On October 6, the acting CDC director accepted the September 18–19 ACIP recommendations to not recommend use of MMRV vaccine (ProQuad, Merck) for children younger than age 4 years. He also accepted all of ACIP’s COVID-19 vaccination recommendations, including the individual-based decision-making (also known as shared clinical decision-making [SCDM]) recommendation for COVID-19 vaccination of all people age 6 months and older following discussion with a healthcare professional. His acceptance makes the ACIP’s recommendations official CDC recommendations.

On October 7, CDC updated the Child and Adolescent Immunization Schedule and the Adult Immunization Schedule to reflect these changes. The CDC schedule now reflects the new ACIP recommendation that COVID-19 vaccination during pregnancy is recommended based on shared clinical decision-making. Beginning May 2025, the CDC schedule was silent on COVID-19 vaccination during pregnancy, while the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists continued to recommend routine use of COVID-19 vaccine during pregnancy. Immunize​.org is updating its materials as needed to reflect these new CDC recommendations.

Some vaccine providers report recent claim denials by Centers for Medicare and Medicaid Services (CMS) for vaccine administration when both COVID-19 and another Medicare Part B vaccine are administered at the same visit. The National Community Pharmacists Association sent the message below to its members to address this issue. Similar advice may be warranted in other settings.

CMS and its Medicare Administrative Contractors (MACs) require modifier 59 “Distinct Procedural Service” be added to the second (or any additional) vaccine administration codes when the COVID-19 vaccine is administered on the same date of service as other Part B vaccines. For example, in addition to the CPT or HCPCS codes for the COVID-19 and flu vaccine products, the claim should include 90480 and G0008-59, respectively, to claim reimbursement for administering the vaccine products. Pharmacies that use a billing intermediary to format prescription claims for the MAC should ask for updated instructions (e.g. a DUR Reason for Service code) on preparing the Rx claim when COVID-19 is one of two or more Part B vaccines administered to a patient on the same date of service.

Medscape Education released a curriculum, Targeting Viral Hepatitis: A Road Map for Providers, featuring expert perspectives on preventing and managing viral hepatitis. Two sections focus on hepatitis C and the third focuses on universal hepatitis B screening and vaccination. The hepatitis B module was codeveloped and moderated by Immunize​.org’s L.J Tan, PhD.

To earn CME, ABIM MOC, or CE credit please click here.

The American Hospital Association (AHA) launched its United Against the Flu Toolkit with easy-to-share content to spread awareness about availability of influenza vaccine for at-risk and vulnerable populations. This toolkit features messages and social media assets that hospitals and health systems can use on their own channels.

Our newest website, LetsGetRealAboutVaccines.org, is a trustworthy, parent-friendly platform that delivers factual information about childhood vaccines. It equips families with trustworthy answers to questions and providers with tools to advocate for childhood immunization confidently.



At the third menu tab, the Share the Facts section offers shareable fact sheets, social media graphics, videos, and infographics. New this month, each of the 19 downloadable infographics are available in printable form (PDFs with added page breaks), to post in your clinic waiting and exam rooms. The printable versions have the same content as the originals and are designated with a purple banner on the top of the image that says, "printable."

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Below are just a few examples of these infographics.

• Vaccines Are Safe (printable version)
• Getting COVID-19 vs. Getting Vaccinated (printable version)
• Getting Measles vs. Getting Vaccinated (printable version)

Visit LetsGetRealAboutVaccines.org to access 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.

In its October 1 issue, Human Vaccines & Immunotherapeutics published Healthcare Worker Perspectives on System-Level Barriers to Hepatitis B Birth Dose Vaccination: An Analysis in Five Urban U.S. Hospitals. A portion of the abstract and a summary of key findings appear below.

Despite three decades of recommendations, hepatitis B birth dose vaccination coverage remains suboptimal at 81.5% nationally, falling short of other routine immunizations and public health targets. This study examined implementation practices across five Washington, DC birthing hospitals through semi-structured interviews with 36 healthcare workers representing professional roles.
 
Key findings of this study include:

• Providers demonstrated strong support for vaccination, with 94% routinely recommending the birth dose for newborns
• Only 69% consistently recommended vaccination for premature infants, revealing concerning practice variability and knowledge gaps regarding weight-based guidelines
• 64% unaware or uncertain about vaccination tracking systems 
• Lack of designated vaccine champions and minimal leadership engagement
• Only 19% received regular education on birth-dose importance and 86% lacked training to address vaccine hesitancy
• Only 17% used electronic reminder systems, despite proven effectiveness

• Give Birth to the End of Hep B main page  
• Hepatitis B Birth Dose Honor Roll web page

In its October 8 issue, New England Journal of Medicine published Association of 2024–2025 COVID-19 Vaccine with COVID-19 Outcomes in U.S. Veterans. Portions of the abstract appear below.

We conducted an observational study that used the electronic health records of the Department of Veterans Affairs to evaluate the effectiveness of the 2024–2025 COVID-19 vaccine among veterans who received the COVID-19 and influenza vaccines on the same day (164,132 participants) and in an active-comparator group of veterans who received the influenza vaccine only (131,839 participants), between September 3 and December 31, 2024. . . .

At 6 months of follow-up, the estimated vaccine effectiveness was 29.3% . . . against COVID-19–associated emergency department visits . . . , 39.2% . . . against COVID-19–associated hospitalizations . . . , and 64.0% against COVID-19–associated deaths . . . Vaccine effectiveness against a composite of these outcomes was 28.3% . . . The COVID-19 vaccine was associated with decreased risks of these outcomes across prespecified subgroups defined according to age (<65 years, 65 to 75 years, and >75 years), the presence or absence of major coexisting conditions, and immunocompetence status.