Issue 1778: October 2, 2024

On September 23, CDC issued a Health Alert Network (HAN) Health Advisory: Prevention Strategies for Mpox, Including Vaccinating People at Risk via Sexual Exposure, for U.S. Travelers Visiting Countries with Clade 1 Mpox Outbreaks. This updates information provided in its August 7, 2024, HAN Health Advisory. A portion of the summary of the HAN appears below.



MPXV [monkey pox virus] transmission in countries where the virus is endemic is typically via exposure to infected wildlife with subsequent person-to-person spread via close contact (including intimate or sexual contact) with a person with mpox, or direct contact with their respiratory secretions (e.g., snot, mucus) or contaminated objects (e.g., bedding). During the global clade II outbreak, human-to-human transmission of mpox has been predominantly spreading through sexual contact. During 2024, the Democratic Republic of the Congo (DRC) has reported >21,000 suspected clade I mpox cases, its largest annual number on record. . . . Early data indicate that a large proportion of clade Ib mpox cases among adults has been associated with sexual contact, including via ongoing transmission believed to be occurring in some countries where the virus is not normally found. Travelers to DRC or other countries with sustained spread of clade I mpox, regardless of sexual orientation or gender identity, should be made aware of activities associated with cases and should be vaccinated with two doses of JYNNEOS if they anticipate certain sexual exposures while traveling. . . . Continue to follow CDC’s current vaccine guidance to prevent clade II MPXV infection, which continues to circulate in the United States, and will also help protect against clade I MPXV.

Immunize.org recently updated its Vaccines A–Z: Mpox main page to display the latest CDC guidance and resources, including CDC’s standing orders template for the administration of Jynneos to adults at risk. Key facts include:

• Mpox vaccination with a 2-dose series (4 weeks apart) of Jynneos (Bavarian Nordic) is recommended for all adults at risk of exposure to mpox
• Details of sexual and close contact risk factors and guidance for vaccination appear in the current CDC Recommended Adult Immunization Schedule
• An FDA Emergency Use Authorization (EUA) remains in effect enabling vaccination of children younger than age 18 who are at risk, when indicated

• CDC: Interim Clinical Considerations for Use of Jynneos Vaccine for Mpox Prevention in the United States
• CDC: 2024 U.S. Recommended Adult Immunization Schedule for Ages 19 Years or Older (PDF)
• Immunize.org: Vaccines A–Z: Mpox main page
• Immunize.org: Mpox VIS and available translations

CDC published Decline in Vaccination Coverage by Age 24 Months and Vaccination Inequities Among Children Born in 2020 and 2021—National Immunization Survey–Child, United States, 2021–2023 on September 26 in MMWR. Among many reported findings, the survey identified 1.2% of children who had received zero doses of vaccine by age 24 months, with the highest point estimate (1.4%) measured among White children. Readers are encouraged to review the article to see vaccine-specific coverage rates and disparities nationally and where you live. A portion of the summary appears below.

The Advisory Committee on Immunization Practices currently recommends routine vaccination against 15 potentially serious illnesses for children by age 24 months. . . .

Estimated coverage with most childhood vaccines was lower among children born during 2020–2021 (during or after the height of the health care disruption from the COVID-19 pandemic) compared with those born during 2018–2019. Disparities by race and ethnicity, health insurance status, poverty status, and urbanicity persist. Coverage also varied widely by jurisdiction, especially for influenza vaccine. . . .

Financial barriers, access issues, vaccine hesitancy, and vaccine-related misinformation all need to be overcome to increase coverage, ensure full recovery from the impact of the COVID-19 pandemic, eliminate disparities, and protect all children from vaccine-preventable diseases.

Access the MMWR article in HTML or PDF.

Related Link

• CDC: MMWR main page providing access to the MMWR family of publications
• Immunize.org: Vaccines A–Z: COVID-19 main page

CDC published Maternal Respiratory Syncytial Virus Vaccination and Receipt of Respiratory Syncytial Virus Antibody (Nirsevimab) by Infants Aged <8 Months—United States, April 2024 on September 26 in MMWR. A portion of the summary appears below. 

