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Issue 1,738: February 7, 2024
Top Stories
* Please take our brief survey about Immunize​.org activities (#IZ1)
* CDC reminds healthcare providers to stay alert for measles cases (#IZ2)
* "Early Estimates of Updated 2023–2024 (Monovalent XBB.1.5) COVID-19 Vaccine Effectiveness against Symptomatic SARS-CoV-2 Infection Attributable to Co-Circulating Omicron Variants among Immunocompetent Adults—Increasing Community Access to Testing Program, United States, September 2023–January 2024" published in MMWR (#IZ3)
* Immunize​.org updates two meningococcal resources for healthcare providers and patients (#IZ4)
* “Hepatitis A and Hepatitis B Vaccines: Be Sure Your Patients Get the Correct Dose” handout updated to reflect ACIP recommendations (#IZ5)
* Infectious Diseases Society of America podcast reviews RSV immunization strategies (#IZ6)
* Influenza-like illness remains high in many parts of the country; continue to promote influenza, COVID-19, and RSV vaccination (#IZ7)
* What, if anything, should you do when an adult with documented HepB vaccination in childhood has no evidence of immunity on a routine hepatitis B screening serology? Watch the 2-minute answer, part of the Ask the Experts Video Series on YouTube. (#IZ8)
* Vaccines in the news (#IZ9)


Immunize​.org Website and Clinical Resources
* Recap: Immunize​.org launches "Ask the Experts: RSV" web section (#IZ10)
* Recap: A fresh, new look for Immunize​.org’s VaccineInformation.org website for the general public (#IZ11)
* Recap: Immunize​.org updates two 1-page patient handouts on which vaccines are recommended for adults and why adult vaccination is important (#IZ12)
* Recap: Use Immunize​.org’s recently updated “HPV Vaccine: A Guide for Adults Ages 18–26 Years” to educate patients on the importance of HPV vaccine (#IZ13)


Featured Resources
* February is Black History Month; Immunize​.org celebrates the contributions of Black Americans in vaccinology (#IZ14)
* Place your order! Sturdy, laminated versions of the 2024 U.S. immunization schedules from Immunize​.org shipping now. (#IZ15)
* Updated 65+ Flu Defense website offers resources for healthcare professionals serving older adults (#IZ16)


Upcoming Events
* Virtual: National Adult and Influenza Immunization Summit and American College of Obstetricians and Gynecologists cohost webinar titled “Maternal Immunization: Opportunities and Challenges” on February 22 at 3:30 p.m. (ET) (#IZ17)


Editorial Information (#Editorial)
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Top Stories
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Please take our brief survey about Immunize​.org activities

Dear IZ Express readers, please help Immunize​.org by completing a brief evaluation of our activities.

Since 1994, Immunize​.org has been a partner of CDC. CDC currently provides Immunize​.org with support for our major activities: publishing IZ Express, "Ask the Experts," providing Vaccine Information Statements (VISs) and their translations, our website, our support of state and local immunization coalitions, and creation of ready-to-print immunization education materials for healthcare professionals and their patients.

Evaluating the impact of our activities and resources on your work is an important part of our CDC cooperative agreement. To do this, we have an online survey about our activities. The survey will skip sections you mark as not relevant to you. Answering all sections may take as little as 5 minutes. Your answers will provide us with important insights for planning.
* Click here ([link removed]) to help us with Immunize​.org's 2024 online survey.

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Thank you for taking the time to share your thoughts about Immunize​.org and our support for your work saving lives through immunization.
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CDC reminds healthcare providers to stay alert for measles cases

On January 25, CDC issued a Clinician Outreach and Communication Activity (COCA) Now message titled, Stay Alert for Measles Cases ([link removed]) . It reminds healthcare providers to watch for patients with febrile rash and symptoms of measles (e.g., cough, runny nose, conjunctivitis).

Between December 1, 2023, and January 23, 2024, CDC was notified of 23 confirmed U.S. cases of measles, including seven direct importations of measles by international travelers and two outbreaks with more than five cases each. Most of these cases were among children and adolescents who had not received a measles-containing vaccine (MMR or MMRV), even if age eligible. A portion of the message outlining recommendations for healthcare providers is shown below.
* Isolate: Do not allow patients with suspected measles to remain in the waiting room or other common areas of the healthcare facility; isolate [them], ideally in a single-patient airborne infection isolation room (AIIR) if available, or in a private room with a closed door until an AIIR is available. Healthcare providers should be adequately protected against measles and should adhere to standard and airborne precautions when evaluating suspect cases regardless of their vaccination status.

