IZ Express #1,669: CDC recommends updated COVID-19 vaccines for children younger than age 5 years, and more

On December 9, CDC expanded its recommendations for the updated (bivalent) Moderna and Pfizer-BioNTech COVID-19 vaccines to include children who begin the vaccination series as early as age 6 months. The updated (bivalent) dose is recommended as the third dose in the primary series for Pfizer vaccine recipients and as a booster (third) dose for recipients of the Moderna vaccine 2-dose primary series. This follows the FDA amendment to the emergency use authorizations (EUAs) of the updated (bivalent) Moderna and Pfizer-BioNTech COVID-19 vaccines in this age group. A portion of the news release appears below.

CDC expanded the use of updated (bivalent) COVID-19 vaccines for children ages 6 months through 5 years. Children ages 6 months through 5 years who previously completed a Moderna primary series are eligible to receive a Moderna bivalent booster 2 months after their final primary series dose. Children ages 6 months through 4 years who are currently completing a Pfizer primary series will receive a Pfizer bivalent vaccine as their third primary dose.

The CDC web page, Use of COVID-19 Vaccines in the United States Interim Clinical Considerations, now states:

Children age 6 months–4 years who complete a Moderna primary series should receive one bivalent Moderna booster dose at least 2 months after completion of the primary series
Children age 5 years who complete a Moderna primary series may receive either the previously authorized bivalent Pfizer-BioNTech booster dose or the newly authorized bivalent Moderna booster dose at least 2 months after completion of the Moderna primary series
The previously authorized 3-dose Pfizer-BioNTech primary series for children age 6 months–4 years has been revised as follows: a monovalent Pfizer-BioNTech vaccine is administered for the first and second doses, followed by one bivalent Pfizer-BioNTech vaccine as the third primary series dose, at least 8 weeks after the second monovalent primary series dose. A booster dose is not authorized for children in this age group who receive a Pfizer-BioNTech 3-dose primary series, including children who previously received a 3-dose monovalent Pfizer-BioNTech primary series.

Healthcare professionals who administer these vaccines for children should review CDC’s interim clinical considerations for dose and other information.

Related Links

CDC: Interim Clinical Considerations main page summarizing use of COVID-19 vaccines in the United States
CDC: CDC Expands Updated COVID-19 Vaccines to Include Children Ages 6 Months through 5 Years (12/9/22)
FDA: Coronavirus (COVID-19) Update: FDA Authorizes Updated (Bivalent) COVID-19 Vaccines for Children Down to 6 Months of Age (12/8/22)
FDA: COVID-19 Vaccines main page

Influenza activity is high across the nation; urge vaccination now

Urge your unprotected patients, coworkers, and loved ones to be vaccinated against influenza now, before they gather during the holidays. High levels of influenza activity are nationwide. CDC expects influenza activity to continue to increase in its seasonal epidemic pattern. CDC's Weekly U.S. Influenza Surveillance Report, FluView, provides a valuable snapshot of influenza activity state-by-state.

Influenza Surveillance
For week 48, ending December 3, CDC's Weekly U.S. Influenza Surveillance Report, FluView reports that, nationwide, 7.2% of patient visits reported through the Outpatient Influenza-Like Illness Surveillance Network (ILINet) were due to respiratory illness that included fever plus a cough or sore throat (i.e., influenza-like illness [ILI]). This exceeds the national baseline of 2.5%. Multiple respiratory viruses are co-circulating; the relative contribution of influenza virus infection to ILI varies by location. At this point, 21 children have already died from influenza-associated causes during the 2022–23 season.

Influenza Vaccination Dashboard
CDC's Weekly Flu Vaccination Dashboard data show that 155 million influenza vaccine doses were distributed in the United States through December 9, 2022. For all children, vaccination coverage for the week ending November 26, 2022, was similar to 1 year ago (42.5% compared with 40.9%) and 4.2 percentage points lower than the same time 2 years ago (42.5% compared with 46.7%). Efforts are still needed to close the vaccination gap and protect more children.

