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IAC Express #1,584 - Your weekly immunization news service: IAC summarizes ACIP meeting, CDC releases 14 VISs, and more
| From | Immunization Action Coalition <[email protected]> |
| Subject | IAC Express #1,584 - Your weekly immunization news service: IAC summarizes ACIP meeting, CDC releases 14 VISs, and more |
| Date | August 18, 2021 11:46 AM |
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Issue 1,584: August 18, 2021
Top Stories
* IAC summarizes August 13 ACIP meeting on new recommendation for additional dose of mRNA COVID-19 vaccine for people with moderate to severe immunocompromise
* CDC releases 14 updated Vaccine Information Statements; translations in progress
* CDC strengthens recommendation for COVID-19 vaccination for people who are or may become pregnant, in light of reassuring safety data for vaccination in all stages of pregnancy
* "Use of COVID-19 Vaccines after Reports of Adverse Events among Adult Recipients of Janssen (Johnson & Johnson) and mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna): Update from the Advisory Committee on Immunization Practices—United States, July 2021" published in MMWR Early Release
* For National Immunization Awareness Month, use the new “We Can Do This” social media posts and graphics to promote back-to-school vaccinations
* Multiple vaccine advocacy groups publish white paper describing challenges that prevent maternal immunization in the United States
* IAC Spotlight! IAC’s Immunize.org website offers many useful navigation features
* Journalists interview IAC experts
* Vaccines in the news
Immunize.org Pages and Handouts
* IAC updates "Vaccine with Diluents: How to Use Them" handout for healthcare professionals
Vaccine Information Statements
* IAC updates "You Must Provide Patients with Vaccine Information Statements (VISs) – It's the Law!" to reflect new VIS version dates
* IAC revises "Dates of Current Vaccine Information Statements (VISs)" checklist to reflect new VIS version dates
Featured Resources
* National Governors Association Center for Best Practices releases new publication, "State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities"
* IAC’s gateway page “Vaccination and COVID-19” offers a collection of tools from many organizations to sustain routine vaccination services during the pandemic
* Organizing a new vaccination program? Use IAC's Vaccinating Adults: A Step-by-Step Guide—free to download by chapter or in its entirety
* Encourage others to get vaccinated by ordering IAC's “Me Vacuné…” and “I Got My COVID-19 Vaccine” buttons and stickers, now FREE to all organizations promoting or offering COVID-19 vaccination!
* Fall is right around the corner; so is flu season! Stock up on IAC's flu vaccine buttons and stickers for staff and patients.
Notable Publications
* “Randomized Trial of a Third Dose of mRNA-1273 Vaccine in Transplant Recipients” published in NEJM
* MMWR recap: Reduced risk of reinfection of COVID-19 after vaccination
* “Pediatric Immunization Schedule: Best Available Evidence for 2021” published in Clinical Advisor
* “Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents” published in NEJM
Global News
* “The CAPACITI Decision-Support Tool for National Immunization Programs” published in Value in Health
Immunization PSAs from the Archive
* In this upbeat 2003 PSA from Texas Department of Health, a doctor and mother explains why she recommends vaccinations for her own children and patients
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Top Stories
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IAC summarizes August 13 ACIP meeting on new recommendation for additional dose of mRNA COVID-19 vaccine for people with moderate to severe immunocompromise
On August 13 ([link removed]), the Advisory Committee on Immunization Practices (ACIP) ([link removed]) met to review the FDA’s August 12 modifications to its Emergency Use Authorizations (EUAs) for the Pfizer-BioNTech ([link removed]) and Moderna ([link removed]) mRNA COVID-19 vaccines. ACIP members unanimously recommended administration of an additional dose of mRNA vaccine for moderately to severely immunocompromised people who have completed either 2-dose mRNA COVID-19 vaccine series. This recommendation does not apply to immunocompromised people who received Janssen COVID-19 Vaccine (Johnson & Johnson). Presentation slides ([link removed]) from the meeting are available online, and details of this recommendation are provided below.
Background: Approximately 7 million people (2.7% of the population) in the United States are immunocompromised. These individuals are more likely to get severely ill from SARS-CoV-2 infection and shed the virus for prolonged periods. Small studies indicate that, when compared to non-immunocompromised people, immunocompromised people are more likely to have serious breakthrough infection; 40–44% of fully vaccinated individuals hospitalized with breakthrough infection have been immunocompromised. A blood test showing detectable neutralizing antibodies after vaccination is a simple but imperfect estimate of a person’s protection from COVID-19 illness. Among immunocompromised people with no detectable antibody response to a 2-dose mRNA vaccine series, 33–50% developed a detectable antibody response after a third dose.
Available evidence supports the conclusion that an additional dose is safe in immunocompromised people. Public health authorities in other countries, including France, Israel, Germany, and the United Kingdom, have recommended an additional dose of COVID-19 vaccine be given to immunocompromised people.
CDC presenters emphasized the difference between an additional dose in this context and a booster dose. An “additional” dose of vaccine is a dose administered when the immune response to a standard primary vaccine series is likely not to be protective. A “booster” dose of vaccine is a dose administered to restore protection after the effectiveness of protection from the primary series has declined. ACIP does not recommend booster doses at this time.
Implementation and Clinical Considerations: Following approval of the ACIP recommendation, CDC updated its Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States ([link removed]). COVID-19 vaccine providers should review this CDC document carefully for complete information. Highlights of key aspects of implementation guidance for this recommendation are provided below.
Moderately to Severely Immunocompromised People: The ACIP recommendation applies to people with moderate to severe immunocompromise due to a medical condition or immunosuppressive treatment. According to CDC, these conditions and treatments include but are not limited to:
* Active treatment for solid tumor and hematologic malignancies
* Receipt of solid-organ transplant and taking immunosuppressive therapy
* Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppressive therapy)
* Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
* Advanced or untreated HIV infection
* Active treatment with high-dose corticosteroids (i.e., 20 mg or more prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis [factor] (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.
The ACIP recommendation does not require vaccine providers to obtain a prescription or medical verification of a person’s condition; patients may simply attest to their immunocompromised status.
Vaccine Type:
* The recommendation applies only to people who have completed a mRNA vaccine series.
* When possible, the additional dose should be the same mRNA vaccine as the primary series. However, the other mRNA vaccine may be used if the primary series product is not available.
Vaccination Timing: The additional dose of mRNA COVID-19 vaccine should be administered at least 28 days after the second dose.
Age Range: Age groups authorized to receive the additional dose:
* Pfizer-BioNTech COVID-19 Vaccine: age 12 years and older
* Moderna COVID-19 Vaccine: age 18 years and older
Patient Counseling: Immunocompromised people should continue to practice the same COVID-19 infection prevention measures as unvaccinated people (e.g., mask wearing, social distancing, and avoiding crowds or poorly ventilated indoor spaces) because they may not be adequately protected from breakthrough illness even after receiving an additional dose.
Serologic Testing: Post-vaccination serologic testing is not part of this recommendation. The FDA has not approved a test for this purpose.
Action Step: Update EUA Fact Sheets used in your clinic to current versions (see links below).
Additional Presentations: Following the vote described above, CDC updated the ACIP on COVID-19 epidemiology and vaccine effectiveness. Notably, as of August 2, among the more than 164 million fully vaccinated people in the U.S., there have been only 7,101 hospitalizations and 1,507 COVID-related deaths. The majority (75%) of hospitalized or fatal breakthrough cases were in people age 65 years and older.
The day’s final presentation included background information for future policy discussions on booster doses (see definition above) of COVID-19 vaccines for immunocompetent people who have completed a primary series.
Future ACIP Meetings: The next announced ACIP meetings are scheduled for August 24 (COVID-19 vaccines only), September 29–30 (catch-up on other vaccine-preventable diseases), and the regularly scheduled meeting on October 20–21. Additional meetings may be announced; information about past and future ACIP meetings ([link removed]) may be found on the ACIP website.
