From Immunize.org <[email protected]>
Subject IZ Express #1,758: Meningococcal disease and Saudi Arabia, remembering our colleague, influenza A(H5N1), and more
Date May 29, 2024 10:15 AM
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Issue 1,758: May 29, 2024

Top Stories
* CDC’s Health Alert Network (HAN) Health Advisory: meningococcal disease cases linked to travel to Saudi Arabia
* On a personal note: Immunize.org honors the life of Mike Franey, PhD, an essential force at Immunization Action Coalition (IAC)
* Highly pathogenic avian influenza A(H5N1) viruses in U.S. dairy cattle and two human cases reported in MMWR and CDC HAN
* “Monkeypox Virus Infections after 2 Preexposure Doses of JYNNEOS Vaccine—United States, May 2022–May 2024” published in MMWR
* “Clade II Mpox Surveillance Update—United States, October 2023–April 2024” published in MMWR
* Immunize.org posts seven new translations of its popular patient handout, “Vaccinations for Preteens and Teens”
* Immunize.org posts new Spanish translations of eight patient handouts for adults and one clinical resource for healthcare personnel
* Immunize.org’s Hepatitis B Birth Dose Honor Roll recognizes 582 institutions, including two new honorees
* Is it acceptable to draw up vaccine doses in advance? 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: "Official Guidance: CDC"
* Recap: Immunize.org posts seven new translations of its popular patient handout, “Vaccinations for Adults: You're Never Too Old to Get Vaccinated!”


Featured Resources
* “Shop Immunize.org” offers many resources for your practice: laminated adult immunization schedules, T-shirts, and enamel pins
* Recap: CDC launches restructured, streamlined CDC.gov website


Upcoming Events
* Virtual: FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) meets June 5 to discuss COVID-19 vaccine strain selection for the fall


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Top Stories
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CDC’s Health Alert Network (HAN) Health Advisory: meningococcal disease cases linked to travel to Saudi Arabia

On May 20, CDC issued a Health Alert Network (HAN) Health Advisory: Meningococcal Disease Cases Linked to Travel to the Kingdom of Saudi Arabia (KSA): Ensure Pilgrims are Current on Meningococcal Vaccination ([link removed]). In the HAN, CDC alerts healthcare providers to 12 cases of disease caused by Neisseria meningitidis linked to travel to the Kingdom of Saudi Arabia (KSA) for Umrah since April 2024. Umrah is an Islamic pilgrimage to the city of Mecca that may be performed any time in the year; the Hajj is an annual pilgrimage event to Mecca, next taking place June 14–19, 2024.

* Countries: United States (5 cases), France (4 cases), and the United Kingdom (3 cases)

* Age: 18 years or younger (2 cases), 18–44 years (4 cases), age 45–64 years (4 cases), 65 years or older (2 cases)

* Travelers and contacts: travelers to KSA (10 cases), close contacts of travelers to KSA (2 cases)

* Serogroups: serogroup W (10 cases), serogroup C (1 U.S. case), unknown (1 U.S. case)

* Meningococcal vaccination status: unvaccinated (9 cases), unknown status (3 cases)

* Antibiotic susceptibility: ciprofloxacin resistant (1 serogroup C, 2 serogroup W), susceptible to ciprofloxacin or penicillin (8 serogroup W)

Meningococcal serogroups C and W are vaccine-preventable. Vaccination recommendations are summarized below.

In the United States, quadrivalent meningococcal (MenACWY) conjugate vaccination is routinely recommended for adolescents, and also recommended for travelers to countries where meningococcal disease is hyperendemic or epidemic, including a booster dose of MenACWY if the last dose was administered 3–5 or more years previously (depending on the age at most recent dose received). In addition, all Hajj and Umrah pilgrims aged one year and older are required by KSA to receive quadrivalent meningococcal vaccine. Healthcare providers should work with their patients considering travel to perform Hajj or Umrah to ensure that those aged one year or older have received a MenACWY conjugate vaccine within the last 5 years administered at least 10 days prior to arrival in KSA.

CDC notes that healthcare providers should:
* Maintain increased suspicion for meningococcal disease in anyone presenting with symptoms of meningococcal disease after recent travel to KSA for Hajj or Umrah pilgrimage
* Consider rifampin, ceftriaxone, or azithromycin (instead of ciprofloxacin) for chemoprophylaxis of close contacts of meningococcal disease cases associated with travel to KSA

Access the complete CDC HAN Health Advisory ([link removed]).

