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Issue 1,501: June 17, 2020

-TOP STORIES-
* CDC issues guidance for immunization services in light of falling vaccine rates due to COVID-19 pandemic
* Updated! Ask the Experts: COVID-19 and Routine Vaccination Questions and Answers
* Sabin-Aspen Vaccine Science and Policy Group releases its second annual report titled “Meeting the Challenge of Vaccination Hesitancy”
* IAC’s Repository of Resources for Maintaining Immunization during COVID-19 Pandemic now exceeds 110 materials
* CDC publishes “Measles Outbreak on an Army Post and a Neighboring Community—El Paso, Texas, July–September 2019” in MMWR
* Not-to-miss immunization articles in the news

-IAC HANDOUTS-
* IAC revises three of its Q&A handouts for patients and providers: diphtheria, pertussis (whooping cough), and tetanus
* IAC updates popular patient handouts “Protect Yourself from Hepatitis B…Get Vaccinated!” and “Protect Yourself from Shingles…Get Vaccinated!” in both English and Spanish

-FEATURED RESOURCES-
* In this week’s “Video of the Week,” Dr. Sandra Fryhofer discusses the HPV vaccine for adults
* Check out the website www.Give2MenACWY.org to enhance your efforts at increasing rates of the MenACWY booster and other adolescent vaccinations

-JOURNAL ARTICLES AND NEWSLETTERS-
* “The Vaccines for Children Program at 25—Access, Affordability, and Sustainability” published in New England Journal of Medicine
* Theme issue with 33 articles on "Vaccine Acceptance" published by Human Vaccines & Immunotherapeutics

-EDUCATION AND TRAINING-
* NCSL offers webinar “COVID-19: Maintaining Child Vaccination Rates During a Pandemic” on June 22

-CONFERENCES AND MEETINGS-
* Reminder! You can watch the virtual ACIP meeting on June 24

-ON THE LIGHTER SIDE-
* Eye-opening 1997 video lets mom know shots aren’t just for babies


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-TOP STORIES-
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=CDC ISSUES GUIDANCE FOR IMMUNIZATION SERVICES IN LIGHT OF FALLING VACCINE RATES DUE TO COVID-19 PANDEMIC=

Stay-at-home and shelter-in-place orders during the pandemic have caused healthcare providers to change how they provide essential services to patients. On June 9, CDC issued Interim Guidance for Immunization Services during the COVID-19 Pandemic ([link removed]) at a web page to help immunization providers in a variety of clinical settings plan for safe vaccine administration during the COVID-19 pandemic. IAC transformed this content (accessed June 14) into a PDF document for your ease of use—click here to view it ([link removed]).

Routine vaccination is an essential preventive care service for children, adolescents, and adults (including pregnant women) that should not be delayed because of the COVID-19 pandemic. In light of COVID-19-related reductions in people accessing vaccination services, it is important to assess the vaccination status of all children and adolescents at each patient visit to avoid missed opportunities for vaccination and ensure timely vaccine catch-up. All vaccines due or overdue should be administered according to the recommended CDC immunization schedules ([link removed]) during that visit, unless a specific contraindication exists, to provide protection as soon as possible as well as to minimize the number of healthcare visits needed to complete vaccination.

The vaccination status of all patients across the life span should be considered at each health visit. Encourage vaccination to help stop the spread of disease and communicate with patients and families about how vaccines can be administered safely during the pandemic. The guidance also states that adults are encouraged to take steps to receive vaccines according to the standards for adult immunization practice ([link removed]) .

CDC guidance recommends all people age 6 months or older be given the influenza vaccine to reduce the overall burden of respiratory illnesses during the upcoming 2020–2021 influenza season. Providers should use every opportunity to administer the influenza vaccine to essential workers, people at increased risk for severe illness from COVID-19, those over the age of 65, and people at high risk for influenza complications such as infants, young children, pregnant women, and those with underlying medical conditions.

