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Issue 1,735: January 17, 2024
Top Stories
* 2024 U.S. recommended immunization schedules for children and teens and for adults published in MMWR with articles detailing changes (#IZX1)
* Place your order! Sturdy, laminated versions of the 2024 U.S. immunization schedules from Immunize.org ship by early February. (#IZX2)
* Newly updated 65+ Flu Defense website offers resources for healthcare professionals serving older adults   (#IZX3)
* CDC releases survey results on nirsevimab acceptance among pregnant people on the Weekly RSV Vaccination Dashboard (#IZX4)
* Immunize.org updates "Standing Orders for Administering Nirsevimab RSV Preventive Antibody to Infants" to follow original ACIP recommendations (#IZX5)
* January is Cervical Health Awareness Month; promote the importance of HPV vaccination (#IZX6)
* Review your COVID-19 resources with the latest Immunize.org “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools”  (#IZX7)
* Influenza-like illness is high from coast to coast; encourage influenza, COVID-19, and RSV vaccination now (#IZX8)
* “Hepatitis B Infection Diagnosed after Vaccination”: watch the 2-minute answer, part of the Ask the Experts Video Series on YouTube (#IZX9)
* IZ Express keeps 55,000+ readers up to date on what’s new in vaccines each week; invite your colleagues to subscribe! (#IZX10)
* Vaccines in the news (#IZX11)


Immunize​.org Website and Clinical Resources
* Immunize.org updates “Checklist for Safe Vaccine Storage and Handling” (#IZX12)
* Recap: Find Immunize.org resources to help you address vaccination pain and anxiety curated at our new “Clinical Resources: Improving the Vaccination Experience” web page (#IZX13)
* Spotlight on the website (#IZX14)


Featured Resources
* WithinReach launches new “Hepatitis B Health Disparities in Refugee and Immigrant Communities” e-course; CE available  (#IZX15)
* Center for Black Health and Equity offers Truth Check Media Literacy Series to provide skills to spot and address misinformation on social media   (#IZX16)


Notable Publications
* “Effectiveness of Bivalent mRNA Vaccines in Preventing COVID-19-Related Thromboembolic Events among Medicare Enrollees Aged ≥65 Years and Those with End Stage Renal Disease―Unites States, September 2022–March 2023” published in MMWR (#IZX17)

Editorial Information (#Editorial)
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Top Stories
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2024 U.S. recommended immunization schedules for children and teens and for adults published in MMWR with articles detailing changes

On January 11, CDC published two articles in MMWR summarizing the 2024 revisions to the U.S. immunization schedules:
* Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger—United States, 2024 ([link removed])
* Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older—United States, 2024 ([link removed])

The schedules described in these articles were originally posted online in November at CDC's Immunization Schedules for Healthcare Providers ([link removed]) web page.

The updated schedules for children and adolescents include multiple new vaccine recommendations ([link removed]) made by ACIP during 2023, including:
* Nirsevimab RSV preventive antibody for infants
* 20-valent pneumococcal conjugate vaccine as an option
* Mpox vaccine for certain 18-year-olds with behavioral risks
* RSV vaccine for certain pregnant teens
* Pentavalent meningococcal ABCWY vaccine as an option when MenB and MenACWY are indicated
* Updates related to previously recommended vaccines, including COVID-19, influenza, and poliovirus

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

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The updated schedules for adults include multiple new vaccine recommendations made by ACIP during 2023, ([link removed]) including:
* RSV vaccine selectively for older adults and during pregnancy
* Mpox vaccine for certain adults with behavioral risk factors
* Pentavalent meningococcal ABCWY vaccine as an option when MenB and MenACWY vaccines are due
* Updates related to previously recommended vaccines, including COVID-19, influenza, and poliovirus

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

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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 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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Place your order! Sturdy, laminated versions of the 2024 U.S. immunization schedules from Immunize​.org ship by early February.

Laminated versions of the 2024 U.S. child and adolescent immunization schedule ([link removed]) and the 2024 U.S. adult immunization schedule ([link removed]) are now available for order in the Immunize​.org shop. The schedules are being printed now and will ship by early February.

