From Immunize.org <[email protected]>
Subject IZ Express #1,657: Association of COVID-19 infection with new-onset diabetes in children, and more
Date October 12, 2022 10:30 AM
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Issue 1,657: October 12, 2022

Top Stories
* "Association of SARS-CoV-2 Infection with New-Onset Type 1 Diabetes among Pediatric Patients from 2020 to 2021" published in JAMA Network Open
* Pediatric Infectious Diseases Society offers free access to Comprehensive Vaccine Education Program
* CDC and the National Foundation for Infectious Diseases kick off the 2022–23 influenza vaccination season; CDC’s FluView surveillance reports now posting
* American Pharmacists Month celebrated in October; U.S. pharmacists delivered half of COVID-19 vaccinations to date
* Spotlight: Immunize.org resources focused on vaccination during pregnancy
* Vaccines in the news


Immunize​.org Pages and Handouts
* Immunize​.org updates “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools”; review your documents monthly


Featured Resources
* 2022 edition of The Vaccine Handbook App is available in free iOS and Android formats, courtesy of Pediatric Infectious Diseases Society
* Voices for Vaccines releases podcast with Paul Offit to discuss studies on aluminum
* Organizing a new vaccination program? Use Immunize.org’s Vaccinating Adults: A Step-by-Step Guide—free to download by chapter or in its entirety.


Notable Publications
* “Essential Services: Quantifying the Contributions of America’s Pharmacists in COVID-19 Clinical Interventions” published in Journal of the American Pharmacists Association
* “QuickStats: Percentage of Residential Care Communities That Offer Annual Influenza Vaccination to Residents and to Employees and Contract Staff Members, by Community Bed Size—United States, 2020” published in MMWR


Upcoming Events
* On-demand: CDC’s “The Pink Book” chapter webinars on vaccine-preventable diseases and best practices roll out weekly. Pneumococcal vaccines webinar now available, with CE.


Editorial Information
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Top Stories
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"Association of SARS-CoV-2 Infection with New-Onset Type 1 Diabetes among Pediatric Patients from 2020 to 2021" published in JAMA Network Open

In the September 23 issue, JAMA Network Open published Association of SARS-CoV-2 Infection with New-Onset Type 1 Diabetes among Pediatric Patients from 2020 to 2021 ([link removed]). A portion of the discussion section appears below.

In this study, new T1D [type 1 diabetes] diagnoses were more likely to occur among pediatric patients with prior COVID-19 than among those with other respiratory infections (or with other encounters with health systems). Respiratory infections have previously been associated with onset of T1D, but this risk was even higher among those with COVID-19 in our study, raising concern for long-term, post–COVID-19 autoimmune complications among youths. Study limitations include potential biases owing to the observational and retrospective design of the electronic health record analysis, including the possibility of misclassification of diabetes as type 1 vs type 2, and the possibility that additional unidentified factors accounted for the association. Results should be confirmed in other populations. The increased risk of new-onset T1D after COVID-19 adds an important consideration for risk-benefit discussions for prevention and treatment of SARS-CoV-2 infection in pediatric populations.

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Pediatric Infectious Diseases Society offers free access to Comprehensive Vaccine Education Program

The Pediatric Infectious Diseases Society (PIDS) offers free access to its two-pronged Comprehensive Vaccine Education Program ([link removed]) (CVEP). CVEP aims to help trainees (e.g., medical or nursing students) who need an introduction to key vaccination topics and experienced providers who want a refresher.

CVEP consists of two innovative components available via the QR code above.
* Collaboration for Vaccine Education and Research (CoVER) program: This online curriculum with 19 interactive modules includes topics such as vaccine fundamentals, safety, specific vaccine-preventable diseases, and how to communicate effectively about vaccines. The updated modules are more user-friendly, and the program now features group enrollment to a learning management system that enables program directors to track learners’ progress. This is useful whether you use a set of modules (e.g., residencies) or single modules (e.g., coalitions’ performance improvement projects). Immunize​.org’s director for research, Sharon G. Humiston, MD, MPH, is the lead author of the CoVER curriculum.

* The Vaccine Handbook App (TVH App): Available for iOS and Android devices, the app contains the new 11th edition of The Vaccine Handbook: A Practical Guide for Clinicians (also known as “The Purple Book”). TVH App provides key details about every vaccine licensed in the United States and much more.

Learn more about CVEP and enrollment here ([link removed]).

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CDC and the National Foundation for Infectious Diseases kick off the 2022–23 influenza vaccination season; CDC’s FluView surveillance reports now posting

CDC and the National Foundation for Infectious Diseases (NFID) kicked off the 2022–23 flu vaccination season during an October 4 press conference held at the National Press Club in Washington, DC. A summary of the event is available at 2022–2023 Flu Vaccination Campaign Kickoff ([link removed]).

