- January is over; time to discontinue use of RSV vaccine during pregnancy in most of the United States. Continue protecting infants with RSV preventive antibody through March.
- Immunize.org reviews, updates “Ask the Experts: Vaccine Recommendations” content; adds new information on acceptable injection volume in a single limb
- “Do Infants Born Soon After Maternal RSV Vaccination Need RSV Preventive Antibody?” Watch the 1-minute answer, part of the Ask the Experts Video Series on YouTube.
- Immunize.org reviews, updates Ask the Experts content on Hib vaccine
- Influenza activity remains elevated; vaccination is best way to prevent influenza
- Immunize.org’s Influenza Vaccination Honor Roll for healthcare worker vaccination requirements welcomes a new overseas military facility
- Vaccines in the news
- Spotlight on the website: Resources to enhance vaccine confidence and help you discuss complementary and alternative medicine questions related to vaccination
- Recap: Immunize.org reviews, updates “Ask the Experts: Hepatitis B”
- Recap: Immunize.org reviews, updates “Ask the Experts: Dengue”
- Recap: Immunize.org updates five hepatitis B resources for healthcare professionals, noting option to use Heplisav-B in pregnancy and discontinuation of PreHevbrio
- Recap: Immunize.org updates “Evidence Shows Vaccines Unrelated to Autism”
- Recap: Immunize.org updates resource summarizing the endorsements of professional organizations for school vaccination requirements and opposing nonmedical exemptions
- Recap: Immunize.org updates two vaccine storage and handling resources
- Recap: Immunize.org updates “Vaccine Administration Record for Adults” and the “Vaccine Administration Record for Children and Teens”
- Virtual: Clinical Care Options offers webinar titled “RSV Prevention in Long-Term Care: Optimizing Vaccination in a Critical Setting” on February 6 at 3:30 p.m. (ET) and February 12 at 12:30 p.m. (ET); CE credit available
- Questions about our website? Register for Immunize.org Website Office Hours February 12 at 4:00 p.m. (ET) or February 13 at 12:00 p.m. (ET). Previous sessions archived online.
- Virtual: Boost Oregon hosts webinar titled “Boost Your Knowledge: Sorting Through Vaccine Information, Misinformation, and Disinformation” on February 25 at 3:00 p.m. (ET)
In most of the contiguous United States, recommendations call for discontinuing RSV vaccination (Abrysvo, Pfizer) during pregnancy each year on January 31, in line with the typical seasonality of RSV. Maternal vaccination from 32 through 36 weeks and 6 days gestation should resume on September 1.
RSV continues to circulate widely. CDC recommends administration of nirsevimab (Beyfortus, Sanofi) through March 31 to susceptible infants younger than 8 months of age in most of the contiguous United States. As with RSV vaccination during pregnancy, specific recommendations concerning timing of RSV immunization in tropical areas or in Alaska may vary due to differences in RSV seasonal patterns. RSV preventive antibodies provide immediate protection to the young child. Nirsevimab is important for all infants not otherwise protected against RSV if they are younger than 8 months. Those who are at high risk for severe RSV disease age 8 months through 19 months should also get nirsevimab during their second RSV season.
Refer to the 2025 CDC Recommended Immunization Schedule for Children and Adolescents or to Immunize.org’s nirsevimab standing orders template for details. There are no issues with nirsevimab supply.
RSV-NET is part of the Respiratory Virus Hospitalization Surveillance Network (RESP-NET), which monitors laboratory-confirmed hospitalizations associated with RSV, influenza (FluSurv-NET), and COVID-19 (COVID-NET). The RSV-NET chart below displays the current data on hospitalizations from RSV among infants younger than 1 year of age. Many of these hospitalizations are preventable through maternal RSV vaccination or nirsevimab administration.
