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Issue 1493: May 6, 2020

-TOP STORIES-
* IAC Commentary: Society wants a COVID-19 vaccine—it’s not just a matter of when, but also how much and for whom (part 1)
* Immunize Colorado executive director discusses the urgent need for maintaining routine immunizations during the COVID-19 pandemic
* FDA licenses MenQuadfi (Sanofi Pasteur) for prevention of invasive meningococcal disease caused by serogroups A, C, W, and Y in individuals 2 years of age and older
* IAC Spotlight! These IAC patient and staff educational materials were updated in March and April
* Not-to-miss immunization articles in the news
* Stay up to date on the latest coronavirus information

-IAC HANDOUTS-
* New! IAC handout titled “Adult Immunization: Importance of Staying Up to Date with Vaccines”
* IAC updates three patient sheets on vaccines needed by adults with high-risk conditions: heart disease, lung disease, and those without a spleen
* IAC posts update to popular handout “Which Vaccines Do I Need Today?”
* IAC revises handout “Vaccinations for Men Who Have Sex with Men”

-FEATURED RESOURCES-
* “Shop IAC” on immunize.org offers many resources for your practice. Order laminated 2020 U.S. immunization schedules for your exam rooms today!

-JOURNAL ARTICLES AND NEWSLETTERS-
* CDC publishes April issue of Immunization Works newsletter
* “State Policies on Access to Vaccination Services for Low-Income Adults” published in JAMA
* “Use of Standing Orders for Vaccination among Pediatricians” published in Pediatrics
* “Improving Birth Dose Hepatitis B Vaccination Rates: A Quality Improvement Intervention” published in Hospital Pediatrics
* “Effect of State Immunization Information System Centralized Reminder and Recall on HPV Vaccination Rates” published in Pediatrics
* “Vaccines Are Integral Part of Chronic Disease Management” published in Becker’s Hospital Review

EDUCATION AND TRAINING
* This week's "Video of the Week" explains the updated pneumococcal vaccine recommendations for older adults
* CDC and Public Health Foundation will host webinar on vaccinating adults with chronic conditions on May 28

-ON THE LIGHTER SIDE-
* Animated music video, “The Vaccine Song,” promotes childhood vaccination with wit

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-TOP STORIES-
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IAC COMMENTARY: SOCIETY WANTS A COVID-19 VACCINE—IT’S NOT JUST A MATTER OF WHEN, BUT ALSO HOW MUCH AND FOR WHOM (PART 1)

by John D. Grabenstein, RPh, PhD, IAC Express associate editor

News channels are full of stories about this or that SARS-CoV-2 (COVID-19) vaccine candidate advancing to this or that stage of clinical development. Some people are confident a vaccine will be available within X months, while others counsel that it could be Y months or longer.

IAC Express is not bringing stories of this slow-motion horse race to you, because it’s not information you can act on. Whichever vaccine candidate is first over the finish line, there won’t be enough of it at first, not for a country with 325+ million people, nor a planet with 7.8+ billion people.

Let’s be clear about that “finish line.” It is not a day when some big box arrives with enough vaccine for everybody served by your site. It will be the day when there is just enough evidence for efficacy and just enough evidence for safety to vaccinate somewhat more broadly.

On April 30, the New York Times ran an excellent article, How Long Will a Vaccine Really Take? ([link removed]) , by Stuart Thompson, that graphically explains how typical vaccine-development timelines are being compressed to deliver one or more SARS-CoV-2 vaccines as soon as feasible. As can be seen on the graphic (click the graphic’s buttons to see which modifications yield time gains of what size), compressing the timeline largely comes from conducting various steps simultaneously. The pharmaceutical industry refers to this as doing things “at risk,” meaning at risk of waste or futility. Some dollars will be wasted, with an understanding that paying for several simultaneous efforts may help to get to at least one successful vaccine sooner, even if inefficiently.

Next week, in IAC Express issue #1494, we’ll consider “for whom” and how to get ready.

