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Issue 1,674: January 25, 2023

Top Stories
* Register for February 28 webinar! Immunize​.org, with pain mitigation expert, Anna Taddio, PhD, presents “Improving the Vaccination Experience: Reducing Pain and Anxiety for Children and Adults.”
* “Reasons for Receiving or Not Receiving Bivalent COVID-19 Booster Vaccinations among Adults—United States, November 1–December 10, 2022” published in MMWR
* “Early and Increased Influenza Activity among Children—Tennessee, 2022–23 Influenza Season” published in MMWR
* Influenza continues to decline, but remains a threat; keep encouraging vaccination
* Immunize.org remembers Hal Margolis, MD, our long-time friend and partner in the fight against hepatitis B and other infectious diseases
* Spotlight: Immunize.org resources that focus on vaccine products and manufacturers
* Vaccines in the news


Vaccine Information Statements
* Immunize.org continues to expand its translations of new and updated Vaccine Information Statements for varicella, MMR, and MMRV, MenB, MenACWY, and zoster vaccines. Be sure you are using the latest translations!


Featured Resources
* ACOG offers free, online, CME-accredited COVID-19 Vaccine Confidence training
* Newly updated 65+ Flu Defense website offers resources for healthcare professionals serving older adults
* Immunize.org's elegant "Vaccines Save Lives" black enamel pins make thoughtful tokens of thanks for hard-working colleagues


Notable Publications
* “Codetections of Other Respiratory Viruses among Children Hospitalized with COVID-19” published in Pediatrics


Global News
* “Epidemiology of Human Mpox—Worldwide, 2018–2021” published in MMWR


Upcoming Events
* Virtual: NFID offers webinar “NFID Cancer Prevention through Human Papillomavirus (HPV) Vaccination” on January 26; CME available
* Virtual: North Dakota State University Center for Immunization Research and Education offers webinar "Is Polio Coming Back?" on February 23, featuring Paul Offit, MD; CME available


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Top Stories
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Register for February 28 webinar! Immunize​.org, with pain mitigation expert, Anna Taddio, PhD, presents “Improving the Vaccination Experience: Reducing Pain and Anxiety for Children and Adults.”

Anxiety about needles and injections affects as many as 2 out of 3 children and 1 out of 4 adults. This anxiety can contribute to dreading, delaying, or avoiding vaccinations, even when the importance of preventing illness is understood. The good news is that there are safe, effective, and practical steps that vaccinators, vaccine recipients, and caregivers can take to reduce vaccination-related pain and anxiety. Creating a less stressful vaccination experience increases confidence in vaccination.

In this live, 1-hour webinar hosted by Immunize​.org, Improving the Vaccination Experience: Reducing Pain and Anxiety for Children and Adults ([link removed]) at 1:00 p.m. (ET) on February 28, we will learn more about the principles behind vaccination pain and anxiety and discuss simple evidence-based strategies to reduce apprehension. These strategies were developed and promoted by the experts from HELP Eliminate Pain in Kids and Adults ([link removed]). Their work was used by the World Health Organization (WHO), Public Health Canada, and others to develop guidelines for reducing vaccination pain.

The panelists will be:
* Anna Taddio, BScPhm, PhD; Professor, Faculty of Pharmacy, University of Toronto; Senior Associate Scientist, The Hospital for Sick Children (SickKids), Toronto, Ontario
* Kelly L. Moore, MD, MPH; President and CEO, Immunize​.org
* Lucie Marisa Bucci, MA; Director, Policy and Government Relations, Society for Infodemic Management (SIM), Québec, Québec
* Sharon Humiston, MD, MPH; Director for Research, Immunize​.org

Following the presentation, ample time is reserved for your questions.

Register now ([link removed]) to be sure you don’t miss this important session designed to help you make vaccination a more positive experience for everyone.

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“Reasons for Receiving or Not Receiving Bivalent COVID-19 Booster Vaccinations among Adults—United States, November 1–December 10, 2022” published in MMWR

CDC published Reasons for Receiving or Not Receiving Bivalent COVID-19 Booster Vaccinations among Adults—United States, November 1–December 10, 2022 ([link removed]) in the January 20 issue of MMWR ([link removed]). A summary appears below.

Vaccination with an updated bivalent COVID-19 vaccine, which contains mRNA for the spike proteins of both the original virus that causes COVID-19 and Omicron variants, is recommended to restore waning protection from severe disease. However, by the end of 2022, just 31% of eligible U.S. adults had received an updated vaccine. An online survey conducted in November–December 2022, assessed reasons for this among 1,200 COVID-19–vaccinated U.S. adults.

