Issue 1,520: October 7, 2020
Top Stories
IAC Handouts
Featured Resources
Journal Articles and Newsletters
Education and Training
Conferences and Meetings
On the Lighter Side
Top Stories
CDC publishes “Influenza and Tdap Vaccination Coverage among Pregnant Women—United States, April 2020” in MMWR
CDC published Influenza and Tdap Vaccination Coverage among Pregnant Women—United States, April 2020 in the October 2 issue of MMWR. The internet panel survey evaluated self-reports on influenza and Tdap vaccination among women aged 18–49 years, pregnant between October 2019–January 2020.
- 61% of women reported receiving influenza vaccine before or during their pregnancy, an increase of 7.5 percentage points over the previous season
- 57% reported receiving Tdap vaccine during their pregnancy, 1.7 percentage points above the previous season
- Overall 40% received both vaccines, but this was true for only 23% of Black women and 25% of Hispanic women
- Flu vaccination coverage increased for both Black and Hispanic women
- Tdap vaccination decreased for Hispanic women compared with last season
- Flu vaccination coverage was higher among those who received a provider offer or referral
Overall, disparities remain and maternal vaccination coverage continues to be suboptimal. Routine vaccination is more important than ever during 2020–21 to protect pregnant women and their babies from flu, and to prevent potentially deadly diseases like whooping cough.
CDC publishes “Flu Vaccination Coverage, United States, 2019–20 Influenza Season” via FluVaxView
CDC published Flu Vaccination Coverage, United States, 2019–20 Influenza Season on the FluVaxView gateway page on October 2.
CDC analyzed data from two telephone surveys, the National Immunization Survey-Flu (NIS-Flu) and the Behavioral Risk Factor Surveillance System (BRFSS), to estimate flu vaccination coverage for the U.S. population during the 2019–20 flu season.
- Coverage with ≥1 dose of flu vaccine was 63.8% among children 6 months through 17 years, an increase of 1.2 percentage points from the 2018–19 flu season
- Coverage among adults ≥18 years was 48.4%, an increase of 3.1 percentage points from the prior season
- 51.8% of persons six months and older were vaccinated during the 2019–20 season, an increase of 2.6 percentage points from the prior season
- Racial/ethnic disparities in flu vaccination coverage persisted; non-Hispanic black children had lower flu vaccination coverage than children in all other racial/ethnic groups, while Hispanic adults and non-Hispanic black adults had lower flu vaccination coverage than non-Hispanic white adults
CDC notes: Getting a flu vaccine will be more important than ever this fall and winter, because it is likely that flu viruses and the virus that causes COVID-19 will both be spreading in the United States. Flu vaccination could help prevent or reduce the severity of flu illness, and reduction of outpatient illnesses, hospitalizations, and intensive care unit admissions could alleviate stress on the U.S. health care system. September and October are good times to get vaccinated; however, as long as flu viruses are circulating, vaccination should continue. To avoid missed opportunities for vaccination, providers should offer vaccination during routine health care visits and hospitalizations. Guidance for vaccine planning during the COVID-19 pandemic is available at https://www.cdc.gov/vaccines/pandemic-guidance/index.html.
Related Links
CDC publishes “Influenza Vaccination Coverage among Health Care Personnel—United States, 2019–20 Influenza Season” via FluVaxView
CDC Published Influenza Vaccination Coverage among Health Care Personnel—United States, 2019–20 Influenza Season on the FluVaxView gateway page on October 2. The summary is reprinted below.
The Advisory Committee on Immunization Practices (ACIP) recommends that all health care personnel (HCP) receive an annual influenza vaccination to reduce influenza-related morbidity and mortality among HCP and their patients as well as to reduce absenteeism among HCP (1-4). CDC conducted an opt-in Internet panel survey of 2,401 U.S. HCP to estimate influenza vaccination coverage during the 2019–20 influenza season.
- Overall, 80.6% of HCP reported receiving influenza vaccination during the 2019–20 season, similar to reported coverage in the previous season.
- Coverage was higher among HCP who were required by their employer to be vaccinated (94.4%) than among those whose employer did not require vaccination (69.6%).
