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Issue 1,547:
February 3, 2021
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Featured Resources
Journal Articles and Newsletters
Education and Training
Conferences and Meetings
On the Lighter Side
Top Stories
IAC summarizes ACIP meeting of January 27, including COVID-19 vaccine safety update
During its meeting on January 27, the Advisory Committee on Immunization Practices (ACIP) received an overview of AstraZeneca’s COVID-19 vaccine candidate and heard presentations on COVID-19 epidemiology, as well as safety and effectiveness data on the currently available mRNA COVID-19 vaccines. Highlights of the meeting, at which no votes were taken, are found below.
COVID-19 Vaccine Safety
Since COVID-19 vaccination began in mid-December, the U.S. government has implemented the most intense and comprehensive vaccine safety monitoring program in history. ACIP received updates on COVID-19 vaccine safety data collected from multiple sources, such as CDC’s V-safe After-Vaccination Health Checker, which includes more than 2 million participants. Overall, the safety profiles are reassuring and consistent with observations from pre-authorization clinical trials.
Notably, the first report of rapid cycle analysis (RCA) from the Vaccine Safety Datalink project found no elevations above baseline for any outcome of interest, including heart attack, Bell’s palsy, seizures, encephalitis, myelitis, Guillain-Barré syndrome, myocarditis, narcolepsy, stroke, or pulmonary embolism. Now that more data has been accumulated, anaphylaxis has been observed at rates lower than what were published earlier in the MMWR, namely, a rate of 5 cases per million doses for the Pfizer-BioNTech vaccine and 2.8 per million doses for the Moderna vaccine. Data do not suggest any causes for concern with respect to overall safety or deaths following vaccination in older adult residents of long-term care facilities. ACIP’s COVID-19 Vaccine Safety Technical (VaST) Subgroup will continue to monitor available safety data and provide updates to ACIP on a regular basis.
AstraZeneca COVID-19 Vaccine (AZD1222)
Representatives from AstraZeneca (AZ) provided an update on the initial results from the Phase 3 clinical trial of the company’s COVID-19 vaccine (AZD1222), which was developed in conjunction with the University of Oxford. Safety and efficacy information, gathered from the vaccine trials conducted in the United Kingdom, Brazil, and South Africa, was reported in The Lancet. The vaccine has been authorized for use (either emergency use or full approval) in dozens of countries, including the United Kingdom and the European Union.
AZD1222 was developed on an adenovirus that circulates among chimpanzees (type 63), to minimize issues with pre-existing immunity to human adenoviruses. AZD1222 was generally well tolerated during the clinical trials. Each 0.5 mL dose is administered intramuscularly. It is supplied in 5 mL preservative-free, non-latex multidose vials which can be stored at 2 o to 8 oC for at least 6 months. Following puncture, the vaccine may be stored for up to 6 hours at room temperature or up to 48 hours at 2 o to 8 oC. No dilution or reconstitution is required.
Analysis of pooled data from four globally diverse studies, including one site with a different dosing regimen from the others, indicated 70.4% vaccine efficacy against symptomatic COVID-19. Analysis only of data for the standard dosing regimen being considered in the United States demonstrated 62.1% efficacy against symptomatic disease. Investigation is currently underway to determine efficacy against newly identified variants.
ACIP will review AZD1222 data more fully after the vaccine is submitted to the FDA to obtain Emergency Use Authorization.
COVID-19 in Children and Teens
Children and teens younger than 18 years of age have lower rates of COVID-19 incidence, hospitalization, and mortality than adults. Just over half of children hospitalized with COVID-19 had an underlying condition, with obesity the one most frequently reported. Almost 1,700 cases of Multisystem Inflammatory Syndrome in Children (MIS-C) have been reported in the U.S., with a disproportionate number of these cases occurring among Black and Hispanic children. COVID-19 vaccine trials in adolescents are underway or planned for several vaccines in use or anticipated for use in the U.S., and studies in younger children are planned in early 2021.
