- “COVID-19 Vaccination Recommendations and Practices for Women of Reproductive Age, by Health Care Providers—Fall DocStyles Survey, United States, 2022” published in MMWR
- “Inequities in COVID-19 Vaccination Coverage among Pregnant Persons, by Disaggregated Race and Ethnicity—Massachusetts, May 2021–October 2022” published in MMWR
- “Effectiveness of Maternal mRNA COVID-19 Vaccination during Pregnancy against COVID-19–Associated Hospitalizations in Infants Aged <6 Months during SARS-CoV-2 Omicron Predominance—20 States, March 9, 2022–May 31, 2023” published in MMWR
- “Influenza, Tdap, and COVID-19 Vaccination Coverage and Hesitancy among Pregnant Women—United States, April 2023” published in MMWR
Top Stories
CDC issues updated 2023 child and adult recommended immunization schedules, adding addenda listing new 2023 recommendations Acting ahead of its annual February publication cycle, CDC issued updated 2023 recommended immunization schedules. The additional page (addendum) on each schedule summarizes recommendations adopted earlier in 2023. The updated documents include:
By publishing updated official schedules now, CDC is able to reduce the time between new recommendations and insurance coverage for the new recommendations, as required by the Affordable Care Act. The updated schedules highlight changes with red markings. The addenda summarize new recommendations published since February 2023 for the prevention of COVID-19, RSV, poliovirus, and influenza.
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CDC and CMS issue letter encouraging prevention of RSV this season with newly recommended vaccines and monoclonal antibody
CDC and the Centers for Medicare and Medicaid Services (CMS) issued a letter to public health partners to raise awareness of the new prevention tools available to protect babies and older adults from illness and complications related to respiratory syncytial virus (RSV). The letter explains funding options for the monoclonal antibody and vaccines.
The letter explains the availability of the long-acting monoclonal antibody, nirsevimab (Beyfortus, Sanofi/AstraZeneca), and two RSV vaccines (Arexvy, GSK, and Abrysvo, Pfizer). The recommendations for these products appear in the addenda of the revised 2023 child and adolescent immunization schedule and adult immunization schedule.
For Children:
- Nirsevimab will be covered by Medicaid and the Children’s Health Insurance Program (CHIP) for children, with children enrolled in Medicaid generally receiving nirsevimab doses through the VFC program
- The maternal RSV vaccine (Abrysvo) will be included in the VFC program for pregnant people younger than age 19 years
For Adults:
- State Medicaid agencies will be required to cover Arexvy and Abrysvo without cost-sharing for nearly all full-benefit beneficiaries age 19 and older who are covered under traditional Medicaid if the ACIP recommendations apply
- State separate CHIP programs will also be required to cover both RSV vaccines without cost-sharing for enrollees age 19 and older if the ACIP recommendations apply
- Both RSV vaccines must be covered without cost sharing by Medicare Part D Plans
For Both Children and Adults:
- Most private health insurers must cover these immunization products without cost sharing, starting with plan years beginning on or after the date that is one year after the ACIP recommendation is adopted by the CDC Director
- Similarly, Medicaid alternative benefit plans (ABPs) must also cover these products without cost-sharing for adults age 21 and older beginning on that same date
- Until that point, private insurers will be making choices about coverage and reimbursement for these immunization products subject to applicable state law, as will Medicaid state agencies operating ABPs
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October 5 is World Meningitis Day. Vaccination prevents meningococcal meningitis.
World Meningitis Day, organized by the Confederation of Meningitis Organisations (CoMO), is observed on October 5.
Meningococcal disease, any illness caused by Neisseria meningitidis, includes infections of the lining of the brain and spinal cord (meningitis) and bloodstream (sepsis). These infections are often severe and can be deadly.
