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Issue 1,829: August 27, 2025

Top Stories
* Immunize​.org posts RSV preventive antibody standing order templates for clesrovimab (new) and nirsevimab (updated)
* AAP publishes its own evidence-based childhood and adolescent immunization schedules for 2025, with guidance for influenza, RSV, and COVID-19 immunization
* ACOG releases its updated immunization guidance for COVID-19, influenza, and RSV during pregnancy
* “Respiratory Syncytial Virus Immunization Coverage Among Infants Through Receipt of Nirsevimab Monoclonal Antibody or Maternal Vaccination—United States, October 2023–March 2024” published in MMWR
* No new measles cases reported in Texas in more than 42 days; measles continues to spread in other states and Canada
* “Why Was the Bexsero MenB Vaccine 2-Dose Interval Changed in 2024?” Watch the 2-minute answer, part of the Ask the Experts Video Series on YouTube.
* Journalists interview Immunize​.org experts
* Vaccines in the news


Immunize​.org Website and Clinical Resources
* Spotlight on the LetsGetRealAboutVaccines.org website: Share the Facts


Featured Resources
* Be prepared! Centers for Medicare and Medicaid Services publish information on seasonal influenza vaccine pricing, billing, and payment for the 2025–26 influenza season.
* That's a wrap on National Immunization Awareness Month! Continue to use these resources to encourage vaccination.
* Immunize​.org lifetime immunization record cards available for patient-held records


Notable Publications
* “Video and Infographic Messages from Primary Care Physicians and Influenza Vaccination Rates” published in JAMA Network


Upcoming Events
* Virtual: Register for Immunize​.org Website Office Hours. Each session now only 30 minutes! Ask questions and learn about the VIS web section on September 10 at 4:00 p.m. (ET) or September 11 at 12:00 p.m. (ET). Recorded sessions archived.

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Top Stories
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Immunize​.org posts RSV preventive antibody standing order templates for clesrovimab (new) and nirsevimab (updated)

In response to new CDC recommendations for routine use of an additional RSV preventive antibody product in infants, Immunize​.org published the clinical resource: Standing Order for Administering Clesrovimab RSV Preventive Antibody (Enflonsia, by Merck) to Infants ([link removed]). Immunize​.org also updated its existing Standing Order for Administering Nirsevimab RSV Preventive Antibody (Beyfortus, by Sanofi) to Infants and High-Risk Young Children ([link removed]).

The new preventive antibody product, Enflonsia, is an option for protection of infants younger than age 8 months before or during their first RSV season. There is no preference between Beyfortus and Enflonsia for eligible infants. The Beyfortus standing orders template was updated to note that the other two options for protection of infants during their first RSV season are to administer Enflonsia to the infant or to administer the Abrysvo RSV vaccine (Pfizer) during pregnancy. Only Beyfortus is licensed and recommended for older children, age 8 through 19 months, who are at high risk for severe RSV disease and are entering their second RSV season.

Immunize​.org is also updating the Abrysvo standing orders ([link removed]) for vaccination during pregnancy to note the alternative options of Beyfortus or Enflonsia for infant RSV protection.

Related Links
* Immunize​.org: Clinical Resources: Standing Orders Templates ([link removed]) main page
* Immunize​.org: Vaccines A–Z: RSV (Respiratory Syncytial Virus) ([link removed]) main page
* Immunize​.org: Clinical Resources A–Z ([link removed]) main page, where you can filter by topic, vaccine, language, or other criteria

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AAP publishes its own evidence-based childhood and adolescent immunization schedules for 2025, with guidance for influenza, RSV, and COVID-19 immunization

On August 19, the American Academy of Pediatrics (AAP) published its own evidence-based childhood and adolescent immunization schedule ([link removed]). AAP has a history of publishing its own schedule for childhood immunization going back to the 1930s. Although AAP endorses the CDC recommended schedule as originally published in November 2024, it has withdrawn its support for the CDC schedule as amended in 2025 and currently posted by CDC.

The new AAP schedule differs from the most current CDC recommendations regarding influenza and COVID-19 vaccination. For RSV, there are no differences between the current CDC and AAP schedules.

For influenza, both CDC and AAP recommend annual vaccination of all children age 6 months and older. However, AAP continues to recommend, in the absence of evidence of harm, that age-appropriate influenza vaccine products packaged in multidose vials containing thimerosal as a preservative are an acceptable option for any child.

