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Issue 1,592: September 29, 2021

Top Stories
* CDC recommends a booster dose for recipients of a Pfizer-BioNTech COVID-19 Vaccine primary series who are age 65 years or older, who reside in long-term care facilities, who are age 18 through 64 with underlying health conditions, or who are at high risk of occupational or institutional exposure to COVID-19
* “Use of Pfizer-BioNTech COVID-19 Vaccine in Persons Aged ≥16 Years: Recommendations of the Advisory Committee on Immunization Practices—United States, September 2021” published in MMWR
* Use lessons from COVID-19 vaccination efforts to protect more patients from influenza! Two IAC influenza webinars for vaccine providers are now available for online viewing.
* CDC launches "I Get It" flu vaccination campaign
* CMS launches new Medicare.gov feature to compare nursing homes by COVID-19 vaccination rate
* IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination now features 1,156 organizations, including two new facilities
* IAC Spotlight: IAC's Handouts web page provides free access to hundreds of vaccination-related handouts and fact sheets
* Journalists interview IAC experts
* Vaccines in the news

Featured Resources
* Spread the word, not the virus! IAC offers FREE “I Got My COVID-19 Vaccine” buttons and stickers to those promoting vaccination in hesitant communities. Available in English and Spanish.

Notable Publications
* MMWR Recap: “Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations among Adults without Immunocompromising Conditions––United States, March–August 2021”
* "Association between Human Papillomavirus Infection among Pregnant Women and Preterm Birth" published in JAMA Network Open

Upcoming Events
* Watch today (September 29 at 10 a.m. ET): ACIP meeting on zoster, pneumococcal, and hepatitis B vaccination and other topics; no registration required
* Virtual: CDC offers archived webinar for clinicians titled "What Clinicians Need to Know about the Latest CDC Recommendations for Pfizer-BioNTech COVID-19 Booster Vaccination"
* Virtual: CDC and AAP will host webinar for clinicians titled "2021–22 Recommendations for Influenza Prevention and Treatment in Children: An Update for Pediatric Practitioners" on October 7
* Virtual: NFID to hold influenza/pneumococcal news conference on October 7
* Virtual: Register now for online NFID Clinical Vaccinology Course, November 15–17; CME/CNE available

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Top Stories
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CDC recommends a booster dose for recipients of a Pfizer-BioNTech COVID-19 Vaccine primary series who are age 65 years or older, who reside in long-term care facilities, who are age 18 through 64 with underlying health conditions, or who are at high risk of occupational or institutional exposure to COVID-19

On September 22, the FDA updated its Emergency Use Authorization (EUA) for Pfizer-BioNTech COVID-19 Vaccine (also known as Comirnaty) to authorize administration of a third (booster) dose in certain individuals. The next day, CDC’s Advisory Committee on Immunization Practices (ACIP) made interim recommendations for certain populations to receive a booster dose of Pfizer-BioNTech’s COVID-19 Vaccine at least 6 months after completing their Pfizer-BioNTech vaccine primary series. In addition, the CDC Director recommended a booster dose for Pfizer-BioNTech primary series recipients in certain high risk occupational and institutional settings. The recommendations are:

* people age 65 years and older and residents in long-term care settings should receive a booster dose of Pfizer-BioNTech COVID-19 Vaccine at least 6 months after their Pfizer-BioNTech primary series;

* people age 50 through 64 with certain underlying medical conditions ([link removed]) should receive a booster dose of Pfizer-BioNTech COVID-19 Vaccine at least 6 months after their Pfizer-BioNTech primary series;

* people age 18 through 49 who are at high risk for severe COVID-19 due to certain underlying medical conditions ([link removed]) may receive a booster dose of Pfizer-BioNTech COVID-19 Vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks; and

* people age 18 through 64 years who are at increased risk for COVID-19 exposure and transmission because of occupational or institutional setting may receive a booster dose of Pfizer-BioNTech COVID-19 Vaccine at least 6 months after their Pfizer-BioNTech primary series, based on their individual benefits and risks.

Individuals requesting a booster dose due to an underlying medical condition are not required to provide documentation of their condition; self-attestation is sufficient.

CDC has issued updated clinical considerations ([link removed]) providing guidance on these booster recommendations. Discussions on booster doses for recipients of Moderna and Janssen (Johnson & Johnson) COVID-19 vaccines will be held following FDA authorization of additional doses of those products. Due to limitations of the FDA authorization, Moderna and Janssen vaccine recipients are not recommended to receive a Pfizer-BioNTech booster at this time.