- By setting, vaccination coverage was highest among HCP in ambulatory care and hospital settings with vaccination requirements (96.1% and 95.7%, respectively), and lowest in ambulatory and long-term care settings without vaccination requirements, promotion, or on-site offer (47.7% and 49.9%, respectively).
Implementing workplace strategies to improve vaccination coverage among HCP, particularly in long-term care settings, including active promotion of on-site vaccinations can help ensure HCP and patients are protected against influenza (5). Reducing the overall burden of respiratory illnesses in the upcoming season by maximizing HCP influenza vaccination uptake can help protect vulnerable populations including long-term care facility residents and conserve healthcare resources for treatment of COVID-19.
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National Academies of Sciences, Engineering, and Medicine releases final consensus report: Framework for Equitable Allocation of COVID-19 Vaccine
The National Academies of Sciences, Engineering, and Medicine released its Framework for Equitable Allocation of COVID-19 Vaccine, the final report of a consensus study recommending a four-phased equitable allocation framework to guide the federal government and decision-making bodies. The goal of the committee’s framework is to reduce severe morbidity and mortality and negative societal impact due to SARS-CoV-2 transmission.
CDC and the National Institutes of Health asked the National Academies of Sciences, Engineering, and Medicine to convene an ad hoc committee. The resulting report, Framework for Equitable Allocation of COVID-19 Vaccine, discusses important implementation considerations related to coordination, cost, risk communication, community engagement, vaccine acceptance, and global allocation.
The committee also developed three foundational ethical principles (maximum benefit, equal concern, and mitigation of health inequities) and three procedural principles (fairness, transparency, and evidence-based). To put these principles into practice, the committee used four risk-based criteria to set general priorities among various population groups to allocate the vaccine within the framework. The criteria include the risk of acquiring infection, risk of severe morbidity and mortality, risk of negative societal impact, and risk of transmitting infection to others.
Current evidence shows that COVID-19 disproportionately affects particular racial and ethnic minority groups, with many of these groups experiencing increased social risks, and the impact of structural inequalities that contribute to health inequities, along with pre-existing conditions that put them at higher risk of severe illness and death from COVID-19. Mitigating these inequities by explicitly addressing the higher burden of COVID-19 experienced by these populations is a moral imperative of any equitable vaccine allocation framework.
The vaccine allocation framework consists of four phases of vaccine distribution. Within each phase, all groups have equal priority. Phase 1 in the NASEM framework focuses on high-risk health workers who risk exposure to bodily fluids or aerosols, people with comorbid and underlying conditions that put them at significantly higher risk, and older adults living in congregate or overcrowded settings.
The committee also considered key implementation issues, such as program administration, risk communication and community engagement, addressing vaccine acceptance, and global equity in vaccine allocation.
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Reminder: IAC will host “Mass Vaccination Clinics: Challenges and Best Practices” webinar on October 15
Mass vaccination clinics allow the rapid and efficient administration of vaccines to a large number of people over a relatively short period of time. This approach can help during delivery of routinely recommended vaccines like influenza. It can also be used once COVID-19 vaccines are released. How can you plan and manage such a daunting undertaking?
Mark your calendar to attend IAC’s informative webinar, “Mass Vaccination Clinics: Challenges and Best Practices” on October 15, 2020, at 1:00–2:30 p.m. ET. Experienced providers will discuss successes and challenges in conducting mass-vaccination clinics and they will highlight best practices and offer practical information for ensuring a successful clinic. Expert speakers include:
- Kevin Cleveland, PharmD, ANP, Assistant Dean and Director for Experiential Education, Idaho State University College of Pharmacy, Meridian, ID
- Karen Sharpnack, Executive Director, Idaho Immunization Coalition, Shoshone, ID
- Ruth Carrico, PhD, DNP, ARPN, CIC, Professor, University of Louisville, Louisville, KY
- Jeanne Marconi, MD; FAAP; Behavioral and Mental Health, Pediatricians; The Center for Advanced Pediatrics, Norwalk, CT
- Andrew Kroger, MD, MPH, Medical Officer, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
Register now to attend this free webinar.
This webinar is supported by a medical education grant from Seqirus, Inc.
