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Issue 1,587: September 1, 2021

Top Stories
* Following full FDA licensure, ACIP recommends use of Pfizer-BioNTech COVID-19 Vaccine (Comirnaty) for individuals age 16 years and older
* Register now for IAC’s September 9 webinar! Our expert panel answers your questions on preventing influenza during the COVID-19 pandemic.
* “Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021–22 Influenza Season” published in MMWR Recommendations and Reports
* “COVID-19 Vaccination Coverage among Adolescents Aged 12–17 Years—United States, December 14, 2020–July 31, 2021” published in MMWR Early Release
* IAC updates its “Ask the Experts: COVID-19” web page to answer questions about FDA licensure, vaccination during pregnancy, additional doses of mRNA vaccines for immunocompromised people, Guillain-Barré syndrome, and myocarditis
* IAC Spotlight! IAC's “Clinic Tools: Administering Vaccines” gateway page provides resources from authoritative sources
* Journalists interview IAC experts
* Vaccines in the news

Immunize.org Pages and Handouts
* IAC updates its popular temperature logs for refrigerators and freezers; available in Celsius and Fahrenheit
* IAC updates its Vaccine Storage Troubleshooting Record to document occurrence and resolution of questionable or unacceptable vaccine storage events
* IAC updates its handout for healthcare professionals titled “Checklist for Safe Vaccine Storage and Handling”
* IAC updates its handout for healthcare professionals titled "Don't Be Guilty of These Preventable Errors in Vaccine Administration!"
* IAC updates its handout for healthcare professionals titled “Supplies You May Need at an Immunization Clinic”
* Echo: These updated IAC patient and staff educational materials were released during July and August

Vaccine Information Statements
* Be sure to update your VISs! CDC releases 14 updated Vaccine Information Statements; translations in progress.

Featured Resources
* Show your strong support! Order 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!
* It’s time to kick off flu vaccine season. Don’t delay; order IAC's flu vaccine buttons and stickers for staff and patients today!
* Teens are back in school, but many are still missing vaccinations! Check out updated www.Give2MenACWY.org website to increase coverage for the MenACWY booster and other adolescent vaccinations.
* American Hospital Association launches new PSA campaign to encourage hesitant hospital workers to get vaccinated

Notable Publications
* "Safety of the BNT162b2 mRNA COVID-19 Vaccine in a Nationwide Setting" published in New England Journal of Medicine
* "Vaccinations against COVID-19 May Have Averted up to 140,000 Deaths in the United States" published in Health Affairs
* “A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor’s Appointment” published in Proceedings of the National Academy of Sciences
* MMWR recap: COVID-19 cases and hospitalizations by vaccination status and vaccine effectiveness estimates

Global News
* CDC and WHO report on progress toward polio eradication, worldwide, in this week's MMWR and Weekly Epidemiological Record, respectively (#IACX25)

Upcoming Events
* Watch today (September 1 at 5 p.m. ET): National Academy of Medicine’s webinar “COVID-19 Conversations #21 the Fourth Wave: Vaccines, Variants, and the Future”; CME available
* Also today (September 1 at 3 p.m. ET): Nevada Immunization Learning Exchange’s webinar "The State of the Pandemic: Where Do We Stand and Where Do We Go from Here?"; CEU available
* IAC's Calendar of Events provides information about federal, state, and national partners' vaccination conferences, as well as professional societies' annual meetings

Immunization PSAs from the Archive
* In this compelling PSA from Pennsylvania Department of Health, we hear Tim Baker, an infant diagnosed with pertussis, struggle to breathe during coughing fits

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Top Stories
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Following full FDA licensure, ACIP recommends use of Pfizer-BioNTech COVID-19 Vaccine (Comirnaty) for individuals age 16 years and older

On August 30 ([link removed]), the Advisory Committee on Immunization Practices (ACIP) ([link removed]) unanimously (14–0) recommended use of the first COVID-19 vaccine to receive full FDA licensure. On August 23, FDA approved Pfizer-BioNTech COVID-19 Vaccine ([link removed]), which will now be marketed as Comirnaty, for use in people age 16 years and older. Presentation slides ([link removed]) from the meeting are available online.

In reaching this decision, ACIP utilized its Evidence to Recommendations framework to summarize data on the vaccine’s safety and efficacy. ACIP also considered the benefits and risks of using the vaccine in this population. ACIP members noted that, while the initial emergency use authorization (EUA) issued in December 2020 was based on information from Phase 2/3 clinical trials with 2 months of follow up, the Committee now has clinical trial data with 6 months of follow-up showing an overall effectiveness of 91% against symptomatic infection and extensive real-world data from millions of administered doses that clearly support the safety and efficacy of this vaccine. Clinical trial data did not include the time period after the Delta variant emerged, so it does not reflect vaccine effectiveness against the variant causing the current wave of infections in the United States.

