From Immunize.org <[email protected]>
Subject IZ Express #1,724: 2024 immunization schedules, global measles threat, and more
Date November 22, 2023 11:16 AM
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Issue 1,724: November 22, 2023

Top Stories
* CDC releases 2024 U.S. recommended immunization schedule for children and teens
* CDC releases 2024 U.S. recommended immunization schedule for adults
* Important updates about the new Immunize​.org website search features
* CDC and WHO issue joint press release describing growth of global measles threat
* "Progress toward Measles Elimination—Worldwide, 2000–2022" published in MMWR
* Immunize​.org updates “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools” to include CDC’s updated Novavax 2023–2024 Formula Standing Orders
* "A Cluster of Multi-Strain Invasive Pneumococcal Disease among Persons Experiencing Homelessness and Use of Pneumococcal Conjugate Vaccine—El Paso County, Colorado, 2022" published in MMWR
* “Fainting Related to Vaccination: What You Need to Know”: watch the 3-minute video, part of the Improving the Vaccination Experience Video Series on YouTube
* Influenza activity is increasing in most of the country; encourage vaccination before holiday gatherings!
* Vaccines in the news


Immunize​.org Pages and Handouts
* Immunize​.org updates patient handout titled "Haemophilus influenzae type b (Hib): Questions and Answers"
* Protect your vaccine inventory from being mishandled with these helpful Immunize​.org signs: "Warning! Expensive Vaccine in Storage!" and "Do Not Unplug Refrigerator or Freezer"


Vaccine Information Statements
* Recap: Immunize​.org posts Spanish translations of COVID-19 and RSV VISs, and RSV Preventive Antibody Immunization Information Statement


Featured Resources
* UCLA School of Medicine and the Autism Society release CME activity promoting vaccination access and uptake in the neurodivergent community


Notable Publications
* "U.S. Public Support and Opposition to Vaccination Mandates in K-12 Education in Light of the COVID-19 Pandemic" published in Vaccine
* "Clinician Prompts for Human Papillomavirus Vaccination: A Cluster Randomized Trial" published in Academic Pediatrics
* "mRNA SARS-CoV-2 Vaccination before vs during Pregnancy and Omicron Infection among Infants" published in Pediatrics


Upcoming Events
* Happy Thanksgiving from Immunize​.org!


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Top Stories
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CDC releases 2024 U.S. recommended immunization schedule for children and teens

In a break with its tradition of publishing the new annual schedule each February, on November 16, CDC posted the 2024 recommended immunization schedule for children and adolescents ([link removed]) on CDC's Immunization Schedules for Healthcare Providers ([link removed]) web page. The schedule includes an addendum page (currently empty) that will be filled later as ACIP issues updates to its recommendations throughout 2024. The MMWR publication of the schedule will occur in January. The purpose of publishing the schedule earlier is to allow more time for immunization providers to train and prepare their teams.

The updated schedule for children and adolescents includes:
* Table 1: Recommendations for Ages 18 Years or Younger, United States, 2024 ([link removed])
* Table 2: Catch-Up Immunization Schedule for Children and Adolescents Who Start Late or Who Are More than 1 Month Behind ([link removed])
* Table 3: Child and Adolescent Immunization Schedule by Medical Indication ([link removed])

Access the full-color, 15-page PDF of the child/adolescent schedule ([link removed]).

View what changed on the child/adolescent schedule for 2024 ([link removed]).

As in previous years, Immunize​.org will produce sturdy, waterproof, laminated copies of these schedules for sale in early 2024. Pre-ordering information will be shared in a special Shop Edition of IZ Express as soon as it is available.

Related Links
* CDC: Schedule-Related Resources for Healthcare Providers ([link removed]) web page
* CDC: For You and Your Family: Parent-Friendly Schedules and More Vaccination Resources ([link removed]) web page (pending update)
* CDC: Resources for Healthcare Providers ([link removed]) web page

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CDC releases 2024 U.S. recommended immunization schedule for adults

CDC moved up the online release of the 2024 recommended immunization schedule for adults ([link removed]) three months earlier than in the past in order to give immunization providers earlier access to new and updated current recommendations on the immunization schedule. On November 16, CDC posted the 2024 recommended immunization schedule for adults on CDC’s Immunization Schedules for Healthcare Providers ([link removed]) web page. The online schedule includes an addendum page (currently empty) that will be filled later as ACIP issues updates to its recommendations throughout 2024. The typical MMWR publication of the schedule will be issued in January 2024.