CDC recommends routine Meningococcal ACWY (MenACWY) vaccination for all preteens age 11–12 years with a booster at age 16 years. Meningococcal B (MenB) vaccination is recommended for individuals age 10 years or older at increased risk for meningococcal disease and for others age 16 through 23 years who want protection, through shared clinical decision making. Keeping up to date with recommended vaccines is the best protection against meningococcal disease.
To encourage sharing information about the signs and symptoms of meningitis, CoMO created a toolkit, free to download and share. Use the hashtag #DefeatMeningitis in your social media postings.
Visit the websites of these three parent-led, nonprofit partner organizations:
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“Pregnancy and Flu Vaccine”: watch the 1-minute answer, part of the Ask the Experts Video Series on Facebook, LinkedIn, X (Twitter), YouTube, and Instagram
Immunize.org's social media channels make it easy for you to learn a little more every day. This week, our featured episode from the Ask the Experts Video Series is Pregnancy and Flu Vaccine. This is available on our YouTube channel, along with our full collection of quick video answers to popular Ask the Experts questions.
Like, follow, and share Immunize.org’s social media accounts and encourage colleagues and others interested in vaccination to do likewise:
Institute for Safe Medication Practices highlights potential for dosing error with Fluzone high-dose vaccine
In the September 7 issue of its subscriber newsletter, the Institute for Safe Medication Practices (ISMP) published a safety brief on a potential for confusion about dosing caused by the packaging of Fluzone High-Dose Quadrivalent Vaccine. An excerpt from the article appears below.
We received a report about this year’s FLUZONE (influenza) high-dose quadrivalent vaccine for adults 65 years and over by Sanofi Pasteur. The carton's primary display panel states it contains 10 single-dose prefilled syringes–five trays with two syringes sealed in one tray. The concern is that some may think both syringes are needed to administer a dose. If your organization purchases this vaccine, notify staff and ensure barcode scanning is used when dispensing and administering. Consider adding auxiliary labels to each tray noting that each dose requires only one syringe. If stored outside the carton, consider removing the syringes from each tray.
ISMP published a follow-up story in its September 21 subscriber newsletter describing a report in which a patient was given two injections at one visit. If your organization purchases this vaccine, consider taking these actions:
- Notify staff about the potential for errors and remind them only one injection is needed
- Ensure barcode scanning is used where available
- Either dispense as a unit dose syringe or, if the entire carton must be dispensed, add auxiliary labels noting that each dose requires only one syringe
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IZ Express keeps 55,000+ readers up to date on what’s new in vaccines each week; invite your colleagues to subscribe!
Encourage your coworkers to subscribe to IZ Express so they get all the news that matters to vaccinators in their own inbox each Wednesday. IZ Express, the weekly e-newsletter produced by Immunize.org, alerts 55,000+ readers to the week’s important vaccine developments. IZ Express also features:
- Educational materials from Immunize.org, CDC, AAP, and others
- Newly posted Vaccine Information Statements and their translations
- Notices about online and in-person educational opportunities, many offering free continuing education credit
 
We appreciate you as a subscriber! Thank you for helping us spread the latest vaccine news.
Spotlight: Immunize.org resources focused on adolescent vaccination 
Immunize.org offers many useful materials on adolescent vaccination for professionals and parents.
Resources for Adolescent Vaccination main page highlights all the adolescent educational materials from Immunize.org and partner organizations.
Adolescent Vaccination main page contains the handouts that pertain to adolescent vaccinations.
CDC Schedules main page provides print-ready PDFs of the recommended vaccination 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.