* Notify: Immediately notify local or state health departments about any suspected case of measles to ensure rapid testing and investigation. Measles cases are reported by states to CDC through the National Notifiable Diseases Surveillance System (NNDSS) and can also be reported directly to CDC at [email protected].

* Test: Follow CDC’s testing recommendations and collect either a nasopharyngeal swab or throat swab for reverse transcription polymerase chain reaction (RT-PCR), as well as a blood specimen for serology from all patients with clinical features compatible with measles. RT-PCR is available at CDC, at many state public health laboratories, and through the APHL/CDC Vaccine Preventable Disease Reference Centers.

* Manage: In coordination with local or state health departments, provide appropriate measles post-exposure prophylaxis (PEP) to close contacts without evidence of immunity, either MMR or immunoglobulin. The choice of PEP is based on elapsed time from exposure or medical contraindications to vaccination.

* Vaccinate: Make sure all your patients are up to date on measles vaccine, especially before international travel. People 6 months of age or older who will be traveling internationally should be protected against measles.

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Related Links
* Clinician Outreach and Communication Activity (COCA) ([link removed]) web page
* CDC: Measles (Rubeola): For Healthcare Professionals ([link removed]) web page
* CDC: Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings ([link removed]) (PDF)
* CDC: Manual for the Surveillance of Vaccine-Preventable Diseases, Chapter 7: Measles ([link removed]) web page
* Immunize​.org: Measles ([link removed]) main page

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"Early Estimates of Updated 2023–2024 (Monovalent XBB.1.5) COVID-19 Vaccine Effectiveness against Symptomatic SARS-CoV-2 Infection Attributable to Co-Circulating Omicron Variants among Immunocompetent Adults—Increasing Community Access to Testing Program, United States, September 2023–January 2024" published in MMWR

CDC published Early Estimates of Updated 2023–2024 (Monovalent XBB.1.5) COVID-19 Vaccine Effectiveness against Symptomatic SARS-CoV-2 Infection Attributable to Co-Circulating Omicron Variants among Immunocompetent Adults—Increasing Community Access to Testing Program, United States, September 2023–January 2024 ([link removed]) in the February 1 issue of MMWR ([link removed]) . A portion of the summary appears below.

In September 2023, CDC’s Advisory Committee on Immunization Practices recommended updated 2023–2024 (monovalent XBB.1.5) COVID-19 vaccination for all persons aged ≥6 months to prevent COVID-19, including severe disease. Many variants co-circulated during fall 2023; the JN.1 lineage became predominant in January 2024. Few estimates of updated 2023–2024 vaccine effectiveness (VE) are available. . . .

Receipt of updated COVID-19 vaccine provided approximately 54% increased protection against symptomatic SARS-CoV-2 infection compared with no receipt of updated vaccine. Vaccination provides protection against JN.1 and other circulating lineages. . . .

All persons aged ≥6 months should receive updated 2023–2024 COVID-19 vaccine. CDC will continue monitoring COVID-19 VE, including against severe disease and for expected waning.

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

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

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Immunize​.org updates two meningococcal resources for healthcare providers and patients

Immunize​.org recently updated two of its meningococcal resources:
* Meningococcal ACWY Vaccine Recommendations by Age and Risk Factor ([link removed])
* Meningococcal: Questions and Answers ([link removed])

For both, references to Menactra (Sanofi) were removed following expiration of the last doses of this discontinued product and a note regarding recommended use of MenABCWY (Penbraya, Pfizer) was added. A QR code linking to the online version of the document was added.

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Related Links
* Immunize​.org: Meningococcal ACWY Vaccine Recommendations by Age and Risk Factor ([link removed]) (PDF)
* Immunize​.org: Meningococcal: Questions and Answers ([link removed]) (PDF)
* 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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“Hepatitis A and Hepatitis B Vaccines: Be Sure Your Patients Get the Correct Dose” handout updated to reflect ACIP recommendations

Immunize​.org updated its Hepatitis A and Hepatitis B Vaccines: Be Sure Your Patients Get the Correct Dose ([link removed]) handout for healthcare providers. Minor changes were made, including the addition of a QR code linking to the online version of the document.

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Related Links
* Immunize​.org: Hepatitis A and Hepatitis B Vaccines: Be Sure Your Patients Get the Correct Dose ([link removed]) (PDF)
* Immunize​.org: Clinical Resource ([link removed]) main page to see educational materials sorted by category

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Infectious Diseases Society of America podcast reviews RSV immunization strategies

In an episode of the Infectious Diseases Society of America ([link removed]) (IDSA) podcast Let's Talk ID ([link removed]) , pediatric infectious disease specialist and host Buddy Creech, MD, MPH, shares the latest on RSV immunization, including mechanisms of action, eligibility criteria, and challenges surrounding finding doses this season.

