Issue 1,613: January 26, 2022
(Formerly IAC Express)
Top Stories

Immunize.org Pages and Handouts 
Featured Resources
Notable Publications  
Global News
Upcoming Events  
Top Stories
“Use of Recombinant Zoster Vaccine in Immunocompromised Adults Aged ≥19 Years: Recommendations of the Advisory Committee on Immunization Practices—United States, 2022” published in MMWR

CDC published Use of Recombinant Zoster Vaccine in Immunocompromised Adults Aged ≥19 Years: Recommendations of the Advisory Committee on Immunization Practices—United States, 2022 on January 21 in MMWR. A portion of the summary appears below. 

Immunocompromised persons experience a higher incidence of herpes zoster and related complications. On July 23, 2021, the Food and Drug Administration expanded the indication for use of recombinant zoster vaccine (RZV) to include immunodeficient or immunosuppressed adults. …

On October 20, 2021, the Advisory Committee on Immunization Practices recommended 2 RZV doses for prevention of herpes zoster and related complications in immunodeficient or immunosuppressed adults aged ≥19 years. …

RZV is the first herpes zoster vaccine approved for use in immunocompromised persons. With moderate to high vaccine efficacy and an acceptable safety profile, RZV has the potential to prevent considerable herpes zoster incidence and related complications.


Clinical guidance in this ACIP policy note addresses important questions including timing of vaccination and evaluation of a patient’s history of varicella disease. Access the MMWR article in HTML or PDF.

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Immunize.org updates its popular “Ask the Experts” web page on COVID-19 vaccines with CDC guidelines through January 17; “Ask the Experts” HPV page also updated

Immunize.org has updated two of its “Ask the Experts” web pages for COVID-19 and human papillomavirus (HPV) vaccines. The COVID-19 page was updated on January 17 to incorporate the January 2022 updates to CDC’s recommendations for the use of booster doses in all adolescents age 12 years and older, the 5-month booster interval for mRNA vaccines, and the recommendations for additional primary series doses in immunocompromised children age 5 through 11 years. 

All “Ask the Experts” sections are periodically reviewed, even in the absence of any changes in CDC recommendations. The Human Papillomavirus (HPV) page was recently reviewed and updated with current epidemiologic data. There have been no major HPV policy changes since the last revision.

Immunize.org's Ask the Experts main page leads you to 29 distinct web pages on a variety of topics with more than 1,100 common or challenging questions and answers (Q&As) about vaccines and their administration. Immunize.org's team of experts includes Kelly L. Moore, MD, MPH (team lead), Carolyn B. Bridges, MD, FACP, and Iyabode Beysolow, MD, MPH.

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“Use of the Janssen (Johnson & Johnson) COVID-19 Vaccine: Updated Interim Recommendations from the Advisory Committee on Immunization Practices—United States, December 2021” published in MMWR

CDC published Use of the Janssen (Johnson & Johnson) COVID-19 Vaccine: Updated Interim Recommendations from the Advisory Committee on Immunization Practices—United States, December 2021 on January 21 in MMWR. A portion of the summary appears below.

On December 16, 2021, after reviewing updated vaccine effectiveness and safety data, the Advisory Committee on Immunization Practices made a preferential recommendation for the use of mRNA COVID-19 vaccines over the Janssen adenoviral-vectored COVID-19 vaccine in all persons aged ≥18 years in the United States. …

Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines are preferred over the Janssen COVID-19 vaccine for primary and booster vaccination. The Janssen COVID-19 vaccine may be considered in some situations, including for persons with a contraindication to receipt of mRNA COVID-19 vaccines.


Access the MMWR article in HTML or PDF.

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

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“COVID-19 Incidence and Death Rates among Unvaccinated and Fully Vaccinated Adults with and without Booster Doses during Periods of Delta and Omicron Variant Emergence—25 U.S. Jurisdictions, April 4–December 25, 2021” published as an MMWR Early Release

CDC published COVID-19 Incidence and Death Rates among Unvaccinated and Fully Vaccinated Adults with and without Booster Doses during Periods of Delta and Omicron Variant Emergence—25 U.S. Jurisdictions, April 4–December 25, 2021 on January 21 in MMWR Early Release. A portion of the summary appears below. 