Related Links
“Is It 0.25 mL or 0.5 mL? What Is the Correct Dose of Injectable Flu Vaccine for Children Younger than 3?" Dr. Wexler’s Technically Speaking monthly column is available on immunize.org
September's Technically Speaking column by IAC's executive director, Deborah L. Wexler, MD, is reprinted below.
Is It 0.25 mL or 0.5 mL? What Is the Correct Dose of Injectable Flu Vaccine for Children Younger than 3?
by Deborah L. Wexler, MD
Determining the correct dosage of influenza vaccine for children 6 months to 3 years of age has become more challenging in recent years. Until recently, only one injectable influenza vaccine was licensed for children in this age group. Currently, four injectable vaccines are approved for these young children, and their dosages vary from product to product.
Be sure you administer the correct dose according to the vaccine brand(s) you have available in your clinic.
Here's what you need to know:
- Afluria (Seqirus): For children age 6–35 months, give 0.25 mL. For children age 3 years and older, give 0.5 mL.
- Fluarix and FluLaval (GSK): For children age 6 months and older, give 0.5 mL.
- Fluzone (Sanofi): For children age 6–35 months, give either 0.25 mL or 0.5 mL. (Yes, you really can give either dosage.) For children age 3 years and older, give 0.5 mL.
Additional flu vaccines for children:
- Flucelvax (Seqirus): Children must be age 4 years or older to receive this vaccine. Give 0.5 mL.
- FluMist (AstraZeneca): Children must be age 2 years or older to receive this nasal spray vaccine.
Helpful Resources from IAC
Technically Speaking is a monthly column written by Dr. Wexler for Vaccine Update, a monthly e-newsletter from the Vaccine Education Center (VEC) at Children's Hospital of Philadelphia. All past columns are available on IAC’s Technically Speaking gateway page at www.immunize.org/technically-speaking.
Access the complete article here.
To subscribe to VEC's Vaccine Update e-newsletter, go to the sign-up form.
Six additional colleges and universities require flu vaccine to protect staff and students—good news on campus!
Many colleges and universities across the nation are mandating flu vaccine for staff and students. IAC has recently become aware of six additional schools that will require influenza vaccine this year: Albion College, Creighton University, Indiana University—nine campuses, Marist College, University of North Carolina Charlotte, and Wake Forest University
In addition, the following schools require influenza vaccine this year: University of California system—ten campuses, University of Tennessee system—four campuses, Butler University, Cornell University, Dordt University, Duke University, Elon University, Purdue University, Rochester Institute of Technology, Rosalind Franklin University, Syracuse University, University of Miami, University of Pennsylvania, University of Southern California, Wabash College, and Wayne State University.
Under a new statewide regulation in Massachusetts, approximately 115 colleges and universities will be implementing requirements for influenza vaccination this year.
If you know of additional colleges or universities that require influenza vaccination, please send the name of the institution, as well as a link to the relevant policy (if available) to [email protected].
IAC Spotlight! These updated IAC patient and staff educational materials were released during August and September
IAC Express regularly provides readers with information about IAC’s new and updated educational materials for healthcare professionals and handouts for patients. All IAC materials are free to download, print, and distribute. Important web page updates were announced as well.
In case you missed them during recent weeks, these helpful materials were announced:
Staff Education and Workflow Materials
Influenza Materials for Healthcare Professionals
Handouts for Your Patients
Updated Web Pages
Many Ask the Experts vaccine and topics of interest web pages were reviewed and updated: Hepatitis A, Hib, Influenza, Polio, Rabies, Rotavirus, Varicella, Contraindications and Precautions, Documenting Vaccination, Scheduling Vaccines, Travel Vaccines, and Vaccine Safety.
Related Links
Order IAC’s child, adult, and lifetime immunization record cards—wallet-sized, designed to last!
IAC's personal immunization record cards, printed on rip-proof, smudge-proof, water-proof paper, are designed to last a lifetime. They’re sized to fit in a wallet when folded. The record cards are for you to give to your patients as a permanent vaccination record and are sold in boxes of 250.
Make bulk purchases and receive quantity discounts. For quotes on larger quantities or customizing, or to request sample cards, call 651-647-9009 or email [email protected].