CDC’s surveillance systems are reporting an increasing proportion of clinical specimens testing positive for influenza, especially in the southeastern United States. CDC expects influenza activity, which is currently minimal, to increase in the coming weeks or months. CDC’s Weekly U.S. Influenza Surveillance Report, FluView ([link removed]), provides a valuable snapshot of influenza activity state-by-state.

Influenza Surveillance
For week 39, ending October 1, CDC's Weekly U.S. Influenza Surveillance Report, FluView ([link removed]) reports that, nationwide, 2.4% of patient visits reported through the outpatient Influenza-Like Surveillance Network (ILINet) were due to respiratory illness that included fever plus a cough or sore throat (i.e., influenza-like illness [ILI]). Multiple respiratory viruses are co-circulating; the relative contribution of influenza virus infection to ILI varies by location.

Influenza Vaccination Dashboard
CDC's Weekly Flu Vaccination Dashboard ([link removed]) data show that 91.2 million doses of influenza vaccine have been distributed in the United States through September 24, 2022. Vaccine manufacturers project that they will supply the United States with 173.5 million to 183.5 million doses for the 2022–23 season.

CDC recommends everyone age 6 months and older get annual influenza vaccination. Influenza and other vaccines (e.g., COVID-19 vaccines) may be given at the same visit, if needed. COVID-19 vaccination alone provides no protection from influenza or any other respiratory virus. To be listed as a provider by VaccineFinder, see the information at this website ([link removed]).

If you don’t provide influenza vaccine at your site, please strongly recommend vaccination and refer people to sites that do vaccinate. To enable easy referral to vaccinating sites, the American College of Physicians offers free Adult Vaccination Prescription Pads ([link removed]*drmh0y*_ga*ntqzmzi5mju1lje2nti4mji3nzy.*_ga_pm4f5hbgfq*mty2mju3nde3os4xntkums4xnjyyntc3mdmxlju5ljauma..&_ga=2.227238552.440966330.1662519116-543329255.1652822776&_gac=1.255840506.1661269092.cj0kcqjw9zgybhcearisaeuxitwuuaivyw-epaaozx8nprmbzpmo8erzuefz5wvnwp97z0cragqoeo8aambfealw_wcb) listing ACIP-recommended vaccines.

“Vaccines.gov” offers VaccineFinder ([link removed]), a service of Boston Children’s Hospital, to help people find influenza and COVID-19 vaccines for any age group.

Related Links
* CDC: Weekly National Flu Vaccination Dashboard ([link removed]) main page
* CDC: FluView ([link removed]) main page
* CDC: Influenza (Flu) ([link removed]) main page
* Immunize.org: free educational materials and patient handouts related to influenza ([link removed])
* Immunize.org: Vaccines: Influenza ([link removed]) main page
* Immunize.org: Ask the Experts: Influenza ([link removed]) main page
* Families Fighting Flu: Flu Resources for Healthcare Professionals ([link removed]) main page

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American Pharmacists Month celebrated in October; U.S. pharmacists delivered half of COVID-19 vaccinations to date

American Pharmacists Month ([link removed]) is observed in October, organized by the American Pharmacists Association (APhA). A portion of the campaign web page appears below.

As the COVID-19 pandemic spread across the United States, pharmacists and their teammates contributed to protecting America's health and promoting recovery by providing lifesaving vaccinations and expanding clinical services in their pharmacies and communities.

According to a recent article in Journal of the American Pharmacists Association (JAPhA) ([link removed](22)00279-5/fulltext), pharmacists plausibly accounted for more than 50% of all COVID-19 vaccinations in the United States, with conservative estimates that pharmacists and their teammates averted over 1 million deaths, more than 8 million hospitalizations, and $450 billion in health care costs because of their pandemic interventions.

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Spotlight: Immunize​.org resources focused on vaccination during pregnancy

In this week's Spotlight, we summarize resources at Immunize​.org that focus on vaccination during pregnancy.

Handouts: Pregnancy and Vaccines ([link removed]) main page offers free access to pregnancy and vaccination-related handouts and fact sheets for healthcare professionals and the public. All items are ready to print, copy, and distribute widely.

Screening Checklists about Vaccine Contraindications and Precautions ([link removed]) main page links you to forms that patients fill out to expedite assessment of vaccination needs and contraindications. These include the labor and delivery HBsAg admission checklist.

Adult Vaccination ([link removed]) main page contains all the Immunize​.org handouts that pertain to adult vaccinations. These include the “Summary of Recommendations for Adult Immunization” that contains many call outs for vaccination during pregnancy.

CDC Schedules ([link removed]) main page provides printable PDF versions of the recommended immunization schedules for adults. The first column in Table 2 of the adult schedule lists the vaccines to give or defer during pregnancy.

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Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.

