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Issue 1343
Issue 1343: January 3, 2018


TOP STORIES


IAC HANDOUTS


VACCINE INFORMATION STATEMENTS


WORLD NEWS


FEATURED RESOURCES


JOURNAL ARTICLES AND NEWSLETTERS


EDUCATION AND TRAINING

 


TOP STORIES


CDC Health Alert Network releases advisory about seasonal influenza activity and antiviral treatment of patients with influenza

On December 27, the CDC Health Alert Network released a "CDC Health Advisory" titled Seasonal Influenza A(H3N2) Activity and Antiviral Treatment of Patients with Influenza. The "Background" section is reprinted below.

In the United States (U.S.), influenza activity has increased significantly over recent weeks with influenza A(H3N2) viruses predominating so far this season. In the past, A(H3N2) virus-predominant influenza seasons have been associated with more hospitalizations and deaths in persons aged 65 years and older and young children compared to other age groups. In addition, influenza vaccine effectiveness (VE) in general has been lower against A(H3N2) viruses than against influenza A(H1N1)pdm09 or influenza B viruses. Last season, VE against circulating influenza A(H3N2) viruses was estimated to be 32% in the U.S. CDC expects that VE could be similar this season, should the same A(H3N2) viruses continue to predominate. For this reason, in addition to influenza vaccination for prevention of influenza, the use of antiviral medications for treatment of influenza becomes even more important than usual. The neuraminidase inhibitor (NAI) antiviral medications are most effective in treating influenza and reducing complications when treatment is started early. Evidence from previous influenza seasons suggests that NAI antivirals are underutilized in outpatients and hospitalized patients with influenza who are recommended for treatment.

This CDC Health Advisory is being issued to—

  1. Remind clinicians that influenza should be high on their list of possible diagnoses for ill patients because influenza activity is increasing nationwide, and
  2. Advise clinicians that all hospitalized patients and all high-risk patients (either hospitalized or outpatient) with suspected influenza should be treated as soon as possible with a neuraminidase inhibitor antiviral. While antiviral drugs work best when treatment is started within 2 days of illness onset, clinical benefit has been observed even when treatment is initiated later.

Access the complete Health Advisory: Seasonal Influenza A(H3N2) Activity and Antiviral Treatment of Patients with Influenza.

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Reminder: CDC requests nominations for its Childhood Immunization Champion Awards; submissions due by February 2

The CDC Childhood Immunization Champion Award is an annual award that recognizes individuals who make a significant contribution toward improving public health through their work in childhood immunization.
 
Each year, up to one CDC Immunization Champion from each of the 50 U.S. states, eight U.S. territories and freely associated states, and the District of Columbia will be honored. Champions can include coalition members, parent advocates, healthcare professionals (e.g., physicians, nurses, physicians’ assistants, nurse practitioners, and medical assistants), and other immunization leaders who meet the award criteria. Self-nominations are welcome, or you may submit an application for a deserving individual.

State immunization program managers, state and federal government employees of health agencies, individuals who have been affiliated with and/or employed by pharmaceutical companies, and those who have already received the award are not eligible to apply (for details, see page 3 of the nomination packet).

Awardees will be announced during National Infant Immunization Week (NIIW), which runs April 21–28 in 2018. Champions will receive a certificate of recognition, will be featured on CDC’s web site, and may be recognized by their immunization program during NIIW.

Nominations should be submitted to the immunization program manager in the state or territory where the nominee resides by February 2. Please contact your state immunization program to confirm your state’s deadline. 

Related Links

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IAC Spotlight! Visit IAC's popular Vaccine Information Statement (VIS) web section for VISs in up to 50 languages, as well as information about their use

In 2017, visitors to IAC's immunize.org website downloaded more than 2.5 million Vaccine Information Statements (VISs). Besides links to the 26 VISs in English, the site also offers translations in 49 other languages—alphabetically, from Amharic to Yiddish! (Note: Not all VISs are available in all languages.)

The VIS main page is found at www.immunize.org/vis.

You can also access VISs sorted by language at http://www.immunize.org/vis/?f=9, with 50 languages listed.

Both pages also feature a handy table of current VIS dates, an easy way to check that you are using the most recent version.

