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IZ Express #1,777: Immunize.org website office hours; updates on COVID-19, RSV, and influenza vaccines, nirsevimab, and more
| From | Immunize.org <[email protected]> |
| Subject | IZ Express #1,777: Immunize.org website office hours; updates on COVID-19, RSV, and influenza vaccines, nirsevimab, and more |
| Date | September 25, 2024 10:15 AM |
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Issue 1,777: September 25, 2024
Top Stories
* CDC posts 2024–25 COVID-19 mRNA vaccine standing orders templates and at-a-glance resources. Immunize.org updates “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools.”
* Immunize.org updates “Standing Orders for Administering Respiratory Syncytial Virus Vaccine (RSV) to Adults Age 60 Years and Older”
* Use Immunize.org’s suite of 2024–25 influenza vaccination resources. All now up to date for this season.
* Resume administration of nirsevimab preventive antibody (Beyfortus, Sanofi) to protect infants from RSV beginning October 1 in most jurisdictions
* Stay alert for measles cases
* Encourage COVID-19 and RSV vaccine recipients to enroll in V-safe
* “Wastewater Surveillance for Influenza A Virus and H5 Subtype Concurrent with the Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in Cattle and Poultry and Associated Human Cases—United States, May 12–July 13, 2024” published in MMWR
* “Why Is Hepatitis A Vaccination, Not IG, Recommended for At-Risk Infant Travelers?”: Watch the 2-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: Register today for Immunize.org’s new Website Office Hours sessions on October 2 at 4:00 p.m. (ET) and October 3 at 10:00 a.m. (ET)
* Recap: Immunize.org updates its “Ask the Experts” web page on COVID-19
Notable Publications
* Recap: “Use of 2024–2025 COVID-19 Vaccines for Persons Aged ≥6 Months: Recommendations of the Advisory Committee on Immunization Practices — United States” published in MMWR Early Release
* Recap: "Use of 21-Valent Pneumococcal Conjugate Vaccine among U.S. Adults: Recommendations of the Advisory Committee on Immunization Practices—United States, 2024" published in MMWR
* Recap: "Use of Haemophilus influenzae Type b–Containing Vaccines among American Indian and Alaska Native Infants: Updated Recommendations of the Advisory Committee on Immunization Practices―United States, 2024" published in MMWR
Upcoming Events
* Virtual: NFID offers 2024 Clinical Vaccinology Course, November 6–8; fee to register (CE credit available)
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Top Stories
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CDC posts 2024–25 COVID-19 mRNA vaccine standing orders templates and at-a-glance resources. Immunize.org updates “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools.”
CDC posted highly anticipated new 2024–25 COVID-19 mRNA vaccine resources at its U.S. COVID-19 Vaccine Product Information ([link removed]) main page. This page links to standing orders templates for Pfizer-BioNTech and Moderna mRNA vaccines (each vaccine has one template for young children and a separate one for people age 5 years and older). It also links to at-a-glance summaries for the two mRNA vaccines. Corresponding resources for the 2024–25 Novavax COVID-19 vaccine are coming soon.
Immunize.org reviews its 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. Due to the high priority of these updated CDC resources, Immunize.org revised the checklist for a second time in September.
All COVID-19 vaccine providers should regularly review this checklist. Download the latest documents and discard outdated versions.
Related Links
* Immunize.org: Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools ([link removed]) (PDF)
* Immunize.org: Vaccines A–Z: COVID-19 ([link removed]) main page
* CDC: Interim Clinical Considerations ([link removed]) main page for use of COVID-19 vaccines in the United States
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Immunize.org updates “Standing Orders for Administering Respiratory Syncytial Virus Vaccine (RSV) to Adults Age 60 Years and Older”
Immunize.org updated its clinician resource, Standing Orders for Administering Respiratory Syncytial Virus Vaccine (RSV) to Adults Age 60 Years and Older ([link removed]) to incorporate changes CDC recently made to its website for clinical considerations for RSV vaccination of adults age 60 through 74 ([link removed]) at increased risk of severe disease. The changes to the website align the online guidance with the final, published ACIP recommendation. The following changes were made to the Immunize.org standing orders template:
* The indication for vaccination based on residential setting was limited to nursing homes only. Previously, CDC’s website guidance included residents of nursing homes and other long-term care facilities (LTCFs).
* Examples were added to illustrate the types of people age 60 through 74 without an ACIP-specified risk factor who may, nonetheless, be judged by a clinician to be at increased risk for severe RSV disease
* A note was added to indicate ACIP’s recommendation that a vaccination provider should not deny a patient age 60 through 74 RSV vaccination because they lack documentation of a self-reported risk factor for severe RSV disease
Related Links
* Immunize.org: Vaccine 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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Use Immunize.org’s suite of 2024–25 influenza vaccination resources. All now up to date for this season.