The updated schedule for adults includes:
* Table 1: Recommendations for Ages 19 Years or Older, United States, 2024 ([link removed])
* Table 2: Adult Immunization Schedule by Medical Condition and Other Indication ([link removed])

Access the full-color, 13-page PDF of the adult schedule ([link removed]).

View what changed on the adult schedule for 2024 ([link removed]).

As in previous years, Immunize​.org will produce sturdy, waterproof, laminated copies of these schedules for sale in early 2024. Pre-ordering information will be shared in a special Shop Edition of IZ Express as soon as it is available.

Related Links
* CDC: Schedule-Related Resources for Healthcare Providers ([link removed]) web page
* CDC: There Are Vaccines You Need as an Adult ([link removed]) web page includes links for Adult Vaccinations ([link removed]) and Pregnancy and Vaccination ([link removed])
* CDC: Resources for Healthcare Providers ([link removed]) web page

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Important updates about the new Immunize​.org website search features

Immunize​.org launched our redesigned website on November 9 and we hope you are enjoying it. As excited as we are about the new site, some changes related to the site’s search functionality are not yet functioning as expected. Our vendor is working on these issues, but we do not have a date for resolution. We will keep our readers and website users posted on our progress. In the meantime, here’s three things you should know:

Slower-than-normal responses when using keyword searches and filters:
Users of Ask the Experts and Clinical Resources (formerly Handouts) will notice that the site may take up to 6 or 7 seconds to return results when a keyword search or filter is applied. Our vendor is working to achieve normal 2–3 second result times in all searches.

The “key” to effective keyword searches of Ask the Experts and Clinical Resources:
Initiate any keyword search only on the “All Questions” page of Ask the Experts ([link removed]) or the “Search All Clinical Resources” page of Clinical Resources ([link removed]) . If you do, your search will return only results that contain your keyword. You may then filter the results using the filter options, if you wish.

Currently, if you go to a specific vaccine or topic section before entering the keyword search, as you might typically do, the keyword search will return everything in that section and simply highlight the keyword where it appears. We are working to resolve this.

Using filters:
Some filter options (e.g., Adults) have subcategories (e.g., Adults 65+). At this time, if you select a subcategory, the results return everything in the category (not only the subcategory). This bug should be resolved soon.

We commit to keeping our IZ Express readers up to date as we resolve these technical issues. Thank you for your support and patience.

Related Links
* Immunize​.org: Ask the Experts: View All Questions ([link removed])
* Immunize​.org: Clinical Resources: Search All Clinical Resources ([link removed])

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CDC and WHO issue joint press release describing growth of global measles threat

On November 16, CDC and WHO issued a joint press release titled Global Measles Threat Continues to Grow as Another Year Passes with Millions of Children Unvaccinated ([link removed]). A portion of the press release appears below.

Following years of declines in measles vaccination coverage, measles cases in 2022 have increased by 18%, and deaths have increased by 43% globally (compared to 2021). This takes the estimated number of measles cases to 9 million and deaths to 136,000 – mostly among children – according to a new report from the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC).

Measles continues to pose a relentlessly increasing threat to children. In 2022, 37 countries experienced large or disruptive outbreaks compared with 22 countries in 2021. Of the countries experiencing outbreaks, 28 were in the WHO Region for Africa, six in the Eastern Mediterranean, two in Southeast Asia, and one in the European Region.

Related Links
* WHO: Global Measles Threat Continues to Grow as Another Year Passes with Millions of Children Unvaccinated ([link removed])
* MMWR: Progress Toward Measles Elimination—Worldwide, 2000–2022 (HTML ([link removed]) or PDF ([link removed]))

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"Progress toward Measles Elimination—Worldwide, 2000–2022" published in MMWR

CDC published Progress toward Measles Elimination—Worldwide, 2000–2022 ([link removed]) in the November 17 issue of MMWR ([link removed]). A portion of the summary appears below.

During 2000–2022, estimated measles vaccination prevented approximately 57 million deaths worldwide. However, millions of children missed vaccinations during the COVID-19 pandemic, resulting in an 18% increase in estimated measles cases and a 43% increase in estimated measles deaths in 2022 compared with 2021. Large or disruptive outbreaks were reported in 37 countries. Measles surveillance remains suboptimal. . . .

To continue progress toward measles elimination, all children should receive 2 MCV doses to address pandemic-related immunity gaps and measles surveillance should be strengthened.

