Issue 1738: February 7, 2024

Dear IZ Express readers, please help Immunize.org by completing a brief evaluation of our activities.

Since 1994, Immunize.org has been a partner of CDC. CDC currently provides Immunize.org with support for our major activities: publishing IZ Express, "Ask the Experts," providing Vaccine Information Statements (VISs) and their translations, our website, our support of state and local immunization coalitions, and creation of ready-to-print immunization education materials for healthcare professionals and their patients.

Evaluating the impact of our activities and resources on your work is an important part of our CDC cooperative agreement. To do this, we have an online survey about our activities. The survey will skip sections you mark as not relevant to you. Answering all sections may take as little as 5 minutes. Your answers will provide us with important insights for planning.

• Click here to help us with Immunize.org's 2024 online survey.

Thank you for taking the time to share your thoughts about Immunize.org and our support for your work saving lives through immunization.

On January 25, CDC issued a Clinician Outreach and Communication Activity (COCA) Now message titled, Stay Alert for Measles Cases. It reminds healthcare providers to watch for patients with febrile rash and symptoms of measles (e.g., cough, runny nose, conjunctivitis).

Between December 1, 2023, and January 23, 2024, CDC was notified of 23 confirmed U.S. cases of measles, including seven direct importations of measles by international travelers and two outbreaks with more than five cases each. Most of these cases were among children and adolescents who had not received a measles-containing vaccine (MMR or MMRV), even if age eligible. A portion of the message outlining recommendations for healthcare providers is shown below.

• Isolate: Do not allow patients with suspected measles to remain in the waiting room or other common areas of the healthcare facility; isolate [them], ideally in a single-patient airborne infection isolation room (AIIR) if available, or in a private room with a closed door until an AIIR is available. Healthcare providers should be adequately protected against measles and should adhere to standard and airborne precautions when evaluating suspect cases regardless of their vaccination status.
• Notify: Immediately notify local or state health departments about any suspected case of measles to ensure rapid testing and investigation. Measles cases are reported by states to CDC through the National Notifiable Diseases Surveillance System (NNDSS) and can also be reported directly to CDC at measlesreport@cdc.gov.
• Test: Follow CDC’s testing recommendations and collect either a nasopharyngeal swab or throat swab for reverse transcription polymerase chain reaction (RT-PCR), as well as a blood specimen for serology from all patients with clinical features compatible with measles. RT-PCR is available at CDC, at many state public health laboratories, and through the APHL/CDC Vaccine Preventable Disease Reference Centers.
• Manage: In coordination with local or state health departments, provide appropriate measles post-exposure prophylaxis (PEP) to close contacts without evidence of immunity, either MMR or immunoglobulin. The choice of PEP is based on elapsed time from exposure or medical contraindications to vaccination.
• Vaccinate: Make sure all your patients are up to date on measles vaccine, especially before international travel. People 6 months of age or older who will be traveling internationally should be protected against measles.

Related Links

• Clinician Outreach and Communication Activity (COCA) web page
• CDC: Measles (Rubeola): For Healthcare Professionals web page
• CDC: Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings (PDF)
• CDC: Manual for the Surveillance of Vaccine-Preventable Diseases, Chapter 7: Measles web page
• Immunize.org: Measles main page

In an episode of the Infectious Diseases Society of America (IDSA) podcast Let's Talk ID, pediatric infectious disease specialist and host Buddy Creech, MD, MPH, shares the latest on RSV immunization, including mechanisms of action, eligibility criteria, and challenges surrounding finding doses this season.



Related Links

• Let's Talk ID podcast page
• The Cribsiders podcast page
• The Curbsiders podcast page

CDC’s Weekly U.S. Influenza Surveillance Report, FluView, provides a valuable picture of laboratory-confirmed influenza and influenza-like-illness activity state by state.

Influenza Surveillance
For week 4, ending January 27, CDC’s Weekly U.S. Influenza Surveillance Report, FluView shows that 20 jurisdictions experienced high or very high activity. Nationwide, 4.3% 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., ILI). The national baseline is 2.5%. Eight pediatric influenza-associated deaths were reported this week, bringing the total to 65 pediatric deaths thus far during the 2023–24 season.



RESP-NET
Visit the CDC Respiratory Virus Hospitalization Surveillance Network (RESP-NET) for weekly reports of hospitalizations across the United States due to three vaccine-preventable seasonal respiratory viruses: COVID-19, influenza, and RSV.