Immunize.org completed the annual review of our entire suite of influenza clinical content for the 2024–25 season. In addition to resources that required updates, those that did not require changes to content also have a new date in the footnote to indicate they are current for 2024–25 season. The final batch of updated resources includes:
* Communicating the Benefits of Influenza Vaccination ([link removed]): updated data on influenza disease burden, vaccination rates, and use of the SHARE method for practitioners to use in discussing the value of vaccination (co-developed with the Association of Immunization Managers)
* Declination of Influenza Vaccination ([link removed]): reviewed, no changes to content
* Guide for Determining the Number of Doses of Influenza Vaccine to Give to Children Age 6 Months Through 8 Years ([link removed]): updated date and URL for the ACIP influenza recommendations only
* Talking with Your Patient about Contraindications and Precautions to Influenza Vaccination ([link removed]): added expanded influenza vaccine options for solid organ transplant recipients
* Not Sure If You Can Get an Influenza Vaccine? ([link removed]): updated date and URL for the ACIP influenza recommendations only
* Don’t Take Chances with Your Family’s Health—Make Sure You All Get Vaccinated ([link removed]): reviewed, no changes to content
Find all of our influenza vaccine resources for the 2024–25 season at the Vaccines A–Z: Influenza ([link removed]) main page.
Related Links
* Immunize.org: Vaccines A–Z: Influenza ([link removed]) main page
* Immunize.org: Ask the Experts ([link removed]) main page with more than 1,300 questions and answers
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Resume administration of nirsevimab preventive antibody (Beyfortus, Sanofi) to protect infants from RSV beginning October 1 in most jurisdictions
The 2023 ACIP recommendation for administration of nirsevimab ([link removed]) (Beyfortus, Sanofi), the RSV preventive antibody product recommended as a one-time dose for infants younger than age 8 months born to mothers not effectively vaccinated against RSV during pregnancy, takes into account the seasonality of RSV activity. ACIP recommends that nirsevimab use should generally begin October 1 and end March 31 in jurisdictions with RSV seasonality typical of most of the contiguous United States (the “lower 48”).
Alaska and tropical climates may have RSV circulation patterns that differ from most of the contiguous United States. Locations with tropical climates include southern Florida, Hawaii, Guam, Puerto Rico, U.S. Virgin Islands, and U.S.-affiliated Pacific Islands. Providers in these jurisdictions should follow state or territorial public health guidance on timing of nirsevimab administration.
Healthcare providers should resume age-appropriate nirsevimab administration to eligible infants and high-risk toddlers as of October 1, unless otherwise recommended by your public health department. This includes:
* Infants born from October through March, during their first week of life, if the mother was not effectively vaccinated with Abrysvo (Pfizer) RSV vaccine during pregnancy
* Infants born April through September (younger than age 8 months) as they enter their first RSV season, if the mother was not effectively vaccinated with Abrysvo (Pfizer) RSV vaccine during pregnancy
* Children age 8 through 19 months entering their second RSV season who are at increased risk of severe RSV disease (e.g., American Indian and Alaska Native children, children with chronic lung disease of prematurity, severe immunocompromise, cystic fibrosis with growth under 10th percentile), regardless of history of maternal vaccination
Providers are encouraged to send reminders to parents of high-risk infants age 8 through 19 months who need a dose this fall.
See Immunize.org’s standing orders template for the use of nirsevimab ([link removed]) to review details of recommendations, including dosing, criteria for nirsevimab use in high-risk children during their second RSV season, and guidance for rare circumstances when nirsevimab is recommended for an infant younger than age 8 months despite maternal RSV vaccination.
Related Links
* CDC: 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)
* CDC: Frequently Asked Questions about RSV Immunization with Monoclonal Antibody for Children 19 Months and Younger ([link removed]) main page
* Immunize.org: Standing Orders for Administering Nirsevimab RSV Preventive Antibody (Beyfortus, by Sanofi) to Infants ([link removed])
* American Academy of Pediatrics: Nirsevimab Frequently Asked Questions ([link removed]) web page
* Immunize.org: Vaccine A–Z: RSV (Respiratory Syncytial Virus) ([link removed]) main page
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Stay alert for measles cases
Given the 2024 increase in reported U.S. measles cases, Immunize.org reminds healthcare providers to watch for unvaccinated patients with febrile rash and other symptoms of measles (e.g., cough, runny nose, conjunctivitis). According to CDC's Measles Cases and Outbreaks ([link removed]) web page:
* As of September 19, 2024, a total of 262 measles cases were reported by 32 jurisdictions
* Thirteen outbreaks (defined as 3 or more related cases) have been reported in 2024, and 70% of cases (184 of 262) are outbreak-associated. For comparison, 4 outbreaks were reported during 2023 and 49% of cases (29 of 59) were outbreak-associated.
On January 25, 2024, CDC issued a Clinician Outreach and Communication Activity (COCA) Now message titled Stay Alert for Measles Cases ([link removed]). A portion of the message outlining the recommendations for managing a suspected measles case 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.