Respiratory syncytial virus (RSV) is the most common cause of hospitalization among U.S. infants. Receipt of either a maternal RSV vaccine or administration of RSV antibody (nirsevimab) to infants was first recommended during the 2023–24 RSV season. . . .

In a CDC survey, 33% of eligible pregnant women reported receiving an RSV vaccination. Among women with a live birth, 45% reported that their infant received nirsevimab. Overall, 56% of infants were protected against severe RSV disease by either product or both. Provider recommendation for immunization was associated with higher coverage. . . .

Enhanced measures to implement provider RSV immunization recommendations are needed to protect infants from severe RSV disease.



Access the MMWR article in HTML or PDF.

Related Links

• CDC: MMWR main page providing access to the MMWR family of publications
• Immunize.org: Vaccines A–Z: RSV main page

CDC published COVID-19–Associated Hospitalizations and Maternal Vaccination Among Infants Aged <6 Months—COVID-NET, 12 States, October 2022–April 2024 on September 26 in MMWR. A portion of the summary appears below. 

Infants aged <6 months have high COVID-19–associated hospitalization rates and are not age-eligible for COVID-19 vaccination. . . .

COVID-19–associated hospitalization rates among infants aged <6 months remain higher than those among any other age group except adults aged ≥75 years and were comparable to hospitalization rates in adults aged 65–74 years. Among approximately 1,000 hospitalized infants with COVID-19, 22% were admitted to an intensive care unit, and nine died while hospitalized. The percentage of hospitalized infants whose mothers had been vaccinated during pregnancy was 18% during October 2022–September 2023 and decreased to <5% during October 2023–April 2024. . . .

COVID-19 can cause severe disease in infants aged <6 months; prevention should focus on ensuring that pregnant persons receive recommended COVID-19 vaccines to protect themselves and their young infants.



Access the MMWR article in HTML or PDF.

Related Links

• CDC: MMWR main page providing access to the MMWR family of publications
• Immunize.org: Vaccines A–Z: COVID-19 main page

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 MenACWY vaccination for all preteens age 11–12 years with a booster at age 16 years. 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, based on a discussion with their healthcare provider. 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.  

Additionally, the American Society for Meningitis Prevention (ASMP) offers resources, including social media graphics for World Meningitis Day. Use #UnpredictableMeningitis in your social media postings to amplify your messages. 

Related Links

• CoMO: World Meningitis Day toolkit main page
• WHO: Defeating Meningitis by 2030 web page
• WHO: Meningitis Disease web page
• CDC: Meningococcal Vaccination web page
• National Meningitis Association (archived) 
• Immunize.org: Vaccines A–Z: Meningococcal ACWY main page
• Immunize.org: Give2MenACWY.org website
• Immunize.org: Vaccines A–Z: Meningococcal B main page

Immunize.org's Influenza Vaccination Honor Roll recognizes facilities that take a stand for patient safety by implementing policies requiring healthcare personnel influenza vaccination. Immunize.org recently welcomed Siouxland Community Health Center, Sioux City, IA, to our honor roll.

Eligibility

• Eligible organizations: hospitals, long-term care facilities, medical practices, pharmacies, professional organizations, health departments, and other government entities
• Requirements:
  • Your policy must require influenza vaccination for all staff
  • The application must describe measures to prevent transmission of influenza from unvaccinated personnel to patients (e.g., masking for the entire shift)

• Immunize.org: Honor Roll Honorees: Influenza
• About the Influenza Vaccination Honor Roll

This week, our featured episode from the Ask the Experts Video Series is Can Someone with a Positive HPV Cervical Screening Test Be Vaccinated for HPV? The video describes how vaccination does not treat an existing HPV infection, but can prevent infection with additional types of HPV.

The 1-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

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 53,000+ readers to the week’s important vaccine developments. IZ Express also features:

• Educational materials from Immunize.org, CDC, AAP, and others
• Newly posted VISs 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 get the latest vaccine news to every clinical and public health professional who needs to know.