In addition to full FDA licensure for people age 16 years and older, the vaccine will continue to be administered under emergency use authorization (EUA) for people age 12 through 15 years and for the administration of a third dose in certain immunocompromised individuals.

Comirnaty is in the identical formulation and presentation as the Pfizer-BioNTech COVID-19 Vaccine already authorized under the EUA. Therefore, clinicians may use currently available inventory as licensed or authorized. The updated FDA Vaccine Information Fact Sheet for Recipients and Caregivers ([link removed]) should continue to be given to all approved age groups before vaccination. CDC is not releasing a Vaccine Information Statement (VIS) for Comirnaty at this time.

CDC experts presented updated COVID-19 vaccine safety information obtained from reports to the Vaccine Adverse Events Reporting System (VAERS) and the Vaccine Safety Datalink (VSD) system. Data confirm an estimated rate of severe allergic reaction (e.g., anaphylaxis) immediately following vaccination with mRNA vaccines of about 5 per 1,000,000 doses administered. Additional data were presented on the epidemiology of rare instances of myocarditis and myopericarditis following COVID-19 vaccination, consistent with earlier estimates showing the highest risk in males 12 through 49 years: follow-up studies of longer-term outcomes are underway. Among 685 confirmed cases reported to VAERS with known outcome, 75% had already recovered at the time of the report. The projected benefits from vaccination in preventing hospitalization, ICU admission, and death greatly outweighed any risk from vaccination in all age groups analyzed. Surveillance reports continue to strongly support the overall acceptable safety of currently available COVID-19 vaccines.

During the meeting’s final session, ACIP reviewed its framework for determining if a booster dose of COVID-19 vaccine should be recommended for immunocompetent people who have completed a primary series. Data presented at this meeting indicate COVID-19 vaccines continue to maintain a high level of protection against severe disease, hospitalization, and death, while protection against infection appears lower in recent months. ACIP will continue to evaluate the ability of booster doses to improve protection, the impact of variants on vaccine effectiveness, and available safety data. If or when FDA authorizes an additional dose of a COVID-19 vaccine for use as a booster dose in immunocompetent people, ACIP will reconvene to consider data for a recommendation, possibly limiting the recommendation initially to people at the highest risk of severe disease outcomes. ACIP anticipates reconvening in mid-September to consider additional data on safety and effectiveness of a booster dose for immunocompetent people in preparation for a future vote. In the interim, it was noted that CDC recommends against administering COVID-19 vaccine boosters to immunocompetent people in the absence of FDA authorization and ACIP recommendation. A CDC speaker noted that off-label use ahead of an ACIP recommendation is not permitted under the conditions of the COVID-19 Vaccine Provider Agreement ([link removed]) and potentially could affect provider liability coverage under the Public Readiness and Emergency Preparedness (PREP) Act ([link removed]) and patient protections under the Countermeasures Injury Compensation Program ([link removed]).

Future ACIP Meetings
The next announced ACIP meetings are scheduled for September 29–30 (non-COVID-19 vaccine catch-up), and the regularly scheduled meeting on October 20–21. An additional meeting in September may be announced; information about past and future ACIP meetings ([link removed]) may be found on the ACIP website.

Related Links
* CDC: ACIP Presentation Slides August 30, 2021 Meeting ([link removed])
* FDA: Comirnaty and Pfizer-BioNTech COVID-19 Vaccine ([link removed]) web page
* FDA: Vaccine Information Fact Sheet for Healthcare Providers about Comirnaty (COVID-19 Vaccine, mRNA) and Pfizer-BioNTech COVID-19 Vaccine to prevent coronavirus disease 2019 (COVID-19) administering COVID-19 vaccine ([link removed]) (8/23/21)
* FDA: Vaccine Information Fact Sheet for Recipients and Caregivers about Comirnaty (COVID-19 Vaccine, mRNA) and Pfizer-BioNTech COVID-19 Vaccine to prevent coronavirus disease 2019 (COVID-19) administering COVID-19 vaccine ([link removed]) (8/23/21)
* FDA: Comirnaty prescribing information ([link removed]) (package insert, 8/23/21)
* CDC: Pfizer-BioNTech COVID-19 Vaccine ([link removed])
* CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Authorized in the United States ([link removed])
* CDC: COVID-19 Vaccine Booster Shot ([link removed])

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Register now for IAC’s September 9 webinar! Our expert panel answers your questions on preventing influenza during the COVID-19 pandemic.