Related Links
* CDC: Measles Cases and Outbreaks ([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: Vaccines A—Z: Measles ([link removed]) main page
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Encourage COVID-19 and RSV vaccine recipients to enroll in V-safe
V-safe ([link removed]) is CDC’s voluntary smartphone-based vaccine safety monitoring system allowing COVID-19 and RSV vaccine recipients to report their side effects following vaccination. Everyone who offers these vaccines is encouraged to post a sign in the vaccination area encouraging eligible vaccine recipients or their guardians to enroll. It takes just a few minutes to register ([link removed]) using a computer, tablet, or smartphone. After enrolling in V-safe, eligible people will receive periodic, brief, confidential surveys via text messages or emails.
Related Links
* CDC: V-safe ([link removed]) web page
* CDC: V-safe Registration ([link removed]) web page
* CDC: V-safe Frequently Asked Questions ([link removed]) web page
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“Wastewater Surveillance for Influenza A Virus and H5 Subtype Concurrent with the Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in Cattle and Poultry and Associated Human Cases—United States, May 12–July 13, 2024” published in MMWR
CDC published Wastewater Surveillance for Influenza A Virus and H5 Subtype Concurrent with the Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in Cattle and Poultry and Associated Human Cases—United States, May 12–July 13, 2024 ([link removed]) on September 19 in MMWR. A portion of the summary appears below.
Wastewater surveillance can detect influenza A virus and the H5 subtype, although current testing does not distinguish between human and animal sources. . . .
During May 12–July 13, 2024, high influenza A virus levels were detected in wastewater in four states, including three states with seasonal human influenza virus activity noted during this time. The H5 subtype was detected in wastewater in nine states; follow-up investigations in many of these states revealed likely animal-related sources, including those related to milk processing. . . .
Early work to interpret influenza A virus and H5 subtype detections in wastewater can help with public health preparedness and response for the upcoming respiratory illness season.
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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“Why Is Hepatitis A Vaccination, Not IG, Recommended for At-Risk Infant Travelers?”: 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 Why Is Hepatitis A Vaccination, Not IG, Recommended for At-Risk Infant Travelers? ([link removed]). The video briefly describes how the risk of measles among infants who travel internationally relates to the need for HepA vaccination rather than immune globulin.
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.
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.
* Washington Post: FDA Approves First Nasal Spray Flu Vaccine for Use at Home ([link removed]) (9/20/24)
* Tampa Bay Times: Experts Refute Latest Florida Guidance on COVID Vaccine as Flawed and Dangerous ([link removed]) (9/17/24)
* CBS: Experts Warn Against Vaccine Skepticism ([link removed]) (9/15/24)
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Immunize.org Website and Clinical Resources
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Spotlight on the website: Register today for Immunize.org’s new Website Office Hours sessions on October 2 at 4:00 p.m. (ET) and October 3 at 10:00 a.m. (ET)
We want to help you locate what you need on the Immunize.org website quickly and easily. To that end, we are introducing a program of live Website Office Hours sessions with members of our website team. If you have challenges or questions about using our new website, please register for a Website Office Hours session: Wednesday October 2 at 4:00 p.m. (ET) ([link removed]) or Thursday October 3 at 10:00 a.m. (ET) ([link removed]). Initially, we will offer two online Website Office Hours sessions every other week. We will adjust this service as we learn from our experience.
We will open each of the first two sessions with a short, live demonstration on navigating the 1,300 practical clinical questions and answers in our popular Ask the Experts ([link removed]) website section. After the demonstration, you will be able to submit questions through the Q&A box on Zoom. We may not get to every question during a session, but we will hold these sessions regularly and develop additional resources to support users based on your feedback.
Register today for an Immunize.org Website Office Hours session.
* Registration for October 2nd ([link removed])
* Registration for October 3rd ([link removed])
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Recap: Immunize.org updates its “Ask the Experts” web page on COVID-19
Immunize.org updated its "Ask the Experts" web page for COVID-19 vaccine ([link removed]). Updates incorporate new clinical guidance for the use of the 2024–25 COVID-19 vaccines.
Immunize.org's Ask the Experts ([link removed]) main page leads you to 30 distinct web pages on a variety of topics with more than 1,300 common or challenging questions and answers (Q&As) 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 R. Zucker, MD, MPH.
Related Links
* Immunize.org: Ask the Experts: COVID-19 ([link removed]) main page
* Immunize.org: Ask the Experts ([link removed]) main page to access more than 1,300 questions and answers
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Notable Publications
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Recap: “Use of 2024–2025 COVID-19 Vaccines for Persons Aged ≥6 Months: Recommendations of the Advisory Committee on Immunization Practices — United States” published in MMWR Early Release
CDC published Use of 2024–2025 COVID-19 Vaccines for Persons Aged ≥6 Months: Recommendations of the Advisory Committee on Immunization Practices—United States ([link removed]) in the September 10 issue of MMWR Early Release. The summary appears below.
