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Issue 1,593: October 6, 2021

Top Stories

* CDC issues urgent health advisory to increase COVID-19 vaccination for people before, after, or during pregnancy
* IAC summarizes September 29 ACIP meeting on zoster, pneumococcal, and hepatitis B vaccination and other diseases
* New VIS translations to download now: IAC posts Arabic, Burmese, French, and Somali translations of August 6 Vaccine Information Statements for multiple vaccines
* "Safety Monitoring of an Additional Dose of COVID-19 Vaccine—United States, August 12–September 19, 2021" published in MMWR Early Release
* IAC Spotlight: Check out the Immunize.org resources to help with your vaccine advocacy
* IAC’s Hepatitis B Birth Dose Honor Roll recognizes 540 institutions, including one new honoree. Five previously honored institutions qualify for additional years' honors.
* Your colleagues don’t want to be the last to know. Urge them to subscribe to IAC Express for free.
* Journalists interview IAC experts
* Vaccines in the news

Immunize.org Pages and Handouts

* IAC and AIM update print-ready training tool: "Communicating the Benefits of Influenza Vaccine during COVID-19"
* Echo: These updated IAC educational materials for clinicians were released during August and September


Vaccine Information Statements

* Echo: These new VISs and VIS translations were released during August and September

Featured Resources

* CDC provides field guide with 12 evidence-based strategies to promote COVID-19 vaccination confidence and uptake* Public Health Communications Collaborative releases resources to help answer questions about COVID-19 vaccine booster doses and support vaccination outreach
* 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.
* Explore the updated www.Give2MenACWY.org website to increase coverage for the MenACWY booster and other adolescent vaccinations
* IAC's red "FLU VACCINE" buttons and stickers are a bright idea. Order today!
* IAC's Calendar of Events provides information about federal, state, and national partners' vaccination conferences, as well as professional societies' annual meetings

Notable Publications

* CHOP's Vaccine Education Center publishes September issue of Vaccine Update newsletter
* "Disparities in COVID-19 Vaccination Status, Intent, and Perceived Access for Noninstitutionalized Adults, by Disability Status—National Immunization Survey Adult COVID Module, United States, May 30–June 26, 2021" published in MMWR
* “Protection of BNT162b2 Vaccine Booster against COVID-19 in Israel” published in NEJM
* “Effectiveness of mRNA Covid-19 Vaccine among U.S. Health Care Personnel” published in NEJM

Upcoming Events
* Virtual: Massachusetts Immunization Action Partnership hosts 26th annual "MIAP Pediatric Immunization Skills Building Conference" on October 28; CE available
* Virtual: University of Nevada, Las Vegas offers webinar titled COVID-19 Vaccines, Masks, and Mandates: Exploring the Legal Boundaries of Public Health Protections on November 4


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Top Stories
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CDC issues urgent health advisory to increase COVID-19 vaccination for people before, after, or during pregnancy

On September 29, CDC issued an urgent health advisory ([link removed]) to increase COVID-19 vaccination among people who are pregnant, recently were pregnant (including those who are lactating), are trying to become pregnant, or might become pregnant in the future. A portion of the media statement ([link removed]) appears below.

The CDC health advisory strongly recommends COVID-19 vaccination ([link removed]) either before or during pregnancy because the benefits of vaccination for both pregnant persons and their fetus or infant outweigh known or potential risks. Additionally, the advisory calls on health departments and clinicians to educate pregnant people on the benefits of vaccination and the safety of recommended vaccines.

According to CDC data, only 31 percent of pregnant people have been vaccinated against COVID-19 and vaccination rates vary markedly by race and ethnicity. Vaccination coverage is highest among Asian people who are pregnant (45.7 percent), but lower among Hispanic or Latino pregnant people (25 percent), and lowest among Black pregnant people (15.6 percent).

Through September 27th, there were more than 125,000 confirmed cases of COVID-19 in pregnant people ([link removed]) including more than 22,000 hospitalized and 161 deaths; of which, 22 deaths occurred in the month of August alone. Cases of COVID-19 in symptomatic, pregnant people have a two-fold risk of admission into intensive care and a 70 percent increased risk of death. Pregnant people with COVID-19 are at increased risk of adverse pregnancy outcomes that could include preterm birth, stillbirth, and admission into the ICU of a newborn also infected with COVID-19.