Related Links
* CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States ([link removed])
* NEJM: Randomized Trial of a Third Dose of mRNA-1273 Vaccine in Transplant Recipients ([link removed])
* CDC: Additional mRNA COVID-19 Vaccines for Moderately to Severely Immunocompromised People ([link removed] ) Clinician Outreach and Communication Activity (COCA) teleconference recording
* FDA: Emergency Use Authorization (EUA) fact sheets for healthcare providers administering COVID-19 vaccine (Pfizer-BioNTech ([link removed]), 8/12/21) (Moderna ([link removed]), 8/12/21)
* FDA: Emergency Use Authorization (EUA) fact sheets for recipients and caregivers (Pfizer-BioNTech ([link removed]), 8/12/21) (Moderna ([link removed]), 8/12/21)
* FDA: COVID-19 Vaccine Frequently Asked Questions (Pfizer-BioNTech ([link removed]), 8/12/21) (Moderna ([link removed]), 8/12/21)
* CDC: COVID-19 Vaccine Recipient Education ([link removed]) web page
* CDC: COVID Data Tracker ([link removed])
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CDC RELEASES 14 UPDATED VACCINE INFORMATION STATEMENTS; TRANSLATIONS IN PROGRESS
On August 9, CDC posted 14 updated Vaccine Information Statements ([link removed]) (VISs). Access these VISs on their respective IAC web pages by clicking on the links below.
* DTaP (Diphtheria, Tetanus, Pertussis) ([link removed])
* Haemophilus influenzae type b (Hib) ([link removed])
* HPV (Human Papillomavirus) ([link removed])
* Influenza, inactivated or recombinant ([link removed])
* Influenza, live intranasal ([link removed])
* Meningococcal ACWY ([link removed])
* Meningococcal B ([link removed])
* MMR (Measles, Mumps, and Rubella) ([link removed])
* MMRV (Measles, Mumps, Rubella, and Varicella) ([link removed])
* Pneumococcal Conjugate (PCV13) ([link removed])
* Polio ([link removed])
* Td (Tetanus, Diphtheria) ([link removed])
* Tdap (Tetanus, Diphtheria, Pertussis) ([link removed])
* Varicella (Chickenpox) ([link removed])
CDC encourages providers to begin using these VISs immediately; however, existing supplies of the previous editions may be used until exhausted.
IAC will produce translations of these new VISs and post them on Immunize.org as they become available over the next several weeks. Translations of previous VIS versions may be used until new translations become available. CDC states that the corresponding up-to-date English-language VIS must also be supplied when providing an out-of-date translation.
Related Links
* IAC: Vaccine Information Statement ([link removed]) gateway page for VISs in 47 languages ([link removed])
* IAC: Dates of Current Vaccine Information Statements ([link removed]) (PDF)
* CDC: What's New with VISs ([link removed]) web page
* CDC: Current VISs ([link removed]) web page
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CDC STRENGTHENS RECOMMENDATION FOR COVID-19 VACCINATION FOR PEOPLE WHO ARE OR MAY BECOME PREGNANT, IN LIGHT OF REASSURING SAFETY DATA FOR VACCINATION IN ALL STAGES OF PREGNANCY
On August 11, CDC released a statement ([link removed]) on the safety of COVID-19 vaccines in pregnant individuals and is strengthening the recommendation that all people 12 years of age and older get vaccinated against COVID-19. A portion of the statement appears below.
A new CDC analysis ([link removed]) of current data from the v-safe pregnancy registry assessed vaccination early in pregnancy and did not find an increased risk of miscarriage among nearly 2,500 pregnant women who received an mRNA COVID-19 vaccine before 20 weeks of pregnancy....
Previously, data from three safety monitoring systems ([link removed]) did not find any safety concerns for pregnant people who were vaccinated late in pregnancy or for their babies. Combined, these data and the known severe risks of COVID-19 during pregnancy demonstrate that the benefits of receiving a COVID-19 vaccine for pregnant people outweigh any known or potential risks.
Related Links
* Preprint: Receipt of mRNA COVID-19 Vaccines Preconception and during Pregnancy and Risk of Self-Reported Spontaneous Abortions, CDC v-safe COVID-19 Vaccine Pregnancy Registry 2020–21 ([link removed])
* CDC: COVID-19 Vaccine Monitoring Systems for Pregnant People ([link removed])
* CDC media statement: New CDC Data: COVID-19 Vaccination Safe for Pregnant People ([link removed]) (8/11/21)
* CDC: COVID-19 Vaccines for People Who Would Like to Have a Baby ([link removed]) web page
* CDC: COVID-19 Vaccines While Pregnant or Breastfeeding ([link removed]) web page
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"Use of COVID-19 Vaccines after Reports of Adverse Events among Adult Recipients of Janssen (Johnson & Johnson) and mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna): Update from the Advisory Committee on Immunization Practices—United States, July 2021" published in MMWR Early Release
CDC published Use of COVID-19 Vaccines after Reports of Adverse Events among Adult Recipients of Janssen (Johnson & Johnson) and mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna): Update from the Advisory Committee on Immunization Practices—United States, July 2021 ([link removed]) on August 10 as an MMWR Early Release. A portion of the summary appears below.
Rare serious adverse events have been reported after COVID-19 vaccination, including Guillain-Barré syndrome (GBS) and thrombosis with thrombocytopenia syndrome (TTS) after Janssen COVID-19 vaccination and myocarditis after mRNA (Pfizer-BioNTech and Moderna) COVID-19 vaccination....
On July 22, 2021, the Advisory Committee on Immunization Practices reviewed updated benefit-risk analyses after Janssen and mRNA COVID-19 vaccination and concluded that the benefits outweigh the risks for rare serious adverse events after COVID-19 vaccination....
Continued COVID-19 vaccination will prevent COVID-19 morbidity and mortality far exceeding GBS, TTS, and myocarditis cases expected. Information about rare adverse events should be disseminated to providers, vaccine recipients, and the public.
Access the MMWR Early Release article in HTML format ([link removed]) or in PDF format ([link removed]).
Related Link
* MMWR's gateway page ([link removed]) provides access to MMWR Weekly and its companion publications
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FOR NATIONAL IMMUNIZATION AWARENESS MONTH, USE THE NEW “WE CAN DO THIS” SOCIAL MEDIA POSTS AND GRAPHICS TO PROMOTE BACK-TO-SCHOOL VACCINATIONS
August is National Immunization Awareness Month ([link removed]) (NIAM). This annual observance highlights the efforts of healthcare professionals to protect patients of all ages against vaccine-preventable diseases through on-time vaccination.
The Department of Health and Human Services' (HHS) We Can Do This ([link removed]) campaign now offers social media graphic posts ([link removed]) to promote COVID-19 vaccination among students 12 years and older. Post them on your social media accounts to encourage students, parents, teachers, school staff, and others in our communities to get vaccinated as they return to school.
Don't forget about promoting all other vaccinations during NIAM! CDC’s NIAM web page includes two toolkits, one for reaching healthcare professionals ([link removed]) and the other for reaching parents and patients ([link removed]). Each includes key messages, sample social media content, and educational resources. CDC encourages its partners to share these messages and resources throughout August using the hashtag #ivax2protect. Stay tuned for more resources to be released throughout the coming weeks.
Related Links
* Made to Save and We Can Do This National Back to School Week of Action ([link removed]) web page
* The White House press release: Fact Sheet: Biden Administration Announces Additional Actions to Help Kids Go Back to School Safely ([link removed]) (8/5/21)
* The White House: Back to School Vaccination Week of Action Kickoff ([link removed]) video on YouTube
* Made to Save ([link removed]) website
* HHS: We Can Do This ([link removed]) website
* HHS: Back-to-School Social Media Toolkit ([link removed]) web page
* CDC: Toolkit for Reaching Healthcare Professionals ([link removed]) gateway page
* CDC: Toolkit for Reaching Parents and Patients ([link removed]) gateway page
* CDC: NIAM ([link removed]) gateway page
* HRSA:Maternal and Child Health ([link removed]) website
* HRSA: Bright Futures ([link removed]) web page
* HRSA: Child Health ([link removed]) web page
* HRSA: Adolescent and Young Adult Health ([link removed]) web page
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Multiple vaccine advocacy groups publish white paper describing challenges that prevent maternal immunization in the United States
IAC and fifteen other professional societies and vaccine advocacy groups recently published a white paper titled Improving Maternal Immunization Status: Working toward Solutions to the Policy, Data, and Implementation Challenges Driving Suboptimal U.S. Maternal Vaccination Rates ([link removed]). The document offers “an overview of the current landscape, limitations, and impacts of challenges related to maternal immunization data collection/reporting and implementation.” It also details potential solutions that could strengthen efforts in place to address longstanding barriers to vaccinations among pregnant individuals.