The 2023–2024 COVID-19 vaccines provided protection against SARS-CoV-2 XBB-sublineage strains; however, these strains are no longer predominant in the United States. . . .
On June 27, 2024, the Advisory Committee on Immunization Practices recommended 2024–2025 COVID-19 vaccination with a Food and Drug Administration (FDA)–authorized or approved vaccine for all persons aged ≥6 months. In August 2024, the FDA approved and authorized the Omicron JN.1 lineage (JN.1 and KP.2), 2024–2025 COVID-19 vaccines by Moderna and Pfizer-BioNTech (KP.2 strain) and Novavax (JN.1 strain). . . .
The 2024–2025 COVID-19 vaccines are recommended for all persons aged ≥6 months to target currently circulating SARS-CoV-2 strains and provide additional protection against severe COVID-19–associated illness and death.
Access the MMWR article in HTML ([link removed]).
Related Links
* CDC: MMWR main page ([link removed]) providing access to the MMWR family of publications
* Immunize.org: Vaccines A–Z: COVID-19 ([link removed]) main page
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Recap: "Use of 21-Valent Pneumococcal Conjugate Vaccine among U.S. Adults: Recommendations of the Advisory Committee on Immunization Practices—United States, 2024" published in MMWR
CDC published Use of 21-Valent Pneumococcal Conjugate Vaccine among U.S. Adults: Recommendations of the Advisory Committee on Immunization Practices—United States, 2024 ([link removed]) in the September 12 issue of MMWR ([link removed]). The summary appears below.
On June 27, 2024, the Advisory Committee on Immunization Practices recommended 21-valent PCV (PCV21) as an option for adults aged ≥19 years who are currently recommended to receive PCV15 or PCV20. PCV21 contains eight serotypes not included in other licensed vaccines. . . .
Adding PCV21 as an option in the current PCV recommendation is expected to prevent additional disease caused by pneumococcal serotypes unique to PCV21. Postlicensure monitoring of safety and public health impact of PCV use will guide future recommendations.
As illustrated in the table above, PCV21 (Capvaxive, Merck) is designed to protect against serotypes responsible for disease in adults. Unlike PCV15 (Vaxneuvance, Merck) and PCV20 (Prevnar 20, Pfizer), which are routinely recommended for children, PCV21 does not protect against certain serotypes historically responsible for a significant burden of disease in children that are not significant causes of disease in adults. For this reason, PCV21 is not licensed or recommended for use in children.
Access the MMWR article in HTML ([link removed]) or PDF ([link removed]).
Related Links
* CDC: MMWR main page ([link removed]) providing access to the MMWR family of publications
* Immunize.org: Vaccines A–Z: Pneumococcal ([link removed]) main page
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Recap: "Use of Haemophilus influenzae Type b–Containing Vaccines among American Indian and Alaska Native Infants: Updated Recommendations of the Advisory Committee on Immunization Practices―United States, 2024" published in MMWR
CDC published Use of Haemophilus influenzae Type b–Containing Vaccines among American Indian and Alaska Native Infants: Updated Recommendations of the Advisory Committee on Immunization Practices―United States, 2024 ([link removed]) in the September 12 issue of MMWR ([link removed]). The summary appears below.
Haemophilus influenzae type b (Hib) vaccination with a monovalent Hib conjugate vaccine consisting of Hib capsular polysaccharide (polyribosylribitol phosphate [PRP]) conjugated to the outer membrane protein complex of Neisseria meningitidis serogroup B (PRP-OMP [PedvaxHIB]) has historically been preferred for American Indian and Alaska Native (AI/AN) infants to provide earlier protection in these populations at increased risk for invasive Hib disease. . . .
On June 26, 2024, the Advisory Committee on Immunization Practices recommended that hexavalent Vaxelis (diphtheria and tetanus toxoids and acellular pertussis, inactivated poliovirus, Hib conjugate, and hepatitis B vaccine [DTaP-IPV-Hib-HepB]) should be included with monovalent PRP-OMP in the preferential recommendation for AI/AN infants based on the Hib component. . . .
A primary Hib vaccination series consisting of monovalent PRP-OMP or DTaP-IPV-Hib-HepB is preferred for AI/AN infants.
Access the MMWR article in HTML ([link removed]) or PDF ([link removed]).
Related Links
* CDC: MMWR main page ([link removed]) providing access to the MMWR family of publications
* Immunize.org: Vaccines A–Z: Hib ([link removed]) (Haemophilus influenzae type b) main page
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Upcoming Events
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Virtual: NFID offers 2024 Clinical Vaccinology Course, November 6–8; fee to register (CE credit available)
The NFID ([link removed]) will hold its Clinical Vaccinology Course ([link removed]) online November 6–8. This 3-day online course focuses on new developments and issues related to the use of vaccines. Expert faculty provide the latest information on vaccines, including updated recommendations for vaccinations across the lifespan, and innovative and practical strategies for ensuring timely and appropriate vaccination.
