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Issue 1,549:
February 17, 2021
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World News
Featured Resources
Journal Articles and Newsletters
Education and Training
Conferences and Meetings
Top Stories
2021 U.S. recommended
immunization schedule for children and teens released along with MMWR article detailing changes
On February 12, CDC posted the 2021 recommended immunization schedules for children and adolescents on CDC's Immunization
Schedules for Healthcare Providers web page.
For children and adolescents
The immunization schedule for children and adolescents is available on the CDC web page titled Table 1: Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2021. Also
updated are
Table 2: Catch-up Schedule as well as Table 3: By Medical Indications.
Access the full-color, 8-page PDF of the child/adolescent schedule.
View what has changed on the child schedule for 2021.
Related Links
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2021 U.S. recommended immunization schedule for adults released along with
MMWR article detailing changes
On February 12, CDC also posted the 2021 recommended immunization schedules for adults on CDC's Immunization
Schedules for Healthcare Providers web page.
The immunization schedule for adults is available on the CDC web page titled
Table 1: Recommended Adult Immunization Schedule for Ages 19
Years or Older, United States, 2021. Also updated is
Table 2: By medical indications.
Access the full-color, 6-page PDF of the adult schedule.
View what has changed on the adult schedule for 2021.
Related Links
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CDC’s Dr. Shimabukuro and Janine Cory to
present overviews of CDC’s safety monitoring and communications for the COVID-19 vaccines during IAC webinar on March 4; register
today
IAC will host a webinar, “Overviews of CDC’s Post-authorization/Post-licensure Safety Monitoring and Communications for the
COVID-19 Vaccines,” on March 4 from 1 p.m. to 2 p.m. (ET). Topics will include the COVID-19 vaccine safety monitoring systems, i.e., the
Vaccine Adverse Events Reporting System (VAERS) and v-safe, as well as CDC’s COVID-19 vaccine communication products, and their
Vaccinate with Confidence framework.
These important and timely topics will be addressed by speakers from the CDC Immunization Safety Office and CDC’s Vaccine Task Force.
- Tom Shimabukuro, MD, MPH, MBA, deputy director, Immunization Safety Office
- Janine Cory, MPH, associate director for communications, Vaccine Task Force
Kelly L. Moore, MD, MPH, IAC deputy director, will moderate the webinar. Speakers will be available to answer audience questions at the conclusion of the presentations.
Register now to be sure you don’t miss this informative session.
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CDC updates guidance on transport of mRNA
COVID-19 vaccines in its Vaccine Storage and Handling Toolkit and applies these principles to COVID-19 vaccination of homebound persons
On February 5, the CDC updated the COVID-19 Vaccine Addendum (pages 49–62) of its Vaccine Storage and Handling Toolkit to include vaccine-specific reference sheets summarizing
storage and handling guidance for the Pfizer-BioNTech and Moderna COVID-19 vaccines. CDC also updated guidance on transport of mRNA COVID-19
vaccines.
CDC does not recommend routine transport of mRNA COVID-19 vaccines beyond original shipping destinations. However, the guidance acknowledges
circumstances where COVID-19 vaccine needs to be transported, such as to support off-site or satellite clinics, to vaccinate the homebound, or to prevent
vaccine waste.
In general, the routine storage and handling guidance outlined in “Section Six: Vaccine Transport” of the Toolkit should be
followed. In addition, key highlights from the updated Addendum include:
- CDC recommends transporting vaccine in their original vials. However, similar to the
recently published guidance from the U.S
Pharmacopeia (USP), the CDC Toolkit now states that “there may be instances when the only option is to transport vaccine in a
predrawn syringe.” The USP document notes that such syringes must be maintained at appropriate temperatures and administered within 6 hours
after the source vial is diluted (Pfizer-BioNTech) or punctured (Moderna).
- Punctured vials may be transported. However, a partially used vial cannot be transferred from one provider to another or across state
lines.
- The vaccines should be handled with extreme care to minimize shaking and avoid breakage.
- Moderna COVID-19 vaccine: If individual vials are transported, they should be cushioned with padding material such as bubble
wrap. Transport in a portable freezer is preferred. Doses that will be transported in a refrigerated state should begin transport in a frozen state, if
possible.
