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Issue 1,526: November 4, 2020

Top Stories
* IAC summarizes October 2020 ACIP Virtual Meeting
* CDC updates “Interim Guidance for Routine and Influenza Immunization Services during the COVID-19 Pandemic”
* CDC posts web-on-demand video, “Influenza Update: 2020–21,” discussing flu vaccination during COVID-19, vaccine storage and handling, and best practices
* Webinar on mass vaccination strategies now archived and available for viewing on IAC's newest website: Mass-Vaccination-Resources.org
* “ACIP Updates Recommendations on the Use of MenACWY and MenB Vaccines,” Dr. Wexler’s Technically Speaking monthly column, is available on immunize.org
* IAC Spotlight! These updated IAC patient and staff educational materials were released during October
* Influenza activity will increase soon. Keep vaccinating!
* Six additional colleges and universities require flu vaccine to protect staff and students—good news for more campuses!
* Not-to-miss immunization articles in the news
* Stay up to date on the latest coronavirus information

IAC Handouts
* IAC posts updated Spanish translations of six handouts for adults with high-risk conditions: HIV, liver disease, diabetes, heart disease, lung disease, and asplenia (those without a spleen)
* IAC posts updated Spanish translations of “Vaccinations for Men Who Have Sex with Men” and “Protect Yourself from Hepatitis A and Hepatitis B: A Guide for Gay and Bisexual Men”

Featured Resources
* AIM releases white paper titled “Flu Vaccination in a Pandemic: Leadership Lessons from Public Health Immunization Programs”
* NACCHO releases new resources for the 2020–21 flu season, including the “School-Located Influenza Vaccination Toolkit”
* In IAC's "Video of the Week," Voices for Vaccines executive director discusses combating vaccine hesitancy by explaining how vaccine clinical trials work
* IAC's bright red "FLU VACCINE" buttons and stickers will help you keep vaccinating against flu. Order today!
* Check out the www.Give2MenACWY.org website to enhance your efforts at increasing rates of MenACWY booster and other adolescent vaccinations
* Public television documentary, Protecting Health: Saving Lives, features 30-year history of IAC. Please share.

Journal Articles and Newsletters
* “Implementation of a Mandatory Influenza Vaccine Program: A 10-Year Experience” published in Clinical Infectious Diseases
* “How Health Care Providers Should Address Vaccine Hesitancy in the Clinical Setting: Evidence for Presumptive Language in Making a Strong Recommendation” published in Human Vaccines & Immunotherapeutics

On the Lighter Side
* In this 1998 PSA, “Cakewalk Saturday,” former first lady of Oklahoma Cathy Keating promotes timely childhood vaccination

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Top Stories
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IAC SUMMARIZES OCTOBER 2020 ACIP VIRTUAL MEETING

The Advisory Committee on Immunization Practices (ACIP) ([link removed]) conducted a 3-day virtual meeting on October 28–30, 2020 ([link removed] ). Routinely recommended and travel vaccines were discussed during the first 2 days of the session, and one vote was taken. The final day was devoted to continuing discussions of COVID-19 vaccines and their implementation. Presentation slides ([link removed]) for all topic areas are available on the ACIP website.

During the regular session, ACIP received updates on seasonal influenza vaccines, disease burden, and estimates of influenza vaccine effectiveness during the 2019–2020 season. The group also reviewed information on orthopoxvirus vaccines, as well as vaccines against dengue, pneumococcal disease, cholera, and tick-borne encephalitis. Safety-monitoring data for recombinant zoster vaccine was reviewed. An extensive discussion on rabies vaccine prepared the members for a potential vote at the February 2021 ACIP meeting.

In the meeting’s single vote, ACIP members unanimously approved adoption of edits to the 2021 recommended child/adolescent and adult immunization schedules. The modifications do not provide new guidance; rather, the schedule changes will reflect votes taken during 2020 meetings. In general, these edits involved applying new wording or formatting to improve readability and to better harmonize the two schedules. A comprehensive list of the updates will be available in February 2021 when CDC releases the 2021 immunization schedules for children/teens and adults in the MMWR and on CDC web pages.

COVID-19 Vaccines – The final day of the meeting focused on updates related to COVID-19 vaccine development and discussion of plans for vaccination. Highlights of this session are provided below.

Vaccine Development – ACIP heard a synopsis of the October 22 meeting of the Vaccine and Related Biological Products Advisory Committee (VRBPAC) ([link removed]), which provides input to FDA on investigational vaccines. ACIP members were particularly interested in VRBPAC’s discussion on clinical considerations for use of COVID-19 vaccines under Emergency Use Authorization (EUA) ([link removed]). At their meeting, VRBPAC members emphasized the critical importance of maintaining public confidence in licensed vaccines by remaining transparent on clinical evidence in decision-making. VRBPAC will re-convene before any FDA regulatory action is taken.