For COVID-19, CDC’s schedule currently recommends optional childhood vaccination based upon shared clinical decision-making and has no recommendation for COVID-19 vaccination during pregnancy. AAP’s schedule calls for routine vaccination of all young children age 6 through 23 months, routine vaccination of specific older children at high risk, and routine vaccination during pregnancy.

The schedule is also available in Red Book Online ([link removed]), the AAP’s clinical guidebook for infectious disease prevention and treatment. To ensure it is easily accessible, AAP will publish a parent-friendly version on HealthyChildren.org ([link removed]) and AAP.org ([link removed]).

Related Links
* AAP: Press Release: The American Academy of Pediatrics Releases Its Own Evidence-Based Immunization Schedule ([link removed]) (8/19/25)
* AAP: Recommended Child and Adolescent Immunization Schedules for Ages 18 Years or Younger, United States, 2025 ([link removed])
* AAP: Fact Checked: Children’s Health, Not Financial Incentives, Guides Pediatricians’ Immunization Recommendations ([link removed])

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ACOG releases its updated immunization guidance for COVID-19, influenza, and RSV during pregnancy

On August 22, the American College of Obstetricians and Gynecologists (ACOG) released updated evidence-based clinical guidance regarding vaccination during pregnancy against COVID-19, influenza, and RSV ([link removed]). The three guidance documents, each recommending maternal immunization, describe the body of current scientific evidence that supports the safety and benefits for mother and baby when vaccinating against these serious respiratory conditions during pregnancy. The documents are briefly described below.

COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care ([link removed]): ACOG recommends that patients receive an updated COVID-19 vaccine at any point during pregnancy, when planning to become pregnant, in the postpartum period, or when lactating.

Influenza in Pregnancy: Prevention and Treatment ([link removed]): ACOG recommends that everyone who is or will be pregnant during influenza season receive any age-appropriate injectable influenza vaccine as soon as it is available, during any trimester of pregnancy.

Maternal Respiratory Syncytial Virus Vaccination ([link removed]): ACOG recommends a single dose of Abrysvo RSV vaccine (Pfizer) when seasonally appropriate (generally September through January), to prevent RSV lower respiratory tract infection in infants. Eligibility criteria include no maternal history of previous RSV vaccination and gestational age between 32 and 36 6/7 weeks’ gestation.

Related Links
* ACOG: Press Release: ACOG Releases Updated Maternal Immunization Guidance for COVID-19, Influenza, and RSV ([link removed]) (8/22/25)
* ACOG: Practice Advisory: COVID-19 Vaccination Considerations for Obstetric–Gynecologic Care ([link removed])
* ACOG: Practice Advisory: Influenza in Pregnancy: Prevention and Treatment ([link removed])
* ACOG: Practice Advisory: RSV, Maternal Respiratory Syncytial Virus Vaccination ([link removed])
* Immunize​.org: Standing Orders Templates ([link removed]) for prevention of RSV infection

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“Respiratory Syncytial Virus Immunization Coverage Among Infants Through Receipt of Nirsevimab Monoclonal Antibody or Maternal Vaccination—United States, October 2023–March 2024” published in MMWR

CDC published Respiratory Syncytial Virus Immunization Coverage Among Infants Through Receipt of Nirsevimab Monoclonal Antibody or Maternal Vaccination—United States, October 2023–March 2024 ([link removed]) in the August 21 issue of MMWR. Readers will note that the results of this CDC survey estimated significantly lower coverage than a CDC internet panel survey published in September 2024 ([link removed]), covering a similar time period. Differences may be related to bias toward inflated self-reported coverage in the internet survey or suppressed coverage rates due to the incompleteness of records in immunization information systems (IIS), or both. In either case, there are many opportunities for improvement in coverage in the coming season. The summary of this IIS survey appears below.

Respiratory syncytial virus (RSV) is the most common cause of hospitalization among U.S. infants. In 2023, a long-acting monoclonal antibody for infants (nirsevimab) and a maternal vaccine were recommended to prevent RSV among infants. In the same year, data from state- and jurisdiction-level immunization information systems (IISs) became available at CDC. . . .

