Immunize.org’s new webinar, “Improving the Vaccination Experience: Accessible Vaccination for Neurodiverse People at Any Age,” now available for on-demand viewing
On December 13, Immunize.org and experts from the Autism Society hosted a 1-hour webinar, Improving the Vaccination Experience: Accessible Vaccination for Neurodiverse People at Any Age. In this webinar, participants learned more about the Autism Society’s practical tips to improve vaccine confidence by employing strategies to reduce stress when vaccinating neurodiverse patients.
People with autism and other developmental disabilities have lower childhood vaccination rates than their peers without autism, leaving them vulnerable to many vaccine-preventable diseases. The vaccination visit can be especially stressful for these families. Effective strategies exist to reduce pain and anxiety during the vaccination visit.
The video of the webinar is now available at our website for on-demand viewing. Please view share this important webinar with your colleagues.
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Immunize.org updates “Vaccines: COVID-19” main page and "Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools" with content on bivalent booster doses for children younger than age 5 years Immunize.org revised its four-page job aid, Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools, and its Vaccines: COVID-19 main page on December 13 to reflect the latest updates to federal COVID-19 vaccine guidance and resources. Both now include content on the use of bivalent boosters for children younger than age 5 years.
Immunize.org updates Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools at least monthly, prominently indicating when it was last updated at the top of the page.
All COVID-19 vaccination providers are encouraged to review this checklist each time it is revised to be sure practices stay up to date.
Immunize.org's Vaccines: COVID-19 main page connects you with a comprehensive list of resources from CDC and FDA including fact sheets, clinical considerations, vaccine administration tools, and storage and handling guidance.
Bookmark this page for quick access to key COVID-19 vaccine resource pages. We will continue to update this page as new COVID-19 materials are released.
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December 12 marked second anniversary of COVID-19 vaccination program; new book tells the story of the public health and clinical heroes who made it happen December 2022 marks the 2-year anniversary of COVID-19 vaccinations being recommended and administered in the United States.
In the 2 years since, administration of 660 million doses to 268 million Americans averted nearly 120 million infections, 18.6 million hospitalizations, and 3.3 million deaths, according to a study from The Commonwealth Fund.
"The estimated infections, hospitalizations, and deaths averted by vaccination are particularly striking when compared to the actual values observed during this time period," the report explains. "Since December 12, 2020, 82 million infections, 4.8 million hospitalizations, and 798,000 deaths have been reported in the U.S. In other words, without vaccination the U.S. would have experienced 1.5 times more infections, 3.8 times more hospitalizations, and 4.1 times more deaths. These losses would have been accompanied by more than $1 trillion in additional medical costs that were averted because of fewer infections, hospitalizations, and deaths."
Immunize.org extends our heartfelt gratitude to all the vaccinators and support teams who made it possible to protect hundreds of millions of people in just 2 years. We salute your dedication and innovative efforts to reach the vulnerable, the hesitant, and hard-to-reach communities.
A new book released by the American Public Health Association Press tells the story of the public health and clinical heroes who made this vaccination program happen. Vaccinating America: The Inside Story Behind the Race to Save Lives, and End a Pandemic, by Michael Fraser and Brent Ewig, spotlights the local, state, and federal public servants who planned and executed this unprecedented program to combat COVID-19 amidst overwhelming logistical and bureaucratic challenges.
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"Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19–Associated Emergency Department or Urgent Care Encounters and Hospitalizations among Immunocompetent Adults—VISION Network, Nine States, September–November 2022" published in MMWR Early ReleaseCDC published Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19–Associated Emergency Department or Urgent Care Encounters and Hospitalizations among Immunocompetent Adults—VISION Network, Nine States, September–November 2022 on December 16 in MMWR Early Release. A portion of the summary appears below.
Bivalent mRNA COVID-19 booster doses containing an Omicron BA.4/BA.5 sublineage component were recommended on September 1, 2022. . . .
Bivalent booster doses provided additional protection against COVID-19–associated emergency department/urgent care encounters and hospitalizations in persons who previously received 2, 3, or 4 monovalent vaccine doses. Because of waning of monovalent vaccine-conferred immunity, relative effectiveness of bivalent vaccines was higher with increased time since the previous monovalent dose. . . .