Related Links
- CDC: Healthcare Providers: RSV Vaccination for Pregnant Women web page
- CDC: RSV Immunization Guidance for Infants and Young Children web page
- Immunize.org: Standing Orders for Administering Nirsevimab RSV Preventive Antibody (Beyfortus, by Sanofi) to Infants
Immunize.org reviewed and updated its Ask the Experts: Vaccine Recommendations web page with the latest CDC web links. With the addition of nirsevimab (Beyfortus, Sanofi) to the infant schedule, with a 1-mL injection volume to deliver a 100-mg dose, we have received several questions concerning maximum injection volumes in a single limb. Infants who need nirsevimab may also need routine vaccinations at the same visit.
A new question was added regarding acceptable injection volumes:
Q: Is there a strict limit to the volume of vaccine and/or monoclonal antibody that can be administered in a single limb (deltoid or thigh) at one immunization visit? Someone told me recently not to administer more than 1 mL of volume into an infant’s thigh.
A: This question has arisen more frequently since the introduction of the RSV preventive antibody, nirsevimab (Beyfortus, Sanofi), which has an injection volume of 1 mL for infants younger than 8 months who weigh 5 kg or more at the time of immunization. High risk children entering their second RSV season require a Beyfortus dose volume of 2 mL. Beyfortus is often administered at a routine visit when other infant immunizations are due.
There is no specific guidance to not exceed 1 mL in one muscle. In fact, there is no clear standard of practice and reference texts vary in guidance. Facilities or health systems may have medication policies/procedures that outline guidance for their staff. Professional judgement is needed when administering intramuscular medications or immunizations to people, including children, because muscle size varies from person to person.
CDC experts suggest a range of volume, depending upon the muscle injected. For the deltoid, the typical volume injected is 0.5 mL (maximum: 2 mL). For the vastus lateralis (the thigh), the typical volume that may be injected is 1–4 mL (maximum: 5 mL). Infants and toddlers fall at the lower end of these ranges, whereas adolescents and adults generally fall on the higher end of the range.
If more than 1 mL of volume needs to be injected into the thigh, that can be done while staying well within the acceptable range. Use of combination vaccines, when indicated and available, can decrease injection volume.
Related Links
- Immunize.org: Ask the Experts: Vaccine Recommendations main page
- Immunize.org: Ask the Experts main page to access more than 1,300 questions and answers
This week, our featured episode from the Ask the Experts Video Series is Do Infants Born Soon After Maternal RSV Vaccination Need RSV Preventive Antibody? The video explains that if infants are born less than 14 days after the mother received the RSV vaccine, the infants should receive nirsevimab (Beyfortus, Sanofi).
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
Immunize.org updated its Ask the Experts: Hib (Haemophilus influenzae type b) content. It now includes updated Hib epidemiology and surveillance data.
Immunize.org's Ask the Experts main page leads you to 30 distinct web pages on dozens of topics with more than 1,300 common or challenging questions and answers (Q&As) about vaccines and their administration. Immunize.org's team of experts includes Kelly L. Moore, MD, MPH (team lead); Carolyn B. Bridges, MD, FACP; Iyabode Beysolow, MD, MPH; and Jane R. Zucker, MD, MSc.
Related Links
- Immunize.org: Ask the Experts: Hib (Haemophilus influenzae type b) main page
- Immunize.org: Ask the Experts main page to access more than 1,300 questions and answers
For week 4, ending January 25, CDC’s Weekly U.S. Influenza Surveillance Report, FluView, showed influenza-like illness activity at high to very high levels in 44 jurisdictions. This week, 6.9% of outpatient visits were for influenza-like illness, well above the epidemic threshold of 3.0% for the ninth consecutive week. Sixteen pediatric deaths associated with seasonal influenza virus infection were reported this week, bringing the 2024–25 season total to 47 pediatric deaths.
RESP-NET
Visit the CDC Respiratory Virus Hospitalization Surveillance Network (RESP-NET) for weekly reports of hospitalizations 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 18, 36.7% of pregnant patients had received influenza vaccination, the same rate as this time in 2024. Vaccination coverage was highest among non-Hispanic Asian pregnant patients (52.0%) and lowest among non-Hispanic Black pregnant patients (24.9%). Vaccination during pregnancy helps protect both mother and infant from the consequences of influenza infection.