Coronavirus infection prevention practices such as physical distancing, hand and respiratory hygiene, wearing of personal protective equipment, disinfection of surfaces, and source control while in the healthcare facility are important in limiting the spread of disease. The subsection titled “General Practices for the Safe Delivery of Vaccination Services” provides a list of safeguards. Routine vaccination for people with a suspected or confirmed case of COVID-19 should be temporarily deferred from vaccinations regardless of symptoms.

CDC encourages all stakeholders to share this guidance with your colleagues.

Related Links
* CDC's issued Interim Guidance for Immunization Services during the COVID-19 Pandemic ([link removed]) (HTML) or PDF ([link removed])
* IAC's Repository of Resources for Maintaining Immunization during the COVID-19 Pandemic ([link removed])

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=UPDATED! ASK THE EXPERTS: COVID-19 AND ROUTINE VACCINATION QUESTIONS AND ANSWERS=

IAC recently updated its Ask the Experts: COVID-19 and Routine Vaccination ([link removed]) web page. The refreshed web page answers questions about the importance of administering all recommended immunizations for children and adults during the pandemic, and provides links to the latest CDC guidelines on immunization during a pandemic. The page addresses questions on many related topics (e.g., using telemedicine visits for vaccine assessment and counseling and differentiating COVID-19 symptoms from a self-limited Shingrix reaction). This section of Ask the Experts will grow with more Q&As as additional information becomes available.

IAC’s Ask the Experts ([link removed]) gateway page is a compilation of common as well as challenging questions and answers about vaccines and their administration. IAC wishes to recognize its team of experts: Kelly L. Moore, MD, MPH (lead); Carolyn Bridges, MD, FACP; William Atkinson, MD, MPH; and Deborah Wexler, MD.

Related Links
* IAC's Ask the Experts: COVID-19 and Routine Vaccination ([link removed]) web page
* IAC's Ask the Experts ([link removed]) gateway page, linking to 28 topics with more than 1,000 Q&As

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=SABIN-ASPEN VACCINE SCIENCE AND POLICY GROUP RELEASED ITS SECOND ANNUAL REPORT TITLED “MEETING THE CHALLENGE OF VACCINATION HESITANCY”=

The Sabin-Aspen Vaccine Science & Policy Group released its second annual report, Meeting the Challenge of Vaccination Hesitancy ([link removed]), in June 2020.

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Based on its findings, the Group proposes three “big ideas” to help reverse the trend toward vaccine hesitancy and reestablish full uptake of vaccines as a social norm:

* Structure. The creation of a new media collaborative to serve as an interface between the vaccination community and social media platforms.
* Knowledge. A research agenda to create ample evidence-based knowledge about the sources of vaccine hesitancy and the best ways to counter it.
* Strategy. Building a new narrative to shift the conversation around immunization to one that focuses on its achievements and promise and helps build resiliency in the vaccination enterprise.

Framing the key findings of the report are five original background papers detailing current challenges and opportunities to approach vaccination hesitancy across various disciplines, including social media and online misinformation, social and behavioral science insights, and research into the genesis of social movements.

Share videos, quotes, and quick-share posts with your network to help raise awareness about the report by using the social media toolkit ([link removed]).

Related Links
* Meeting the Challenge of Vaccination Hesitancy ([link removed]) (175 pages; PDF format)
* Sabin Vaccine Institute's Meeting the Challenge of Vaccination Hesitancy ([link removed]) gateway page
* Sabin Vaccine Institute's Vaccine Acceptance ([link removed]) gateway page

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IAC’s Repository of Resources for Maintaining Immunization during COVID-19 Pandemic now exceeds 110 materials

In May, IAC launched the Repository of Resources for Maintaining Immunization during the COVID-19 Pandemic ([link removed]) to assist in maintaining routine immunization rates during the COVID-19 pandemic. Located on the website of the National Network of Immunization Coalitions ([link removed]) , a project of IAC, this repository includes links to both national and state-level policies and guidance; advocacy materials, including talking points, webinars, press releases, articles, and social media posts; and telehealth resources. These resources are intended for healthcare settings, state and local health departments, professional societies, immunization coalitions, advocacy groups, and the community to use in their efforts to sustain routine immunizations during the COVID-19 pandemic.

