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Issue 1,815: May 28, 2025
Top Stories
* FDA licenses Novavax COVID-19 Vaccine (Nuvaxovid) for selected adults; ACIP will consider recommendations for its use at its June meeting (#IZX1)
* Immunize​.org posts Pohnpeian translations of 16 VISs (#IZX2)
* Immunize​.org updates references in three more standing orders templates (#IZX3)
* Confirmed measles cases increase to 1,046 across 30 states; encourage vaccination (#IZX4)
* Questions about our website? Use your smartphone to watch our 2-minute video to learn about joining our live Website Office Hours. (#IZX5)
* Vaccines in the news (#IZX6)


Immunize​.org Website and Clinical Resources
* Spotlight on the website: State Immunization Websites and Additional State Resources (#IZX7)
* Recap: Immunize​.org updates web link in “Vaccine Storage Troubleshooting Record” (#IZX8)


Featured Resources
* View the documentary Defeating a Virus That Killed Half a Billion People—The Plea, telling the story of the eradication of smallpox with the world’s first vaccine (#IZX9)
* Vaccinate adults! Order laminated 2025 U.S. adult immunization schedule booklets. (#IZX10)
* Immunize​.org's elegantly designed "Vaccines Save Lives" black enamel pins make wonderful gifts or workplace recognitions! (#IZX11)


Notable Publications
* “Menstrual Disturbance Associated with COVID-19 Vaccines: A Comprehensive Systematic Review and Meta-Analysis” published in PLOS One (#IZX12)


Global News
* "Estimated Current and Future Congenital Rubella Syndrome Incidence with and Without Rubella Vaccine Introduction—19 Countries, 2019–2055" published in MMWR (#IZX13)


Upcoming Events
* Virtual: Clinical Care Options hosts “Expert Answers to Best Practices to Turning Your Practice into a Vaccine Center of Excellence” on June 5 at 11:00 a.m. (ET) featuring Immunize.org’s L.J Tan; CE credit available (#IZX14)
* Virtual: Register for Immunize​.org Website Office Hours. Ask questions and learn about our "News & Updates" web section on June 11 at 4:00 p.m. (ET) or June 12 at 12:00 p.m. (ET). Recorded sessions archived. (#IZX15)


Editorial Information (#Editorial)
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Top Stories
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FDA licenses Novavax COVID-19 Vaccine (Nuvaxovid) for selected adults; ACIP will consider recommendations for its use at its June meeting

On May 16, FDA licensed Nuvaxovid (Novavax) ([link removed]) to prevent COVID-19 disease in adults age 65 years and older as well as those age 12 through 64 years with at least one underlying condition that elevates their risk for severe outcomes from COVID-19. Each dose contains 50 mcg of spike protein plus Matrix-M adjuvant. This is the only COVID-19 vaccine licensed in the United States not based on mRNA technology. The Novavax COVID-19 Vaccine had been offered under emergency use authorization since July 2022.

In June, ACIP is expected to consider its recommendations for use of COVID-19 vaccines for preventing COVID-19 disease.

FDA posted the Nuvaxovid package insert ([link removed]) and approval letter ([link removed]) .

Related Link
* Immunize​.org: Vaccines A–Z: COVID-19 ([link removed]) main page

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Immunize​.org posts Pohnpeian translations of 16 VISs

Immunize​.org continues to expand its repository of ([link removed]) VIS ([link removed]) translations ([link removed]) , all available in print-ready PDF format. Cerro Gordo County Health Department, based in Mason City, Iowa, generously donated 16 Pohnpeian ([link removed]) VIS translations, shown below. Pohnpeian is primarily spoken in the Federated States of Micronesia in the south Pacific.
* COVID-19 ([link removed]) * (view in English ([link removed]) )
* Hepatitis B ([link removed]) * (view in English ([link removed]) )
* Haemophilus influenza type b ([link removed]) (Hib) (view in English ([link removed]) )
* Influenza (inactivated or recombinant) ([link removed]) * (view in English ([link removed]) )
* MMR ([link removed]) * (Measles, Mumps, and Rubella) (view in English ([link removed]) )
* MMRV ([link removed]) * (view in English ([link removed]) )
* Meningococcal B ([link removed]) * (view in English ([link removed]) )
* Multi-vaccine pediatric ([link removed]) (view in English ([link removed]) )
* Polio ([link removed]) * (view in English ([link removed]) )
* Pneumococcal conjugate ([link removed]) (view in English ([link removed]) )
* Rotavirus ([link removed]) (view in English ([link removed]) )
* RSV ([link removed]) * (Respiratory Syncytial Virus) (view in English ([link removed]) )
* Smallpox/Monkeypox ([link removed]) * (view in English ([link removed]) )
* Td ([link removed]) (Tetanus, Diphtheria) (view in English ([link removed]) )
* Varicella (Chickenpox) ([link removed]) * (view in English ([link removed]) )
* Zoster (Shingles) ([link removed]) (view in English ([link removed]) )

*Indicates that translations are out of date because they do not reflect the pronoun changes made in the January 31, 2025, versions of VISs that were altered to comply with a presidential executive order. As always, a copy of the current official VIS, in English, should be provided along with the translated VIS.

