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Issue 1,836: October 8, 2025
Top Stories
* Immunize​.org updates four patient handouts summarizing immunization schedules for babies, children, and teens
* Now is a great time for you and your patients to get influenza, RSV, and COVID-19 vaccines
* Confirmed measles cases in 2025 increase to 1,544 across 41 states
* “Drawing Up Vaccine Doses in Advance” is usually a bad idea. Learn why in this 1-minute video, 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 website: Official Guidance: WHO and FDA 
* Recap: October 1 kicks off the season of giving RSV preventive antibody to infants in most parts of the United States


Vaccine Information Statements
* Recap: Immunize​.org posts translations of both current official pneumococcal VISs (PCV and PPSV23), dated May 2025
* Recap: Immunize​.org updates "You Must Provide Patients with Vaccine Information Statements (VISs) – It’s Federal Law!"


Featured Resources
* AMA releases new vaccine infographics for patients and physicians
* Families Fighting Flu launches "Kaden Blaze – Flu Fighter" campaign
* Vaccine Track shows adult vaccination rates were higher in first quarter 2025 than first quarter 2024
* Immunize​.org lifetime immunization record cards available for patient-held records


Notable Publications
* “Viewpoint: The Measles Resurgence," published in JAMA
* “Efficacy and Safety of Respiratory Syncytial Virus Vaccines” published in Cochrane Database of Systematic Reviews


Upcoming Events
* Today! Register for Immunize​.org Website Office Hours. Join a 30-minute discussion about the Clinical Resources web section on October 8 at 4:00 p.m. (ET) or October 9 at 12:00 p.m. (ET). Recorded sessions archived.


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Top Stories
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Immunize​.org updates four patient handouts summarizing immunization schedules for babies, children, and teens

Immunize​.org updated four patient handouts summarizing immunization schedules for babies, children, and teens. The updates were made to advise parents to talk with their child's healthcare provider about COVID-19 vaccination.

Updated handouts include:
* Immunizations for Babies ([link removed])
* Vaccinations for Infants and Children, Age 0–10 Years ([link removed])
* Vaccinations for Preteens and Teens ([link removed])
* When Do Children and Teens Need Vaccinations ([link removed])

Related Links
* Immunize​.org: Clinical Resources: Parent Handouts ([link removed]) main page
* Immunize​.org: Clinical Resources: Schedules for Patients ([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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Now is a great time for you and your patients to get influenza, RSV, and COVID-19 vaccines

October marks the unofficial start of respiratory disease season. Now is a great time to vaccinate against influenza, RSV, and COVID-19, if indicated. Nationally, for the week ending September 26 ([link removed]) seasonal influenza activity and RSV activity are low. Wastewater monitoring indicates that COVID-19 activity is at moderate levels.

Level of Respiratory Illness Activity
CDC monitors respiratory illness activity using an acute respiratory illness (ARI) metric. The ARI metric measures emergency department visits for a wide range of causes of acute respiratory illness, with or without fever, including the common cold, as well as influenza, RSV, and COVID-19. It offers a more complete picture than the influenza-like illness (ILI) metric used in past seasons.

Emergency Department Visits for Viral Respiratory Illness
The illustration below shows the proportion of emergency department visits (ranging from 0 to 10 percent) associated with influenza, RSV, and COVID-19. The horizontal axis shows trends from October 2024 through September 2025 for the three diseases.

Respiratory Illness Data Channel
CDC's Respiratory Illness Data Channel ([link removed]) shows a snapshot of the amount of acute respiratory illness causing people to seek health care in the United States. Local data is available by state or territory and by county. This site summarizes the activity on a 5-point scale from very low to very high.

Season Outlook
You can now view CDC’s 2025–2026 Respiratory Disease Season Outlook ([link removed]), which is based on historical trends, expert opinion, and scenario modeling results. At present, CDC expects the upcoming fall and winter respiratory disease season in the United States will be similar to last season. CDC will update the published outlook every 2 months throughout the season and as warranted by changes in the trajectories of any of the three viruses.

Updates to these reports are likely to be delayed during the federal government closure.