Over 320 COVID-19 vaccines are currently under development ([link removed]), five of which have proceeded to phase 3 clinical trials in Europe or the U.S. ACIP received reports on two candidate vaccines (BioNTech/Pfizer and Moderna) during the August meeting ([link removed]). Details about two additional vaccines were provided at the October meeting.
– Novavax (NVX-CoV2373) ([link removed]) – This vaccine candidate exhibited a robust neutralizing antibody response in early trials, and the preliminary safety profile is reassuring. Up to 30,000 adults are expected to be enrolled in the phase 3 trial.
* Dosage and Administration: 0.5 mL dose, 2 IM doses given 21 days apart
* Packaging: Multidose vials, 10 doses per vial, without preservative
* Storage: Shipped and stored at 2° to 8° C (36° to 46° F), no reconstitution required

– Janssen, a subsidiary of Johnson & Johnson (Ad26.COV2.S) ([link removed]) – This vaccine candidate also elicited robust neutralizing antibody responses and was generally well tolerated. Although the trial was paused to assess one serious adverse event that occurred in a trial participant, subsequent review by the independent Data Safety and Monitoring Board (DSMB) allowed the trial to resume. An estimated 60,000 persons will be enrolled in the phase 3 clinical trial.
* Dosage and Administration: 0.5 mL dose, 1 IM dose
* Packaging: Multidose vials, 5 doses per vial, without preservative
* Storage: Shipped and stored at 2° to 8° C (36° to 46° F) for up to 3 months, no reconstitution required

Plans for COVID-19 Vaccination – All 64 CDC jurisdictions have submitted their plans ([link removed]) for a phased approach to COVID-19 vaccination. Executive summaries of these plans will be posted to the CDC website as soon as possible. Although no vaccine currently has been authorized or licensed for use, CDC is currently working with states to establish a “readiness date” of November 15. CDC emphasized the importance of partnering with pharmacies to help increase access to vaccines, noting that 90% of Americans live within 10 miles of a pharmacy. Several ACIP members stressed the importance of adequate funding for vaccine implementation. ACIP member Grace Lee, MD, MPH, emphasized that “while the country has invested heavily in vaccine development, implementation is where we will have an impact.”
New resources for the public and healthcare providers are frequently added to CDC’s COVID-19 Vaccines ([link removed]) website. The agency’s Vaccinate with Confidence ([link removed]) strategy provides a national framework for reinforcing confidence in COVID-19 vaccines. ACIP members emphasized special attention should be given to the importance of addressing vaccine confidence among healthcare workers and within communities of color.

Vaccine Safety Monitoring – Two presenters reviewed how vaccine safety monitoring will be conducted. In addition to the passive surveillance conducted through the Vaccine Adverse Event Reporting System (VAERS), the FDA will monitor vaccine safety ([link removed]) through its Biologics Effectiveness and Safety (BEST) System. Plans are being coordinated for near real-time surveillance (i.e., rapid-cycle analysis) based on 10 to 20 outcomes of interest reported by multiple federal government agencies, including FDA, CDC, Centers for Medicare and Medicaid Services (CMS), Veterans Administration (VA), and the Department of Defense (DoD). CDC-specific monitoring efforts ([link removed]) include its existing Vaccine Safety Datalink (VSD) and Clinical Immunization Safety Assessment (CISA) projects. In addition, CDC will support the v-safe smartphone-based active surveillance of vaccine recipients who agree to post-vaccination follow-up via text messaging. CDC is developing a 1-page information sheet about the v-safe program that can be shared with vaccine recipients to aid in recruitment. Committee members also received an update on the activities of the ACIP COVID-19 Vaccine Safety Technical Sub-Group (VaST) ([link removed]). The group is transitioning to a smaller data review group that will provide frequent technical reports for internal ACIP and partner use, as well as data summaries for public release.

Allocation Strategies – Scientists modeled the relative impact ([link removed]) on infections and deaths resulting from vaccination of adults aged 65+, adults with high-risk medical conditions, and essential workers. The modelers assumed two doses of vaccine would be given 28 days apart. Based on vaccinating 10 million people per week, modelers noted it would take 9 months to fully vaccinate all people currently included in the proposed phase 1 and phase 2 priority groups. The model found that vaccinating adults in the 65+ age group would avert the greatest percentage of deaths, while vaccinating essential workers or high-risk adults would avert the greatest percentage of infections. However, model results were highly influenced by the timing of vaccine introduction (i.e., whether it was introduced before disease incidence rose, as incidence rose, or as incidence fell).

ACIP revisited its ethical principles for phased allocation of COVID-19 vaccines ([link removed]) (i.e., maximizing benefits and minimizing harms, equity, justice, fairness, and transparency). Key questions have now been developed to assist ACIP in “translating” these principles when considering vaccine allocation strategies.

COVID-19 Immunity and Epidemiology – CDC scientists reviewed the current epidemiology ([link removed]) of COVID-19 and what is known about post-infection immunity, COVID-19 reinfection, and disease in pregnant women. Although data on post-infection immunity is limited, it suggests naturally induced antibodies wane over time. Similarly, limited data suggest reinfection is unlikely within 3 months of infection. Pregnancy data demonstrate increased risks of severe maternal illness and preterm birth due to COVID-19 infection, but there is no evidence that breastfeeding is an important risk for transmission.

Next Steps – The meeting concluded with a summary of the COVID-19 Workgroup’s interpretations of the data ([link removed]) presented during the day’s sessions and an outline of policy questions facing ACIP and the decision-making framework ([link removed]) that will be used to answer those questions.

The next regularly scheduled ACIP meeting will be February 24–25, 2021. However, it is likely that ACIP will meet before that date to address recommendations for use of any FDA-authorized COVID-19 vaccine(s). Information about past and future ACIP meetings ([link removed]) may be found on the ACIP website.