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
Immunize.org Pages and Handouts
Recap: Immunize.org updated these clinical resources in August and SeptemberIZ Express regularly summarizes Immunize.org’s new and updated educational materials and web pages. All Immunize.org materials are free to distribute. In recent weeks, Immunize.org updated or created new helpful materials:
Immunize.org Materials for Clinicians
- Brand New Resources
- Influenza
- Other Screening Checklists
- Other Vaccine Administration Resources
- Hepatitis B Vaccination and Testing
Immunize.org Printable Materials for Patients
Immunize.org Web Pages
Related Links
- Immunize.org: Handouts main page to see educational materials sorted by category
- Immunize.org: Ask the Experts main page to access more than 1,200 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 240 ready-to-print staff educational materials and patient handouts
Vaccine Information Statements
Reminder! Immunize.org posts 28 new translations of Vaccine Information Statement for RSV vaccine for older adults. Immunize.org posted 28 new translations of the Vaccine Information Statement (VIS) for respiratory syncytial virus (RSV) vaccination of adults age 60 years or older using shared clinical decision-making. These translations join the Spanish (RTF) VIS.
All translations are available in print-ready PDF format.
 
Respiratory Syncytial Virus (RSV) Vaccine VIS: (view in English):
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Recap: Vaccine Information Statements and translations released in August and SeptemberIZ Express regularly provides readers with information about new and updated Vaccine Information Statements (VISs) and their translations.
On July 24, CDC released an updated interim VIS for Pediatric Multi-vaccines (Your Child's First Vaccines). Immunize.org recently provided the following translations.
Pediatric Multi-vaccines (Your Child’s First Vaccines) view in English:
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Featured Resources
National Network of Immunization Coalitions’ webinar, “What You Need to Know about New RSV Immunizations for Children and Adults,” available for on-demand viewing
On September 25, the National Network of Immunization Coalitions hosted a live, 1-hour webinar, What You Need to Know about New RSV Immunizations for Children and Adults. During this webinar, CDC experts provided an overview of the burden of RSV on pediatric and older adult populations, and shared information about the new ACIP recommendations for protecting adults 60 years of age and older against RSV. They also discussed the new ACIP recommendations to prevent disease in infants, including maternal vaccination and the new long-acting monoclonal antibody for infants. An expert from the American Academy of Pediatrics (AAP) provided advice on billing and coding for administering the long-acting monoclonal antibody.
The webinar video is now available on the National Network of Immunization Coalitions website for on-demand viewing. Please view and share this important webinar with your colleagues.
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Public Health Foundation and CDC create three videos to help clinicians differentiate “expiration date” and “beyond use date” for vaccines
The Public Health Foundation partnered with CDC to create the Vaccine Expiration Date and Beyond-Use Date or Time Video Series. The three videos' topics (and length) are:
Training the vaccination workforce on the importance of monitoring vaccine expiration and beyond-use dates is crucial for inventory management and helps ensure the safety and efficacy of vaccines. The videos are part of the TRAIN Learning Network TRAIN Learning Network.
Public Health Communications Collaborative offers social media graphics and messages to communicate key details about respiratory illness prevention
The Public Health Communications Collaborative (PHCC) created the Toolkit: Fall and Winter 2023 Vaccination Promotion, to help communicate timely, effective, and consistent information about flu, COVID-19, and RSV vaccinations. Unbranded and available in English and Spanish, it is designed to communicate the most relevant information to the public. It includes, for example:
Related Links
Explore the 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 the recommended MenACWY vaccine booster dose at age 16. Many teens are behind on vaccines because of the pandemic, so vaccine outreach 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 update Algorithm for MenACWY Immunization in Adolescents 11 through 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
“COVID-19 Vaccination Recommendations and Practices for Women of Reproductive Age, by Health Care Providers—Fall DocStyles Survey, United States, 2022” published in MMWR CDC published COVID-19 Vaccination Recommendations and Practices for Women of Reproductive Age, by Health Care Providers—Fall DocStyles Survey, United States, 2022 on September 29 in MMWR. A portion of the summary appears below.
Although most (82.9%) surveyed HCPs recommended that women of reproductive age stay up to date with COVID-19 vaccines, only 54.7% offered or administered the vaccine in their practice. HCPs were more likely to offer or administer COVID-19 vaccination on-site to pregnant patients if they also offered or administered influenza (adjusted prevalence ratio [aPR] = 5.5) and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines (aPR = 2.3).
Access the MMWR article in HTML or PDF.