Related Links
* CDC: Weekly National Flu Vaccination Dashboard ([link removed]) main page
* CDC: FluView ([link removed]) main page
* CDC: RESP-NET ([link removed]) main page

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Confirmed measles cases in 2025 increase to 1,544 across 41 states

As of September 30, CDC reported 1,544 confirmed measles cases ([link removed]) in 2025 in 41 states. Of reported confirmed cases, 27% were younger than age 5 years and 12% were hospitalized. Canada reports 5,006 confirmed and probable cases for 2025 through September 20.

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.

A map of 2025 measles cases ([link removed]) in the contiguous United States, as of September 29, from the Johns Hopkins International Vaccine Access Center ([link removed]), appears below. The U.S. Measles Tracker ([link removed]) website includes state and county-level data.

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

Another credible source is the American Academy of Pediatrics’ Fact Checked: The Measles Vaccine Is Safe and Effective ([link removed]) web page.
Related Links
* CDC: Measles Cases and Outbreaks ([link removed]) main page
* CDC: Be Ready for Measles Toolkit ([link removed])
* Health 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
* Immunize​.org: Vaccines A–Z: Measles ([link removed]) main page

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“Drawing Up Vaccine Doses in Advance” is usually a bad idea. Learn why in this 1-minute video, part of the Ask the Experts Video Series on YouTube.

This week, our featured episode from the Ask the Experts Video Series is titled Drawing Up Vaccine Doses in Advance ([link removed]) . The video describes why CDC discourages filling syringes in advance of patient arrival, primarily because this increases the possibility of administration and dosing errors.

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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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.

* Patient Care: Kelly Moore, MD, MPH, Is Concerned About COVID-19 Vaccination Equity in Post-Universal Coverage America ([link removed]) (10/2/25)

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Vaccines in the news

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

* USA Today: New Vaccination Maps Reveal Outbreak Risks. Is Your County Protected? ([link removed]) (10/6/25)

* ACC: Focus on Prevention: ACC Streamlines Immunization Recommendations for CVD ([link removed]) (10/1/25)

* New York Times: What 20 Years of Listening to Vaccine-Hesitant Parents Has Taught Me ([link removed]) (9/30/25)

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Immunize​.org Website and Clinical Resources
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Spotlight on the website: Official Guidance: WHO and FDA 

Today, we turn the spotlight on WHO ([link removed]) and FDA ([link removed])  immunization-related resources, which are located under the Official Guidance menu tab atop each page. 

Selecting the “WHO” option under Official Guidance leads you to our World Health Organization ([link removed]) page, which links to current vaccine-specific and general position papers. Also included are links to the Bulletin of the World Health Organization and Weekly Epidemiological Record.

Find direct links to vaccine package inserts ([link removed]) and related content under Official Guidance. Click “FDA” and then click “FDA Package Inserts & EUAs.” Use the Vaccine or Disease Name filter to narrow results.   

Package inserts can also be accessed from their respective Vaccines A–Z ([link removed]) page. For example, package inserts for each PCV (PCV13, PCV15, PCV20, and PCV21) as well as PPSV23 are included on Pneumococcal Vaccine ([link removed]). View the right-hand menu on this page and click on “FDA Package Inserts & EUAs” to jump directly to their location. 

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Recap: October 1 kicks off the season of giving RSV preventive antibody to infants in most parts of the United States

According to the 2023 ACIP recommendation for administration of nirsevimab ([link removed]) (Beyfortus, Sanofi ([link removed]) ) and the 2025 recommendation for administration of clesrovimab ([link removed]) (Enflonsia, Merck ([link removed]) ), RSV monoclonal antibodies for infants should generally begin on October 1 and continue through March 31 in jurisdictions with RSV seasonality typical of most of the contiguous United States.

Alaska and tropical climates have RSV circulation patterns that differ from most of the contiguous United States. Locations with tropical climates include southern Florida, Hawaii, Guam, Puerto Rico, U.S. Virgin Islands, and U.S.-affiliated Pacific Islands. Providers in these jurisdictions should follow state or territorial public health guidance on timing of RSV monoclonal antibody administration.

A preventive RSV antibody is recommended as a single dose for infants younger than age 8 months and 0 days whose mothers were not effectively vaccinated against RSV during pregnancy. Infants whose mothers were effectively vaccinated against RSV and those who received a dose of Beyfortus late last season should not receive a dose of RSV preventive antibody now, even if they are still younger than age 8 months.

