Issue 1,544: January 13, 2021
Top Stories
Vaccine Information Statements
IAC Handouts
Featured Resources
Journal Articles and Newsletters
Education and Training
On the Lighter Side
Top Stories
“Allergic Reactions including Anaphylaxis after Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine—United States, December 14–23, 2020” published in MMWR
CDC published Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine—United States, December 14–23, 2020 in an Early Release MMWR on January 6. Key findings in the report appear below.
- Early safety monitoring detected 21 cases of anaphylaxis after administration of 1,893,360 first doses of Pfizer-BioNTech COVID-19 vaccine (11.1 cases per million vaccine doses)
- 86% of anaphylaxis cases had symptom onset within 30 minutes of vaccination
- 81% of these cases had a history of allergies or allergic reactions, including some with previous anaphylaxis events
- 90% of these anaphylaxis cases after receipt of Pfizer-BioNTech COVID-19 vaccine occurred in women (a higher frequency than the 64% of recipients who are women)
- Anaphylaxis is potentially life-threatening and requires preparedness to start immediate treatment if it happens
- Anaphylaxis after Pfizer-BioNTech COVID-19 vaccine appears to be a rare event
- CDC and FDA continue enhanced monitoring for anaphylaxis among recipients of COVID-19 vaccines
Based on these findings, CDC updated the allergy screening portion of the COVID-19 vaccination clinical considerations to state that contraindications to vaccination with either the Pfizer-BioNTech or Moderna COVID-19 vaccines include a history of severe allergic reaction after a previous dose of an mRNA COVID-19 vaccine or any of its components or immediate allergic reaction of any severity to a previous dose of an mRNA COVID-19 vaccine or any of its components (including polyethylene glycol [PEG]) or polysorbate). Additional details appear in CDC clinical considerations and in guidance on managing anaphylaxis.
Access the MMWR article in HTML format or in PDF format.
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Don't get it wrong! Schedule COVID-19 vaccine dose #2 at 21 or 28 days, not sooner, say CDC and FDA
CDC and FDA each issued statements affirming the use of the standard dosing interval for the two authorized mRNA vaccines.
On January 6, CDC revised Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States. The portion regarding dosing intervals is summarized below:
- Routine Scheduling. Do not schedule people to receive dose #2 earlier than recommended (i.e., 21 days for Pfizer-BioNTech or 28 days for Moderna).
- Inadvertent Early Doses. Dose #2 inadvertently administered as much as 4 days too early (“grace period”) should be considered valid.
- No Maximum Interval. There is no maximum interval between dose #1 and dose #2 for either vaccine. If dose #2 is administered beyond 21 or 28 days, there is no need to restart the series or repeat the dose.
- Errors. Vaccine administration errors should be reported to the Vaccine Adverse Event Reporting System (VAERS).
Visit CDC's COVID-19 Vaccination: Clinical Considerations gateway page for more information.
On January 4, the U.S. Food and Drug Administration (FDA) issued FDA Statement on Following the Authorized Dosing Schedules for COVID-19 Vaccines. A portion of the statement is reprinted below.
Using a single dose regimen and/or administering less than the dose studied in the clinical trials without understanding the nature of the depth and duration of protection that it provides is concerning, as there is some indication that the depth of the immune response is associated with the duration of protection provided. If people do not truly know how protective a vaccine is, there is the potential for harm because they may assume that they are fully protected when they are not, and accordingly, alter their behavior to take unnecessary risks.
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IAC launches "Vaccines: COVID-19" web page, directing you to the most important resources from CDC and others
The large body of COVID-19 vaccine information continues to expand daily. To help healthcare professionals stay up to date with current versions of COVID-19 resources for frontline vaccinators, IAC has launched its new Vaccines: COVID-19 web page at www.immunize.org/covid-19.