COVID-19 Vaccine Implementation
COVID-19 vaccination is underway throughout the country. Vaccine has been shipped to more than 18,000 providers in the U.S., and over 20 million people have been vaccinated. Because ACIP prioritization recommendations were intended to be a framework to support equitable and efficient administration of vaccine while allowing jurisdictional flexibility, populations prioritized for COVID-19 vaccination vary between states. As of January 25, 11 states are reported to be in Phase 1a, 38 states in Phase 1b, and 2 states in Phase 1c, using CDC’s categories. As more people are vaccinated, CDC will evaluate real-world vaccine effectiveness.
Next Steps
The session concluded with a review of the COVID-19 Work Group’s interpretation of the data presented at the meeting.
The next regular meeting of the ACIP is scheduled for February 24–25. However, an emergency meeting could be called before that time if the FDA authorizes an additional vaccine for emergency use. Janssen anticipates submitting results from its Phase 3 trial to the FDA this week. Future meetings are announced on the ACIP meeting website.
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CDC provides ready-made toolkits for medical centers, pharmacies, and clinicians to help build confidence in COVID-19 vaccination among healthcare teams
CDC has released several audience-specific toolkits with ready-to-use materials to help build confidence in COVID-19 vaccination, answer patient questions, and provide proper storage and handling information. The toolkit resources include:
- Guides for building vaccine confidence within community-based organizations and critical infrastructure sectors
- Turn-key slide decks for virtual town halls or other informational meetings
- Posters and flyers for multiple occupations and settings
- Fact sheets and FAQs in eight languages
- Newsletter content and letters to members
- Social media sample messages
- Printable buttons/stickers to wear after vaccination
View CDC's toolkits:
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CDC’s VaxText, a free text messaging resource, conveniently reminds people to get their second dose of COVID-19 vaccine; encourage vaccinees to enroll!
VaxText is a text messaging platform that can remind vaccine recipients who enroll about timing of second COVID-19 vaccine doses. The service is free. People text ENROLL to 1-833-VaxText (829-8398) to start getting their weekly second dose reminders in either English or Spanish. The VaxText text messaging service will ask vaccine recipients who participate for basic vaccination information (i.e., vaccination date, COVID-19 vaccine name) so it can provide reminders based on the correct vaccination schedule. VaxText does not ask for personal information.
VaxText can also receive information on COVID-19 vaccines and links to additional information on CDC websites. VaxText encourages patients to sign up for V-safe, a tool that allows people to record their health status after vaccination.
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Vaccinate Your Family offers links to every state and territorial health department’s COVID-19 web page
Vaccinate Your Family (VYF) has created a COVID-19 Vaccines: Find Your Health Department gateway page that provides direct links to state and territorial health department COVID-19 web pages. These pages offer details on COVID-19 vaccination plans, and let you know where to get your COVID-19 vaccine once it becomes available to you and where to sign up for the vaccine.
Related LInks
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"Don't Make the Mistake of Scheduling Dose #2 of COVID-19 Vaccine Too Early," Dr. Wexler's Technically Speaking monthly column, available on immunize.org
January's Technically Speaking column by IAC's executive director, Deborah L. Wexler, MD, is reprinted below.
Don't Make the Mistake of Scheduling Dose #2 of COVID-19 Vaccine Too Early
by Deborah L. Wexler, MD
There have been numerous reports of mRNA COVID-19 vaccine recipients being asked to return earlier than the recommended interval to receive their second dose. Frequently this has been caused by a misunderstanding about the intent of allowing a 4-day grace period when determining the interval between dose #1 and dose #2.
When the clinical considerations for COVID-19 vaccines were first published by CDC, they included the concept that a “grace period” of 4 days was allowable if the minimum interval between doses was inadvertently shortened. A similar grace period has been in place for other vaccines for many years. However, the grace period was intended to be used only when a vaccine was determined retroactively to have been given at less than the recommended minimum interval. In that case, a dose given within 4 days of the recommended interval would not have to be repeated. The grace period was not intended to be used when scheduling future vaccination visits.