While the schedules are available online from CDC at no cost, Immunize​.org’s printed, laminated booklets are ideal for use in any busy healthcare setting where vaccinations are given.
* Durable: their tough coating can be wiped down, and they’re durable enough to stand up to a year's worth of use
* Format: each schedule is produced in a 16-page, 8.5” X 11” booklet format; with color coding for easy reading, our laminated schedules replicate the original CDC formatting, including all tables and notes
* Easy access to CDC updates: CDC added an online addendum page to the schedule, where new recommendations from ACIP made during 2024 can be posted. The laminated schedule addendum pages include custom QR codes you can scan to view or print the current CDC addendum from CDC's website, as needed.
* Adult schedule bonus content: the adult schedule includes a bonus page with Immunize​.org’s popular 1-page handout summarizing the dose, route, and needle size recommendations for all vaccines and recipients

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Pricing
1 copy: $10.00
2–4 copies: $9.50 each
5–19 copies: $8.50 each
20–99 copies: $7.50 each
100–499 copies: $6.00 each
500–999 copies: $5.00 each
1,000–1,999 copies: $4.00 each
2,000+ copies: $3.25 each

Visit the Shop Immunize.org: Laminated Schedules ([link removed]) web page to view images of all the pages, to download the order form, and to order today!

For additional information, call 651-647-9009 or email [email protected] (mailto:[email protected]) .

Related Links
* Immunize​.org: Laminated Child and Adolescent Immunization Schedules (0–18 years) ([link removed]) web page
* Immunize​.org: Laminated Adult Immunization Schedules (19 and older) ([link removed]) web page
* Immunize​.org: Shop Immunize.org ([link removed]) main page

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Newly updated 65+ Flu Defense website offers resources for healthcare professionals serving older adults  

Confident recommendations for influenza vaccine from healthcare providers are powerfully persuasive. To assist you in maximizing protection for your patients, Immunize​.org, in collaboration with CSL Seqirus, updated the 65+ Flu Defense ([link removed]) website at www.influenza-defense.org.

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This helpful site includes information, tools, and tips for communicating with adults age 65 and older about the scope and severity of influenza. Resources include:
* Influenza in Adults 65+: The Facts ([link removed])
* Influenza Vaccination: Questions Patients Aged 65 and Older Frequently Ask Their HCP ([link removed])
* The Importance of Preventing Influenza and COVID-19 ([link removed])

Older adults are at increased risk of severe influenza, COVID-19, and RSV illness, including hospitalization and death, especially if they are not up to date on these vaccinations. A clinician recommendation is the most important reason why a patient will get vaccinated.

Check out the updated 65+ Flu Defense website at www.influenza-defense.org ([link removed]) to assist your ongoing efforts in protecting this vulnerable population.

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CDC releases survey results on nirsevimab acceptance among pregnant people on the Weekly RSV Vaccination Dashboard

On January 10, CDC released National Immunization Survey (NIS) data from the NIS-Adult COVID Module on the acceptance of nirsevimab among pregnant people. Among females age 18–49 years with a baby younger than 8 months of age interviewed during October 29–November 25, 2023:
* 20.6% reported they got nirsevimab for their infant
* 26.9% reported they definitely will get nirsevimab for their baby
* 47.3% probably will get nirsevimab for their baby or are unsure
* 5.2% probably or definitely will not get nirsevimab for their baby

CDC will update estimates and release them monthly on CDC's Weekly RSV Vaccination Dashboard, RSVVaxView ([link removed]) .

RSV activity remains elevated nationwide and is continuing to increase in many parts of the country.