The white paper includes a discussion of:
* Background information
* Evolving data and implementation challenges in commercial and Medicaid contexts
* Longstanding barriers to maternal immunization
* Existing and proposed solutions, including
+ High quality data collection, monitoring and reporting
+ On-the-ground coordination and implementation
Related Links
* CDC: Pregnancy and Vaccination: Research on Maternal Immunization ([link removed]) (8/10/17)
* CDC: Influenza and Tdap Vaccination Coverage among Pregnant Women—United States, April 2020. ([link removed]) MMWR. 2020; 69: 1391–1397.
* CDC: Barriers to Receipt of Prenatal Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine among Mothers of Infants Aged <4 Months with Pertussis—California, 2016 ([link removed]). MMWR 2018; 67: 1068–1071.
* CDC: Public Health Grand Rounds: Maternal Immunization: Current Status and Future Directions ([link removed])
* HHS: NVAC Maternal Immunization Working Group ([link removed]) gateway page
* ACOG Maternal Task Force. Immunization for Pregnant Women: A Call to Action, July 2020 ([link removed]).
* ACOG: Clinical: Maternal Immunization ([link removed] maternal-immunization)
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IAC SPOTLIGHT! IAC’S IMMUNIZE.ORG WEBSITE OFFERS MANY USEFUL NAVIGATION FEATURES
In this week's IAC Spotlight, we summarize features of IAC's Immunize.org website that ease navigation to our many resources.
Our “Favorites” tab is left-most of the six blue tabs atop each Immunize.org web page. Clicking on the tab will take you to the Favorite Web Sections ([link removed]) gateway page, and then onward to 18 of the most highly visited gateway pages on IAC's content-rich website.
Our "Guide to Immunize.org" appears at the bottom of each Immunize.org web page with a light gray background. The alphabetized topics link you directly to IAC's gateway pages.
Our Google search bar appears at the top right corner of each Immunize.org web page. The search function is limited to the Immunize.org website.
Our Handouts for Patients and Staff ([link removed]) gateway page contains all the handouts in a table sortable by title, language, data, and item number. To find it, hover over "Handouts and Staff Materials," the second of the six blue tabs atop each Immunize.org web page. Click on “View All Resources,” the first option in the drop-down menu; this will bring you to the sortable table. At the end of the 26 options, What’s New: Handouts ([link removed]) will take you to a list of our most recent additions and revisions.
At the top right of each page are three tabs.
* “For Healthcare Professionals” is the option for Immunize.org itself.
* “For the Public” leads to vaccineinformation.org, our website for easy-to-read content.
* “For Coalitions” takes you to the website for the Immunization Coalitions Network.
Each gateway page within the Immunize.org website has a treasure trove of resources listed. Please invest a few minutes to explore the Immunize.org website. We believe it will save you time when you next need immunization information in a hurry.
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Journalists interview IAC experts
Journalists seek out IAC experts to help explain vaccines to the public and policy makers. We help the media understand and communicate the complex work vaccinators do. Here is a recent citation:
* Healthline: Vaccine Mandates in Schools Aren’t New. They’ve Been Used since 1850. ([link removed]) (8/8/21)
Related Link
* IAC in the News ([link removed]) gateway page
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Vaccines in the news
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* The Hill: How ‘Waiting for Full FDA Approval’ Was Weaponized by Vaccine Opponents ([link removed]) (8/10/21)
* ABC: Unvaccinated COVID-19 Patients Share Why They Changed Their Minds about the Shot ([link removed]) (8/10/21)
* The Guardian: US Urged to Fast-Track Vaccine Approval for Children under 12 as Cases Rise ([link removed]) (8/10/21)
* Life Hacker: How to Find Your Complete Vaccination Record ([link removed]) (8/10/21)
* Homeland Preparedness News: BARDA DRIVe Partners with US Biologic for Oral Flu Vaccine ([link removed]) (8/9/21)
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Immunize.org Pages and Handouts
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IAC updates "Vaccine with Diluents: How to Use Them" handout for healthcare professionals
IAC recently updated its handout for healthcare professionals titled Vaccines with Diluents: How to Use Them ([link removed]) to remove Zostavax and to add a box referring those seeking information about COVID-19 vaccine diluents to a CDC site.
Related Links
* IAC: Clinic Tools: Storage and Handling ([link removed]) gateway page
* View all IAC print materials on vaccine handling and storage ([link removed])
* IAC: Handouts for Patients and Staff ([link removed]) gateway page, grouped by topic, vaccine, or language
* 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, sortable by title, language, date, and number
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Vaccine Information Statements
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IAC updates "You Must Provide Patients with Vaccine Information Statements (VISs) – It's the Law!" to reflect new VIS version dates
IAC recently updated the 2-page handout for healthcare providers You Must Provide Patients with Vaccine Information Statements (VISs) – It’s Federal Law! ([link removed]) to reflect updated Vaccine Information Statement (VIS) version dates.
Related Links
* IAC: Vaccine Information Statements ([link removed]) gateway page for VISs in 47 languages ([link removed])
* CDC: Facts about VISs ([link removed]) web page
* CDC: Instructions for Using VISs ([link removed]) web page
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IAC revises "Dates of Current Vaccine Information Statements (VISs)" checklist to reflect new VIS version dates
IAC recently updated its Dates of Current Vaccine Information Statements (VISs) ([link removed]) 4-panel checklist to reflect the new Vaccine Information Statement (VIS) version dates. Use this checklist to make sure your whole inventory is up to date.
Related Links
* IAC: Vaccine Information Statements ([link removed]) gateway page for VISs in 47 languages ([link removed])
* CDC: Facts about VISs ([link removed]) web page
* CDC: Instructions for Using VISs ([link removed]) web page
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Featured Resources
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National Governors Association Center for Best Practices releases new publication, "State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities"
The National Governors Association Center for Best Practices (NGA Center) released a new publication, State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities ([link removed]). Access to health care is a common challenge for rural and frontier communities due to provider shortages and insufficient broadband Internet availability. Additional challenges surfaced during the pandemic. The fast-paced nature of the pandemic spurred new and changing information with misinformation spreading as quickly as reliable news, undercutting science and public policies, especially related to COVID-19 vaccines.
To address these issues, this publication compiles best practices for Governors, including building vaccine confidence through consistent, transparent, and factual communication; establishing straightforward pathways for people to access vaccines; and developing sustainable systems to distribute vaccines to rural and frontier populations.
Related Link
* NGA Center for Best Practices: State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities ([link removed]) (8/13/21)
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IAC’s gateway page “Vaccination and COVID-19” offers a collection of tools from many organizations to sustain routine vaccination services during the pandemic
IAC’s Vaccination and COVID-19 ([link removed]) gateway page assists healthcare professionals faced with challenges in providing routine and catch-up vaccination during the pandemic. In this gateway page, IAC has assembled key links to help both new and experienced vaccinators deliver safe, effective vaccination to people of all ages, applicable in typical and nontraditional vaccination settings.
The site facilitates access to key pandemic resource pages from major clinical and public health organizations involved in vaccination. We will update the page as needed with new links and resources specific to catch-up vaccination, so be sure to check back regularly.
To easily locate this gateway page on Immunize.org ([link removed]) , go to the light blue band of tabs across the top, and choose "Clinic Tools." You also can use the Guide to Immunize.org at the bottom of each web page.
Related Links
* IAC: Vaccination and COVID-19 ([link removed]) gateway page
* IAC: Ask the Experts: COVID-19 and Routine Immunization ([link removed]) page
* IAC: Repository of Resources for Maintaining Immunization during the COVID-19 Pandemic ([link removed])
* IAC: Mass Vaccination Resources ([link removed]) website
* CDC: Vaccination Guidance during a Pandemic ([link removed].)
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Organizing a new vaccination program? Use IAC's Vaccinating Adults: A Step-by-Step Guide—free to download by chapter or in its entirety
Download IAC's free 142-page book on adult vaccination to help build your program and train your team: Vaccinating Adults: A Step-by-Step Guide (Guide) ([link removed]).
This thorough "how to" guide on adult vaccination provides easy-to-use, practical information covering all essential activities. It helps vaccine providers enhance their existing adult vaccination services or introduce them into any clinical setting.
The Guide is available to download/print either by chapter or in its entirety free at www.immunize.org/guide. The National Vaccine Program Office and CDC both supported the development of the Guide and provided early technical review.
