Issue 1,514: September 2, 2020
Top Stories
IAC Handouts
World News
Featured Resources
Journal Articles and Newsletters
Education and Training
Conferences and Meetings
On the Lighter Side
Top Stories
IAC summarizes ACIP's 2nd special session on COVID-19 vaccine candidates and vaccination strategies
On August 26, the Advisory Committee on Immunization Practices (ACIP) held a virtual meeting to receive updates on two COVID-19 vaccine candidates, vaccine safety monitoring, epidemiology of COVID-19, and initial considerations for ACIP recommendations for vaccine distribution and prioritization planning. Highlights of the meeting, at which no votes were taken, are outlined below.
Vaccine Development – The Committee received information on two mRNA vaccines (Moderna [mRNA-1273] and Pfizer/BioNTech [BNT162b2]). Both vaccine manufacturers reported encouraging results from phase I trials. Moderna presented data from two small cohorts of older (age 56–70 and 71+ years) volunteers. In general, these older adults exhibited antibody response levels and adverse event profiles that were similar to those previously reported for persons age 18–55 years. Pfizer/BioNTech showed similar data on robust antibody responses in volunteers age 18–55 and 65–85 years and noted that adverse events were less frequent in older vaccine recipients. No serious adverse events were reported after vaccination in these small trials. Phase II and III trials are ongoing. For phase III, each manufacturer has enrolled approximately half of its anticipated 30,000 participants, and each has expressed a strong commitment to assuring racial and ethnic diversity in the trials.
These two mRNA vaccines differ in several respects. A brief comparison appears below. However, these specifications could change as product development work continues. Of note, CDC staff at the meeting commented that providers should defer purchasing new ultra-low temperature freezers in anticipation of the storage requirements discussed below. CDC is working on possible solutions to these complex storage parameters.
– Moderna (mRNA-1273)
- Dosage and Administration: 100-mcg dose, 2 IM doses given 28 days apart
- Packaging: Frozen liquid in multidose vials, 10 doses per vial, without preservative
- Storage: Shipped and may be stored at –20oC (–4oF) for up to 6 months. May refrigerate at 2o to 8oC (36o to 46oF) for up to 7 days. Once the vial has been punctured, discard any doses unused after 6 hours.
– Pfizer/BioNTech (BNT162b2)
- Dosage and Administration: 30-mcg dose, 2 IM doses given 21 days apart
- Packaging: Frozen liquid in multidose vials, 5 doses per vial, without preservative. Minimum 195 vials (975 doses) per shipment. Requires mixing with separately shipped diluent before administration.
- Storage: Shipped directly from manufacturer to end user, on dry ice at –70oC (+/- 10oC) (–94oF). May be stored in an ultra-low temperature freezer for up to 6 months or in the specially designed shipping container, unopened, for up to 10 days. After opening, shipping container may be used for storage if dry ice is replenished upon receipt and every 5 days, and if container openings are limited per the manufacturer’s instructions. May be refrigerated at 2o to 8oC (36o to 46oF) no more than 24 hours or stored at room temperature no more than 2 hours after thawing. After mixing with diluent, use within 6 hours. Discard any doses unused after 6 hours.
Vaccine Safety Monitoring – CDC reviewed the existing U.S. vaccine safety monitoring systems, including the post-licensure safety monitoring roles of both the federal government and vaccine manufacturers. Current systems are capable of monitoring COVID-19 vaccine safety under both Emergency Use Authorization (EUA) and post-licensure scenarios. Monitoring will be carried out through the Vaccine Adverse Event Reporting System (VAERS) plus active surveillance of multiple federal program databases (e.g., Medicare, Department of Defense, Veterans Affairs, Indian Health Service, and CDC’s Vaccine Safety Datalink project). New safety-monitoring methods, including text and email surveys of early vaccine recipients, as well as analysis of data from state immunization information systems (IIS), are planned to enhance rapid assessment of vaccine safety.
COVID-19 Epidemiology – More than 5.6 million cases of COVID-19 have been reported in the U.S. through August 23. The most common underlying medical conditions associated with persons hospitalized with COVID-19 were hypertension, obesity, diabetes, and cardiovascular disease. More than 60% of hospitalized adults had three or more underlying medical conditions, and this proportion increased to 80% for adults age 65 and older. CDC’s COVIDView offers a weekly surveillance summary of COVID-19 epidemiology in the U.S.
Vaccination Strategies – CDC staff presented models estimating disease and death outcomes of various vaccination strategies early in a COVID-19 vaccination program, when vaccine quantities are expected to be limited. Targeted vaccination of healthcare personnel, essential workers, or adults with underlying conditions resulted in similar reductions of COVID-19 infections and deaths in the U.S. population, whereas vaccinating only adults age 65 and older resulted in a smaller decline in infections, but a larger decline in deaths. Another model showed that, if a choice had to be made between vaccinating only the staff or only the residents of nursing homes, vaccinating only nursing home staff prevented more illness and death among residents than vaccinating only residents.