ACIP noted that the booster recommendations do not change the definition of who is considered “fully vaccinated” for public health or administrative purposes. “Fully vaccinated” status begins 2 weeks after completing a 2-dose mRNA vaccine (Pfizer-BioNTech or Moderna) series or the single dose of the Janssen COVID-19 Vaccine (Johnson & Johnson).

In making these recommendations, ACIP members and the CDC Director emphasized that vaccination of unvaccinated people continues to be the top priority. Data presented at the meeting indicate hospitalization rates for unvaccinated adults were 13- to 23-times higher (varying by age) than for vaccinated adults.

During its two-day meeting ([link removed]), ACIP also heard presentations (presentation slides ([link removed]) available online) from CDC experts on the current epidemiology of COVID-19 disease in the United States and updates on COVID-19 vaccine safety and effectiveness assessed through multiple surveillance systems. Additional presentations highlighted the growing body of evidence supporting the benefits and safety of COVID-19 vaccination during any stage of pregnancy as routinely recommended by CDC and the American College of Obstetricians and Gynecologists (ACOG), among others. Despite this recommendation, only 30% of pregnant people are currently fully vaccinated ([link removed]) with COVID-19 vaccine.

Clinicians administering Pfizer-BioNTech COVID-19 Vaccine should give vaccine recipients the updated (September 22, 2021) EUA Fact Sheet ([link removed]) for Recipients and Caregivers. Clinicians should familiarize themselves with the revised Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for Healthcare Providers.

Future ACIP Meetings
The next announced ACIP meetings are scheduled for today, September 29 (see story in “Upcoming Meetings”), 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: Statement on ACIP Booster Recommendations ([link removed])
* CDC: ACIP Presentation Slides ([link removed]) September 22–23 Meeting
* 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])
* FDA: Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for Healthcare Providers ([link removed]) (9/22/2021)
* FDA: Pfizer-BioNTech COVID-19 Vaccine EUA Fact Sheet for Recipients and Caregivers ([link removed]) (9/22/2021)
* FDA: Comirnaty and Pfizer-BioNTech COVID-19 Vaccine ([link removed]) web page
* ACOG: COVID-19 Vaccination Considerations for Obstetric-Gynecologic Care ([link removed])

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“Use of Pfizer-BioNTech COVID-19 Vaccine in Persons Aged ≥16 Years: Recommendations of the Advisory Committee on Immunization Practices—United States, September 2021” published in MMWR

CDC published Use of Pfizer-BioNTech COVID-19 Vaccine in Persons Aged ≥16 Years: Recommendations of the Advisory Committee on Immunization Practices—United States, September 2021 ([link removed]) in the September 24 issue of MMWR ([link removed]). This publication predates the September 25, 2021, authorization of booster doses for many recipients; see story above. A portion of the summary appears below.

On August 23, 2021, the Food and Drug Administration granted full approval of the Pfizer-BioNTech COVID-19 vaccine for persons aged ≥16 years....

On August 30, 2021, after a systematic review of the data, the Advisory Committee on Immunization Practices revised its interim recommendation to a standard recommendation for use of the Pfizer-BioNTech COVID-19 vaccine in persons aged ≥16 years for the prevention of COVID-19....

Continued use of the Pfizer-BioNTech COVID-19 vaccine, now fully approved by the FDA in persons aged ≥16 years, is recommended based on increased certainty that its benefits (prevention of asymptomatic infection, COVID-19, and associated hospitalization and death) outweigh vaccine-associated risks....

Related Links
* Articles in HTML ([link removed]) or PDF ([link removed])
* MMWR's main page ([link removed]) provides access to MMWR Weekly and its companion publications

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Use lessons from COVID-19 vaccination efforts to protect more patients from influenza! Two IAC influenza webinars for vaccine providers are now available for online viewing.

On September 20, IAC hosted a webinar titled "Translating COVID-19 Strategies to Improve Influenza Seasonal Flu Vaccination Efforts." The entire webinar is now archived for viewing ([link removed]). The topics included:
* Information to improve influenza immunization for under-served populations and improving vaccine equity
* Public health strategies to reach small communities
* Making a strong recommendation for influenza vaccination this season
* Pharmacists’ lessons learned for improving vaccine access and vaccine equity for vulnerable populations

Also archived for viewing ([link removed]) is IAC's September 9 webinar titled "The Continued Threat of Influenza and How to Sustain Influenza Vaccination Efforts." Please share both webinar links with your colleagues.