A dose of Beyfortus is also recommended for certain children at high risk of severe RSV disease age 8 months through 19 months entering their second RSV season, regardless of their history of maternal vaccination or receipt of a preventive antibody during their first RSV season. These high-risk groups include American Indian and Alaska Native children (particularly those living in remote areas and with limited access to medical services), children with chronic lung disease of prematurity, severe immunocompromise, and cystic fibrosis with growth under 10th percentile.

CDC has published the following timeline infographic to make it easier for clinical staff to determine which RSV prevention measures are recommended at which times of year in most of the United States.

The American Academy of Pediatrics and the American Academy of Family Physicians share the same recommendations for the use of these RSV prevention products.

To review details of recommendations, including dosing criteria, and guidance for rare circumstances, view Immunize​.org's:
* Standing Orders for Administering Nirsevimab RSV Preventive Antibody (Beyfortus, by Sanofi) to Infants and High-Risk Young Children ([link removed])
* Standing Orders for Administering Clesrovimab RSV Preventive Antibody (Enflonsia, by Merck) to Infants ([link removed])

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Vaccine Information Statements
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Recap: Immunize​.org posts translations of both current official pneumococcal VISs (PCV and PPSV23), dated May 2025

On May 29, 2025, CDC updated VISs for PCV and PPSV23. Immunize​.org recently posted new VIS translations, including:

PPSV23 VIS ([link removed]) PCV VIS ([link removed])

Arabic ([link removed]) Arabic ([link removed])

Armenian ([link removed]) Armenian ([link removed])

Burmese ([link removed]) Burmese ([link removed])
Bengali ([link removed])

Chinese-Simplified ([link removed]) Chinese-Simplified ([link removed])

Chinese-Traditional ([link removed])
Chinese-Traditional ([link removed])

Dari ([link removed])

Farsi ([link removed])
Farsi ([link removed])

French ([link removed]) French ([link removed])
German ([link removed])

Haitian Creole ([link removed])

Hindi ([link removed])

Italian ([link removed])

Japanese ([link removed])

Khmer ([link removed])
Khmer ([link removed])

Korean ([link removed])

Pashto ([link removed])

Polish ([link removed])

Portuguese ([link removed])

Russian ([link removed])
Russian ([link removed])
Somali ([link removed])
Somali ([link removed])

Spanish PDF ([link removed]), RTF ([link removed])
Spanish PDF ([link removed]), RTF ([link removed])

Swahili ([link removed])

Tagalog ([link removed])
Tagalog ([link removed])

Ukrainian ([link removed])

Urdu ([link removed])

Vietnamese ([link removed])
Vietnamese ([link removed])
Yiddish ([link removed])

To locate VIS translations for a particular vaccine on Immunize​.org, click the top tab Vaccines & VISs, click on “VISs,” and then select a specific vaccine. Scrolling down the resulting page, you will see:
* The current English VIS (the official federal version)
* Current translations (i.e., translations of the current English VIS)
* Where applicable, out-of-date translations (i.e., translations of past English versions if no current translation is available)
* Sheets explaining how to use VISs

Families given any VIS translation should also receive the current official VIS, which is in English.

Check the version date of your inventory of VIS translations. Discard translations of previous versions as translations of current versions become available.

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Recap: Immunize​.org updates "You Must Provide Patients with Vaccine Information Statements (VISs) – It’s Federal Law!"

Immunize​.org updated its clinician resource, You Must Provide Patients with Vaccine Information Statements (VISs) – It’s Federal Law! ([link removed]) VISs are always required when administering vaccines included in the federal Vaccine Injury Compensation Program (VICP). Previously, VISs were also required when federally funded vaccines that were not covered by the VICP were administered. The resource was updated to state that CDC recommends providing a VIS when administering vaccines not included in the VICP, but it is not required for these vaccines, regardless of funding source. Examples of vaccines not covered by VICP include COVID-19, RSV, PPSV23, and zoster.

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Featured Resources
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AMA releases new vaccine infographics for patients and physicians

The American Medical Association (AMA) released new tools ([link removed]) to help patients and physicians cut through the confusion around vaccines, and converse openly and honestly. The tools are described below.

