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Issue 1,826: August 6, 2025

Top Stories
* AAP reaffirms support for routine pediatric influenza vaccination, eliminating nonmedical school vaccination exemptions and reaffirming the childhood recommended immunization schedule as published online by CDC in November 2024
* FDA approves updated rabies vaccine package insert to include a 2-dose pre-exposure prophylaxis regimen, as recommended by ACIP and CDC in 2022
* Children’s Hospital of Philadelphia publishes “Hepatitis B ‘Fast Facts’ for Healthcare Providers” and shares new "Vaccines Make Memories" resources
* It’s National Immunization Awareness Month! Use these resources to encourage vaccination.
* Confirmed U.S. measles cases in 2025 increase to 1,333 across 39 states; Canada’s measles case count surges to 4,206 as of July 28
* “What Are the Pneumococcal Vaccination Options for a Previously Unvaccinated 50-Year-Old?” Watch the 1-minute answer, part of the Ask the Experts Video Series on YouTube.
* Vaccines in the news


Immunize​.org Website and Clinical Resources
* Spotlight on the website: View our Immunize​.org website on your mobile device!


Featured Resources
* Recap: CDC releases at-a-glance resources for RSV products to help you prepare for respiratory virus season
* Explore the www.Give2MenACWY.org website to increase coverage for the MenACWY booster and other adolescent vaccinations


Notable Publications
* "Global Estimates of Lives and Life-Years Saved by COVID-19 Vaccination During 2020–2024" published in JAMA Health Forum
* “Influenza-Associated Acute Necrotizing Encephalopathy in U.S. Children” published in JAMA


Upcoming Events
* Today, virtual: Register for Immunize​.org Website Office Hours. Ask questions and learn about the “Official Guidance” (state resources) web section on Immunize​.org on August 6 at 4:00 p.m. (ET) or August 7 at 12:00 p.m. (ET). Recorded sessions archived.
* Virtual: Children’s Hospital of Philadelphia hosts Current Issues in Vaccines webinar titled “Aluminum Adjuvants: Separating Fact from Fear” on September 10 at 12:00 p.m. (ET); CE credit offered


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Top Stories
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AAP reaffirms support for routine pediatric influenza vaccination, eliminating nonmedical school vaccination exemptions and reaffirming the childhood recommended immunization schedule as published online by CDC in November 2024

In the July issue of Pediatrics, the American Academy of Pediatrics (AAP) published two policy statements. One reaffirms their ongoing support for routine pediatric influenza vaccination. The other updates and reaffirms AAP’s support since 2016 for elimination of nonmedical school vaccination exemptions. Excerpts appear below.

Recommendations for Prevention and Control of Influenza in Children, 2025–2026: Policy Statement ([link removed])

The AAP recommends annual influenza vaccination of all children without medical contraindications starting at 6 months of age. Influenza vaccination is an important strategy for protecting children and the broader community as well as reducing the overall burden of respiratory illnesses when other viruses are cocirculating. Any licensed influenza vaccine appropriate for age and health status can be administered, as soon as possible in the season, without preference for one product or formulation.

Medical vs Nonmedical Immunization Exemptions for Child Care and School Attendance: Policy Statement ([link removed])

Routine childhood immunizations against infectious diseases are an integral part of our public health infrastructure. They provide direct protection to the immunized individual and indirect protection to children and adults unable to be immunized by reducing spread of vaccine-preventable diseases in the community. . . . The American Academy of Pediatrics (AAP) supports certification of immunization to attend child care and school as a sound means of providing a safe environment for attendees and employees of these settings. The AAP also supports medically indicated exemptions to specific immunizations as determined for each individual child. The AAP advocates for the elimination of nonmedical exemptions from immunizations as contrary to optimal individual and public health.

AAP continues its support for the recommended immunization schedule for children ([link removed]) as published by CDC online in November 2024, including routine vaccination of children against COVID-19. AAP does not endorse the CDC schedule currently online on the CDC website that does not recommend routine childhood COVID-19 vaccination. The schedule endorsed by AAP is the version that Immunize​.org offered for sale as a laminated booklet until it sold out earlier this year.