As COVID-19 vaccination efforts continue, seasonal influenza vaccination remains essential to protect health and ease the burden on healthcare systems. IAC will host a webinar titled The Continued Threat of Influenza and How to Sustain Influenza Vaccination Efforts ([link removed]) on September 9 at 1:00 p.m. (ET). Topics will include:
* Influenza surveillance in the United States and worldwide
* Changes in circulation of other common respiratory pathogens, e.g., RSV
* Changes in influenza vaccine strains and changes in influenza ACIP recommendations
* Communication issues providers may face regarding perceptions of the need for influenza vaccination
* A public perspective on the importance of influenza vaccination and advocacy for vulnerable populations

These topics will be addressed by speakers:
* Alicia Budd, MPH, Influenza Division of CDC’s National Center for Immunization and Respiratory Diseases (NCIRD)
* Robert H. Hopkins Jr., MD, University of Arkansas for Medical Sciences
* Gary Stein, MBA, Families Fighting Flu

Register now ([link removed]) to be sure you don’t miss this informative session.

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"Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021–22 Influenza Season" published in MMWR Recommendations and Reports

CDC published Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021–22 Influenza Season ([link removed]) in the August 27 issue of MMWR Recommendations and Reports. A portion of the summary showing the six updates appears below.

First, all seasonal influenza vaccines available in the United States for the 2021–22 season are expected to be quadrivalent.

Second, the composition of 2021–22 U.S. influenza vaccines includes updates to the influenza A(H1N1)pdm09 and influenza A(H3N2) components.…

Third, the approved age indication for the cell culture–based inactivated influenza vaccine, Flucelvax Quadrivalent (ccIIV4), has been expanded from ages ≥4 years to ages ≥2 years.

Fourth, discussion of administration of influenza vaccines with other vaccines includes considerations for coadministration of influenza vaccines and COVID-19 vaccines. Providers should also consult current ACIP COVID-19 vaccine recommendations and CDC guidance concerning coadministration of these vaccines with influenza vaccines. Vaccines that are given at the same time should be administered in separate anatomic sites.

Fifth, guidance concerning timing of influenza vaccination now states that vaccination soon after vaccine becomes available can be considered for pregnant women in the third trimester. As previously recommended, children who need 2 doses … should receive their first dose as soon as possible after vaccine becomes available to allow the second dose (which must be administered ≥4 weeks later) to be received by the end of October. For nonpregnant adults, vaccination in July and August should be avoided unless there is concern that later vaccination might not be possible.

Sixth, contraindications and precautions to the use of ccIIV4 and RIV4 have been modified, specifically with regard to persons with a history of severe allergic reaction (e.g., anaphylaxis) to an influenza vaccine. A history of a severe allergic reaction to a previous dose of any egg-based IIV, LAIV, or RIV of any valency is a precaution to use of ccIIV4. A history of a severe allergic reaction to a previous dose of any egg-based IIV, ccIIV, or LAIV of any valency is a precaution to use of RIV4. Use of ccIIV4 and RIV4 in such instances should occur in an inpatient or outpatient medical setting under supervision of a provider who can recognize and manage a severe allergic reaction; providers can also consider consulting with an allergist to help identify the vaccine component responsible for the reaction. For ccIIV4, history of a severe allergic reaction (e.g., anaphylaxis) to any ccIIV of any valency or any component of ccIIV4 is a contraindication to future use of ccIIV4. For RIV4, history of a severe allergic reaction (e.g., anaphylaxis) to any RIV of any valency or any component of RIV4 is a contraindication to future use of RIV4.

Updates for IAC influenza materials to reflect these six changes are in progress.

Access the MMWR article in HTML format ([link removed]) or in PDF format ([link removed]).

Related Links
* CDC: Influenza ACIP Vaccine Recommendations ([link removed]) web page
* CDC: Influenza (Flu) ([link removed]) gateway page
* MMWR gateway page ([link removed]) provides access to MMWR Weekly and its companion publications
* IAC: Influenza Vaccine Products for the 2021–2022 Influenza Season ([link removed]) (PDF)

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“COVID-19 Vaccination Coverage among Adolescents Aged 12–17 Years—United States, December 14, 2020–July 31, 2021” published in MMWR Early Release

CDC published COVID-19 Vaccination Coverage among Adolescents Aged 12–17 Years—United States, December 14, 2020–July 31, 2021 ([link removed]) in the August 27 MMWR Early Release. A portion of the summary appears below.

As of July 31, 2021, coverage with ≥1 dose of COVID-19 vaccine among adolescents aged 12–17 years was 42%, and 32% had completed the series. Series completion rates varied widely by state, ranging from 11% to 60%, and was 25% for adolescents aged 12–13 years, 30% for those aged 14–15 years, and 40% for those aged 16–17 years….

Improving adolescent COVID-19 vaccination coverage is crucial to reduce COVID-19–associated morbidity and mortality among adolescents and can help facilitate safer reopening of schools for in-person learning.

Access the MMWR article in HTML format ([link removed]) or in PDF format ([link removed]).