The Guide is a valuable resource to assist providers in increasing adult vaccination rates. Be sure to get a copy today!
Related Links
* Vaccinating Adults: A Step-by-Step Guide ([link removed]) gateway page, permitting download of entire Guide (142 pages, PDF) ([link removed])
* View the table of contents and individual chapters (PDF):
– Table of Contents ([link removed])
– Step 1: Getting Started ([link removed])
– Step 2: Setting Up for Vaccination Services ([link removed])
– Step 3: Vaccine Storage and Handling ([link removed])
– Step 4: Deciding Whom to Vaccinate ([link removed])
– Step 5: Administering Vaccines ([link removed])
– Step 6: Documentation and Related Issues ([link removed])
– Step 7A: Financial Considerations ([link removed])
– Step 7B: How to Bill for Adult Immunizations ([link removed])
* Promotional flyer for Vaccinating Adults: A Step-by-Step Guide ([link removed])
* IAC’s educational materials (handouts) on adult immunization ([link removed])
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Encourage others to get vaccinated by ordering IAC's “Me Vacuné…” and “I Got My COVID-19 Vaccine” buttons and stickers, now FREE to all organizations promoting or offering COVID-19 vaccination!
All organizations promoting or offering COVID-19 vaccination may order IAC’s FREE “Me Vacuné…” and “I Got My COVID-19 Vaccine” buttons and stickers ([link removed]), provided with support from CDC. Access this order form ([link removed]) to request the FREE buttons and stickers for your outreach efforts while supplies last.
Related Links
* IAC: FREE “Me Vacuné…” and "I Got My COVID-19 Vaccine" buttons and stickers order form ([link removed]) for promoting vaccination
* Shop IAC ([link removed]) gateway page: All the buttons, stickers, laminated schedules, record cards, and other products offered by IAC
* Vaccines.gov: COVID-19 Vaccine Incentives ([link removed]) web page
* Waves of Adrenaline: Something Great (the vaccine song) ([link removed]) video on YouTube
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FALL IS RIGHT AROUND THE CORNER; SO IS FLU SEASON! STOCK UP ON IAC'S FLU VACCINE BUTTONS AND STICKERS FOR STAFF AND PATIENTS.
After you order your vaccine, don’t forget to order your buttons and stickers. IAC “FLU VACCINE” buttons and stickers ([link removed]) are ready to ship! Their bright red color helps broadcast your important message about the need for influenza vaccination. And the cost is reasonable.
“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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Notable Publications
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“Randomized Trial of a Third Dose of mRNA-1273 Vaccine in Transplant Recipients” published in NEJM
In the August 11 issue, NEJM published Randomized Trial of a Third Dose of mRNA-1273 [Moderna] Vaccine in Transplant Recipients ([link removed]) . A portion of the description of this double-blind, randomized, controlled trial, performed with 120 transplant recipients (median age of 66.6 years; median time from transplantation to the third dose was 3.16 years), appears below.
A third dose of mRNA vaccine in transplant recipients had substantially higher immunogenicity than placebo... This trial had short follow-up and was not powered to detect differences in clinical outcomes. We also acknowledge that the cutoff value … for the … antibody level is … not necessarily predictive of resistance to infection. A third dose was safe when risk versus benefit was considered. We note that a small subgroup of patients who received placebo did have modest increases in antibody levels. This may reflect ongoing mRNA vaccine-induced B-cell stimulation, as recently described, and highlights the importance of evaluating a control group. We conclude that a third-dose booster Covid-19 vaccine should be considered, in conjunction with regulatory approval, for transplant recipients who have received two doses of mRNA-1273.
Related Link
* NEJM Commentary: Third Time’s a Charm—Covid-19 Vaccine Hope for Solid-Organ Transplant Recipients ([link removed]) (8/11/21)
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MMWR recap: Reduced risk of reinfection of COVID-19 after vaccination
CDC recently published an article first distributed as an MMWR Early Release:
* Reduced Risk of Reinfection with SARS-CoV-2 after COVID-19 Vaccination—Kentucky, May–June 2021 (MMWR, August 13, HTML format ([link removed]) or PDF format ([link removed])
Related Link
* MMWR ([link removed]) gateway page provides access to MMWR Weekly and its companion publications
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“Pediatric Immunization Schedule: Best Available Evidence for 2021” published in Clinical Advisor
In the August 9 issue, Clinical Advisor published Pediatric Immunization Schedule: Best Available Evidence for 2021 ([link removed]), authored by IAC’s Mary Beth Koslap-Petraco, DNP. A portion of the article appears below.
Routine pediatric immunization rates decreased in 2020–2021 due to the COVID-19 pandemic, making it even more important for nurse practitioners (NP) and PAs to use the best available evidence to catch up on vaccines for children and keep them on track to receive all medically- and age-appropriate vaccines....
All vaccines due or overdue should be administered according to the recommended ACIP schedules during that visit unless a specific contraindication exists. Identify children who have missed well-child visits and/or recommended vaccinations and contact parents to schedule in-person appointments, starting with newborns, infants, and children up to 24 months, young children, and extending through adolescence.
If vaccines for pregnant people (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis [Tdap] and influenza) have been delayed because of reduced or deferred in-person prenatal care visits, schedule patients for follow-up and administer vaccinations during the next in-person appointment. Provide protection as soon as possible. Giving vaccines during regularly scheduled follow-up visits will reduce the number of health care visits needed to complete vaccination.
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“Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents” published in NEJM
In the August 9 issue, NEJM published Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents ([link removed]). The discussion section of the abstract appears below.
The mRNA-1273 vaccine had an acceptable safety profile in adolescents. The immune response was similar to that in young adults, and the vaccine was efficacious in preventing Covid-19.
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Global News
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“The CAPACITI Decision-Support Tool for National Immunization Programs” published in Value in Health
In the August issue, Value in Health published The CAPACITI Decision-Support Tool for National Immunization Programs ([link removed]). IAC’s Kelly L. Moore, MD, MPH, is one of the coauthors.
This tool was developed by the World Health Organization in collaboration with national immunization program decision makers in low-income and middle-income countries (LMICs) to structure and document an evidence-based, context-specific process for prioritizing or selecting among multiple vaccination products, services, or strategies. This is important as programs vie for limited resources and national immunization programs are forced to make choices that are best suited to their setting. The authors report:
Pilot countries valued the CAPACITI decision-support tool as a means to consider multiple criteria and stakeholder perspectives and to evaluate trade-offs and the impact of data quality. With use, it is expected that LMICs will tailor steps to their context and streamline the tool for decision making.
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Immunization PSAs from the Archive
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IN THIS UPBEAT 2003 PSA FROM TEXAS DEPARTMENT OF HEALTH, A DOCTOR AND MOTHER EXPLAINS WHY SHE RECOMMENDS VACCINATIONS FOR HER OWN CHILDREN AND PATIENTS
In this upbeat 2003 public service announcement (PSA) offered by the Texas Department of Health in both English ([link removed]) and Spanish ([link removed]), a family physician explains that the risks of not vaccinating far outweigh the small chance of a bad reaction from a vaccination. This PSA is part of a collection curated by vaccine expert William L. Atkinson, MD, MPH, that spans a period of more than 50 years.
Previous PSAs featured in "Immunization PSAs from the Archive” are available when viewing this Vimeo video ([link removed]).
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IAC Express
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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-in-Chief
Kelly L. Moore, MD, MPH ([email protected])
Managing Editor
John Grabenstein, RPh, PhD ([email protected])
Associate Editor
Sharon Humiston, MD, MPH ([email protected])
Writer/Publication Coordinator
Taryn Chapman, MS ([email protected])
Courtnay Londo, MA ([email protected])
Style and Copy Editor
Marian Deegan, JD ([email protected])
Web Edition Manager
Sheila M. Franey, MA
Contributing Writer
Laurel H. Wood, MPA ([email protected])
Technical Reviewer
Robin VanOss ([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. Its contents are solely the responsibility of IAC and do not necessarily represent the official views of CDC.