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CDC UPDATES “INTERIM GUIDANCE FOR ROUTINE AND INFLUENZA IMMUNIZATION SERVICES DURING THE COVID-19 PANDEMIC”

CDC recently added a new section to the webpage Interim Guidance for Routine and Influenza Immunization Services during the COVID-19 Pandemic ([link removed]). The section, "Additional Considerations for Influenza Vaccination of Persons in Healthcare Facilities and Congregate Settings during the COVID-19 Pandemic," provides recommendations for individuals living in supportive/congregate settings (e.g., long-term care facilities, group homes and shelters).

General measures for COVID-19 infection prevention and control are discussed, along with deferment of routine vaccination of patients who have known close contact with an individual with COVID-19 or who have asymptomatic, pre-symptomatic, or symptomatic COVID-19 themselves. This section recommends postponing all vaccination visits for the following individuals:

* Asymptomatic and pre-symptomatic persons who have tested positive: 10 days from a positive test result

* Symptomatic persons: Met criteria to discontinue isolation; 10 days after symptom onset and 24 hours with no fever without the use of fever-reducing medications, and COVID-19 symptoms improving; and no longer moderately to severely ill

* Persons exposed to a person with COVID-19: After 14-day quarantine period has ended

Other specific topics covered are infection prevention practices, personal protective equipment (PPE), and strategies for promoting catch-up immunizations. This guidance will be updated as the COVID-19 pandemic evolves.

Related Links
* CDC's Interim Guidance for Routine and Influenza Immunization Services during the COVID-19 Pandemic ([link removed]) web page
* CDC's Resources for Hosting a Vaccination Clinic ([link removed]) gateway page
* CDC's Infection Control Guidance for Healthcare Professionals about Coronavirus (COVID-19) ([link removed]) gateway page
* IAC's Vaccination and COVID-19 ([link removed]) gateway page
* IAC’s Ask the Experts: COVID-19 and Routine Immunization ([link removed]) page
* IAC's Repository of Resources for Maintaining Immunization during the COVID-19 Pandemic ([link removed])

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CDC POSTS WEB-ON-DEMAND VIDEO, “INFLUENZA UPDATE: 2020–21,” DISCUSSING FLU VACCINATION DURING COVID-19, VACCINE STORAGE AND HANDLING, AND BEST PRACTICES

A strong influenza vaccine recommendation is one of the most important factors in patients accepting the vaccine. CDC has released a 22-minute video ([link removed]) that provides information on the importance of flu vaccination during COVID-19, frequently asked questions about influenza vaccine, storage and handling, administration recommendations, and best practices for the 2020–21 influenza season.

Related Links
* CDC's Seasonal Flu gateway page ([link removed])
* CDC's free resources related to influenza ([link removed])
* IAC's free educational materials and patient handouts related to influenza ([link removed])
* IAC's Influenza: Vaccines ([link removed]) web page

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WEBINAR ON MASS VACCINATION STRATEGIES NOW ARCHIVED AND AVAILABLE FOR VIEWING ON IAC'S NEWEST WEBSITE: MASS-VACCINATION-RESOURCES.ORG

Mass vaccination clinics allow rapid and efficient administration of vaccines to many people over a relatively short period of time. This approach can help during delivery of routinely recommended vaccines such as influenza. It can also be used once COVID-19 vaccines are released. How can you plan and manage such a daunting undertaking?

On October 15, IAC hosted Mass Vaccination Clinics: Challenges and Best Practices ([link removed]) webinar with nearly 900 attendees. During this 1.75-hour session, a panel of experienced providers described their successes and challenges in conducting mass vaccination clinics. The panelists highlighted best practices and offered practical information for conducting a successful mass vaccination clinic.

When visiting www.mass-vaccination-resources.org/webinar, you can watch the full-length webinar, or you can view the individual speakers’ presentations listed below. The presenters’ bios and slide-set handouts are also available on the web page.

* “Mass Clinic: Vaccine Storage and Handling and Vaccine Administration” by Andrew Kroeger, MD, MPH, NCIRD, CDC

* “Experiences, Recommendations and Lessons Learned for Conducting Mass Vaccination Clinics” by Ruth Carrico, PhD, DNP, University of Louisville

* “Vaccine Drive-Thru Clinics” by Jeanne Marconi, MD, FAAP, PM Pediatrics, Lake Success, NY

* “Mobile Drive-Thru Flu Shot Clinics: Process, Partnerships and Lessons Learned” by Kevin Cleveland, PharmD, ANP, Idaho State University College of Pharmacy, and Karen Sharpnack, Idaho Immunization Coalition

* “Mass Vaccination on a College Campus” by Amy Sauls, PharmD, BCACP; Michelle Camarena, MSN, RN; and Thevy Chai, MD, University of North Carolina at Chapel Hill

The archived webinar is found on IAC's newest website: www.Mass-Vaccination-Resources.org. 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].

The webinar and the new website are supported by a medical education grant from Seqirus, Inc.

Related Links
* IAC's Mass Vaccination Clinics: Challenges and Best Practices ([link removed]) archived webinar
* IAC's Mass Vaccination Resources ([link removed]) website
* CDC’s Guidance for Planning Vaccination Clinics Held at Satellite, Temporary, or Off-Site Locations ([link removed])
* Becker’s Hospital Review: Influenza Vaccination Is More Important than Ever: To Help, Immunization Action Coalition Launches New Mass Vaccination Resources Website ([link removed]) (10/23/20)

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“ACIP Updates Recommendations on the Use of MenACWY and MenB Vaccines,” Dr. Wexler’s Technically Speaking monthly column, is available on immunize.org

October's Technically Speaking column by IAC's executive director, Deborah L. Wexler, MD, is reprinted below.