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Related Links
* Immunize​.org: Vaccine Information Statement ([link removed]) s main page for VISs in 47 languages ([link removed])
* Immunize​.org: Dates of Current Vaccine Information Statements ([link removed]) (PDF)
* CDC: What's New with VISs ([link removed]) web page
* CDC: Current VISs ([link removed]) web page

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Immunize​.org updates references in three more standing orders templates

Immunize​.org continues to update its standing orders templates ([link removed]) to remove the reference to the excipient table that used to appear in Appendix B ([link removed]) of the Epidemiology and Prevention of Vaccine-Preventable Diseases (the "Pink Book"). The three updated standing order templates posted in the past week are:
* Standing Orders for Administering Rotavirus Vaccine to Infants ([link removed])
* Standing Orders for Administering Human Papillomavirus Vaccine to Children and Teens ([link removed] ) (additional update to font and QR code)
* Standing Orders for Administering Human Papillomavirus Vaccine to Adults ([link removed] )

Previously announced updated standing orders templates include:
* Standing Orders for Administering Hepatitis A Vaccine to Children and Teens ([link removed])
* Standing Orders for Administering Hepatitis A Vaccine to Adults ([link removed])
* Standing Orders for Administering Varicella Vaccine to Adults ([link removed])
* Standing Orders for Administering Varicella Vaccine to Children and Teens ([link removed])
* Standing Orders for Administering Haemophilus influenzae Type B Vaccine to Adults ([link removed])
* Standing Orders for Administering Pneumococcal Vaccines to Children and Teens ([link removed])

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Related Links
* Immunize​.org: Clinical Resources: Standing Orders Templates ([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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Confirmed measles cases increase to 1,046 across 30 states; encourage vaccination

As of May 23, CDC reported 1,046 confirmed measles cases ([link removed]) in 2025 in 30 states. Most (728 of 1,046, 69.6%) were reported by the Texas Department of State Health Services ([link removed]) . Among confirmed cases, 12% were hospitalized and two out of three were younger than age 20 years.

CDC only requires reporting of laboratory-confirmed measles cases. Cases without laboratory testing for confirmation are not included in these numbers. Actual numbers of cases are, therefore, expected to be higher than confirmed case counts.

A map of 2025 measles cases ([link removed]) in the contiguous United States, as of May 23, from the Johns Hopkins Center for Outbreak Response Innovation ([link removed]) (CORI) appears below. The CORI Measles Outbreak Response ([link removed]) website offers various ways to visualize the outbreak.

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CDC offers a suite of resources for public health, healthcare professionals, and families in communities experiencing a measles outbreak. Resources include infographics for families, images to help clinic personnel identify cases, and a Be Ready for Measles communication toolkit ([link removed]) . A quick reference for healthcare professionals provides guidance for caring for patients with measles ([link removed]) . Find all these resources on the CDC Measles Cases and Outbreaks ([link removed]) page.

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Related Links
* CDC: Measles Cases and Outbreaks ([link removed]) main page
* CDC: Be Ready for Measles Toolkit ([link removed])
* Center for Outbreak Response Innovation: Measles Outbreak Response ([link removed]) main page
* Immunize​.org: Vaccines A–Z: Measles ([link removed]) main page
* Immunize​.org: Standing Orders for Administering Measles, Mumps, and Rubella Vaccine to Children and Teens ([link removed]) (PDF)
* Immunize​.org: Standing Orders for Administering Measles, Mumps, and Rubella Vaccine to Adults ([link removed]) (PDF)
* Immunize​.org: Ask the Experts: MMR (Measles, Mumps, and Rubella) ([link removed]) web page

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Questions about our website? Use your smartphone to watch our 2-minute video to learn about joining our live Website Office Hours.

Learn about Immunize​.org’s Website Office Hours live and recorded webinars on the go with your smartphone. Check out the “mobile view” version of our 2-minute Orientation Video Series: Introducing Website Office Hours ([link removed]) .

The entire Orientation Video Series ([link removed]) is available on our YouTube channel ([link removed]) .
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Share these videos with anyone who wants to learn more about effective immunization practices with Immunize​.org.