Related Links
* New York Times: How Long Will a Vaccine Really Take? ([link removed]) (4/30/20)
* WebMD: Finish Line Unpredictable for COVID Vaccine Race ([link removed]) (4/24/20)
* Newsday: A Vaccination Magic Bullet? ([link removed]) (4/29/20)
* New York Times: Profits and Pride at Stake, the Race for a Vaccine Intensifies ([link removed]) (5/2/20)
* Washington Post: Inside the Extraordinary Race to Invent a Coronavirus Vaccine ([link removed]) (5/2/20)

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IMMUNIZE COLORADO EXECUTIVE DIRECTOR DISCUSSES THE URGENT NEED FOR MAINTAINING ROUTINE IMMUNIZATIONS DURING THE COVID-19 PANDEMIC

Immunize Colorado published Maintaining Routine Immunizations during the Pandemic: An Urgent Growing Need ([link removed]), by the executive director, Stephanie Wasserman, on April 27.

Ms. Wasserman notes that shelter-in-place orders due to COVID-19 are keeping families in their homes, which have led to cancellations of well-care visits and an adverse effect on routine immunization rates. She writes:

Maintaining routine immunization during the pandemic is critical especially for children age 24 months or younger, pregnant women, seniors and people with chronic diseases. Many major health professional organizations such as the American Academy of Pediatrics, the American Academy of Family Physicians and World Health Organization have issued interim guidelines for maintaining immunizations…

Related Links
* Immunize Colorado's Maintaining Routine Immunizations During the Pandemic: An Urgent Growing Need ([link removed]) web page
* CDC’s Information for Pediatric Healthcare Providers: Maintaining Childhood Immunizations during COVID-19 Pandemic ([link removed]) web page
* CDC's Resources for Hospitals and Healthcare Professionals Preparing for Patients with Suspected or Confirmed COVID-19 ([link removed]) gateway page
* AAFP's COVID-19: Guidance for Family Physicians on Preventive and Non-urgent Care ([link removed])
* AAP's COVID-19 Clinical Guidance Q&A ([link removed]) web page

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FDA LICENSES MENQUADFI (SANOFI PASTEUR) FOR PREVENTION OF INVASIVE MENINGOCOCCAL DISEASE CAUSED BY SEROGROUPS A, C, W, AND Y IN INDIVIDUALS 2 YEARS OF AGE AND OLDER

On April 23, the FDA issued an approval letter ([link removed]) for MenQuadfi (Sanofi Pasteur), a vaccine for individuals 2 years of age and older to help prevent invasive meningococcal disease (including meningitis) caused by Neisseria meningitidis serogroups A, C, W, and Y. MenQuadfi does not prevent serogroup B disease. MenQuadfi is expected to be available to providers and pharmacies in the U.S. in 2021.

Related Links
* FDA approval letter for MenQuadfi vaccine ([link removed])
* Package insert for MenQuadfi vaccine ([link removed])
* FDA web page for MenQuadfi vaccine ([link removed])
* Sanofi Pasteur news release for MenQuadfi ([link removed]) (4/23/20)
* IAC’s Package Inserts and FDA Product Approvals ([link removed]) gateway page

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IAC SPOTLIGHT! THESE IAC PATIENT AND STAFF EDUCATIONAL MATERIALS WERE UPDATED IN MARCH AND APRIL

IAC Express regularly provides readers with information about IAC’s new and updated educational materials for healthcare professionals and handouts for patients. All materials are free to download, print, and distribute.

In case you missed them during recent weeks, these helpful materials were announced:

Staff Education Materials
* New! Science Supports Our Confidence in Vaccines ([link removed])
* New! The Vaccine Injury Compensation Program of 1986: An Effective Balance of Public Health and Personal Remedy ([link removed])
* Dates of Current Vaccine Information Statements (VISs) ([link removed])
* You Must Provide Patients with Vaccine Information Statements (VISs)—It's Federal Law! ([link removed])
* Hepatitis B and Healthcare Personnel ([link removed])
* Before You Vaccinate Adults, Consider Their "H-A-L-O"! ([link removed])
* DTaP, Tdap, and Td Catch-Up Vaccination Recommendations by Prior Vaccine History and Age ([link removed])
* Standing Orders for Administering Td/Tdap Vaccine to Adults ([link removed])
* Pneumococcal Vaccines: IAC Answers Your Questions ([link removed])
* Pneumococcal Vaccination Recommendations for Children and Adults by Age and/or Risk Factor ([link removed])
* Meningococcal ACWY Vaccine Recommendations by Age and Risk Factor ([link removed])