View event details. ([link removed])
Register for the online course ($700 fee) ([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 alink 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])
ISSN: 2771-8085
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Issue 1,777: September 25, 2024
Top Stories
* CDC posts 2024–25 COVID-19 mRNA vaccine standing orders templates and at-a-glance resources. Immunize.org updates “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools.”
* Immunize.org updates “Standing Orders for Administering Respiratory Syncytial Virus Vaccine (RSV) to Adults Age 60 Years and Older”
* Use Immunize.org’s suite of 2024–25 influenza vaccination resources. All now up to date for this season.
* Resume administration of nirsevimab preventive antibody (Beyfortus, Sanofi) to protect infants from RSV beginning October 1 in most jurisdictions
* Stay alert for measles cases
* Encourage COVID-19 and RSV vaccine recipients to enroll in V-safe
* “Wastewater Surveillance for Influenza A Virus and H5 Subtype Concurrent with the Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in Cattle and Poultry and Associated Human Cases—United States, May 12–July 13, 2024” published in MMWR
* “Why Is Hepatitis A Vaccination, Not IG, Recommended for At-Risk Infant Travelers?”: Watch the 2-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: Register today for Immunize.org’s new Website Office Hours sessions on October 2 at 4:00 p.m. (ET) and October 3 at 10:00 a.m. (ET)
* Recap: Immunize.org updates its “Ask the Experts” web page on COVID-19
Notable Publications
* Recap: “Use of 2024–2025 COVID-19 Vaccines for Persons Aged ≥6 Months: Recommendations of the Advisory Committee on Immunization Practices — United States” published in MMWR Early Release
* Recap: "Use of 21-Valent Pneumococcal Conjugate Vaccine among U.S. Adults: Recommendations of the Advisory Committee on Immunization Practices—United States, 2024" published in MMWR
* Recap: "Use of Haemophilus influenzae Type b–Containing Vaccines among American Indian and Alaska Native Infants: Updated Recommendations of the Advisory Committee on Immunization Practices―United States, 2024" published in MMWR
Upcoming Events
* Virtual: NFID offers 2024 Clinical Vaccinology Course, November 6–8; fee to register (CE credit available)
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Top Stories
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CDC posts 2024–25 COVID-19 mRNA vaccine standing orders templates and at-a-glance resources. Immunize.org updates “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools.”
CDC posted highly anticipated new 2024–25 COVID-19 mRNA vaccine resources at its U.S. COVID-19 Vaccine Product Information ([link removed]) main page. This page links to standing orders templates for Pfizer-BioNTech and Moderna mRNA vaccines (each vaccine has one template for young children and a separate one for people age 5 years and older). It also links to at-a-glance summaries for the two mRNA vaccines. Corresponding resources for the 2024–25 Novavax COVID-19 vaccine are coming soon.
Immunize.org reviews its 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. Due to the high priority of these updated CDC resources, Immunize.org revised the checklist for a second time in September.
All COVID-19 vaccine providers should regularly review this checklist. Download the latest documents and discard outdated versions.
Related Links
* Immunize.org: Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools ([link removed]) (PDF)
* Immunize.org: Vaccines A–Z: COVID-19 ([link removed]) main page
* CDC: Interim Clinical Considerations ([link removed]) main page for use of COVID-19 vaccines in the United States
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Immunize.org updates “Standing Orders for Administering Respiratory Syncytial Virus Vaccine (RSV) to Adults Age 60 Years and Older”
Immunize.org updated its clinician resource, Standing Orders for Administering Respiratory Syncytial Virus Vaccine (RSV) to Adults Age 60 Years and Older ([link removed]) to incorporate changes CDC recently made to its website for clinical considerations for RSV vaccination of adults age 60 through 74 ([link removed]) at increased risk of severe disease. The changes to the website align the online guidance with the final, published ACIP recommendation. The following changes were made to the Immunize.org standing orders template:
* The indication for vaccination based on residential setting was limited to nursing homes only. Previously, CDC’s website guidance included residents of nursing homes and other long-term care facilities (LTCFs).
* Examples were added to illustrate the types of people age 60 through 74 without an ACIP-specified risk factor who may, nonetheless, be judged by a clinician to be at increased risk for severe RSV disease
* A note was added to indicate ACIP’s recommendation that a vaccination provider should not deny a patient age 60 through 74 RSV vaccination because they lack documentation of a self-reported risk factor for severe RSV disease
Related Links
* Immunize.org: Vaccine 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
------------------------------------------------------------
Use Immunize.org’s suite of 2024–25 influenza vaccination resources. All now up to date for this season.