- Pfizer-BioNTech COVID-19 vaccine may be transported at ultra-cold temperatures (full trays only) or refrigerated temperatures
(individual vials or partially filled trays)
- For both the Pfizer-BioNTech and Moderna vaccines, take care to ensure thawed vaccines do not refreeze during transport
The updated vaccine transport guidance was integrated into CDC’s new clinical guidance,
Vaccinating
Homebound Persons with COVID-19 Vaccine. Vaccination of people confined to their residence requires careful planning and preparation in several
key areas, including:
- Estimating the number of doses needed as accurately as possible, including making contingency plans for vaccination of caregivers or
others in the home to avoid vaccine wastage
- Mapping out travel plans to ensure vaccination takes place within the approved time frames for use of vaccine at different temperatures and
after a vial is punctured
- Monitoring, maintaining, and reporting appropriate vaccine storage temperatures from the time the vaccine is taken out of a clinic facility up
to the time that vaccine is administered
Related Links
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CDC updates clinical considerations for mRNA COVID-19
vaccines
CDC updated its Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the
United States.
Recent changes to the Clinical Considerations web page include:
- New recommendations for preventing, reporting, and managing mRNA COVID-19 vaccine administration errors (Appendix A)
- Clarification on contraindications and precautions
- Contraindication: Persons with a known (diagnosed) allergy to PEG, another mRNA vaccine component, or polysorbate, have a
contraindication to vaccination
- Precaution: Persons with a reaction to a vaccine or injectable therapy that contains multiple components, one of which is PEG,
another mRNA vaccine component or polysorbate, but in whom it is unknown which component elicited the immediate allergic reaction have a
precaution to vaccination
- Updated information on delayed, injection-site reactions after the first mRNA vaccine dose: these reactions are neither a contraindication
nor precaution to the second dose
- Updated quarantine recommendations for vaccinated persons. Fully vaccinated persons who meet criteria no longer are required to
quarantine following an exposure to someone with COVID-19. Additional considerations for patients and residents in healthcare settings are provided.
- Additional information and updated recommendations for testing for tuberculosis infection; TB testing may be done before or at the same
time as mRNA COVID-19 vaccination or should be delayed for ≥4 weeks after the completion of mRNA COVID-19 vaccination
View CDC's Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the
United States.
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IAC updates “Talking about Vaccines” gateway pages on alternative medicine and
thimerosal
IAC has updated our Talking about Vaccines: Alternative Medicine and
Talking about Vaccines: Thimerosal
gateway pages. These pages lead to many resources from IAC, CDC, and others to help healthcare professionals communicate with parents and patients
about important vaccine topics.
- The Talking about Vaccines: Alternative Medicine gateway page includes a primer on complementary and
alternative medicine, and resources addressing chiropractors, homeopathic products, and natural immunity. Children who receive care from
complementary health practitioners are less likely to get recommended vaccinations and are more likely to be diagnosed with a vaccine-preventable
disease.
- The Talking about Vaccines: Thimerosal gateway page includes a summary on vaccines and autism, a timeline on thimerosal
in vaccines, and other important vaccine safety resources. Numerous studies show that there is no relationship between vaccines, either with or without
thimerosal, and the development of autism or other neurologic problems in children.
To easily locate these gateway pages on immunize.org, go to the upper right corner of the page, and choose the "Talking about Vaccines" tab. You also can use
the Guide to immunize.org at the bottom of every web page.
Related Links
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Becker's Hospital Review publishes
"Lessons Learned from Influenza Mass Immunization Clinics Will Serve Us Well as COVID-19 Vaccination Efforts Ramp Up" by IAC
authors—read it on IAC’s mass-vaccination-resources.org website
In its February issue, Becker's Hospital Review published Lessons Learned from Influenza Mass Immunization Clinics Will Serve
Us Well as COVID-19 Vaccination Efforts Ramp Up, written by IAC's Drs. Carolyn Bridges and L.J Tan. A summary from the article is reprinted
below.
Mass immunization clinics are a critical tool in the public health toolbox to rapidly and efficiently provide large numbers of influenza vaccinations.
Experience gained from influenza mass immunization clinics will be beneficial as COVID-19 mass immunization efforts roll out across the
country.
Related Links
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ACOG adds resources on COVID-19 vaccination for pregnant or lactating
individuals
The American College of Obstetrics and Gynecology (ACOG) has augmented its guidance documents and resources on COVID-19 vaccines for
pregnant or lactating individuals.
The National Adult and Influenza Immunization Summit (NAIIS) has compiled a one-page document, COVID-19 Vaccines and Pregnancy: Resources from the American College of Obstetricians and
Gynecologists (ACOG), to provide easy access to these recommendations. The Summit site also includes a summary of a
presentation on this topic given by Sarah Carroll, ACOG’s director of immunization, infectious disease, and public health preparedness.
ACOG recommends that COVID-19 vaccines not be withheld from pregnant individuals who meet criteria for vaccination, and these individuals should be
free to make their own decision regarding vaccination. Pregnant individuals are encouraged to discuss this decision with their healthcare team, but
documentation of this discussion is not required.