Although COVID-19 vaccine effectiveness decreased with emergence of the Delta variant and waning of vaccine-induced immunity, protection against hospitalization and death has remained high. …

In 25 U.S. jurisdictions, decreases in case incidence rate ratios for unvaccinated versus fully vaccinated persons with and without booster vaccine doses were observed when the Omicron variant emerged in December 2021. Protection against infection and death during the Delta-predominant period against infection during Omicron emergence were higher among booster vaccine dose recipients, and especially among persons aged 50–64 and ≥65 years.


Access the MMWR article in HTML or PDF.



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“Effectiveness of a Third Dose of mRNA Vaccines against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations among Adults during Periods of Delta and Omicron Variant Predominance—VISION Network, 10 States, August 2021–January 2022” published as an MMWR Early Release

CDC published Effectiveness of a Third Dose of mRNA Vaccines against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations among Adults during Periods of Delta and Omicron Variant Predominance—VISION Network, 10 States, August 2021–January 2022 on January 21 in MMWR Early Release. A portion of the summary appears below. 

COVID-19 mRNA vaccine effectiveness (VE) in preventing COVID-19 might decline because of waning of vaccine-induced immunity or variant immune evasion. …

VE was significantly higher among patients who received their second mRNA COVID-19 vaccine dose <180 days before medical encounters compared with those vaccinated ≥180 days earlier. During both Delta- and Omicron-predominant periods, receipt of a third vaccine dose was highly effective at preventing COVID-19–associated emergency department and urgent care encounters (94% and 82%, respectively) and preventing COVID-19–associated hospitalizations (94% and 90%, respectively). …

All unvaccinated persons should start vaccination as soon as possible. All adults who have received mRNA vaccines during their primary COVID-19 vaccination series should receive a third dose when eligible, and eligible persons should stay up to date with COVID-19 vaccinations.


Access the MMWR article in HTML or PDF.

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“COVID-19 Cases and Hospitalizations by COVID-19 Vaccination Status and Previous COVID-19 Diagnosis—California and New York, May–November 2021” published as an MMWR Early Release

CDC published COVID-19 Cases and Hospitalizations by COVID-19 Vaccination Status and Previous COVID-19 Diagnosis—California and New York, May–November 2021 on January 19 in MMWR Early Release. A portion of the summary appears below.

Although the epidemiology of COVID-19 might change as new variants emerge, vaccination remains the safest strategy for averting future SARS-CoV-2 infections, hospitalizations, long-term sequelae, and death. Primary vaccination, additional doses, and booster doses are recommended for all eligible persons. Additional future recommendations for vaccine doses might be warranted as the virus and immunity levels change.

Access the MMWR article in HTML or PDF.

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Influenza activity expected to continue for several weeks; keep vaccinating!

Influenza Surveillance
For week 2, ending on January 15, CDC’s Weekly U.S. Influenza Surveillance Report, FluView summary reports that seasonal influenza activity in the United States is expected to continue for several weeks. The high levels of acute respiratory illness reflected in the national map include both influenza and non-influenza (e.g., COVID-19) respiratory illnesses.



Influenza Vaccination Dashboard
CDC’s new Weekly Flu Vaccination Dashboard shares preliminary vaccination data. This week’s key fact: influenza vaccinations for adults 18 and older have declined at both pharmacies and at physician medical clinics this year. An estimated 9.5 million fewer influenza vaccinations were administered in pharmacies as of the week ending December 18, 2021 (37.1 million vs. 46.6 million at the same point in 2020). An estimated 3.4 million fewer influenza vaccinations were administered in physician medical offices as of the week ending January 2, 2022, compared to the same time in 2021 (31.0 million vs. 27.6 million).

CDC recommends everyone age 6 months and older get an annual flu vaccine. Influenza and 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. 

Vaccine Finder
If you don’t provide influenza vaccine at your site, please strongly recommend vaccination and refer people to sites that do vaccinate. Use VaccineFinder, a user-friendly website to help people of all ages find influenza, COVID-19, and other vaccines. Participating providers can update their vaccine inventory estimates on VaccineFinder. For questions or more information, contact vaccine@healthmap.org.