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On a personal note: Immunize.org honors the life of Mike Franey, PhD, an essential force at Immunization Action Coalition (IAC)

In May, the Immunize.org (formerly Immunization Action Coalition [IAC]) family lost one of its most valued members with the passing of Mike Franey, PhD. A physicist by training, Mike worked alongside IAC founder and executive director emerita, Dr. Deborah Wexler, for 30 years, applying his exceptional array of skills and incisive thinking to expanding the work of IAC until his retirement in fall 2021.

Mike established the website www.immunize.org in 1996, making IAC the first nongovernmental organization with a site on the internet providing immunization educational resources for healthcare professionals. Mike worked closely with Dr. Wexler, other experts, and with his sister, Sheila Franey, to design and code every page of the original versions of www.immunize.org, and its smaller site for the general public, www.vaccineinformation.org. For many years, these well-loved educational sites received about 25,000 visits a day from professionals and the public.

Mike applied his administrative and writing skills to grant writing, staff hiring and mentoring, project planning, and business operations leadership. He was a stickler for the clear, precise use of language in all IAC communications. Mike could elicit a smile and a sigh when a discussion would almost conclude and he would say “now just a minute . . . let me see if I understand . . . ?”, but we also knew that whatever he noticed was likely to be crucial. His input always made IAC’s work better.

Before his own retirement in late 2021, he helped engineer the smooth leadership transition from our founder, Dr. Deborah Wexler, to Dr. Kelly Moore and the next generation of IAC: Immunize.org.

Mike determinedly avoided the spotlight, preferring always to focus on supporting others to grow and flourish personally and professionally. For this reason, few of our thousands of IZ Express readers are aware of the impact of our kind, generous, funny, brilliant friend who helped Dr. Wexler realize her vision at IAC so effectively for so many years. He kept IAC steadfast in its focus on saving lives by preventing disease.

Immunize.org would not be what it is today without his years of service and visionary thinking. Our hearts go out to Mike’s family and to Dr. Wexler. Thank you for everything, Mike.

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Highly pathogenic avian influenza A(H5N1) viruses in U.S. dairy cattle and two human cases reported in MMWR and CDC HAN

CDC published Outbreak of Highly Pathogenic Avian Influenza A(H5N1) Viruses in U.S. Dairy Cattle and Detection of Two Human Cases—United States, 2024 ([link removed]) on May 24 in MMWR Early Release. A portion of the summary appears below.

Influenza A(H5) virus infection was detected in two U.S. farm workers during a multistate outbreak of A(H5N1) viruses in dairy cows; these are the first known instances of presumed cow-to-human transmission of avian influenza A viruses. . . .

Approximately 350 exposed farm workers are being monitored; one of the two cases was identified via daily, active monitoring. Surveillance has identified no unusual influenza activity trends in the United States. A(H5) candidate vaccine viruses are available, and laboratory analyses indicate that A(H5N1) viruses circulating in cows and other animals are susceptible to FDA-approved antivirals. . . .

Current risk to the U.S. public from A(H5N1) viruses is low; however, persons exposed to infected animals or contaminated materials, including raw cow’s milk, are at higher risk and should take precautions and self-monitor for illness. A One Health (human, animal, and environmental) approach is critical to preparing for circumstances that could increase risk to human health.

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

Access the CDC Health Alert Network (HAN) Health Advisory: Highly Pathogenic Avian Influenza A(H5N1) Virus: Identification of Human Infection and Recommendations for Investigations and Response ([link removed]) , issued on April 5.

Related Links
* CDC HAN Health Advisory: Highly Pathogenic Avian Influenza A(H5N1) Virus: Identification of Human Infection and Recommendations for Investigations and Response ([link removed]) (4/5/24)

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

* CDC: CDC Reports Second Human Case of H5 Bird Flu Tied to Dairy Cow Outbreak: CDC’s Risk Assessment for the General Public Remains Low ([link removed]) (5/22/24)

* CDC: How CDC is monitoring influenza data to better understand the current avian influenza A (H5N1) situation in people ([link removed]) (5/24/24)

* CDC: About One Health ([link removed])

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“Monkeypox Virus Infections after 2 Preexposure Doses of JYNNEOS Vaccine—United States, May 2022–May 2024” published in MMWR

CDC published Monkeypox Virus Infections after 2 Preexposure Doses of JYNNEOS Vaccine—United States, May 2022–May 2024 ([link removed]) on May 23 in MMWR. A portion of the summary appears below.

