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FDA authorizes and CDC recommends certain adults consider second booster doses of mRNA COVID-19 vaccines; Immunize.org updates its COVID-19 document checklist On March 29, FDA authorized a second booster dose of either mRNA COVID-19 vaccine for older and immunocompromised individuals. Following the authorization, CDC updated their Interim Clinical Considerations for Use of COVID-19 Vaccines Currently Approved or Authorized in the United States on March 30. All healthcare professionals administering or counseling patients on COVID-19 vaccination should review the changes in this important guidance.
CDC revised its recommendations for who may receive a second booster mRNA vaccine dose at least 4 months after the first booster dose:
- People age 12 years and older who are moderately or severely immunocompromised
- Adults age 50 years and older who are not moderately or severely immunocompromised
- Adults age 18–49 years who are not moderately or severely immunocompromised and who received Janssen COVID-19 Vaccine as both their primary series dose and booster dose
The revisions further clarify safety issues including those related to multisystem inflammatory syndrome in children (MIS-C) and adults (MIS-A) and myocarditis.
The vaccine product table updates information on the Moderna COVID-19 Vaccine supplied in a vial with a red cap, which provides a 50-mcg booster dose in a 0.25-mL dosage volume, and Moderna COVID-19 Vaccine supplied in a vial with a blue cap, which provides a 50-mcg booster dose in a 0.5-mL dosage volume.
To incorporate the new COVID-19 booster recommendations released this week, Immunize.org revised its Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools for healthcare professionals. The checklist includes the most recent revision dates of CDC’s primary COVID-19 vaccination websites, as well as print-ready PDF documents from CDC and FDA. Each date is hyperlinked to the original document or web page. Immunize.org will update this list at least monthly, indicating when it was last updated prominently at the top of the page. We encourage all COVID-19 vaccination providers to compare the documents in use in your facility to this list monthly to be sure your practices stay up to date.
 
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"Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices—United States, 2022" published in MMWRCDC published Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices—United States, 2022 on April 1 in MMWR. Immunize.org's Kelly L. Moore, MD, MPH, is a co-author. Hepatitis B vaccination is now recommended by CDC as follows:
- All adults age 19 through 59 years and adults age 60 years and older with risk factors for hepatitis B infection should be vaccinated against hepatitis B
- Adults age 60 years and older without known risk factors may also receive HepB
The publication also describes the use of PreHevbrio (VBI), a trivalent hepatitis B vaccine licensed in late 2021 for use as a 3-dose series administered over 6 months and recommended by ACIP as an option for hepatitis B vaccination of adults age 18 years or older.
All healthcare professionals should routinely offer HepB to adults who lack documentation of hepatitis B vaccination or previous infection, rather than wait for patients to request vaccination. Pre-vaccination serologic testing is not required; however, if serologic testing is done, it may be done immediately before administering the first dose of vaccine at the same visit. In recent years, rates of acute hepatitis B reported to CDC among adults in their 30s through 50s have been gradually increasing. For most people, a single hepatitis B vaccination series of 2 or 3 doses (depending upon brand), will prevent hepatitis B infection for a lifetime.
CDC continues to recommend hepatitis B vaccination for all infants and catch-up vaccination of children and teens younger than age 19 years. Immunize.org is in the process of updating its handouts and Ask the Experts to reflect the new recommendations.
Access the MMWR article in HTML or PDF.
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Immunize.org issues updated adult hepatitis B vaccination standing orders template for clinicians Immunize.org issued its updated Standing Orders for Administering Hepatitis B Vaccine to Adults template with CDC’s new universal adult hepatitis B recommendations described in the previous article. The standing orders template covers the use of all licensed and recommended hepatitis B vaccines: Engerix-B (GSK), Recombivax-HB (Merck), Heplisav-B (Dynavax), and PreHevbrio (VBI).
U.S. government launches COVID.gov as one-stop shop for resources on vaccines, tests, treatments, masks, and information On March 30, the U.S. government launched COVID.gov, a consolidated website to help people in the United States gain easier access to vaccines, tests, treatments, and masks, as well as updates on COVID-19 incidence in their area. As part of COVID.gov, a new Test-to-Treat locator will help people access pharmacies and community health centers where they can get COVID-19 testing and appropriate antiviral treatment, if indicated. A portion of the press release appears below.
The Administration has worked over the past 14 months to set up over 90,000 vaccination sites, make more than 400 million high-quality masks available for free, send free tests to peoples’ homes, and stand up new test-to-treat sites where people can get tested and receive life-saving antivirals all in one place. Now, with a click of a button, people will be able to find where to access all of these tools, as well as receive the latest CDC data on the level of COVID-19 in their community.
