Issue 1,533: December 2, 2020
Top Stories
IAC Handouts
Vaccine Information Statements
Featured Resources
Journal Articles and Newsletters
Education and Training
On the Lighter Side
Top Stories
ACIP recommends healthcare personnel and LTCF residents for phase 1a of COVID-19 vaccination program; IAC summarizes two ACIP meetings held on November 23 and December 1
At its December 1 virtual meeting, the Advisory Committee on Immunization Practices (ACIP) adopted a recommendation defining the priority groups for phase 1a of a national COVID-19 vaccination program. People in these groups would be offered the first limited quantities of mRNA vaccines against SARS-CoV-2. Although this prioritization does not become official until explicitly adopted by CDC, phase 1a would include healthcare personnel and adult residents of long-term care facilities (LTCFs).
ACIP defines healthcare personnel as paid and unpaid people working in healthcare settings who have the potential for direct or indirect exposure to patients or infectious material. ACIP and CDC repeatedly noted that this definition includes people in healthcare facilities who provide environmental services and food services, as well as those who provide home health services and workers in small medical practices. This definition encompasses an estimated 21 million people in the United States and includes the staff working in LTCFs. Adult residents of LTCFs in the U.S. are estimated to total another 3 million people.
Should supply constraints or other circumstances call for sub-prioritization, the group considered several subgroups within healthcare personnel and within LTCF residents. These subgroups may be included in planning discussions or future CDC documents.
The December 1 recommendation deals with vaccine allocation for phase 1a only. Contingent on FDA decisions, ACIP would reconvene later in December to determine whether the scientific evidence underlying specific mRNA vaccine candidates warrants ACIP recommendation. Once vaccine supplies increase, perhaps in January, ACIP would consider recommendations for additional prioritized cohorts of vaccine recipients. Those discussions could address preferred sequences for essential workers, people 65 years or older, and adults with high-risk medical conditions.
ACIP’s vote was the culmination of discussions during seven public meetings held since June 2020. The timing of ACIP’s recommendation is unusual in that it preceded any product’s release by the FDA. This was done to provide states and other jurisdictions additional time to coordinate planning efforts before vaccine distribution.
CDC is developing additional support materials to augment the ones already posted at CDC web pages. CDC and ACIP acknowledged that allocation policies will need to adapt as new information (e.g., vaccine performance, supply, demand) becomes available. For example, gating criteria will be needed to know when to proceed from one phase to the next, as demand is satisfied.
Eight distinct safety assessment systems will contribute data to FDA and CDC evaluation. These data will be reviewed by the Vaccine Safety Technical (VaST) Sub-Group, which is co-chaired by members of the ACIP and the National Vaccine Advisory Committee (NVAC).
Vaccines to prevent COVID-19 will not become available until FDA either licenses them or issues Emergency Use Authorizations (EUAs). FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) will meet December 10 to consider an application from BioNTech and its partner Pfizer for a messenger RNA (mRNA) vaccine candidate known as BNT162b2. A second VRBPAC meeting will be held December 17 to consider Moderna’s candidate, mRNA-1273.
To prepare for the December 1 decision described above, during its November 23 virtual meeting ACIP reviewed current COVID-19 epidemiology. Committee decisions will be based upon the Evidence to Recommendations (EtR) framework, which considers seven domains in making decisions, including evaluation of the public health problem, benefits and harms, values, acceptability, feasibility, resource use, and equity. During this meeting, ACIP focused on equitable access to SARS-CoV-2 vaccines.
In addition to scientific data and implementation feasibility, ACIP’s decisions will be based on four ethical principles described in a special MMWR report released on November 23: maximize benefits/minimize harms, promote justice, mitigate health inequities, and promote transparency.
Summary minutes and presentation slides from the November meeting are posted on the ACIP web site.
The most up-to-date information on the group’s meeting schedule is available on the ACIP Meeting Information page. CDC offers an email update service for ACIP meeting information.
Related Links from CDC
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“The Advisory Committee on Immunization Practices’ Ethical Principles for Allocating Initial Supplies of COVID-19 Vaccine—United States, 2020" in MMWR
CDC published The Advisory Committee on Immunization Practices’ Ethical Principles for Allocating Initial Supplies of COVID-19 Vaccine—United States, 2020 in the November 27 issue of MMWR. A portion of the discussion section appears below.