Two JYNNEOS vaccine doses prevent mpox; however, infection in fully vaccinated persons can occur. . . .

Monkeypox virus infection after receipt of 2 JYNNEOS doses is estimated to have occurred in <1% of fully vaccinated persons and comprises a small proportion of national cases. Among persons who experienced infection after having received a complete 2-dose series and for whom complete data were available, infections have been milder than those among unvaccinated persons. Disparate time intervals from vaccination to infection among fully vaccinated persons suggest that immunity is not waning. . . .

To optimize protection, persons recommended to receive mpox vaccination should complete the 2-dose JYNNEOS vaccination series. No additional vaccine doses are recommended at this time.

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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“Clade II Mpox Surveillance Update—United States, October 2023–April 2024” published in MMWR

CDC published Clade II Mpox Surveillance Update—United States, October 2023–April 2024 ([link removed]) on May 23 in MMWR. Clade II–associated disease is circulating at low levels in the United States and other countries and is generally considered less severe than that of clade I, but immunocompromised people, especially those with advanced HIV, can experience severe infections. Clade I monkeypox is endemic in Central Africa with increasing incidence in the Democratic Republic of the Congo. No cases of clade I have been reported in the United States.

A portion of the MMWR article summary appears below.

After the peak of the 2022 mpox outbreak, when approximately 3,000 cases per week were reported, cases declined sharply and remain significantly lower (approximately 59 reported cases per week during October 1, 2023–April 30, 2024). Most new mpox cases occur in unvaccinated persons. . . .

CDC recommends that persons at risk for mpox exposure, who have not previously recovered from mpox (including certain gay, bisexual, and other men who have sex with men) complete the 2-dose JYNNEOS vaccination series.

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 posts seven new translations of its popular patient handout, “Vaccinations for Preteens and Teens”

Immunize.org posted seven new translations of the current version of its popular patient handout, Vaccinations for Preteens and Teens ([link removed]). This one-page handout summarizes basic information about recommended adolescent vaccines in one table. It is a valuable resource to provide to families of adolescents. These translations help you increase access to vaccination education for families whose preferred language is not English.

New translations include:
* Arabic ([link removed])
* Chinese-Simplified ([link removed])
* French ([link removed])
* Korean ([link removed])
* Russian ([link removed])
* Spanish ([link removed])
* Vietnamese ([link removed])

Related Links
* Immunize.org: Translations ([link removed]) of clinical resources and VISs
* 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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Immunize.org posts new Spanish translations of eight patient handouts for adults and one clinical resource for healthcare personnel

Immunize.org posted new Spanish translations of the current versions of eight patient handouts for adults and one clinical resource for healthcare personnel. Use these resources to support your vaccination practice and educational efforts when working with families whose preferred language is Spanish.

New translations include:
* Screening Checklist for Contraindications to HPV, MenACWY, MenB and Tdap Vaccines for Teens ([link removed]) (view in English ([link removed]))
* HPV Vaccine: A Guide for Adults Ages 18–26 Years ([link removed]) (view in English ([link removed]))
* Vaccination for Adults with Lung Disease ([link removed]) (view in English ([link removed]))
* Vaccination for Adults with Heart Disease ([link removed]) (view in English ([link removed]))
* Vaccination for Adults with Diabetes ([link removed]) (view in English ([link removed]))
* Vaccination for Adults with Chronic Liver Disease or Infection ([link removed]) (view in English ([link removed]))
* Vaccination for Adults with HIV Infection ([link removed]) (view in English ([link removed]))
* Vaccinations for Men Who Have Sex with Men ([link removed]) (view in English ([link removed]))
* Vaccinations for Adults without a Spleen ([link removed]) (view in English ([link removed]))

Related Links
* Immunize.org: Translations ([link removed]) of clinical resources and VISs
* 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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Immunize.org’s Hepatitis B Birth Dose Honor Roll recognizes 582 institutions, including two new honorees

