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Issue 1,752: April 17, 2024

Top Stories
* Immunize​.org updates pneumococcal Ask the Experts clinical questions and answers
* Immunize​.org updates meningococcal Ask the Experts clinical questions and answers
* Immunize​.org updates its Questions and Answers series of patient handouts on pertussis, tetanus, and diphtheria
* National Infant Immunization Week is April 22–29; prepare your promotion with CDC’s digital media toolkit
* Nominate a champion! Association of Immunization Managers accepting nominations for Immunization Champions to represent states, territories, and some cities, due May 10.
* Our final weekly Influenza update of the season: influenza-like illness activity remains elevated but waning
* Help parents understand why HPV vaccine is recommended for preteens. Watch the 1-minute answer, part of the Ask the Experts Video Series on YouTube.
* Vaccines in the news


Immunize​.org Website and Clinical Resources
* Spotlight on the website: National Infant Immunization Week


Featured Resources
* Before we run out! Place your order for these sturdy, laminated versions of the 2024 U.S. immunization schedules from Immunize​.org.
* Recap: CDC releases simple, parent-friendly 2024 immunization schedules in English and Spanish


Notable Publications
* "Measles—United States, January 1, 2020–March 28, 2024" published in MMWR
* "Assessment of Risk for Sudden Cardiac Death among Adolescents and Young Adults after Receipt of COVID-19 Vaccine—Oregon, June 2021–December 2022" published in MMWR

Global News
* World Immunization Week is the last week of April; this year's theme is "Humanly Possible: Saving Lives Through Immunization"
* "COVID-19 Vaccination Coverage—World Health Organization African Region, 2021–2023" published in MMWR


Upcoming Events
* In-person: Registration open for “National Immunization Conference 2024” on August 12–14 in Atlanta; abstract deadline extended to April 26; CE credit offered

Editorial Information

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Top Stories
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Immunize​.org updates pneumococcal Ask the Experts clinical questions and answers

Immunize​.org’s team of experts reviewed and updated all questions and answers in Ask the Experts: Pneumococcal ([link removed]).

Updates reflect the latest recommendations for pneumococcal vaccination of children. This includes the use of 20-valent pneumococcal conjugate vaccine (PCV20) in children, as well as changes to recommendations for 23-valent pneumococcal polysaccharide vaccine (PPSV23) and PCV15 in high-risk children in light of the option to administer a single dose of PCV20. Answers regarding children and adults were also updated with links to relevant CDC resources to support pneumococcal vaccination, including the CDC PneumoRecs VaxAdvisor mobile app ([link removed]), as well as links to Immunize​.org resources, including standing orders templates for pneumococcal vaccination of adults ([link removed]) and children ([link removed]).

Immunize​.org’s Ask the Experts ([link removed]) main page leads you to 30 web pages on various topics with more than 1,300 common or challenging questions and answers about vaccines and their administration. Immunize.org’s team of experts includes Kelly L. Moore, MD, MPH (team lead); Carolyn B. Bridges, MD, FACP; Iyabode Beysolow, MD, MPH; and Jane Zucker, 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: Pneumococcal ([link removed]) web page
* Immunize​.org: Standing Orders for Administering Pneumococcal Vaccines (PCV15, PCV20, and PPSV23) to Adults ([link removed]) (PDF)
* Immunize​.org: Standing Orders for Administering Pneumococcal Vaccines to Children and Teens ([link removed]) (PDF)
* CDC: PneumoRecs VaxAdvisor ([link removed]) mobile app

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Immunize​.org updates meningococcal Ask the Experts clinical questions and answers

Immunize​.org updated all clinical questions and answers related to meningococcal ACWY and meningococcal B vaccines.
* Ask the Experts: Meningococcal ACWY ([link removed])
* Ask the Experts: Meningococcal B ([link removed])

References to the use of Menactra-brand MenACWY vaccines were removed (except regarding historical doses) now that all remaining doses of this product have expired. The questions and answers also address ACIP recommendations for pentavalent MenABCWY combination vaccine, Penbraya (Pfizer) as an option for children and adults age 10 years or older when both MenACWY and MenB (Trumenba) vaccines are needed at the same visit, as long as there is a 6-month interval between Penbraya doses.