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Issue 1,584: August 18, 2021
Top Stories
* IAC summarizes August 13 ACIP meeting on new recommendation for additional dose of mRNA COVID-19 vaccine for people with moderate to severe immunocompromise
* CDC releases 14 updated Vaccine Information Statements; translations in progress
* CDC strengthens recommendation for COVID-19 vaccination for people who are or may become pregnant, in light of reassuring safety data for vaccination in all stages of pregnancy
* "Use of COVID-19 Vaccines after Reports of Adverse Events among Adult Recipients of Janssen (Johnson & Johnson) and mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna): Update from the Advisory Committee on Immunization Practices—United States, July 2021" published in MMWR Early Release
* For National Immunization Awareness Month, use the new “We Can Do This” social media posts and graphics to promote back-to-school vaccinations
* Multiple vaccine advocacy groups publish white paper describing challenges that prevent maternal immunization in the United States
* IAC Spotlight! IAC’s Immunize.org website offers many useful navigation features
* Journalists interview IAC experts
* Vaccines in the news
Immunize.org Pages and Handouts
* IAC updates "Vaccine with Diluents: How to Use Them" handout for healthcare professionals
Vaccine Information Statements
* IAC updates "You Must Provide Patients with Vaccine Information Statements (VISs) – It's the Law!" to reflect new VIS version dates
* IAC revises "Dates of Current Vaccine Information Statements (VISs)" checklist to reflect new VIS version dates
Featured Resources
* National Governors Association Center for Best Practices releases new publication, "State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities"
* IAC’s gateway page “Vaccination and COVID-19” offers a collection of tools from many organizations to sustain routine vaccination services during the pandemic
* Organizing a new vaccination program? Use IAC's Vaccinating Adults: A Step-by-Step Guide—free to download by chapter or in its entirety
* Encourage others to get vaccinated by ordering IAC's “Me Vacuné…” and “I Got My COVID-19 Vaccine” buttons and stickers, now FREE to all organizations promoting or offering COVID-19 vaccination!
* Fall is right around the corner; so is flu season! Stock up on IAC's flu vaccine buttons and stickers for staff and patients.
Notable Publications
* “Randomized Trial of a Third Dose of mRNA-1273 Vaccine in Transplant Recipients” published in NEJM
* MMWR recap: Reduced risk of reinfection of COVID-19 after vaccination
* “Pediatric Immunization Schedule: Best Available Evidence for 2021” published in Clinical Advisor
* “Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents” published in NEJM
Global News
* “The CAPACITI Decision-Support Tool for National Immunization Programs” published in Value in Health
Immunization PSAs from the Archive
* In this upbeat 2003 PSA from Texas Department of Health, a doctor and mother explains why she recommends vaccinations for her own children and patients
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Top Stories
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IAC summarizes August 13 ACIP meeting on new recommendation for additional dose of mRNA COVID-19 vaccine for people with moderate to severe immunocompromise
On August 13 ([link removed]), the Advisory Committee on Immunization Practices (ACIP) ([link removed]) met to review the FDA’s August 12 modifications to its Emergency Use Authorizations (EUAs) for the Pfizer-BioNTech ([link removed]) and Moderna ([link removed]) mRNA COVID-19 vaccines. ACIP members unanimously recommended administration of an additional dose of mRNA vaccine for moderately to severely immunocompromised people who have completed either 2-dose mRNA COVID-19 vaccine series. This recommendation does not apply to immunocompromised people who received Janssen COVID-19 Vaccine (Johnson & Johnson). Presentation slides ([link removed]) from the meeting are available online, and details of this recommendation are provided below.
Background: Approximately 7 million people (2.7% of the population) in the United States are immunocompromised. These individuals are more likely to get severely ill from SARS-CoV-2 infection and shed the virus for prolonged periods. Small studies indicate that, when compared to non-immunocompromised people, immunocompromised people are more likely to have serious breakthrough infection; 40–44% of fully vaccinated individuals hospitalized with breakthrough infection have been immunocompromised. A blood test showing detectable neutralizing antibodies after vaccination is a simple but imperfect estimate of a person’s protection from COVID-19 illness. Among immunocompromised people with no detectable antibody response to a 2-dose mRNA vaccine series, 33–50% developed a detectable antibody response after a third dose.
Available evidence supports the conclusion that an additional dose is safe in immunocompromised people. Public health authorities in other countries, including France, Israel, Germany, and the United Kingdom, have recommended an additional dose of COVID-19 vaccine be given to immunocompromised people.
CDC presenters emphasized the difference between an additional dose in this context and a booster dose. An “additional” dose of vaccine is a dose administered when the immune response to a standard primary vaccine series is likely not to be protective. A “booster” dose of vaccine is a dose administered to restore protection after the effectiveness of protection from the primary series has declined. ACIP does not recommend booster doses at this time.
Implementation and Clinical Considerations: Following approval of the ACIP recommendation, CDC updated its Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States ([link removed]). COVID-19 vaccine providers should review this CDC document carefully for complete information. Highlights of key aspects of implementation guidance for this recommendation are provided below.
Moderately to Severely Immunocompromised People: The ACIP recommendation applies to people with moderate to severe immunocompromise due to a medical condition or immunosuppressive treatment. According to CDC, these conditions and treatments include but are not limited to:
* Active treatment for solid tumor and hematologic malignancies
* Receipt of solid-organ transplant and taking immunosuppressive therapy
* Receipt of CAR-T-cell or hematopoietic stem cell transplant (within 2 years of transplantation or taking immunosuppressive therapy)
* Moderate or severe primary immunodeficiency (e.g., DiGeorge syndrome, Wiskott-Aldrich syndrome)
* Advanced or untreated HIV infection
* Active treatment with high-dose corticosteroids (i.e., 20 mg or more prednisone or equivalent per day), alkylating agents, antimetabolites, transplant-related immunosuppressive drugs, cancer chemotherapeutic agents classified as severely immunosuppressive, tumor-necrosis [factor] (TNF) blockers, and other biologic agents that are immunosuppressive or immunomodulatory.
The ACIP recommendation does not require vaccine providers to obtain a prescription or medical verification of a person’s condition; patients may simply attest to their immunocompromised status.
Vaccine Type:
* The recommendation applies only to people who have completed a mRNA vaccine series.
* When possible, the additional dose should be the same mRNA vaccine as the primary series. However, the other mRNA vaccine may be used if the primary series product is not available.
Vaccination Timing: The additional dose of mRNA COVID-19 vaccine should be administered at least 28 days after the second dose.
Age Range: Age groups authorized to receive the additional dose:
* Pfizer-BioNTech COVID-19 Vaccine: age 12 years and older
* Moderna COVID-19 Vaccine: age 18 years and older
Patient Counseling: Immunocompromised people should continue to practice the same COVID-19 infection prevention measures as unvaccinated people (e.g., mask wearing, social distancing, and avoiding crowds or poorly ventilated indoor spaces) because they may not be adequately protected from breakthrough illness even after receiving an additional dose.
Serologic Testing: Post-vaccination serologic testing is not part of this recommendation. The FDA has not approved a test for this purpose.
Action Step: Update EUA Fact Sheets used in your clinic to current versions (see links below).
Additional Presentations: Following the vote described above, CDC updated the ACIP on COVID-19 epidemiology and vaccine effectiveness. Notably, as of August 2, among the more than 164 million fully vaccinated people in the U.S., there have been only 7,101 hospitalizations and 1,507 COVID-related deaths. The majority (75%) of hospitalized or fatal breakthrough cases were in people age 65 years and older.
The day’s final presentation included background information for future policy discussions on booster doses (see definition above) of COVID-19 vaccines for immunocompetent people who have completed a primary series.
Future ACIP Meetings: The next announced ACIP meetings are scheduled for August 24 (COVID-19 vaccines only), September 29–30 (catch-up on other vaccine-preventable diseases), and the regularly scheduled meeting on October 20–21. Additional meetings may be announced; information about past and future ACIP meetings ([link removed]) may be found on the ACIP website.