ACIP Updates Recommendations on the Use of MenACWY and MenB Vaccines ([link removed])

by Deborah L. Wexler, MD

The Advisory Committee on Immunization Practice's (ACIP's) updated guidance for meningococcal serogroups A, C, W, and Y vaccine (MenACWY) and meningococcal serogroup B vaccine (MenB) was recently published in the MMWR Recommendations and Reports. This publication, Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020 ([link removed]), replaces and consolidates all previously published ACIP meningococcal vaccine recommendations. The descriptive terminology "shared clinical decision-making” has been added for the 2-dose MenB vaccination series in persons age 16–23 years. The guidance also contains new recommendations for off-label administration of booster doses of MenB for persons at increased risk for serogroup B meningococcal disease, including microbiologists and people age >10 years with persistent complement deficiencies, complement inhibitor use, or anatomic or functional asplenia. Booster doses are recommended one year following completion of a MenB primary series followed by MenB booster doses every 2–3 years thereafter. A one-time booster dose also is recommended for persons at increased risk during an outbreak.

A summary (from Box 1, found on page 3 of the publication) of the ACIP recommendations ([link removed]) for MenACWY and MenB vaccines is reprinted below.

ACIP recommends MenACWY vaccination for the following groups:
* Routine vaccination for adolescents age 11 or 12 years, with a booster dose at age 16 years.
* Routine vaccination of persons age >2 months at increased risk for meningococcal disease (dosing schedule varies by age and indication, and interval for booster dose varies by age at time of previous vaccination):
+ Persons with certain medical conditions including anatomic or functional asplenia, complement component deficiencies (e.g., C3, C5–C9, properdin, factor H, or factor D), complement inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]) use, or human immunodeficiency virus infection.
+ Microbiologists with routine exposure to Neisseria meningitidis isolates.
+ Persons at increased risk during an outbreak (e.g., in community or organizational settings, and among men who have sex with men [MSM]).
+ Persons who travel to or live in countries in which meningococcal disease is hyperendemic or epidemic.
+ Unvaccinated or undervaccinated first-year college students living in residence halls.
+ Military recruits.
* Booster doses for previously vaccinated persons who become or remain at increased risk.

ACIP recommends MenB vaccination for the following groups:
* Routine vaccination of persons age >10 years at increased risk for meningococcal disease (dosing schedule varies by vaccine brand; boosters should be administered at 1 year after primary series completion, then every 2–3 years thereafter):
+ Persons with certain medical conditions, such as anatomic or functional asplenia, complement component deficiencies, or complement inhibitor use.
+ Microbiologists with routine exposure to Neisseria meningitidis isolates.
+ Persons at increased risk during an outbreak (e.g., in community or organizational settings, and among MSM).
* Vaccination of adolescents and young adults age 16–23 years with a 2-dose MenB series on the basis of shared clinical decision-making. The preferred age for MenB vaccination is 16–18 years. Booster doses are not recommended unless the person becomes at increased risk for meningococcal disease.
* Booster doses for previously vaccinated persons who become or remain at increased risk.

Additional Resources

From CDC
* Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices ([link removed])
* Meningococcal Vaccination: Information for Healthcare Professionals ([link removed]) gateway page

From IAC
* Ask the Experts: Meningococcal ACWY ([link removed]) web page
* Ask the Experts: Meningococcal B ([link removed]) web page
* Handouts: Meningococcal ACWY ([link removed]) gateway page
* Handouts: Meningococcal B ([link removed]) gateway page
* Meningococcal ACWY VIS ([link removed]) gateway page
* Meningococcal B VIS ([link removed]) gateway page

Technically Speaking is a monthly column written by Dr. Wexler for Vaccine Update ([link removed]), 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 ([link removed]) gateway page at www.immunize.org/technically-speaking.

Access the complete article here ([link removed]).

To subscribe to VEC's Vaccine Update ([link removed]) e-newsletter, go to the sign-up form ([link removed]).

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IAC SPOTLIGHT! THESE UPDATED IAC PATIENT AND STAFF EDUCATIONAL MATERIALS WERE RELEASED DURING OCTOBER

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:
* New! Protective Measures for Vaccinating During the Pandemic ([link removed])
* Influenza: Questions and Answers ([link removed])
* Hepatitis B: Questions and Answers ([link removed])
* Meningococcal: Questions and Answers ([link removed])
* Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults ([link removed])
* Guide to Contraindications and Precautions to Commonly Used Vaccines ([link removed])
* Pneumococcal Vaccination Recommendations for Children and Adults by Age and/or Risk Factor ([link removed])
* Meningococcal B Vaccine Recommendations by Age and Risk Factor ([link removed])
* Meningococcal B Vaccine: IAC Answers Your Questions ([link removed])
* Standing Orders for Administering Meningococcal B Vaccine to Adolescents and Adults ([link removed])

Updated Web Page
* Talking About Vaccines: Alternative Schedules ([link removed])

Related Links
* IAC’s Handouts ([link removed]) gateway page to see educational materials sorted by category
* IAC's Ask the Experts ([link removed]) gateway page to access more than 1,000 questions answered by IAC experts
* IAC's Clinic Tools ([link removed]) gateway page and its seven subtopics
* IAC Educational Materials for Patients and Staff ([link removed])—an alphabetical listing of more than 300 ready-to-print staff educational materials and patient handouts

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INFLUENZA ACTIVITY WILL INCREASE SOON. KEEP VACCINATING!