ACOG also recommends that COVID-19 vaccines be offered to lactating individuals based on their prioritization group. There is no need to avoid starting
nor to discontinue breastfeeding in people who receive a COVID-19 vaccine.
The following ACOG resources explain these recommendations.
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"COVID-19 Vaccination Intent, Perceptions, and
Reasons for Not Vaccinating among Groups Prioritized for Early Vaccination—United States, September and December 2020" published in
MMWR
CDC published COVID-19 Vaccination Intent, Perceptions, and Reasons for Not Vaccinating among Groups Prioritized for Early
Vaccination—United States, September and December 2020 in the
February 12 issue of MMWR. A portion of the
summary is reprinted below.
From September to December 2020, intent to receive COVID-19 vaccination increased from 39.4% to 49.1% among adults and across all priority
groups, and nonintent decreased from 38.1% to 32.1%. Despite decreases in nonintent from September to December, younger adults, women, non-
Hispanic Black adults, adults living in nonmetropolitan areas, and adults with less education and income, and without health insurance continue to have the
highest estimates of nonintent to receive COVID-19 vaccination.
Access the MMWR article in HTML format or in PDF format.
Related Link
- MMWR's
gateway page provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance
Summaries, and MMWR Supplements
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Sawbones releases "How to Talk about
Vaccine Hesitancy" podcast, a guide for using a kind, empathetic approach
Sawbones:
A Marital Tour of Misguided Medicine is a one-of-a-kind podcast reaching adults of all ages with entertaining dialogue about the history of
medicine, medical quackery, and current issues. Family physician Dr. Sydnee McElroy and her joke-cracking journalist husband Justin McElroy
have produced weekly episodes of Sawbones since 2013. Their shows frequently include information about the importance of getting
vaccinated.
In their January 26 episode,
How to Talk about Vaccine Hesitancy, Dr. Sydnee and Justin provide a guide for talking with
those who are vaccine hesitant and explaining how using a kind, empathetic approach can help them see the light (and the antibodies). They even
give a kind nod to the Immunization Action Coalition (thank you!).
All recent and past podcasts of Sawbones are available online at www.maximumfun.org/podcast/sawbones, where you can also
access "How to Listen."
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Vaccinate Your Family and the
National Council of Negro Women have teamed up to launch Good Health WINs (Women’s Immunization Networks)
On February 10, Vaccinate Your Family (VYF) and the National Council of Negro Women (NCNW)
launched a new
collaboration to help African American and Latinx communities thrive through good health. This new program called Good Health
WINs (Women’s Immunization Networks) pairs NCNW’s unparalleled network of two million American women and men of
African descent with VYF’s deep knowledge of vaccines and immunization policy. The collaboration will work to ensure all communities have
access to accurate vaccination information, in addition to vaccines. The final paragraph of the press release is reprinted below.
Vaccinate Your Family’s cofounders, former first lady Rosalynn Carter and former first lady of Arkansas Betty Bumpers, understood the
power of women’s networks....Much has changed over the past three decades, but one thing has remained steadfast: women continue to be the
stewards of good health for their families. Good Health WINs will activate those very networks to create a new future for families to live in good
health.
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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:
Related Link
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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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World News
WHO offers "Vaccine Explainers" in seven languages: how they are developed, how they work, quality control
WHO has published a four-part series of “explainers”—plain language primers with instructive graphics—on vaccine
development and distribution. Topics include:
Most are available in seven languages (English, Arabic, Chinese, French, Russian, Spanish, and Portuguese).
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WHO issues news release on
extraordinary meeting of the Strategic Advisory Group of Experts on Immunization (SAGE)
On February 8, the Strategic Advisory Group of Experts on Immunization (SAGE) met virtually to propose recommendations to WHO on the use of
COVID-19 vaccine(s). The final agenda, list of participants, interim recommendations, background documents, and presentations are
available online. During
the meeting, SAGE issued interim recommendations for use of the Oxford/AstraZeneca
COVID-19 vaccine.
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Featured Resources
Pre-order available soon! Laminated versions of CDC's immunization schedules—great for exam rooms, with discounts for bulk
purchases
IAC's laminated versions of the 2021 U.S. child/adolescent immunization schedule and the 2021 U.S. adult immunization schedule will soon be
available for purchase.
These 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.
The child/adolescent schedule is eight pages (i.e., four double-sided pages) and the adult schedule is six pages (i.e., three double-sided pages), but both
schedules fold down to a convenient 8.5" x 11" size.
To inquire about pre-orders, call 651-647-9009 or email admininfo@immunize.org. Stay tuned for more details in future
issues of IAC Express.