All persons should stay up to date with recommended COVID-19 vaccinations, including receiving a bivalent booster dose if eligible.
Access the MMWR article in HTML.
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"Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19–Associated Hospitalization among Immunocompetent Adults Aged ≥65 Years—IVY Network, 18 States, September 8–November 30, 2022" published in MMWRCDC published Early Estimates of Bivalent mRNA Vaccine Effectiveness in Preventing COVID-19–Associated Hospitalization among Immunocompetent Adults Aged ≥65 Years—IVY Network, 18 States, September 8–November 30, 2022 on December 16 in MMWR Early Release. A portion of the summary appears below.
Immunity from monovalent COVID-19 mRNA vaccination wanes over time. A bivalent COVID-19 mRNA booster dose is recommended for all eligible persons; however, little is known about its effectiveness against COVID-19 hospitalization. . . .
Among immunocompetent adults aged ≥65 years hospitalized in the multistate IVY Network, a bivalent booster dose provided 73% additional protection against COVID-19 hospitalization compared with past monovalent mRNA vaccination only. . . .
To maximize protection against severe COVID-19 this winter season, all eligible persons, especially adults aged ≥65 years, should receive a bivalent booster dose and consider additional prevention strategies, including masking in indoor public spaces.
Access the MMWR article in HTML.
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Influenza activity remains high; lower vaccination rates among pregnant people require action Roll up your sleeve! Now is the best time to vaccinate anyone not yet protected from influenza this season. CDC’s Weekly U.S. Influenza Surveillance Report, FluView, provides a valuable snapshot of influenza activity state-by-state.
Influenza Surveillance
For week 49, ending December 10, CDC's Weekly U.S. Influenza Surveillance Report, FluView reports that, nationwide, 6.9% of patient visits reported through the Outpatient Influenza-Like Illness Surveillance Network (ILINet) were due to respiratory illness that included fever plus a cough or sore throat (i.e., influenza-like illness [ILI]). This exceeds the national baseline of 2.5%. Multiple respiratory viruses are co-circulating; the relative contribution of influenza virus infection to ILI varies by location. So far this season, 30 children have died from influenza-associated causes.
Influenza Vaccination Dashboard
CDC's Weekly Flu Vaccination Dashboard shows that influenza vaccination rates are down among pregnant people, which is cause for concern, given the overwhelming evidence for the safety and importance of influenza vaccination during pregnancy to protect the health of both mother and child. Overall coverage among pregnant people at the end of November 2022 (44.1%) is 11.2 percentage points lower compared with the end of November 2021 (55.3%) and 18 percentage points lower than at the end of November 2020 (62.1%).
CDC recommends everyone age 6 months and older get annual influenza vaccination. “Vaccines.gov” offers VaccineFinder, a service of Boston Children’s Hospital, to help people find influenza and COVID-19 vaccines for any age group. To be listed as a provider by VaccineFinder, see the information at this website.
Coadministration of influenza and COVID-19 bivalent booster vaccinations when both are due is safe, recommended, and efficient. COVID-19 vaccination alone provides no protection from influenza or any other respiratory virus. To gain confidence in your approach to administering multiple intramuscular vaccinations to an adult, download Immunize.org’s printable document How to Administer Multiple Intramuscular Vaccines to Adults during One Visit.
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Spotlight: Immunize.org’s “Standing Orders Templates for Administering Vaccines” main page helps you simplify your vaccination practice 
Immunize.org’s Standing Orders Templates for Administering Vaccines main page includes 46 straightforward standing order templates that allow qualified healthcare professionals to assess the need for and administer vaccines to patients meeting certain criteria, such as age or underlying medical condition. In addition to templates developed by Immunize.org, the page includes links to CDC’s standing orders templates for all COVID-19 vaccines and all age groups, as well as CDC’s new standing orders template for mpox (monkeypox) vaccination with Jynneos (Bavarian Nordic).
Standing orders help you increase vaccination rates by enabling assessment and vaccination of the patient without the need for clinician examination or a direct order from the attending provider at the time of the interaction. Standing orders can be established for the administration of one or more specific vaccines to a broad or narrow set of patients in healthcare settings such as clinics, hospitals, pharmacies, and long-term care facilities.