[link removed]

Related Links
* CDC Health Alert Network: COVID-19 Vaccination for Pregnant People to Prevent Serious Illness, Deaths, and Adverse Pregnancy Outcomes ([link removed]) (9/29/21)
* CDC media statement: CDC Statement on Pregnancy Health Advisory ([link removed]) (9/29/21)
* CDC: COVID-19 Vaccines while Pregnant or Breastfeeding ([link removed])
* CDC: Considerations Involving Pregnancy, Lactation, and Fertility ([link removed])
* CDC: Data on COVID-19 during Pregnancy: Severity of Maternal Illness ([link removed])

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IAC summarizes September 29 ACIP meeting on zoster, pneumococcal, and hepatitis B vaccination and other diseases

The Advisory Committee on Immunization Practices ([link removed]) (ACIP) met on September 29, 2021 ([link removed]) , to review information on vaccines to prevent tick-borne encephalitis (TBE), zoster, pneumococcal disease, hepatitis B, and orthopoxvirus diseases. With the exception of TBE, the Committee reviewed each vaccine using its Evidence to Recommendations (EtR) framework to prepare for potential votes during future meetings. No votes were held at this meeting. Presentation slides ([link removed]) are available online, and highlights of the meeting are provided below.

Tick-borne encephalitis (TBE) vaccine – Information was presented on the safety and immunogenicity of TBE vaccine (Ticovac, Pfizer) licensed by FDA on August 13, 2021, as a 3-dose primary series (with a booster, if needed, after 3 years) administered intramuscularly to individuals age 1 year or older. TBE does not occur naturally in the Americas; however, this vaccine and similar vaccines have been in use in endemic countries for decades with high levels of effectiveness against TBE reported. ACIP is considering recommendations for U.S. adults and children at risk of exposure to infected ticks while traveling in endemic regions of Europe and Asia and workers at risk of exposure to TBE virus in a laboratory setting. Because the disease is rare, the vaccine has been approved based on its immunogenicity, with protective antibody levels detected in at least 94% of vaccine recipients after 3 years. Available data identified no major safety issues and few systemic or severe local reactions
reported. A vote is proposed for the February 2022 ACIP meeting.

Zoster vaccine – ACIP discussed policy options and evidence to support the use of recombinant shingles vaccine (Shingrix, GSK) as a 2-dose series in immunocompromised people age 19 years and older. Because Shingrix is already recommended for immunocompetent adults age 50 years and older and licensed for all adults age 50 and older, there was little specific discussion of this age group. The benefit of vaccination varies widely due to the different degrees of risk of shingles and its complications among people with different types of immunocompromising conditions. However, adults age 19 through 49 with common autoimmune conditions, such as psoriasis, remain at 2- to 4-fold higher risk than the healthy people age 50 or older currently recommended for vaccination. Due to this variability, the work group endorsed support for a simple, broad ACIP recommendation. A vote is anticipated at a future ACIP meeting.

Pneumococcal vaccine – ACIP reviewed policy options for the use of two new pneumococcal conjugate vaccines licensed by FDA during summer 2021: a 15-valent pneumococcal conjugate vaccine (PCV15, Merck) and a 20-valent PCV (PCV20, Pfizer). They compared each vaccine separately against current pneumococcal vaccine recommendations. They did not compare the two new vaccines against each other. The work group had settled on a list of possible policies. For PCV20, they evaluated the evidence to support recommending PCV20 for all adults beginning at either age 50 years or age 65 years, and they also evaluated PCV20 for younger adults beginning at age 19 years who have chronic medical conditions or immunocompromise. For PCV15, the work group considered it only if used in combination with the current 23-valent pneumococcal polysaccharide vaccine (PPSV23), beginning at 65 and older for all or beginning at age 19 years for people with chronic medical conditions or immunocompromise. Economically, the
PCV20 recommendations were more favorable than the PCV15+PPSV23 options; however, it is possible for the ACIP to recommend both. Discussion focused on the complexity of the pneumococcal vaccination schedule and hopes for a simpler set of recommendations. A vote is anticipated at the upcoming October 20–21 meeting.

Hepatitis B vaccine (HepB) – ACIP reviewed evidence to support a potential recommendation for HepB vaccination of all unvaccinated adults, replacing the current recommendations that limit HepB vaccination to those who report risk factors or who request it. Such an expansion would address persistent rates of acute hepatitis B infection among adults, especially those age 30 to 50 years without reported risk factors. There are federal public health goals to reduce acute hepatitis B infections by 90% by 2030, but adult vaccination rates remain low. In addition to the policy discussion, a large, observational safety study was presented comparing the risk of an acute myocardial infarction after vaccination with either 3-dose hepatitis B vaccine (Engerix-B, GSK) or 2-dose hepatitis B vaccine (Heplisav-B, Dynavax) showing no evidence of any difference in risk of acute myocardial infarction by type of hepatitis B vaccine given. After receiving the work group’s conclusion to recommend the expansion,
the committee discussed the relative value of a universal vaccination policy compared to the current risk-based recommendations. A vote is anticipated for the upcoming October 20–21 ACIP meeting.