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

Related Link
* CDC: MMWR main page ([link removed]) providing access to the MMWR family of publications

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Immunize​.org updates “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools” to include CDC’s updated Novavax 2023–2024 Formula Standing Orders

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. A special mid-month update was made on November 14 to add CDC’s new Standing Orders template ([link removed]) and “At-A-Glance” summary ([link removed]) for the updated (2023–2024 Formula) Novavax COVID-19 vaccine.

All COVID-19 vaccine 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.

Related Links
* Immunize​.org: Clinical Resources: Standing Orders Templates ([link removed]) main page
* Immunize​.org: Clinical Resources A-Z ([link removed]) main page, where you can filter by topic, vaccine, language, or other criteria

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"A Cluster of Multi-Strain Invasive Pneumococcal Disease among Persons Experiencing Homelessness and Use of Pneumococcal Conjugate Vaccine—El Paso County, Colorado, 2022" published in MMWR

CDC published A Cluster of Multi-Strain Invasive Pneumococcal Disease among Persons Experiencing Homelessness and Use of Pneumococcal Conjugate Vaccine—El Paso County, Colorado, 2022 ([link removed]) in the November 17 issue of MMWR ([link removed]) . A portion of the summary appears below.

Persons experiencing homelessness are often at increased risk for invasive pneumococcal disease (IPD) due to underlying health conditions or risk factors (risk conditions). Homelessness alone is not an indication for pneumococcal vaccination according to current Advisory Committee on Immunization Practices (ACIP) recommendations: adults aged ≥65 years or 19–64 years with certain underlying medical conditions or risk factors with no previous or unknown history of receipt of pneumococcal conjugate vaccine (PCV) should receive 1 dose of either 20-valent or 15-valent PCV (PCV20 or PCV15, respectively). On November 29, 2022, El Paso (Colorado) County Public Health (EPCPH) was informed by a single hospital of three cases of IPD among persons experiencing homelessness, with all illness onset dates occurring within a single week.

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

Related Link
* CDC: MMWR main page ([link removed]) providing access to the MMWR family of publications

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“Fainting Related to Vaccination: What You Need to Know”: watch the 3-minute video, part of the Improving the Vaccination Experience Video Series on YouTube

This week’s featured video is meant for both vaccine recipients and healthcare professionals. Learn why some people feel dizzy or faint when getting an injection, along with simple steps to reduce the risk of fainting and injuries related to falls in our 3-minute video, Fainting Related to Vaccination: What You Need to Know ([link removed]) . This video is part of Immunize​.org’s new Improving the Vaccination Experience Video Series. It 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.

This week's featured video highlights the information covered in Immunize​.org’s new 1-page resource for families: Fainting Related to Vaccination: What You Need to Know ([link removed]).

Immunize​.org’s series of short videos introduces you to different ways to improve the vaccination experience for infants, children, teens, and adults. Three are for a general audience, and three are intended for healthcare professionals. As with all Immunize​.org resources, these videos are free to download, link, copy, and share.
[link removed]

Like, follow, and share Immunize​.org’s social media accounts and encourage colleagues and others interested in vaccination to do likewise:
* Facebook at ImmunizeOrg ([link removed])
* Instagram at ImmunizeOrg ([link removed])
* LinkedIn at ImmunizeOrg ([link removed])
* X (Twitter) at ImmunizeOrg ([link removed])
* YouTube at ImmunizeOrg ([link removed])

Related Links
* Immunize​.org: YouTube channel ([link removed])
* Immunize​.org: Clinical Resources: Addressing Vaccination Anxiety ([link removed]) main page
* Immunize​.org: Improving the Vaccination Experience: Reducing Pain and Anxiety for Children and Adults ([link removed]) on-demand webinar (2/28/23)
* Immunize​.org: Improving the Vaccination Experience: Accessible Vaccination for Neurodiverse People at Any Age ([link removed]) on-demand webinar (12/13/22)
* Immunize​.org: Clinical Resources: Screening Checklists ([link removed]) main page (includes questions to screen for a history of fainting or for vaccination-related anxiety)

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Influenza activity is increasing in most of the country; encourage vaccination before holiday gatherings!

For week 45, ending November 11, CDC’s Weekly U.S. Influenza Surveillance Report, FluView, ([link removed]) shows that seasonal influenza activity continues to increase in most parts of the country, most notably in the southern half of the United States. Nationwide, 3.5% of patient visits reported through the Outpatient Influenza-Like Illness Surveillance Network (ILINet) were due to respiratory illness that included fever plus a cough or sore throat (i.e., influenza-like illness [ILI]). The national baseline is 2.5%. So far, one influenza-associated pediatric death occurring during the 2023–24 season has been reported to CDC.