On this new web page, IAC has assembled links to key COVID-19 vaccine resource pages from CDC, IAC, and other medical and public health partners. To ease access, the web page is divided into topic areas, including:
- ACIP Recommendations
- CDC COVID-19 Vaccination Information (main page)
- Information about COVID-19 Vaccine Products
- Vaccine Fact Sheets for Recipients and Caregivers (EUA Vaccines)
- Clinic Resources and Tools (including vaccine administration, clinical considerations and special populations, safety, storage and handling, staff training materials, and reimbursement)
- Patient Education Tools
- Vaccine Confidence and Hesitancy
- Frequently Asked Questions
- Key Contacts for COVID-19 Vaccine Information and Policies
There are three ways to easily locate the new web page:
- From the yellow box at the top of the IAC home page
- Use www.immunize.org/covid-19
- Go to the light blue band of tabs across the top of any IAC web page, choose the "Vaccines” tab, and then select “COVID-19”
The Vaccines: COVID-19 web page will be updated frequently, so check back regularly for the most current information.
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Reminder! Ask the Experts: COVID-19 web page answers your questions about COVID-19 vaccines
IAC recently created its Ask the Experts: COVID-19 web page to answer questions about the administration of mRNA COVID-19 vaccines authorized for emergency use by the FDA and recommended by CDC’s Advisory Committee on Immunization Practices. This Ask the Experts web page also provides links to CDC guidance that will likely evolve. The Ask the Experts: COVID-19 web page will grow as more information becomes available and whenever new vaccines are authorized.
IAC’s Ask the Experts gateway page leads you to 29 distinct web pages on a variety of topics comprising a total of more than 1,000 common or challenging questions and answers (Q&As) about vaccines and their administration. IAC wishes to recognize its team of experts: Kelly L. Moore, MD, MPH (lead); Carolyn Bridges, MD, FACP; William Atkinson, MD, MPH; and Deborah Wexler, MD.
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HHS announces $22 billion in funding to support expanded COVID-19 testing and vaccination
In a January 6 press release, the Department of Health and Human Services (HHS) announced the Coronavirus Response and Relief Supplemental Appropriations Act will enable the CDC to provide more than $22 billion in funding to states, localities, and territories to support the nation’s response to the COVID-19 pandemic.
The $22 billion includes $19 billion for testing and $3 billion for vaccination activities. The funding is to be disbursed by January 19, 2021, to support testing and vaccination-related activities. Award recipients will include 64 jurisdictions including all 50 states, the District of Columbia, five major cities, and U.S. territories/islands. Funds will be allocated by a population-based formula.
For more information about CDC’s ongoing support to states, please visit this CDC's COVID-19 Budget Fact Sheet gateway page.
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HHS releases national strategic plan to address viral hepatitis in the U.S.
On January 7, the U.S. Department of Human Health Services (HHS) released its Viral Hepatitis National Strategic Plan for the United States: A Roadmap to Elimination 2021–2025 to address this serious, preventable public health threat.
The Viral Hepatitis Plan for 2021–25 focuses on hepatitis A, hepatitis B, and hepatitis C, the three most common hepatitis viruses affecting the health of the nation. The plan identifies populations that experience the highest burden of viral hepatitis so that federal agencies and other stakeholders can focus their resources for the greatest effect.
The Viral Hepatitis Plan includes five goals to guide planning efforts:
- Prevent new viral hepatitis infections
- Improve health outcomes of people with viral hepatitis
- Reduce viral hepatitis-related disparities and health inequities
- Improve viral hepatitis surveillance and data use
- Achieve integrated, coordinated efforts that address the viral hepatitis epidemics among all partners and stakeholders
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Voices for Vaccines releases new podcast, interviewing Stanley Plotkin on common COVID-19 vaccine questions
Voices for Vaccines (VFV) has posted a new entry in its Vax Talk podcast series: Let’s Ask Dr. Stanley Plotkin About These COVID-19 Vaccines. A description from their web page is reprinted below.
Millions of people have received a COVID-19 vaccine, which gives us a lot of information about the safety of these vaccines. We asked Dr. Stanley Plotkin, inventor of the rubella vaccine and co-inventor of a rotavirus vaccine, to join us to answer our questions and to make some predictions.
Voices for Vaccines is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters. VFV invites everyone who values vaccines to become a member, use VFV tools in their own community, and sign up for VFV’s free newsletter. Please spread the word to your friends and colleagues to join VFV!