Orthopoxvirus vaccines – The committee ended its day with a discussion of proposed recommendations for the use of a non-replicating vaccine (Jynneos, Bavarian Nordic) against orthopoxviruses (a family of viruses that includes monkeypox, vaccinia, and smallpox). Jynneos is approved as a 2-dose series (0, 4 weeks) administered subcutaneously and available only through the federal Strategic National Stockpile (SNS) to designated recipients. The vaccine is being considered by ACIP only for research and clinical laboratory personnel performing diagnostic testing for orthopoxviruses and for designated response teams at risk of occupational exposure. Booster doses are being considered every 2 years for individuals at ongoing risk of exposure to high virulence orthopoxviruses (i.e., monkeypox, smallpox) and every 10 years for individuals at ongoing risk of exposure to lower virulence orthopoxviruses (e.g., cowpox, vaccinia). Jynneos is being considered as an alternative to the current live vaccinia
vaccine, ACAM2000 (Emergent BioSolutions), which is based on the traditional smallpox vaccine and administered by scarification of the skin. As a non-replicating vaccine, Jynneos has a lower risk of serious adverse events and fewer contraindications than ACAM2000. A vote is proposed for the October 20–21 meeting.

Future ACIP Meetings
The next regularly scheduled ACIP meeting will be held on October 20–21. However, in the interim, ACIP may call additional meetings to address updated recommendations for use of any FDA-authorized COVID-19 vaccine(s). Information about past and future ACIP meetings ([link removed]) may be found on the ACIP website.
Related Links
* CDC: ACIP meeting information ([link removed]) web page
* CDC: September 29, 2021 ([link removed]) (PDF)
* CDC: ACIP Presentation Slides: September 29, 2021, Meeting ([link removed]) web page
* CDC: Tick-Borne Encephalitis Vaccine ([link removed]) web page
* CDC: Shingles (Herpes Zoster) Vaccination Information for Healthcare Providers ([link removed]) web page
* CDC: Pneumococcal Vaccination: Information for Healthcare Professionals ([link removed]) web page
* CDC: Hepatitis B Vaccination: Information for Healthcare Providers ([link removed]) web page
* CDC: Monkeypox and Smallpox Vaccine Guidance ([link removed]) web page

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New VIS translations to download now: IAC posts Arabic, Burmese, French, and Somali translations of August 6 Vaccine Information Statements for multiple vaccines

IAC has posted new translations of Vaccine Information Statements ([link removed]) (VISs) issued by CDC on August 6. The new languages available are Arabic, Burmese, French, and Somali. All translations are available in PDF and print-ready format.

VIS translations in Arabic ([link removed]) :
* DTaP (Diphtheria, Tetanus, Pertussis) PDF ([link removed]) (view in English ([link removed]) )
* Haemophilus influenzae type b (Hib) PDF ([link removed]) (view in English ([link removed]) )
* HPV (Human Papillomavirus) PDF ([link removed]) (view in English ([link removed]) )
* Influenza, inactivated PDF ([link removed]) (view in English ([link removed]) )
* Influenza, live intranasal PDF ([link removed]) (view in English ([link removed]) )
* Meningococcal ACWY PDF ([link removed]) (view in English ([link removed]) )
* Meningococcal B PDF ([link removed]) (view in English ([link removed]) )
* MMR (Measles, Mumps, and Rubella) PDF ([link removed]) (view in English ([link removed]) )
* MMRV (Measles, Mumps, Rubella, and Varicella) PDF ([link removed]) (view in English ([link removed]) )
* Pneumococcal Conjugate (PCV13) PDF ([link removed]) (view in English ([link removed]) )
* Polio PDF ([link removed]) (view in English ([link removed]) )
* Td (Tetanus, Diphtheria) PDF ([link removed]) (view in English ([link removed]) )
* Tdap (Tetanus, Diphtheria, Pertussis) PDF ([link removed]) (view in English ([link removed]) )
* Varicella (Chickenpox) PDF ([link removed]) (view in English ([link removed]) )

VIS translations in Burmese ([link removed]) :·
* DTaP (Diphtheria, Tetanus, Pertussis) PDF ([link removed]) (view in English ([link removed]) )
* Haemophilus influenzae type b (Hib) PDF ([link removed]) (view in English ([link removed]) )
* HPV (Human Papillomavirus) PDF ([link removed]) (view in English ([link removed]) )
* Influenza, inactivated PDF ([link removed]) (view in English ([link removed]) )
* Influenza, live intranasal PDF ([link removed]) (view in English ([link removed]) )
* Meningococcal ACWY PDF ([link removed]) (view in English ([link removed]) )
* Meningococcal B PDF ([link removed]) view in English ([link removed]) )
* MMR (Measles, Mumps, and Rubella) PDF ([link removed]) (view in English ([link removed]) )
* MMRV (Measles, Mumps, Rubella, and Varicella) PDF ([link removed]) (view in English ([link removed]) )
* Pneumococcal Conjugate (PCV13) PDF ([link removed]) (view in English ([link removed]) )
* Polio PDF ([link removed]) (view in English ([link removed]) )
* Td (Tetanus, Diphtheria) PDF ([link removed]) (view in English ([link removed]) )
* Tdap (Tetanus, Diphtheria, Pertussis) PDF ([link removed]) (view in English ([link removed]) )
* Varicella (Chickenpox) PDF ([link removed]) (view in English ([link removed]) )

