Issue 1,503: July 1, 2020
Top Stories
IAC Handouts
Featured Resources
Journal Articles and Newsletters
On the Lighter Side
Top Stories
Happy Canada Day! An introduction to immunization information and advocacy in Canada
O Canada! In tribute to Canada’s 153rd national anniversary, we are sharing select Canadian resources for immunization information and advocacy. Best wishes to all our vaccinating friends in Canada!
Expert committees: Advocacy groups and resources:
Government institutions:
These Canadian documents and resources are provided in both English and French.
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IAC summarizes the June 2020 ACIP Virtual Meeting
For the first time, the Advisory Committee on Immunization Practices (ACIP) conducted a regular meeting virtually on June 24, 2020. Two votes were taken during the morning session of the meeting. The afternoon was devoted to discussions of COVID-19 epidemiology and prospects for SARS-CoV-2 vaccines and vaccination.
Votes
New MenACWY Vaccine Added to VFC Program. ACIP voted
unanimously to add MenACWY-TT (MenQuadfi, Sanofi Pasteur) as an option within the Vaccines For Children (VFC) program. This vaccine was licensed by the FDA in April 2020 for use in persons 2 years of age and older. No ACIP policy vote was needed, as the addition of MenQuadfi required no changes to the current meningococcal recommendations for dosing and scheduling. Trials are ongoing to seek eventual expansion of the age indication down to 6 weeks of age and to evaluate its use with varying pediatric immunization schedules in use throughout the world. MenQuadfi will become available in the U.S. in 2021.
Recommendations for 2020–21 Influenza Season. ACIP received multiple updates on the 2019–2020 influenza season. Preliminary results indicate an overall vaccine effectiveness (VE) rate of 39% against medically attenuated influenza. Although it would be desirable to see higher VE rates, it is important to remember this means that influenza-related outpatient visits and hospitalizations were reduced by almost 40%, which translates to millions of Americans.
The committee unanimously approved inclusion of several updates to the influenza statement for the 2020–21 season. ACIP recommendations are not official until published in the MMWR.
- Vaccine composition—Three new vaccine strains will be incorporated for H1N1, H3N2, and B Victoria. The B Yamagata strain included in quadrivalent vaccine formulations remains unchanged from the 2019–2020 season.
- New quadrivalent vaccine formulations—Two recently licensed quadrivalent vaccines will be available for persons 65 years and older: Fluzone High-Dose Quadrivalent (Sanofi Pasteur) and Fluad Quadrivalent (Seqirus).
- Contraindications/precautions table—The title of the table will be simplified to “Contraindications,” with the accompanying text providing more detail concerning which contraindications are printed in package inserts and which derive from ACIP recommendations.
- LAIV recommendations
- Contraindications to the use of LAIV will be added for persons with cochlear implants, active CSF leaks, and anatomical or functional asplenia.
- To prevent possible interference with LAIV replication, intervals between use of antivirals and LAIV will be clarified to address the use of long-acting, single-dose influenza antivirals.
- Egg allergy—Language will be updated to indicate that no special precautions are needed when using egg-free vaccines (RIV and ccIIV) in persons with severe egg allergy.
In anticipation of greatly increased demand for influenza vaccine and possible concurrent spread of SARS-Cov-2 in the upcoming season, CDC has purchased an additional 7.1 million doses of influenza vaccine to be made available for adults through state immunization programs in November or later in the influenza vaccination season.
COVID-19 Update
The remainder of the meeting was devoted to updates on COVID-19 disease and clinical epidemiology. The committee also reviewed information on various coronavirus vaccine candidates in development. In addition, ACIP heard from Matthew Hepburn, MD, Joint Product Lead for Operation Warp Speed (OWS), the federal effort to coordinate vaccine development and use in the U.S. Dr. Hepburn noted that OWS was established to take advantage of the best expertise available in the Department of Health and Human Services and Department of Defense. Three complementary teams have been established within OWS to coordinate pre-clinical and clinical research, vaccine manufacturing, and vaccine distribution and administration. The latter group will be headed by CDC’s Dr. Nancy Messonnier.
The ACIP COVID-19 work group presented and solicited feedback on its preliminary work on establishing priority groups to receive vaccine when it becomes available. The guiding principles for the work group’s efforts are: (1) safety is paramount; (2) vaccine clinical trials should be inclusive of populations most affected by the disease, e.g., older adults and selected racial and ethnic groups; (3) vaccine should be distributed in an equitable and efficient manner; and (4) flexibility must be allowed.
CDC also provided an overview of the recent precipitous drop in routine vaccination levels in the U.S. due to the pandemic response. The agency stressed that catch-up for childhood vaccination needs to be undertaken now, so that clinical capacity can be directed to back-to-school and influenza vaccination in the summer and fall. CDC has issued multiple resources to assist providers in this effort.
Vaccine Supply Update
In the meeting’s final presentation, CDC provided two updates on the nation’s current vaccine supply:
- Adult Hepatitis B—The adult and dialysis formulations of Merck’s adult hepatitis B vaccine (Recombivax HB) will be returning to the U.S. market the week of July 20.
- Zostavax—Beginning July 1, 2020, Merck will no longer be selling Zostavax, zoster vaccine live. All remaining Zostavax supplies in the U.S. will expire no later than November 2020.
All recommendations approved by ACIP are provisional until they are approved by the CDC director and published in MMWR. Presentation slides from the June meeting should be posted on the ACIP website in the next 4–6 weeks. In addition to the next regularly scheduled (virtual) ACIP session on October 28–29, the committee plans to conduct additional virtual public meetings to review SARS-CoV-2 vaccine developments. These meetings, which are tentatively set for August 12 and September 16, will be announced on the ACIP website.
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Vaccinate Your Family releases supplemental report on our nation’s “ImmUnion” in regard to vaccination during the pandemic
On June 23, Vaccinate Your Family released a special supplemental report, 2020 State of the ImmUnion: Special Supplement: COVID-19 Vaccination, to their earlier 2020 State of the ImmUnion: A Report on Vaccine-Preventable Diseases in the U.S.
In the supplement, they examine five steps Congress must take to strengthen the country’s vaccine infrastructure and three ways in which members of Congress can help their constituents understand the value of vaccines.
Related Links
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CDC issues “Dear Colleague” letter asking for your help in maintaining vaccination coverage levels, preparing for flu season, and protecting at-risk and vulnerable populations
On June 22, CDC published a "Dear Colleague" call-to-action letter asking for help in protecting our communities through vaccination in these unprecedented times. The letter stresses that maintaining vaccination coverage levels, preparing for the upcoming flu season, and working to protect at-risk and vulnerable populations are crucial activities. The letter contains many resources for encouraging vaccination. Click on the image below to read the letter.
 