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“Use of Ebola Vaccine: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020” published in MMWR
CDC published Use of Ebola Vaccine: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020. A portion of the summary section is reprinted below.
ACIP recommends preexposure vaccination with Ervebo for adults aged ≥18 years in the U.S. population who are at highest risk for potential occupational exposure to Ebola virus species Zaire ebolavirus because they are responding to an outbreak of EVD, work as health care personnel at federally designated Ebola treatment centers in the United States, or work as laboratorians or other staff at biosafety level 4 facilities in the United States. Recommendations for use of Ervebo in additional populations at risk for exposure and other settings will be considered and discussed by ACIP in the future.
Access the MMWR article in HTML format or in PDF format.
Related Link
- MMWR gateway page provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements
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IAC experts called on by news media
With vaccines in the news so much lately, journalists have sought out IAC experts to communicate the intricacies of running a quality vaccination program. Our insights have helped explain vaccines to the public and policy makers. We want to help them understand the complex work vaccinators do. We've reached mass markets and local stations, across the U.S. and overseas, via print, radio, television, blogs, and more. Here is a selection of our recent citations:
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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Vaccine Information Statements
IAC Handouts
New! IAC publishes “COVID-19 mRNA Vaccines – What Clinic Personnel Need to Know,” a side-by-side comparison of Pfizer-BioNTech and Moderna COVID-19 vaccines
IAC has released its newest resource for healthcare professionals, COVID-19 mRNA Vaccines – What Clinic Personnel Need to Know, a 5-page summary offering a side-by-side comparison of the two FDA-authorized mRNA COVID-19 vaccines.
The table lists key characteristics of and resources for the Pfizer-BioNTech and Moderna mRNA vaccines. The resource presents information on each vaccine, including summary guidance and links to key resources available from CDC, FDA, and the vaccine manufacturers. Topics covered for each vaccine include:
- Age indication
- Presentation and packaging
- Storage and handling
- Vaccine preparation and administration
- Vaccine safety
- Vaccine product and administration codes
“COVID-19 mRNA Vaccines – What Clinic Personnel Need to Know” will be updated as new key resources become available.
Related Links
IAC updates “Decision to Not Vaccinate My Child – Declination Form”
IAC recently revised its Decision to Not Vaccinate My Child – Declination Form, adding “Declination Form” to the title and updating explanatory statements and references.
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Featured Resources
CHOP’s Vaccine Education Center releases English- and Spanish-language versions of their COVID-19 mRNA Q&As
Children's Hospital of Philadelphia's (CHOP) Vaccine Education Center has released a 4-page, printable Q&A for the public titled COVID-19 mRNA Vaccines: What You Should Know.
View the handout in Spanish.
As with their other Q&A sheets, these sheets can be photocopied for distribution, and the links can be added to websites. Print versions will be available in coming weeks.
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In IAC’s “Video of the Week,” CDC's Dr. Amanda Cohn explains how ACIP advises CDC on use of vaccines
In this CDC video, Dr. Amanda Cohn, executive secretary of CDC’s Advisory Committee on Immunization Practices (ACIP), explains that ACIP consists of independent experts who debate and develop recommendations on using vaccines to control vaccine-preventable diseases, including COVID-19. The committee prioritizes safety and effectiveness while reviewing scientific evidence.
Use IAC’s expanded “Repository of Resources for Maintaining Immunization during the COVID-19 Pandemic” to catch up people who fell behind
IAC now offers more than 275 items in its Repository of Resources for Maintaining Immunization during the COVID-19 Pandemic gateway page to assist in maintaining routine immunization rates during the COVID-19 pandemic. Located on the website of the National Network of Immunization Coalitions, a project of IAC, this repository includes links to both national and state-level policies and guidance; advocacy materials, including talking points, webinars, press releases, articles, and social media posts; and telehealth resources.
These resources are intended for healthcare settings, state and local health departments, professional societies, immunization coalitions, advocacy groups, and the community to use in their efforts to sustain routine immunizations during the COVID-19 pandemic. The resources can be sorted and searched by date, title, geographic area, source, type, age category, or setting.