Visit the Standing Orders Templates for Administering Vaccines main page on Immunize.org to view the standing orders templates.
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
Vaccine Information Statements
Immunize.org posts 12 new translations of current Vaccine Information Statement for rabies vaccine
Thanks to CDC support for Immunize.org’s efforts to substantially expand its repository of Vaccination Information Statement (VIS) translations, Immunize.org posted 12 new translations of VISs for rabies vaccine, issued by CDC on June 2, 2022. All translations are available in print-ready PDF format.
VIS translations for rabies vaccine:
Check the version dates of your office copies of newly updated translations. Translations of previous VIS versions should be discarded now that translations of the current versions are available.
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Immunize.org posts 24 new translations of current Vaccine Information Statements for HPV; measles, mumps, rubella, and varicella; rotavirus; and varicella vaccines Thanks to the generous contribution of the California Department of Health Immunization Program and CDC support, Immunize.org posted 24 new and updated translations of four Vaccine Information Statements (VISs) for human papillomavirus; measles, mumps, rubella, and varicella; rotavirus; and varicella vaccines.
All translations are available in print-ready PDF format.
Human Papillomavirus (HPV) VIS (view in English):
Measles, Mumps, Rubella, and Varicella (MMRV) VIS (view in English):
Rotavirus VIS (view in English):
Varicella VIS (view in English):
Check the version dates of your office copies of newly updated translations. Translations of previous VIS versions should be discarded now that translations of the current versions are available.
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Reminder: CDC recommends updated (bivalent) COVID-19 vaccines for children younger than age 5 years
On December 9, CDC expanded its recommendations for the updated (bivalent) Moderna and Pfizer-BioNTech COVID-19 vaccines to include children who begin the vaccination series as early as age 6 months. The updated (bivalent) dose is recommended as the third dose in the primary series for Pfizer vaccine recipients and as a booster (third) dose for recipients of the Moderna vaccine 2-dose primary series. This follows the FDA amendment to the emergency use authorizations (EUAs) of the updated (bivalent) Moderna and Pfizer-BioNTech COVID-19 vaccines in this age group. A portion of the news release appears below.
CDC expanded the use of updated (bivalent) COVID-19 vaccines for children ages 6 months through 5 years. Children ages 6 months through 5 years who previously completed a Moderna primary series are eligible to receive a Moderna bivalent booster 2 months after their final primary series dose. Children ages 6 months through 4 years who are currently completing a Pfizer primary series will receive a Pfizer bivalent vaccine as their third primary dose.
The CDC web page, Use of COVID-19 Vaccines in the United States Interim Clinical Considerations, now states:
- Children age 6 months–4 years who complete a Moderna primary series should receive one bivalent Moderna booster dose at least 2 months after completion of the primary series
- Children age 5 years who complete a Moderna primary series may receive either the previously authorized bivalent Pfizer-BioNTech booster dose or the newly authorized bivalent Moderna booster dose at least 2 months after completion of the Moderna primary series
- The previously authorized 3-dose Pfizer-BioNTech primary series for children age 6 months–4 years was revised as follows: a monovalent Pfizer-BioNTech vaccine is administered for the first and second doses, followed by one bivalent Pfizer-BioNTech vaccine as the third primary series dose, at least 8 weeks after the second monovalent primary series dose. A booster dose is not authorized for children in this age group who receive a Pfizer-BioNTech 3-dose primary series, including children who previously received a 3-dose monovalent Pfizer-BioNTech primary series.
Healthcare professionals who administer these vaccines for children should review CDC’s interim clinical considerations for dose and other information.
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Kaiser Family Foundation finds the minority of parents who question school-entry vaccination requirements has grown to 1 in 3; belief in value of vaccination remains high
For decades, school-entry vaccination requirements have helped make schools a safe and healthy learning environment for everyone. On December 16, Kaiser Family Foundation (KFF) posted a report titled KFF COVID-19 Vaccine Monitor: December 2022, showing that, while support for the value of vaccination among parents remains very high, the size of the minority of parents who say they oppose school-entry vaccination requirements has grown. A portion of the press release announcing the report appears below.