To prevent severe RSV disease in infants, either Pfizer's RSV vaccine (Abrysvo) for pregnant people or nirsevimab (Beyfortus, Sanofi) for infants is recommended.
* Maternal vaccination: seasonal administration of maternal RSV is only recommended through the end of January for most of the continental United States
* Infant immunization: infants born to unvaccinated mothers during RSV season should receive nirsevimab through the end of March in most of the continental United States

Related Links
* CDC: RSVVaxView ([link removed]) main page
* CDC: Respiratory Syncytial Virus (RSV) Immunizations ([link removed]) main page
* Immunize​.org: Vaccines A–Z: RSV (Respiratory Syncytial Virus) ([link removed]) main page

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Immunize​.org updates "Standing Orders for Administering Nirsevimab RSV Preventive Antibody to Infants" to follow original ACIP recommendations

Immunize​.org updated its Standing Orders for Administering Nirsevimab RSV Preventive Antibody to Infants ([link removed] ) to follow CDC's recommendation that healthcare providers return to ACIP’s original recommendations for nirsevimab use in light of improved supplies.

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Related Links
* Immunize​.org: Clinical Resources: Standing Orders Templates ([link removed]) main page
* Immunize​.org: Vaccines A–Z: RSV (Respiratory Syncytial Virus) ([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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January is Cervical Health Awareness Month; promote the importance of HPV vaccination

January is Cervical Health Awareness Month ([link removed]) , a great time to share the importance of human papillomavirus (HPV) vaccination. Almost all cervical cancer cases (99%) are linked to infection with high-risk HPV strains, a very common virus transmitted through intimate contact.

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CDC recommends HPV vaccination for everyone 26 years old or younger, beginning as early as age 9. Adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their clinician.

Protect your patients from cervical cancer, and the many other HPV-related cancers affecting men and women, by recommending, promoting, and offering the HPV vaccine.

Related Links
* CDC: Cervical Cancer Awareness ([link removed]) web page
* CDC: HPV for Healthcare Professionals ([link removed]) main page
* NCCC: Cervical Health Awareness Month ([link removed]) web page
* ASHA: Ten Questions to Ask Your Healthcare Provider about Sexual Health ([link removed]) web page
* Immunize​.org: Vaccines A–Z: Human Papillomavirus (HPV) ([link removed]) main page
* Immunize​.org: Ask the Experts: Human Papillomavirus (HPV) ([link removed]) web page

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Review your COVID-19 resources with the latest Immunize​.org “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. The January 9 checklist provides updated links to CDC's COVID-19 materials.

Several footnotes now highlight the different storage requirements for two presentations (glass or plastic) of Pfizer-BioNTech’s Comirnaty vaccine available in manufacturer-filled syringes (MFSs).
* Glass MFSs must be stored at refrigerated temperatures (2º through 8ºC, 35º through 46ºF) and should NOT be frozen. Labels on individual glass syringes and their cartons prominently display a “DO NOT FREEZE” warning.
* Plastic MFSs are shipped and may be stored at ultracold temperatures (–90º through –60ºC, –130º through –76ºF)

Future CDC materials will indicate this difference in storage guidance.

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All COVID-19 vaccine providers should review the checklist regularly and download the latest CDC schedule and standing order documents. Discard any outdated versions of cited documents. The checklist is posted on Immunize​.org's Vaccines A–Z: COVID-19 ([link removed]) main page to help practices stay up to date.

Related Links
* Immunize​.org: Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools ([link removed]) (PDF)
* Immunize​.org: Clinical Resources: Screening Checklists ([link removed]) main page
* Immunize​.org: Vaccines A–Z: COVID-19 ([link removed]) main page
* Immunize​.org: Ask the Experts: COVID-19 ([link removed]) main page
* CDC: Interim Clinical Considerations ([link removed]) main page summarizing use of COVID-19 vaccines in the United States

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Influenza-like illness is high from coast to coast; encourage influenza, COVID-19, and RSV vaccination now

CDC’s Weekly U.S. Influenza Surveillance Report, FluView ([link removed]) , provides a valuable picture of laboratory-confirmed influenza and influenza-like-illness (ILI) activity state by state. ILI activity is caused by a variety of respiratory illnesses, including three vaccine-preventable infections: influenza, COVID-19, and RSV.