Influenza season has begun, and CDC expects flu activity to remain low but increase in the coming weeks. Visit the CDC’s Weekly U.S. Influenza Surveillance Report, FluView ([link removed]), for details.

Influenza vaccination is recommended for everyone 6 months of age and older, so please continue to vaccinate all your patients in this age range. If you don’t provide influenza vaccine at your site, please recommend vaccination and refer to a site that does vaccinate.

Boston Children’s Hospital, in partnership with CDC, has developed VaccineFinder, a user-friendly website to help adult and pediatric patients find flu and other vaccines ([link removed]). Participating providers can now update supply estimates on VaccineFinder ([link removed]) for a more accurate reporting. For questions or more information, contact [email protected].

Related Links
* CDC's Seasonal Flu gateway page ([link removed])
* CDC's FluView gateway page ([link removed])
* CDC's free resources related to influenza ([link removed])
* IAC's free educational materials and patient handouts related to influenza ([link removed])
* IAC's Influenza: Vaccines ([link removed]) web page
* VaccineFinder ([link removed]) website
* National Adult and Influenza Immunization Summit ([link removed]) website
* The Summit Buzz: ([link removed]) newsletter of the National Adult and Influenza Immunization Summit (NAIIS)
* Influenza Vaccine Availability Tracking System—IVATS: ([link removed]) a resource for healthcare settings looking to purchase influenza vaccine (made available from NAIIS)

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SIX ADDITIONAL COLLEGES AND UNIVERSITIES REQUIRE FLU VACCINE TO PROTECT STAFF AND STUDENTS—GOOD NEWS FOR MORE CAMPUSES!

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 require influenza vaccine this year: Columbia University ([link removed]), Johns Hopkins University ([link removed]), McDaniel College ([link removed]), Notre Dame ([link removed]), Pepperdine University ([link removed]), and University of Denver ([link removed]).

In addition, the following schools require influenza vaccine this year: Indiana University ([link removed])—nine campuses, University of California system ([link removed])—ten campuses, University of Tennessee system ([link removed])—four campuses, Albion College ([link removed]), Butler University ([link removed]), Colby College ([link removed]), Cornell University ([link removed]), Creighton University ([link removed]), Dordt University
([link removed]), Duke University ([link removed]), Elon University ([link removed]), Marist College ([link removed]), Purdue University ([link removed]), Rochester Institute of Technology ([link removed]), Rosalind Franklin University ([link removed]), Syracuse University ([link removed]), University of Dayton ([link removed]), University of Kentucky ([link removed]), University of
Miami ([link removed]), University of North Carolina Charlotte ([link removed]), University of Pennsylvania ([link removed]), University of Southern California ([link removed]), Wabash College ([link removed]), Wake Forest University ([link removed]), Washington University in St. Louis ([link removed]), and Wayne State University ([link removed]).

Under a new statewide regulation in Massachusetts ([link removed]), approximately 115 colleges and universities are 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].

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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.

* USA Today: Who Gets the COVID-19 Vaccine First? CDC Committee Meets to Start the Discussion ([link removed]) (10/30/20)

* Reuters: U.S. Pharmacies Attract New Flu Shot Customers as Coronavirus Surges ([link removed]) (10/28/20)

* Politico: The Next Vaccine Questions ([link removed]) (10/27/20)

* CIDRAP: Flu Vaccine Demand Creates Minor Regional U.S. Shortages ([link removed]) (10/27/20)

* CNN: Despite the Trump Administration’s New Policy, Many Pharmacies Still Won’t Vaccinate Children against Flu ([link removed]) (10/26/20)

* KFF: Distributing a COVID-19 Vaccine across the U.S. – A Look at Key Issues ([link removed]) (10/20/20)

* Shot of Prevention: Rotary—Eradicating Polio & Creating Lifelong Friendships ([link removed]) (10/24/20)

* CIDRAP: U.S. Toddler Vaccine Rates Steady, but Lack of Insurance Plays Role ([link removed]) (10/23/20)

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STAY UP TO DATE ON THE LATEST CORONAVIRUS INFORMATION

CDC, NIH, WHO, and Johns Hopkins are closely monitoring the SARS-CoV-2 ([link removed]) pandemic. Check the resources below for the latest information. Stay in touch with your local and state health departments.

Related Links
* CDC’s COVID-19 gateway page, CDC.gov/coronavirus ([link removed]), links to CDC’s Situation Summary ([link removed]) web page and Latest News ([link removed]) gateway page. The COVIDView ([link removed]) gateway page summarizes the epidemiologic intelligence.
* NIH's Coronavirus (COVID-19) ([link removed]) gateway page links to news releases on vaccine trials
* WHO's Coronavirus Disease (COVID-19) Outbreak ([link removed]) gateway page links to WHO’s Situation Reports ([link removed]) web page
* Johns Hopkins' Coronavirus Resource Center ([link removed]) gateway page links to the Coronavirus COVID-19 Global Cases CSSE ([link removed]) web page
* Eriksen's COVID-19 Resources to Support Accurate Translation ([link removed]) gateway page

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IAC Handouts
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IAC POSTS UPDATED SPANISH TRANSLATIONS OF SIX HANDOUTS FOR ADULTS WITH HIGH-RISK CONDITIONS: HIV, LIVER DISEASE, DIABETES, HEART DISEASE, LUNG DISEASE, AND ASPLENIA (THOSE WITHOUT A SPLEEN)

IAC recently updated the Spanish translations of six of its one-page patient handouts that show the vaccines needed by adults with high-risk conditions.