ACIP COVID-19 Work Group (WG) – The WG continues to review emerging data on all COVID-19 vaccine candidates, focusing on which groups of people should be prioritized when the first lots of vaccine become available. Groups being considered include healthcare personnel, essential workers, persons with high-risk medical conditions, and adults age 65 years and older. Because these groups overlap and account for more than half of the U.S. population, the WG may further define sub-groups to prioritize for initial vaccine supplies. The WG also will consider challenges presented by stringent vaccine storage and handling requirements. For example, CDC staff conjectured about scenarios in which some vaccines might be more suitable for use at centralized sites with the ability to efficiently vaccinate large numbers of people in a relatively short period of time. The WG asked ACIP members whether, in general, they agreed with prioritizing healthcare personnel and essential workers, and most oral comments indicated agreement with that concept.
The next ACIP virtual meeting to discuss COVID-19 vaccination will be held on September 22, followed by the routinely scheduled meeting on October 28–29. Details about past and future ACIP meetings are available on the ACIP website.
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Reminder: ACIP recommendations for influenza vaccination for 2020–21 season published on August 21
On August 21, CDC released Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2020–21 Influenza Season in MMWR Recommendations and Reports.
Access the MMWR article in HTML format or in PDF format.
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IAC’s new gateway page, "Vaccination and COVID-19," offers a concise collection of tools to support providing vaccination services during the time of COVID-19
IAC’s new gateway page, Vaccination and COVID-19, is now available to assist healthcare professionals who are faced with challenges in providing routine and catch-up vaccination services during the COVID-19 pandemic. On this gateway page, IAC has assembled key resources and links to help both new and experienced vaccinators deliver safe, effective vaccination to people of all ages, applicable in typical and nontraditional vaccination settings alike.
Do you have specific COVID-19 questions? The site facilitates easy access to key COVID-19 resource pages from major clinical and public health partners involved in immunization. The page will be updated frequently with new links and resources specific to COVID-19 vaccination, so be sure to check back regularly.
To easily locate this gateway page from anywhere on immunize.org, go to the light blue band of tabs across the top, choose the "Clinic Tools" tab, and then select "Vaccination and COVID-19” from the drop-down menu. To link directly to the site, go to www.immunize.org/vax-and-covid-19. You can also use the Guide to immunize.org at the bottom of every web page.
Related Links
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Africa has “kicked out” wild polio, WHO announces
On August 25, the Global Polio Eradication Initiative, the World Health Organization (WHO), and CDC announced that Africa had "kicked out" wild polio. Smallpox was wiped out 40 years ago, making poliovirus the second virus affecting humans that has been eliminated from Africa.
Read their announcements of this momentous achievement:
The Global Polio Eradication Initiative is a public-private partnership with six partners—the World Health Organization (WHO), Rotary International, CDC, UNICEF, Bill & Melinda Gates Foundation, and Gavi, the Vaccine Alliance.
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Use IAC's expanded Repository of Resources for Maintaining Immunization during the COVID-19 Pandemic to catch up patients who fell behind
IAC now offers more than 187 items in its Repository of Resources for Maintaining Immunization during the COVID-19 Pandemic to assist in maintaining routine immunization rates during the COVID-19 pandemic. Located on the website of the National Network of Immunization Coalitions, a project of IAC, this repository includes links to both national and state-level policies and guidance; advocacy materials, including talking points, webinars, press releases, articles, and social media posts; and telehealth resources.
These resources are intended for healthcare settings, state and local health departments, professional societies, immunization coalitions, advocacy groups, and the community to use in their efforts to sustain routine immunizations during the COVID-19 pandemic. The resources can be sorted and searched by date, title, geographic area, source, type, age category, or setting.
If you have a resource to suggest for the repository, please send a message to info@immunizationcoalitions.org.
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IAC Spotlight! These new or updated IAC patient and staff educational materials were announced during July and August
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 were announced as well.
In case you missed them during recent weeks, these helpful materials were announced:
Staff Education Materials
New and Updated Pages and Gateway Pages
Related Links
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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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IAC Handouts
IAC updates parent handout titled “Top Ten Reasons to Protect Your Child by Vaccinating”
IAC recently updated its handout for parents titled Top Ten Reasons to Protect Your Child by Vaccinating. Minor changes were made.
Related Links
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World News
WHO reports on influenza surveillance data during the COVID-19 pandemic in Weekly Epidemiological Record
The World Health Organization (WHO) published Interpreting Influenza Surveillance Data in the Context of the COVID-19 Pandemic in the August 28 issue of its Weekly Epidemiological Record. An excerpt from a relevant passage appears here.
As the main symptoms of COVID-19 disease are fever and cough, similar to influenza, they are likely to be captured by the case definitions for ARI [acute respiratory infection], ILI [influenza-like illness] and SARI [severe acute respiratory infection] in syndromic disease surveillance, and influenza sentinel surveillance systems can be expected to be sensitive to increases in ARI, ILI or SARI due to SARS-CoV-2 transmitted in the community.
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Featured Resources
PBS documentary about IAC, Protecting Health: Saving Lives, makes a powerful case for vaccination. Please share with your colleagues and friends on social media!