Related Link
* MMWR gateway page ([link removed]) provides access to MMWR Weekly and its companion publications

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IAC updates its “Ask the Experts: COVID-19” web page to answer questions about FDA licensure, vaccination during pregnancy, additional doses of mRNA vaccines for immunocompromised people, Guillain-Barré syndrome, and myocarditis

IAC has again updated its Ask the Experts: COVID-19 ([link removed]) web page to reflect important Q&As about the latest updates to CDC recommendations for the use of COVID-19 vaccines. At this web page, you will find updates on FDA licensure, vaccination during pregnancy, additional doses of mRNA vaccines for immunocompromised people, Guillain-Barré syndrome, and myocarditis.

The Ask the Experts: COVID-19 ([link removed]) web page is updated regularly as guidance and vaccine authorizations change.
[link removed]

IAC's Ask the Experts ([link removed]) gateway page leads you to 29 distinct web pages on a variety of topics with more than 1,000 common or challenging questions and answers (Q&As) about vaccines and their administration. IAC's team of experts includes Kelly L. Moore, MD, MPH (team lead) and Carolyn B. Bridges, MD, FACP.

Related Links
* IAC: Ask the Experts: COVID-19 ([link removed]) web page
* IAC: Ask the Experts ([link removed]) gateway page to access more than 1,000 questions answered by IAC experts
* IAC: Vaccines: COVID-19 ([link removed]) gateway page
* CDC: COVID-19 ACIP Vaccine Recommendations ([link removed]) gateway page

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IAC Spotlight! IAC's “Clinic Tools: Administering Vaccines” gateway page provides resources from authoritative sources

IAC's Clinic Tools: Administering Vaccines ([link removed]) gateway page is a collection of resources from IAC, CDC, and other organizations related to administering vaccinations. This gateway page can be found by selecting the "Clinic Tools" tab in the middle of the blue banner across the top of every Immunize.org web page and then selecting "Administering Vaccines" in the drop-down menu.

In the left-hand column of the page, you will find IAC's educational materials such as Administering Vaccines: Dose, Route, Site, and Needle Size; Don’t Be Guilty of These Preventable Errors in Vaccine Administration; Skills Checklist for Vaccine Administration; and related resources.

The right-hand column of the page features resources from CDC, including links to vaccine administration guidelines, “General Best Practice Guidelines for Immunization,” and The Epidemiology and Prevention of Vaccine-Preventable Diseases ("The Pink Book").

Visit the Clinic Tools: Administering Vaccines ([link removed]) gateway page on Immunize.org.

Related Links
* IAC: Clinic Tools ([link removed]) gateway page
* IAC: Clinic Tools: Administering Vaccines ([link removed]) gateway page
* IAC: Clinic Tools: Adolescent Vaccination ([link removed]) gateway page
* IAC: Clinic Tools: Adult Vaccination ([link removed]) gateway page
* IAC: Clinic Tools: D ([link removed]) ocumenting Vaccinations ([link removed]) gateway page
* IAC: Clinic Tools: Scheduling Vaccines ([link removed]) gateway page
* IAC: Clinic Tools: Screening for Vaccine Contraindications and Precautions ([link removed]) gateway page
* IAC: Clinic Tools: Vaccine Storage and Handling ([link removed]) gateway page
* IAC: Clinic Tools: Vaccination and COVID-19 ([link removed]) gateway page
* IAC: Clinic Tools: Vaccine Recommendations ([link removed]) gateway page

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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 selection of our recent citations.
* 7NewsDC: What Do Major Religions Say about Vaccines? ([link removed]) (8/30/21)
* Patient Care: Immunization Action Coalition President and Flu Expert Dr. Kelly Moore Explains Primary Care's "Tall Order" ([link removed]-) (8/27/21)

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.
* WAVY: Father Warns Others to Get Vaccinated after 7 Kids Catch COVID-19 ([link removed]) (8/26/21)
* Science: Editorial: Colleges Must Require Vaccination ([link removed]) (8/26/21)
* Washington Post: A Group of Moms on Facebook Built an Island of Good-Faith Vaccine Debate in a Sea of Misinformation ([link removed]) (8/24/21)
* Reuters: U.S. COVID-19 Vaccine Approval Is ‘Seismic’ Shift for Legality of Mandates, Experts Say’ ([link removed]) (8/24/21)
* Fortune: All the Major Companies Requiring Vaccines for Workers ([link removed]) (8/24/21)
* Fortune: Low Vaccination Rate among Pregnant People Is Causing a ‘Perfect Storm,’ Doctors Warn ([link removed]) (8/24/21)
* NPR: It's Pronounced Koe-Mir'-Na-Tee. How the Pfizer-BioNTech Vaccine's Name Came to Be ([link removed]) (8/24/21)
* Johns Hopkins Medicine: Full FDA Approval of a COVID-19 Vaccine: What You Should Know ([link removed]) (8/23/21)
* NBC: "My Missing Piece": Nurse Who Lost Baby to COVID Highlights Risks for Pregnancies ([link removed]) (8/21/21)

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Immunize.org Pages and Handouts
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IAC updates its popular temperature logs for refrigerators and freezers; available in Celsius and Fahrenheit

IAC recently updated its four temperature logs ([link removed]) to help with proper vaccine storage and handling. IAC’s logs now refer users to the COVID-19 Vaccine Addendum of CDC’s Vaccine Storage and Handling Toolkit.