* Vaccinations for Adults with Diabetes ([link removed]): Changes were made to MenACWY information and to incorporate recently updated ACIP recommendations for HPV, MenB, PCV13, and Tdap (English-language version ([link removed]))

* Vaccinations for Adults with HIV Infection ([link removed]): Changes were made to incorporate recently updated ACIP recommendations for HepA, HPV, MenB, and Tdap (English-language version ([link removed]))

* Vaccinations for Adults with Chronic Liver Disease or Infection ([link removed]): Changes were made to MenACWY information and to incorporate recently updated ACIP recommendations for HPV, MenB, PCV13, and Tdap (English-language version ([link removed]))

* Vaccinations for Adults with Heart Disease ([link removed]): Changes were made to MenACWY information and to incorporate recently updated ACIP recommendations for HPV, MenB, PCV13, and Tdap (English-language version ([link removed]))

* Vaccinations for Adults with Lung Disease ([link removed]): Changes were made to MenACWY information and to incorporate recently updated ACIP recommendations for HPV, MenB, PCV13, and Tdap (English-language version ([link removed]))

* Vaccinations for Adults Without a Spleen ([link removed]): Changes were made to incorporate recently updated ACIP recommendations for HPV, MenB, and Tdap (English-language version ([link removed]))

[link removed] [link removed] [link removed]

Related Links
* IAC's Adult Vaccination: Schedules for Patients ([link removed]) gateway page
* IAC’s Handouts: Spanish-language materials ([link removed]) gateway page
* IAC’s Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials by topic, vaccine, or language
* IACEducational Materials for Patients and Staff ([link removed])—an alphabetical listing of more than 300 ready-to-print staff educational materials and patient handouts

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IAC POSTS UPDATED SPANISH TRANSLATIONS OF “VACCINATIONS FOR MEN WHO HAVE SEX WITH MEN” AND “PROTECT YOURSELF FROM HEPATITIS A AND HEPATITIS B: A GUIDE FOR GAY AND BISEXUAL MEN”

IAC recently updated the Spanish translations of “Vaccinations for Men Who Have Sex with Men” and “Protect Yourself from Hepatitis A and Hepatitis B: A Guide for Gay and Bisexual Men.”

* Vaccinations for Men Who Have Sex with Men ([link removed]): Changes were made to MenACWY information and to incorporate recently updated ACIP recommendations for MenB, PCV13, and Tdap (English-language version ([link removed]))

* Protect Yourself from Hepatitis A and Hepatitis B ([link removed]): A Guide for Gay and Bisexual Men: Changes were made to incorporate additional groups needing vaccination, including all unvaccinated children and teens, people with HIV infection, and unvaccinated participants in settings with certain high-risk clientele. Additional changes were made to incorporate the most current data on new hepatitis A infections, hepatitis A-related deaths, and vaccine efficacy. (English-language version ([link removed]))

Related Links
* IAC’s Handouts: Spanish-language materials ([link removed]) gateway page
* IAC’s Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials by topic, vaccine, or language
* IAC’s Educational Materials for Patients and Staff ([link removed])—an alphabetical listing of more than 300 ready-to-print staff educational materials and patient handouts

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Featured Resources
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AIM RELEASES WHITE PAPER TITLED “FLU VACCINATION IN A PANDEMIC: LEADERSHIP LESSONS FROM PUBLIC HEALTH IMMUNIZATION PROGRAMS”

The Association of Immunization Managers (AIM), the nonprofit organization that represents the leaders of 64 state, territorial, and local immunization programs, published a new white paper titled Flu Vaccination in a Pandemic: Leadership Lessons from Public Health Immunization Programs ([link removed]). It synthesizes information gathered from immunization program leaders to highlight the four key elements of a successful flu vaccination campaign and outline associated strategies. Topics covered include provider communication tips, recommendations for increasing confidence in flu vaccination, and strategies for improving vaccine administration and storage and handling.

Access Flu Vaccination in a Pandemic: Leadership Lessons from Public Health Immunization Programs. ([link removed])

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NACCHO RELEASES NEW RESOURCES FOR THE 2020–21 FLU SEASON, INCLUDING THE “SCHOOL-LOCATED INFLUENZA VACCINATION TOOLKIT”

To assist local health departments in their efforts to protect their communities from influenza, the National Association of County and City Health Officials (NACCHO) has released two updated resources for the 2020–21 flu season ([link removed] ):

* NACCHO Influenza ([link removed]) web page

* School-Located Influenza Vaccination (SLIV) Toolkit ([link removed]): Topics include planning, relationships and communications, educational materials, implementation, and evaluation.