Cross-sectional analysis of data from IISs representing 33 states and the District of Columbia found that 29% of infants born during October 2023–March 2024 were immunized against RSV through receipt of nirsevimab or through maternal RSV vaccination during pregnancy in the 2023–24 respiratory virus season, the first season that these products were available. State-specific immunization coverage from nirsevimab or maternal vaccination ranged from 11% to 53%. . . .

Continued efforts are needed to increase infant RSV immunization coverage and reduce associated morbidity. IISs are population-based data sources that can be used to monitor jurisdiction-level coverage.

Access the MMWR article in HTML ([link removed]) or PDF ([link removed]).

Related Link
* CDC: MMWR main page ([link removed]) providing access to the MMWR family of publications

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No new measles cases reported in Texas in more than 42 days; measles continues to spread in other states and Canada

As of August 19, CDC reported 1,375 confirmed measles cases ([link removed]) in 2025 in 41 states. Two-thirds of reported confirmed cases are younger than age 20 years. Just 4% of confirmed cases 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.

On August 18, the Texas Department of State Health Services issued a press release ([link removed]) announcing the end of the West Texas measles outbreak. The press release states, “It has been more than 42 days since a new case was reported in any of the counties that previously showed evidence of ongoing transmission.” Since late January, 762 measles cases have been confirmed in the Texas outbreak. Ninety-nine people were hospitalized during the outbreak. Two previously healthy school-aged children died.

Canada is currently experiencing a measles outbreak ([link removed]) with official case counts and incidence rates that far exceed those in the United States. Canada has reported 4,638 confirmed and probable 2025 cases through August 18. During week 32 (August 3–9), 93 new cases were reported. The distribution of measles cases in Canada appears below:

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

Recently, Public Health of Seattle and King County published a comic explaining how contagious measles is ([link removed]), shown 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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“Why Was the Bexsero MenB Vaccine 2-Dose Interval Changed in 2024?” Watch the 2-minute answer, part of the Ask the Experts Video Series on YouTube.

This week, our featured episode from the Ask the Experts Video Series is titled Why Was the Bexsero MenB Vaccine 2-Dose Interval Changed in 2024? ([link removed]) The video describes FDA's August 2024 revision to the licensed schedule for Bexsero, changing the recommended 2-dose interval from 1 month to 6 months, matching the other MenB vaccine, Trumenba (Pfizer). The change was prompted by evidence of a small, but significant, improvement in the immune response to Bexsero when 2 doses were given 6 months apart, instead of 1 month apart, as previously licensed. Those who previously received two Bexsero doses with a 1-month interval when that interval was approved are not recommended to receive an additional dose.

The 2-minute video is available on our YouTube channel ([link removed]), along with our full collection of quick video answers to popular Ask the Experts ([link removed]) questions.

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

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Journalists interview Immunize​.org experts

Journalists seek out Immunize​.org experts to help explain vaccines to the public and policy makers. We help the media understand and communicate the complex work vaccinators do. Here is a recent citation.
* Katie Couric Media: What to Know About the New At-Home Flu Vaccine ([link removed]) (8/19/25)

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Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* New York Times: COVID Vaccine Opponent Tapped to Lead Federal Review Team ([link removed]) (8/22/25)
* New York Times: The Playbook Used to ‘Prove’ Vaccines Cause Autism ([link removed]) (8/19/25)
* CIDRAP: Vaccine Integrity Project Presents Reassuring Data on Vaccines for Upcoming Respiratory Virus Season ([link removed]) (8/19/25)
* Axios: School Reopenings Bring More Vaccine Confusion ([link removed]) (8/18/25)

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Immunize​.org Website and Clinical Resources
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Spotlight on the LetsGetRealAboutVaccines.org website: Share the Facts

This week we continue to spotlight our newest website, LetsGetRealAboutVaccines.org ([link removed]), a trustworthy, parent-friendly platform that delivers factual vaccine guidance. It equips families and providers with tools to advocate for childhood immunization confidently.

This week’s feature is the Share the Facts ([link removed]) section of LetsGetRealAboutVaccines.org ([link removed]). Found at the third menu tab, these pages offer sharable resources explaining the benefits of vaccines. Resources include fact sheets, social media graphics, videos, and infographics.

The main page includes the full list and preview of more than 70 resources that can be filtered by audience, topic, and format. Each item can be viewed, downloaded, or shared directly to social media.