Allocation of limited vaccine supplies is complicated by efforts to address the multiple goals of a vaccine program, most notably those related to the reduction of morbidity and mortality and the minimization of disruption to society and the economy. If the goals of a pandemic vaccination program are not clearly articulated and prioritized, drawing distinctions between groups that merit consideration for allocation of vaccine when supply is constrained can become difficult. The unanimity in opinion for early vaccination of health care personnel indicates that maintenance of health care capacity has emerged as a high priority in the context of a severe pandemic. This perspective aligns with ethical considerations for pandemic influenza planning. If vaccine supply remains constrained, it might be necessary to identify subsets of other groups for subsequent early allocation of COVID-19 vaccine. At the national, state, tribal, local, and territorial levels, such decisions should be guided, in part, by ethical principles and consideration of essential questions, with particular consideration of mitigation of health inequities in persons experiencing disproportionate COVID-19 morbidity and mortality. In the setting of a constrained supply, the benefits of vaccination will be delayed for some persons; however, as supply increases, there will eventually be enough vaccine for everyone.
In addition to ethical considerations, ACIP’s recommendations regarding receipt of the initial allocations of COVID-19 vaccine during the period of constrained supply will be based on science (e.g., available information about the vaccine’s characteristics such as safety and efficacy in older adults and epidemiologic risk) and feasibility of implementation (e.g., storage and handling requirements). Thus, ACIP’s allocation recommendations will be made in conjunction with specific recommendations for the use of each FDA-authorized or licensed COVID-19 vaccine. Although the ethical principles in this report are fundamental for stewardship of limited vaccine supply, they can also be applied when COVID-19 vaccines are widely available, to ensure equitable and just access for all persons.
Access the MMWR article in PDF format o r in HTML format.
Related Link
- MMWR's gateway page provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements
CDC releases COVID-19 vaccine training titled “General Overview of Immunization Best Practices for Healthcare Professionals”
On November 19, CDC released COVID-19 Vaccine Training: General Overview of Immunization Best Practices for Healthcare Providers. This is a new, web-on-demand, self-paced 27-slide module for healthcare providers who will be administering COVID-19 vaccine. This module provides healthcare providers with information about Emergency Use Authorizations and vaccine safety, as well as general information about vaccine storage, handling, administration, and reporting. Continuing education will not be available for this module but there will be a certificate of completion available.
Related Links
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CDC Vaccine Storage and Handling Toolkit has been expanded with a COVID-19 addendum
On November 20, CDC updated its vaccine Storage and Handling Toolkit to include a COVID-19 Vaccine Addendum (pages 49–55 of the booklet). The addendum provides information to assist COVID-19 vaccination providers in properly storing and handling COVID-19 vaccines, which is essential to meeting the requirements of the COVID-19 Vaccination Program Provider Agreement.
Additional information and materials are available on CDC’s Vaccine Storage and Handling Toolkit gateway page.
Related Links
Reminder! CDC leaders Drs. Nancy Messonnier and Amanda Cohn to present “COVID-19 Vaccination Implementation and the ‘Vaccinate with Confidence’ Strategy” during IAC webinar on December 3
IAC will host the 1-hour webinar “COVID-19 Vaccination Implementation” on December 3 at 1 p.m. (ET). This important and timely topic will be addressed by key leaders at the Centers for Disease Control and Prevention (CDC). Register now to be sure you don’t miss this informative session.
CDC Speakers:
- Dr. Nancy Messonnier, Director, National Center for Immunization and Respiratory Diseases (NCIRD); Director, COVID-19 Vaccine Task Force
- Dr. Amanda Cohn, Chief Medical Officer, NCIRD and COVID-19 Vaccine Task Force
This presentation will update partners on COVID-19 vaccine planning and implementation. Specific topics include an overview of the SARS-CoV-2 vaccine distribution strategy, current state planning efforts, and the COVID-19 “Vaccinate with Confidence” Strategy.
L.J Tan, MS, PhD, IAC’s chief strategy officer will moderate the webinar.
The presentations will be followed by a Q&A session with CDC subject matter experts.
Please submit questions ahead of time to [email protected].
Register now to be sure you don’t miss this informative session.
The webinar will be recorded for viewing at a later date.
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NVAC to discuss COVID-19 vaccines for pregnant women and overall safety surveillance on December 4
The National Vaccine Advisory Committee (NVAC) will hold a virtual meeting on December 4 from 1 to 5:30 p.m. (ET). The agenda will focus on options for including pregnant women in COVID-19 vaccine trials plus a review of vaccine safety surveillance systems for upcoming COVID-19 vaccination programs.