For COVID-19 vaccines currently available in the U.S., the recommended interval which should be used for scheduling between dose #1 and dose #2 is:
- Pfizer-BioNTech – 21 days
- Moderna – 28 days
On January 6, CDC revised its Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States to emphasize the necessity of vaccinating according to the recommended schedule. The information regarding dosing intervals is summarized below:
- Routine Scheduling. Do not schedule people to receive dose #2 earlier than the recommended intervals (i.e., 21 days for Pfizer-BioNTech or 28 days for Moderna).
- Inadvertent Early Doses. If dose #2 is inadvertently administered as much as 4 days too early (“grace period”), it may be considered valid, but this 4-day period should not be utilized for routine scheduling.
- No Maximum Interval. There is no maximum interval between dose #1 and dose #2 for either vaccine. If dose #2 is administered beyond 21 (Pfizer-BioNTech) or 28 days (Moderna), there is no need to restart the series.
Visit CDC's Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States for full details.
Related Links
Technically Speaking is a monthly column written by Dr. Wexler for Vaccine Update, a monthly e-newsletter from the Vaccine Education Center (VEC) at Children's Hospital of Philadelphia. All past columns are available on IAC’s Technically Speaking gateway page at www.immunize.org/technically-speaking.
Access the complete article here.
To subscribe to VEC's Vaccine Update e-newsletter, go to the sign-up form.
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IAC Spotlight! These updated IAC staff and patient educational materials, webpages, and VIS translations were released during December and January
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 download, print, and distribute. Important web page updates and VIS translations are announced as well.
In case you missed them during recent weeks, these helpful materials were announced:
Updated Materials for Clinicians
Updated Handouts for Your Patients
New and Updated COVID-19 Web Pages
New and Updated VIS Translations
IAC received donations of VIS translations in:
- Albanian (Influenza – Inactivated and Live, PPSV)
- French (MMRV)
- German (Influenza – Inactivated)
- Hebrew (MMR, Varicella)
- Karen (Influenza – Inactivated and Live)
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IAC experts called on by news media
With vaccines in the news so much lately, journalists have sought out IAC experts to communicate the intricacies of running a quality vaccination program. Our insights have helped explain vaccines to the public and policy makers. We want to help them understand the complex work vaccinators do. We've reached mass markets and local stations, across the U.S. and overseas, via print, radio, television, blogs, and more. Here is a selection of our recent citations:
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Not-to-miss immunization articles in the news
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
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Featured Resources
In IAC’s “Video of the Week,” Dr. Paul Offit explains how COVID-19 vaccines based on messenger RNA technology work
In this video from November 2020, Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, explains that mRNA is a protein that instructs our bodies to make replicas of the spike protein found on the surface of COVID-19 viruses. Using the mRNA as a vaccine, our bodies learn to make this spike protein. Our natural immune system then makes antibodies against the viral protein, thus protecting us from infection.
Visit the whole collection at the VOTW archive.
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CHOP’s Vaccine Education Center adds new resources to its “Questions and Answers about COVID-19 Vaccines” web page
The Vaccine Education Center at the Children's Hospital of Philadelphia (CHOP) has released nine new YouTube videos on its Questions and Answers about COVID-19 Vaccines web page including:
Check back for additional videos in the coming weeks.
VEC's printable Q&A for the public titled COVID-19 mRNA Vaccines: What You Should Know is now available in Japanese. As with their other Q&A sheets, these sheets can be photocopied for distribution, and the links can be added to websites. Print versions will be available in coming weeks.
View the Q&A PDF in English and Spanish.
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State of Hawaii releases COVID-19 resources in up to 17 languages, including FAQs, fact sheets, public health flyers, and social media toolkits
The State of Hawaii released multilingual resources related to COVID-19. Resources include FAQs, fact sheets, public health flyers, and social media toolkits. These resources can be found in all or some of the following languages: Chinese-Simplified, Chinese-Traditional, English, Español (Spanish), Gagana Samoa (Samoan), Hawaiian, Ilokano, Japanese, Kajin M̧aje (Marshallese), Kapasen Chuuk (Chuukese), Korean, Kosraean, Pohnpeian, Tagalog, Tiếng Việt (Vietnamese), Tongan, and Yapese.