In addition, CDC’s web page Vaccination Guidance During a Pandemic provides a collection of federal resources designed to guide vaccine planning during the COVID-19 pandemic.
Related Links
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Vaccines For Children (VFC) program offers updated handout and article with information for parents and guardians who may not realize that free vaccines are available for their children
Due to the COVID-19 pandemic, many children are no longer covered by private insurance. Parents may not be aware that these children are eligible for free vaccines through the Vaccines For Children (VFC) program. VFC is a federally funded program that provides vaccines at no cost to certain children 18 and younger who might not otherwise be vaccinated because of the inability to pay.
This updated 1-page handout for parents of children ages 0–18 years is easy to share.
CDC has also updated its Vaccines For Children web page. Please consider sharing this information via your social media channels to help ensure that all children have a better chance of getting their recommended vaccines on schedule.
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CHOP’s Vaccine Education Center revises its pertussis and tetanus Q&A handouts for the public
CHOP's Vaccine Education Center (VEC) recently revised two of its Q&A handouts for the public.
Pertussis: What You Should Know (Volume 6, Spring 2020) was revised to add Tdap for decennial tetanus-containing boosters and remove text related to cocooning. It was also updated in Spanish.
 
Tetanus: What You Should Know (Volume 2, Spring 2020) was updated to include Tdap for decennial boosters.
 
These Q&A sheets can be photocopied for sharing with patients and families, or ordered from VEC at a nominal cost. Links can also be added to websites or shared on social media platforms.
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IAC Spotlight! "IAC in the News" gateway page is a collection of media articles and appearances featuring IAC experts
IAC leaders have been go-to immunization resources for the media for years. The IAC in the News gateway page leads to a collection of these media articles and appearances. This page can be found by selecting "About IAC" in the whitespace that runs along the top of every immunize.org web page and then selecting "IAC In the News" from the left sidebar.
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AAP virtual learning collaborative will focus on improving coverage with HPV and influenza vaccination in rural and underserved pediatric populations
Through State Immunization and Strategy Action Teams, the American Academy of Pediatrics (AAP) will support a virtual learning collaborative focused on improving human papillomavirus (HPV) and pediatric influenza vaccination in rural and underserved areas with low vaccination rates. The collaborative will support state teams in developing and implementing plans to reach rural and underserved populations. The collaborative will hold virtual team meetings from September 2020 through July 2021.
AAP chapters, health departments, immunization coalitions, health care systems, and other organizations interested in working to address rural and underserved populations should submit an application and three letters of support by July 27, 2020. The application form can be viewed here.
For more information, contact Melissa Ponce at mponce@aap.org or 630-626-6209.
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Voices for Vaccines releases podcast "Can We Get Back to Routine Vaccines?" discussing the importance of routine childhood vaccines amid COVID-19 pandemic
Voices for Vaccines (VFV) has posted a new entry in its Vax Talk podcast series: Can We Get Back to Routine Vaccines? While the world is focused on COVID-19, measles, polio, and even diphtheria are finding pathways to resurgence. What is going on with those routine childhood vaccines? Are they really important right now? Karen and Nathan discuss this critical topic and what you can do to make sure we are preventing multiple health crises at once.
Voices for Vaccines is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters. VFV invites everyone who values vaccines to become a member, use VFV tools in their own community, and sign up for VFV’s free newsletter. Please spread the word to your friends and colleagues to join VFV!
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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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Handouts
IAC revises three of its age-specific screening checklists for contraindications to vaccination
IAC recently revised the second page of three of its screening checklists for contraindications to vaccines handouts.
URLs have been updated on the Screening Checklist for Contraindications to Vaccines for Children and Teens. Page two has also been updated to clarify that isolated humoral immunodeficiency is not a precaution to varicella vaccine, and to observe a 30-day interval between yellow fever vaccine and another live virus vaccine.
 