Related Links
* AAP: endorsed evidence-based Child and Adolescent Immunization Schedule ([link removed]*68hj10*_gcl_au*MTk4MDI5MTgwNy4xNzQ4NTU2NjY3*_ga*MTExMTM4OTYzOC4xNjY1NTkyOTU2*_ga_GMZCQS1K47*czE3NTQxNDc5NTckbzgkZzAkdDE3NTQxNDc5NTckajYwJGwwJGgw*_ga_FD9D3XZVQQ*czE3NTQxNDc5NTckbzUyJGcwJHQxNzU0MTQ3OTU3JGo2MCRsMCRoMA..?autologincheck=redirected) (November 2024)
* AAP: Patient Care: Immunizations ([link removed]) web page
* AAP Podcast: Episode 50 – Vaccine Facts, Recommendations & Schedules: Everything Parents Need to Know ([link removed]) (7/24/2025) with Drs. Ari Brown and Julie Boom

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FDA approves updated rabies vaccine package insert to include a 2-dose pre-exposure prophylaxis regimen, as recommended by ACIP and CDC in 2022

On July 24, 2025, FDA revised the rabies vaccine (Imovax Rabies, Sanofi Pasteur) ([link removed]) package insert to include the 2-dose pre-exposure prophylaxis (PrEP) regimen. This aligns the package insert with the ACIP rabies PrEP recommendations ([link removed]) published in MMWR on May 6, 2022. Current PrEP recommendations are for a 2-dose (days 0 and 7) intramuscular rabies vaccination series. Booster dose and titer recommendations following the 2-dose PrEP series vary by a person’s risk category.

Related Links
* FDA: Imovax Rabies package insert ([link removed]) (PDF)
* FDA: Novel Drug Approvals for 2025 ([link removed]) web page
* CDC: Use of a Modified Preexposure Prophylaxis Vaccination Schedule to Prevent Human Rabies: Recommendations of the Advisory Committee on Immunization Practices—United States, 2022 ([link removed])
* Immunize​.org: Package Inserts and FDA Product Approvals ([link removed]) main page

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Children’s Hospital of Philadelphia publishes “Hepatitis B ‘Fast Facts’ for Healthcare Providers” and shares new "Vaccines Make Memories" resources

The Children’s Hospital of Philadelphia (CHOP) Vaccine Education Center (VEC) published News & Views—Hepatitis B: 'Fast Facts' for Healthcare Providers ([link removed]) in their Vaccine Update Newsletter ([link removed]). This article reviews the hepatitis B virus, its transmission, the disease it causes, and why HepB vaccination continues to be critical, especially at birth.

VEC also released two new posters ([link removed]) with the vaccine-positive message: “Vaccines Make Memories.” Available in English and Spanish, the posters focus on protecting the moments that matter most through vaccination.

The posters are available for purchase ([link removed]) in individual quantities or in sets of 10.

Related Link
* Immunize​.org: Vaccines A–Z: Hepatitis B ([link removed]) web page

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It’s National Immunization Awareness Month! Use these resources to encourage vaccination.

August is National Immunization Awareness Month ([link removed]) (NIAM). This annual observance highlights the importance of protecting people of all ages against vaccine-preventable diseases through on-time vaccination. This year, NIAM serves as a focal point to share trustworthy, credible information about the importance of staying up to date with routine immunizations.

Multiple partners offer resources, including social media messaging that you can use in your NIAM communication.

* Voices for Vaccines' (VFV) NIAM 2025 web page ([link removed]) includes key messages and sample social media content, organized by week, to focus positive public attention on immunizations. This week, use VFV's resources to highlight how well vaccines work, using the hashtag #NIAM2025.

* Immunize Canada and Vaccine Ambassadors partnered on an NIAM campaign ([link removed]), which includes images, posters, and social media content

* Vaccinate Your Family's #FirstDayVax campaign ([link removed]) reminds families that vaccines should be part of every back-to-school checklist. Find the shareable assets in the #FirstDayVax toolkit ([link removed]), also available in Spanish ([link removed]).

During NIAM, encourage your patients to schedule appointments to get up to date on annual exams and recommended vaccines. Research shows that healthcare providers remain the most trusted source of vaccine information for parents and patients.