If you wish to provide verbal public comment during the meeting, please confirm your request by sending an email to [email protected]. If you wish to provide written comments, please submit them at least 5 business days in advance to [email protected].
Related Links
National Influenza Vaccination Week is December 6–12; promote flu vaccination with resources from CDC’s and IAC’s gateway pages
National Influenza Vaccination Week (NIVW), observed December 6–12 this year, was established by CDC in 2005 to highlight the importance of continuing influenza vaccination activities throughout the holiday season and beyond. It's a great time to send reminder messages and vaccinate all those who have not received flu vaccine this vaccination season. Vaccination efforts should continue into the spring because influenza activity often does not peak until February.
CDC has made a call to action, encouraging everyone to get their annual flu shot—especially those with chronic conditions. The CDC invites partners to get the word out about NIVW on social media using CDC's 2020 NIVW Digital Media Toolkit that includes social media messages, NIVW resources, vaccination messages, and activities you can use to share key flu information with your networks.
Use #FightFlu to join the conversation all week and tag @CDCFlu on Twitter.
Related Links:
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Newly updated 65+ Flu Defense website features tools and resources for healthcare professionals serving older adults
In the 2018–19 season, only 68% of adults age 65 and older were vaccinated against influenza. Confident recommendations for flu vaccine from healthcare providers are powerfully persuasive and make a significant difference in decisions your patients make about vaccination.
To assist you in maximizing protection for your patients, IAC, in collaboration with Seqirus, has updated the 65+ Flu Defense website at www.influenza-defense.org. This helpful site includes information, tools, and tips for communicating with these adults about the scope and severity of influenza, for example:
One new handout on the site, The Importance of Preventing Influenza During a Pandemic, offers responses to help guide discussions with patients on the increased importance of flu vaccination during the COVID-19 pandemic. Age increases risks associated with COVID-19 infection including hospitalization and death. Preliminary studies suggest coinfection with influenza B and SARS-CoV-2 may elevate the risk of poor outcomes.
Be sure to check out the updated 65+ Flu Defense website at www.influenza-defense.org to assist your efforts in protecting this vulnerable population.
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“Prevent Shoulder Injuries Caused by Missing the Deltoid Muscle When Injecting Vaccines,” Dr. Wexler’s Technically Speaking monthly column, available on immunize.org
November's Technically Speaking column by IAC's executive director, Deborah L. Wexler, MD, is reprinted below.
Prevent Shoulder Injuries Caused by Missing the Deltoid Muscle When Injecting Vaccines!
by Deborah L. Wexler, MD
It's essential that you know how to choose the proper site on the arm when administering vaccines. A correctly placed injection not only will optimize the protection afforded by the vaccine, it also will help you avoid the risk of shoulder or arm injury resulting from an injection placed too high or too low in the arm.
Knowing exactly where to inject a vaccine is critical whether you’re "catching up" children, teens, and adults on their missed vaccinations during the COVID-19 pandemic, getting patients vaccinated against influenza, or administering COVID-19 vaccines in the near future.
The websites of the Centers for Disease Control and Prevention (CDC), the Immunization Action Coalition (IAC), and the California Department of Health Immunization Program are rich with practical tools and resources on how to identify the correct spot for administering vaccines. For example, the two CDC videos listed below have a combined total of more than 500,000 views, and the IAC materials listed are among the top downloads accessed on our website. Be sure to check out these and the other great materials shown below.
Watch these brief videos from CDC
Refer to these instructions from IAC
Use these job aids from the California Department of Public Health Vaccines For Children program (EZIZ)
Additional Resources
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.
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All institutions of higher learning in Los Angeles County plus four other colleges now require flu vaccine for staff and students. Do you know of more?
Many colleges and universities across the nation are mandating flu vaccine to protect staff and students. IAC has recently become aware of additional schools that require influenza vaccine this year: all colleges and universities in Los Angeles County, Claremont Colleges, Emory University, La Salle University, and The University of the South (Sewanee).
The following schools also require influenza vaccine this year: Indiana University—nine campuses, Indiana University—nine campuses, University of California system—ten campuses, University of Tennessee system—four campuses, Albion College, Butler University, Carleton College, Colby College, Columbia University, Cornell University, Creighton University, Dordt University, Duke University, Elon University, Johns Hopkins University, Marist College, McDaniel College, Montclair State University, Notre Dame, Pepperdine University, Purdue University, Rochester Institute of Technology, Rosalind Franklin University, Syracuse University, University of Dayton, University of Denver, University of Kentucky, University of Miami, University of North Carolina at Charlotte, University of Pennsylvania, University of Southern California, Wabash College, Wake Forest University, Washington University in St. Louis, and Wayne State University.