The most commonly reported reasons for not receiving an updated vaccine were lack of awareness of eligibility (23%) or availability (19%) and perceived existing protection against infection (19%). The frequency varied by age group, with younger adults more likely to report being unaware they were eligible and adults age 60 years or older more likely to report they felt they already had adequate protection.

After viewing vaccine availability information and eligibility criteria, two thirds of the participants who had not yet received an updated vaccine reported planning to do so. One month later, 29% of the participants who planned to receive the vaccine had done so. Most of the respondents who had not yet received the vaccine still planned to receive it but, many reported being too busy (36%).

Healthcare professionals and public health practitioners should convey information about vaccination recommendations, eligibility, and waning immunity and encourage patients to get vaccinated.

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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“Early and Increased Influenza Activity among Children—Tennessee, 2022–23 Influenza Season” published in MMWR

CDC published Early and Increased Influenza Activity among Children—Tennessee, 2022–23 Influenza Season ([link removed]) in the January 20 issue of MMWR ([link removed]). A summary appears below.

A field investigation of influenza activity in Tennessee during November 2022 found that children were twice as likely as adults to test positive for influenza and were hospitalized with flu at rates that rivaled past high-severity influenza seasons. This highlights that, to help prevent flu and severe flu complications, everyone age 6 months and older should get an annual flu vaccine.

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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Influenza continues to decline, but remains a threat; keep encouraging vaccination

Now is the best time to vaccinate anyone not yet protected from influenza this season. 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 2, ending January 14, CDC's Weekly U.S. Influenza Surveillance Report, FluView ([link removed]), reports that nationwide, 3.0% of outpatient visits 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. So far this season, 85 children have died from influenza-associated causes.

Influenza Vaccination Dashboard
CDC's Weekly Flu Vaccination ([link removed]) shows that vaccination coverage for all children is similar to the estimate at the same time in December 2021 (50.3% compared with 49.5%) and 2.8 percentage points lower compared with same time in December 2020 (50.3% compared with 53.1%). Vaccination rates are lowest for children living in rural areas. Coverage for children residing in rural areas is 16.4 percentage points lower compared with children living in suburban areas (35.6% compared with 52.0%) and 17.0 percentage points lower compared with children living in urban areas (35.6% compared with 52.5%).

CDC recommends everyone age 6 months and older get annual influenza vaccination. 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. To be listed as a provider by VaccineFinder, see the information at this website ([link removed]).

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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Immunize.org remembers Hal Margolis, MD, our long-time friend and partner in the fight against hepatitis B and other infectious diseases

It is with great sadness that we acknowledge the death of former CDC employee and long-time friend of Immunize.org (formerly IAC), Harold S. “Hal” Margolis, MD, on November 25, 2022, at the age of 76. Below is a remembrance from Deborah L. Wexler, MD, Immunization Action Coalition (IAC) Founder and Executive Director Emerita.

Hal and I became friends at the 1990 Asian and Pacific Islander American Health Forum conference on hepatitis B. Quickly after that, Hal did everything he possibly could to assist IAC, including bringing IAC’s hepatitis B vaccine birth dose activities to the attention of the CDC. It was Hal’s critical support and encouragement in 1995 that led to our receiving the first of many CDC cooperative agreements.

Over the years, Hal continued to provide his expertise to IAC in unlimited ways, including answering hundreds of “Ask the Experts” questions on hepatitis B that were published in our semiannual newsletter Needle Tips.

It was Hal who nominated IAC in 1997 for CDC’s prestigious Partners in Public Health Award, which we were honored to receive.

In addition to IAC, Hal collaborated with organizations and governments far and wide, across the nation and around the world, providing his unique vision of ways to improve public health services.

Hal Margolis was a true international hero of public health.

Related Link
* Legacy: Dr. Harold S. Margolis Obituary ([link removed])

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Spotlight: Immunize​.org resources that focus on vaccine products and manufacturers

In this week's Spotlight, we summarize resources at Immunize​.org that focus on specific vaccine products.

Package Inserts and FDA Product Approvals ([link removed]) main page provides up-to-date product information links and links to FDA vaccine approval web pages for all vaccines licensed for use in the United States.

Vaccine Manufacturers ([link removed]) main page provides links to the websites of the vaccine manufacturers in the United States, as well as providing contact information such as telephone numbers and email addresses. In addition, the vaccine products for each of the companies are listed.

Vaccines ([link removed]) main page links to information about 24 vaccines and the diseases they prevent. For each vaccine, access the latest recommendations, information, and resources from Immunize​.org and CDC.