* Immunize​.org: Webinars & Videos: Orientation Video Series ([link removed]) page
* 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.
* STAT: The FDA Is Circumventing Key Roles and Procedures for Licensure and Use of COVID Vaccines ([link removed]) (5/22/25)
* CNN: FDA Requires COVID Vaccine Makers to Expand Warning About Risk of Rare Heart Inflammation ([link removed]) (5/21/25)
* Contemporary Pediatrics: Maternal RSV Vaccine Data Reveal Uptake Disparities ([link removed]) (5/20/25)
* Our World in Data: Measles Vaccines Save Millions of Lives Each Year ([link removed]) (5/19/25)
* Medpage Today: New Dads, Non-Birthing Partners Less Likely to Get Prenatal Counseling on Vaccines ([link removed]) (5/19/25)
* Medical Xpress: Study Finds Mix of Incentives, Texts, and Local Outreach Boosts Immunization Rates ([link removed]) (5/19/25)
* Annenberg Public Policy Center: Americans Say Benefits of MMR Vaccine for Children Outweigh Risks by Nearly 5-1 ([link removed]) (5/16/25)

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Immunize​.org Website and Clinical Resources
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Spotlight on the website: State Immunization Websites and Additional State Resources

This week, we spotlight our links to state-specific resources: State Immunization Websites ([link removed]) and Additional State Resources ([link removed]) . These can be found by choosing the Official Guidance tab from the main menu atop each web page, then selecting States from the left-hand menu.

Each state and the District of Columbia are included on the State Immunization Websites ([link removed]) web page. Click on names to display additional content. Blue text indicates a hyperlink to directly access the state’s immunization program, plus available childcare, school, or college immunization requirements or related resources.

Additional State Resources ([link removed]) connects you to important contact information for state immunization program managers and other important contacts (e.g., perinatal hepatitis B prevention and Indian Health Service programs). Links to other useful government and nongovernment organization sites are also provided.
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Recap: Immunize​.org updates web link in “Vaccine Storage Troubleshooting Record”

Immunize​.org updated a nonfunctioning URL in its Vaccine Storage Troubleshooting Record ([link removed]) .
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Featured Resources
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View the documentary Defeating a Virus That Killed Half a Billion People—The Plea, telling the story of the eradication of smallpox with the world’s first vaccine

Defeating a Virus That Killed Half a Billion People—The Plea ([link removed]) is a documentary that tells the story of the first vaccine and the eradication of smallpox. The 25-minute film shows the impact of smallpox through various historical periods, using graphics and art to demonstrate the impact of the virus. The documentary provides inspiration for the efforts to eradicate other diseases, including polio.

A portion of the narrative appears below:

People whose job it is to worry about measles or about whether we're prepared for future pandemics, or about those in poor countries where vaccines are out of reach—they're doing incredible work but need support to be successful. And you may notice that these days their pleas for help are too often going unanswered, which is why now feels like a good time to remember smallpox, to remember how many died, how many were saved, and what we're capable of.

The film is free to watch on YouTube ([link removed]) .

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Vaccinate adults! Order laminated 2025 U.S. adult immunization schedule booklets.

Laminated booklets of the 2025 U.S. adult immunization schedule ([link removed]) are still available in the Immunize​.org shop. The 2025 child and adolescent schedule booklets sold out.

The schedules are available online as PDFs from CDC ([link removed]) at no cost. Immunize​.org’s laminated booklets are ideal for use in any busy healthcare setting where vaccines are given.
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Pricing:

Adult Booklets
1 copy: $10.00
2–4 copies: $9.50 each
5–19 copies: $8.50 each
20–99 copies: $7.50 each
100–499 copies: $6.00 each
500–999 copies: $5.00 each
1,000–1,999 copies: $4.00 each
2,000+ copies: $3.25 each

Visit the Shop Immunize.org: Laminated Schedules ([link removed]) web page to view images and order today!

For additional information, call 651-647-9009 or email [email protected] (mailto:[email protected]) .

Related Links
* Immunize​.org: Laminated Adult Immunization Schedules (19 and older) ([link removed]) web page
* Immunize​.org: Shop Immunize​.org ([link removed]) main page

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Immunize​.org's elegantly designed "Vaccines Save Lives" black enamel pins make wonderful gifts or workplace recognitions!

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

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Wear these pins on clothing, ([link removed]) uniforms, and white coats to show that you value vaccines.