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Related Links
* Let's Talk ID podcast ([link removed]'s%20Talk%20ID) page
* The Cribsiders podcast ([link removed]) page
* The Curbsiders podcast ([link removed]) page

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Influenza-like illness remains high in many parts of the country; continue to promote influenza, COVID-19, and RSV vaccination

CDC’s Weekly U.S. Influenza Surveillance Report, FluView ([link removed]) , provides a valuable picture of laboratory-confirmed influenza and influenza-like-illness activity state by state.

Influenza Surveillance
For week 4, ending January 27, CDC’s Weekly U.S. Influenza Surveillance Report, FluView ([link removed]) shows that 20 jurisdictions experienced high or very high activity. Nationwide, 4.3% 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%. Eight pediatric influenza-associated deaths were reported this week, bringing the total to 65 pediatric deaths thus far during the 2023–24 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 January 20, coverage estimates for all children for the 2023–24 season are 3.5 percentage points lower this season compared with the same time last season (47.8% compared with 51.3%). Coverage this season so far is 9.6 percentage points lower compared with pre-pandemic coverage at the same time in January 2020 (57.4%).

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. Infants age 6 months 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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What, if anything, should you do when an adult with documented HepB vaccination in childhood has no evidence of immunity on a routine hepatitis B screening serology? 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 Past HepB Vaccination, Negative Screening Anti-HBs. What Now? ([link removed]) The video briefly describes whether adults who were properly vaccinated with HepB vaccine need to be revaccinated if they have a negative surface antibody (anti-HBs) result on their triple panel screening test for hepatitis B.

The 2-minute video 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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Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* New York Times: Opinion: The Monster Measles Outbreak in Europe Is a Warning ([link removed]) (2/1/24)
* CBS News: Data Shows at Least 8,500 U.S. Schools at Greater Risk of Measles Outbreaks as Vaccination Rates Decline ([link removed]) (1/30/24)
* The Guardian: Measles Making a Comeback in US Due to Vaccine Skepticism, Says CDC ([link removed]) (1/30/24)
* The Wire: Climate Change Is Driving Up Spread of Diseases, but Fewer People Confident in Vaccines ([link removed]) (1/29/24)

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Immunize​.org Website and Clinical Resources
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Recap: Immunize​.org launches "Ask the Experts: RSV" web section

Immunize​.org recently launched a new section of its popular Ask the Experts resource, Ask the Experts: RSV ([link removed]) , that covers RSV disease and use of RSV vaccines and preventive antibody product (nirsevimab).

The clinical questions and answers covered in this new section address issues such as the safety and effectiveness of vaccination and nirsevimab, the benefit to older adults from protection against RSV, and timing of RSV vaccination with Abrysvo (Pfizer) during pregnancy (reminder: January 31 was the last day for most of the United States!).

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Immunize​.org’s Ask the Experts ([link removed]) main page leads you to 20 web pages on vaccines and 10 on broader immunization topics. Ask the Experts offers answers to more than 1,300 common or challenging questions. 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 1,300 questions and answers
* Immunize​.org: Ask the Experts: RSV ([link removed]) web page
* MMWR: Use of the Pfizer Respiratory Syncytial Virus Vaccine during Pregnancy for the Prevention of Respiratory Syncytial Virus–Associated Lower Respiratory Tract Disease in Infants: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023 ([link removed]) (10/13/23)
* MMWR: Use of Nirsevimab for the Prevention of Respiratory Syncytial Virus Disease among Infants and Young Children: Recommendations of the Advisory Committee on Immunization Practices—United States, 2023 ([link removed])
(8/25/23)
* MMWR: Use of Respiratory Syncytial Virus Vaccines in Older Adults: Recommendations of the Advisory Committee on Immunization Practices ([link removed]) (7/21/23)

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Recap: A fresh, new look for Immunize​.org’s VaccineInformation.org website for the general public

Following the redesign of our flagship Immunize​.org website last fall, we welcome you to visit our updated educational website for the general public, www.vaccineinformation.org ([link removed]) .

This website is suitable for anyone with questions about vaccines and vaccination. The updated site offers straightforward and accurate information including:
* Basic facts about recommended vaccines and the diseases they prevent
* Patient-oriented vaccine resources from Immunize​.org
* Links to resources from trusted partner organizations
* Information available by age groups: infants and children, preteens, teens, and adults
* Personal testimonies from people affected by vaccine-preventable diseases
* Videos and historic public service announcements in our video library
* Links to information to help people find where to get vaccinated

VaccineInformation.org now provides pages with basic information and key links on COVID-19, mpox, RSV, and dengue vaccines.