Three supporting pages are available from this page and from the menu:
* Parent and Provider Stories ([link removed]): stories from real parents and healthcare providers who choose to vaccinate
* Watch PSA Videos ([link removed]): short public service announcement videos promoting the LetsGetRealAboutVaccines.org website
* Sharing Your Support ([link removed]): easy ways for parents to share support for vaccines on social media

Please share these links with anyone seeking credible, unbiased information about childhood vaccines.

View the archived Website Office Hours: Let's Get Real About Vaccines ([link removed]) website webinar to learn simple tips and tricks for using the website efficiently.

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Featured Resources
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Be prepared! Centers for Medicare and Medicaid Services publish information on seasonal influenza vaccine pricing, billing, and payment for the 2025–26 influenza season.

Updated resources are available from the Centers for Medicare and Medicaid Services (CMS) to help you prepare for influenza vaccine purchasing, billing, and payment during the 2025–26 season. In the August 21 issue of MLN Connects ([link removed]), CMS published information about seasonal influenza vaccine pricing for the 2025–26 season ([link removed]). In addition, the updated CMS Flu Shot ([link removed]) web page includes helpful information on vaccination frequency and coverage, billing resources, and ICD-10, CPT, and other relevant codes.

Related Link
* CMS: MLN Connects Newsletter Archive ([link removed])

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That's a wrap on National Immunization Awareness Month! Continue to use these resources to encourage vaccination.

National Immunization Awareness Month ([link removed]) (NIAM), an annual observance that highlights the importance of on-time vaccination, is winding down. However, the need to share accurate and understandable messages about immunization continues to grow.

Multiple partners offer resources, including social media messages, that you can use in your immunization 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.
* 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]).

In addition to these resources, consider sharing some of the new resources from LetsGetRealAboutVaccines.org ([link removed]).

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Immunize​.org lifetime immunization record cards available for patient-held records

Immunize​.org offers wallet-sized Lifetime Immunization Record Cards ([link removed]) , printed on rip-proof, smudge-proof, waterproof paper designed to last a lifetime. Sold in boxes of 250.

To purchase record cards, please visit the Immunize​.org Shop ([link removed]).

Related Link
* Immunize​.org: Shop Immunize​.org ([link removed]) main page

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Notable Publications
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“Video and Infographic Messages from Primary Care Physicians and Influenza Vaccination Rates” published in JAMA Network

In its August 13 issue, JAMA Network published Video and Infographic Messages from Primary Care Physicians and Influenza Vaccination Rates ([link removed]). This was coauthored by Immunize​.org’s director for research, Sharon Humiston, MD, MPH. Although these interventions were found to have no effect on influenza immunization rates in adults, they did have a positive effect on influenza immunization rates in children. Portions of the abstract appear below.

This 3-arm randomized clinical trial included patients from 6 months to older than 65 years of age served by 21 primary care physicians in 21 practices at UCLA Health who were listed in the electronic health record as not receiving influenza vaccination between October 31, 2023, and April 1, 2024. . . .

Patients within each physician patient population were randomized to receive usual care or a physician-created video or an infographic with their physician’s photograph encouraging receipt of influenza vaccinations. Primary care physicians used a suggested script to create a brief video with their smartphone or a video conference recording, or an infographic containing their photograph and a similar script was created, both encouraging patients to receive influenza vaccinations. The video or infographic was sent via the patient portal up to 3 times (October, November, and December). . . .

In this randomized clinical trial, neither physician-created videos nor infographics increased influenza overall vaccination rates by April 1, 2024. However, among children, both interventions were effective by end of influenza season. Messages personalized by physicians may represent a potential strategy to improve influenza vaccination among children, but further innovations are needed across the entire age spectrum.

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Upcoming Events
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Virtual: Register for Immunize​.org Website Office Hours. Each session now only 30 minutes! Ask questions and learn about the VIS web section on September 10 at 4:00 p.m. (ET) or September 11 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, September 10, at 4:00 p.m. (ET) ([link removed]) or Thursday, September 11, at 12:00 p.m. (ET) ([link removed]). The same content will be covered in both sessions.

We will open each 30-minute session with a short, live demonstration on navigating the popular VIS website section on Immunize​.org. 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, September 10, at 4:00 p.m. (ET) ([link removed])
* Thursday, September 11, 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.

Mark your calendar ([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. 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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