CDC recommends everyone age 6 months and older get annual influenza vaccination. “Vaccines.gov” offers VaccineFinder, a service of Boston Children’s Hospital, to help people find influenza and COVID-19 vaccines for any age group. To be listed as a provider by VaccineFinder, see the information at this website.

Coadministration of influenza and COVID-19 bivalent booster vaccinations when both are due is safe, recommended, and efficient. COVID-19 vaccination alone provides no protection from influenza or any other respiratory virus. To gain confidence in your approach to administering multiple intramuscular vaccinations to an adult, download Immunize.org’s printable document How to Administer Multiple Intramuscular Vaccines to Adults during One Visit.

Related Links

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

Immunize.org updates its “Vaccines: Monkeypox (mpox)” web page

Immunize.org updated its Vaccines: Monkeypox (mpox) main page that provides links to key resource pages from CDC, FDA, Immunize.org, and other professional organizations. Revisions were made as shown below.

Incorporate WHO's preferred name "mpox" as a synonym for monkeypox
Add new materials under "Clinic Resources and Tools" for vaccine safety, training materials for providers, and administrative and operational issues
Provide direct links to all sections of Interim Clinical Considerations for mpox vaccination
Add information for clinical considerations for specific populations, including people who are pregnant or breastfeeding, people with HIV, and children and adolescents
Add links to new educational materials from CDC, particularly on vaccine storage and handling
Add links to CDC’s Visual Examples of Mpox Rash (also in Spanish)

Bookmark Immunize.org’s new Vaccines: Monkeypox (mpox) main page for key links to important resources. The page will be updated as new guidelines and resources become available.

Related Links

CDC: Mpox main page
CDC: Mpox: Vaccine Considerations web page
CDC: Video: How to Administer a JYNNEOS Vaccine Intradermally
CDC: JYNNEOS Smallpox and Monkeypox Vaccine: Standing Orders for Administering Vaccine (PDF)
CDC: Monkeypox Vaccine: Storage and Handling Summary (PDF)
Immunize.org: Vaccines: Monkeypox (mpox) main page
WHO: WHO Recommends New Name for Monkeypox Disease (11/28/22)

“Reduced Risk for Mpox after Receipt of 1 or 2 Doses of JYNNEOS Vaccine Compared with Risk among Unvaccinated Persons—43 U.S. Jurisdictions, July 31–October 1, 2022” published in MMWR

CDC published Reduced Risk for Mpox after Receipt of 1 or 2 Doses of JYNNEOS Vaccine Compared with Risk among Unvaccinated Persons—43 U.S. Jurisdictions, July 31–October 1, 2022 on December 9 in MMWR. A portion of the summary appears below.

Real-world data on the magnitude and durability of protection by JYNNEOS vaccine against monkeypox (mpox) remain limited. . . .

Among JYNNEOS vaccine-eligible men aged 18–49 years in 43 U.S. jurisdictions, mpox incidence among unvaccinated persons was 9.6 times as high as that among persons who had received 2 vaccine doses and 7.4 times as high as that among persons who had received only the first dose. Preliminary evidence indicates no difference in protection between subcutaneous and intradermal administration routes. . . .

Although further study is needed to determine the magnitude and durability of protection, evidence indicates that JYNNEOS vaccination provides protection against mpox. Vaccine-eligible persons should complete the 2-dose vaccination series.

Access the MMWR article in HTML or PDF.

Related Link

MMWR's main page provides access to MMWR Weekly and its companion publications

During May 22–October 21, 2022, nearly 1 million JYNNEOS doses were administered in the United States. The vaccine safety profile was consistent with prelicensure studies. The most common adverse health events reported were nonserious and included injection site reactions. Serious adverse events were rare among adults, and no serious adverse events have been identified among persons aged <18 years. . . .

Surveillance supports JYNNEOS vaccine safety. CDC and FDA will continue to monitor the safety of JYNNEOS.

Access the MMWR article in HTML or PDF.

Related Link

The lead article, 25 Years of Varicella Vaccination in the United States, describes the health and economic impact of the varicella vaccination program. The United States was the first country to introduce varicella vaccine into the routine childhood vaccination program. Over the next 25 years, this program significantly reduced varicella disease burden. High vaccine coverage led to declines of more than 97% in varicella incidence and at least 90% in varicella-related hospitalizations and deaths. The declines were greatest (99%) in people younger than 20 years of age born during the vaccination program, in whom varicella hospitalizations and deaths have been nearly eliminated in the United States.