Handouts for Your Patients
* Pneumococcus: Questions and Answers ([link removed])
* Protect Yourself from Pneumococcal Disease…Get Vaccinated! ([link removed]) Also available in Spanish ([link removed])
* Human Papillomavirus (HPV): Questions and Answers ([link removed])
* Human Papillomavirus: A Parent’s Guide to Preteen and Teen HPV Vaccination ([link removed])
* HPV Vaccine: A Guide for Adults Ages 18–26 Years ([link removed])
* Protect Yourself from HPV…Get Vaccinated! ([link removed]) Also available in Spanish ([link removed])
* Protect Yourself from Hepatitis A…Get Vaccinated! ([link removed]) Also available in Spanish ([link removed])

Related Links
* IAC’sHandouts ([link removed]) gateway page to see educational materials sorted by category
* IAC's Ask the Experts ([link removed]) gateway page to access more than 1,000 questions answered by IAC experts
* IAC'sClinic Tools ([link removed]) gateway page and its seven subtopics
* IACEducational Materials for Patients and Staff ([link removed]) —an alphabetical listing of more than 300 ready-to-print staff educational materials and patient handouts

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NOT-TO-MISS IMMUNIZATION ARTICLES IN THE NEWS

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* New York Times: Coronavirus as a Reminder of the Urgency of Getting Your Vaccines ([link removed]) (4/27/20)
* FactCheck.org: No Evidence That Flu Shot Increases Risk of COVID-19 ([link removed]) (4/27/20)
* Washington Post: Anti-vaxxers Will Fight the Eventual Coronavirus Vaccine. Here’s How to Stop Them. ([link removed]) (4/29/20)
* Children’s Hospital of Philadelphia: News & Views: Are You Still Vaccinating during the Coronavirus Pandemic? ([link removed]) (4/23/20)
* ABC News: UN: New Polio Outbreak in Niger after Vaccination Suspended ([link removed]) (4/29/20)

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STAY UP TO DATE ON THE LATEST CORONAVIRUS INFORMATION

CDC, NIH, WHO, and Johns Hopkins are closely monitoring the SARS-CoV-2 ([link removed]) pandemic. Be sure to check the resources below for the latest information. Stay in touch with your local and state health departments.

Related Links
* CDC’s COVID-19 gateway page, CDC.gov/coronavirus ([link removed]) , links to CDC’s Situation Summary ([link removed]) web page and Latest News ([link removed]) web page. The COVIDView gateway page ([link removed]) summarizes the epidemiologic intelligence.
* NIH's Coronavirus (COVID-19) ([link removed]) gateway page links to news releases on vaccine trials
* WHO's Coronavirus Disease (COVID-19) Outbreak ([link removed]) gateway page links to WHO’s Situation Reports ([link removed]) web page
* Johns Hopkins' Coronavirus Resource Center ([link removed]) gateway page links to the Coronavirus COVID-19 Global Cases CSSE ([link removed]) web page
* Eriksen's COVID-19 Resources to Support Accurate Translation ([link removed]) web page


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-IAC HANDOUTS-
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NEW! IAC HANDOUT TITLED “ADULT IMMUNIZATION: IMPORTANCE OF STAYING UP TO DATE WITH VACCINES"

IAC posted a new handout titled Adult Immunization: Importance of Staying Up to Date with Vaccines ([link removed]) . This one-page handout was created to give an overview of the importance of adult vaccinations.

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Related Links
* IAC's Handouts: Adult Vaccination ([link removed]) gateway page
* IAC’s Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials by topic, vaccine, or language
* IAC’s Educational Materials for Patients and Staff ([link removed]) —an alphabetical listing of more than 300 ready-to-print staff educational materials and patient handouts

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IAC UPDATES THREE PATIENT SHEETS ON VACCINES NEEDED BY ADULTS WITH HIGH-RISK CONDITIONS: HEART DISEASE, LUNG DISEASE, AND THOSE WITHOUT A SPLEEN

IAC recently revised three of its one-page handouts describing vaccines needed by adults with high-risk conditions.