Related Links
* IAC: September 20 webinar ([link removed])
* IAC: September 9 webinar ([link removed])

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CDC launches "I Get It" flu vaccination campaign

CDC launched the "I Get It" ([link removed]) campaign to encourage everyone age 6 months and older to get vaccinated against influenza and to share their reasons for getting vaccinated. Campaign materials include:
* CDC web resources
+ 2021–22 Flu Season FAQ ([link removed])
+ Adults with Chronic Conditions ([link removed])
+ Key Facts About Flu Vaccines ([link removed])
+ And many other themes
* Digital campaign resources
+ Digital Media Toolkit ([link removed]) (will be continually updated throughout the season)
+ Social Media Toolkit ([link removed])
+ "I Get It" Frames ([link removed])
+ Spanish Social Media Toolkit ([link removed])
* Multi-language resources
+ Multi-Language Factsheets ([link removed])
+ Spanish Communication Resources ([link removed])

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CMS launches new Medicare.gov feature to compare nursing homes by COVID-19 vaccination rate

CMS is making it easier to check COVID-19 vaccination rates for nursing home staff and residents ([link removed]) with a new feature on Medicare.gov ([link removed]). Vaccination data is now available in a user-friendly format to help people make informed decisions when choosing a nursing home for themselves or a loved one. CMS and CDC continue using this data to monitor vaccine uptake among residents and staff and identify facilities that may need assistance to respond to the pandemic.

Related Links
* Press Release: CMS Launches New Medicare.gov Tool to Compare Nursing Home Vaccination Rates ([link removed]) (9/21/21)
* CMS: COVID-19 Nursing Home Data ([link removed])

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IAC'S INFLUENZA VACCINATION HONOR ROLL FOR MANDATORY HEALTHCARE WORKER VACCINATION NOW FEATURES 1,156 ORGANIZATIONS, INCLUDING TWO NEW FACILITIES

There are now 1,156 organizations enrolled in IAC's Influenza Vaccination Honor Roll ([link removed]). The honor roll recognizes hospitals, long-term care facilities, medical practices, pharmacies, professional organizations, health departments, and other government entities that take a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel.

Since September 8, when IAC Express last reported on the Influenza Vaccination Honor Roll ([link removed]), two additional healthcare organizations have been enrolled.
* Leidos Biomedical Research, Inc, Frederick, MD
* Delaware Valley Community Health, Philadelphia, PA

To be included in the Influenza Vaccination Honor Roll, the institutional mandate you report must require influenza vaccination for all staff. Additionally, the application must describe measures to prevent transmission of influenza from unvaccinated personnel to patients (e.g., masking for the entire work shift, reassignment to non-patient-care duties, dismissal).

IAC urges qualifying healthcare organizations to complete the Application page ([link removed]).

Related Links
* IAC: List of Influenza Vaccination Honorees, all healthcare settings ([link removed]), by state
* IAC: Long-Term Care/Assisted Living Influenza Vaccination Honorees ([link removed]) by state
* IAC: Influenza Vaccination Honor Roll program ([link removed]), including:
+ Position statements ([link removed]) from professional societies and leading healthcare organizations in support of mandatory influenza vaccination
+ Application form for Influenza Vaccination Honor Roll ([link removed])
* IAC: Honor Roll for Patient Safety ([link removed]) web page

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IAC Spotlight! IAC's Handouts web page provides free access to hundreds of vaccination-related handouts and fact sheets

IAC's Handouts for Patients and Staff ([link removed]) web page leads users to hundreds of free vaccination-related patient handouts and fact sheets for healthcare professionals. All items are ready to print, copy, and distribute widely!

Visit the Handouts for Patients and Staff ([link removed]) web page to view more than 300 handouts sorted by:
* Topic ([link removed])
* Vaccine ([link removed])
* Language ([link removed])

From the main page, you can search on any of the 23 topics. Some of the most popular are:
* Administering Vaccines ([link removed])
* Parent Handouts ([link removed])
* Screening Checklists ([link removed])
* Standing Orders ([link removed])
* Temperature Logs ([link removed])
* Top Handouts ([link removed])

The right-hand side of the web page includes links to some of IAC's most popular handouts, including:
* Summary of Recommendations for Children and Teens ([link removed])
* Summary of Recommendations for Adults ([link removed])
* Vaccinations for Adults—You’re Never Too Old to Get Immunized ([link removed])
* When Do Children and Teens Need Vaccinations? ([link removed])
* How to Administer IM and SC ([link removed])

You can also view an alphabetical listing of IAC’s more than 300 ready-to-print staff educational materials and patient handouts ([link removed]).