* Why Vaccines Matter to Your Health: ([link removed]) an infographic for patients explaining why vaccination is an important part of staying healthy and encouraging families to discuss their questions with their doctor

* How To Talk to Your Patients About Vaccines ([link removed]) : an infographic for physicians with sample conversation starters for speaking with patients who may be unsure about vaccines—helping to build trust and understanding

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Families Fighting Flu launches "Kaden Blaze – Flu Fighter" campaign

Families Fighting Flu (FFF) launched a new campaign to share Kaden Stevenson’s story ([link removed]) through the comic book Kaden Blaze Fights the Flu Bug ([link removed]) and other supporting materials. Below is a summary of Kaden's story.

In December 2022, 7-year-old Kaden contracted the flu. Due to severe complications, he spent over 9 weeks in the hospital and ultimately lost both of his legs. That same winter, another young boy—just 5 years old—was hospitalized with the flu and tragically didn’t survive.

After his recovery, Kaden told his mom he must have superpowers because he survived—and that he wanted to use those powers to protect other kids from the flu. From that mission, Kaden Blaze was born.

Campaign resources ([link removed]) include:
* Kaden Blaze flu fact sheet
* Stickers and postcards
* Graphics and social media toolkit
* Educational worksheets

FFF will continue adding new content throughout the season to support your influenza awareness and engagement efforts.

Related Link
* Families Fighting Flu ([link removed]) web page

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Vaccine Track shows adult vaccination rates were higher in first quarter 2025 than first quarter 2024

Vaccine Track ([link removed]) is a website that displays state and national trend data on the use of recommended adult vaccines. Updated quarterly, Vaccine Track is produced through a partnership between GSK and IQVIA, a data analytics company.

The October 2025 report notes that first quarter vaccination claims were notably higher compared to first quarter 2024 across insurance coverage markets, racial and ethnic groups, and healthcare access points.

Excluding seasonal influenza and RSV, the map below depicts the percentage change in first quarter vaccination claims from 2024 to 2025 among adults age 19 or older by metro area.

Vaccine Track ([link removed]) data are refreshed quarterly, whereas CDC data are typically updated less often. Vaccine Track makes comprehensive vaccination claims data across different payer types available publicly.

Related Links
* GSK/IQVIA: Vaccine Track ([link removed]) web page
* CDC: VaxView ([link removed]) main page

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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.
[link removed]

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

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Notable Publications
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“Viewpoint: The Measles Resurgence," published in JAMA

In its October 1 issue, JAMA published Viewpoint: The Measles Resurgence ([link removed]). This article was written by Jane R. Zucker, MD, MSc, a physician consultant with Immunize​.org and the former Assistant Commissioner, New York City Health Department. Dr. Zucker concludes the article:

The nation is undergoing a dismantling of public health, destruction of evidence-based immunization policy, and loss of vaccine access. If vaccination levels continue to decrease, vaccine-preventable disease outbreaks will be more frequent. Measles has already surged and diseases no longer observed in the U.S. will make a comeback. We risk a return to the situation of the early 1900s and the prevaccine era.

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“Efficacy and Safety of Respiratory Syncytial Virus Vaccines” published in Cochrane Database of Systematic Reviews

In its September 29 issue, Cochrane Database of Systematic Reviews published Efficacy and Safety of Respiratory Syncytial Virus Vaccines ([link removed]). The authors' conclusions section appears below.

RSV prefusion vaccines [i.e., Abrysvo, Pfizer; Arexvy, GSK] reduced RSV‐associated lower respiratory tract illness and acute respiratory illness in older adults. There may be little to no difference in SAEs [serious adverse events] related to vaccination in older adults.

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Upcoming Events
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Today! Register for Immunize​.org Website Office Hours. Join a 30-minute discussion about the Clinical Resources web section on October 8 at 4:00 p.m. (ET) or October 9 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, October 8, at 4:00 p.m. (ET) ([link removed]) or Thursday, October 9, 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 Clinical Resources 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 sessions):
* Wednesday, October 8, at 4:00 p.m. (ET) ([link removed])
* Thursday, October 9, 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])
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