The award-winning PBS television documentary series, Visionaries, hosted by Sam Waterston features IAC in the episode, Protecting Health: Saving Lives. This 30-minute film showcases IAC’s founder and executive director Dr. Deborah Wexler’s commitment to supporting the nation’s healthcare professionals with immunization education information and materials. Protecting Health: Saving Lives makes a powerful case for vaccination, addressing and defusing the fears that fuel the antivaccine movement, presenting stories of vaccine-preventable disease, and recognizing the science that has saved millions of lives through vaccination.
Protecting Health: Saving Lives is premiering on more than 100 PBS stations nationwide in the months ahead, but you can watch it right now on IAC’s website at www.immunize.org/aboutus/iac-film-history.asp. We’d very much appreciate your circulating the film by sharing this link with your colleagues and friends through member newsletters, e-mail listservs, social media channels, conferences and web-based events, and web pages.
Sharing Protecting Health: Saving Lives is easy! Just go to https://www.immunize.org/aboutus/iac-film-history.asp or click on the film's image in the right column of IAC's immunize.org main page. Click the “share” button, and choose the social media site where you’d like your friends, family, and colleagues to view the film.
To learn more about the PBS Visionaries series , visit www.visionaries.org.
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It's time to start vaccinating against flu. IAC is shipping tens of thousands of our bright red "FLU VACCINE" buttons and stickers. Order yours now!
IAC “FLU VACCINE” buttons and stickers are flying out of IAC’s office by the thousands! Their bright red color helps broadcast your important message about the need for flu vaccination. And the cost is nominal.
“FLU VACCINE” BUTTONS
The button measures 1.25" across and carries a bold message! Pin on lab coats, uniforms, other clothing, tote bags, or backpacks to show support for flu vaccine.
Buttons are delivered in bags of 10 buttons per bag.
Click here for pricing and ordering information for "FLU VACCINE" buttons.
“FLU VACCINE” STICKERS
Measuring 1.5" across, these stickers adhere well to clothing and have an easy-peel-off back.
Stickers are delivered to you cut individually (not on rolls)—available in bundles of 100.
Click here for pricing and ordering information for “FLU VACCINE” stickers.
Visit Shop IAC for additional items, including "Vaccines Save Lives" enamel pins, patient record cards, and a vaccine administration training video.
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Read Shot of Prevention blog post titled “Do Kids Need Vaccines If They’re Doing Virtual Learning or Home School This Fall?”
On August 20, Vaccinate Your Family's Shot of Prevention blog posted an entry titled Do Kids Need Vaccines If They’re Doing Virtual Learning or Home School This Fall? This entry gives several reasons why the answer is a clear "Yes."
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AIM offers reminder/recall postcard and social media templates for providers and health departments
The Association of Immunization Managers (AIM) has created catch-up reminder/recall postcard and social media templates for providers and local health departments to use for routine immunizations. The two versions are in customizable PDF format that can be tailored to your program's information and needs.
 
Contact AIM Communications Director Jasmine Berry at jberry@immunizationmanagers.org with any questions or requests for alternative template formats.
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In IAC's "Video of the Week," "The Vaccine Mom" explains the difference between natural and vaccine immunity and why vaccine immunity is better
In this June 2020 video from Vaccinate Your Family, Taryn Chapman, MS, "The Vaccine Mom,” tells us that natural immunity happens after you get sick and survive the infection. Natural immunity has risks because diseases can cause serious complications. Vaccines can give long-lasting immunity without causing illness, because most side effects are mild.
Visit the VOTW archive.
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The Vaccine Makers Project, the classroom-based program of the Vaccine Education Center, has posted three new sets of trivia question games on its "Kahoot!" gateway page in honor of what would have been Dr. Maurice Hilleman's 101st birthday on August 30. These questions relate to the life of Dr. Maurice Hilleman, often called "the Father of Modern Vaccines."
Visit the Vaccine Makers Project's Kahoot! gateway page to access these questions and the other elementary to high school educational activities related to the immune system, infectious diseases, and the science of vaccines.
Related Links
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Journal Articles and Newsletters
“Acute Cardiovascular Events Associated with Influenza in Hospitalized Adults” published in Annals of Internal Medicine
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“Maternal and Infant Outcomes following Exposure to Quadrivalent Human Papillomavirus Vaccine during Pregnancy” published in Vaccine
In the August 18 issue, Vaccine published Maternal and Infant Outcomes following Exposure to Quadrivalent Human Papillomavirus Vaccine during Pregnancy. The study found no association between inadvertent exposure to 4vHPV during pregnancy and any adverse pregnancy or infant outcomes.
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Education and Training
In Vaccine Education Center’s webinar on September 23, Dr. Paul Offit discusses COVID-19 vaccine development
The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia will present a 1-hour webinar, beginning at 12:00 p.m. (ET) on September 23. Part of its Current Issues in Vaccines series, the webinar will feature Paul Offit, MD, director of the VEC. Dr. Offit's topic for this webinar is titled "Making a COVID-19 Vaccine at Warp Speed."
Free continuing-education credits (CME, CEU, and CPE) will be available for both the live and archived events.
Register for the webinar.
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CDC’s recorded webinar on polio and Hib vaccines, as well as nine other segments in "The Pink Book" weekly series, available now
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