As part of COVID.gov, a new Test-to-Treat locator will help people access pharmacies and community health centers across the nation where people can get tested for COVID-19 and receive appropriate treatments if they need them. … the Administration has already launched over 2,000 of these sites, plus more than 240 sites across Veteran’s Health Administration and Department of Defense facilities to serve veterans, military personnel, and their families.
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National Public Health Week is April 4–10; remind people “Public Health Is Where You Are” with resources and social media toolkit The American Public Health Association (APHA) is hosting the 27th National Public Health Week (NPHW) April 4–10, with this year's theme being "Public Health Is Where You Are." The theme celebrates how the places we are mentally, physically, and societally affect our health and our lives.
Become part of the growing movement to celebrate the power of prevention, advocate for healthy and fair policies, share strategies for increasing equity, and champion the role of a strong public health system. The NPHW Toolkit and social media sharables make it fun and easy to promote healthy behaviors and raise awareness in your community.
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April is National Oral Cancer Month; HPV vaccination helps prevent oropharyngeal cancers The fastest-growing cause of oral cancer in young, healthy, non-smoking individuals is human papillomavirus (HPV). Professional advocacy and public awareness of the need for HPV vaccination are essential to saving lives.
In addition to HPV vaccination, the Oral Cancer Foundation (OCF) invites you to join in its national screening campaign for early detection of oral cancer during National Oral Cancer Month this April. See links below for additional information.
You can also raise awareness of oral cancer and HPV vaccination to prevent it during National Oral Cancer Month on your website or social media platform.
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Influenza activity is highest in central and south-central regions; vaccination is still encouraged Influenza Surveillance
For week 12, ending on March 26, CDC's Weekly U.S. Influenza Surveillance Report, FluView summary reports that influenza activity is highest in central and south-central regions of the country but appears to be declining slightly in these regions. Influenza activity is increasing in the northeast and northwest regions.
Influenza Vaccination Dashboard
CDC's new Weekly Flu Vaccination Dashboard shares preliminary vaccination data. This week’s key fact: Influenza vaccination coverage among all adults age 18 years and older varies widely among the states and territories as of mid-February 2022, ranging from just 35.6% to a high of 59.8%; overall, national vaccination coverage is 45.1%.
CDC recommends everyone age 6 months and older get an annual influenza 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: Review of resources at Immunize.org focused on adolescent vaccination Immunize.org offers many useful materials on adolescent vaccination for professionals and parents.
Resources for Adolescent Vaccination main page offers all the adolescent educational materials from Immunize.org and partner organizations.
Adolescent Vaccination main page contains the handouts that pertain to adolescent vaccinations.
Schedules main page provides print-ready PDFs of the recommended immunization schedules for children and adolescents, as well as for adults.
Screening Checklists about Vaccine Contraindications and Precautions main page links you to forms that patients can fill out to expedite assessment of vaccination needs and contraindications.
Give2MenACWY website offers resources to help providers increase teen vaccination and MenACWY booster dose rates.
IZ Express keeps readers up to date on what’s new in vaccines each week; invite your colleagues to subscribe!
We appreciate you as a subscriber! Encourage your colleagues to subscribe to IZ Express themselves so they get everything that matters to vaccinators in their own inbox each Wednesday.
IZ Express succinctly summarizes each week’s important vaccine developments, including new and updated recommendations from CDC and the latest vaccine decisions by FDA. IZ Express also features:
- Newly posted Vaccine Information Statements and their translations
- Educational materials from Immunize.org, CDC, AAP, and others
- Notices about online and in-person educational opportunities, many offering free continuing education credit
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 one of our recent citations.
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
Immunize.org Pages and Handouts
Recap: These updated Immunize.org educational materials and web pages for clinicians were released during February and March IZ Express regularly provides readers with information about Immunize.org new and updated educational materials and web pages for healthcare professionals. All Immunize.org materials are free to distribute.
In case you missed them during recent weeks, updates were made to these helpful materials:
Immunize.org Updated PDF Materials for Clinicians
Immunize.org Updated Web Pages
Immunize.org Updated PDF Materials for Patients
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- Immunize.org: Handouts main page to see educational materials sorted by category
- Immunize.org: Ask the Experts main page to access more than 1,100 questions answered by Immunize.org experts
- Immunize.org: Clinic Tools main page and its nine subtopics
- Immunize.org: Educational Materials for Patients and Staff—an alphabetical list of more than 230 ready-to-print staff educational materials and patient handouts
Vaccine Information Statements
Recap: These new VISs and VIS translations were released during February and March In February, CDC released updated pneumococcal conjugate (PCV) vaccine and recombinant zoster (shingles) vaccine VISs. During March, nine updated translations for each VIS were posted in: Arabic, Burmese, Chinese (Simplified and Traditional), French, Russian, Somali, Spanish, and Vietnamese.