Visit IAC's Handouts for Patients and Staff ([link removed]) web page on Immunize.org today!

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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.

* USA Today: More than 20M Americans Are Eligible for Pfizer-BioNTech Booster Shots. Should You Get One? ([link removed]) (9/26/21)

* The Journalist's Resource: It’s Flu Season. Here’s What Research Shows about Adult Vaccinations. ([link removed]) (9/22/21)

* American Medical Association: L.J Tan, PhD, MS, Talks about a Call to Action to Increase Adult Immunizations ([link removed]) (9/21/21)

* Fintech Zoom: CVS – Flu Season Prep, Complicated by COVID-19, Starts Early This Year ([link removed]) (9/19/21)

* New York Times: It's That Time of Year, Experts Warn: Get a Flu Shot ([link removed]) (9/17/21)
* ABC News: What Vaccines Are Already Required to Attend School in the U.S. ([link removed]) (9/17/21)

* Washington Post: Can You Get a COVID Booster and a Flu Shot Together? Here’s What You Need to Know. ([link removed]) (9/13/21)

* AARP: 7 Things We've All Learned about Vaccines ([link removed]) (9/10/21)

Related Link
* IAC in the News ([link removed]) main 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.

* CNN: COVID-19 Death Rate More Than 4 Times Higher in Least Vaccinated States than in Most Vaccinated ([link removed]) (9/22/21)

* Bloomberg: U.S. Racial Vaccine Gaps Are Bigger Than We Thought ([link removed]) (9/21/21)

* NPR: COVID Vaccine for Kids Ages 5 to 11 Is Safe and Effective, Pfizer Says ([link removed]) (9/20/21)

* STAT: COVID-19 Overtakes 1918 Spanish Flu as Deadliest Disease in American History ([link removed]) (9/20/21)

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Featured Resources
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Spread the word, not the virus! IAC offers FREE “I Got My COVID-19 Vaccine” buttons and stickers to those promoting vaccination in hesitant communities. Available in English and Spanish.

Any group or person promoting COVID-19 vaccination can order IAC’s FREE “I Got My COVID-19 Vaccine” buttons and stickers ([link removed]), provided with support from CDC. Available in English and Spanish, the buttons and stickers look great on lab coats, uniforms, jackets, lanyards, ID badges, or backpacks to show confidence in COVID-19 vaccination. Access this order form ([link removed]) to request the FREE buttons and stickers for your outreach efforts while supplies last.

Related Links
* IAC: FREE "I Got My COVID-19 Vaccine" buttons and stickers order form ([link removed])
* Shop IAC ([link removed]) main page: All the buttons, stickers, record cards, and other products offered by IAC

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Notable Publications
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MMWR Recap: “Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations among Adults without Immunocompromising Conditions—United States, March–August 2021”

CDC recently published the following article as an MMWR Early Release:
* Comparative Effectiveness of Moderna, Pfizer-BioNTech, and Janssen (Johnson & Johnson) Vaccines in Preventing COVID-19 Hospitalizations among Adults without Immunocompromising Conditions—United States, March–August 2021 (MMWR, September 24, HTML ([link removed]) or PDF ([link removed])

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

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"Association between Human Papillomavirus Infection among Pregnant Women and Preterm Birth" published in JAMA Network Open

In the September 1 issue, JAMA Network Open published Association between Human Papillomavirus Infection among Pregnant Women and Preterm Birth ([link removed]). The conclusions and relevance section appears below.

The study's results suggest that persistent HPV-16/18 infection is associated with an increased risk of preterm birth, independent of cervical treatment. Future studies should investigate the association of HPV vaccination and vaccination programs with the risk of preterm birth.