If you have a resource to suggest for the repository, please send a message to [email protected].
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Newly updated 65+ Flu Defense website offers resources for healthcare professionals serving older adults
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.
A new fact sheet 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.
This helpful site includes information, tools, and tips for communicating with these adults about the scope and severity of influenza, for example:
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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Great for workplace recognitions! IAC’s elegantly designed “Vaccines Save Lives” black enamel pins show how much you value vaccination.
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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Check out IAC’s new website Mass-Vaccination-Resources.org to find resources to help set up your mass vaccination clinics—new resources added!
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.
More resources have been added including:
In addition, IAC's archived, full-length webinar highlighting best practices and offering practical information for conducting a successful mass vaccination clinic, Mass Vaccination Clinics: Challenges and Best Practices, can also be viewed on www.Mass-Vaccination-Resources.org.
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.
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Journal Articles and Newsletters
“A Quality Improvement Learning Collaborative for Human Papillomavirus Vaccination” published in Pediatric Quality and Safety
In the January/February 2021 issue, Pediatric Quality and Safety published A Quality Improvement Learning Collaborative for Human Papillomavirus Vaccination. The senior author on the project is IAC’s Sharon G. Humiston, MD, MPH. The conclusion section is reprinted below.
This learning collaborative aimed to engage multiple AAP chapters and pediatric practices to teach QI skills and improve HPV vaccination rates using the Project ECHO telementoring platform. At the chapter level, the collaborative demonstrated success in satisfaction and in teaching the necessary skills to allow all participating chapters to go on to lead HPV QI learning collaboratives of their own. At the practice level, participants gained confidence in HPV vaccine communication and QI skills. The collaborative demonstrated early improvements in reducing missed opportunities to vaccinate, while the impact on HPV vaccination initiation and completion lagged. Future projects should be extended for more than 8 data cycles or use more frequent data collection to capture this change and further identify barriers to system-level change.
“Population Mortality and Laws Encouraging Vaccination for Hospital Workers” published in Annals of Internal Medicine
In the January 5 issue, Annals of Internal Medicine published Population Mortality and Laws Encouraging Vaccination for Hospital Workers. The conclusion section is reprinted below.
State laws promoting hospital worker vaccination against influenza may be effective in preventing pneumonia- and influenza-related deaths, particularly among elderly persons. Vaccinating hospital workers may substantially reduce the spread of influenza and protect the most vulnerable populations.
Education and Training
Moderna scientists will offer two webinars regarding mRNA COVID-19 vaccination on January 14 and 19
Moderna will offer two webinars on mRNA vaccination against SARS-CoV-2, the virus that causes COVID-19. Ashfield Healthcare will coordinate the webinars on behalf of Moderna. CE credit will not be offered for these webinars.
On January 14, the webinar titled Important Information for Healthcare Providers about Moderna COVID-19 Vaccine will start at 11:00 a.m. (ET).
Register for the January 14 webinar.
On January 19, the webinar Examining the SARS-CoV-2 Pandemic and the Moderna COVID-19 Vaccine: A Panel Discussion will be held from 7:00–8:00 p.m. (ET). This will be a conversational 1-hour presentation examining evolving epidemiology, the vaccine development timeline, the mRNA mechanism of action, and clinical data supporting an Emergency use Authorization (EUA).
Register for the January 19 webinar.
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On the Lighter Side
In this cute 1998 PSA from Nevada Health Division, a baby’s toys inform her that she can get the chickenpox vaccine
In this cute 1998 public service announcement (PSA) from the Nevada Health Division, a baby’s toys explain the importance of getting the chickenpox vaccine to help protect her from the potentially deadly disease. This PSA is part of a collection curated by vaccine expert William L. Atkinson, MD, MPH.
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Video of the Week
How CDC Develops COVID-19 Vaccine Recommendations: Dr. Amanda Cohn, executive secretary of CDC’s Advisory Committee on Immunization Practices (ACIP), explains that ACIP consists of independent experts who debate and develop recommendations on using vaccines to control vaccine-preventable diseases, including COVID-19. The committee prioritizes safety and effectiveness while reviewing scientific evidence. [1:44]
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