RESP-NET
Visit the CDC Respiratory Virus Hospitalization Surveillance Network (RESP-NET) ([link removed]) for weekly reports of hospitalizations across the United States due to three vaccine-preventable seasonal respiratory viruses: COVID-19, influenza, and RSV.

Influenza Vaccination Dashboard
CDC's Weekly Flu Vaccination Dashboard ([link removed]) shows that as of October 28 an estimated 25 million doses of flu vaccine were administered in pharmacies and over 13 million doses in medical offices. So far, vaccine uptake appears to be lagging behind this time in 2022. It is critical to protect as many people as possible now, before influenza activity becomes widespread.

CDC recommends everyone age 6 months and older get annual influenza vaccination. Influenza and other vaccines (e.g., COVID-19 vaccine, RSV vaccine) may be given at the same visit, if needed. Locate influenza and COVID-19 vaccines in your area by entering your zip code in the VaccineFinder on Vaccines.gov ([link removed]) or Vacunas.gov ([link removed]) . To be listed as a provider by VaccineFinder, see the information on this website ([link removed]).

Related Links
* CDC: Weekly National Flu Vaccination Dashboard ([link removed]) main page
* CDC: FluView ([link removed]) main page
* CDC: RESP-NET ([link removed]) main page
* Immunize​.org: Vaccines A-Z: Influenza ([link removed]) main page
* Immunize​.org: Ask the Experts: Influenza ([link removed]) main page

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Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.

* Washington Post: CDC Releases 77,000 More Doses of RSV Shot for Infants ([link removed]) (11/17/23)

* Kaiser Family Foundation: KFF COVID-19 Vaccine Monitor November 2023: With COVID Concerns Lagging, Most People Have Not Gotten Latest Vaccine and Half Say They Are Not Taking Precautions this Holiday Season ([link removed]) (11/17/23)

* Washington Post: There’s a Racial Gap on COVID Vaccine — Because of the Partisan Gap ([link removed]) (11/17/23)

* Washington Post: The Checkup with Dr. Wen: Four Virus Safety Considerations for Thanksgiving Gatherings ([link removed]) (11/16/23)

* Vaccines Today: Childhood COVID-19 Vaccination: Will It Shape Parents’ Decisions on Routine Vaccines? ([link removed]) (11/16/23)

* Medscape: ‘Tripledemic’: Your Questions Answered ([link removed] ) (11/13/23)

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Immunize​.org Pages and Handouts
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Immunize​.org updates patient handout titled "Haemophilus influenzae type b (Hib): Questions and Answers"

Immunize​.org recently updated its resource Haemophilus influenzae type b (Hib): Questions and Answers ([link removed]). The document now includes updated Hib epidemiology and surveillance data. A QR code linking to the online version of the document was added.

Related Links
* Immunize​.org: Haemophilus influenzae type b (Hib): Questions and Answers ([link removed])
* Immunize​.org: Clinical Resources A-Z ([link removed]) main page, where you can filter by topic, vaccine, language, or other criteria

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Protect your vaccine inventory from being mishandled with these helpful Immunize​.org signs: "Warning! Expensive Vaccine in Storage!" and "Do Not Unplug Refrigerator or Freezer"

It is very important that vaccine storage units be clearly labeled, as well as their electrical outlets. Thousands of dollars in vaccine inventory can be lost by thoughtless handling. Immunize​.org recently added QR codes linking to the online versions of these warning signs. Be sure to use them on your storage units and electrical outlets.

* Warning! Expensive Vaccine in Storage! ([link removed]): to be posted near circuit breakers

* Do Not Unplug Refrigerator or Freezer ([link removed]): to be posted on clinic equipment or near electrical outlets

Related Links
* Immunize​.org: Clinical Resources: Storage & Handling ([link removed]) main page
* Immunize​.org: Clinical Resources A-Z ([link removed]) main page, where you can filter by topic, vaccine, language, or other criteria

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Vaccine Information Statements
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Recap: Immunize​.org posts Spanish translations of COVID-19 and RSV VISs, and RSV Preventive Antibody Immunization Information Statement

Thanks to CDC support, Immunize​.org expanded its repository of VIS translations ([link removed]). Immunize​.org posted new and updated Spanish translations for COVID-19 and RSV VISs and the RSV preventive antibody Immunization Information Statement (IIS).

All translations are available in print-ready PDF format.

