these templates with the current versions. Related Links
Immunize.org revises its clinical resource “Communicating the Benefits of Influenza Vaccination” for the 2023–24 season
Immunize.org revised its clinical resource, co-branded with Association of Immunization Managers (AIM), Communicating the Benefits of Influenza Vaccination. The influenza vaccination rates displayed on the top right were updated and the document acknowledges the potential need for immunization against other respiratory viruses, including COVID-19 and RSV. Use this resource to improve communications with patients.  Related Links
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Immunize.org updates three handouts, “Notification of Immunization Letter Template,” “Hepatitis A is a Serious Liver Disease: Vaccination Can Protect You!,” and “Hepatitis A: Questions and Answers” Immunize.org updated three handouts to include a QR code linking users to the PDF of the current document. Additional changes to the resources include:
  
Related Links
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Immunize.org’s Vaccine Timeline main page was updated to include new events related to vaccines and immunization. Vaccine Information Statements
Immunize.org posts 12 new translations of CDC’s recently updated multi-vaccine Vaccine Information Statement for infants
Immunize.org posted 12 translations of the multi-vaccine Vaccine Information Statement (VIS) titled Your Child’s First Vaccines VIS, which CDC updated on July 24, 2023. These translations join the Spanish (RTF) VIS. This VIS provides information on diphtheria, tetanus, pertussis, Hib, hepatitis B, pneumococcal, and poliovirus vaccines, including 20-valent pneumococcal conjugate vaccine (PCV20) as an option for vaccination.
Check the version dates of your office copies of newly updated translations. Translations of previous VIS versions should be discarded now that translations of the current version are available.
Featured Resources Vaccinate Your Family launches its 2023–24 “Not ‘Just’ the Flu” campaign to raise awareness about the seriousness of influenza
Vaccinate Your Family launched its Not “Just” the Flu campaign to raise awareness about the seriousness of influenza and the importance of flu vaccination.
 The campaign will run for as long as influenza season lasts. Please share on your social platforms with the hashtag #NotJustFlu. Feel free to co-brand materials. Please reach out to [email protected] with your branding questions. Back to top
Voices for Vaccines releases video “What is Community Immunity?” to share with patients and the public Voices for Vaccines released an animated video with voice-over titled What is Community Immunity? (3:18 minutes). It is designed to explain how people build immunity to infectious diseases and why it's important to get vaccinated.
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).
Global News
“Interim Effectiveness Estimates of 2023 Southern Hemisphere Influenza Vaccines in Preventing Influenza-Associated Hospitalizations—REVELAC-I Network, March–July 2023” published in MMWR
CDC published Interim Effectiveness Estimates of 2023 Southern Hemisphere Influenza Vaccines in Preventing Influenza-Associated Hospitalizations—REVELAC-I Network, March–July 2023 in the September 15 issue of MMWR. A portion of the summary appears below. Effectiveness of seasonal influenza vaccine varies by season and circulating virus type. . . .
Upcoming Events
CDC will convene its Advisory Committee on Immunization Practices (ACIP) on September 22, from 10:00 a.m.–5:00 p.m. (ET). The committee will discuss maternal respiratory syncytial virus (RSV) vaccination. In August, the U.S. Food and Drug Administration (FDA) licensed one RSV vaccine (Abrysvo, Pfizer) for use during pregnancy between 32—36 weeks gestation to prevent lower respiratory tract disease caused by RSV in infants from birth through 6 months of age.
Virtual: NCIRD offers webinar “Clinical Guidance for Use of Products to Prevent RSV Disease in Infants” on September 27 at 12:00 p.m. (ET); CE available
The Immunization Services Division (ISD) in CDC's National Center for Immunization and Respiratory Diseases (NCIRD) will host a webinar in their Current Issues in Immunization Webinar (CIIW) Series titled Clinical Guidance for Use of Products to Prevent RSV Disease in Infants, 12:00–1:00 p.m. (ET) on September 27. The presentation will review the ACIP-recommended use of nirsevimab, a long-acting monoclonal antibody for the prevention of RSV in infants, as well as any recommendations made by ACIP on September 22 concerning the use of RSV vaccine during pregnancy. 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. Join the event directly. Virtual: Moderna offers multiple informational briefings for clinical staff on the updated 2023–2024 Moderna COVID-19 vaccine formulation in September
Moderna will host several virtual informational briefings for clinical staff titled Understanding the Updated Moderna COVID-19 Vaccine (2023–2024 Formulation) through September 29. Briefings will feature 15-minute presentations, followed by live, 30-minute Q&A sessions. Topics will include:
For more upcoming events, visit our Calendar of Events.
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