The Screening Checklist for Contraindications to HPV, MenACWY, MenB, and Tdap Vaccines for Teens was updated to provide guidance on the MenB vaccine for pregnant teens.
 
The Screening Checklist for Contraindications to Vaccines for Adults was revised to clarify issues of Guillain Barre syndrome and influenza vaccination, and to update content on MenB vaccination during pregnancy.
 
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Featured Resources
In our “Video of the Week,” teens from British Columbia are amazed when they learn that the HPV vaccine can prevent certain types of cancers
In this January 2020 video, We Can Be the First, from ImmunizeBC, teens and preteens from British Columbia share their connections to people who have had cancer. These children are surprised when they find out the HPV vaccine can protect them from these same cancers.
Visit the VOTW archive.
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“Shop IAC” on immunize.org offers many resources for your practice. Order laminated 2020 U.S. immunization schedules for your exam rooms today!
On the Shop IAC web page, you will find many resources such as laminated vaccination schedules, personal immunization record cards, pins for your lapel, and more! Your purchases will help IAC keep delivering free educational materials to healthcare professionals and to the public.
IAC's laminated versions of the 2020 U.S. child/adolescent immunization schedule and the 2020 U.S. adult immunization schedule are ideal for use in any busy healthcare setting where vaccinations are given.
 
The schedules' coating can be wiped down, and they’re durable enough to stand up to a year's worth of use. Visit the Shop IAC: Laminated Schedules web page for more information on the schedules.
IAC’s three personal immunization record cards—child & teen, adult, and lifetime—are printed on durable rip-, smudge-, and water-proof paper. Sized to fit in a wallet when folded, the cards are brightly colored to stand out. Give these nearly indestructible personal record cards to your patients. They're sold in boxes of 250.
You too can show your support for vaccination with IAC’s elegantly designed “Vaccines Save Lives” pin on your lapel. The pin makes a refined statement in hard black enamel with gold lettering and edges, measuring 1.125" x 0.75”. Order yours today to show how much you value immunizations!
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Journal Articles and Newsletters
CHOP's Vaccine Education Center publishes June issue of Vaccine Update newsletter
The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia (CHOP) publishes a monthly immunization-focused newsletter titled Vaccine Update. The June issue includes the following articles:
Additional resources, including information booklets for patients, are available in the full newsletter.
Access the sign-up form to subscribe to Vaccine Update.
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“Parental Hesitancy About Routine Childhood Influenza Vaccinations: A National Survey” published in Pediatrics
In its June 2020 issue, Pediatrics published Parental Hesitancy About Routine Childhood and Influenza Vaccinations: A National Survey, by Allison Kempe, et al. The conclusions appear below.
Almost 1 in 15 U.S. parents are hesitant about routine childhood vaccines, whereas >1 in 4 are hesitant about influenza vaccine. Furthermore, 1 in 8 parents are concerned about vaccine safety for both routine childhood and influenza vaccines, and only 1 in 4 believe influenza vaccine is effective. Vaccine hesitancy, particularly for influenza vaccine, is prevalent in the United States.
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CDC publishes “Measles Outbreak Associated with International Air Travel—California, March–April 2017” in MMWR
CDC published Measles Outbreak Associated with International Air Travel—California, March–April 2017 in the June 26 issue of MMWR (pages 803–804).
Contact investigations for travel-associated measles outbreaks are costly and labor intensive. In March 2017, the County of San Diego Health and Human Services Agency (COSD HHSA) notified CDC of a measles case in a passenger (patient A) who had recently traveled to Indonesia. Public health agencies aimed to locate and quarantine possible exposures from the flight. COSD HHSA reported a second case (patient B) in late March who had been in contact with patient A in the clinic waiting room. At the end of March, Orange County Health Care Agency (OCHCA) reported a confirmed measles case, patient C, a flight attendant who served patient A. In the days following, OCHCA confirmed measles cases in two unvaccinated siblings, however, the investigation could not establish a link between the confirmed cases. All five patients were the only isolates identified in the United States from March–April 2017. The travel-associated outbreak serves as a reminder that vaccine-eligible adult travelers lacking evidence of immunity should receive two MMR doses before traveling internationally.
Access the MMWR article in HTML format or in PDF format.
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On the Lighter Side
Two-year-old wishes for the gift of health along with his birthday cake
In the 1998 video, Birthday, a 2-year-old boy might appreciate his cake as well as the gift of health. The spot was produced by the Sioux Falls (South Dakota) Health Department and is part of a PSA collection curated by vaccine expert William L. Atkinson, MD, MPH.
Previous videos mentioned in “On the Lighter Side” are available on IAC's Vimeo channel.
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