COVID-19 VIS (view in English ([link removed]) ):
New! Spanish PDF ([link removed]) (RTF ([link removed]) )

RSV VIS (view in English ([link removed]) ):
Updated! Spanish PDF ([link removed]) (RTF ([link removed]) )

RSV Preventive Antibody IIS (view in English ([link removed]) ):
New! Spanish PDF ([link removed]) (RTF ([link removed]) )

The COVID-19 VIS and the RSV Preventive Antibody IIS are new translations. Check the version date of your office copies of the newly updated RSV vaccine translation. Discard translations of the previous RSV VIS version now that a translation of the current version is available.

Related Links
* Immunize​.org: Vaccine Information Statements ([link removed]) main page for VISs in 47 languages ([link removed])
* Immunize​.org: Dates of Current Vaccine Information Statements ([link removed]) (PDF)
* Immunize​.org: VISs: COVID-19 vaccine ([link removed]) page
* Immunize​.org: VISs: RSV vaccine ([link removed]) page
* Immunize​.org: RSV Preventive Antibody ([link removed]) IIS page
* 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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UCLA School of Medicine and the Autism Society release CME activity promoting vaccination access and uptake in the neurodivergent community

The UCLA School of Medicine, in collaboration with the Autism Society, released a free CME activity titled Intellectual and Developmental Disabilities: Promoting Health and Well-Being ([link removed]). This provider training program promotes health and uptake of all vaccines—including the COVID-19 vaccine—among people with disabilities and their families.

This series includes three modules:
* Module 1: The Experiences: interviews with the neurodivergent community, and their family members, focusing on their vaccine experiences
* Module 2: The Facts: evidence-based strategies for vaccine uptake and implementing strategies to reduce needle anxiety
* Module 3: Spreading the Word: the Autism Society of America provides actionable strategies for creating accessible healthcare messages

[link removed]

All healthcare providers are invited to participate in this free 1-hour virtual CME program hosted by UCLA Health. Access the training ([link removed]) today and follow the instructions to receive your CME credit.

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Notable Publications
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"U.S. Public Support and Opposition to Vaccination Mandates in K-12 Education in Light of the COVID-19 Pandemic" published in Vaccine

In the October 17 issue, Vaccine published U.S. Public Support and Opposition to Vaccination Mandates in K-12 Education in Light of the COVID-19 Pandemic ([link removed]). The conclusions section appears below.

Vaccination mandates in K-12 have broad support among the American public, even in more controversial cases such as HPV and COVID-19. Vocal opposition and growing interest by policymakers to limit or undo vaccination mandates are not supported by the broader public.

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"Clinician Prompts for Human Papillomavirus Vaccination: A Cluster Randomized Trial" published in Academic Pediatrics

In the November 1 issue, Academic Pediatrics published Clinician Prompts for Human Papillomavirus Vaccination: A Cluster Randomized Trial ([link removed](23)00401-1/fulltext). This was co-authored by Immunize​.org’s associate director for research, Sharon Humiston, MD, MPH. The researchers trained practices to implement a staff prompt to the clinician (e.g., printed reminders placed on the keyboard) plus electronic health record prompts (if not already done) at well and acute/chronic visits for initial and subsequent HPV vaccination. The conclusions section appears below.

Clinician prompts reduced missed opportunities for HPV vaccination at well child care visits. Understaffing related to the COVID-19 pandemic may have led to worsening missed opportunities for both groups and likely impeded practices in fully implementing changes.

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"mRNA SARS-CoV-2 Vaccination before vs during Pregnancy and Omicron Infection among Infants" published in Pediatrics

In the November 10 issue, Pediatrics published mRNA SARS-CoV-2 Vaccination before vs during Pregnancy and Omicron Infection among Infants ([link removed]). The conclusions and relevance section appears below.

In this population-based cohort study, maternal mRNA vaccination was associated with a lower risk of Omicron SARS-CoV-2 infection among infants up to 6 months of age only if the vaccine was given during the antenatal period. These findings suggest that mRNA vaccination during pregnancy may be needed for lower risk of SARS-CoV-2 infection among newborns.

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Upcoming Events
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Happy Thanksgiving from Immunize​.org!

As we prepare for Thanksgiving festivities, the Immunize​.org crew is grateful to be part of the community of dedicated people who work to protect the public’s health.

Never hesitate to give us feedback on what would make your immunization work easier or more effective. A world free of vaccine-preventable diseases can only be realized with all of us working together.

The IZ Express team at Immunize​.org is thankful for our 55,000 dedicated readers. We wish you and your families a happy and healthy Thanksgiving!

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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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