IAC has a cooperative agreement with CDC to provide VIS translations in seven languages for routinely recommended vaccines for children and adults—Arabic, Chinese, French, Russian, Spanish, Somali, and Vietnamese. These are the most commonly used second languages in the U.S. Most other VIS translations have been donated by other organizations, who generously partner with us to provide translations. You can see all available translations here

If your organization is interested in becoming a translation partner of IAC, please contact translations@immunize.org.

The VIS main page also includes links to information about new VISs, instructions for correctly using VISs, FAQs from CDC, and more.

Related Links

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Updated slide set on adolescent immunization and the 16-year-old visit by Dr. William Atkinson now available 

On July 10, 2017, Dr. William L. Atkinson, MD, MPH, IAC’s associate director for immunization education, presented a webinar titled “Adolescent Immunization Update and the 16-Year-Old Platform.” The related slide set has been updated to include the 2016 National Immunization Survey-Teen (NIS-Teen) data. The revised slide set is available in PDF format on IAC’s PowerPoint Slide Set web page. At this link, you can also request the full PowerPoint slide set to create your own adolescent immunization presentation.

Dr. Atkinson's July 2017 webinar provided a review of immunization platforms—healthcare visits where specific vaccines are indicated—specifically the 16-year-old immunization platform that was added to the Child and Adolescent Immunization Schedule in 2017. It also included a discussion of immunization rates among adolescents [based on the 2015 NIS-Teen data] and recommendations for Tdap, HPV, and meningococcal vaccines. Strategies to improve immunization rates among adolescents were also summarized.

The original July 2017 webinar can be accessed from the home page of IAC’s main website at www.immunize.org. To view it, scroll down to the middle of the page to Dr. Atkinson’s photo and click on the link.

CDC's 2016 NIS-Teen data showed that during 2015–2016, less than one-half (43.4%) of adolescents in the U.S. received 3 doses of HPV vaccine and only 39.1% of teens who were age 16 or 17 at the time of the interview had received the recommended second dose of meningococcal conjugate vaccine (known as MenACWY or MCV4). 

Explore Dr. Atkinson's presentation and updated slide set, as well as the resources listed below, to discover ways to improve adolescent vaccination rates in your practice.

Related Links

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Voices for Vaccines releases new podcast—a recording of a session at NFID's Clinical Vaccinology Course about vaccine messaging

Voices for Vaccines (VFV) has posted a new entry in its Vax Talk podcast series: Live at NFID. In this podcast, Karen Ernst, Voices for Vaccines, and Dr. Nathan Boonstraw, Blank Children's Hospital, traveled to Bethesda, Maryland, to record a live episode about vaccine messaging at NFID’s Vaccinology Course. 

Voices for Vaccines is a national organization of parents and others who are dedicated to raising the level of the voices of immunization supporters. VFV invites everyone who values vaccines to become a member. Please spread the word to your friends and colleagues to join VFV!
 
Related Links

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Help #TravelingFluBug on its journey to #FightFlu!

The National Foundation for Infectious Diseases (NFID) invites everyone to download a Flu Bug icon and take a photo of the cutout in their hometown, office, school, or near an interesting landmark to help publicize the need to fight flu. You can also print out a blank template and have your patients color it themselves.

Share your photo on Twitter using #TravelingFluBug to appear in the online gallery. Creativity can be compelling, as the examples below demonstrate.
#TravelingFluBug


IAC Express's managing editor's dog Kinsey says, "Stomp out the flu!" #TravelingFluBug



Related Link

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IAC's new 142-page book, Vaccinating Adults: A Step-by-Step Guide, describes how to implement adult vaccination services in your healthcare setting and provides a review for staff who already vaccinate adults; IAC Guide available for free download or purchase

The Immunization Action Coalition (IAC) recently announced the publication of its new book, Vaccinating Adults: A Step-by-Step Guide (Guide).



This completely updated guide on adult immunization (originally published in 2004) provides easy-to-use, practical information covering important “how-to” activities to help providers enhance their existing adult immunization services or introduce them into any clinical setting, including:

  • setting up for vaccination services,
  • storing and handling vaccines,
  • deciding which people should receive which vaccines,
  • administering vaccines,
  • documenting vaccinations (including legal issues), and
  • understanding financial considerations and billing information. 