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Spotlight! Immunize.org’s “Clinic Tools: Administering Vaccines” main page provides tools from authoritative sources

Immunize.org's Clinic Tools: Administering Vaccines main page is a collection of resources from Immunize.org, CDC, and other organizations related to administering vaccinations. This main page can be found by selecting the "Clinic Tools" tab in the middle of the blue banner atop every Immunize.org web page and then selecting "Administering Vaccines."

In the left-hand column of the page, you will find Immunize.org's educational materials such as:

  • Administering Vaccines: Dose, Route, Site, and Needle Size
  • Don’t Be Guilty of These Preventable Errors in Vaccine Administration
  • Skills Checklist for Vaccine Administration; and related resources

 The right-hand column of the page features resources from CDC, including:

  • Links to vaccine administration guidelines
  • “General Best Practice Guidelines for Immunization”
  • The Epidemiology and Prevention of Vaccine-Preventable Diseases ("The Pink Book")


   

Visit the Clinic Tools: Administering Vaccines main page on Immunize.org.

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Journalists interview Immunize.org experts

Journalists seek out Immunize.org experts to help explain vaccines to the public and policy makers. We help the media understand and communicate the complex work vaccinators do. Here is a recent citation.

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Vaccines in the News

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

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Immunize.org Pages and Handouts
Immunize.org updates “Using Standing Orders for Administering Vaccines: What You Should Know”

Immunize.org recently revised Using Standing Orders for Administering Vaccines: What You Should Know. Minor changes were made.

The use of standing orders facilitates the delivery of vaccination services to patients in clinics, hospitals, and community settings. Standing orders have been shown to increase vaccination coverage rates. This piece answers the following questions:

  • What are standing orders?
  • Who recommends standing orders?
  • What are the elements of a standing order?
  • Who is authorized to administer vaccines under standing orders?
  • Who is authorized to sign the standing orders?
  • What should be done with the standing orders after they have been signed?
  • Do standing orders need to be renewed?
  • Where can I find sample standing orders?

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Featured Resources
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 Seqirus, has updated the "65+ Flu Defense" website at www.influenza-defense.org.

A new fact sheet on the site, The Importance of Preventing Influenza during a Pandemic, offers responses to help guide discussions with patients on the increased importance of flu vaccination during the COVID-19 pandemic. Age increases risks associated with COVID-19 infection including hospitalization and death. Preliminary studies suggest coinfection with influenza B and SARS-CoV-2 may elevate the risk of poor outcomes.



This helpful site includes information, tools, and tips for communicating with these adults about the scope and severity of influenza, for example:

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FREE! Immunize.org offers “Me Vacuné Contra el COVID-19” and “I Got My COVID-19 Vaccine” buttons and stickers. Free shipping!

As COVID-19 vaccination programs vaccinate children age 5 through 11 years and offer booster doses to more people, now is the time to stock up on Immunize.org’s FREE “I Got My COVID-19 Vaccine” buttons and stickers, provided at no cost for product or shipping thanks to support from CDC. These buttons and stickers are perfect for people of all ages who want to show their confidence in COVID-19 vaccination. 

  • Available in Spanish – Buttons and stickers
  • Available in English – Stickers only

Click the picture to place your order now:

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FREE! Order Immunize.org’s popular red "Vacuna Contra LA GRIPE" buttons and stickers. Free shipping! Available in Spanish only.

Immunize.org still has a limited supply of our popular “Vacuna Contra LA GRIPE” buttons and stickers, available at no charge for product or shipping, thanks to funding from Seqirus. Now more than ever, it is important to remind everyone of the importance of influenza vaccination. This bright red button does the trick.
 
Due to supply chain and manufacturing constraints, once all available supplies are reserved, we will not be making more this season. Currently, we only have the Spanish version available.

Click the picture to place your order now:



“FLU VACCINE” BUTTONS

The buttons measure 1.25" across and are delivered in bags of 10 buttons per bag.

“FLU VACCINE” STICKERS

Measuring 1.5" across, these stickers adhere well to clothing and have an easy-peel-off backing.

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Boost yourself, then encourage your friends by adding Immunize.org’s “I Got My COVID-19 Vaccine” Facebook profile photo frame.