([link removed])

Click here for "Vaccines Save Lives" pin pricing and ordering information. ([link removed])
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Notable Publications
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“Menstrual Disturbance Associated with COVID-19 Vaccines: A Comprehensive Systematic Review and Meta-Analysis” published in PLOS One

In its May 16 issue, PLOS One published Menstrual ([link removed]) Disturbance Associated with COVID-19 Vaccines: A Comprehensive Systematic Review and Meta-Analysis ([link removed]) . The meta-analysis found an increased likelihood of brief menstrual cycle changes after COVID-19 vaccination. While noticeable, the temporary changes were not considered clinically meaningful. Portions of the abstract appear below.

Seventeen studies with >1.9 million participants were analyzed. We found a 19% greater risk of increase in menstrual cycle length as compared to unvaccinated people or pre-vaccination time-periods . . . In the first cycle after vaccination, length increased by [0.34 days] . . . after the first dose and by 0.62 days . . . after the second dose. In the second cycle after vaccination, the risk was not elevated . . . The increase in risk was between 7–9% but statistically insignificant for heavier flow; 7% for post-menopausal bleeding . . . and 16–41% for unexpected or intermenstrual bleeding . . .

We observed a mild increase in the risk of menstrual disturbance associated with COVID-19 vaccines. Such risks are likely clinically unmeaningful. Vaccine recipients should be appropriately counseled.
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Global News
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"Estimated Current and Future Congenital Rubella Syndrome Incidence with and Without Rubella Vaccine Introduction—19 Countries, 2019–2055" published in MMWR

CDC published Estimated Current and Future Congenital Rubella Syndrome Incidence with and Without Rubella Vaccine Introduction—19 Countries, 2019–2055 ([link removed]) on May 22 in MMWR. A portion of the summary appears below.

Rubella infection during early pregnancy can result in miscarriage, fetal death, or a constellation of birth defects known as congenital rubella syndrome (CRS). By 2023, among 194 World Health Organization member countries, 175 (90%) had introduced a rubella-containing vaccine (RCV) into their routine immunization program. . . .

In this modeling study of vaccination, in the 19 countries that have not introduced RCV and where an estimated 24,000 CRS cases occurred in 2019, universal RCV introduction during 2025–2055 would avert an estimated 986,000 CRS cases. In 2024, based on these estimates and other considerations, the World Health Organization recommended universal RCV introduction in these 19 countries. . . .

Universal RCV introduction during the next 5 years could accelerate progress toward rubella and CRS elimination worldwide.

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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: RSV (Respiratory Syncytial Virus) ([link removed]) main page

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Upcoming Events
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Virtual: Clinical Care Options hosts “Expert Answers to Best Practices to Turning Your Practice into a Vaccine Center of Excellence” on June 5 at 11:00 a.m. (ET) featuring Immunize​.org’s L.J Tan; CE credit available

Clinical Care Options ([link removed]) will host an event titled Expert Answers to Best Practices to Turning Your Practice into a Vaccine Center of Excellence ([link removed]) at 11:00 a.m. (ET) on June 5. During this webinar, expert faculty will answer questions regarding vaccine management, how to be a vaccine expert for your patients, and how to optimize immunization in clinical practice. The webinar will feature Immunize​.org's L.J Tan, MS, PhD, and Robert H. Hopkins, Jr., MD, MACP, of the National Foundation for Infectious Diseases.

CME, CNE, and CPE credit is available at no charge.

Register for the event ([link removed]) .
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Virtual: Register for Immunize​.org Website Office Hours. Ask questions and learn about our "News & Updates" web section on June 11 at 4:00 p.m. (ET) or June 12 at 12:00 p.m. (ET). Recorded sessions archived.

To learn simple tips and tricks for using our website efficiently, please register for our next set of Website Office Hours on Wednesday, June 11 at 4:00 p.m. (ET) ([link removed]) or Thursday, June 12 at 12:00 p.m. (ET) ([link removed]) . The same content will be covered in both sessions.

We will open each 45-minute session with a short, live demonstration on navigating ourNews & Updates ([link removed]) website section. You can submit questions when you register or live on Zoom during the session.

Register today for Immunize​.org Website Office Hours (content is the same for both):
* Wednesday, June 11 at 4:00 p.m. (ET) ([link removed])
* Thursday, June 12 at 12:00 p.m. (ET) ([link removed])

The archive of previous Website Office Hours content ([link removed]) is posted at Immunize​.org’s "Webinars & Videos" page. These archived programs include Ask the Experts; Clinical Resources; Vaccine Information Statements (VISs); Affiliated Websites; Images, Webinars, Videos, & Social Media; Official Guidance; Publication Archives, Vaccine Timeline, & About Us; Travel Vaccines, Vaccine Confidence, & Addressing Concerns; and Vaccines A–Z.

See our Calendar of Events ([link removed]) for future Immunize​.org Website Office Hours.
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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. Gr
äbenstein, 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. NH23IP922654 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 (http:// [link removed])
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