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We encourage you to share www.vaccineinformation.org ([link removed]) with your patients or with anyone interested in learning more about vaccines or vaccine-preventable diseases.
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Recap: Immunize​.org updates two 1-page patient handouts on which vaccines are recommended for adults and why adult vaccination is important

Immunize​.org staff recently updated two of its resources, Adult Immunization: Importance of Staying Up to Date with Vaccines ([link removed]) and Vaccinations for Adults: You’re Never Too Old to Get Vaccinated! ([link removed]) Changes are described below.
* Adult Immunization: Importance of Staying Up to Date with Vaccines ([link removed]) : now includes the protection of infants through either RSV vaccination during pregnancy or RSV preventive antibody after birth for the infant
* Vaccinations for Adults: You’re Never Too Old to Get Vaccinated! ([link removed]) : updated to include vaccinations for RSV and mpox, as well as a MenABCWY option for adults needing both MenACWY and MenB

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Related Links
* Immunize​.org: Adult Immunization: Importance of Staying Up to Date with Vaccines ([link removed]) (PDF)
* Immunize​.org: Vaccinations for Adults: You’re Never Too Old to Get Vaccinated! ([link removed]) (PDF)
* 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: Use Immunize​.org’s recently updated “HPV Vaccine: A Guide for Adults Ages 18–26 Years” to educate patients on the importance of HPV vaccine

Immunize​.org recently updated its HPV Vaccine: A Guide for Adults Ages 18–26 Years ([link removed]) resource to help patients better understand HPV disease and the value of vaccination.

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CDC recommends HPV vaccination for everyone age 26 years or younger, beginning as early as age 9 years. 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 and offering the HPV vaccine.

Related Links
* CDC: Cervical Cancer Awareness ([link removed]) web page
* CDC: HPV for Healthcare Professionals ([link removed]) main page
* American Cancer Society: National HPV Vaccination Roundtable: Resource Center ([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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Featured Resources
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February is Black History Month; Immunize​.org celebrates the contributions of Black Americans in vaccinology

February is Black History Month ([link removed]) . Immunize​.org recognizes the contributions of Black Americans to vaccinology throughout history, including:
* Onesimus, an enslaved man, introduced the idea of smallpox variolation in the United States in the 1700s
* Louis Tompkins Wright, the first Black surgeon on staff at Harlem Hospital in New York City, developed a new way to give the smallpox vaccine in the 1920s and 1930s
* Loney Clinton Gordon was one of three women to develop the pertussis vaccine in the 1940s
* Henrietta Lacks' cancer cells from the 1950s contributed to the development of the first polio vaccine, the HPV vaccine, and the COVID-19 vaccine
* Mae C. Jemison, the first Black astronaut, worked in vaccine research at CDC in the 1980s and 1990s
* Kizzmekia S. Corbett, a viral immunologist at NIH, now at Harvard, played a key role in developing the Moderna mRNA COVID-19 vaccine

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Health inequities and disparities result, in part, from lower vaccination rates among Black Americans. Immunize​.org encourages everyone to do their part to close the gaps in vaccination awareness, access, affordability, and coverage as part of our work to address disparities in health outcomes.

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Place your order! Sturdy, laminated versions of the 2024 U.S. immunization schedules from Immunize​.org shipping now.

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.

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: 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 adult 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, including large bulk orders, 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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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.

Older adults are at increased risk of severe influenza and COVID-19 illness, including hospitalization and death, especially if they are not up to date on these vaccinations. An updated fact sheet on the website, The Importance of Preventing Influenza and COVID-19, ([link removed]) ([link removed]) offers responses to help guide discussions with patients on the importance of preventing influenza and COVID-19.

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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])

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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Upcoming Events
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Virtual: National Adult and Influenza Immunization Summit and American College of Obstetricians and Gynecologists cohost webinar titled “Maternal Immunization: Opportunities and Challenges” on February 22 at 3:30 p.m. (ET)

The National Adult and Influenza Immunization Summit ([link removed]) (NAIIS, the “Summit”) and the American College of Obstetricians and Gynecologists ([link removed]) (ACOG) will cohost a 1-hour webinar titled Maternal Immunization: Opportunities and Challenges ([link removed]) at 3:30 p.m. (ET) on February 22. Hear about the importance of maternal immunization, challenges facing clinicians recommending and administering maternal vaccines, and possible solutions.

Register for the webinar ([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])
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