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Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
* The Hill: Vaccine Hesitancy Is Surging Again, Regardless of the Science ([link removed]) (1/18/23)
* Wired: Twitter Is a Megaphone for 'Sudden Death' Vaccine Conspiracies ([link removed]) (1/16/23)
* The Hill: What We Know about the Ohio Measles Outbreak ([link removed]) (1/15/23)
* Houston Chronicle: Peter Hotez on New COVID XBB1.5 Variant: ‘People Are Saying This Will Be Mild. It’s Not Mild’ ([link removed]) (1/11/23)

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Vaccine Information Statements
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Immunize​.org continues to expand its translations of new and updated Vaccine Information Statements for varicella, MMR, and MMRV, MenB, MenACWY, and zoster vaccines. Be sure you are using the latest translations!

Thanks to CDC support, Immunize​.org substantially expanded its repository of Vaccination Information Statement (VIS) ([link removed]) translations. Immunize​.org posted new and updated VIS translations for varicella, MMR, and MMRV, MenB, MenACWY, and zoster vaccines.

All translations are available in print-ready PDF format.

Varicella VIS (view in English ([link removed])):
Updated: Farsi ([link removed])
New! German ([link removed])
New: Hindi ([link removed])
New! Italian ([link removed])
Updated: Khmer (Cambodian) ([link removed])
New! Polish ([link removed])
New! Swahili (Kiswahili) ([link removed])
New! Urdu ([link removed])
New! Yiddish ([link removed])

MMR (Measles, Mumps, and Rubella) VIS (view in English ([link removed])):
New! German ([link removed])
New! Italian ([link removed])
New! Polish ([link removed])
New! Swahili (Kiswahili) ([link removed])
New! Urdu ([link removed])
New! Yiddish ([link removed])

MMRV (Measles, Mumps, Rubella, and Varicella) VIS (view in English ([link removed])):
Updated: Farsi ([link removed])
New! German ([link removed])
New! Hindi ([link removed])
New! Italian ([link removed])
Updated: Khmer (Cambodian) ([link removed])
New! Polish ([link removed])
New! Swahili (Kiswahili) ([link removed])
New! Urdu ([link removed])
New! Yiddish ([link removed])

MenACWY (Meningococcal ACWY) VIS (view in English ([link removed])):
New! Armenian ([link removed])
New! Farsi ([link removed])
New! German ([link removed])
New! Hindi ([link removed])
Updated: Italian ([link removed])
Updated: Japanese ([link removed])
New! Khmer (Cambodian) ([link removed])
New! Korean ([link removed])
Updated: Polish ([link removed])
Updated: Swahili (Kiswahili) ([link removed])
New! Tagalog ([link removed])
Updated: Urdu ([link removed])
Updated: Yiddish ([link removed])

MenB (Meningococcal B) VIS (view in English ([link removed])):
Updated: Armenian ([link removed])
Updated: Farsi ([link removed])
New! German ([link removed])
Updated: Hindi ([link removed])
New! Italian ([link removed])
Updated Japanese ([link removed])
Updated: Khmer (Cambodian) ([link removed])
Updated: Korean ([link removed])
New! Polish ([link removed])
New! Swahili (Kiswahili) ([link removed])
Updated: Tagalog ([link removed])
New! Urdu ([link removed])
New! Yiddish ([link removed])

Zoster recombinant VIS (view in English ([link removed])):
New! Armenian ([link removed])
Updated: Farsi ([link removed])
New! German ([link removed])
New! Hindi ([link removed])
New! Italian ([link removed])
Updated: Japanese ([link removed])
Updated: Khmer (Cambodian) ([link removed])
Updated: Korean ([link removed])
New! Polish ([link removed])
New! Swahili (Kiswahili) ([link removed])
Updated: Tagalog ([link removed])
New! Urdu ([link removed])
New! Yiddish ([link removed])

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 are available.
Related Links
* Immunize​.org: Vaccine Information Statement ([link removed]) main page for VISs in 47 languages ([link removed])
* Immunize​.org: 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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ACOG offers free, online, CME-accredited COVID-19 Vaccine Confidence training

The American College of Obstetricians and Gynecologists (ACOG) is offering a free, online, CME-accredited training titled "Inform to Empower: Building COVID-19 Vaccine Confidence One Conversation at a Time” ([link removed]) to help clinicians hold effective conversations with their patients about COVID-19 vaccines. Training highlights include evidence-based patient communication strategies such as:
* Motivational interviewing
* Techniques for dispelling myths and misinformation
* Tips for creating a culture of vaccine confidence among staff and peers.

Each module is supplemented with a toolkit comprised of educational materials for healthcare personnel and patients.

ACOG found that almost all (96% or more) of the ob-gyns who took the training were satisfied with and enjoyed the training, and agreed or strongly agreed that it was important for their job.