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 nirsevimab (Beyfortus, Sanofi).
Identify pharmacies in your area that may offer influenza and COVID-19 vaccines by entering a zip code in the VaccineFinder on Vaccines.gov or Vacunas.gov.
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 A–Z: Influenza 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 Camp Lemonnier Medical Facility in Djibouti City, Djibouti, 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
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
- CNN: Dr. Sanjay Gupta: Benefits of Vaccines Are a Matter of Fact (1/29/25)
- Partnership to Fight Infectious Disease: New Poll: Majority of Americans Support Keeping Vaccines Widely Available to Protect Children and Communities (1/29/25)
- New York Times: The Vaccine Schedule Is Under Fire. What’s the Evidence for It? (1/28/25)
This week, we spotlight Immunize.org’s clinical resources for improving confidence and addressing concerns about vaccinations. The practical resources available in this section of our website are intended to be shared with patients and families.
Vaccine Confidence & Addressing Concerns is located under the Clinical Resources menu. Thirteen topics are addressed, including autism, improving the vaccination experience, religious concerns, vaccine safety, and complementary and alternative medicine partner resources.
Immunize.org recently updated its page, Complementary and Alternative Medicine: Partner Resources. Find links to federal and nongovernmental resources. These partner resources can help you discuss vaccination-related complementary and alternative medicine questions with your patients.
Immunize.org updated the questions and answers in its "Ask the Experts" web page for HepB vaccine. Updates reflect that Heplisav-B (Dynavax) is an option for use during pregnancy now that safety data is available. The web page was also updated to reflect the removal of PreHevbrio, which VBI Vaccines withdrew from the U.S. market in November 2024 for business reasons. The section addresses how to complete series initiated with PreHevbrio.
Immunize.org updated its "Ask the Experts" web page for the dengue vaccine. Updates incorporate:
- A note that Dengvaxia (Sanofi) production is scheduled to end in early 2026
- Updates links to CDC’s “General Best Practices for Immunization”
- Updates to the epidemiology of dengue
Immunize.org updated five hepatitis B resources to address two recent developments: the addition of Heplisav-B (Dynavax) as an option for vaccination during pregnancy and the withdrawal of PreHevbrio (VBI Vaccines) from the U.S. market in November 2024 for business reasons. Where relevant, the resources now discuss how to complete the series initiated with PreHevbrio with any other available HepB products. The updated resources include:
- Hepatitis B and Healthcare Personnel
- Standing Orders for Administering Hepatitis B Vaccine to Adults
- Hepatitis A and Hepatitis B Vaccines: Be Sure Your Patients Get the Correct Dose
- Healthcare Personnel Vaccination Recommendations, which also updates the option to administer MenABCWY to laboratory workers, if indicated
- Hepatitis B: Questions & Answers, which also states that people with a severe allergy to yeast should not receive any currently available HepB vaccine, because PreHevbrio was the only HepB option not manufactured using yeast cells
Immunize.org recently updated its Evidence Shows Vaccines Unrelated to Autism resource. Updates reflect the latest science that continues to show no relationship between vaccines and autism. We acknowledge the partnership of the Autism Science Foundation, which co-brands this resource, providing advice from their subject matter experts.
Immunize.org updated Leading Medical Organizations Endorse Strong School and Childcare Vaccination Requirements and Elimination of Nonmedical Exemptions. The resource is updated with the most current position statements from a variety of medical organizations. The resource also links to Immunize.org's web page displaying information on states' exemption policies.
Immunize.org updated two storage and handling resources. The resources include:
- Checklist for Safe Vaccine Storage and Handling: Edits emphasize the value of using digital data loggers for vaccine storage and the importance of never using dormitory-style combination units for vaccine storage.
- Vaccine Storage Emergency Response Worksheet: Contact information for manufacturers was verified. Edits remove VBI Vaccines from the list of manufacturers and specify Bavarian Nordic as the manufacturer of Vaxchora (oral cholera vaccine) and Vivotif (oral typhoid vaccine).