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In IAC’s “Video of the Week,”
Gregory Brown and Mitchell Moffit use illustrations and lively explanations to discuss COVID-19 mRNA vaccines
IAC’s “Vaccination and
COVID-19” gateway page offers a collection of tools from many organizations to sustain routine vaccination services during the
pandemic
IAC’s Vaccination and COVID-19 gateway page assists healthcare professionals faced with challenges in providing routine and catch-up
vaccination during the pandemic. In this gateway page, IAC has assembled key links to help both new and experienced vaccinators deliver safe, effective
vaccination to people of all ages, applicable in typical and nontraditional vaccination settings.
The site facilitates access to key pandemic resource pages from major clinical and public health organizations involved in immunization. We will update
this page frequently with new links and resources specific to catch-up vaccination, so be sure to check back regularly.
To easily locate this gateway page on immunize.org, go to the light blue band of tabs across the top, and choose the "Clinic Tools." You also
can use the Guide to immunize.org
at the bottom of every web page.
Related Links
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Organizing a new vaccination program? Use IAC's comprehensive Vaccinating
Adults: A Step-by-Step Guide—free to download by chapter or in its entirety (142 pages)
Download IAC's free book on all aspects of adult immunization, to help train your team and refresh your leaders: Vaccinating Adults: A Step-by-
Step Guide (Guide).
This up-to-date, thorough "how to" guide on adult immunization provides easy-to-use, practical information covering
essential adult immunization activities. It helps vaccine providers enhance their existing adult immunization services or introduce them into any clinical
setting.
In addition, the Guide is filled with hundreds of web addresses and references to help providers stay up to date on the latest
immunization information, both now and in the future.
The Guide is available to download/print either by chapter or in its entirety free at www.immunize.org/guide. The downloaded version is suitable for
double-sided printing. The National Vaccine Program Office and CDC both supported the development of the Guide and provided
early technical review.
The Guide is a uniquely valuable resource to assist providers in increasing adult vaccination rates. Be sure to get a copy today!
Related Links
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Journal Articles and Newsletters
“Oral Human Papillomavirus Infection in Children during the First 6 Years of Life, Finland” published in Emerging Infectious
Diseases
In the March 2021 issue, Emerging Infectious Diseases published Oral Human Papillomavirus Infection in Children during the First 6 Years
of Life, Finland. The abstract is reprinted below.
Human papillomavirus (HPV) infections are found in children, but transmission modes and outcomes are incompletely understood. We evaluated
oral samples from 331 children in Finland who participated in the Finnish Family HPV Study from birth during 9 follow-up visits (mean time 51.9 months).
We tested samples for 24 HPV genotypes. Oral HPV prevalence for children varied from 8.7% (at a 36-month visit) to 22.8% (at birth), and 18 HPV
genotypes were identified. HPV16 was the most prevalent type to persist, followed by HPV18, HPV33, and HPV6. Persistent, oral, high-risk HPV infection
for children was associated with oral HPV carriage of the mother at birth and seroconversion of the mother to high-risk HPV during follow-up (odds ratio
1.60–1.92, 95% CI 1.02–2.74). Children acquire their first oral HPV infection at an early age. The HPV status of the mother has a major
impact on the outcome of oral HPV persistence for her offspring.
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Education and Training
NILE offers webinar titled "How Politicization and Disinformation Impacted the Mitigation of COVID-19" on February 23; CE
available
On February 23 at 12:00 p.m. (PST), Nevada Immunization Learning Exchange (NILE) will offer a webinar titled How Politicization and Disinformation Impacted the Mitigation of COVID-19. This program will offer one free nursing,
pharmacy, or CHW II CEU credit upon completion of the post-webinar survey.
Registration information.
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Watch
virtual ACIP meetings on February 24–25; no registration required
Live, virtual meetings of the Advisory Committee on Immunization Practices (ACIP) will be held on February 24 and 25. The agenda is posted and will include a vote on rabies vaccine. No registration is required to watch the live ACIP
meeting or listen via telephone. Opportunities for public comment are described at the website.
An ACIP meeting is anticipated in late February or early March to consider a Janssen (JNJ) COVID-19 Vaccine, which is based on an adenovirus
vector. First, an EUA must be granted by the FDA, similar to the process followed for the Pfizer-BioNTech and Moderna mRNA vaccines. IAC
Express will keep you informed.
Related Link
- ACIP
gateway page for recordings and content from previous meetings, as well as information about future meetings
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Immunize Nevada hosts 2021 Virtual Annual Nevada
Health Conference on March 8–9; register today
The Annual Nevada Health Conference will be held virtually on March 8–9. This event will bring
together practitioners and community partners from different health professions including Chronic Disease Prevention and Health Promotion;
Immunizations; and Maternal, Child, and Adolescent Health. Continuing education credits are available for multiple healthcare-related fields.
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