The SLIV Toolkit ([link removed]) is a comprehensive collection of information, best practices, and lessons learned from health departments, as well as federal and national partners, working with schools to conduct SLIV clinics. Resources are organized by topic area: Planning, Relationships and Communications, Educational Materials, Implementation, and Evaluation.

Access NACCHO's updated resources ([link removed]) today.

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IN IAC'S "VIDEO OF THE WEEK," VOICES FOR VACCINES EXECUTIVE DIRECTOR DISCUSSES COMBATING VACCINE HESITANCY BY EXPLAINING HOW VACCINE CLINICAL TRIALS WORK

Combating Vaccine Hesitancy: Today's Fight against Misinformation ([link removed]): In this excerpt from the virtual discussion hosted by the Clinton Global Initiative University (CGI U), Karen Ernst, executive director, Voices for Vaccines, tells how important it is to explain to the public in easy-to-understand terms how vaccine clinical trials work. With knowledge of how vaccine safety and effectiveness are evaluated, parents will be more comfortable making decisions about receiving vaccines.

Visit the VOTW archive ([link removed]).

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IAC'S BRIGHT RED "FLU VACCINE" BUTTONS AND STICKERS WILL HELP YOU KEEP VACCINATING AGAINST FLU. ORDER TODAY!

IAC “FLU VACCINE” buttons and stickers ([link removed]) are flying out of our office by the thousands! More than a half-million stickers already shipped this year! Their bright red color helps broadcast your important message about the need for flu vaccination. And the cost is nominal.

“FLU VACCINE” BUTTONS

The button measures 1.25" across and carries a bold message! Pin on lab coats, uniforms, other clothing, tote bags, or backpacks to show support for flu vaccine.

Buttons are delivered in bags of 10 buttons per bag.

Click here for pricing and ordering information for "FLU VACCINE" buttons ([link removed]).

“FLU VACCINE” STICKERS

Measuring 1.5" across, these stickers adhere well to clothing and have an easy-peel-off backing.

Stickers are delivered to you cut individually (not on rolls)—available in bundles of 100.

Click here for pricing and ordering information for “FLU VACCINE” stickers. ([link removed])

Visit Shop IAC for additional items ([link removed]), including "Vaccines Save Lives" enamel pins, patient record cards, and a vaccine administration training video.

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CHECK OUT THE WWW.GIVE2MENACWY.ORG WEBSITE TO ENHANCE YOUR EFFORTS AT INCREASING RATES OF MENACWY BOOSTER AND OTHER ADOLESCENT VACCINATIONS

The website www.Give2MenACWY.org ([link removed]) promotes the importance of adolescent vaccination and administering a booster dose of MenACWY vaccine at age 16.

Aimed at healthcare professionals, the site was revised to incorporate updated materials and to highlight the importance of all recommended vaccines for 16-year-olds. A simplified navigation structure makes locating information a breeze.

The colorful Give2MenACWY.org website ([link removed]) is divided into five easy-to-access sections:
* Vaccinate Teens ([link removed]) – The tools included on this web page offer helpful information on teen vaccination schedules and tips for improving adolescent vaccination rates
* Give 2 Doses ([link removed]) – Just a little over half of teens have received a second dose of MenACWY vaccine; this web page offers tools to help improve second dose coverage
* 16-Year-Old Visit ([link removed]) – These resources help both providers and their patients remember the important vaccines recommended for 16-year-olds
* Tools for Providers ([link removed]) – These tools from CDC, IAC, and other organizations explain meningococcal ACWY vaccine recommendations and assist in improving coverage for all recommended adolescent vaccines
* Resources ([link removed]) – This section offers print materials ([link removed]), links to organizations ([link removed]) involved in adolescent vaccination, personal stories ([link removed]) about the importance of vaccination, and additional resources ([link removed]) of interest

Additional time savings are provided by the site’s single location where all website materials are listed ([link removed]) according to whether they are primarily of interest to providers or to patients/parents. Other sections relate to general adolescent immunization, as well as meningococcal disease and vaccine information.

Visit Give2MenACWY.org ([link removed]) and enjoy browsing (and deploying) its bountiful resources, brought to you by IAC's collaboration with Sanofi Pasteur.

Related Links
* MenACWY Campaign’s Give2MenACWY.org ([link removed]) website
* Multi-organization Dear Colleague Letter: 16-Year-Old Patients: Make Sure They Receive Their Annual Well Visit and Vaccinations ([link removed])
* MenACWY Campaign’s Algorithm for MenACWY Immunization in Adolescents 11–18 Years of Age ([link removed])
* MenACWY Campaign’s MenACWY: You're Not Done If You Give Just One: Give 2 Doses to Strengthen Protection ([link removed])
* MenACWY Campaign’s Recommending MenACWY: What to Say and How to Say It ([link removed])
* MenACWY Campaign’s Top 10 Ways to Improve Adolescent Immunization Rates ([link removed])
* MenACWY Campaign’s Developing an Immunization Culture in Your Office ([link removed])
* MenACWY Campaign’s Know Your Rates: Measuring Immunization Success in Your Practice ([link removed])
* IAC's You're 16: We Recommend These Vaccines for You ([link removed])
* National Meningitis Association's The16Vaccine.org ([link removed]) website

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Public television documentary, Protecting Health: Saving Lives, features 30-year history of IAC. Please share.