This free training is accredited to provide 1.5 Continuing Medical Education credits for physicians. It is accessible on the ACOG Learning Management System ([link removed]) and can be accessed by non-ACOG members through free and simple account creation.

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Newly updated 65+ Flu Defense website offers resources for healthcare professionals serving older adults

Confident recommendations for influenza vaccine from healthcare providers are powerfully persuasive. To assist you in maximizing protection for your patients, Immunize.org, in collaboration with CSL Seqirus, updated the 65+ Flu Defense ([link removed]) website.

Older adults are at increased risk of severe influenza and COVID-19 illness, including hospitalization and death, especially if they are not up to date on these vaccinations. An updated fact sheet on the website, The Importance of Preventing Influenza and COVID-19, ([link removed]) ([link removed]) offers responses to help guide discussions with patients on the importance of preventing influenza and COVID-19.

This helpful site includes information, tools, and tips for communicating with adults age 65 and older about the scope and severity of influenza. Resources include:
* Influenza in Adults 65+: The Facts ([link removed])
* Influenza Vaccination: Questions Patients Aged 65 and Older Frequently Ask Their HCP ([link removed])
* The Importance of Preventing Influenza and COVID-19 ([link removed])

Check out the updated 65+ Flu Defense website at www.influenza-defense.org ([link removed]) to assist your ongoing efforts in protecting this vulnerable population.

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Immunize.org's elegant "Vaccines Save Lives" black enamel pins make thoughtful tokens of thanks for hard-working colleagues

Immunize.org’s elegantly designed “Vaccines Save Lives” pins ([link removed]) are meaningful gifts for people who care about vaccination. The pin makes a refined statement in hard black enamel with gold lettering and edges, measuring 1.125" x 0.75".

[link removed]
The pin is a stick-through-post variety with the back end covered by a round rubber cap that holds the pin securely. A gold metal spring-lock clasp is also provided.

Wear these pins on clothing, ([link removed]) uniforms, and white coats to show that you value vaccines.

Click here for "Vaccines Save Lives" pin pricing and ordering information. ([link removed])

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Notable Publications
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“Codetections of Other Respiratory Viruses among Children Hospitalized with COVID-19” published in Pediatrics

In the January 18 issue, Pediatrics published Codetections of Other Respiratory Viruses among Children Hospitalized with COVID-19 ([link removed]). The authors concluded that respiratory virus codetections, including respiratory syncytial virus (RSV) and rhinovirus/enterovirus, may increase illness severity among children younger than age 5 years hospitalized with SARS-CoV-2 infection.

Related Link
* AAP: Young COVID Patients Are Sicker When They Have a Second Infection, like a Cold or RSV ([link removed]) (1/18/23)

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Global News
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“Epidemiology of Human Mpox—Worldwide, 2018–2021” published in MMWR

CDC published Epidemiology of Human Mpox—Worldwide, 2018–2021 ([link removed]) in the January 20 issue of MMWR ([link removed]). The MMWR article summary appears below.

The number of mpox cases reported from rural areas in West and Central Africa had been increasing before 2018. . . .

During 2018–2021, mpox cases were confirmed in six African countries. Eight primary and three secondary cases associated with travel to Nigeria were identified in four non-African countries. Online training courses on mpox prevention and control have been available since 2018. . . .

Mpox continues to present challenges to public health and health care personnel in endemic areas. Improvements in surveillance and community engagement will be critical to detection and containment of the virus. Vaccines and treatments might reduce morbidity and mortality in areas with endemic disease.

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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Virtual: NFID offers webinar “Cancer Prevention through Human Papillomavirus (HPV) Vaccination” on January 26; CME available

The National Foundation for Infectious Diseases (NFID) will host a webinar titled Cancer Prevention through Human Papillomavirus (HPV) Vaccination ([link removed]) on January 26 from 2:00 to 3:00 p.m. (ET). Participants will learn about the importance of HPV vaccination to prevent certain types of cancer. NFID designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit.

Register for the webinar ([link removed]).

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Virtual: North Dakota State University Center for Immunization Research and Education offers webinar "Is Polio Coming Back?" on February 23, featuring Paul Offit, MD; CME available

North Dakota State University's Center for Immunization Research and Education will host a webinar titled Is Polio Coming Back? ([link removed]) on February 23 from 1:00 to 2:00 p.m. (ET). During the event, Paul Offit, MD, will discuss the recent case of paralytic polio in Rockland County, NY, and whether this case signals a larger problem for public health. Dr. Offit will also discuss the strengths and weaknesses of the inactivated and oral poliovirus vaccines, and provide insight into whether or not we will be able to eradicate polio with our current vaccine strategy. This activity is approved for AMA PRA Category 1 Credit.

Register for the webinar ([link removed]).

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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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