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

• Washington Post: Keep Forgetting Your Shingles Shot? These Sufferers Wish They Hadn’t. (9/24/24) 
• San Francisco Chronicle: After Federal Government Ends Free COVID Vaccine Program, California Extends Its Own (9/24/24) 
• CBS: Commentary: Florida’s New COVID Booster Guidance Is Straight-Up Misinformation (9/23/24) 
• NPR: Whooping Cough Cases Spike in the U.S., After People Missed Vaccinations During Pandemic (9/21/24) 

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Spotlight on the website: What’s new on Immunize.org?

Use What’s New on Immunize.org to find out what key content changed and when it happened. This feature helps quickly find Immunize.org’s recently updated Clinical Resources, Ask the Experts sections, VISs, translations, or other web pages. 

How to access “What’s New on Immunize.org": 

• Click on the News & Updates tab on the menu bar found at the top of each page
• Select Immunize.org Updates on the left
• Then click on Website Updates on the right

Next, you will see a reverse chronologic list of key Immunize.org updates. You may filter results by resource type using one of five categories:  

• Ask the Experts topics  
• Clinical Resources   
• Translations of VISs or Clinical Resources 
• VISs  
• Web pages  

Click on the hyperlinked result to access the selected content. Additional filters of year, month, or status (new or updated) are available. 

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Today and tomorrow: Register for Immunize.org’s Website Office Hours sessions on October 2 at 4:00 p.m. (ET) or October 3 at 10:00 a.m. (ET) 

We want to help you locate what you need on the Immunize.org website quickly and easily. To that end, we are introducing a program of live Website Office Hours sessions with members of our website team. If you have challenges or questions using our website, please register for a Website Office Hours session today, October 2, at 4:00 p.m. (ET) or tomorrow, October 3, at 10:00 a.m. (ET). Initially, we will offer two online Website Office Hours sessions every other week. We will adjust this service as we learn from our experience.
 
We will open each of the first two sessions with a short, live demonstration on navigating the 1,300 practical clinical questions and answers in our popular Ask the Experts website section. After the demonstration, you will be able to submit questions through the Q&A box on Zoom. We may not get to every question during a session, but we will hold these sessions regularly and develop additional resources to support users based on your feedback.

Register for an Immunize.org Website Office Hours session.

• Registration for October 2 (today)
• Registration for October 3 (tomorrow)

Mark your calendar for our future Immunize.org Website Office Hours. The next topic discussed will be navigating the VIS website section on October 15, at 1:00 p.m. (ET) and October 16, at 4:00 p.m. (ET).

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Recap: Immunize.org updates “Standing Orders for Administering Respiratory Syncytial Virus Vaccine (RSV) to Adults Age 60 Years and Older” 

Immunize.org updated its clinician resource, Standing Orders for Administering Respiratory Syncytial Virus Vaccine (RSV) to Adults Age 60 Years and Older to incorporate changes CDC recently made to its website for clinical considerations for RSV vaccination of adults age 60 through 74 at increased risk of severe disease. The changes to the website align the online guidance with the final, published ACIP recommendation. The following changes were made to the Immunize.org standing orders template:

• The indication for vaccination based on residential setting was limited to nursing homes only. Previously, CDC’s website guidance included residents of nursing homes and other long-term care facilities (LTCFs).
• Examples were added to illustrate the types of people age 60 through 74 without an ACIP-specified risk factor who may, nonetheless, be judged by a clinician to be at increased risk for severe RSV disease.
• A note was added to indicate ACIP’s recommendation that a vaccination provider should not deny a patient age 60 through 74 RSV vaccination because they lack documentation of a self-reported risk factor for severe RSV disease.

Related Links

• Immunize.org: Vaccine A–Z: RSV (Respiratory Syncytial Virus) main page
• Immunize.org: Clinical Resources A–Z main page, where you can filter by topic, vaccine, language, or other criteria

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Recap: Use Immunize.org’s suite of 2024–25 influenza vaccination resources. All now up to date for this season. 