Immunize.org updated vaccine administration records for adults and for children and teens as age-appropriate, adding recently recommended vaccines, including PCV21 (Capvaxive, Merck), mRNA RSV (mResvia, Moderna), and mpox vaccine (Jynneos, Bavarian Nordic) and removing PreHevbrio (HepB, VBI). Polio vaccine (Ipol, Sanofi) was added to the adult form.
Laminated booklets of the 2025 U.S. child and adolescent immunization schedule and the 2025 U.S. adult immunization schedule are available now in the Immunize.org shop. The laminated booklets are shipping now.
The schedules are available online as PDFs from CDC at no cost. Immunize.org’s laminated booklets are ideal for use in any busy healthcare setting where vaccines are given. Features include:
- Durability: Their tough coating can be wiped down, and they can stand up to a year's worth of use.
- Format: Each schedule is produced in an 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. The adult schedule is 16 pages and the child and adolescent schedule is 20 pages.
- Easy access to CDC updates: The CDC online schedule includes an addendum page that will display ACIP’s new recommendations as CDC adopts them during 2025. Each Immunize.org laminated schedule addendum page includes QR codes you can scan to view or print the online addendum page as it is revised.
- Bonus content: Both schedules include a bonus page with Immunize.org’s popular 1-page handout summarizing the dose, route, and needle size recommendations for all vaccines and recipients.
Pricing:
| Child and Adolescent Booklets | Adult Booklets | |
| 1 copy: $10.50 | 1 copy: $10.00 | |
| 2–4 copies: $10.00 each | 2–4 copies: $9.50 each | |
| 5–19 copies: $9.00 each | 5–19 copies: $8.50 each | |
| 20–99 copies: $8.00 each | 20–99 copies: $7.50 each | |
| 100–499 copies: $6.50 each | 100–499 copies: $6.00 each | |
| 500–999 copies: $5.50 each | 500–999 copies: $5.00 each | |
| 1,000–1,999 copies: $4.50 each | 1,000–1,999 copies: $4.00 each | |
| 2,000+ copies: $3.75 each | 2,000+ copies: $3.25 each | |
For additional information, 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
Clinical Care Options, in partnership with the Post-Acute and Long-Term Care Medical Association, will host a webinar titled RSV Prevention in Long-Term Care: Optimizing Vaccination in a Critical Setting, 3:30–4:30 p.m. (ET) on February 6 and 12:30–1:30 p.m. (ET) on February 12.
Participants will learn about the burden of RSV among older adults residing in long-term care, develop strategies for counseling patients and caregivers on the risk of severe RSV, and gain insights on how to implement RSV vaccine recommendations in long-term care settings. Presenters include two professors of geriatric medicine: Dallas Nelson, MD, FACP, and Nicole Osevala, MD, FACP. The program is supported by an educational grant from GSK.
There is no fee to attend. CME, CNE, and CPE credit are available.
Register for the webinar.
To learn simple tips and tricks for using our website efficiently, please register for our next set of Website Office Hours on Wednesday, February 12 at 4:00 p.m. (ET) or Thursday, February 13 at 12:00 p.m. (ET). The same content will be covered in both sessions.
We will open each 45-minute session with a short, live demonstration on navigating the Official Guidance (part 2: state resources) website section and address questions submitted in advance. This section is extremely useful for those who want to know about state immunization requirements for school and childcare. You can submit questions when you register or live on Zoom during the session.
Register today for Immunize.org Website Office Hours (content is the same for both):
Mark your calendar for future Immunize.org Website Office Hours.
Boost Oregon will present a 1-hour webinar titled Boost Your Knowledge: Sorting Through Vaccine Information, Misinformation, and Disinformation at 3:00 p.m. (ET) on February 25. Led by Carrie Bader, Boost Oregon’s training director, and Ryan Hassan, MD, Boost Oregon’s medical director, this webinar will focus on building digital media literacy skills to critically evaluate vaccine-related information online.
Register for the webinar.