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Confirmed U.S. measles cases in 2025 increase to 1,333 across 39 states; Canada’s measles case count surges to 4,206 as of July 28

As of July 23, CDC reported 1,333 confirmed measles cases ([link removed]) in 2025 in 39 states. Two-thirds of reported confirmed cases are younger than age 20 years. Just 4% of confirmed cases have occurred in people who received two doses of measles-containing vaccine.

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, higher than confirmed case counts.

Like the United States, Canada is also experiencing a huge measles outbreak ([link removed]), with 4,206 confirmed and probable cases reported through July 28. During week 29 (July 13–19), 230 new cases were reported.

A map of cases in Canada is provided below:
[link removed]

Immunize​.org offers measles-related resources for the public on several of our affiliated websites:
* VaccineInformation​.org: Measles ([link removed]) web page
* LetsGetRealAboutVaccines​.org: Measles ([link removed]) web page
* Immunize​.org: Vaccines A–Z: Measles ([link removed]) main page

The Children’s Hospital of Philadelphia (CHOP) Vaccine Education Center (VEC) has produced an MMR infographic for families ([link removed]) (below).

Related Links
* CDC: Measles Cases and Outbreaks ([link removed]) main page
* CDC: Be Ready for Measles Toolkit ([link removed])
* Government of Canada: Measles and Rubella Weekly Monitoring Report ([link removed])
* Johns Hopkins Bloomberg School of Public Health Center for Outbreak Response Innovation: Measles Outbreak Response ([link removed]) main page
* Johns Hopkins Bloomberg School of Public Health: U.S. Measles Tracker ([link removed])
* Immunize​.org: Vaccines A–Z: Measles ([link removed]) main page

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“What Are the Pneumococcal Vaccination Options for a Previously Unvaccinated 50-Year-Old?” Watch the 1-minute answer, part of the Ask the Experts Video Series on YouTube.

This week, our featured episode from the Ask the Experts Video Series addresses the question: "What Are the Pneumococcal Vaccination Options for a Previously Unvaccinated 50-Year-Old?" ([link removed]) The video summarizes the two new options available for adults 50 years and older with no prior pneumococcal vaccination or whose previous vaccination history is unknown.

The 1-minute video is available on our YouTube channel ([link removed]) , along with our full collection of quick video answers to popular Ask the Experts ([link removed]) questions.

Like, follow, and share Immunize​.org’s social media accounts and encourage colleagues and others interested in vaccination to do likewise.
* Facebook at ImmunizeOrg ([link removed])
* Instagram at ImmunizeOrg ([link removed])
* LinkedIn at ImmunizeOrg ([link removed])
* YouTube at ImmunizeOrg ([link removed])

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Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.

* STAT: Representatives of Expert Groups to Be Barred from Work Supporting CDC’s Vaccine Advisers ([link removed]) (8/1/25)

* NPR: In a First, the Senate Confirms a New CDC Director ([link removed]) (7/29/25)

* CIDRAP: Kennedy Calls for Changes to Vaccine Injury Compensation Program ([link removed]) (7/29/25)

* KFF: Measles Elimination Status: What It Is and How the U.S. Could Lose It ([link removed]) (7/28/25)

* CNN: States, Cities Face Loss of Vaccination Programs and Staff After ‘Baffling’ Cuts to Federal Funding ([link removed]) (7/25/25)

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Immunize​.org Website and Clinical Resources
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Spotlight on the website: View our Immunize​.org website on your mobile device!

The Immunize​.org website ([link removed]) adapts seamlessly to the smaller screens of tablets and smartphones with configurations that make it simple to read and use. Navigation is responsive and features easy-access links for finger scrolling.

When you open the site on a mobile device, start your search using the “hamburger” icon (three horizontal lines) or search feature at the top right of the screen. From that menu, you will see content categories. Immunize​.org provides valuable content, no matter how you view us.