Immunize.org is pleased to welcome two new institutions into its Hepatitis B Birth Dose Honor Roll ([link removed]), for a total of 582 honorees. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses. 
* Mercy Jefferson Hospital, Festus, MO (92%)
* Yale New Haven Health – Lawrence & Memorial Hospital, New London, CT (93%)

Please join us in recognizing these honorees for qualifying for an additional year: 
* Jackson Hospital, Marianna, FL (95%) (2 years) 
* Memorial Hospital West, Pembroke Pines, FL (93%) (2 years)
* Mercy Hospital Washington, Washington, MO (92%) (4 years)
* UnityPoint Grinnell Regional Medical Center, Grinnell, IA (92%) (5 years)
* Central Vermont Medical Center, Berlin, VT (96%) (6 years)

The Honor Roll includes 582 birthing institutions from 45 states, the District of Columbia, Puerto Rico, Guam, Saipan, and our U.S. hospital in England. 
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The Honor Roll is a key part of Immunize.org’s initiative urging the nation’s hospitals to Give Birth to the End of Hep B ([link removed]). Hospitals and birthing centers are recognized for attaining high coverage for hepatitis B vaccine at birth and meeting additional criteria. To learn whether your organization qualifies and to access the application form, please see Hepatitis B Birth Dose Honor Roll online ([link removed]).

Honorees receive an 8.5" x 11" color certificate suitable for printing and framing. Their acceptance is announced through Immunize.org’s social media channels and to IZ Express’s 54,000+ readers.

Please visit the Hepatitis B Birth Dose Honor Roll web page that lists these institutions and celebrates their vigorous efforts to protect infants from perinatal hepatitis B transmission.

Related Immunize.org Resources
* Give Birth to the End of Hep B ([link removed]) main page 

* Fact sheet: Do You Qualify for the Hepatitis B Birth Dose Honor Roll? If So, Apply Today. ([link removed])

* Handout on Immunize.org’s campaign: Give Birth to the End of Hep B ([link removed])

* Hepatitis B Birth Dose Honor Roll ([link removed]) web page

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Is it acceptable to draw up vaccine doses in advance? 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 Is it okay to draw up vaccines at the beginning of the shift? If it isn’t, how much in advance can this be done? ([link removed]) The video briefly shares the reasons why ACIP discourages the practice of prefilling vaccine into syringes, primarily because of the increased possibility of administration and dosing errors. An exception may be considered when only a single type of vaccine is to be administered during a clinic (e.g., influenza).

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: HPV Vaccines Prevent Cancer in Men as Well as Women, New Research Suggests ([link removed]) (5/23/24)

* The Hill: Vaccines Lower Risk of Long COVID: Study ([link removed]) (5/23/24)

* CIDRAP: HHS Advances Plan to Produce 4.8 Million H5N1 Vaccine Doses ([link removed]) (5/22/24)

* The Hill: CDC to End Free COVID Vaccine Program for Uninsured Early ([link removed]) (5/17/24)

* Medpage Today: Measles Is Preventable. How Did the World End Up Back Here? (opinion) ([link removed]) (5/19/24)

* Washington Post: Paul Parkman, an Inventor of the Rubella Vaccine, Dies at 91 ([link removed]) (5/17/24)

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Immunize​.org Website and Clinical Resources
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Spotlight on the website: "Official Guidance: CDC"

This week’s spotlight features CDC recommendations and resources. We provide easy access to immunization information and key web pages for healthcare professionals. This area of our website includes:

* The CDC Recommended Schedules ([link removed]) page features official recommended immunization schedules for children, teens, and adults. You can view or download PDF versions of the schedules, or download a schedules app for mobile devices.

* The ACIP Vaccine Recommendations ([link removed]) page provides a list of current and archived recommendations from ACIP. Separate tabs display comprehensive (not vaccine-specific) or vaccine-specific recommendations. You may filter results to display only current recommendations and you may sort by date order.

* The Additional CDC Resources ([link removed]) page offers links to important CDC website pages related to immunization services and public health. You will find links to CDC publications, educational content, reference materials, and contact information.

You can find the CDC section by selecting the “Official Guidance” menu, then “CDC” from the left side of the menu, then by selecting one of the three pages on the right.

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Recap: Immunize.org posts seven new translations of its popular patient handout, “Vaccinations for Adults: You're Never Too Old to Get Vaccinated!”