Immunize.org completed the annual review of our entire suite of influenza clinical content for the 2024–25 season. In addition to resources that required updates, those that did not require changes to content also have a new date in the footnote to indicate they are current for 2024–25 season. The final batch of updated resources includes:
* Communicating the Benefits of Influenza Vaccination ([link removed]): updated data on influenza disease burden, vaccination rates, and use of the SHARE method for practitioners to use in discussing the value of vaccination (co-developed with the Association of Immunization Managers)
* Declination of Influenza Vaccination ([link removed]): reviewed, no changes to content
* Guide for Determining the Number of Doses of Influenza Vaccine to Give to Children Age 6 Months Through 8 Years ([link removed]): updated date and URL for the ACIP influenza recommendations only
* Talking with Your Patient about Contraindications and Precautions to Influenza Vaccination ([link removed]): added expanded influenza vaccine options for solid organ transplant recipients
* Not Sure If You Can Get an Influenza Vaccine? ([link removed]): updated date and URL for the ACIP influenza recommendations only
* Don’t Take Chances with Your Family’s Health—Make Sure You All Get Vaccinated ([link removed]): reviewed, no changes to content
Find all of our influenza vaccine resources for the 2024–25 season at the Vaccines A–Z: Influenza ([link removed]) main page.
Related Links
* Immunize.org: Vaccines A–Z: Influenza ([link removed]) main page
* Immunize.org: Ask the Experts ([link removed]) main page with more than 1,300 questions and answers
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Resume administration of nirsevimab preventive antibody (Beyfortus, Sanofi) to protect infants from RSV beginning October 1 in most jurisdictions
The 2023 ACIP recommendation for administration of nirsevimab ([link removed]) (Beyfortus, Sanofi), the RSV preventive antibody product recommended as a one-time dose for infants younger than age 8 months born to mothers not effectively vaccinated against RSV during pregnancy, takes into account the seasonality of RSV activity. ACIP recommends that nirsevimab use should generally begin October 1 and end March 31 in jurisdictions with RSV seasonality typical of most of the contiguous United States (the “lower 48”).
Alaska and tropical climates may have RSV circulation patterns that differ from most of the contiguous United States. Locations with tropical climates include southern Florida, Hawaii, Guam, Puerto Rico, U.S. Virgin Islands, and U.S.-affiliated Pacific Islands. Providers in these jurisdictions should follow state or territorial public health guidance on timing of nirsevimab administration.
Healthcare providers should resume age-appropriate nirsevimab administration to eligible infants and high-risk toddlers as of October 1, unless otherwise recommended by your public health department. This includes:
* Infants born from October through March, during their first week of life, if the mother was not effectively vaccinated with Abrysvo (Pfizer) RSV vaccine during pregnancy
* Infants born April through September (younger than age 8 months) as they enter their first RSV season, if the mother was not effectively vaccinated with Abrysvo (Pfizer) RSV vaccine during pregnancy
* Children age 8 through 19 months entering their second RSV season who are at increased risk of severe RSV disease (e.g., American Indian and Alaska Native children, children with chronic lung disease of prematurity, severe immunocompromise, cystic fibrosis with growth under 10th percentile), regardless of history of maternal vaccination
Providers are encouraged to send reminders to parents of high-risk infants age 8 through 19 months who need a dose this fall.
See Immunize.org’s standing orders template for the use of nirsevimab ([link removed]) to review details of recommendations, including dosing, criteria for nirsevimab use in high-risk children during their second RSV season, and guidance for rare circumstances when nirsevimab is recommended for an infant younger than age 8 months despite maternal RSV vaccination.
Related Links
* CDC: 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)
* CDC: Frequently Asked Questions about RSV Immunization with Monoclonal Antibody for Children 19 Months and Younger ([link removed]) main page
* Immunize.org: Standing Orders for Administering Nirsevimab RSV Preventive Antibody (Beyfortus, by Sanofi) to Infants ([link removed])
* American Academy of Pediatrics: Nirsevimab Frequently Asked Questions ([link removed]) web page
* Immunize.org: Vaccine A–Z: RSV (Respiratory Syncytial Virus) ([link removed]) main page
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Stay alert for measles cases
Given the 2024 increase in reported U.S. measles cases, Immunize.org reminds healthcare providers to watch for unvaccinated patients with febrile rash and other symptoms of measles (e.g., cough, runny nose, conjunctivitis). According to CDC's Measles Cases and Outbreaks ([link removed]) web page:
* As of September 19, 2024, a total of 262 measles cases were reported by 32 jurisdictions
* Thirteen outbreaks (defined as 3 or more related cases) have been reported in 2024, and 70% of cases (184 of 262) are outbreak-associated. For comparison, 4 outbreaks were reported during 2023 and 49% of cases (29 of 59) were outbreak-associated.
On January 25, 2024, CDC issued a Clinician Outreach and Communication Activity (COCA) Now message titled Stay Alert for Measles Cases ([link removed]). A portion of the message outlining the recommendations for managing a suspected measles case 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.