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* Vaccinations for Adults with Heart Disease ([link removed]) : Changes were made to MenACWY information and to incorporate recently updated ACIP recommendations for HPV, MenB, PCV13, and Tdap
* Vaccinations for Adults with Lung Disease ([link removed]) : Changes were made to MenACWY information and to incorporate recently updated ACIP recommendations for HPV, MenB, PCV13, and Tdap
* Vaccinations for Adults Without a Spleen: ([link removed]) Changes were made to incorporate recently updated ACIP recommendations for HPV, MenB, and Tdap

Related Links
* IAC's Vaccinations for Adults You’re Never Too Old to Get Vaccinated! ([link removed])
* IAC’s Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials by topic, vaccine, or language
* IACEducational Materials for Patients and Staff ([link removed]) —an alphabetical listing of more than 300 ready-to-print staff educational materials and patient handouts

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IAC POSTS UPDATE TO POPULAR HANDOUT “WHICH VACCINES DO I NEED TODAY?”

IAC recently revised Which Vaccines Do I Need Today? ([link removed]) Multiple changes were made to conform to revised ACIP recommendations for HPV, MenB, PPSV23, and Tdap.

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Related Links
* IAC’s Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials by topic, vaccine, or language
* IACEducational Materials for Patients and Staff ([link removed]) —an alphabetical listing of more than 300 ready-to-print staff educational materials and patient handouts

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IAC REVISES HANDOUT “VACCINATIONS FOR MEN WHO HAVE SEX WITH MEN"

IAC recently revised Vaccinations for Men Who Have Sex with Men ([link removed]) . Changes were made to MenACWY information and to incorporate recently updated ACIP recommendations for MenB, PCV13, and Tdap.

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Related Links
* IAC’s Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials by topic, vaccine, or language
* IAC’s Educational Materials for Patients and Staff ([link removed]) —an alphabetical listing of more than 300 ready-to-print staff educational materials and patient handouts

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-FEATURED RESOURCES-
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“SHOP IAC” ON IMMUNIZE.ORG OFFERS MANY RESOURCES FOR YOUR PRACTICE. ORDER LAMINATED 2020 U.S. IMMUNIZATION SCHEDULES FOR YOUR EXAM ROOMS TODAY!

On the Shop IAC ([link removed]) web page you will find many resources such as laminated vaccination schedules, personal immunization record cards, pins for your lapel, and more! Your purchases will help IAC keep delivering free, educational materials to healthcare professionals and to the public.

IAC's laminated versions of the 2020 U.S. child/adolescent immunization schedule ([link removed]) and the 2020 U.S. adult immunization schedule ([link removed]) are ideal for use in any busy healthcare setting where vaccinations are given.

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The schedules' coating can be wiped down, and they’re durable enough to stand up to a year's worth of use. Visit the Shop IAC: Laminated Schedule ([link removed]) s web page for more information on the schedules.

IAC’s three personal immunization record cards—child & teen, adult, and lifetime ([link removed]) —are printed on durable rip-, smudge-, and water-proof paper. Sized to fit in a wallet when folded, the cards are brightly colored to stand out. Give these nearly indestructible personal record cards to your patients. They're sold in boxes of 250.

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You too can show your support for vaccination with IAC’s elegantly designed “Vaccines Save Lives” pin ([link removed]) on your lapel. The pin makes a refined statement in hard black enamel with gold lettering and edges, measuring 1.125" x 0.75”. Order yours today to show how much you value immunizations!

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NOTE: Our online shopping cart will continue to operate during Minnesota's reduction to essential services. The IAC office will make shipments once per week. If your need for an item is urgent, please email us at [email protected] (mailto:[email protected]) .

Related Links:
* IAC’s Laminated Child/Adolescent Immunization Schedule ([link removed]) (0–18 years)
* IAC’s Laminated Adult Immunization Schedule ([link removed]) (19 and older)
* IAC’s Laminated Schedules print-ready order form ([link removed]) (PDF)
* IAC’s Child & Teen Immunization Record Cards ([link removed])
* IAC’s Adult Immunization Record Cards ([link removed])
* IAC's Lifetime Immunization Record Cards ([link removed])
* IAC’s “Vaccines Save Lives” pins ([link removed])
* IAC’s Shop IAC ([link removed]) gateway page

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-JOURNAL ARTICLES AND NEWSLETTERS-
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CDC publishes April issue of Immunization Works newsletter

CDC recently released the April issue ([link removed]) of its monthly newsletter Immunization Works. The newsletter offers the immunization community information about current topics. The information is in the public domain and can be reproduced and circulated widely.