Related Links
* CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States ([link removed])
* NEJM: Randomized Trial of a Third Dose of mRNA-1273 Vaccine in Transplant Recipients ([link removed])
* CDC: Additional mRNA COVID-19 Vaccines for Moderately to Severely Immunocompromised People ([link removed] ) Clinician Outreach and Communication Activity (COCA) teleconference recording
* FDA: Emergency Use Authorization (EUA) fact sheets for healthcare providers administering COVID-19 vaccine (Pfizer-BioNTech ([link removed]), 8/12/21) (Moderna ([link removed]), 8/12/21)
* FDA: Emergency Use Authorization (EUA) fact sheets for recipients and caregivers (Pfizer-BioNTech ([link removed]), 8/12/21) (Moderna ([link removed]), 8/12/21)
* FDA: COVID-19 Vaccine Frequently Asked Questions (Pfizer-BioNTech ([link removed]), 8/12/21) (Moderna ([link removed]), 8/12/21)
* CDC: COVID-19 Vaccine Recipient Education ([link removed]) web page
* CDC: COVID Data Tracker ([link removed])
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CDC RELEASES 14 UPDATED VACCINE INFORMATION STATEMENTS; TRANSLATIONS IN PROGRESS
On August 9, CDC posted 14 updated Vaccine Information Statements ([link removed]) (VISs). Access these VISs on their respective IAC web pages by clicking on the links below.
* DTaP (Diphtheria, Tetanus, Pertussis) ([link removed])
* Haemophilus influenzae type b (Hib) ([link removed])
* HPV (Human Papillomavirus) ([link removed])
* Influenza, inactivated or recombinant ([link removed])
* Influenza, live intranasal ([link removed])
* Meningococcal ACWY ([link removed])
* Meningococcal B ([link removed])
* MMR (Measles, Mumps, and Rubella) ([link removed])
* MMRV (Measles, Mumps, Rubella, and Varicella) ([link removed])
* Pneumococcal Conjugate (PCV13) ([link removed])
* Polio ([link removed])
* Td (Tetanus, Diphtheria) ([link removed])
* Tdap (Tetanus, Diphtheria, Pertussis) ([link removed])
* Varicella (Chickenpox) ([link removed])
CDC encourages providers to begin using these VISs immediately; however, existing supplies of the previous editions may be used until exhausted.
IAC will produce translations of these new VISs and post them on Immunize.org as they become available over the next several weeks. Translations of previous VIS versions may be used until new translations become available. CDC states that the corresponding up-to-date English-language VIS must also be supplied when providing an out-of-date translation.
Related Links
* IAC: Vaccine Information Statement ([link removed]) gateway page for VISs in 47 languages ([link removed])
* IAC: Dates of Current Vaccine Information Statements ([link removed]) (PDF)
* CDC: What's New with VISs ([link removed]) web page
* CDC: Current VISs ([link removed]) web page
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CDC STRENGTHENS RECOMMENDATION FOR COVID-19 VACCINATION FOR PEOPLE WHO ARE OR MAY BECOME PREGNANT, IN LIGHT OF REASSURING SAFETY DATA FOR VACCINATION IN ALL STAGES OF PREGNANCY
On August 11, CDC released a statement ([link removed]) on the safety of COVID-19 vaccines in pregnant individuals and is strengthening the recommendation that all people 12 years of age and older get vaccinated against COVID-19. A portion of the statement appears below.
A new CDC analysis ([link removed]) of current data from the v-safe pregnancy registry assessed vaccination early in pregnancy and did not find an increased risk of miscarriage among nearly 2,500 pregnant women who received an mRNA COVID-19 vaccine before 20 weeks of pregnancy....
Previously, data from three safety monitoring systems ([link removed]) did not find any safety concerns for pregnant people who were vaccinated late in pregnancy or for their babies. Combined, these data and the known severe risks of COVID-19 during pregnancy demonstrate that the benefits of receiving a COVID-19 vaccine for pregnant people outweigh any known or potential risks.
Related Links
* Preprint: Receipt of mRNA COVID-19 Vaccines Preconception and during Pregnancy and Risk of Self-Reported Spontaneous Abortions, CDC v-safe COVID-19 Vaccine Pregnancy Registry 2020–21 ([link removed])
* CDC: COVID-19 Vaccine Monitoring Systems for Pregnant People ([link removed])
* CDC media statement: New CDC Data: COVID-19 Vaccination Safe for Pregnant People ([link removed]) (8/11/21)
* CDC: COVID-19 Vaccines for People Who Would Like to Have a Baby ([link removed]) web page
* CDC: COVID-19 Vaccines While Pregnant or Breastfeeding ([link removed]) web page
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"Use of COVID-19 Vaccines after Reports of Adverse Events among Adult Recipients of Janssen (Johnson & Johnson) and mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna): Update from the Advisory Committee on Immunization Practices—United States, July 2021" published in MMWR Early Release
CDC published Use of COVID-19 Vaccines after Reports of Adverse Events among Adult Recipients of Janssen (Johnson & Johnson) and mRNA COVID-19 Vaccines (Pfizer-BioNTech and Moderna): Update from the Advisory Committee on Immunization Practices—United States, July 2021 ([link removed]) on August 10 as an MMWR Early Release. A portion of the summary appears below.
Rare serious adverse events have been reported after COVID-19 vaccination, including Guillain-Barré syndrome (GBS) and thrombosis with thrombocytopenia syndrome (TTS) after Janssen COVID-19 vaccination and myocarditis after mRNA (Pfizer-BioNTech and Moderna) COVID-19 vaccination....
On July 22, 2021, the Advisory Committee on Immunization Practices reviewed updated benefit-risk analyses after Janssen and mRNA COVID-19 vaccination and concluded that the benefits outweigh the risks for rare serious adverse events after COVID-19 vaccination....
Continued COVID-19 vaccination will prevent COVID-19 morbidity and mortality far exceeding GBS, TTS, and myocarditis cases expected. Information about rare adverse events should be disseminated to providers, vaccine recipients, and the public.
Access the MMWR Early Release article in HTML format ([link removed]) or in PDF format ([link removed]).
Related Link
* MMWR's gateway page ([link removed]) provides access to MMWR Weekly and its companion publications
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FOR NATIONAL IMMUNIZATION AWARENESS MONTH, USE THE NEW “WE CAN DO THIS” SOCIAL MEDIA POSTS AND GRAPHICS TO PROMOTE BACK-TO-SCHOOL VACCINATIONS
August is National Immunization Awareness Month ([link removed]) (NIAM). This annual observance highlights the efforts of healthcare professionals to protect patients of all ages against vaccine-preventable diseases through on-time vaccination.
The Department of Health and Human Services' (HHS) We Can Do This ([link removed]) campaign now offers social media graphic posts ([link removed]) to promote COVID-19 vaccination among students 12 years and older. Post them on your social media accounts to encourage students, parents, teachers, school staff, and others in our communities to get vaccinated as they return to school.
Don't forget about promoting all other vaccinations during NIAM! CDC’s NIAM web page includes two toolkits, one for reaching healthcare professionals ([link removed]) and the other for reaching parents and patients ([link removed]). Each includes key messages, sample social media content, and educational resources. CDC encourages its partners to share these messages and resources throughout August using the hashtag #ivax2protect. Stay tuned for more resources to be released throughout the coming weeks.
Related Links
* Made to Save and We Can Do This National Back to School Week of Action ([link removed]) web page
* The White House press release: Fact Sheet: Biden Administration Announces Additional Actions to Help Kids Go Back to School Safely ([link removed]) (8/5/21)
* The White House: Back to School Vaccination Week of Action Kickoff ([link removed]) video on YouTube
* Made to Save ([link removed]) website
* HHS: We Can Do This ([link removed]) website
* HHS: Back-to-School Social Media Toolkit ([link removed]) web page
* CDC: Toolkit for Reaching Healthcare Professionals ([link removed]) gateway page
* CDC: Toolkit for Reaching Parents and Patients ([link removed]) gateway page
* CDC: NIAM ([link removed]) gateway page
* HRSA:Maternal and Child Health ([link removed]) website
* HRSA: Bright Futures ([link removed]) web page
* HRSA: Child Health ([link removed]) web page
* HRSA: Adolescent and Young Adult Health ([link removed]) web page
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Multiple vaccine advocacy groups publish white paper describing challenges that prevent maternal immunization in the United States
IAC and fifteen other professional societies and vaccine advocacy groups recently published a white paper titled Improving Maternal Immunization Status: Working toward Solutions to the Policy, Data, and Implementation Challenges Driving Suboptimal U.S. Maternal Vaccination Rates ([link removed]). The document offers “an overview of the current landscape, limitations, and impacts of challenges related to maternal immunization data collection/reporting and implementation.” It also details potential solutions that could strengthen efforts in place to address longstanding barriers to vaccinations among pregnant individuals.