Related Links
* CDC: Measles Cases and Outbreaks ([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: Vaccines A—Z: Measles ([link removed]) main page
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Encourage COVID-19 and RSV vaccine recipients to enroll in V-safe
V-safe ([link removed]) is CDC’s voluntary smartphone-based vaccine safety monitoring system allowing COVID-19 and RSV vaccine recipients to report their side effects following vaccination. Everyone who offers these vaccines is encouraged to post a sign in the vaccination area encouraging eligible vaccine recipients or their guardians to enroll. It takes just a few minutes to register ([link removed]) using a computer, tablet, or smartphone. After enrolling in V-safe, eligible people will receive periodic, brief, confidential surveys via text messages or emails.
Related Links
* CDC: V-safe ([link removed]) web page
* CDC: V-safe Registration ([link removed]) web page
* CDC: V-safe Frequently Asked Questions ([link removed]) web page
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“Wastewater Surveillance for Influenza A Virus and H5 Subtype Concurrent with the Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in Cattle and Poultry and Associated Human Cases—United States, May 12–July 13, 2024” published in MMWR
CDC published Wastewater Surveillance for Influenza A Virus and H5 Subtype Concurrent with the Highly Pathogenic Avian Influenza A(H5N1) Virus Outbreak in Cattle and Poultry and Associated Human Cases—United States, May 12–July 13, 2024 ([link removed]) on September 19 in MMWR. A portion of the summary appears below.
Wastewater surveillance can detect influenza A virus and the H5 subtype, although current testing does not distinguish between human and animal sources. . . .
During May 12–July 13, 2024, high influenza A virus levels were detected in wastewater in four states, including three states with seasonal human influenza virus activity noted during this time. The H5 subtype was detected in wastewater in nine states; follow-up investigations in many of these states revealed likely animal-related sources, including those related to milk processing. . . .
Early work to interpret influenza A virus and H5 subtype detections in wastewater can help with public health preparedness and response for the upcoming respiratory illness season.
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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“Why Is Hepatitis A Vaccination, Not IG, Recommended for At-Risk Infant Travelers?”: 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 Why Is Hepatitis A Vaccination, Not IG, Recommended for At-Risk Infant Travelers? ([link removed]). The video briefly describes how the risk of measles among infants who travel internationally relates to the need for HepA vaccination rather than immune globulin.
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.
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.
* Washington Post: FDA Approves First Nasal Spray Flu Vaccine for Use at Home ([link removed]) (9/20/24)
* Tampa Bay Times: Experts Refute Latest Florida Guidance on COVID Vaccine as Flawed and Dangerous ([link removed]) (9/17/24)
* CBS: Experts Warn Against Vaccine Skepticism ([link removed]) (9/15/24)
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Immunize.org Website and Clinical Resources
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Spotlight on the website: Register today for Immunize.org’s new Website Office Hours sessions on October 2 at 4:00 p.m. (ET) and October 3 at 10:00 a.m. (ET)
We want to help you locate what you need on the Immunize.org website quickly and easily. To that end, we are introducing a program of live Website Office Hours sessions with members of our website team. If you have challenges or questions about using our new website, please register for a Website Office Hours session: Wednesday October 2 at 4:00 p.m. (ET) ([link removed]) or Thursday October 3 at 10:00 a.m. (ET) ([link removed]). Initially, we will offer two online Website Office Hours sessions every other week. We will adjust this service as we learn from our experience.
We will open each of the first two sessions with a short, live demonstration on navigating the 1,300 practical clinical questions and answers in our popular Ask the Experts ([link removed]) website section. After the demonstration, you will be able to submit questions through the Q&A box on Zoom. We may not get to every question during a session, but we will hold these sessions regularly and develop additional resources to support users based on your feedback.
Register today for an Immunize.org Website Office Hours session.
* Registration for October 2nd ([link removed])
* Registration for October 3rd ([link removed])
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Recap: Immunize.org updates its “Ask the Experts” web page on COVID-19
Immunize.org updated its "Ask the Experts" web page for COVID-19 vaccine ([link removed]). Updates incorporate new clinical guidance for the use of the 2024–25 COVID-19 vaccines.
Immunize.org's Ask the Experts ([link removed]) main page leads you to 30 distinct web pages on a variety of topics with more than 1,300 common or challenging questions and answers (Q&As) 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 R. Zucker, MD, MPH.
Related Links
* Immunize.org: Ask the Experts: COVID-19 ([link removed]) main page
* Immunize.org: Ask the Experts ([link removed]) main page to access more than 1,300 questions and answers
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Notable Publications
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Recap: “Use of 2024–2025 COVID-19 Vaccines for Persons Aged ≥6 Months: Recommendations of the Advisory Committee on Immunization Practices — United States” published in MMWR Early Release
CDC published Use of 2024–2025 COVID-19 Vaccines for Persons Aged ≥6 Months: Recommendations of the Advisory Committee on Immunization Practices—United States ([link removed]) in the September 10 issue of MMWR Early Release. The summary appears below.
The 2023–2024 COVID-19 vaccines provided protection against SARS-CoV-2 XBB-sublineage strains; however, these strains are no longer predominant in the United States. . . .