The more than 110 resources that appear in the repository come from the federal government, nationally recognized healthcare organizations, state health departments, state immunization coalitions, and other organizations devoted to disseminating accurate immunization information.

These resources can be sorted and searched by date, title, geographic area, source, type, age category, or setting.

If you have a resource to submit to the repository, please send a message to [email protected] (mailto:[email protected]) .

Access the repository to view the range of valuable resources available to support the patients, families, and communities you serve.

Related Link
* National Network of Immunization Coalitions ([link removed]) website

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CDC publishes “Measles Outbreak on an Army Post and a Neighboring Community—El Paso, Texas, July–September 2019” in MMWR

CDC published Measles Outbreak on an Army Post and a Neighboring Community—El Paso, Texas, July–September 2019 ([link removed]) in the June 12 issue of MMWR.
Measles remains a risk to unvaccinated persons in the United States. In July 2019, the initial identification of two cases of measles in Fort Bliss, Texas led to a coordinated effort by federal, state, city, and army public health agencies to locate others who may have been exposed and to prevent further spread. Ultimately, six cases were found. Three cases occurred in children age 1–4 years, none of whom had received any vaccines; the other three were adults. One adult patient had laboratory evidence of immunity suggesting previous vaccination; the vaccination status of the other two adult patients was unknown. Although the coordinated prevention and control measures likely prevented a larger outbreak, this event served as an important reminder that persons without presumptive evidence of immunity should receive MMR vaccine according to published recommendations by the Advisory Committee on Immunization Practices.

Access the MMWR article inhttps://www.cdc.gov/mmwr/volumes/68/wr/mm6842a1.htmHTML format ([link removed]) [link removed] inhttps://www.cdc.gov/mmwr/volumes/68/wr/mm6842a1.htmPDF format ([link removed]) .

Related Link
* MMWR ([link removed]) gateway page provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements

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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.
* Med Page Today: Vaccine Access, Hesitancy Amid COVID-19—Public Health Officials Work to Get Ahead of the Anti-Vaxxers, Improve Uptake ([link removed]) (6/3/20)
* Global Citizen: What Lessons Can We Learn From Polio in Tackling COVID-19? ([link removed]) (6/8/20)
* Reuters: Fact Check: Vaccines Do Not Differ Based on Insurance ([link removed]) (6/9/20)
* UConn: UConn Research Talks Vaccine Realities in an Unprecedented Time ([link removed]) (6/11/20)
* New York Times Magazine: Can a Vaccine for COVID-19 Be Developed in Record Time? ([link removed]) (6/9/20)
* New York Times: Coronavirus Vaccine Tracker ([link removed]) (6/10/20)
* Medical Xpress: Social Media Messages Influences Parents About HPV ([link removed]) (6/11/20)

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-IAC HANDOUTS-
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=IAC REVISES THREE OF ITS Q&A HANDOUTS FOR PATIENTS AND PROVIDERS: DIPHTHERIA, PERTUSSIS (WHOOPING COUGH), AND TETANUS=

IAC revised three of its popular question and answer patient handouts:
* Diphtheria: Questions and Answers ([link removed])
* Pertussis (Whooping Cough): Questions and Answers ([link removed])
* Tetanus: Questions and Answers ([link removed])

The handouts now highlight:
* Updated U.S. disease morbidity data for diphtheria, pertussis, and tetanus, respectively
* The benefit of vaccination during pregnancy, i.e., 90% reduction in the risk of the infant acquiring pertussis
* Updated ACIP recommendations that either Td or Tdap may be used for people age 7 years and older for any dose
* Clarification that adolescents who inadvertently received a dose of Tdap at age 10 years can now count it toward the dose recommended at age 11–12 years

Related Links
* IAC's Q&As Diseases and Vaccines ([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
* 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 UPDATES POPULAR PATIENT HANDOUTS “PROTECT YOURSELF FROM HEPATITIS B…GET VACCINATED!” AND “PROTECT YOURSELF FROM SHINGLES…GET VACCINATED!” IN BOTH ENGLISH AND SPANISH=

IAC recently revised Protect Yourself from Hepatitis B…Get Vaccinated! ([link removed]) to add diabetes as a risk factor for hepatitis B. It was also updated in Spanish ([link removed]).