The white paper includes a discussion of:
* Background information
* Evolving data and implementation challenges in commercial and Medicaid contexts
* Longstanding barriers to maternal immunization
* Existing and proposed solutions, including
+ High quality data collection, monitoring and reporting
+ On-the-ground coordination and implementation
Related Links
* CDC: Pregnancy and Vaccination: Research on Maternal Immunization ([link removed]) (8/10/17)
* CDC: Influenza and Tdap Vaccination Coverage among Pregnant Women—United States, April 2020. ([link removed]) MMWR. 2020; 69: 1391–1397.
* CDC: Barriers to Receipt of Prenatal Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccine among Mothers of Infants Aged <4 Months with Pertussis—California, 2016 ([link removed]). MMWR 2018; 67: 1068–1071.
* CDC: Public Health Grand Rounds: Maternal Immunization: Current Status and Future Directions ([link removed])
* HHS: NVAC Maternal Immunization Working Group ([link removed]) gateway page
* ACOG Maternal Task Force. Immunization for Pregnant Women: A Call to Action, July 2020 ([link removed]).
* ACOG: Clinical: Maternal Immunization ([link removed] maternal-immunization)
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IAC SPOTLIGHT! IAC’S IMMUNIZE.ORG WEBSITE OFFERS MANY USEFUL NAVIGATION FEATURES
In this week's IAC Spotlight, we summarize features of IAC's Immunize.org website that ease navigation to our many resources.
Our “Favorites” tab is left-most of the six blue tabs atop each Immunize.org web page. Clicking on the tab will take you to the Favorite Web Sections ([link removed]) gateway page, and then onward to 18 of the most highly visited gateway pages on IAC's content-rich website.
Our "Guide to Immunize.org" appears at the bottom of each Immunize.org web page with a light gray background. The alphabetized topics link you directly to IAC's gateway pages.
Our Google search bar appears at the top right corner of each Immunize.org web page. The search function is limited to the Immunize.org website.
Our Handouts for Patients and Staff ([link removed]) gateway page contains all the handouts in a table sortable by title, language, data, and item number. To find it, hover over "Handouts and Staff Materials," the second of the six blue tabs atop each Immunize.org web page. Click on “View All Resources,” the first option in the drop-down menu; this will bring you to the sortable table. At the end of the 26 options, What’s New: Handouts ([link removed]) will take you to a list of our most recent additions and revisions.
At the top right of each page are three tabs.
* “For Healthcare Professionals” is the option for Immunize.org itself.
* “For the Public” leads to vaccineinformation.org, our website for easy-to-read content.
* “For Coalitions” takes you to the website for the Immunization Coalitions Network.
Each gateway page within the Immunize.org website has a treasure trove of resources listed. Please invest a few minutes to explore the Immunize.org website. We believe it will save you time when you next need immunization information in a hurry.
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Journalists interview IAC experts
Journalists seek out IAC experts to help explain vaccines to the public and policy makers. We help the media understand and communicate the complex work vaccinators do. Here is a recent citation:
* Healthline: Vaccine Mandates in Schools Aren’t New. They’ve Been Used since 1850. ([link removed]) (8/8/21)
Related Link
* IAC in the News ([link removed]) gateway page
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Vaccines in the news
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* The Hill: How ‘Waiting for Full FDA Approval’ Was Weaponized by Vaccine Opponents ([link removed]) (8/10/21)
* ABC: Unvaccinated COVID-19 Patients Share Why They Changed Their Minds about the Shot ([link removed]) (8/10/21)
* The Guardian: US Urged to Fast-Track Vaccine Approval for Children under 12 as Cases Rise ([link removed]) (8/10/21)
* Life Hacker: How to Find Your Complete Vaccination Record ([link removed]) (8/10/21)
* Homeland Preparedness News: BARDA DRIVe Partners with US Biologic for Oral Flu Vaccine ([link removed]) (8/9/21)
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Immunize.org Pages and Handouts
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IAC updates "Vaccine with Diluents: How to Use Them" handout for healthcare professionals
IAC recently updated its handout for healthcare professionals titled Vaccines with Diluents: How to Use Them ([link removed]) to remove Zostavax and to add a box referring those seeking information about COVID-19 vaccine diluents to a CDC site.
Related Links
* IAC: Clinic Tools: Storage and Handling ([link removed]) gateway page
* View all IAC print materials on vaccine handling and storage ([link removed])
* IAC: Handouts for Patients and Staff ([link removed]) gateway page, grouped by topic, vaccine, or language
* 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, sortable by title, language, date, and number
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Vaccine Information Statements
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IAC updates "You Must Provide Patients with Vaccine Information Statements (VISs) – It's the Law!" to reflect new VIS version dates
IAC recently updated the 2-page handout for healthcare providers You Must Provide Patients with Vaccine Information Statements (VISs) – It’s Federal Law! ([link removed]) to reflect updated Vaccine Information Statement (VIS) version dates.
Related Links
* IAC: Vaccine Information Statements ([link removed]) gateway page for VISs in 47 languages ([link removed])
* CDC: Facts about VISs ([link removed]) web page
* CDC: Instructions for Using VISs ([link removed]) web page
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IAC revises "Dates of Current Vaccine Information Statements (VISs)" checklist to reflect new VIS version dates
IAC recently updated its Dates of Current Vaccine Information Statements (VISs) ([link removed]) 4-panel checklist to reflect the new Vaccine Information Statement (VIS) version dates. Use this checklist to make sure your whole inventory is up to date.
Related Links
* IAC: Vaccine Information Statements ([link removed]) gateway page for VISs in 47 languages ([link removed])
* CDC: Facts about VISs ([link removed]) web page
* CDC: Instructions for Using VISs ([link removed]) web page
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Featured Resources
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National Governors Association Center for Best Practices releases new publication, "State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities"
The National Governors Association Center for Best Practices (NGA Center) released a new publication, State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities ([link removed]). Access to health care is a common challenge for rural and frontier communities due to provider shortages and insufficient broadband Internet availability. Additional challenges surfaced during the pandemic. The fast-paced nature of the pandemic spurred new and changing information with misinformation spreading as quickly as reliable news, undercutting science and public policies, especially related to COVID-19 vaccines.
To address these issues, this publication compiles best practices for Governors, including building vaccine confidence through consistent, transparent, and factual communication; establishing straightforward pathways for people to access vaccines; and developing sustainable systems to distribute vaccines to rural and frontier populations.
Related Link
* NGA Center for Best Practices: State Strategies to Increase COVID-19 Vaccine Uptake in Rural Communities ([link removed]) (8/13/21)
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IAC’s gateway page “Vaccination and COVID-19” offers a collection of tools from many organizations to sustain routine vaccination services during the pandemic
IAC’s Vaccination and COVID-19 ([link removed]) gateway page assists healthcare professionals faced with challenges in providing routine and catch-up vaccination during the pandemic. In this gateway page, IAC has assembled key links to help both new and experienced vaccinators deliver safe, effective vaccination to people of all ages, applicable in typical and nontraditional vaccination settings.
The site facilitates access to key pandemic resource pages from major clinical and public health organizations involved in vaccination. We will update the page as needed with new links and resources specific to catch-up vaccination, so be sure to check back regularly.
To easily locate this gateway page on Immunize.org ([link removed]) , go to the light blue band of tabs across the top, and choose "Clinic Tools." You also can use the Guide to Immunize.org at the bottom of each web page.
Related Links
* IAC: Vaccination and COVID-19 ([link removed]) gateway page
* IAC: Ask the Experts: COVID-19 and Routine Immunization ([link removed]) page
* IAC: Repository of Resources for Maintaining Immunization during the COVID-19 Pandemic ([link removed])
* IAC: Mass Vaccination Resources ([link removed]) website
* CDC: Vaccination Guidance during a Pandemic ([link removed].)
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Organizing a new vaccination program? Use IAC's Vaccinating Adults: A Step-by-Step Guide—free to download by chapter or in its entirety
Download IAC's free 142-page book on adult vaccination to help build your program and train your team: Vaccinating Adults: A Step-by-Step Guide (Guide) ([link removed]).
This thorough "how to" guide on adult vaccination provides easy-to-use, practical information covering all essential activities. It helps vaccine providers enhance their existing adult vaccination services or introduce them into any clinical setting.
The Guide is available to download/print either by chapter or in its entirety free at www.immunize.org/guide. The National Vaccine Program Office and CDC both supported the development of the Guide and provided early technical review.