Immunize​.org’s Ask the Experts ([link removed]) main page leads you to 30 web pages on various topics with more than 1,300 common or challenging questions and answers about vaccines and their administration. Immunize.org’s team of experts includes Kelly L. Moore, MD, MPH (team lead); Carolyn B. Bridges, MD, FACP; Iyabode Beysolow, MD, MPH; and Jane Zucker, 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: Meningococcal ACWY ([link removed]) web page
* Immunize​.org: Ask the Experts: Meningococcal B ([link removed]) web page

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Immunize​.org updates its Questions and Answers series of patient handouts on pertussis, tetanus, and diphtheria

Immunize​.org recently updated three topics in its series of educational resources suitable for patients or healthcare providers:
* Pertussis (Whooping Cough): Questions and Answers ([link removed])
* Tetanus: Questions and Answers ([link removed])
* Diphtheria: Questions and Answers ([link removed])

Changes include updates to disease epidemiology, removal of references to the pediatric DT vaccine that is no longer available, and CDC’s new recommendations for off-label use of adult Td instead of DTaP in children younger than age 7 years who develop encephalopathy not due to another identifiable cause within 7 days of a dose of DTaP. Because this condition could be an adverse reaction to the pertussis component of DTaP, these new recommendations for Td replace previous recommendations to use DT to ensure tetanus and diphtheria protection in such children.

Related Links
* Immunize​.org: Pertussis (Whooping Cough): Questions and Answers ([link removed]) (PDF)
* Immunize​.org: Tetanus: Questions and Answers ([link removed]) (PDF)
* Immunize​.org: Diphtheria: 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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National Infant Immunization Week is April 22–29; prepare your promotion with CDC’s digital media toolkit

National Infant Immunization Week ([link removed]) (NIIW), April 22–29, highlights the importance of protecting infants from vaccine-preventable diseases. Since 1994, hundreds of communities have celebrated the crucial role vaccination plays in protecting our children, communities, and public health.

CDC and the American Academy of Pediatrics (AAP) recommend that children stay on track with their well-child appointments and routine vaccinations. Completing the recommended childhood immunizations by age 2 years is the best way to protect young children from 16 potentially life-threatening diseases.

CDC makes it simple to plan your NIIW activities by using their promotional materials ([link removed]) including English and Spanish logos, sample social media content, social graphics, and key messages. Please share your posts using the hashtag #ivax2protect.

AAP resources will be released on April 18 at aap.org.

Related Links
* CDC: National Infant Immunization Week ([link removed]) main page
* CDC: Promotional Materials ([link removed]) main page
* Immunize​.org: Parent Handouts ([link removed]) main page

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Nominate a champion! Association of Immunization Managers accepting nominations for Immunization Champions to represent states, territories, and some cities, due May 10.

Today, you can recognize an immunization champion you know! The Association of Immunization Managers (AIM) invites nominations for its Immunization Champion Awards ([link removed]). The awards honor those doing an exemplary job to promote immunizations for children and adults in their communities. The program will honor a champion from each of the 50 U.S. states, the District of Columbia, six major cities, and eight U.S. territories. Each jurisdiction directly funded by CDC for immunization work will be represented.

Visit the AIM website ([link removed]) to learn more about the Immunization Champion Awards. Email questions to [email protected].

Related Links
* AIM: 2024 Immunization Champion Toolkit ([link removed])
* AIM: 2024 Immunization Champion Nomination Form ([link removed])

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Our final weekly influenza update of the season: influenza-like illness activity remains elevated but waning

For week 14, ending April 6, CDC’s Weekly U.S. Influenza Surveillance Report, FluView ([link removed]) shows that seven jurisdictions experienced moderate activity and one state experienced high activity. Nationwide, 2.8% 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 2.9%. Five pediatric influenza-associated deaths were reported this week, bringing the total to 138 children who died of influenza thus far during the 2023–24 season.

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
CDC recommends everyone age 6 months and older get annual influenza vaccination.