* Temperature log for refrigerator – Celsius ([link removed])
* Temperature log for refrigerator – Fahrenheit ([link removed])

* Temperature log for freezer – Celsius ([link removed])
* Temperature log for freezer – Fahrenheit ([link removed])

Related Links
* IAC: Ask the Experts: Storage and Handling ([link removed]) web page
* IAC: Clinic Tools: Vaccine Storage and Handling ([link removed]) gateway page
* IAC: Handouts: Storage and Handling ([link removed]) gateway page
* IAC: Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials 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

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IAC UPDATES ITS VACCINE STORAGE TROUBLESHOOTING RECORD TO DOCUMENT OCCURRENCE AND RESOLUTION OF QUESTIONABLE OR UNACCEPTABLE VACCINE STORAGE EVENTS

IAC recently revised its Vaccine Storage Troubleshooting Record ([link removed]) to refer users to the COVID-19 Vaccine Addendum of CDC’s Vaccine Storage and Handling Toolkit.

Related Links
* IAC: Ask the Experts: Storage and Handling ([link removed]) web page
* IAC: Clinic Tools: Vaccine Storage and Handling ([link removed]) gateway page
* IAC: Handouts: Storage and Handling ([link removed]) gateway page
* IAC: Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials 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

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IAC UPDATES ITS HANDOUT FOR HEALTHCARE PROFESSIONALS TITLED “CHECKLIST FOR SAFE VACCINE STORAGE AND HANDLING”

IAC recently posted its updated resource for healthcare professionals titled Checklist for Safe Vaccine Storage and Handling ([link removed]). A new box refers readers to CDC's website for information on COVID-19 vaccine storage and handling. New checklist items were added for vaccine inventory management and equipment storage.

Related Links
* IAC: Ask the Experts: Storage and Handling ([link removed]) web page
* IAC: Clinic Tools: Vaccine Storage and Handling ([link removed]) gateway page
* IAC: Handouts: Storage and Handling ([link removed]) gateway page
* IAC: Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials 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

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IAC UPDATES ITS HANDOUT FOR HEALTHCARE PROFESSIONALS TITLED "DON'T BE GUILTY OF THESE PREVENTABLE ERRORS IN VACCINE ADMINISTRATION!"

IAC recently posted its updated resource for healthcare professionals titled Don't Be Guilty of These Preventable Errors in Vaccine Administration! ([link removed]) Changes include the addition of a box to refer those seeking information on COVID-19 vaccines to CDC's website, greater detail on options for buffering a digital data logger temperature probe, and several updated links.

Related Links
* IAC: Ask the Experts: Administering Vaccines ([link removed]) web page
* IAC: Clinic Tools: Administering Vaccines ([link removed]) gateway page
* IAC: Handouts: Administering Vaccines ([link removed]) gateway page
* IAC: Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials 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

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IAC UPDATES ITS HANDOUT FOR HEALTHCARE PROFESSIONALS TITLED “SUPPLIES YOU MAY NEED AT AN IMMUNIZATION CLINIC”

IAC updated its handout for immunization providers titled Supplies You May Need at an Immunization Clinic ([link removed]). The handout was reorganized and new useful materials to have on hand were added.

This one-page checklist provides an easy-to-use way to prepare. Supply categories include vaccines, documents, emergency supplies, Vaccine Information Statements, and office supplies.

Related Links
* IAC: Ask the Experts: Administering Vaccines ([link removed]) web page
* IAC: Clinic Tools: Administering Vaccines ([link removed]) gateway page
* IAC: Handouts: Administering Vaccines ([link removed]) gateway page
* IAC: Handouts for Patients and Staff ([link removed]) gateway page, where you can sort materials 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

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ECHO: THESE UPDATED IAC PATIENT AND STAFF EDUCATIONAL MATERIALS WERE RELEASED DURING JULY AND AUGUST

IAC Express regularly provides readers with information about IAC’s new and updated educational materials for healthcare professionals and handouts for patients. All IAC materials are free to distribute.