Share your excitement about COVID-19 vaccination and inspire your friends! After you are vaccinated against COVID-19, add Immunize.org's new "I Got My COVID-19 Vaccine" Facebook photo frame to liven up your profile picture.

You can obtain the frame in three ways:

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Immunize.org’s elegantly designed “Vaccines Save Lives” black enamel pins make wonderful gifts or workplace recognitions

Immunize.org's “Vaccines Save Lives” pins make meaningful gifts for people who care about vaccination.

Click the picture to place your order now:



The pin is designed in hard black enamel with gold lettering and edges, measuring 1.125" x 0.75". 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, uniforms, and white coats to show that you value vaccines!

  

Click here for "Vaccines Save Lives" pin pricing and ordering information.

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Notable Publications
“Frequency of Adverse Events in the Placebo Arms of COVID-19 Vaccine Trials: A Systematic Review and Meta-Analysis” published in JAMA Network

On January 18, 2022, JAMA Network published Frequency of Adverse Events in the Placebo Arms of COVID-19 Vaccine Trials: A Systematic Review and Meta-Analysis. The article’s Findings appear below:

In this systematic review and meta-analysis of 12 articles including AE [adverse event] reports for 45380 trial participants, systemic AEs were experienced by 35% of placebo recipients after the first dose and 32% after the second. Significantly more AEs were reported in the vaccine groups, but AEs in placebo arms (“nocebo responses”) accounted for 76% of systemic AEs after the first COVID-19 vaccine dose and 52% after the second dose.

Nocebo responses are adverse health effects attributed to an intervention which is, in this case, a placebo. These events (such as headache or fatigue) are often routine background symptoms misattributed to the intervention or the result of anxiety or anticipation of adverse events. The authors suggest providing vaccine recipients with simple information about nocebo effects (e.g., “participants in the placebo arm of the randomized clinical trials testing this intervention reported similar AEs, probably because of worry and anxiety”) to reduce their expectations of and anxiety about adverse events. This will help diminish the nocebo effect.

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“Influenza Vaccine Uptake and Missed Opportunities among the Medicare-Covered Population with High-Risk Conditions during the 2018 to 2019 Influenza Season” published in Annals of Internal Medicine

In the January 2022 issue, Annals of Internal Medicine published Influenza Vaccine Uptake and Missed Opportunities among the Medicare-Covered Population with High-Risk Conditions during the 2018 to 2019 Influenza Season. The conclusions section appears below.

Influenza vaccination coverage for Medicare beneficiaries continues to be suboptimal, with missed opportunities despite availability of influenza vaccination with no copayment. Disparities persist in vaccination uptake by race/ethnicity.

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Global News

“Progress toward Poliomyelitis Eradication—Afghanistan, January 2020–November 2021” published in MMWR

CDC published Progress toward Poliomyelitis Eradication—Afghanistan, January 2020–November 2021 on January 21 in MMWR. A portion of the summary appears below.

Despite an increase in the numbers of inaccessible children in Afghanistan in 2021 and disruption of polio eradication activities caused by the COVID-19 pandemic and abrupt changes in government, the number of wild poliovirus type 1 cases and percentage of positive sewage samples have markedly decreased by 93% and 97%, respectively, from the same period in 2020. …

Although challenges remain, prospects for vaccination of previously inaccessible children along with sustained, robust polio eradication efforts in Afghanistan could result in substantial progress toward eradication during 2022–2023.


Access the MMWR article in HTML or PDF.

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Upcoming Events
Virtual: Today! APHA offers webinar “The Third Year of COVID-19: Is This the New Normal?” CE available. 

The American Public Health Association (APHA) will offer a webinar titled The Third Year of COVID-19: Is This the New Normal? on January 26 at 5:00 p.m. (ET). This webinar will provide insight into what we have learned from the Omicron variant and how understanding of vaccine efficacy, emerging therapeutics, and public health guidance can help us move toward the new normal. Webinar participants can earn 1.5 CPH, CME, CNE, or CHES continuing education credits.

To register, click here.

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For more upcoming events, visit our Calendar of Events. 
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.

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
ISSN 2771-8085

About IZ Express

IZ Express is supported in part by Grant No. NH23IP922654 from CDC’s National Center for Immunization and Respiratory Diseases. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.

IZ Express Disclaimer
ISSN 2771-8085

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

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