Influenza Vaccination Dashboard
CDC's Weekly Flu Vaccination Dashboard shows that, as of January 20, coverage estimates for all children for the 2023–24 season are 3.5 percentage points lower this season compared with the same time last season (47.8% compared with 51.3%). Coverage this season so far is 9.6 percentage points lower compared with pre-pandemic coverage at the same time in January 2020 (57.4%).

CDC recommends everyone age 6 months and older get annual influenza vaccination. Influenza and other vaccines (e.g., COVID-19 vaccine, RSV vaccine) may be given at the same visit, if needed. Infants age 6 months and older may receive influenza and COVID-19 vaccines at the same visit when they receive the RSV preventive antibody, nirsevimab. Locate influenza and COVID-19 vaccines in your area by entering your zip code in the VaccineFinder on Vaccines.gov or Vacunas.gov. To be listed as a provider by VaccineFinder, see the information on this website.

Related Links

• CDC: Weekly National Flu Vaccination Dashboard main page
• CDC: FluView main page
• CDC: RESP-NET main page
• Immunize.org: free clinical resources and patient handouts related to influenza
• Immunize.org: Vaccines: Influenza main page
• Immunize.org: Ask the Experts: Influenza main page

This week, our featured episode from the Ask the Experts Video Series is Past HepB Vaccination, Negative Screening Anti-HBs. What Now? The video briefly describes whether adults who were properly vaccinated with HepB vaccine need to be revaccinated if they have a negative surface antibody (anti-HBs) result on their triple panel screening test for hepatitis B.

The 2-minute video 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:

• Facebook at ImmunizeOrg
• Instagram at ImmunizeOrg
• LinkedIn at ImmunizeOrg
• YouTube at ImmunizeOrg

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.

• New York Times: Opinion: The Monster Measles Outbreak in Europe Is a Warning (2/1/24)
• CBS News: Data Shows at Least 8,500 U.S. Schools at Greater Risk of Measles Outbreaks as Vaccination Rates Decline (1/30/24)
• The Guardian: Measles Making a Comeback in US Due to Vaccine Skepticism, Says CDC (1/30/24)
• The Wire: Climate Change Is Driving Up Spread of Diseases, but Fewer People Confident in Vaccines (1/29/24)

Immunize.org recently launched a new section of its popular Ask the Experts resource, Ask the Experts: RSV, that covers RSV disease and use of RSV vaccines and preventive antibody product (nirsevimab).

The clinical questions and answers covered in this new section address issues such as the safety and effectiveness of vaccination and nirsevimab, the benefit to older adults from protection against RSV, and timing of RSV vaccination with Abrysvo (Pfizer) during pregnancy (reminder: January 31 was the last day for most of the United States!).

Immunize.org’s Ask the Experts main page leads you to 20 web pages on vaccines and 10 on broader immunization topics. Ask the Experts offers answers to more than 1,300 common or challenging questions. Immunize.org’s team of experts includes Kelly L. Moore, MD, MPH (team lead), Carolyn B. Bridges, MD, FACP, and Iyabode Beysolow, MD, MPH.

Related Links

• Immunize.org: Ask the Experts main page with more than 1,300 questions and answers
• Immunize.org: Ask the Experts: RSV web page
• MMWR: Use of the Pfizer Respiratory Syncytial Virus Vaccine during Pregnancy for the Prevention of Respiratory Syncytial Virus–Associated Lower Respiratory Tract Disease in Infants: Recommendations of the Advisory Committee on Immunization Practices — United States, 2023 (10/13/23)
• MMWR: Use of Nirsevimab for the Prevention of Respiratory Syncytial Virus Disease among Infants and Young Children: Recommendations of the Advisory Committee on Immunization Practices—United States, 2023
  (8/25/23)
• MMWR: Use of Respiratory Syncytial Virus Vaccines in Older Adults: Recommendations of the Advisory Committee on Immunization Practices (7/21/23)

Immunize.org recently updated its HPV Vaccine: A Guide for Adults Ages 18–26 Years resource to help patients better understand HPV disease and the value of vaccination.



CDC recommends HPV vaccination for everyone age 26 years or younger, beginning as early as age 9 years. Adults age 27 through 45 years who are not already vaccinated may decide to get the HPV vaccine after speaking with their clinician.

Protect your patients from cervical cancer, and the many other HPV-related cancers affecting men and women, by recommending and offering the HPV vaccine.