Under a new statewide regulation in Massachusetts, 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) on [email protected].
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Three healthcare organizations join IAC’s Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination
There are now 1,146 organizations enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, long-term care facilities (LTCFs), medical practices, pharmacies, professional organizations, health departments, and other government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel.
Since September 9, when IAC Express last reported on the Influenza Vaccination Honor Roll, three additional healthcare organizations have been enrolled.
- San Ysidro Health, San Diego, CA
- Rocky Mountain Cancer Centers, Greenwood Village, CO
- Trinity Health Mid-Atlantic, Newton Square, PA
IAC urges qualifying healthcare organizations to complete the Application page.
Related Links
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IAC Spotlight! These updated IAC staff and patient educational materials were released during October and November
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 Materials
Handouts for Your Patients
Updated Web Pages
IAC recently completed reviewing and updating 24 sections of Ask the Experts: which include questions and answers to common and challenging situations immunization providers face daily. Find answers 24/7 to your immunization questions on administering vaccines, contraindications and precautions, COVID-19 and routine vaccination, hepatitis A, influenza, meningococcal B, polio, scheduling vaccines, storage and handling, and much more!
Related Links
Not-to-miss immunization articles in the news
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
COVID-19
Routine Vaccinations
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IAC Handouts
Many updated translations available for IAC’s screening checklist for contraindications to vaccines for children/teens and for adults
IAC now offers seven updated translations to match the English-language version of its Screening Checklist for Contraindications to Vaccines for Children and Teens.
The Screening Checklist for Contraindications to Vaccines for Children and Teens has been translated into Spanish, Arabic, Chinese-Simplified, French, Korean, Russian, and Vietnamese.
IAC also now offers six updated translations to match the English-language version of its Screening Checklist for Contraindications to Vaccines for Adults
The Screening Checklist for Contraindications to Vaccines for Adults has been translated into Spanish, Arabic, Chinese-Traditional, French, Korean, Russian, and Vietnamese.
Related Links
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Vaccine Information Statements
IAC posts new and updated translations of VISs in Albanian, Karen, and Hebrew
IAC has posted new and updated translations of Vaccine Information Statements (VISs) in Albanian, Karen, and Hebrew.
Access the Albanian VIS translations generously donated by St. Peter’s Health Partners, Albany, NY.
Access the Karen VIS translations generously donated by St. Peter’s Health Partners, Albany, NY.
Access the Hebrew VIS translations generously donated by Georgetown Translators.
Related Links
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Featured Resources
In IAC’s “Video of the Week,” lead physicians from HHS assure us that any FDA-licensed vaccine will be safe and effective
In this October 2020 video, Tell Me More about Vaccines—Episode 1, lead physicians from the U.S. Department of Health and Human Services present information on how vaccines for COVID-19 are being developed, tested, licensed, and manufactured. They assure us that any FDA-licensed vaccine will be safe and effective. Dr. Fauci explains why he is cautiously optimistic. [runtime: 6:32]
Visit the VOTW archive.
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Reminder: CDC releases provider resources to aid in patient conversations about COVID-19 vaccines
CDC has created resources to help providers start planning how to communicate with patients about SARS-CoV-2 vaccines when they become available. These CDC materials help clinicians plan for vaccination, access patients' vaccine information needs, and communicate effectively to meet those needs. Resources are listed below.
Another valuable tool is the CDC Vaccine Storage and Handling Toolkit that now contains a COVID-19 Vaccine Storage and Handling Addendum with information on storage and handling best practices for COVID-19 vaccines. Following these practices will be necessary to meet the requirements of the COVID-19 Vaccination Program Provider Agreement. Jurisdictions and providers are encouraged to check the website often or sign up for email alerts (on far left column of the Vaccine Storage and Handling Toolkit website) to be notified when updates are made.
Please share these resources with your colleagues!