In case you missed them during recent weeks, IAC has made updates to these helpful materials:

IAC’s Updated Materials for Clinicians
* Dates of Current Vaccine Information Statements (VISs) ([link removed])
* You Must Provide Patients with Vaccine Information Statements (VISs) – It’s Federal Law! ([link removed])
* Vaccines with Diluents: How to Use Them ([link removed])
* Administering Vaccines: Dose, Route, Site, and Needle Size ([link removed])
* Guide to Contraindications and Precautions to Commonly Used Vaccines ([link removed])
* Guide to Contraindications and Precautions to Commonly Used Vaccines in Adults ([link removed])
* Emergency Response Worksheet ([link removed])
* Vaccines Are Safe: Explaining Why ([link removed])
* Notification of Vaccination Letter Template ([link removed])

Updated Ask the Experts Web Page
* Ask the Experts: Administering Vaccines ([link removed]) web page (updated 8/15/2021)

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

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Vaccine Information Statements
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BE SURE TO UPDATE YOUR VISS! 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 they are depleted.

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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Featured Resources
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SHOW YOUR STRONG SUPPORT! ORDER 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, record cards, and other products offered by IAC

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IT’S TIME TO KICK OFF FLU VACCINE SEASON. DON’T DELAY; ORDER IAC'S FLU VACCINE BUTTONS AND STICKERS FOR STAFF AND PATIENTS TODAY!

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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TEENS ARE BACK IN SCHOOL, BUT MANY ARE STILL MISSING VACCINATIONS! CHECK OUT UPDATED WWW.GIVE2MENACWY.ORG WEBSITE TO INCREASE COVERAGE FOR THE MENACWY BOOSTER AND OTHER ADOLESCENT VACCINATIONS.

IAC’s www.Give2MenACWY.org ([link removed]) website promotes the importance of adolescent vaccination, including administering the recommended booster dose of MenACWY vaccine at age 16. Many teens are behind on vaccines because of the pandemic, so adolescent vaccination is more important than ever.

Original materials on this colorful website for healthcare professionals have been updated to incorporate the 2020 ACIP meningococcal vaccine recommendations ([link removed]) and the most recent vaccine coverage statistics from CDC’s National Immunization Survey–Teen (NIS–Teen). One particularly popular resource on the site is the updated Algorithm for MenACWY Immunization in Adolescents 11–18 Years of Age ([link removed]).

The website’s navigation structure makes locating information a breeze; it is divided into five easy-to-access sections:
* Vaccinate Teens ([link removed]) – Teen vaccination schedules and tips for improving adolescent vaccination rates
* Give 2 Doses ([link removed]) – Tools to help improve second dose coverage of MenACWY vaccine
* 16-Year-Old Visit ([link removed]) – Resources to help providers and patients remember the important vaccines recommended for 16-year-olds
* Tools for Providers ([link removed]) – Tools to explain meningococcal ACWY vaccine recommendations and improve coverage for all adolescent vaccines
* Resources ([link removed]) – Links to print materials ([link removed]), organizations ([link removed]) involved in adolescent vaccination, personal stories, and additional resources ([link removed]) of interest

The site also categorizes materials ([link removed]) according to whether they are primarily of interest to providers, to adolescents, or to parents.

Visit Give2MenACWY.org ([link removed]) and enjoy browsing (and deploying) its bountiful resources.

Related Links
* Give2MenACWY.org ([link removed]) website
* Algorithm for MenACWY Immunization in Adolescents 11–18 Years of Age ([link removed])
* MenACWY: You're Not Done If You Give Just One: Give 2 Doses to Strengthen Protection ([link removed])
* Recommending MenACWY: What to Say and How to Say It ([link removed])
* Top 10 Ways to Improve Adolescent Immunization Rates ([link removed])
* Developing an Immunization Culture in Your Office ([link removed])
* Know Your Rates: Measuring Immunization Success in Your Practice ([link removed])
* IAC: You're 16: We Recommend These Vaccines for You ([link removed])
* CDC: 2020 ACIP Meningococcal Vaccine Recommendations ([link removed])
* CDC: Adolescent Vaccination Coverage in the United States ([link removed])
* Dear Colleague Letter: 16-Year-Old Patients: Make Sure They Receive Their Annual Well Visit and Vaccinations ([link removed]) – signed by six medical societies
* IAC: Ask the Experts: Meningococcal ACWY ([link removed])

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American Hospital Association launches new PSA campaign to encourage hesitant hospital workers to get vaccinated

The American Hospital Association (AHA) has released three public service announcements (PSAs) featuring clinicians sharing their reasons for getting vaccinated against COVID-19 vaccine and encouraging their colleagues and communities to overcome concerns by seeking guidance from the trusted healthcare professionals in their lives. Each of the PSAs, which also are available with Spanish subtitles, can be accessed on AHA's vaccine confidence ([link removed]) web page.