Immunize.org completed the annual review of our entire suite of influenza clinical content for the 2024–25 season. In addition to resources that required updates, those that did not require changes to content also have a new date in the footnote to indicate they are current for 2024–25 season. The final batch of updated resources includes:

• Communicating the Benefits of Influenza Vaccination: updated data on influenza disease burden, vaccination rates, and use of the SHARE method for practitioners to use in discussing the value of vaccination (codeveloped with the Association of Immunization Managers)
• Declination of Influenza Vaccination: reviewed, no changes to content
• Guide for Determining the Number of Doses of Influenza Vaccine to Give to Children Age 6 Months Through 8 Years: updated date and URL for the ACIP influenza recommendations only
• Talking with Your Patient About Contraindications and Precautions to Influenza Vaccination: added expanded influenza vaccine options for solid organ transplant recipients
• Not Sure If You Can Get an Influenza Vaccine?: updated date and URL for the ACIP influenza recommendations only
• Don’t Take Chances with Your Family’s Health—Make Sure You All Get Vaccinated: reviewed, no changes to content

Find all of our influenza vaccine resources for the 2024–25 season at the Vaccines A–Z: Influenza main page.

Related Links

• Immunize.org: Vaccines A–Z: Influenza main page
• Immunize.org: Ask the Experts main page with more than 1,300 questions and answers

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Summary: These updated Immunize.org educational materials for clinicians were released during August and September

IZ Express regularly provides readers with information about Immunize.org’s new and updated web pages, educational materials for healthcare professionals, and patient handouts. All Immunize.org clinical resources are free to distribute.  

Immunize.org Materials for Clinicians  

• Influenza materials and Ask the Experts web section updated for the 2024–25 season  
  • Screening Checklist for Contraindications to Injectable Influenza Vaccination, also available in Spanish  
  • Screening Checklist for Contraindications to Live Attenuated Intranasal Influenza Vaccination, also available in Spanish  
  • Influenza Questions and Answers  
  • Guide for Determining the Number of Doses of Influenza Vaccine to Give to Children Age 6 Months Through 8 Years 
  • Communicating the Benefits of Influenza Vaccination 
  • Talking with Your Patient About Contraindications and Precautions to Influenza Vaccination 
  • Not Sure If You Can Get an Influenza Vaccine? 
  • Don't Take Chances with Your Family's Health – Make Sure You All Get Vaccinated Against Influenza Every Year! 
  • Declination of Influenza Vaccination 
  • Ask the Experts: Influenza  
• Standing orders for administering:  
  • Nirsevimab RSV Preventive Antibody (Beyfortus, by Sanofi) to Infants  
  • Respiratory Syncytial Virus Vaccine (RSV) to Adults Age 60 Years and Older  
  • Pfizer Respiratory Syncytial Virus (RSV) Vaccine (Abrysvo) During Pregnancy  
  •  Haemophilus influenzae type B to Children & Teens 
  • Meningococcal B Vaccine (MenB) to Adolescents and Adults 
• Materials supporting the administration of vaccines 
  • Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools  
  • Administering Vaccines: Dose, Route, Site, and Needle Size 
  • Administering Vaccines to Adults: Dose, Route, Site, and Needle Size 
  • Before You Vaccinate Adults, Consider Their “H-A-L-O”!  
  • Notification of Immunization Letter Template 
  • Vaccines with Diluents: How to Use Them   
  • Meningococcal B Vaccine Recommendations by Age and Risk Factor 

Immunize.org Materials for Patients  

• Vaccinations for Adults: You’re Never Too Old to Get Vaccinated!  

Web Pages  

• Vaccines A–Z: Mpox 
• Ask the Experts:  
  • COVID-19 
  • Respiratory Syncytial Virus (RSV)  
  • Pneumococcal  

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Featured Resources

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National Foundation for Infectious Diseases issues Call to Action to increase adult immunization following round table meeting with partners, including Immunize.org

The National Foundation for Infectious Diseases (NFID) released Call to Action: Strategies to Improve Adult Immunization in the U.S. following a round table discussion with more than 20 partner organizations, including Immunize.org, in May 2024. Discussions focused on the burden of vaccine-preventable diseases among U.S. adults and practical approaches to boost adult vaccine uptake targeting healthcare systems, providers, patients, and policymakers.



View the Call to Action.