Amid controversies around the COVID-19 vaccine and growing distrust of public health authorities, more than four in ten Republicans and Republican-leaning independents, and a third of parents, now say they oppose requiring children in public schools to receive some childhood vaccines, up since 2019, a new KFF COVID-19 Vaccine Monitor survey finds.
Overall, nearly three in ten adults (28%) nationally now say that parents should be able to decide not to vaccinate their children for measles, mumps, and rubella rather than those vaccinations being required to attend public schools, up from 16% in a 2019 Pew Research Center poll conducted before the COVID-19 pandemic. Among parents, opposition to requiring those childhood vaccines now stands at 35%, up from 23% in 2019.
While most of the public still say that healthy children should be required to get those vaccines to attend public schools (71%), that share is down from 82% in 2019.
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"Prevalence of SARS-CoV-2 and Influenza Coinfection and Clinical Characteristics among Children and Adolescents Aged <18 Years Who Were Hospitalized or Died with Influenza—United States, 2021–2022 Influenza Season" published in MMWRCDC published Prevalence of SARS-CoV-2 and Influenza Coinfection and Clinical Characteristics among Children and Adolescents Aged <18 Years Who Were Hospitalized or Died with Influenza—United States, 2021–2022 Influenza Season on December 16 in MMWR. A portion of the media summary appears below.
Seasonal flu and COVID-19 contribute to substantial pediatric disease burden, and flu and COVID-19 coinfections in children can potentially cause more severe illness, hospitalizations, and deaths. Preliminary data from the 2021–2022 flu season indicate COVID-19 coinfections occurred in 6% of pediatric flu-associated hospitalizations and 16% of pediatric flu-associated deaths. Compared with children with flu only, a higher percentage of those who were hospitalized with coinfection required invasive or noninvasive respiratory support. More than 80% of hospitalized children with a coinfection were not vaccinated against flu and only 53% received flu antiviral treatment. Information on COVID-19 vaccination and COVID-19 antiviral treatment was not available. Among seven coinfected patients who died, none were fully vaccinated against flu and only one received flu antivirals.
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“Progress toward Measles and Rubella Elimination—India, 2005–2021” published in MMWR
CDC published Progress toward Measles and Rubella Elimination—India, 2005–2021 on December 16 in MMWR. A portion of the media summary appears below.
India has one of the world’s largest immunization programs, with the aim of vaccinating a birth cohort of 27 million children annually. During 2017–2021, India adopted a national strategic plan for MR [measles-rubella] elimination, introduced rubella-containing vaccine into the routine immunization program, launched a nationwide MR catch-up vaccination campaign, moved to case-based surveillance, and more than doubled the number of laboratories in the MR network. Coverage of MR vaccines substantially increased, and measles and rubella incidence during 2017–2021 decreased by 62% and 48%, respectively.
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WHO updates position paper on human papillomavirus vaccines
WHO published Human Papillomavirus Vaccines: WHO Position Paper, May 2022 in the December 16 issue of its Weekly Epidemiological Record.
This is the most recent addition to a series of regularly updated WHO position papers on vaccines that have global public health impact, primarily for low- and middle-income countries. The following appears in the position paper:
This position paper is concerned with vaccines and vaccination against diseases caused by human papillomaviruses (HPVs). Its primary focus is the prevention of cervical cancer, given the role of prophylactic HPV vaccination as a foundational pillar of the WHO Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem. It is estimated that implementation of this strategy could prevent 60 million cervical cancer cases and 45 million deaths over the next 100 years. It also considers the broader spectrum of cancers and other diseases preventable by HPV vaccination. It incorporates recent information regarding HPV vaccines, including the licensure of new HPV vaccines and evidence on vaccine immunogenicity and effectiveness with reduced dose schedules.
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Thank you for a great year. IZ Express will return after its holiday break with the first issue of 2023 on January 11.
Thank you for making this a great year for IZ Express. IZ Express will not be published for the next 2 weeks, to give our hard-working team time with their families during the holiday season. Look for the next issue on January 11, 2023. Meanwhile, encourage your colleagues to subscribe, so they get all the latest immunization news for free.
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