Immunize.org posted seven new translations of the current version of its popular patient handout, Vaccinations for Adults: You're Never Too Old to Get Vaccinated! ([link removed]) This one-page handout summarizes basic information about recommended adult vaccines in one table.

New translations include:
* Arabic ([link removed])
* Chinese-Simplified ([link removed])
* French ([link removed])
* Korean ([link removed])
* Russian ([link removed])
* Spanish ([link removed])
* Vietnamese ([link removed])

These translations are added to the nine languages announced previously in IZ Express that were generously donated by the Fargo Cass Public Health Department in Fargo, North Dakota, listed below.
* Bosnian ([link removed])
* Dari ([link removed])
* Haitian Creole ([link removed])
* Kinyarwanda ([link removed])
* Nepali ([link removed])
* Pashto ([link removed])
* Somali ([link removed])
* Swahili ([link removed])
* Ukrainian ([link removed])

Related Links
* Immunize.org: Translations ([link removed]) of clinical resources and VISs
* 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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Featured Resources
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“Shop Immunize.org” offers many resources for your practice: laminated adult immunization schedules, T-shirts, and enamel pins

Laminated versions of the 2024 U.S. adult immunization schedule ([link removed]) are still shipping. We anticipate selling out soon, so put in your order now! While the schedule is available online from CDC at no cost, Immunize​.org’s printed, laminated booklet is ideal for use in any busy healthcare setting where vaccinations are given.

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

In addition to laminated schedules, Immunize​.org is pleased to offer T-shirts in three different designs (unisex, women’s, and baseball). Each T-shirt features our logo on the front and, on the back, our tag line: “Save Lives. Immunize.” These T-shirts are fashioned in a super soft, premium tri-blend fabric that doesn’t shrink or wrinkle with washing. Designed with frontline vaccinators in mind, they pair perfectly with scrub pants for vaccination clinics and make a pro-vaccine statement whenever you or your team want to show your support for immunization. Perfect for the gym, clinic, or anywhere you like!

Click the pictures for more detailed information and to place your order.

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Immunize.org's gold and black enamel “Vaccines Save Lives” pins ([link removed]) are meaningful gifts for people who value vaccination. The pin makes a refined statement in black enamel with gleaming gold lettering and edges, measuring 1.125" x 0.75". Our pin features a stick-through post design. The post is covered by a round rubber cap that holds the pin securely. A gold metal spring-lock clasp is also provided.

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These pins are a striking statement of vaccination support. Wear these pins on lab coats, uniforms, or street clothes ([link removed]) to show that you value vaccines.

Related Links
* Immunize​.org: Laminated Adult Immunization Schedule ([link removed]) (19 and older)
* Immunize​.org: Show Your Support for Immunization ([link removed]) page
* Immunize​.org: “Vaccines Save Lives” pins ([link removed])
* Immunize​.org: Shop Immunize​.org ([link removed]) main page

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Recap: CDC launches restructured, streamlined CDC.gov website

On May 17, CDC announced the launch of its redesigned and streamlined website, CDC.gov. As our readers know, Immunize.org’s websites and clinical resources contain many links to CDC web pages. The Immunize.org team is reviewing our content and updating any broken links resulting from this major site renovation. Excerpts from the CDC press release ([link removed]) are reprinted below.

Today, the CDC unveiled its newly revamped CDC.gov website, marking a significant step forward in the agency’s commitment to better communicate with the public. . . . The newly streamlined website is the culmination of extensive user testing and feedback, ensuring that vital health information is more accessible and easier to find for all audiences. . . .

. . . Through sophisticated site auditing, CDC streamlined the website content by over 65% to make it easier for users to find the information they need to make informed decisions about their health. The content throughout the site has also been written to better meet user needs. . . .

. . . Throughout 2024, expect CDC to continue improving and optimizing its web content, reflecting CDC’s ongoing dedication to serving the public’s health needs.

Explore the newly revamped CDC.gov ([link removed]).

Take a quick video tour of the site.

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Upcoming Events
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Virtual: FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) meets June 5 to discuss COVID-19 vaccine strain selection for the fall

FDA will convene its Vaccines and Related Biological Products Advisory Committee (VRBPAC) ([link removed]) on June 5 from 8:30 a.m. until 5:00 p.m. (ET) to discuss selection of the COVID-19 vaccine strain for fall 2024. Briefing materials can be found at the VRBPAC web page specific for the June 5 meeting ([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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