This story represents the final routine story on influenza-like-illness activity for the 2023–24 season. Late-season influenza vaccination may be helpful, especially for young infants just turning 6 months of age, as long as influenza is circulating.

Don't forget that some children need a second dose in their first season of influenza vaccinations.

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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Help parents understand why HPV vaccine is recommended for preteens. Watch the 1-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 Some parents resist HPV vaccination of their 11- and 12-year-olds because they are not sexually active. How should I counter this position? ([link removed]) The video briefly describes how to talk to parents about the importance of starting and completing HPV vaccination prior to exposure to the virus.

The 1-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.

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.

* TIME: Whooping Cough Is Surging in China with Tens of Thousands of Cases and Over a Dozen Deaths ([link removed]) (4/10/24)

* Detroit Free Press: Detroit Child with Measles Exposed Others at Children’s Hospital, Urgent Care, Pharmacy ([link removed]) (4/10/24)

* U.S. News: Measles Infections Cross 100 in U.S., Nearly Double 2023 Cases ([link removed]) (4/8/24)

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Immunize​.org Website and Clinical Resources
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Spotlight on the website: National Infant Immunization Week

This week’s Spotlight on the Website highlights Immunize​.org content that can aid you with delivering infant immunizations.

Our Clinical Resources A–Z section contains 41 print-ready resources regarding infant immunization for providers and recipients. Several patient handouts are also available in multiple languages. Topics include answers to questions patients frequently ask about vaccines, how to respond to vaccine-hesitant parents, and strategies for addressing vaccine anxiety in infants and toddlers. The list of these resources can be found here ([link removed](%26lt%3B%201%20yr)).

Our popular Ask the Experts web section includes many clinical questions and answers specific to vaccination of infants. Infant-specific content is available within general topics, such as scheduling and administering vaccines, as well as questions and answers about specific vaccines infants receive. By filtering or using a keyword search for infant immunization, you can find Ask the Experts answers specific to infants.

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Featured Resources
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Before we run out! Place your order for these sturdy, laminated versions of the 2024 U.S. immunization schedules from Immunize​.org.

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 shipping. We anticipate selling out, so put in your order now!

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

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].

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

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Recap: CDC releases simple, parent-friendly 2024 immunization schedules in English and Spanish

CDC now offers simple, parent-friendly, and downloadable versions of the childhood immunization schedules:
* 2024 Recommended Immunizations for Birth through 6 Years Old ([link removed])

* 2024 Recommended Immunizations for Children 7–18 Years Old ([link removed])

Related Links
* CDC: Immunization Schedules: For You and Your Family ([link removed]) main page
* CDC: CIIW Webinars: 2024 Updates to the Child/Adolescent and Adult Immunization Schedules ([link removed]) (3/6/24)

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Notable Publications
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"Measles—United States, January 1, 2020–March 28, 2024" published in MMWR

CDC published Measles—United States, January 1, 2020–March 28, 2024 ([link removed]) on April 11 in MMWR. A portion of the summary appears below.

Although endemic U.S. measles was declared eliminated in 2000, measles importations continue to occur. Prolonged outbreaks during 2019 threatened the U.S. measles elimination status. . . .

During January 1, 2020–March 28, 2024, a total of 338 U.S. measles cases were reported; 29% of these cases occurred during the first quarter of 2024, almost all in persons who were unvaccinated or whose vaccination status was unknown. As of the end of 2023, U.S. measles elimination status was maintained. . . .

Risk for widespread U.S. measles transmission remains low because of high population immunity. Enhanced efforts are needed to increase routine U.S. vaccination coverage, encourage vaccination before international travel, identify communities at risk for measles transmission, and rapidly investigate suspected measles cases to reduce cases and complications of measles.

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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"Assessment of Risk for Sudden Cardiac Death among Adolescents and Young Adults after Receipt of COVID-19 Vaccine—Oregon, June 2021–December 2022" published in MMWR

CDC published Assessment of Risk for Sudden Cardiac Death among Adolescents and Young Adults after Receipt of COVID-19 Vaccine—Oregon, June 2021–December 2022 ([link removed]) on April 11 in MMWR. For context, 979,289 doses of COVID-19 vaccines were administered to Oregonians aged 16–30 years from May 1, 2021 through December 31, 2022. A portion of the abstract appears below.