Each year in the United States, varicella vaccination prevents more than an estimated 10,500 varicella hospitalizations and 100 deaths. The program achieved net societal savings of more than $23 billion dollars. This public health achievement was made possible by the efforts of thousands of nurses, physicians, pharmacists, and public health staff who implemented this vaccination program.

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Immunize.org offers many resources that focus on communication between healthcare personnel, patients, and caregivers.

Talking about Vaccines web page provides healthcare professionals with 11 topical web pages to help them discuss vaccination with concerned parents or patients. Topics include, for example, adjuvants, alternative medicine, autism, religious concerns, and thimerosal.

Unprotected People Stories features more than 100 real-life accounts of people who suffered or died from vaccine-preventable diseases.

Handouts for Patients and Staff leads to hundreds of resources that are free to download, print, copy, and distribute widely.

Vaccine Basics: Common Questions about Vaccines on Immunize.org’s public website, vaccineinformation.org, offers patients and caregivers timely and accurate information about vaccines and the diseases they prevent.

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

Immunize.org also updated its 2-page handout, After the Shots . . . What to Do If Your Child Has Discomfort, with space for listing recommended medication, dosage charts for acetaminophen and ibuprofen (page 2), a new footer, and QR code linking users to the PDF of the current document.

Immunize.org recently updated its 1-page resource, Vaccines with Diluents: How to Use Them. Changes include the addition of Comirnaty (COVID-19), Dengvaxia (dengue), and Vaxchora (cholera) vaccines, each of which is reconstituted with a diluent.

Immunize.org posted new Turkish translations of Vaccine Information Statements (VISs) generously donated by Betül Polatdemir, MD, Ankara, Turkey, and Nur Polatdemir Çevik, Near East University, Nicosia, Cyprus.

All translations are available in print-ready PDF format.

VIS translations in Turkish:

Check the version dates of your office copies of newly updated translations. Translations of previous VIS versions should be discarded now that translations of the current versions have become available.

Voices for Vaccines (VFV) posted a new entry in its Vax Talk podcast series: Vaccine Sundays and Equity featuring Julissa Soto, MPH. A description from the VFV web page appears below.

Because vaccines work better when we are all vaccinated, vaccine equity isn’t about justice alone. It is also crucial to public health.

Enter Julissa Soto, MPH. Fresh off her work with other forms of health equity, she has come onto the scene in Colorado to make sure Latino communities can get vaccinated and feel confident doing so through her Vaccine Sundays program.

This episode is about so much more than that, though. Julissa is an inspiring woman whose life has been an amazing journey.

Related Links

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).

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

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

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

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

Related Links

CDC published Human Rabies—Texas, 2021 on December 9 in MMWR. A portion of the summary appears below.

U.S. human rabies deaths typically result from contact with rabid bats. Rabies is preventable when postexposure prophylaxis (PEP) is promptly administered; once clinical signs develop, the disease is nearly always fatal. . . .

A young boy was bitten by a bat; multiple persons knew of the exposure but did not recognize the rabies risk in the absence of a visible bite mark. Medical care was not sought until the child developed signs and symptoms 2 months later. One third of the child’s contacts met exposure criteria, and one quarter sought PEP; no secondary cases were detected. . . .

Enhanced public education about the risk for rabies associated with bat contact and the importance of seeking PEP if contact occurs is needed.

Access the MMWR article in HTML or PDF.

Related Link

The National Foundation for Infectious Diseases (NFID) will host a webinar titled Plan Ahead: Vaccines Recommended for Travel on December 15 from 2:00 to 3:00 p.m. (ET). Participants will learn about the geographic and clinical manifestations of certain pathogens encountered during travel, the current ACIP recommendations for common travel vaccines, and strategies for implementation of recommendations into clinical practice. NFID designates this enduring material for up to 1.0 AMA PRA Category 1 Credit.