Access the direct links to each PSA below.
* I’m a Physician/I’m a Nurse – English ([link removed]) (30 seconds)
* I’m a Physician – English ([link removed]) (15 seconds)
* I’m a Nurse – English ([link removed]) (15 seconds)
* On the Fence – English ([link removed]) (30 seconds)
* On the Fence – English ([link removed]) (15 seconds)

Related Links
* Press Release: New AHA PSAs and Resources Feature Clinicians Encouraging COVID-19 Vaccination ([link removed]) (8/25/21)
* AHA: COVID-19 Vaccine Communications Resources ([link removed]) gateway page

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Notable Publications
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"Safety of the BNT162b2 mRNA COVID-19 Vaccine in a Nationwide Setting" published in New England Journal of Medicine

In the August 25 issue, New England Journal of Medicine published Safety of the BNT162b2 mRNA COVID-19 Vaccine in a Nationwide Setting ([link removed]). A portion of the Conclusions section appears below.

In this study in a nationwide mass vaccination setting, the BNT162b2 vaccine was not associated with an elevated risk of most of the adverse events examined. The vaccine was associated with an excess risk of myocarditis (1 to 5 events per 100,000 persons). The risk of this potentially serious adverse event and of many other serious adverse events was substantially increased after SARS-CoV-2 infection....

Related Link
* New England Journal of Medicine: Editorial: The Importance of Context in Covid-19 Vaccine Safety ([link removed]) (8/25/21)

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"Vaccinations against COVID-19 May Have Averted up to 140,000 Deaths in the United States" published in Health Affairs

In the August 18 issue, Health Affairs published Vaccinations against COVID-19 May Have Averted up to 140,000 Deaths in the United States ([link removed]). The abstract appears below.

COVID-19 vaccination campaigns continue in the United States, with the expectation that vaccines will slow transmission of the virus, save lives, and enable a return to normal life in due course. However, the extent to which faster vaccine administration has affected COVID-19-related deaths is unknown. We assessed the association between US state-level vaccination rates and COVID-19 deaths during the first five months of vaccine availability. We estimated that by May 9, 2021, the US vaccination campaign was associated with a reduction of 139,393 COVID-19 deaths. The association varied in different states. In New York, for example, vaccinations led to an estimated 11.7 fewer COVID-19 deaths per 10,000, whereas Hawaii observed the smallest reduction, with an estimated 1.1 fewer deaths per 10,000. Overall, our analysis suggests that the early COVID-19 vaccination campaign was associated with reductions in COVID-19 deaths. As of May 9, 2021, reductions in COVID-19 deaths associated with vaccines had translated to value of statistical life benefit ranging between $625 billion and $1.4 trillion.

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“A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor’s Appointment” published in Proceedings of the National Academy of Sciences

In the May 18 issue, Proceedings of the National Academy of Sciences published A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor’s Appointment ([link removed]). The abstract appears below.

Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via text message and designed to boost adoption of the influenza vaccine. Our findings suggest that text messages sent prior to a primary care visit can boost vaccination rates by an average of 5%. Overall, interventions performed better when they were 1) framed as reminders to get flu shots that were already reserved for the patient and 2) congruent with the sort of communications patients expected to receive from their healthcare provider (i.e., not surprising, casual, or interactive). The best-performing intervention in our study reminded patients twice to get their flu shot at their upcoming doctor's appointment and indicated it was reserved for them. This successful script could be used as a template for campaigns to encourage the adoption of life-saving vaccines, including against COVID-19.

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MMWR Recap: COVID-19 cases and hospitalizations by vaccination status and vaccine effectiveness estimates

CDC recently published several articles first distributed as MMWR Early Releases:
* New COVID-19 Cases and Hospitalizations among Adults, by Vaccination Status—New York, May 3–July 25, 2021 (MMWR, August 27, HTML format ([link removed]) or PDF format ([link removed]) )
* Sustained Effectiveness of Pfizer-BioNTech and Moderna Vaccines against COVID-19 Associated Hospitalizations among Adults—United States, March–July 2021 (MMWR, August 27, HTML format ([link removed]) or PDF format ([link removed]) )
* Effectiveness of Pfizer-BioNTech and Moderna Vaccines in Preventing SARS-CoV-2 Infection among Nursing Home Residents before and during Widespread Circulation of the SARS-CoV-2 B.1.617.2 (Delta) Variant—National Healthcare Safety Network, March 1–August 1, 2021 (MMWR, August 27, HTML format ([link removed]) or PDF format ([link removed])
* Effectiveness of COVID-19 Vaccines in Preventing SARS-CoV-2 Infection among Frontline Workers before and during B.1.617.2 (Delta) Variant Predominance—Eight U.S. Locations, December 2020–August 2021 (MMWR, August 27, HTML format ([link removed]) or PDF format ([link removed])
* SARS-CoV-2 Infections and Hospitalizations among Persons Aged ≥16 Years, by Vaccination Status—Los Angeles County, California, May 1–July 25, 2021 (MMWR, August 27, 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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Global News
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CDC and WHO report on progress toward polio eradication, worldwide, in this week's MMWR and Weekly Epidemiological Record, respectively

CDC published Progress toward Polio Eradication—Worldwide, January 2019–June 2021 ([link removed]) in the August 27 issue of MMWR ([link removed]). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Progress towards Polio Eradication—Worldwide, January 2019–June 2021 ([link removed]). A media summary of the MMWR article appears below.