Related Links
* CDC's Immunization Works April 2020 ([link removed]) (latest issue)
* CDC's Immunization Works ([link removed]) gateway page with links to archives
* CDC'sSubscription Service ([link removed]) web page

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“State Policies on Access to Vaccination Services for Low-Income Adults” published in JAMA

In its April 27, 2020, issue, JAMA published State Policies on Access to Vaccination Services for Low-Income Adults ([link removed]) , by Charleigh J. Granade, et al. The conclusions appear below.

CONCLUSIONS: ...In many jurisdictions, adult Medicaid beneficiaries lack access to the full slate of ACIP-recommended vaccines. Even in programs providing complete vaccination coverage benefits, reimbursement amounts to health care professionals for vaccine purchase and administration may not fully cover costs to provide vaccination, disincentivizing health care professionals to vaccinate low-income adults. Increased vaccination coverage benefits parity across Medicaid programs and between traditionally eligible and expansion adult populations could decrease income-based health disparities and reduce the proportion of limited program funds expended to treat vaccine-preventable diseases.
Related Link
* JAMA: Continued Challenges with Medicaid Coverage of Adult Vaccines and Vaccination Services ([link removed]) (4/27/20)

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“Use of Standing Orders for Vaccination among Pediatricians” published in Pediatrics

In the May 2020 issue, Pediatrics published Use of Standing Orders for Vaccination among Pediatricians ([link removed]) , by Jessica Cataldi, et al. The conclusions appear below.

CONCLUSIONS: Among pediatricians, use of standing orders for vaccination is far from universal. Interventions to increase use of standing orders should address physicians’ attitudinal barriers as well as organizational factors.

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“Improving Birth Dose Hepatitis B Vaccination Rates: A Quality Improvement Intervention” published in Hospital Pediatrics

In its May 2020 issue, Hospital Pediatrics published Improving Birth Dose Hepatitis B Vaccination Rates: A Quality Improvement Intervention ([link removed]) by Jessica Cataldi, et al. The conclusions appear below.

CONCLUSIONS: Multidisciplinary collaboration, scripting, and provider and staff education regarding the risks of hepatitis B virus, benefits of HepB vaccine, and strategies to discuss HepB vaccination with parents significantly increased vaccination rates. Further efforts to improve vaccination rates to within 12 hours are preferable.

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“Effect of State Immunization Information System Centralized Reminder and Recall on HPV Vaccination Rates” published in Pediatrics

In its May 2020 issue, Pediatrics published Effect of State Immunization Information System Centralized Reminder and Recall on HPV Vaccination Rates ([link removed]) , by Peter Szilagyi, et al. The background and conclusions appear below.

BACKGROUND: Although autodialer centralized reminder and recall (C-R/R) from state immunization information systems (IISs) has been shown to raise childhood vaccination rates, its impact on human papillomavirus (HPV) vaccination rates is unclear.

CONCLUSIONS: IIS-based C-R/R for HPV vaccination did not improve HPV vaccination rates in New York and increased vaccination rates slightly in Colorado.

Related Link
* Pediatrics: Optimizing Human Papillomavirus Immunization: The Role of Centralized Reminder and Recall Systems ([link removed]) (5/2020)

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“Vaccines Are Integral Part of Chronic Disease Management” published in Becker’s Hospital Review

In its April 30, 2020, issue, Becker's Hospital Review, in collaboration with Immunization Action Coalition, published Vaccines Are Integral Part of Chronic Disease Management ([link removed]) . The call to action appears below.

Multiple resources are available to assist healthcare professionals with implementing CDC’s immunization recommendations, including a CDC immunization app and CDC patient and provider communications, tools at www.immunize.org ([link removed]) and the National Adult and Influenza Immunization (www.izsummitpartners.org ([link removed]) ), and through each state's immunization program (www.immunizationmanagers.org/page/mempage.) Additionally, previous Becker publications exist to support the implementation of adult immunization programs within healthcare systems….