IAC also revised Protect Yourself from Shingles…Get Vaccinated! ([link removed]) Discussion of the use of Zostavax was removed as this vaccine is being phased out in the U.S. This handout also was updated in Spanish ([link removed]).

Related Links
* IAC's Handouts: Hepatitis B ([link removed]) gateway page
* IAC's Handouts: Zoster (Shingles) ([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 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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=IN THIS WEEK’S “VIDEO OF THE WEEK,” DR. SANDRA FRYHOFER DISCUSSES THE HPV VACCINE FOR ADULTS=

This week, Sandra Adamson Fryhofer, MD, MACP, FRCP, discusses the HPV vaccine for adults in this Medscape Medicine Matters video ([link removed]).

Visit the VOTW archive ([link removed]).

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=CHECK OUT THE WEBSITE WWW.GIVE2MENACWY.ORG TO ENHANCE YOUR EFFORTS AT INCREASING RATES OF THE MENACWY BOOSTER AND OTHER ADOLESCENT VACCINES=

Last fall, IAC implemented a major upgrade to its collaborative website promoting the importance of receiving a booster dose of meningococcal ACWY ([link removed]) (MenACWY) vaccine.

Aimed at healthcare professionals, the site was revised to incorporate newly updated materials and to highlight the importance of all recommended vaccines for 16-year-olds. A simplified navigation structure makes locating information a breeze.

The colorful Give2MenACWY.org website ([link removed]) is divided into five easy-to-access sections:
* Vaccinate Teens ([link removed]) – The tools included on this web page offer helpful information on teen vaccination schedules and tips for improving adolescent vaccination rates
* Give 2 Doses ([link removed]) – Fewer than half of teens have received the recommended second dose of MenACWY vaccine; this web page offers tools to help providers improve second dose coverage
* 16-Year-Old Visit ([link removed]) – These resources help both providers and their patients remember the important vaccines recommended for 16-year-olds
* Tools for Providers ([link removed]) – These tools from CDC, IAC, and other organizations explain meningococcal ACWY vaccine recommendations and assist in improving adolescent coverage for all recommended vaccines
* Resources ([link removed]) – This section assists provider efforts to improve adolescent vaccination rates; the materials are subdivided into subsections for print materials ([link removed]) , links to organizations ([link removed]) involved in adolescent immunization, personal stories ([link removed]) about the importance of vaccination, and additional resources ([link removed]) of interest

Additional time savings are provided by the site’s single location where all website materials are listed ([link removed]) according to whether they are primarily of interest to providers or to patients/parents. Other sections relate to general adolescent immunization, as well as meningococcal disease and vaccine information.

Visit Give2MenACWY.org ([link removed]) and enjoy browsing (and deploying) its bountiful resources, brought to you by our collaboration with Sanofi Pasteur.

Related Links
* MenACWY Campaign’s Give2MenACWY.org ([link removed]) website
* Multi-organization Dear Colleague Letter: 16-Year-Old Patients: Make Sure They Receive Their Annual Well Visit and Vaccinations ([link removed])
* MenACWY Campaign’s Algorithm for MenACWY Immunization in Adolescents 11–18 Years of Age ([link removed])
* MenACWY Campaign’s MenACWY: You're Not Done If You Give Just One: Give 2 Doses to Strengthen Protection ([link removed])
* MenACWY Campaign’s Recommending MenACWY: What to Say and How to Say It ([link removed])
* MenACWY Campaign’s Top 10 Ways to Improve Adolescent Immunization Rates ([link removed])
* MenACWY Campaign’s Developing an Immunization Culture in Your Office ([link removed])
* MenACWY Campaign’s Know Your Rates: Measuring Immunization Success in Your Practice ([link removed])
* IAC's You're 16: We Recommend These Vaccines for You ([link removed])

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-JOURNAL ARTICLES AND NEWSLETTERS-
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“The Vaccines for Children Program at 25—Access, Affordability, and Sustainability” published in New England Journal of Medicine

On June 11, 2020, the New England Journal of Medicine published The Vaccines for Children Program at 25—Access, Affordability, and Sustainability ([link removed]) , by Jason L. Schwartz and James Colgrove. The first paragraph is reprinted below.