Visit Shop IAC for additional items, including "Vaccines Save Lives" enamel pins, flu vaccine buttons and stickers, and a vaccine administration training video.
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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.
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IAC Handouts
IAC updates 2-page reference table, “Guide to Contraindications and Precautions to Commonly Used Vaccines,” plus its cousin focused on adult vaccines
IAC recently revised Guide to Contraindications and Precautions to Commonly Used Vaccines and Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults to add specific time intervals for which vaccination with LAIV should be avoided for several newer influenza antiviral agents. Also incorporated were updated recommendations for vaccination of people who claim egg allergies.
 
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Featured Resources
In IAC's "Video of the Week," Dr. Melvin Sanicas explains why you need to get the flu shot every year and how the body responds to vaccination
In this November 2017 video from TED-Ed, vaccinologist Dr. Melvin Sanicas explains why we need to get the flu vaccine every year, unlike other vaccines. There are more than 100 subtypes of flu virus that can mutate. Every year, researchers determine which strains are circulating and how they’ve mutated so virologists can develop the most effective vaccine for the coming flu season.
Visit the VOTW archive.
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Reminder: IAC’s new website, Mass-Vaccination-Resources.org, offers high-quality resources to help jumpstart your mass vaccination efforts
The Immunization Action Coalition’s newest website, www.Mass-Vaccination-Resources.org, assists you in finding a wide range of ideas for developing your own mass vaccination clinics. Mass vaccination efforts will be useful for expediting flu vaccination this fall and may be needed after COVID-19 vaccines are licensed for use in large groups of people.
The website features a searchable list of resources for a variety of venues, including curbside, drive-through, and walk-through clinics; mobile medical vans; pharmacies; and schools. The database contains guidance documents, toolkits, publications, and other helpful resources that can be adapted to your community or individual healthcare setting.
Many of the documents were written in the pre-pandemic era and will need modification to ensure that additional protections, such as social distancing and personal protective equipment, help safeguard against COVID-19 transmission.
If you have a resource to suggest for the website, please send a message to [email protected].
This new website is supported by a medical education grant from Seqirus, Inc.
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Journal Articles and Newsletters
“HPV Vaccination and the Risk of Invasive Cervical Cancer” published in New England Journal of Medicine
In the October 1 issue, New England Journal of Medicine published HPV Vaccination and the Risk of Invasive Cervical Cancer. The study used national Swedish demographic and health registers to follow a population of more than 1.6 million girls and women ages 10–30 years from 2006 to 2017 to assess the association between HPV vaccination and the risk of invasive cervical cancer. During the study, nearly one-third of the girls and women received at least one dose of the quadrivalent HPV vaccine, most before age 17. Results showed 19 of those who received the vaccine and 538 of those who did not were diagnosed with cervical cancer. The results show that the incidence of cervical cancer was reduced by 88% in women immunized before age 17 and by 53% in women immunized at ages 17–30.
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CDC publishes September issue of Immunization Works newsletter; subscribe for monthly immunization information
CDC released the September issue of its monthly newsletter Immunization Works. The newsletter offers the immunization community information about current topics. The information is in the public domain and may be circulated widely.
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“A Cross-Sectional Survey to Evaluate Potential for Partnering with School Nurses to Promote Human Papillomavirus Vaccination” published in Preventing Chronic Disease
In the September 24 issue of CDC’s Preventing Chronic Disease, South Carolina researchers published A Cross-Sectional Survey to Evaluate Potential for Partnering with School Nurses to Promote Human Papillomavirus Vaccination. The rates of human papillomavirus (HPV) vaccination are low in many states with large medically underserved areas. This study surveyed lead school nurses in South Carolina, a state with large medically underserved areas, to assess the nurses’ HPV vaccination beliefs, barriers, and role of vaccination in schools. The nurses agreed that lack of time and competing priorities were barriers to HPV vaccination; few other barriers were consistently identified. Their findings suggest that partnering with school nurses may be a feasible strategy to overcome barriers to increasing HPV vaccination rates in medically underserved areas.
Access the full article in PDF format or in HTML format.