The Orientation Video Series, ([link removed]) narrated by Immunize​.org’s Kelly L. Moore, MD, MPH, specifically formatted for mobile devices, showcases resources offered on Immunize​.org in short videos:
* Introducing Immunize​.org ([link removed]) (mobile view), 3:28 minutes
* Introducing Ask the Experts ([link removed]) (mobile view), 3:36 minutes
* Introducing Clinical Resources ([link removed]) (mobile view), 3:29 minutes
* Introducing News & Updates Menu ([link removed]) (mobile view), 3:32 minutes
* Introducing State Immunization Requirements ([link removed]) (mobile view), 3:53 minutes
* Introducing Travel Vaccines ([link removed]) (mobile view), 2:39 minutes
* Introducing VIS and VIS Translations ([link removed]) (mobile view), 4:16 minutes
* Introducing Vaccines A-Z Pages ([link removed]) (mobile view), 2:19 minutes
* Introducing Website Office Hours ([link removed]) (mobile view), 1:54 minutes

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Featured Resources
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Recap: CDC releases at-a-glance resources for RSV products to help you prepare for respiratory virus season

CDC released four new at-a-glance resources for healthcare professionals on RSV prevention products. Each 2-page document addresses a single product. Use these resources to help your clinical team prepare for RSV prevention in adults and infants this fall. These materials are available on the CDC’s main Respiratory Syncytial Virus (RSV) Immunizations ([link removed]) main page and include the following documents:
* CDC: Abrysvo ([link removed]) (PDF)
* CDC: Arexvy ([link removed]) (PDF)
* CDC: mResvia ([link removed]) (PDF)
* CDC: Nirsevimab (Beyfortus) ([link removed]) (PDF)

Related Links
* CDC: Respiratory Syncytial Virus (RSV) Immunizations ([link removed]) main page
* Immunize​.org: Vaccines A–Z: RSV (Respiratory Syncytial Virus) ([link removed]) main page

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Explore the www.Give2MenACWY.org website to increase coverage for the MenACWY booster and other adolescent vaccinations

Immunize​.org's www.Give2MenACWY.org ([link removed]) website promotes the importance of adolescent vaccination, including the recommended MenACWY vaccine booster dose at age 16. Many teens are behind on vaccines, so vaccine outreach is more important than ever.

Materials on this colorful website for healthcare professionals incorporate the 2020 ACIP meningococcal vaccine recommendations ([link removed]) and coverage statistics from CDC’s National Immunization Survey–Teen (NIS–Teen). One particularly popular resource on the site is the Algorithm for MenACWY Immunization in Adolescents 11 Through 18 Years of Age ([link removed]).

The website is divided into five easy-to-access sections:
* Vaccinate Teens ([link removed]): teen vaccination schedules and tips for improving vaccination rates
* Give 2 Doses ([link removed]): tools to help improve second dose coverage of MenACWY vaccine
* 16-Year-Old Visit ([link removed]): resources to help providers and patients remember the important vaccines recommended for 16-year-olds
* Tools for Providers ([link removed]): tools to explain meningococcal ACWY vaccine recommendations and improve coverage for all adolescent vaccines
* Resources ([link removed]): links to print materials ([link removed]), organizations ([link removed]) involved in adolescent vaccination, personal stories ([link removed]) about the importance of vaccination, and otherresources ([link removed]) of interest

The site also categorizes materials ([link removed]) according to whether they are primarily of interest to providers, to adolescents, or to parents.

Visit Give2MenACWY.org ([link removed]) and enjoy browsing (and deploying) its bountiful resources.

Related Links
* Give2MenACWY.org ([link removed]) website
* Algorithm for MenACWY Immunization in Adolescents 11–18 Years of Age ([link removed])
* MenACWY: You're Not Done If You Give Just One: Give 2 Doses to Strengthen Protection ([link removed])
* Recommending MenACWY: What to Say and How to Say It ([link removed])
* Top 10 Ways to Improve Adolescent Immunization Rates ([link removed])
* Developing an Immunization Culture in Your Office ([link removed])
* Know Your Rates: Measuring Immunization Success in Your Practice ([link removed])
* You're 16: We Recommend These Vaccines for You ([link removed])
* Dear Colleague Letter: 16-Year-Old Patients: Make Sure They Receive Their Annual Well Visit and Vaccinations ([link removed]) , signed by six medical societies
* Ask the Experts: Meningococcal ACWY ([link removed])
* CDC: ACIP Meningococcal Vaccine Recommendations ([link removed])
* CDC: Vaccination Coverage Among Adolescents Aged 13–17 Years—National Immunization Survey–Teen, United States, 2023 ([link removed])