The award-winning public television documentary series, Visionaries, hosted by Sam Waterston features IAC in the episode, Protecting Health: Saving Lives ([link removed]). This 30-minute film showcases IAC’s founder and executive director Dr. Deborah Wexler’s commitment to supporting the nation’s healthcare professionals with immunization education information and materials. Protecting Health: Saving Lives makes a powerful case for vaccination, addressing and defusing the fears that fuel the antivaccine movement, presenting stories of vaccine-preventable disease, and recognizing the science that has saved millions of lives through vaccination.

Protecting Health: Saving Lives is premiering on local PBS stations nationwide in the months ahead, but you can watch it right now on IAC’s website at www.immunize.org/aboutus/iac-film-history.asp. We’d very much appreciate your circulating the film by sharing this link with your colleagues and friends through member newsletters, e-mail listservs, social media channels, conferences and web-based events, and web pages.

Sharing Protecting Health: Saving Lives ([link removed]) is easy! Just go to [link removed] or click on the film's image in the right column of IAC's immunize.org main page. Click the “share” button, and choose the social media site where you’d like your friends, family, and colleagues to view the film.

To learn more about the public television Visionaries series, visit www.visionaries.org ([link removed]).

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Journal Articles and Newsletters
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“Implementation of a Mandatory Influenza Vaccine Program: A 10-Year Experience” published in Clinical Infectious Diseases

In the June 17 issue, Clinical Infectious Diseases published Implementation of a Mandatory Influenza Vaccine Program: A 10-Year Experience ([link removed]). Its conclusion appears below.

Implementation of our mandatory influenza vaccination program succeeded in successfully increasing the proportion of immunized HCWs at a quaternary care children’s hospital, reducing annual exemption requests with a small number of terminations secondary to vaccine refusal. Temporal trends suggest a positive impact on the safety of our patients.

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“How Health Care Providers Should Address Vaccine Hesitancy in the Clinical Setting: Evidence for Presumptive Language in Making a Strong Recommendation” published in Human Vaccines & Immunotherapeutics

In the April 3 issue, Human Vaccines & Immunotherapeutics published How Health Care Providers Should Address Vaccine Hesitancy in the Clinical Setting: Evidence for Presumptive Language in Making a Strong Recommendation ([link removed] ). A portion of the abstract is reprinted below.

...Several observational studies indicate that presumptive, announcement language as contrasted with participatory, conversational language makes for a stronger more effective recommendation. Several trials now demonstrate that health care providers and practices can implement this language and obtain higher vaccination uptake. The authors recommend the practice be adopted as a routine practice in the clinical setting for all vaccinations.

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On the Lighter Side
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IN THIS 1998 PSA, "CAKEWALK SATURDAY," FORMER FIRST LADY OF OKLAHOMA CATHY KEATING PROMOTES TIMELY CHILDHOOD VACCINATION

Take a nostalgic look at vaccine advocacy 22 years ago. Former first lady of Oklahoma Cathy Keating promotes timely childhood vaccination in this 30-second PSA encouraging parents to bring their children to "Cakewalk Saturday" ([link removed]) for free immunizations. Produced by Oklahoma Dept of Health in 1998, 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 ([link removed]).


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IAC Express
IAC Express Home ([link removed])
2020 Issues ([link removed])
2019 Issues ([link removed])
2018 Issues ([link removed])
2017 ([link removed]) – 1997 Issues ([link removed])

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Video of the Week

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Combating Vaccine Hesitancy: Today's Fight against Misinformation: In this excerpt from the virtual discussion hosted by the Clinton Global Initiative University (CGI U), Karen Ernst, executive director, Voices for Vaccines, tells how important it is to explain to the public in easy-to-understand terms how vaccine clinical trials work. With knowledge of how vaccine safety and effectiveness are evaluated, parents will be more comfortable making decisions about receiving vaccines.

Visit the VOTW archive ([link removed])

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Follow Us

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Technically Speaking
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Read Dr. Wexler's column for the Vaccine Education Center's monthly newsletter, Vaccine Update

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Vaccinating Adults: A Step-by-Step Guide
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New! IAC's 142-page book available for free download ([link removed]).

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Calendar of Events
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Conferences, meetings, and training opportunities

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Patient Record Cards

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Record cards for patients --child & teen ([link removed]), adult ([link removed]), and lifetime ([link removed]) -- are printed on durable paper and sized to fit in a wallet when folded

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DVD: Immunization Techniques

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Every practice should have this award winning, "how-to" training video

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Protect Newborns Guidebook
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Comprehensive guide Hepatitis B: What Hospitals Need to Do to Protect Newborns ([link removed])

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Editorial Information

Editor
Deborah L. Wexler, MD ([email protected])

Associate Editors
John Grabenstein, RPh, PhD ([email protected])
Sharon Humiston, MD, MPH ([email protected])

Consulting Editors
Taryn Chapman, MS ([email protected])
Marian Deegan, JD ([email protected])
Courtnay Londo, MA ([email protected])

Technical Editor
Liv Augusta Anderson, MPP ([email protected])

About IAC Express
The Immunization Action Coalition welcomes redistribution of this issue of IAC Express or selected articles. When you do so, please add a note that the Immunization Action Coalition is the source of the material and provide a link to this issue ([link removed]).

IAC Express is supported in part by Grant No. 6NH23IP922550 from the National Center for Immunization and Respiratory Diseases, CDC.

IAC Express Disclaimer ([link removed])
ISSN: 1526-1786

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