VIS translations in French ([link removed]) :
* DTaP (Diphtheria, Tetanus, Pertussis) PDF ([link removed]) (view in English ([link removed]) )
* Haemophilus influenzae type b (Hib) PDF ([link removed]) (view in English ([link removed]) )
* HPV (Human Papillomavirus) PDF ([link removed]) (view in English ([link removed]) )
* Influenza, inactivated PDF ([link removed]) (view in English ([link removed]) )
* Influenza, live intranasal PDF ([link removed]) (view in English ([link removed]) )
* Meningococcal ACWY PDF ([link removed]) (view in English ([link removed]) )
* Meningococcal B PDF ([link removed]) (view in English ([link removed]) )
* MMR (Measles, Mumps, and Rubella) PDF ([link removed]) (view in English ([link removed]) )
* MMRV (Measles, Mumps, Rubella, and Varicella) PDF ([link removed]) (view in English ([link removed]) )
* Pneumococcal Conjugate (PCV13) PDF ([link removed]) (view in English ([link removed]) )
* Polio PDF ([link removed]) (view in English ([link removed]) )
* Td (Tetanus, Diphtheria) PDF ([link removed]) (view in English ([link removed]) )
* Tdap (Tetanus, Diphtheria, Pertussis) PDF ([link removed]) (view in English ([link removed]) )
* Varicella (Chickenpox) PDF ([link removed]) (view in English ([link removed]) )

VIS translations in Somali ([link removed]) :
* DTaP (Diphtheria, Tetanus, Pertussis) PDF ([link removed]) (view in English ([link removed]) )
* Haemophilus influenzae type b (Hib) PDF ([link removed]) (view in English ([link removed]) )
* HPV (Human Papillomavirus) PDF ([link removed]) (view in English ([link removed]) )
* Influenza, inactivated PDF ([link removed]) (view in English ([link removed]) )
* Influenza, live intranasal PDF ([link removed]) (view in English ([link removed]) )
* Meningococcal ACWY PDF ([link removed]) (view in English ([link removed]) )
* Meningococcal B PDF ([link removed]) (view in English ([link removed]) )
* MMR (Measles, Mumps, and Rubella) PDF ([link removed]) (view in English ([link removed]) )
* MMRV (Measles, Mumps, Rubella, and Varicella) PDF ([link removed]) (view in English ([link removed]) )
* Pneumococcal Conjugate (PCV13) PDF ([link removed]) (view in English ([link removed]) )
* Polio PDF ([link removed]) (view in English ([link removed]) )
* Td (Tetanus, Diphtheria) PDF ([link removed]) (view in English ([link removed]) )
* Tdap (Tetanus, Diphtheria, Pertussis) PDF ([link removed]) (view in English ([link removed]) )
* Varicella (Chickenpox) PDF ([link removed]) view in English ([link removed]) )

These join the other languages previously announced in IACX: Chinese (Simplified and Traditional) ([link removed]) , Dari ([link removed]) , Pashto ([link removed]) , Russian ([link removed]) , Spanish ([link removed]) , Turkish ([link removed]) , and Vietnamese ([link removed]) .

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]) main 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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"Safety Monitoring of an Additional Dose of COVID-19 Vaccine—United States, August 12–September 19, 2021" published in MMWR Early Release

CDC published Safety Monitoring of an Additional Dose of COVID-19 Vaccine—United States, August 12–September 19, 2021 ([link removed]) on September 28 as an MMWR Early Release. A portion of the summary appears below.

Among 306 Pfizer-BioNTech clinical trial participants, adverse reactions after dose 3 were similar to those after dose 2....

During August 12–September 19, 2021, among 12,591 v-safe registrants who completed a health check-in survey after all 3 doses of an mRNA COVID-19 vaccine, 79.4% and 74.1% reported local or systemic reactions, respectively, after the third dose; 77.6% and 76.5% reported local or systemic reactions after the second dose, respectively....

Voluntary reports to v-safe found no unexpected patterns of adverse reactions after an additional dose of COVID-19 vaccine. CDC will continue to monitor vaccine safety, including for additional COVID-19 doses.

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

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


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IAC SPOTLIGHT: CHECK OUT THE IMMUNIZE.ORG RESOURCES TO HELP WITH YOUR VACCINE ADVOCACY

In this week's IAC Spotlight, we summarize resources at Immunize.org that focus on aiding in your vaccine advocacy efforts.

Our State Laws and Mandates by Vaccine ([link removed]) main page contains links to vaccine-specific requirements state-by-state for daycare, K-12, and post-secondary education settings. State-specific information about exemption policies is available as well.