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Vaccinate Your Family launches “Dispelling Respiratory Rumors” campaign to dispel misinformation about influenza, COVID-19, and RSV this fall

Vaccinate Your Family (VYF) launched its Dispelling Respiratory Rumors campaign to help dispel common myths about influenza, COVID-19, RSV, and general wellness during the winter months. The toolkit includes resources and shareable materials, including graphics and social media messages. Use #ViralTruths to amplify your messages.



View resources and shareable materials.

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American Health Care Association/National Center for Assisted Living  launches "#GetVaccinated" campaign to boost vaccination rates among seniors in care settings 

American Health Care Association/National Center for Assisted Living (AHCA/NCAL) launched its #GetVaccinated campaign. The campaign’s primary focus is supporting providers with tools needed to address the increased risk from respiratory viruses faced by seniors and immunocompromised individuals in long-term care settings. 
 

 
View the campaign resources.
 
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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 Algorithm for MenACWY Immunization in Adolescents 11 Through 18 Years of Age.

The website is divided into five easy-to-access sections:

• Vaccinate Teens – Teen vaccination schedules and tips for improving vaccination rates
• Give 2 Doses – Tools to help improve second dose coverage of MenACWY vaccine
• 16-Year-Old Visit – Resources to help providers and patients remember the important vaccines recommended for 16-year-olds
• Tools for Providers – Tools to explain meningococcal ACWY vaccine recommendations and improve coverage for all adolescent vaccines
• Resources – Links to print materials, organizations involved in adolescent vaccination, personal stories about the importance of vaccination, and other resources of interest

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.

Related Links 

• Give2MenACWY.org website
• Algorithm for MenACWY Immunization in Adolescents 11–18 Years of Age
• MenACWY: You're Not Done If You Give Just One: Give 2 Doses to Strengthen Protection
• Recommending MenACWY: What to Say and How to Say It
• Top 10 Ways to Improve Adolescent Immunization Rates
• Developing an Immunization Culture in Your Office
• Know Your Rates: Measuring Immunization Success in Your Practice
• You're 16: We Recommend These Vaccines for You
• Dear Colleague Letter: 16-Year-Old Patients: Make Sure They Receive Their Annual Well Visit and Vaccinations – signed by six medical societies
• Ask the Experts: Meningococcal ACWY
• CDC: ACIP Meningococcal Vaccine Recommendations
• CDC: Vaccination Coverage Among Adolescents Aged 13–17 Years—National Immunization Survey–Teen, United States, 2023

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Notable Publications

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“Vaccination Coverage by Age 24 Months Among Children Born During 2017–2021—U.S.-Affiliated Pacific Islands” published in MMWR 

CDC published Vaccination Coverage by Age 24 Months Among Children Born During 2017–2021—U.S.-Affiliated Pacific Islands on September 26 in MMWR. A portion of the summary appears below. 

The U.S.-affiliated Pacific Islands (USAPI) immunization programs and CDC collaborate to monitor vaccination coverage in their jurisdictions. . . . 

This report is the first comprehensive analysis of trends in childhood vaccination coverage in USAPI. Coverage of >90% by age 24 months with recommended vaccines was inconsistently met across jurisdictions. . . .

Gaps in coverage identified in this report can be used to identify where evaluation of jurisdiction-specific reasons for lagging on-time vaccination is needed. Monitoring of vaccination coverage can be used to guide intervention implementation and evaluate effectiveness of interventions.



Access the MMWR article in HTML or PDF.

Related Link

• CDC: MMWR main page providing access to the MMWR family of publications

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Upcoming Events

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Virtual: Watch October 23–24 ACIP meeting with wide-ranging discussion on vaccine preventable diseases 

CDC will convene its ACIP on October 23–24, starting at 8:00 a.m. (ET). ACIP will discuss vaccines targeting chikungunya, COVID-19, cytomegalovirus, HPV, influenza, meningococcal disease, mpox, pneumococcal disease, and RSV, as well as adult and child/adolescent immunization schedules.

No registration is required to watch webcasts of live ACIP meetings or listen via telephone. Opportunities for public comment are described on the website.

Related Links

• CDC: ACIP main page for access to webcast, agendas
• CDC: ACIP: Meeting Information for presentation slides, content from previous meetings, and information about future meetings

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For more upcoming events, visit our Calendar of Events.