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EDUCATION AND TRAINING
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THIS WEEK'S "VIDEO OF THE WEEK" EXPLAINS THE UPDATED PNEUMOCOCCAL VACCINE RECOMMENDATIONS FOR OLDER ADULTS

Dr. Miwako Kobayashi, medical epidemiologist at CDC, reviews revised recommendations for PCV13 and PPSV23. Medscape login is required.

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Visit the VOTW archive ([link removed]) .

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CDC AND PUBLIC HEALTH FOUNDATION WILL HOST WEBINAR ON VACCINATING ADULTS WITH CHRONIC CONDITIONS ON MAY 28

The Public Health Foundation is hosting a CDC webinar, Vaccinating Adults with Chronic Conditions: Recommendations and Lessons Learned ([link removed]) , on May 28 at 3:00 p.m. (ET). Three physicians will discuss vaccine recommendations and strategies for increasing immunization among adults with heart disease, lung disease, and diabetes. Speakers will include Sarah Coles, MD, Sandra Adamson Fryhofer, MD, MACP, FRCP, and Lt. Cmdr. Tara Jatlaoui, MD, MPH (USPHS).

Register for the webinar ([link removed]).

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-ON THE LIGHTER SIDE-
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ANIMATED MUSIC VIDEO, “THE VACCINE SONG,” PROMOTES CHILDHOOD VACCINATION WITH WIT
The Vaccine Song ([link removed]) , a witty, animated video from 2010, part of a collection curated by vaccine expert William Atkinson, MD, MPH, offers a look at childhood vaccine advocacy.

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Video of the Week
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Updated Pneumococcal Vaccine Recommendations for Older Adults: Dr. Kobayashi, medical epidemiologist at CDC, says that for adults 65 and older, PCV13 is now recommended on the basis of shared clinical decision-making by provider and patient rather than routinely. PCV13 is still recommended routinely for older adults with certain medical conditions, and PPSV23 is still a routine recommendation for adults 65 and older. Medscape login is required.
Visit the VOTW archive ([link removed])
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Follow Us
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Technically Speaking
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Read Dr. Wexler's column for the Vaccine Education Center's monthly newsletter, Vaccine Update

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Vaccinating Adults:
A Step-by-Step Guide
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IAC's 142-page book available for free download ([link removed]) .

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Calendar of Events
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Conferences, meetings, and training opportunities

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Patient Record Cards
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Record cards for patients – child & teen ([link removed]) , adult ([link removed]) , and lifetime ([link removed]) – are printed on durable paper and sized to fit in a wallet when folded

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DVD: Immunization Techniques
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Every practice should have this award winning, "how-to" training video

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Protect Newborns Guidebook

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Comprehensive guide Hepatitis B: What Hospitals Need to Do to Protect Newborns ([link removed])

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Editorial Information

Editor
Deborah L. Wexler, MD (mailto:[email protected])

Associate Editors
Carolyn Bridges, MD, MPH (mailto:[email protected])
John D. Grabenstein, RPh, PhD (mailto:[email protected])
Sharon Humiston, MD, MPH (mailto:[email protected])

Consulting Editors
Taryn Chapman, MS (mailto:[email protected])
Marian Deegan, JD (mailto:[email protected])
Courtnay Londo, MA (mailto:[email protected])
Jane Myers, MA, EdM (mailto:[email protected])

Technical Editor
Liv Augusta Anderson, MPP (mailto:[email protected])

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About IAC Express
The Immunization Action Coalition welcomes redistribution of this issue of IAC Express or selected articles. When you do so, please add a note that the Immunization Action Coalition is the source of the material and provide a link to this issue. ([link removed])

IAC Express is supported in part by Grant No.
6NH23IP922550 from the National Center for Immunization and Respiratory Diseases, CDC.

IAC Express Disclaimer ([link removed])
ISSN: 1526-1786
Our mailing address is
2550 University Avenue West, Suite 415 North
Saint Paul, MN 55114


Copyright (C) 2020 Immunization Action Coalition
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