The Guide is a valuable resource to assist providers in increasing adult vaccination rates. Be sure to get a copy today!
Related Links
* Vaccinating Adults: A Step-by-Step Guide ([link removed]) gateway page, permitting download of entire Guide (142 pages, PDF) ([link removed])
* View the table of contents and individual chapters (PDF):
– Table of Contents ([link removed])
– Step 1: Getting Started ([link removed])
– Step 2: Setting Up for Vaccination Services ([link removed])
– Step 3: Vaccine Storage and Handling ([link removed])
– Step 4: Deciding Whom to Vaccinate ([link removed])
– Step 5: Administering Vaccines ([link removed])
– Step 6: Documentation and Related Issues ([link removed])
– Step 7A: Financial Considerations ([link removed])
– Step 7B: How to Bill for Adult Immunizations ([link removed])
* Promotional flyer for Vaccinating Adults: A Step-by-Step Guide ([link removed])
* IAC’s educational materials (handouts) on adult immunization ([link removed])
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Encourage others to get vaccinated by ordering IAC's “Me Vacuné…” and “I Got My COVID-19 Vaccine” buttons and stickers, now FREE to all organizations promoting or offering COVID-19 vaccination!
All organizations promoting or offering COVID-19 vaccination may order IAC’s FREE “Me Vacuné…” and “I Got My COVID-19 Vaccine” buttons and stickers ([link removed]), provided with support from CDC. Access this order form ([link removed]) to request the FREE buttons and stickers for your outreach efforts while supplies last.
Related Links
* IAC: FREE “Me Vacuné…” and "I Got My COVID-19 Vaccine" buttons and stickers order form ([link removed]) for promoting vaccination
* Shop IAC ([link removed]) gateway page: All the buttons, stickers, laminated schedules, record cards, and other products offered by IAC
* Vaccines.gov: COVID-19 Vaccine Incentives ([link removed]) web page
* Waves of Adrenaline: Something Great (the vaccine song) ([link removed]) video on YouTube
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FALL IS RIGHT AROUND THE CORNER; SO IS FLU SEASON! STOCK UP ON IAC'S FLU VACCINE BUTTONS AND STICKERS FOR STAFF AND PATIENTS.
After you order your vaccine, don’t forget to order your buttons and stickers. IAC “FLU VACCINE” buttons and stickers ([link removed]) are ready to ship! Their bright red color helps broadcast your important message about the need for influenza vaccination. And the cost is reasonable.
“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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Notable Publications
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“Randomized Trial of a Third Dose of mRNA-1273 Vaccine in Transplant Recipients” published in NEJM
In the August 11 issue, NEJM published Randomized Trial of a Third Dose of mRNA-1273 [Moderna] Vaccine in Transplant Recipients ([link removed]) . A portion of the description of this double-blind, randomized, controlled trial, performed with 120 transplant recipients (median age of 66.6 years; median time from transplantation to the third dose was 3.16 years), appears below.
A third dose of mRNA vaccine in transplant recipients had substantially higher immunogenicity than placebo... This trial had short follow-up and was not powered to detect differences in clinical outcomes. We also acknowledge that the cutoff value … for the … antibody level is … not necessarily predictive of resistance to infection. A third dose was safe when risk versus benefit was considered. We note that a small subgroup of patients who received placebo did have modest increases in antibody levels. This may reflect ongoing mRNA vaccine-induced B-cell stimulation, as recently described, and highlights the importance of evaluating a control group. We conclude that a third-dose booster Covid-19 vaccine should be considered, in conjunction with regulatory approval, for transplant recipients who have received two doses of mRNA-1273.
Related Link
* NEJM Commentary: Third Time’s a Charm—Covid-19 Vaccine Hope for Solid-Organ Transplant Recipients ([link removed]) (8/11/21)
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MMWR recap: Reduced risk of reinfection of COVID-19 after vaccination
CDC recently published an article first distributed as an MMWR Early Release:
* Reduced Risk of Reinfection with SARS-CoV-2 after COVID-19 Vaccination—Kentucky, May–June 2021 (MMWR, August 13, HTML format ([link removed]) or PDF format ([link removed])
Related Link
* MMWR ([link removed]) gateway page provides access to MMWR Weekly and its companion publications
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“Pediatric Immunization Schedule: Best Available Evidence for 2021” published in Clinical Advisor
In the August 9 issue, Clinical Advisor published Pediatric Immunization Schedule: Best Available Evidence for 2021 ([link removed]), authored by IAC’s Mary Beth Koslap-Petraco, DNP. A portion of the article appears below.
Routine pediatric immunization rates decreased in 2020–2021 due to the COVID-19 pandemic, making it even more important for nurse practitioners (NP) and PAs to use the best available evidence to catch up on vaccines for children and keep them on track to receive all medically- and age-appropriate vaccines....
All vaccines due or overdue should be administered according to the recommended ACIP schedules during that visit unless a specific contraindication exists. Identify children who have missed well-child visits and/or recommended vaccinations and contact parents to schedule in-person appointments, starting with newborns, infants, and children up to 24 months, young children, and extending through adolescence.
If vaccines for pregnant people (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis [Tdap] and influenza) have been delayed because of reduced or deferred in-person prenatal care visits, schedule patients for follow-up and administer vaccinations during the next in-person appointment. Provide protection as soon as possible. Giving vaccines during regularly scheduled follow-up visits will reduce the number of health care visits needed to complete vaccination.
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“Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents” published in NEJM
In the August 9 issue, NEJM published Evaluation of mRNA-1273 SARS-CoV-2 Vaccine in Adolescents ([link removed]). The discussion section of the abstract appears below.
The mRNA-1273 vaccine had an acceptable safety profile in adolescents. The immune response was similar to that in young adults, and the vaccine was efficacious in preventing Covid-19.
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Global News
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“The CAPACITI Decision-Support Tool for National Immunization Programs” published in Value in Health
In the August issue, Value in Health published The CAPACITI Decision-Support Tool for National Immunization Programs ([link removed]). IAC’s Kelly L. Moore, MD, MPH, is one of the coauthors.
This tool was developed by the World Health Organization in collaboration with national immunization program decision makers in low-income and middle-income countries (LMICs) to structure and document an evidence-based, context-specific process for prioritizing or selecting among multiple vaccination products, services, or strategies. This is important as programs vie for limited resources and national immunization programs are forced to make choices that are best suited to their setting. The authors report:
Pilot countries valued the CAPACITI decision-support tool as a means to consider multiple criteria and stakeholder perspectives and to evaluate trade-offs and the impact of data quality. With use, it is expected that LMICs will tailor steps to their context and streamline the tool for decision making.
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Immunization PSAs from the Archive
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IN THIS UPBEAT 2003 PSA FROM TEXAS DEPARTMENT OF HEALTH, A DOCTOR AND MOTHER EXPLAINS WHY SHE RECOMMENDS VACCINATIONS FOR HER OWN CHILDREN AND PATIENTS
In this upbeat 2003 public service announcement (PSA) offered by the Texas Department of Health in both English ([link removed]) and Spanish ([link removed]), a family physician explains that the risks of not vaccinating far outweigh the small chance of a bad reaction from a vaccination. This PSA is part of a collection curated by vaccine expert William L. Atkinson, MD, MPH, that spans a period of more than 50 years.
Previous PSAs featured in "Immunization PSAs from the Archive” are available when viewing this Vimeo video ([link removed]).
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IAC Express
IAC Express Home ([link removed])
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2018 ([link removed]) – 1997 Issues ([link removed])
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Follow Us
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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-in-Chief
Kelly L. Moore, MD, MPH ([email protected])
Managing Editor
John Grabenstein, RPh, PhD ([email protected])
Associate Editor
Sharon Humiston, MD, MPH ([email protected])
Writer/Publication Coordinator
Taryn Chapman, MS ([email protected])
Courtnay Londo, MA ([email protected])
Style and Copy Editor
Marian Deegan, JD ([email protected])
Web Edition Manager
Sheila M. Franey, MA
Contributing Writer
Laurel H. Wood, MPA ([email protected])
Technical Reviewer
Robin VanOss ([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. Its contents are solely the responsibility of IAC and do not necessarily represent the official views of CDC.
IAC Express Disclaimer ([link removed])
ISSN: 1526-1786
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