On June 27, 2024, the Advisory Committee on Immunization Practices recommended 2024–2025 COVID-19 vaccination with a Food and Drug Administration (FDA)–authorized or approved vaccine for all persons aged ≥6 months. In August 2024, the FDA approved and authorized the Omicron JN.1 lineage (JN.1 and KP.2), 2024–2025 COVID-19 vaccines by Moderna and Pfizer-BioNTech (KP.2 strain) and Novavax (JN.1 strain). . . .
The 2024–2025 COVID-19 vaccines are recommended for all persons aged ≥6 months to target currently circulating SARS-CoV-2 strains and provide additional protection against severe COVID-19–associated illness and death.
Access the MMWR article in HTML ([link removed]).
Related Links
* CDC: MMWR main page ([link removed]) providing access to the MMWR family of publications
* Immunize.org: Vaccines A–Z: COVID-19 ([link removed]) main page
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Recap: "Use of 21-Valent Pneumococcal Conjugate Vaccine among U.S. Adults: Recommendations of the Advisory Committee on Immunization Practices—United States, 2024" published in MMWR
CDC published Use of 21-Valent Pneumococcal Conjugate Vaccine among U.S. Adults: Recommendations of the Advisory Committee on Immunization Practices—United States, 2024 ([link removed]) in the September 12 issue of MMWR ([link removed]). The summary appears below.
On June 27, 2024, the Advisory Committee on Immunization Practices recommended 21-valent PCV (PCV21) as an option for adults aged ≥19 years who are currently recommended to receive PCV15 or PCV20. PCV21 contains eight serotypes not included in other licensed vaccines. . . .
Adding PCV21 as an option in the current PCV recommendation is expected to prevent additional disease caused by pneumococcal serotypes unique to PCV21. Postlicensure monitoring of safety and public health impact of PCV use will guide future recommendations.
As illustrated in the table above, PCV21 (Capvaxive, Merck) is designed to protect against serotypes responsible for disease in adults. Unlike PCV15 (Vaxneuvance, Merck) and PCV20 (Prevnar 20, Pfizer), which are routinely recommended for children, PCV21 does not protect against certain serotypes historically responsible for a significant burden of disease in children that are not significant causes of disease in adults. For this reason, PCV21 is not licensed or recommended for use in children.
Access the MMWR article in HTML ([link removed]) or PDF ([link removed]).
Related Links
* CDC: MMWR main page ([link removed]) providing access to the MMWR family of publications
* Immunize.org: Vaccines A–Z: Pneumococcal ([link removed]) main page
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Recap: "Use of Haemophilus influenzae Type b–Containing Vaccines among American Indian and Alaska Native Infants: Updated Recommendations of the Advisory Committee on Immunization Practices―United States, 2024" published in MMWR
CDC published Use of Haemophilus influenzae Type b–Containing Vaccines among American Indian and Alaska Native Infants: Updated Recommendations of the Advisory Committee on Immunization Practices―United States, 2024 ([link removed]) in the September 12 issue of MMWR ([link removed]). The summary appears below.
Haemophilus influenzae type b (Hib) vaccination with a monovalent Hib conjugate vaccine consisting of Hib capsular polysaccharide (polyribosylribitol phosphate [PRP]) conjugated to the outer membrane protein complex of Neisseria meningitidis serogroup B (PRP-OMP [PedvaxHIB]) has historically been preferred for American Indian and Alaska Native (AI/AN) infants to provide earlier protection in these populations at increased risk for invasive Hib disease. . . .
On June 26, 2024, the Advisory Committee on Immunization Practices recommended that hexavalent Vaxelis (diphtheria and tetanus toxoids and acellular pertussis, inactivated poliovirus, Hib conjugate, and hepatitis B vaccine [DTaP-IPV-Hib-HepB]) should be included with monovalent PRP-OMP in the preferential recommendation for AI/AN infants based on the Hib component. . . .
A primary Hib vaccination series consisting of monovalent PRP-OMP or DTaP-IPV-Hib-HepB is preferred for AI/AN infants.
Access the MMWR article in HTML ([link removed]) or PDF ([link removed]).
Related Links
* CDC: MMWR main page ([link removed]) providing access to the MMWR family of publications
* Immunize.org: Vaccines A–Z: Hib ([link removed]) (Haemophilus influenzae type b) main page
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Upcoming Events
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Virtual: NFID offers 2024 Clinical Vaccinology Course, November 6–8; fee to register (CE credit available)
The NFID ([link removed]) will hold its Clinical Vaccinology Course ([link removed]) online November 6–8. This 3-day online course focuses on new developments and issues related to the use of vaccines. Expert faculty provide the latest information on vaccines, including updated recommendations for vaccinations across the lifespan, and innovative and practical strategies for ensuring timely and appropriate vaccination.
View event details. ([link removed])
Register for the online course ($700 fee) ([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 alink 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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