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“A Randomized Controlled Trial of an Online Immunization Curriculum” published in Vaccine
In the September 26 issue, Vaccine published A Randomized Controlled Trial of an Online Immunization Curriculum. Vaccine education is not standardized across residency programs, and immunization education for physicians-in-training is crucial to addressing vaccine concerns in a clinical setting. To combat this issue, the Collaboration for Vaccination Education and Research (CoVER) team, including IAC’s Dr. Sharon Humiston, developed an online curriculum for pediatric and family medicine residents. To evaluate the effectiveness of the curriculum, the team conducted a cluster randomized controlled trial over the 2017–18 school year. The CoVER curriculum consisted of four online modules (now posted at https://www.pids.org/education-and-training/vaccine-education-program.html) and an in-person training guide. Control sites continued with their standard vaccine education. Findings suggest that residents in the CoVER curriculum group, over those in the control group, were more likely to report vaccine expertise, confidence in their ability to discuss vaccines with parents, and confidence in their ability to answer parents' questions about vaccines.
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Education and Training
The Ad Council offers webinar on the upcoming flu vaccination PSA campaign on October 8
The Ad Council will offer an Ad Council Flu Vaccination Campaign webinar on October 8 from 3:00–4:30 p.m. (ET). For the 2020–21 flu season, the Ad Council, the American Medical Association (AMA), and CDC are creating a national, culturally relevant ad campaign to motivate all Americans, with an emphasis on engaging Black and Hispanic audiences, to get a flu vaccine. This webinar will give you the opportunity to learn about insights to motivate Americans to get a flu vaccine, see a preview of the PSA assets, and get access to resources to support and amplify these messages.
Register for the webinar.
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Trust for America's Health offers webinar titled "Ensuring COVID-19 Vaccine Access, Safety, and Utilization: Building Vaccination Confidence in Communities of Color" on October 21
Trust for America's Health will offer 90-minute webinar Ensuring COVID-19 Vaccine Access, Safety, and Utilization: Building Vaccination Confidence in Communities of Color on October 21 at 1:00 p.m. (ET). This webinar comes at a critical juncture as COVID-19 vaccine development continues. As with previous public health emergencies, the COVID-19 pandemic is exposing racial inequities that have long existed in the U.S. Racial and ethnic disparities also continue in vaccine access, due to factors such as lack of access to health coverage and care and issues of distrust. The webinar will feature expert panelists to educate policymakers and stakeholders on the historical reasons for vaccine hesitancy in communities of color, highlight ongoing vaccination disparities and discuss policy recommendations to build vaccine confidence and access in communities of color, and will include time for Q&A from the audience.
Register for the webinar.
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Conferences and Meetings
Watch the 3-day, virtual ACIP meeting October 28–30; sign up for public comment; no registration is required
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On the Lighter Side
In this 30-second PSA from 1976, Larry Csonka from the New York Giants warns flu can hit you harder than even the meanest middle linebacker
In this nostalgic PSA, Let's Fight the Flu, Larry Csonka from the New York Giants reminds us to get the flu shot, because—like getting hit by a middle linebacker—sometimes there's just no getting up from the flu. Produced by the New York State Department of Health in 1976, it is part of a PSA collection curated by vaccine expert William L. Atkinson, MD, MPH.
Previous PSAs mentioned in “On the Lighter Side” are available when viewing this Vimeo video.
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Video of the Week
Why Do You Need to Get a Flu Shot Every Year? In this TED-Ed video, vaccinologist Dr. Melvin Sanicas explains why we need to get the flu vaccine every year, unlike other vaccines. There are more than 100 subtypes of flu virus that can mutate. Every year, researchers determine which strains are circulating and how they’ve mutated so virologists can develop the most effective vaccine for the coming flu season.
Visit the VOTW archive
Follow Us
Technically Speaking
Read Dr. Wexler's column for the Vaccine Education Center's monthly newsletter, Vaccine Update
Vaccinating Adults:
A Step-by-Step Guide
Calendar of Events
Conferences, meetings, and training opportunities
Patient Record Cards
Record cards for patients -- child & teen, adult, and lifetime -- are printed on durable paper and sized to fit in a wallet when folded
DVD: Immunization Techniques
Every practice should have this award winning, "how-to" training video
Protect Newborns Guidebook
Editorial Information
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