Our State Exemptions ([link removed]) main page offers information on state mandates by vaccine-preventable disease. It includes policy statements from medical organizations endorsing strong school and childcare vaccination requirements and the elimination of non-medical exemptions.

Our State Information: Exemptions Permitted for State Immunization Requirements ([link removed]) web page shows which states allow medical, religious, and personal vaccination exemptions and offers a map of exemptions permitted for school and child care.

Our State Information: Direct Links to State Immunization Websites ([link removed]) main page offers links to each state's vaccination policy web page.

Our Talking about Vaccines ([link removed]) main page provides medical professionals with background information and practical resources divided into different topics that will help them discuss immunization with concerned parents or patients.

Our Unprotected People Stories ([link removed]) main page features 109 real-life accounts of people who have suffered or died from vaccine-preventable diseases: compelling personal testimonies, remembrances, case reports, and newspaper articles.

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IAC’S HEPATITIS B BIRTH DOSE HONOR ROLL RECOGNIZES 540 INSTITUTIONS, INCLUDING ONE NEW HONOREE. FIVE PREVIOUSLY HONORED INSTITUTIONS QUALIFY FOR ADDITIONAL YEARS' HONORS.

The Immunization Action Coalition (IAC) is pleased to announce that one new institution has been accepted into its Hepatitis B Birth Dose Honor Roll ([link removed]) , for a total of 540 honorees. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.
* Brigham and Women’s Hospital, Boston, MA (92%)

One institution is being recognized for a second year:
* Salina Regional Health Center, Salina, KS (91%)

Two institutions are being recognized for a third year:
* Covenant Children’s Hospital, Lubbock, TX (93%)
* Geary Community Hospital, Junction City, KS (94%)

One institution is being recognized for a fourth year:
* Greene County General Hospital, Linton, IN (96%)

Finally, one institution is being recognized for a fifth year:
* ChristianaCare Christiana Hospital, Newark, DE (93%)

The Honor Roll now includes 540 birthing institutions from 44 states, Puerto Rico, Guam, Saipan, and a U.S. military base in England. One hundred twenty-two institutions have qualified twice, 73 institutions have qualified three times, 42 institutions have qualified four times, 25 institutions have qualified five times, 23 institutions have qualified six times, eight institutions have qualified seven times, two institutions have qualified eight times and one institution has qualified nine times.

The Honor Roll is a key part of IAC’s major initiative urging the nation’s hospitals to Give Birth to the End of Hep B ([link removed]) . Hospitals and birthing centers are recognized for attaining high coverage rates for administering hepatitis B vaccine at birth and meeting specific additional criteria. The initiative urges qualifying healthcare organizations to apply for the Hepatitis B Birth Dose Honor Roll online ([link removed]) .

To be included in the Hepatitis B Birth Dose Honor Roll, a birthing institution must have: (1) reported a coverage rate of 90% or greater, over a 12-month period, for administering hepatitis B vaccine before hospital discharge to all newborns, including those whose parents refuse vaccination, and (2) implemented specific written policies, procedures, and protocols to protect all newborns from hepatitis B virus infection before hospital discharge.

Honorees are also awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IAC Express’s 52,000+ readers.

Please visit the Hepatitis B Birth Dose Honor Roll web page ([link removed]) that lists these institutions and their exceptional efforts to protect infants from perinatal hepatitis B transmission.

Related IAC Resources
* Give Birth to the End of Hep B ([link removed]) main page
* Fact sheet about honor roll: Do You Qualify for the Hepatitis B Birth Dose Honor Roll? If So, Apply Today. ([link removed])
* Handout on IAC’s campaign: Give Birth to the End of Hep B ([link removed])
* Hepatitis B Birth Dose Honor Roll ([link removed]) web page

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Your colleagues don’t want to be the last to know. Urge them to subscribe to IAC Express for free.

IAC Express ([link removed]) , the free weekly e-newsletter produced by the Immunization Action Coalition ([link removed]) (IAC), succinctly summarizes each week’s important vaccine developments, including new and updated recommendations from CDC and the latest vaccine decisions by FDA. IAC Express also features newly posted Vaccine Information Statements and their translations, plus educational materials from IAC, CDC, AAP, and others. Subscribers learn about online and in-person educational opportunities, many offering free continuing education credit.

[link removed]

We appreciate you as a subscriber! Encourage your co-workers to subscribe to IAC Express ([link removed]) themselves so they get everything that matters to vaccinators in their own inbox each Wednesday.