Additionally, two Immunize.org handouts related to VISs were updated:
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Featured Resources
Reminder! Immunize.org updates its “Ask the Experts: Pneumococcal Vaccines” web page with important new 2022 recommendations for adults.
Immunize.org updated its popular Ask the Experts: Pneumococcal Vaccines web page on March 22. This extensive list of clinical questions and answers now reflects new ACIP recommendations (published January 2022) for the use of pneumococcal conjugate vaccines (PCV15 and PCV20) and pneumococcal polysaccharide vaccine (PPSV23). The changes cover advice for adults age 19–64 who are immunocompromised or have chronic health issues that put them at risk for invasive pneumococcal disease, as well as what to do for all adults age 65 and older. In addition, the questions and answers address the vaccination needs of those who received PCV13 or PPSV23 in the past.
Immunize.org's Ask the Experts main page leads you to 30 distinct web pages on a variety of topics with more than 1,100 common or challenging questions and answers 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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Order today! Laminated versions of CDC’s 2022 immunization schedules are available to ship.
Immunize.org laminated versions of the 2022 U.S. child and adolescent immunization schedule and the 2022 U.S. adult immunization schedule are available to order. They are in stock and shipping now. Order while supplies last.
While the schedules are available online from CDC at no cost, Immunize.org’s printed, laminated schedules are ideal for use in any busy healthcare setting where vaccinations are given. Their tough coating can be wiped down, and they’re durable enough to stand up to a year's worth of use.
In 2022, the length of each schedule with appendices was extended by two pages. As a result, the laminated schedules are now published in a standard 8.5” X 11” booklet format.
- The child/adolescent schedule booklet is ten pages (i.e., five double-sided pages) and includes a bonus page with Immunize.org’s popular 1-page handout summarizing the dose, route, and needle size recommendations for all vaccines and recipients
- The adult schedule booklet is eight pages (i.e., four double-sided pages)
 
With color coding for easy reading, our laminated schedules replicate the original CDC formatting, including the essential tables and notes.
PRICING
| Number of Copies |
Cost |
| 1–4 copies |
$7.50 each |
| 5–19 copies |
$5.50 each |
| 20–99 copies |
$4.50 each |
| 100–499 copies |
$4.00 each |
| 500–999 copies |
$3.50 each |
For quotes on customizing or placing orders of 1,000 copies or more, call 651-647-9009 or email admininfo@immunize.org.
Visit the Shop Immunize.org: Laminated Schedules web page for more information on the schedules, to view images of all the pages, to download the order form, and to order today!
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AAP releases new videos in education series addressing parents’ questions about childhood vaccines
On March 15, the American Academy of Pediatrics (AAP) released new videos in its Childhood and Adolescent Vaccine Education Series. In this series, pediatricians address the most common questions parents ask about their children's vaccinations and offer tips on finding correct information online.
These new videos are the product of a YouTube partnership with the AAP, the Children’s Hospital of Philadelphia’s Vaccine Education Center, and the American College of Physicians.
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Explore the updated www.Give2MenACWY.org website to increase coverage for the MenACWY booster and other adolescent vaccinations
Immunize.org's www.Give2MenACWY.org website promotes the importance of adolescent vaccination, including administering the recommended MenACWY vaccine booster dose at age 16. Many teens are behind on vaccines because of the pandemic, so vaccination is more important than ever.
Materials on this colorful website for healthcare professionals incorporate the 2020 ACIP meningococcal vaccine recommendations and coverage statistics from CDC’s National Immunization Survey–Teen (NIS–Teen). One particularly popular resource on the site is the updated Algorithm for MenACWY Immunization in Adolescents 11–18 Years of Age.
The website is divided into five easy-to-access sections:
The site also categorizes materials according to whether they are primarily of interest to providers, to adolescents, or to parents.
Visit Give2MenACWY.org and enjoy browsing (and deploying) its bountiful resources.
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Notable Publications
“Effectiveness of Homologous and Heterologous COVID-19 Booster Doses following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) Vaccine Dose against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations among Adults—VISION Network, 10 States, December 2021–March 2022” published in MMWRCDC published Effectiveness of Homologous and Heterologous COVID-19 Booster Doses following 1 Ad.26.COV2.S (Janssen [Johnson & Johnson]) Vaccine Dose against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations among Adults—VISION Network, 10 States, December 2021–March 2022 on April 1 in MMWR. A portion of the summary appears below.
Little is known about vaccine effectiveness (VE) of different booster strategies following Ad.26.COV2.S (Janssen [Johnson & Johnson]) vaccination, especially during Omicron variant predominance....