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“Inequities in COVID-19 Vaccination Coverage among Pregnant Persons, by Disaggregated Race and Ethnicity—Massachusetts, May 2021–October 2022” published in MMWR
CDC published Inequities in COVID-19 Vaccination Coverage among Pregnant Persons, by Disaggregated Race and Ethnicity—Massachusetts, May 2021–October 2022 on September 29 in MMWR. A portion of the summary appears below.
Among pregnant persons in the United States, Hispanic or Latino (Hispanic) and non-Hispanic Black or African American persons experience the highest COVID-19 rates and the lowest COVID-19 vaccination coverage. Aggregation of race and ethnicity data can obscure within-group diversity and inequities. . . .
Among 102,275 Massachusetts residents with pregnancies resulting in live birth during May 2021–October 2022, data disaggregation into 12 racial and 34 ethnic groups revealed inequities in COVID-19 vaccination coverage that were masked within all larger race and ethnicity groupings. . . .
Disaggregating race and ethnicity data can uncover within-group differences in COVID-19 vaccination coverage that might guide tailored public health messaging.
Access the MMWR article in HTML or PDF.
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“Effectiveness of Maternal mRNA COVID-19 Vaccination during Pregnancy against COVID-19–Associated Hospitalizations in Infants Aged <6 Months during SARS-CoV-2 Omicron Predominance—20 States, March 9, 2022–May 31, 2023” published in MMWR
CDC published Effectiveness of Maternal mRNA COVID-19 Vaccination during Pregnancy against COVID-19–Associated Hospitalizations in Infants Aged <6 Months during SARS-CoV-2 Omicron Predominance—20 States, March 9, 2022–May 31, 2023 on September 29 in MMWR. A portion of the summary appears below.
Infants aged <6 months are not eligible for COVID-19 vaccination and are at risk for COVID-19–associated complications. Maternal vaccination received during pregnancy could protect infants from COVID-19–related hospitalization. . . .
During the period of recent SARS-CoV-2 Omicron predominance, maternal receipt of an mRNA COVID-19 vaccine during pregnancy reduced the likelihood of COVID-19-related hospitalizations and serious complications among infants aged <6 months. . . .
Expectant mothers should remain current with COVID-19 vaccination to protect themselves and their infants from hospitalization and severe outcomes associated with COVID-19.
Access the MMWR article in HTML or PDF.
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“Influenza, Tdap, and COVID-19 Vaccination Coverage and Hesitancy among Pregnant Women—United States, April 2023” published in MMWR
CDC published Influenza, Tdap, and COVID-19 Vaccination Coverage and Hesitancy among Pregnant Women—United States, April 2023 on September 29 in MMWR. A portion of the summary appears below.
During the 2022–23 influenza season, 47.2% of women received influenza vaccination before or during pregnancy, 55.4% of women with a recent live birth received Tdap vaccination during pregnancy, and 27.3% of women received a COVID-19 bivalent booster vaccine before or during pregnancy. Pregnant women who received a provider recommendation for vaccination were less hesitant about influenza and Tdap vaccines. . . .
Promotion of efforts to improve vaccination coverage among pregnant women, such as provider recommendation for vaccination and informative conversations with patients to address vaccine hesitancy, could reduce adverse maternal and infant illness and death from vaccine-preventable diseases.
Access the MMWR article in HTML or PDF.
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Upcoming Events
Today! Virtual: CDC briefing on fall and winter virus season with CDC Director Mandy K. Cohen on October 4 at 12:00 p.m. (ET).
CDC is hosting a briefing on the fall and winter virus season from 12:00 to 1:30 p.m. (ET) on October 4. During the webinar, CDC Director Mandy K. Cohen, MD, MPH, will provide updates on the fall and winter virus season landscape. This will include a sneak peek at CDC’s new communications efforts to address the spread of influenza, COVID-19, and RSV and resources that will be available for partners.
Register for the webinar.
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