Related Links
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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 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 is divided into five easy-to-access sections:
- Vaccinate Teens – The tools included on this web page offer helpful information on teen vaccination schedules and tips for improving adolescent vaccination rates
- Give 2 Doses – 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 – These resources help both providers and their patients remember the important vaccines recommended for 16-year-olds
- Tools for Providers– These tools from CDC, IAC, and other organizations explain meningococcal ACWY vaccine recommendations and assist in improving coverage for all recommended adolescent vaccines
- Resources – This section offers print materials, links to organizations involved in adolescent vaccination, personal stories about the importance of vaccination, and additional resources of interest
Additional time savings are provided by the site’s single location where all website materials are listed 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 and enjoy browsing (and deploying) its bountiful resources, brought to you by IAC's collaboration with Sanofi Pasteur.
Related Links
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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. 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 more than 100 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 is easy! Just go to https://www.immunize.org/aboutus/iac-film-history.asp 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.
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Great gift idea! IAC's elegantly designed "Vaccines Save Lives" black enamel pins make wonderful holiday gifts or workplace recognitions!
Several thousand sold already! IAC’s elegantly designed “Vaccines Save Lives” pins are meaningful gifts for people who care about immunization. The pin makes a refined statement in hard black enamel with gold lettering and edges, measuring 1.125" x 0.75".
The pin is a stick-through-post variety with the back end covered by a round rubber cap that holds the pin securely. A gold metal spring-lock clasp is also provided.
Wear these pins on clothing, uniforms, and white coats to show that you value vaccines! They make a meaningful gift for people who care about immunization.
 
Click here for "Vaccines Save Lives" pin pricing and ordering information.
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Journal Articles and Newsletters
CDC publishes November issue of Immunization Works newsletter; subscribe for monthly immunization information
CDC released the November 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.
Related Links
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“Action Needed Now to Prevent Further Increases in Measles and Measles Deaths in the Coming Years” published by Lancet
In the November 12 issue, Lancet published Action Needed Now to Prevent Further Increases in Measles and Measles Deaths in the Coming Years. A portion of the article is reprinted below.
The COVID-19 pandemic has had a profound effect on global immunisation and control of vaccine-preventable diseases, with vaccination campaigns paused in the early months of 2020 and routine immunisation services greatly disrupted in many countries. However, modelled evidence suggests that the potential risks of delaying vaccination outweigh the risks associated with COVID-19. Since March, most countries have resumed routine immunisation and restarted preventive and outbreak response campaigns to reduce the number of children left susceptible to measles and other vaccine-preventable diseases. Despite these efforts, WHO estimates that by the end of October, 2020, delays to vaccination campaigns in 26 countries have led to 94 million children missing scheduled measles vaccine doses, placing many of them at risk of measles.
Access the article in PDF format or in HTML format.
Education and Training
AAP offers free, online course titled “HPV Vaccine: When, Why, and How”
The American Academy of Pediatrics (AAP) is offering a free, online course: HPV Vaccines: When, Why, and How. The main goals of the course are to motivate clinicians to protect more patients against HPV infection and its outcomes, and to provide clinicians with tools to support their efforts. The course covers HPV vaccine and cancer prevention, recommending HPV vaccine, and increasing HPV vaccine rates. The lead author is IAC’s associate director for research, Sharon Humiston, MD, MPH. One hour of continuing education credit (CE) is offered.
Take the free, online course.
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AAP and CDC offer webinar titled "Now Is the Time! Flu Vaccination for People with Special Healthcare Needs and Disabilities" on December 9
The American Academy of Pediatrics (AAP) will host a 1-hour webinar titled Now Is the Time! Flu Vaccination for People with Special Healthcare Needs and Disabilities on December 9 from 1:00–2:00 p.m. (ET). The webinar will provide the latest information from AAP and CDC on routine flu vaccination recommendations, safely vaccinating during the COVID-19 pandemic, flu activity and surveillance, and why flu vaccination for people with special healthcare needs and disabilities—and those who care for them—is more important than ever.
Registration information.
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On the Lighter Side
In this humorous 20-year-old PSA from the Nevada Health Division, a child in a boxing ring knocks out childhood diseases with his secret weapon
In this Nevada Health Division public service announcement (PSA) from 2000, a child in a boxing ring knocks out an animation of childhood diseases with the “power of immunization.” This PSA is part of a 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
Influenza Update 2020–21: This flu season, a strong influenza vaccine recommendation is one of the most important factors in people accepting the vaccine. This updated CDC video 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. [22:47]
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Technically Speaking
Read Dr. Wexler's column for the Vaccine Education Center's monthly newsletter, Vaccine Update
Vaccinating Adults:
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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
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Every practice should have this award winning, "how-to" training video
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