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Notable Publications
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"Global Estimates of Lives and Life-Years Saved by COVID-19 Vaccination During 2020–2024" published in JAMA Health Forum

In its July 25 issue, JAMA Health Forum published Global Estimates of Lives and Life-Years Saved by COVID-19 Vaccination During 2020–2024 ([link removed]). The findings and meaning sections appear below.

Findings: This comparative effectiveness study found that COVID-19 vaccinations averted 2.5 million deaths during 2020–2024 (sensitivity range estimates, 1.4–4.0 million) and saved 15 million life-years (sensitivity range estimates, 7–24 million life-years). The estimated benefits had a steep age gradient.

Meaning: COVID-19 vaccinations had a substantial benefit on global mortality during 2020–2024, but this benefit was mostly limited to a minority of the population of older individuals.

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“Influenza-Associated Acute Necrotizing Encephalopathy in U.S. Children” published in JAMA

In its July 30 issue, JAMA published Influenza-Associated Acute Necrotizing Encephalopathy in U.S. Children ([link removed]) . This article highlights a rare, serious form of influenza infection in children, most of whom had no known health problems. The related commentary highlights the need for better surveillance and understanding of this grave non-respiratory form of influenza infection. The findings and meaning sections of the article appear below.

Findings: In this multicenter case series of 41 children from 23 U.S. hospitals, influenza-associated ANE [acute necrotizing encephalopathy] carried a 27% mortality rate despite multimodal therapy. Most patients (76%) had no significant medical history, despite 15 of 32 tested (47%) having genetic risk alleles potentially related to risk of ANE identified during diagnostic evaluation. The H1 2009 influenza A strain predominated (34% of cases), and only 16% had received seasonal influenza vaccination. Among survivors, 63% had moderate to severe disability at 90-day follow-up.

Meaning: Influenza-associated ANE represents a rare but devastating neurologic complication primarily affecting previously healthy children. The high morbidity and mortality emphasize the need for prevention, early recognition, intensive treatment, and standardized management protocols.

Related Link
* JAMA: Pediatric Influenza-Associated Acute Necrotizing Encephalopathy—Gaps Need to Be Addressed ([link removed]) (commentary) (7/30/25)

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Upcoming Events
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Today, virtual: Register for Immunize​.org Website Office Hours. Ask questions and learn about the “Official Guidance” (state resources) web section on Immunize​.org on August 6 at 4:00 p.m. (ET) or August 7 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, August 6 at 4:00 p.m. (ET) ([link removed]) or Thursday, August 7 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 the Official Guidance ([link removed]) ("State Policies" and related resources) website section on Immunize​.org. This section was updated in July with 2025 data on state vaccination requirements for school and childcare. 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, August 6 at 4:00 p.m. (ET) ([link removed])
* Thursday, August 7 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; Let's Get Real About Vaccines Website; News & Updates; Official Guidance Part 1 & 2; Publication Archives, Vaccine Timeline, & About Us; Travel Vaccines, Vaccine Confidence, & Addressing Concerns; and Vaccines A–Z.

Mark your calendar ([link removed])  for future Immunize​.org Website Office Hours.

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Virtual: Children’s Hospital of Philadelphia hosts Current Issues in Vaccines webinar titled “Aluminum Adjuvants: Separating Fact from Fear” on September 10 at 12:00 p.m. (ET); CE credit offered

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia (CHOP) will present a 1-hour webinar titled Aluminum Adjuvants: Separating Fact from Fear ([link removed]) beginning at 12:00 p.m. (ET) on September 10. Part of its Current Issues in Vaccines ([link removed]) series, the webinar will feature Paul Offit, MD, director of the VEC.

Free continuing education credits (CME, CEU, and CPE) will be available for both the live and archived events.

Register for the webinar ([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. Gräbenstein, 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])
ISSN: 2771-8085

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