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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.
* AMA: COVID-19 Not the Only Condition for Which Many Go Unvaccinated ([link removed]) (9/30/21)
* Wired: What If Getting a Kids’ Vaccine Approved Is the Easy Part? ([link removed]) (9/28/21)
* Alliance for Health Policy: Preparing for Flu Season and Preventing Another Pandemic ([link removed]) (9/24/21)

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.
* Washington Post: How the Phrase ‘Natural Immunity’ Misleads Us about Real Risks and Dangers ([link removed]) (9/29/21)
* Washington Post: YouTube Is Banning Prominent Anti-vaccine Activists and Blocking All Anti-vaccine Content ([link removed]) (9/29/21)
* Shot of Prevention: Flu 2021 Forecast: Do I Still Need a Flu Vaccine This Year Even If Last Season Was Mild? ([link removed]) (9/29/21)
* New York Times: Many Health Workers at Big U.S. Hospital Chains with Vaccine Mandates Are Getting Shots ([link removed]) (9/29/21)
* NPR: Lots of People Say They’ll Quit over Vaccine Mandates, but Research Shows Few Do ([link removed]) (9/29/21)
* NPR: Getting a Religious Exemption to a Vaccine Mandate May Not Be Easy. Here’s Why. ([link removed]) (9/28/21)
* CNN: What Experts Say about the Best Time to Get a Flu Shot This Year ([link removed]) (9/28/21)
* Shot of Prevention: COVID Vaccine Boosters: What You Need to Know ([link removed] ) (9/28/21)


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Immunize.org Pages and Handouts
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IAC and AIM update print-ready training tool: "Communicating the Benefits of Influenza Vaccine during COVID-19"

IAC and the Association of Immunization Managers (AIM) recently updated the print-ready training tool Communicating the Benefits of Influenza Vaccine during COVID-19 ([link removed]) for discussing the flu vaccine with patients. The 2021–2022 influenza season modifications include:
* Updated CDC estimates of the annual impact from influenza
* Updated influenza vaccination rates
* Acknowledgement of the risk of increased influenza activity in the 2021–22 season as masking and social distancing are relaxed
* Calls for co-administration of influenza and COVID-19 vaccines for those who need both
* Updated references

[link removed]

Related Links
* IAC: Vaccines: COVID-19 ([link removed]) main page
* IAC: Vaccines: Influenza ([link removed]) main page
* IAC:Handouts ([link removed]) main page to see educational materials sorted by category
* 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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ECHO: THESE UPDATED IAC EDUCATIONAL MATERIALS FOR CLINICIANS WERE RELEASED DURING AUGUST AND SEPTEMBER

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, updates were made to these helpful materials:

IAC’s Updated Materials for Clinicians
* Vaccines with Diluents: How to Use Them ([link removed])
* Temperature logs for refrigerators available in Fahrenheit ([link removed]) or Celsius ([link removed])
* Temperature logs for freezers available in Fahrenheit ([link removed]) or Celsius ([link removed])
* Vaccine Storage Troubleshooting Record ([link removed])
* Checklist for Safe Vaccine Storage and Handling ([link removed])
* Don't Be Guilty of the Preventable Errors in Vaccine Storage and Handling! ([link removed])
* Supplies You May Need at an Immunization Clinic ([link removed])

IAC’s Updated Influenza Web Page and Materials for Clinicians
* Ask the Experts: Influenza ([link removed]) web page (updated 9/16/2021)
* Influenza Vaccine Products for the 2021–2022 Influenza Season ([link removed])
* Standing Orders for Administering Influenza Vaccine to Children and Teens ([link removed])
* Standing Orders for Administering Influenza Vaccine to Adults ([link removed])
* Screening Checklist for Contraindication to Inactivated Injectable Influenza Vaccination ([link removed])
* Screening Checklist for Contraindications to Live Attenuated Intranasal Influenza Vaccination ([link removed])

Related Links
* IAC: Handouts ([link removed]) main page to see educational materials sorted by category
* IAC: Ask the Experts ([link removed]) main page to access more than 1,000 questions answered by IAC experts
* IAC: Clinic Tools ([link removed]) main 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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Echo: These new VISs and VIS translations were released during August and September

IAC Express regularly provides readers with information about Vaccine Information Statements (VISs) and translations of VISs.

In August, CDC released updated final versions of 14 VISs. During September, IAC posted translations in Arabic ([link removed]) , Burmese ([link removed]) , Chinese (Simplified and Traditional) ([link removed]) , Dari ([link removed]) , French ([link removed]) , Pashto ([link removed]) , Russian ([link removed]) , Somali ([link removed]) , Spanish ([link removed]) , Turkish ([link removed]) , and Vietnamese ([link removed]) . Here are links to the web page of each new VIS and the available translations:
* DTaP (Diphtheria, Tetanus, Pertussis) Vaccine ([link removed])
* Haemophilus influenzae Type b (Hib) Vaccine ([link removed])
* HPV (Human Papillomavirus) Vaccine ([link removed])
* Influenza (Inactivated or Recombinant) Vaccine ([link removed])
* Influenza (Live, Intranasal) Vaccine ([link removed])
* Meningococcal ACWY Vaccine ([link removed])
* Meningococcal B Vaccine ([link removed])
* MMR Vaccine ([link removed])
* MMRV Vaccine ([link removed])
* Pneumococcal Conjugate (PCV13) Vaccine ([link removed])
* Polio Vaccine ([link removed])
* Td Vaccine ([link removed])
* Tdap Vaccine ([link removed])
* Varicella Vaccine ([link removed])