Related Links

• CDC: Cervical Cancer Awareness web page
• CDC: HPV for Healthcare Professionals main page
• American Cancer Society: National HPV Vaccination Roundtable: Resource Center web page
• Immunize.org: Vaccines A–Z: Human Papillomavirus (HPV) main page
• Immunize.org: Ask the Experts: Human Papillomavirus (HPV) web page

February is Black History Month. Immunize.org recognizes the contributions of Black Americans to vaccinology throughout history, including:

• Onesimus, an enslaved man, introduced the idea of smallpox variolation in the United States in the 1700s
• Louis Tompkins Wright, the first Black surgeon on staff at Harlem Hospital in New York City, developed a new way to give the smallpox vaccine in the 1920s and 1930s
• Loney Clinton Gordon was one of three women to develop the pertussis vaccine in the 1940s
• Henrietta Lacks' cancer cells from the 1950s contributed to the development of the first polio vaccine, the HPV vaccine, and the COVID-19 vaccine
• Mae C. Jemison, the first Black astronaut, worked in vaccine research at CDC in the 1980s and 1990s
• Kizzmekia S. Corbett, a viral immunologist at NIH, now at Harvard, played a key role in developing the Moderna mRNA COVID-19 vaccine

Health inequities and disparities result, in part, from lower vaccination rates among Black Americans. Immunize.org encourages everyone to do their part to close the gaps in vaccination awareness, access, affordability, and coverage as part of our work to address disparities in health outcomes.

Laminated versions of the 2024 U.S. child and adolescent immunization schedule and the 2024 U.S. adult immunization schedule are now available for order in the Immunize.org shop.

While the schedules are available online from CDC at no cost, Immunize.org’s printed, laminated booklets are ideal for use in any busy healthcare setting where vaccinations are given.

• Durable: their tough coating can be wiped down, and they’re durable enough to stand up to a year's worth of use
• Format: each schedule is produced in a 16-page, 8.5” X 11” booklet format; with color coding for easy reading, our laminated schedules replicate the original CDC formatting, including all tables and notes
• Easy access to CDC updates: CDC added an online addendum page to the schedule, where new recommendations from ACIP made during 2024 can be posted. The laminated schedule addendum pages include custom QR codes you can scan to view or print the current CDC addendum from CDC's website, as needed.
• Adult schedule bonus: the adult schedule includes a bonus page with Immunize.org’s popular 1-page handout summarizing the dose, route, and needle size recommendations for all adult vaccines and recipients

    

Pricing

• 1 copy: $10.00
• 2–4 copies: $9.50 each
• 5–19 copies: $8.50 each
• 20–99 copies: $7.50 each
• 100–499 copies: $6.00 each
• 500–999 copies: $5.00 each
• 1,000–1,999 copies: $4.00 each
• 2,000+ copies: $3.25 each

Visit the Shop Immunize.org: Laminated Schedules web page to view images of all the pages, to download the order form, and to order today!

For additional information, including large bulk orders, call 651-647-9009 or email admininfo@immunize.org.

Related Links

• Immunize.org: Laminated Child and Adolescent Immunization Schedules (0–18 years) web page
• Immunize.org: Laminated Adult Immunization Schedules (19 and older) web page
• Immunize.org: Shop Immunize.org main page

Confident recommendations for influenza vaccine from healthcare providers are powerfully persuasive. To assist you in maximizing protection for your patients, Immunize.org, in collaboration with CSL Seqirus, updated the 65+ Flu Defense website.

Older adults are at increased risk of severe influenza and COVID-19 illness, including hospitalization and death, especially if they are not up to date on these vaccinations. An updated fact sheet on the website, The Importance of Preventing Influenza and COVID-19, offers responses to help guide discussions with patients on the importance of preventing influenza and COVID-19.



This helpful site includes information, tools, and tips for communicating with adults age 65 and older about the scope and severity of influenza. Resources include:

• Influenza in Adults 65+: The Facts
• Influenza Vaccination: Questions Patients Aged 65 and Older Frequently Ask Their HCP
• The Importance of Preventing Influenza and COVID-19

Check out the updated 65+ Flu Defense website at www.influenza-defense.org to assist your ongoing efforts in protecting this vulnerable population.

The National Adult and Influenza Immunization Summit (NAIIS, the “Summit”) and the American College of Obstetricians and Gynecologists (ACOG) will cohost a 1-hour webinar titled Maternal Immunization: Opportunities and Challenges at 3:30 p.m. (ET) on February 22. Hear about the importance of maternal immunization, challenges facing clinicians recommending and administering maternal vaccines, and possible solutions.

Register for the webinar.