Influenza Surveillance
For week 1, ending January 6, CDC’s Weekly U.S. Influenza Surveillance Report, FluView ([link removed]) shows that 37 jurisdictions experienced high or very high activity. Nationwide, 5.7% 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., ILI). The national baseline is 2.5%. Thirteen pediatric influenza-associated deaths were reported this week, bringing the total to 40 pediatric deaths thus far during the 2023–24 season. Given the relatively low influenza, COVID-19, and RSV vaccination rates to date, millions more people remain unprotected, compared to last season.

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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 December 30, an estimated 45% of adults have received an influenza vaccine, with state estimates ranging from 31% to 55%. Influenza vaccination among pregnant people is lagging behind where it was in December 2022. Only 36.2% of pregnant people were vaccinated against influenza by December 2023, compared to 39% last year, despite the growing body of evidence of safety and benefit for both mother and infant. It is critical to protect people now, as influenza activity is becoming 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 indicated. Infants 6 months of age and older may receive influenza and COVID-19 vaccines at the same visit when they receive the RSV preventive antibody, nirsevimab.

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: free clinical resources and patient handouts related to influenza ([link removed])
* Immunize​.org: Vaccines: Influenza ([link removed]) main page
* Immunize​.org: Ask the Experts: Influenza ([link removed]) main page

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“Hepatitis B Infection Diagnosed after Vaccination”: watch the 2-minute answer, part of the Ask the Experts Video Series on YouTube

This week, our featured episode from the Ask the Experts Video Series is Hepatitis B Infection Diagnosed after Vaccination ([link removed]   ) . The video briefly describes the reasons a patient might have chronic hepatitis B infection diagnosed despite being vaccinated. 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.

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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])
* YouTube at ImmunizeOrg ([link removed])

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IZ Express keeps 55,000+ readers up to date on what’s new in vaccines each week; invite your colleagues to subscribe!

Encourage your coworkers to subscribe to ([link removed]) IZ Express ([link removed]) ([link removed]) so they get all the news that matters to vaccinators in their own inbox each Wednesday. IZ Express ([link removed]) , the weekly e-newsletter produced by Immunize​.org, alerts 55,000+ readers to the week’s important vaccine developments. IZ Express also features:
* Educational materials from Immunize​.org, CDC, AAP, and others
* Newly posted Vaccine Information Statements and their translations
* Notices about online and in-person educational opportunities, many offering free continuing education credit

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We appreciate you as a subscriber! Thank you for helping us spread the latest vaccine news.
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Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* CIDRAP: More Evidence Vaccination Reduces Risk of Long COVID ([link removed]) (1/12/24)
* ABC: Why Are 1,500 Americans Still Dying from COVID Every Week? ([link removed] ) (1/10/24)
* Forbes: Measles Outbreak in Philadelphia Suggests Growing Problem of Vaccine Hesitancy ([link removed] ) (1/9/24)
* CBS: There’s a New COVID-19 Variant and Cases Are Ticking Up. What Do You Need to Know? ([link removed]) (1/8/24)
* WHYY: Philadelphia Measles Outbreak Reaches 8 Confirmed Cases as City Offers Walk-In Vaccine Clinics ([link removed]) (1/8/24)

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Immunize​.org Website and Clinical Resources
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Immunize​.org updates “Checklist for Safe Vaccine Storage and Handling”

Immunize​.org recently updated its Checklist for Safe Vaccine Storage and Handling ([link removed]) with a QR code linking to the online version of the document. This checklist makes a great basis for staff training events.

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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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Recap: Find Immunize​.org resources to help you address vaccination pain and anxiety curated at our new “Clinical Resources: Improving the Vaccination Experience” web page

With support from CDC, Immunize​.org launched its Clinical Resources: Improving the Vaccination Experience ([link removed]) web page, a home for resources to help you create a positive vaccination experience and ease anxiety in children and adults. Immunize​.org’s print and video resources offer effective and practical steps that vaccination providers, recipients, caregivers, and companions can take to reduce vaccination-related pain and anxiety. Links to additional resources from trusted partner organizations are also provided.