Plus, two IAC handouts related to VISs were updated: Dates of Current Vaccine Information Statements (VISs ([link removed]) ) and You Must Provide Patients with Vaccine Information Statements (VISs) – It's Federal Law! ([link removed])

Related Links
* IAC: Vaccine Information Statement ([link removed]) main page for VISs in 47 languages
* 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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CDC PROVIDES FIELD GUIDE WITH 12 EVIDENCE-BASED STRATEGIES TO PROMOTE COVID-19 VACCINATION CONFIDENCE AND UPTAKE

CDC has produced the COVID-19 Vaccination Field Guide: 12 Strategies for Your Community ([link removed]) to promote COVID-19 vaccination. This guide highlights several strategies derived from evidence-based practices that are being applied in communities to promote vaccine confidence and uptake. The guide is intended to support the work of health departments, community organizations, faith-based communities, and leaders from all sectors of public life.

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The first section highlights some common barriers that communities experience in vaccine confidence and uptake. Because not all barriers are relevant in all communities, the second section of this guide offers tools you can use to identify and understand what barriers and facilitators may be factors in your community. You may need only one of these tools or several to increase your understanding of your community. The final section describes 12 strategies to increase vaccine confidence and uptake. The research that supports each strategy is provided along with case study examples.

While most of the guide focuses on increasing vaccine uptake, several strategies address increasing vaccine confidence. Each strategy highlights the approach, population(s) served, location, barriers addressed, basis in research, and an example of how the strategy is currently being applied to address COVID-19 vaccination.

Related Link
* CDC: COVID-19 Vaccination Field Guide: 12 Strategies for Your Community ([link removed]) (PDF)

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PUBLIC HEALTH COMMUNICATIONS COLLABORATIVE RELEASES RESOURCES TO HELP ANSWER QUESTIONS ABOUT COVID-19 VACCINE BOOSTER DOSES AND SUPPORT VACCINATION OUTREACH

Public Health Communications Collaborative offers resources ([link removed]) to address questions about COVID-19 vaccine booster doses and support local vaccination outreach. The resources include:
* Topline Messages ([link removed])
* Answers to Tough Questions ([link removed])
* Social Media Sample Posts and Shareable Graphics ([link removed])

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Related Link
* Public Health Communications Collaborative: Resource: COVID-19 Booster Dose Messaging and Outreach Tools ([link removed] )

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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.

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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, laminated schedules, record cards, and other products offered by IAC

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EXPLORE THE 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]).

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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 ([link removed]) about the importance of vaccination, 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])
* You're 16: We Recommend These Vaccines for You ([link removed])
* 2020 ACIP Meningococcal Vaccine Recommendations ([link removed])
* Adolescent Vaccination Coverage in the U.S. ([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
* Ask the Experts: Meningococcal ACWY ([link removed])


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IAC'S RED "FLU VACCINE" BUTTONS AND STICKERS ARE A BRIGHT IDEA. ORDER TODAY!

Remember to order your IAC “FLU VACCINE” buttons and stickers ([link removed]) . They are ready to ship! Their bright red color highlights your important message about the need for influenza vaccination. And the cost is reasonable.

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“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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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.

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If you have a vaccination-related event that you would like your colleagues to know about via this Calendar of Events, email IAC (mailto:[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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Notable Publications
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CHOP's Vaccine Education Center publishes September issue of Vaccine Update newsletter

The Vaccine Education Center (VEC) ([link removed]) at Children's Hospital of Philadelphia (CHOP) publishes a monthly immunization-focused newsletter titled Vaccine Update for Providers. The September issue ([link removed]) includes the following articles:
* In the Journals: Mixing COVID-19 Vaccines ([link removed]) by Paul A. Offit, MD
* Technically Speaking—Do You Know the Answers to These Questions about 2021–2022 Influenza Vaccination Recommendations? ([link removed]) by Sharon G. Humiston, MD, MPH

Additional resources, including information booklets for patients, are available in the full newsletter ([link removed]).

Access the sign-up form ([link removed]) to subscribe to Vaccine Update for Providers.


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"Disparities in COVID-19 Vaccination Status, Intent, and Perceived Access for Noninstitutionalized Adults, by Disability Status—National Immunization Survey Adult COVID Module, United States, May 30–June 26, 2021" published in MMWR

CDC published Disparities in COVID-19 Vaccination Status, Intent, and Perceived Access for Noninstitutionalized Adults, by Disability Status—National Immunization Survey Adult COVID Module, United States, May 30–June 26, 2021 ([link removed]) in a September 30 MMWR. A summary appears below.