A video on how to utilize the multilingual resources on social media platforms can be viewed on YouTube.
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Round Up: IAC offers a collection of its new COVID-19 vaccine resources for healthcare personnel
IAC has developed many new resources to help healthcare personnel stay up to date with COVID-19 vaccination information including:
Check back periodically as IAC's COVID-19 vaccine resources expand.
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Check out the www.Give2MenACWY.org website to enhance your efforts at increasing rates of MenACWY booster and other adolescent vaccinations
The website www.Give2MenACWY.org promotes the importance of adolescent vaccination and administering a booster dose of MenACWY vaccine at age 16.
Designed for healthcare professionals, the site incorporates materials and highlights the importance of all recommended vaccines for 16-year-olds. A simplified navigation structure makes locating information a breeze.
The colorful Give2MenACWY.org website is divided into five easy-to-access sections:
The site’s design categorizes materials according to whether they are primarily of interest to providers or to teens or their parents.
Visit Give2MenACWY.org and enjoy browsing (and deploying) its bountiful resources, brought to you by IAC's collaboration with Sanofi Pasteur.
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Journal Articles and Newsletters
CDC published “Addressing COVID-19 Misinformation on Social Media Preemptively and Responsively” in Emerging Infectious Diseases
In the February issue, CDC published Addressing COVID-19 Misinformation on Social Media Preemptively and Responsively in Emerging Infectious Diseases. The abstract is reprinted below.
Efforts to address misinformation on social media have special urgency with the emergence of coronavirus disease (COVID-19). In one effort, the World Health Organization (WHO) designed and publicized shareable infographics to debunk coronavirus myths. We used an experiment to test the efficacy of these infographics, depending on placement and source. We found that exposure to a corrective graphic on social media reduced misperceptions about the science of 1 false COVID-19 prevention strategy but did not affect misperceptions about prevention of COVID-19. Lowered misperceptions about the science persisted >1 week later. These effects were consistent when the graphic was shared by the World Health Organization or by an anonymous Facebook user and when the graphics were shared preemptively or in response to misinformation. Health organizations can and should create and promote shareable graphics to improve public knowledge.
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“Estimating the Health Impact of Vaccination against Ten Pathogens in 98 Low-Income and Middle-Income Countries from 2000 to 2030: A Modelling Study” published in Lancet
In the January 30 issue, Lancet published Estimating the Health Impact of Vaccination against Ten Pathogens in 98 Low-Income and Middle-Income Countries from 2000 to 2030: A Modelling Study. Portions of the summary are reprinted below.
Methods
16 independent research groups provided model-based disease burden estimates under a range of vaccination coverage scenarios for ten pathogens: hepatitis B virus, Haemophilus influenzae type B, human papillomavirus, Japanese encephalitis, measles, Neisseria meningitidis serogroup A, Streptococcus pneumoniae, rotavirus, rubella, and yellow fever. Using standardised demographic data and vaccine coverage, the impact of vaccination programmes was determined by comparing model estimates from a no-vaccination counterfactual scenario with those from a reported and projected vaccination scenario. We present deaths and DALYs averted between 2000 and 2030 by calendar year and by annual birth cohort.
Findings
We estimate that vaccination of the ten selected pathogens will have averted 69 million (95% credible interval 52–88) deaths between 2000 and 2030, of which 37 million (30–48) were averted between 2000 and 2019. From 2000 to 2019, this represents a 45% (36–58) reduction in deaths compared with the counterfactual scenario of no vaccination. Most of this impact is concentrated in a reduction in mortality among children younger than 5 years (57% reduction [52–66]), most notably from measles. Over the lifetime of birth cohorts born between 2000 and 2030, we predict that 120 million (93–150) deaths will be averted by vaccination, of which 58 million (39–76) are due to measles vaccination and 38 million (25–52) are due to hepatitis B vaccination. We estimate that increases in vaccine coverage and introductions of additional vaccines will result in a 72% (59–81) reduction in lifetime mortality in the 2019 birth cohort.