Measles outbreaks in the United States in 2018 and 2019 at a scale not seen in decades demonstrated the continued threat posed by vaccine-preventable diseases. Childhood vaccination programs face numerous challenges, including persistent doubts among some parents regarding the safety and necessity of recommended vaccines and decisions by a small but growing number of “vaccine-hesitant” families to delay or decline vaccinations for their children.
Access the full article. ([link removed])

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Theme issue with 33 articles on “Vaccine Acceptance” published by Human Vaccines & Immunotherapeutics

On May 13, 2020, Human Vaccines & Immunotherapeutics released a theme issue with 33 articles ([link removed]) on the topic of “Vaccine Acceptance.” This included an editorial, Building Vaccine Acceptance Through Communication and Advocacy ([link removed]) , by Kristen A. Feemster. Her conclusion is reprinted below.

The key issues for increasing the number of vaccinated people worldwide, especially children, is to increase the supply of available vaccines, assure funding and affordability for lower-income countries, improve distribution and storage networks, assure the availability of healthcare workers to administer vaccines, improve the ability of the population to access vaccination centers, and minimize refusal/hesitation to maximize acceptability of vaccines. It is noteworthy that among these key issues, all involve physical activities except for the final issue, which is the subject of this Special Issue. Vaccine acceptance/hesitation/refusal is unique in being a state of mind for the potential vaccinee or caregiver, such that different methods must be applied to improve acceptability. The ability of workers in the field to improve acceptability will be directly reflected in increased vaccinations with concomitant reductions in morbidity and mortality from vaccine-preventable diseases. This is a major public health challenge for the coming decade and beyond, which also will be very important for the success of new vaccines in the development pipeline.

Access the full article ([link removed]) in PDF format ([link removed]) .

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-EDUCATION AND TRAINING-
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NCSL offers webinar “COVID-19: Maintaining Child Vaccination Rates During a Pandemic” on June 22

The National Conference of State Legislatures (NCSL) will present a webinar titled COVID-19: Maintaining Child Vaccination Rates During a Pandemic ([link removed]) on June 22 at 2 p.m. (ET). The webinar will be moderated by NSCL program director Tahra Johnson, and will feature NSCL policy associate Erik Skinner; Melinda Wharton, MD, MPH, director of Immunization Services Division at the CDC; and Claire Hannan, MPH, executive director of the Association of Immunization Managers. The speakers will discuss the implications of the decreased rates of childhood vaccinations during the COVID-19 era.

Registration information ([link removed])

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-CONFERENCES AND MEETINGS-
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Reminder! You can watch the virtual ACIP meeting is June 24

The live, virtual June 2020 Advisory Committee on Immunization Practices (ACIP) meeting ([link removed]) will be on June 24. The agenda for the June ACIP meeting ([link removed]) has been posted. No registration is required to watch the live June ACIP meeting or listen via telephone. Topics include meningococcal diseases, influenza, and SARS-CoV-2 (COVID-19).

Related Link
* ACIP gateway page ([link removed])

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-ON THE LIGHTER SIDE-
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=EYE-OPENING 1997 VIDEO LETS MOM KNOW SHOTS AREN’T JUST FOR BABIES=
In this video, Ask My Mommy ([link removed]) , mothers learn that babies will need vaccinations far beyond the childhood years. The spot was produced by the Minnesota Department of Health in 1997 and is part of a PSA collection curated by vaccine expert William L. Atkinson, MD, MPH.

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Previous videos mentioned in “On the Lighter Side” are available on IAC's Vimeo channel ([link removed]).

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Video of the Week

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HPV Vaccine for Adults: Who Needs It? Who Doesn't? In this Medscape video, Dr. Sandra Fryhofer discusses the ACIP recommendations for the use of HPV9 vaccine in adults 27 through 45 years of age. Physicians should discuss with their patients their need for this vaccine based on shared clinical decision-making. She also answers frequently asked questions. 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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New! 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 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])

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
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