VE against COVID-19–associated emergency department/urgent care visits was 24% after 1 Jansen dose, 54% after 2 Jansen doses, and 79% after 1 Janssen/1 mRNA dose, compared to 83% after 3 mRNA doses. VE for the same strategies against COVID-19–associated hospitalization was 31%, 67%, 78%, and 90% respectively....
All eligible persons should receive recommended COVID-19 booster doses to prevent moderate to severe COVID-19. Adult Janssen primary vaccine recipients should preferentially receive a heterologous mRNA vaccine booster dose ≥2 months later.
Access the MMWR article in HTML or PDF.
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“Cardiac Complications after SARS-CoV-2 Infection and mRNA COVID-19 Vaccination—PCORnet, United States, January 2021–January 2022” published as an MMWR Early Release
CDC published Cardiac Complications after SARS-CoV-2 Infection and mRNA COVID-19 Vaccination—PCORnet, United States, January 2021–January 2022 on April 1 as an MMWR Early Release. A portion of the summary appears below.
Studies have found an increased risk for cardiac complications after SARS-CoV-2 infection and mRNA COVID-19 vaccination, but few have compared these risks....
Data from 40 health care systems participating in a large network found that the risk for cardiac complications was significantly higher after SARS-CoV-2 infection than after mRNA COVID-19 vaccination for both males and females in all age groups....
These findings support continued use of recommended mRNA COVID-19 vaccines among all eligible persons aged ≥5 years.
Access the MMWR article in HTML or PDF.
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“Safety of Live Attenuated Influenza Vaccine in Children with Asthma” published in PediatricsIn the March 28 issue, Pediatrics published Safety of Live Attenuated Influenza Vaccine in Children with Asthma. A summary appears below.
A randomized, controlled trial in 5- to 17-year-old children with persistent asthma showed that live attenuated influenza vaccine was no more likely to be associated with asthma exacerbations than inactivated influenza vaccine. In this study, 151 children with asthma, ages 5–17 years, were enrolled over two influenza seasons. The study showed overall low rates of asthma exacerbations in the 42 days after influenza vaccination, regardless of formulation, in the participants. Current recommendations caution against the use of live attenuated influenza vaccine (LAIV4) in children ≥5 years of age with asthma. In conclusion, these data support re-examining precautions to using live attenuated influenza vaccine in children with asthma.
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Upcoming Events
Virtual, today: FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) meets to discuss COVID-19 booster doses and process for COVID-19 vaccine strain selection FDA will convene its Vaccines and Related Biological Products Advisory Committee (VRBPAC) today, April 6 from 8:30 a.m. until 5:00 p.m. (ET) to discuss use of COVID-19 vaccine booster doses and the process for COVID-19 vaccine strain selection to address current and emerging variants. Briefing materials for this meeting can be found at the VRBPAC web page specific for the April 6 meeting.
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Virtual: NFID and AIM host “Communications during a Pandemic—from 1918 to Present Times” webinar on April 26 The National Foundation for Infectious Diseases (NFID) and Association of Immunization Managers (AIM) will host a webinar titled Communications during a Pandemic—from 1918 to Present Times at 12:00 p.m. (ET) on April 26. The webinar will be moderated by NFID Medical Director William Schaffner, MD. The discussion will feature Paul A. Offit, MD, director of the Children's Hospital of Philadelphia's Vaccine Education Center, and Tim Stephens, author of One Day at a Time: Newspapers and the Great Influenza of 1918. The webinar will explore the similarities and differences between the influenza pandemic of 1918 and the current COVID-19 pandemic, including:
- Role of the media in 1918 and the present
- Impact of war and partisanship
- Social factors including the cost and availability of food, immigration, military conscription, and racial violence
- Role of philanthropy and nonprofits and the responsibility of government
- The Cutter incident regarding polio vaccines, and its impact on manufacturing and safety surveillance
- Implications for future outbreaks and pandemic preparedness
Register for the webinar.
Virtual: Montgomery County Immunization Coalition hosts “COVID-19 Vaccines Virtual Conversation” webinar on April 28 to observe National Minority Health Month
Pennsylvania’s Montgomery County Immunization Coalition (MCIC) in partnership with the Norristown NAACP chapter will host a webinar titled National Minority Month: COVID-19 Vaccines Virtual Conversation at 7:00 p.m. (ET) on April 28. During the webinar, healthcare and community leaders will discuss the latest information on the importance of COVID-19 vaccination, including boosters, as one of the strongest tools to end the COVID-19 pandemic that has disproportionately affected communities of color. Attendees can submit questions in advance or ask them live.
Register for the webinar.
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