Interpretation
Increases in vaccine coverage and the introduction of new vaccines into low and middle income countries (LMICs) have had a major impact in reducing mortality. These public health gains are predicted to increase in coming decades if progress in increasing coverage is sustained.
View the article in HTML format or PDF format.
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Education and Training
Smithsonian museum posts webinar tracing U.S. vaccine history from smallpox in colonial Boston to COVID-19
The Smithsonian Institution’s National Museum of American History posted an archived webinar, Pandemic Perspectives: Racing for Vaccines, recorded on January 5. The 73-minute webinar includes remarkable graphics from the Smithsonian's collection of health artifacts. The multi-expert discussion traces U.S. vaccine history from smallpox in colonial Boston to COVID-19. Content spans smallpox, anthrax, rabies, diphtheria, tetanus, influenza, Haemophilus, DTP, poliomyelitis, MMR, HIV, hepatitis B, and COVID-19.
Cultural aspects discussed include Pasteur's experiments, the Iditarod dog sled race, World War II dog tags as metal vaccination records, punch cards to evaluate data from the Salk polio vaccine trial, iron lungs, the Roosevelt dime, and many others. The webinar content was distilled into an article for Smithsonian Magazine: History Shows Americans Have Always Been Wary of Vaccines.
Panelists on the webinar include Paul Offit, MD, Director of the Vaccine Education Center and John D. Grabenstein, RPh, PhD, Associate Director for Scientific Communications at IAC.
Watch the archived webinar.
Other webinars from the series can be found on the Smithsonian's National Museum of American History's Pandemic Preserves: Stories Through Collections web page.
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Johns Hopkins’ IVAC hosts “Social Media Interventions and Vaccine Hesitancy” webinar on February 9
International Vaccine Access Center (IVAC) at the Johns Hopkins School of Medicine will host Social Media Interventions and Vaccine Hesitancy webinar on February 9 from 1:00–2:00 p.m. (ET). During this webinar, the speakers will discuss how misinformation spreads over social media and creates vaccine hesitancy. Immunization and communication experts will discuss what action is needed to prevent anti-vaccine efforts from spreading over social media, and what challenges the infodemic poses to public health. The presenters will be Rupali Limaye, PhD, MPH, director of behavioral and implementation science at IVAC, and Kaitlin Christenson, MPH, vice president of vaccine acceptance and demand at the Sabin Vaccine Institute.
Register for the webinar.
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Conferences and Meetings
NFID hosts 2021 Virtual Annual Conference on Vaccinology Research on April 26–27; abstracts accepted through February 16
The 2021 Virtual Annual Conference on Vaccinology Research (ACVR), sponsored by the National Foundation for Infectious Diseases (NFID), will be held virtually April 26–27. ACVR brings together hundreds of researchers from around the world, featuring presentations, panel discussions, peer-reviewed oral abstracts, meet the expert sessions, scientific awards, lectures, and networking opportunities. The objectives of this conference are:
- Discuss recent scientific advances contributing to vaccine research, development, implementation, and real-world evaluation
- Identify novel research opportunities and scientific challenges associated with vaccine development, implementation, and real-world evaluation
- Evaluate the role of vaccines in preventing and mitigating existing, emerging, and re-emerging infectious diseases
All registered participants will have access to recorded presentations until June 30, 2021.
Registration for the conference is now open.
NFID will be accepting abstract submissions through February 16. Visit Call for Abstracts web page for instructions on submitting an abstract.
This program offers continuing medical education (CME) credit.
Visit the 2021 Virtual Annual Conference on Vaccinology Research (ACVR) gateway page for more information.
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On the Lighter Side
In this revealing 2001 PSA from Idaho Department of Health and Welfare, only the dog, not the playing children, is fully immunized
In this 2001 public service announcement (PSA) titled Our Children Can't Protect Themselves, produced by the Idaho Department of Health and Welfare, the narrator informs viewers that the dog, and not the playing children, is the only one fully immunized. This PSA is part of a collection curated by vaccine expert William L. Atkinson, MD, MPH.
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