In April 2021, cases of myocarditis after COVID-19 vaccination, particularly among young male vaccine recipients, were reported to the Vaccine Adverse Event Reporting System. To assess this possibility, investigators searched death certificates for Oregon residents aged 16–30 years who died during June 2021–December 2022 for cardiac or undetermined causes of death. For identified decedents, records in Oregon’s immunization information system were reviewed for documentation of mRNA COVID-19 vaccination received ≤100 days before death. Among 1,292 identified deaths, COVID-19 was cited as the cause for 30. For 101 others, a cardiac cause of death could not be excluded; among these decedents, immunization information system records were available for 88, three of whom had received an mRNA COVID-19 vaccination within 100 days of death. Of 40 deaths that occurred among persons who had received an mRNA COVID-19 vaccine dose, three occurred ≤100 days after vaccination. Two of these deaths were attributed to chronic underlying conditions; the cause was undetermined for one. No death certificate attributed death to vaccination. These data do not support an association between receipt of mRNA COVID-19 vaccine and sudden cardiac death among previously healthy young persons [emphasis added]. COVID-19 vaccination is recommended for all persons aged ≥6 months to prevent COVID-19 and complications, including death.

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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Global News
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World Immunization Week is the last week of April; this year's theme is "Humanly Possible: Saving Lives Through Immunization"

World Vaccination Week (WIW) ([link removed]) is traditionally celebrated the last week of April. A portion of WHO's press release about WIW ([link removed]) appears below.

This year's campaign aims to:
* Celebrate 50 years of children growing up protected against vaccine-preventable diseases.
* Promote demand for immunization and conduct catch-up vaccination, wherever applicable, to reach zero-dose and under-immunized children in the Western Pacific.
* Increase recognition and awareness of the value of vaccines across the life-course, and mitigate risk of vaccine-preventable disease outbreaks.

Related Links
* WHO: World Vaccination Week (WIW) ([link removed]) web page
* WHO: 50th Anniversary of the Expanded Programme on Immunization (EPI) ([link removed]-(epi)) web page
* WHO: WHO’s Expanded Programme on Immunization: Averting More than Four Million Deaths Every Year ([link removed]) YouTube Video

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"COVID-19 Vaccination Coverage—World Health Organization African Region, 2021–2023" published in MMWR

CDC published COVID-19 Vaccination Coverage—World Health Organization African Region, 2021–2023 ([link removed]) on April 11 in MMWR. A portion of the summary appears below.

The World Health Organization African Region did not receive enough COVID-19 vaccine doses to vaccinate everyone for whom vaccination was recommended and lagged behind other regions. . . .

During 2021–2023, the cumulative number of COVID-19 vaccine doses received in the African Region increased from 321 million to 860 million, and 646 million doses were administered. Cumulative total population coverage with ≥1 dose ranged by country from 0.3% to 89%. By the end of 2023, coverage with a primary COVID-19 vaccination series increased from 7% to 32% for the total population, and increased to 52% among older age groups and to 48% among health care workers in a subset of countries in the African Region. . . .

Additional outreach is needed to increase COVID-19 vaccination coverage among priority high-risk populations. Integrating COVID-19 vaccination into routine immunization and primary health care services could strengthen adult vaccination platforms and improve pandemic preparedness.

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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Upcoming Events
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In-person: Registration open for “National Immunization Conference 2024” on August 12–14 in Atlanta; abstract deadline extended to April 26; CE credit offered

CDC will host its National Immunization Conference 2024 ([link removed]) (NIC) on August 12–14 in Atlanta, GA. Program content will cover science, policy, education, and implementation issues related to immunization and vaccine-preventable diseases.

The abstract deadline was extended to April 26. Notification of acceptance will be sent in mid-June. View abstract submission guidelines ([link removed]).

Registration is now open. The general attendee fee is $685. CE will be offered. Register for the conference ([link removed]).

See CDC's National Immunization Conference 2024 ([link removed]) website for more information.

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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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