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Upcoming Events
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WATCH TODAY (SEPTEMBER 29 AT 10 A.M. ET): ACIP MEETING ON ZOSTER, PNEUMOCOCCAL, AND HEPATITIS B VACCINATION AND OTHER TOPICS; NO REGISTRATION REQUIRED

CDC will convene its Advisory Committee on Immunization Practices (ACIP) ([link removed]) today, September 29, starting at 10:00 a.m. (ET). The committee will discuss zoster, pneumococcal, hepatitis B, tick-borne encephalitis (TBE), and orthopoxvirus vaccination.

No registration is required to watch webcasts of live ACIP meetings or listen via telephone. Opportunities for public comment are described at the website.

View the agenda ([link removed]).

Related Links
* ACIP main page ([link removed]) for access to webcast, agendas
* ACIP Meeting Information ([link removed]) for presentation slides, content from previous meetings, and information about future meetings

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VIRTUAL: CDC OFFERS ARCHIVED WEBINAR FOR CLINICIANS TITLED "WHAT CLINICIANS NEED TO KNOW ABOUT THE LATEST CDC RECOMMENDATIONS FOR PFIZER-BIONTECH COVID-19 BOOSTER VACCINATION"

CDC’s archive of its Clinical Outreach and Communication Activity (COCA) webinars now includes the event from September 28, 2021, What Clinicians Need to Know about the Latest CDC Recommendations for Pfizer-BioNTech COVID-19 Booster Vaccination ([link removed]). CDC provided the following description of this session:

This COCA Call will give clinicians an overview of the Pfizer-BioNTech COVID-19 booster vaccination. Clinicians will learn about the vaccine booster recommendations, safety of booster dose, and clinical guidance for using the Pfizer-BioNTech COVID-19 booster vaccine.

Access more information about this webinar: What Clinicians Need to Know about the Latest CDC Recommendations for Pfizer-BioNTech COVID-19 Booster Vaccination ([link removed]).

Related Link
* CDC: COCA archive ([link removed])

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VIRTUAL: CDC AND AAP WILL HOST WEBINAR FOR CLINICIANS TITLED "2021–22 RECOMMENDATIONS FOR INFLUENZA PREVENTION AND TREATMENT IN CHILDREN: AN UPDATE FOR PEDIATRIC PRACTITIONERS" ON OCTOBER 7

CDC and the American Academy of Pediatrics ([link removed]) (AAP) will host a Clinical Outreach and Communication Activity (COCA) webinar on October 7, 2021 from 2:00–3:00 p.m. (ET) titled "2021–22 Recommendations for Influenza Prevention and Treatment in Children: An Update for Pediatric Practitioners." Webinar details will be available on CDC’s COCA Call web page ([link removed]) the week of the webinar. During this COCA call, experts from AAP and CDC will discuss strategies primary care providers and medical subspecialists can use to improve, prevent, and control influenza among children this season.

Related Link
* CDC: COCA archive ([link removed])

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VIRTUAL: NFID TO HOLD INFLUENZA/PNEUMOCOCCAL NEWS CONFERENCE ON OCTOBER 7

On Thursday, October 7, the National Foundation for Infectious Diseases ([link removed]) (NFID) will host its 2021 Annual NFID Influenza/Pneumococcal News Conference ([link removed]) from 9:30–10:30 a.m. (ET). Confirmed panelists include:
* Rochelle P. Walensky, MD, MPH, CDC director
* William Schaffner, MD, NFID medical director
* Laura E. Riley, MD, obstetrician and gynecologist-in-chief, New York-Presbyterian/Weill Cornell Medical Center
* Cedric “Jamie” Rutland, MD, CEO, West Coast Lung; COVID-19 medical director, Private Health Management
* Patricia A. (Patsy) Stinchfield, MS, CPNP, NFID president-elect; pediatric nurse practitioner, Children’s Minnesota

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VIRTUAL: REGISTER NOW FOR ONLINE NFID CLINICAL VACCINOLOGY COURSE, NOVEMBER 15–17; CME/CNE AVAILABLE

The National Foundation of Infectious Diseases ([link removed]) (NFID) Fall 2021 Clinical Vaccinology Course ([link removed]) will be held online November 15–17. This 3-day online course focuses on new developments and issues related to use of vaccines. Expert faculty provide the latest information on vaccines, including updated recommendations for vaccinations across the lifespan, and innovative and practical strategies for ensuring timely and appropriate immunization.

Continuing Medical Education (CME) and Continuing Nursing Education (CNE) ([link removed]) credit will be offered.

Register for the online course ([link removed]) ($750 fee).


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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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