* Shot of Prevention: Don’t Call It “Just” the Flu ([link removed]) (10/4/22)

* CBS: Health Officials Warn Severe Flu Season Is Coming, Urge Vaccinations ([link removed]) (10/4/22)

* CNBC: Most Americans Don’t Plan to Get a Flu Shot This Season—Lots of Them Say They’ll Mask to Avoid Germs Instead ([link removed]) (10/4/22)

* CNBC: How Polio Came Back to New York for the First Time in Decades, Silently Spread and Left a Patient Paralyzed ([link removed]) (10/4/22)

* Bloomberg Law: Biden Health-Care Vaccine Mandate Survives Supreme Court Appeal ([link removed]) (10/3/22)

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Immunize.org Pages and Handouts
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Immunize​.org updates “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools”; review your documents monthly

Immunize​.org routinely revises its four-page job aid, Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools ([link removed]), to help you keep up with changes to COVID-19 vaccine guidance and resources. The checklist includes the most recent revision dates of CDC’s primary COVID-19 vaccination websites, as well as print-ready PDF documents from CDC and FDA. Each date is hyperlinked to the original document or web page. Immunize​.org updates this list at least monthly, prominently indicating when it was last updated at the top of the page.

The latest version, current as of October 5, 2022, updated several items and removed the Pfizer-BioNTech purple cap formulation of the COVID-19 vaccine, which is no longer in use.

All COVID-19 vaccination providers are encouraged to review this checklist each time it is revised to be sure practices stay up to date.

Related Links
* Immunize​.org: Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools ([link removed]) (PDF)
* Immunize​.org: Vaccines: COVID-19 ([link removed]) main page
* Immunize​.org: Ask the Experts: COVID-19 ([link removed]) web page
* CDC: Interim Clinical Considerations ([link removed]) main page summarizing use of COVID-19 in the United States

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Featured Resources
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2022 edition of The Vaccine Handbook App is available in free iOS and Android formats, courtesy of Pediatric Infectious Diseases Society

The new 2022 The Vaccine Handbook App has been updated with the 11th edition of The Vaccine Handbook ([link removed]) by Gary Marshall, MD, chief of pediatric infectious diseases at the University of Louisville. Sponsored by the Pediatric Infectious Disease Society (PIDS), the app is a comprehensive source of practical information for vaccine providers, educators, and advocates. Highlights of the 11th edition include:
* Information about COVID-19 vaccines and other new vaccines
* Numerous educational resources
* Fully searchable, allowing for bookmarking, highlighting, and annotation, with hyperlinks to valuable online content

The free app is formatted for iOS devices (e.g., iPhones, iPads) and, for the first time, Android devices. The app may be found by searching the Apple App Store or Google Play Store for The Vaccine Handbook App or by using the following QR code.

Print copies of the new 11th edition of The Vaccine Handbook will be available soon and can be purchased online from the publisher, Professional Communications, Inc. ([link removed]) (West Islip, NY). The cost is $39.95 each; bulk discounts are available.

Related Links
* The Vaccine Handbook App ([link removed]) in the Apple App Store
* The Vaccine Handbook App ([link removed]) in the Google Play Store
* The Vaccine Handbook ordering page ([link removed])

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Voices for Vaccines releases podcast with Paul Offit to discuss studies on aluminum

Voices for Vaccines (VFV) posted a new entry in its Vax Talk podcast series: Dr. Offit’s Take on Aluminum ([link removed]) featuring Paul Offit, MD, discussing aluminum as vaccine adjuvants. A description from the VFV web page appears below.

A new study ([link removed]) seems to connect childhood vaccines to asthma. Or does it?

We invited our friend and hero, Dr. Paul Offit, to the show to discuss this study and the other studies from the past investigating vaccines and aluminum adjuvants. Don’t miss his take!

Voices for Vaccines is a national organization of parents and others dedicated to raising the level of the voices of vaccination supporters. VFV invites everyone who values vaccines to become a member, use VFV tools in their own community, and get involved with VFV ([link removed]).

Related Links
* Voices for Vaccines Resources ([link removed]) main page
* Voices for Vaccines podcast page ([link removed])

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Organizing a new vaccination program? Use Immunize​.org’s Vaccinating Adults: A Step-by-Step Guide—free to download by chapter or in its entirety.

Download Immunize​.org’s free 142-page book on adult vaccination to help build your program and train your team: Vaccinating Adults: A Step-by-Step Guide (Guide) ([link removed]).

This thorough "how to" guide on adult vaccination provides easy-to-use, practical information covering all essential activities. It helps vaccine providers enhance their existing adult vaccination services or introduce them into any clinical setting.

The Guide is available to download/print either by chapter or in its entirety free at www.immunize.org/guide ([link removed]). The National Vaccine Program Office and CDC both supported the development of the Guide and provided early technical review.

The Guide is a valuable resource to assist providers in increasing adult vaccination rates. Be sure to get a copy today!