In 2020, wild polio cases increased in Afghanistan and decreased in Pakistan compared with 2019, and rising rates of under-immunized children, as well as COVID-19 disruptions, led to increases in outbreaks of circulating vaccine-derived polio in 13 additional countries. Wild poliovirus continues to circulate in two countries: Afghanistan and Pakistan. In 2020, polio cases increased in Afghanistan and decreased in Pakistan compared with 2019. However, circulating vaccine-derived poliovirus cases continue to spread globally, with outbreaks reported in 32 countries, including 13 new countries in 2020. As the COVID-19 pandemic disrupts polio eradication efforts, the Global Polio Eradication Initiative and partners launched an updated five-year eradication strategy in June 2021. The strategy focuses on stopping wild polio circulation and vaccine-derived polio outbreaks by responding quickly to outbreaks, widening use of a new oral polio vaccine, integrating polio eradication efforts with other country-level outbreak responses and health efforts, and ensuring accountability at all levels to create a polio-free world.

Related Links
* MMWR gateway page ([link removed]) provides access to MMWR Weekly and its companion publications
* Current issue and archives of WHO's Weekly Epidemiological Record ([link removed])

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Upcoming Events
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WATCH TODAY (SEPTEMBER 1 AT 5 P.M. ET): NATIONAL ACADEMY OF MEDICINE’S WEBINAR “COVID-19 CONVERSATIONS #21 THE FOURTH WAVE: VACCINES, VARIANTS, AND THE FUTURE”; CME AVAILABLE

On September 1 at 5:00 p.m. (ET), the National Academy of Medicine (NAM) will offer a webinar titled COVID-19 Conversations #21 the Fourth Wave: Vaccines, Variants, and the Future. ([link removed])

This webinar will provide an update on the current state of COVID-19, focusing specifically on the Delta variant, implications for children under the age of 12, what the rise of this highly infectious variant means for vaccinated and unvaccinated adults and adolescents, and what it will take to move past this surge and end the pandemic.

Live webinar participants can earn 1.5 CPH, CME, CNE, or CHES continuing education credits ([link removed]). Participants must watch the entire webinar, including the Q&A, to be eligible for CE credits.

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ALSO TODAY (SEPTEMBER 1 AT 3 P.M. ET): NEVADA IMMUNIZATION LEARNING EXCHANGE’S WEBINAR "THE STATE OF THE PANDEMIC: WHERE DO WE STAND AND WHERE DO WE GO FROM HERE?"; CEU AVAILABLE

On September 1 at 12:00 p.m. (PT), Nevada Immunization Learning Exchange (NILE) will offer a webinar titled The State of the Pandemic: Where Do We Stand and Where Do We Go from Here? ([link removed])

During this presentation, the co-hosts of Unbiased Science (public health scientist Dr. Jessica Steier and immunologist/microbiologist Dr. Andrea Love) will discuss new and emerging data regarding the Delta variant, as well as risks for future mutations. They will also discuss common vaccine myths and the evidence to debunk those myths, as well as ways to have conversations with vaccine-hesitant people in healthcare settings.

This program offers one free CEU for nurses, Nevada pharmacists, and CHWs, upon completion of the post-webinar survey.

Archived NILE webinars ([link removed]) are available to watch.

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IAC'S CALENDAR OF EVENTS PROVIDES INFORMATION ABOUT FEDERAL, STATE, AND NATIONAL PARTNERS' VACCINATION CONFERENCES, AS WELL AS PROFESSIONAL SOCIETIES' ANNUAL MEETINGS

IAC maintains a Calendar of Events on its website for healthcare professionals at www.immunize.org/calendar. This is an easy way to find out about upcoming regional, state, and national conferences, workshops, and electronic continuing educational opportunities. The calendar also includes special weeks of observances.

If you have a vaccination-related event that you would like your colleagues to know about via this Calendar of Events, email IAC ([email protected]).

You can locate IAC's "Calendar of Events" web page in the “Guide to Immunize.org” index at the bottom of every Immunize.org web page.

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Immunization PSAs from the Archive
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IN THIS COMPELLING PSA FROM PENNSYLVANIA DEPARTMENT OF HEALTH, WE HEAR TIM BAKER, AN INFANT DIAGNOSED WITH PERTUSSIS, STRUGGLE TO BREATHE DURING COUGHING FITS

In this compelling public service announcement (PSA) ([link removed]) from the Pennsylvania Department of Health, an unvaccinated infant struggles to breathe during coughing fits caused by pertussis. 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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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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