An analysis of CDC survey data show adults with a disability were more likely to report difficulty getting a COVID-19 vaccine compared to adults without a disability. Despite disparities related to COVID-19 vaccine access, adults with a disability are less likely to report vaccine hesitancy compared to adults without a disability....Adults with a disability were more likely to report difficulty getting a COVID-19 vaccine due to challenges with getting an appointment online, not knowing where to get vaccinated, and getting to a vaccination site compared to adults without a disability. Efforts that make COVID-19 vaccination more accessible for adults with disabilities could help address inequities and increase vaccination demand and coverage.

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

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

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“Protection of BNT162b2 Vaccine Booster against COVID-19 in Israel” published in NEJM

In the September 15 issue, NEJM published Protection of BNT162b2 Vaccine Booster against COVID-19 in Israel ([link removed]) . The conclusions section appears below.
In this study involving participants who were 60 years of age or older and had received two doses of the [Pfizer-BioNTech] BNT162b2 vaccine at least 5 months earlier, we found that the rates of confirmed Covid-19 and severe illness were substantially lower among those who received a booster (third) dose of the BNT162b2 vaccine.

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“Effectiveness of mRNA Covid-19 Vaccine among U.S. Health Care Personnel” published in NEJM

In the September 22 issue, NEJM published Effectiveness of mRNA Covid-19 Vaccine among U.S. Health Care Personnel ([link removed]). The conclusions section appears below.

The [Pfizer-BioNTech] BNT162b2 and [Moderna] mRNA-1273 vaccines were highly effective under real-world conditions in preventing symptomatic Covid-19 in health care personnel, including those at risk for severe Covid-19 and those in racial and ethnic groups that have been disproportionately affected by the pandemic.



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Upcoming Events
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VIRTUAL: MASSACHUSETTS IMMUNIZATION ACTION PARTNERSHIP HOSTS 26TH ANNUAL "MIAP PEDIATRIC IMMUNIZATION SKILLS BUILDING CONFERENCE" ON OCTOBER 28; CE AVAILABLE


Massachusetts Immunization Action Partnership (MIAP) will host 26th Annual MIAP Pediatric Immunization Skills Building Conference ([link removed]) from 8:00 a.m.–3:45 p.m. (ET) on October 28. This full-day virtual pediatric conference will provide up-to-date information with an emphasis on current recommendations and general updates. Learning objectives include:
* Summarize the current Advisory Committee on Immunization Practices (ACIP) schedules and recommendations
* Cite two current topics related to immunizations in Massachusetts and nationally
* Describe current COVID-19 vaccine recommendations
* Review strategies to identify and catch up children who have fallen behind on their vaccinations

CE is available upon completion of the event. There is a $75 fee to attend.

Register for the event. ([link removed])

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VIRTUAL: UNIVERSITY OF NEVADA, LAS VEGAS OFFERS WEBINAR TITLED COVID-19 VACCINES, MASKS, AND MANDATES: EXPLORING THE LEGAL BOUNDARIES OF PUBLIC HEALTH PROTECTIONS ON NOVEMBER 4

The University of Nevada, Las Vegas (UNLV), William S. Boyd School of Law will host COVID-19 Vaccines, Masks, and Mandates: Exploring the Legal Boundaries of Public Health Protections ([link removed]) from 3:00–4:00 p.m. (PT) on November 4. As virus variations, vaccine hesitancy, and political divergences over personal freedoms fuel a new surge of the COVID-19 pandemic, governments and businesses have adopted or renewed mandates for vaccination, masking, closures, and other measures to stem the rising tide of cases. In this presentation, James G. Hodge, Jr., JD, LLM, director of the Center for Public Health Law and Policy at the Sandra Day O’Connor College of Law, Arizona State University, will discuss legal supports, limits, and practicalities underlying mandates and other public health preventative measures in an evolving legal and political environment.

Register for the event. ([link removed])


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IAC Express

IAC Express Home ([link removed])

2021 Issues ([link removed])

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2018 ([link removed]) – (#IACX4) 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 (mailto:[email protected])
Managing Editor
John Grabenstein, RPh, PhD (mailto:[email protected])
Associate Editor
Sharon Humiston, MD, MPH (mailto:[email protected])
Writer/Publication Coordinator
Taryn Chapman, MS (mailto:[email protected])
Courtnay Londo, MA (mailto:[email protected])
Style and Copy Editor
Marian Deegan, JD (mailto:[email protected])
Web Edition Manager
Sheila M. Franey, MA
Contributing Writer
Laurel H. Wood, MPA (mailto:[email protected])
Technical Reviewer
Robin VanOss (mailto:[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. 1NH23IP922654 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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