Please note: this guide was produced in 2017, before the COVID-19 era, and reflects the recommendations of that time.

Related Links
* Vaccinating Adults: A Step-by-Step Guide ([link removed]) main page, permitting download of entire Guide (142 pages, PDF) ([link removed])
* View the table of contents and individual chapters (PDF):
+ Table of Contents ([link removed])
+ Step 1: Getting Started ([link removed])
+ Step 2: Setting Up for Vaccination Services ([link removed])
+ Step 3: Vaccine Storage and Handling ([link removed])
+ Step 4: Deciding Whom to Vaccinate ([link removed])
+ Step 5: Administering Vaccines ([link removed])
+ Step 6: Documentation and Related Issues ([link removed])
+ Step 7A: Financial Considerations ([link removed])
+ Step 7B: How to Bill for Adult Immunizations ([link removed])
* Immunize​.org’s educational materials (handouts) on adult immunization ([link removed])

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Notable Publications
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“Essential Services: Quantifying the Contributions of America’s Pharmacists in COVID-19 Clinical Interventions” published in Journal of the American Pharmacists Association

In its August 18 issue, the Journal of the American Pharmacists Association published Essential Services: Quantifying the Contributions of America’s Pharmacists in COVID-19 Clinical Interventions ([link removed](22)00279-5/fulltext), written by Immunize.org's director for scientific communications, John D. Grabenstein. Portions of the abstract appear below.

From February 2020 through September 2022, pharmacists and their teammates conducted >42 million COVID-19 tests, provided >270 million vaccinations (including 8.1 million COVID-19 vaccinations for long-term care residents) within community pharmacy programs alone, and provided >50 million influenza and other vaccinations per year. . . . Pharmacists and their teammates contributed to America’s health and recovery during the COVID-19 pandemic by providing >350 million clinical interventions to >150 million people in the form of testing, parenteral antibodies, vaccinations, antiviral therapies, and inpatient care. The number of lives touched and people cared for by pharmacists continues to rise.

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“QuickStats: Percentage of Residential Care Communities That Offer Annual Influenza Vaccination to Residents and to Employees and Contract Staff Members, by Community Bed Size—United States, 2020” published in MMWR

CDC published QuickStats: Percentage of Residential Care Communities That Offer Annual Influenza Vaccination to Residents and to Employees and Contract Staff Members, by Community Bed Size—United States, 2020 ([link removed]) on October 7 in MMWR. The summary appears below.

In 2020, 87.2% of residential care communities offered annual influenza vaccination to residents, and 77.8% offered annual influenza vaccination to all employees and contract staff members. The percentage of residential care communities offering annual influenza vaccination to residents and to all employees and contract staff members increased with increasing community bed size. The percentage of communities offering vaccination to residents ranged from 75.2% of communities with four to 10 beds to 91.7% with 11–25 beds, 97.0% with 26–100 beds, and 99.1% with more than 100 beds. Communities offering vaccination to all employees and contract staff members ranged from 60.9% of communities with four to 10 beds to 80.3% with 11–25 beds, 92.9% with 26–100 beds, and 96.4% with more than 100 beds.

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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Upcoming Events
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On-demand: CDC’s “The Pink Book” chapter webinars on vaccine-preventable diseases and best practices roll out weekly. Pneumococcal vaccines chapter now available, with CE.

CDC continues its free 19-part pre-recorded webinar series ([link removed]) to provide a chapter-by-chapter overview of the 14th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases ([link removed])(also known as "The Pink Book").

The webinar on pneumococcal vaccines was released on October 11. Fifteen webinars are now available on demand. Additional webinars will be released weekly, concluding on November 1, 2022.

No registration is required to view the sessions. Information and program details are available on CDC's Pink Book Webinars ([link removed]) series web page.

CME, CNE, CPE, and CEU credits are available for each event. Questions about the material can be submitted to [email protected].

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For more upcoming events, visit our Calendar of Events ([link removed]).

Editorial Information

Editor-in-Chief
Kelly L. Moore, MD, MPH

Managing Editor
John D. Grabenstein, RPh, PhD

Associate Editor
Sharon G. Humiston, MD, MPH

Writer/Publication Coordinator
Taryn Chapman, MS
Courtnay Londo, MA

Style and Copy Editor
Marian Deegan, JD

Web Edition Managers
Arkady Shakhnovich
Jermaine Royes

Contributing Writer
Laurel H. Wood, MPA

Technical Reviewer
Kayla Ohlde

About IZ Express
Immunize​.org welcomes redistribution of this issue of IZ Express or selected articles. When you do so, please add a note that Immunize​.org is the source of the material and provide a link to this issue ([link removed]).

IZ 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 Immunize​.org and do not necessarily represent the official views of CDC.

IZ Express Disclaimer ([link removed])
ISSN: 2771-8085

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