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Spotlight on the website

Our weekly “Spotlight” series is now entitled “Spotlight on the Website,” aiming to help readers use our website easily. The series will highlight website features and enhancements. This week, we report three updates on Immunize​.org website issues related to searching and filtering:
* Keyword Search: The Keyword Search feature now works properly on all topic pages within Ask the Experts and Clinical Resources. If you choose a topic from the menu, then perform a search for keywords, the results will fulfill your request. Experienced users of the old website will no longer find it necessary to use CTRL-F (text search) on pages with the Keyword Search feature.
* Ask the Experts: Show All Answers: Our new Ask the Experts pages initially display questions only, to allow you to quickly find what you need and open up the text of answers to individual questions at your discretion. Based on user feedback, we added a button at the top of question lists to allow you to expand and view all answers to questions displayed on the page with a single click. See first image below.
* Clinical Resources: Sort By: Based on user feedback, we added options to sort your search and filter results by Title, Item Number, and Updated Date Newest. See second image below.

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Featured Resources
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WithinReach launches new “Hepatitis B Health Disparities in Refugee and Immigrant Communities” e-course; CE available 

National data reveal large disparities in hepatitis B incidence and prevalence in the United States, particularly among immigrants and refugees from hepatitis B endemic regions. WithinReach ([link removed]) , a health advocacy group in Washington State, relaunched its free Hepatitis B Health Disparities in Refugee and Immigrant Communities ([link removed]) e-course to provide tools to work with immigrant and refugee patients and ensure they are screened and effectively treated for hepatitis B. Viewers will learn the most up-to-date information on hepatitis B transmission and epidemiology, prevention through vaccination, screening procedures, and treatment guidelines. The course also covers barriers that refugees and immigrants face with regard to hepatitis B and gives you communication tools to work with these populations.

Continuing education credits (CNE, CME, AAMA) are available upon completion of the online evaluation and submitting an online request.

Access the free course ([link removed]) .
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Center for Black Health and Equity offers Truth Check Media Literacy Series to provide skills to spot and address misinformation on social media  

The Center for Black Health and Equity ([link removed]) offers training for the public titled Truth Check Media Literacy Series ([link removed]) , to teach skills to spot and address misinformation on social media.

Black communities are flooded with misinformation on social media in the form of hoaxes, false claims, and flat-out lies. With the click of a button, fake and harmful information in one's newsfeed can spread widely. Truth Check Media Literacy Series helps arm people with tools to stop the spread of misinformation.

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Truth Check Media Literacy Series is free and offers a toolkit in both English ([link removed]) and Spanish ([link removed]) , media literacy resources, fact sheets, and more.

Find out more at thetruthcheck.org ([link removed]) .
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Notable Publications
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“Effectiveness of Bivalent mRNA Vaccines in Preventing COVID-19-Related Thromboembolic Events among Medicare Enrollees Aged ≥65 Years and Those with End Stage Renal Disease―Unites States, September 2022–March 2023” published in MMWR

CDC published Effectiveness of Bivalent mRNA Vaccines in Preventing COVID-19-Related Thromboembolic Events among Medicare Enrollees Aged ≥65 Years and Those with End Stage Renal Disease―Unites States, September 2022–March 2023 ([link removed]) on January 11 in MMWR. A portion of the summary appears below.

Thromboembolic complications of COVID-19 include ischemic stroke, venous thromboembolism, and myocardial infarction. COVID-19 vaccines are effective in preventing severe outcomes, including hospitalization and death. . . .

During September 2022–March 2023, receipt of bivalent mRNA COVID-19 vaccine was 47% effective in preventing thromboembolic events among immunocompetent persons aged ≥65 years and 51% effective among adults aged ≥18 years with end stage renal disease (ESRD) receiving dialysis, compared with receipt of the original monovalent vaccines alone. . . .

COVID-19 vaccines helped provide protection against COVID-19–related thromboembolic events. Persons aged ≥65 years and adults with ESRD should receive all recommended COVID-19 vaccine doses to prevent COVID-19–associated complications, including thromboembolic events.

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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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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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