In addition, the Guide is filled with hundreds of web addresses and references to help providers stay up to date on the latest immunization information, both now and in the future.

Two options are available to obtain a copy of the updated Guide:

  • Purchase a copy
    A limited number of printed editions of this 142-page book are available for purchase at www.immunize.org/shop. The Guide’s lie-flat binding and 10 tabbed sections make it easy to locate the information being sought. Purchased copies are delivered in a box that includes Immunization Techniques: Best Practices with Infants, Children, and Adults, a 25-minute training DVD developed by the California Department of Public Health. Also included are several selected IAC print materials, such as the "Skills Checklist for Vaccine Administration," an assessment tool to assist in evaluating the skill level of staff who administer vaccines.
  • Download for free and print it yourself
    The entire Guide is available to download/print free of charge at www.immunize.org/guide. The downloaded version is suitable for double-sided printing. Options are available online to download the entire book or selected chapters.

The development of the Guide was supported by the National Vaccine Program Office (NVPO) and the Centers for Disease Control and Prevention (CDC). Expert staff from both agencies also provided early technical review of the content.

The Guide is a uniquely valuable resource to assist providers in increasing adult immunization rates. Be sure to get a copy today!

Related Links

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IAC HANDOUTS


IAC updates its patient handout "Hepatitis B: Questions and Answers"

IAC recently revised its handout for the public titled Hepatitis B: Questions and Answers. Changes were made to update the link to countries with high rates of hepatitis B virus infection and to incorporate the recently licensed hepatitis B vaccine (Heplisav-B; Dynavax). 

Access IAC's "Questions and Answers" handouts for patients for 18 vaccine-preventable diseases.

IAC's Handouts for Patients & Staff web section offers healthcare professionals and the public more than 250 FREE English-language handouts (many also available in translation), which we encourage website users to print out, copy, and distribute widely.

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VACCINE INFORMATION STATEMENTS


IAC posts translations of the Chickenpox VIS in Chuukese, Ilokano, Japanese, Marshallese, Samoan, and Tongan 

IAC recently posted Chuukese, Ilokano, Japanese, Marshallese, Samoan, and Tongan translations of the Chickenpox VIS. IAC thanks the Hawaii State Department of Health for these translations.

Related Links

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IAC posts translations of the HepA, HPV, MenACWY, and Tdap VISs in Chuukese, Ilokano, Marshallese, Samoan, and Tongan  

IAC recently posted Chuukese, Ilokano, Marshallese, Samoan, and Tongan translations of the Hepatitis A, HPV (Human papillomavirus) VIS, Meningoccocal (MenACWY), and Tdap VISs. IAC thanks the Hawaii State Department of Health for these translations.

Hepatitis A VIS

HPV (Human papillomavirus) VIS

Meningococcal (MenACWY) VIS

Tdap VIS

Related Links

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IAC posts translations of the MMR VIS in Japanese, Samoan, and Tongan 

IAC recently posted Japanese, Samoan, and Tongan translations of the MMR VIS. IAC thanks the Hawaii State Department of Health for these translations.

Related Links

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WORLD NEWS


Measles deaths worldwide fell below 100,000 for the first time in 2016 

In October, the World Health Organization (WHO) released the estimated number of measles deaths for 2016—89,780, a new low. The first paragraphs from a related New York Times article are reprinted below.

For the first time in history, annual deaths around the globe from measles have fallen below 100,000, the World Health Organization announced this year. As recently as the 1980s, measles killed 2.6 million people a year.

The decline—a public health triumph, as measles has long been a leading killer of malnourished children—was accomplished by widespread donor-supported vaccination that began in the early 2000s.

The estimated number of deaths fell to 89,780 in 2016, but the figure was released by the W.H.O. only in October.

Measles vaccines were invented in the 1960s. Since 2000, 5.5 billion doses have been given out, according to Gavi, the Geneva-based organization through which most donors support the vaccination effort. The group works with the W.H.O., the United Nations Children’s Fund, the Centers for Disease Control and Prevention, the American Red Cross, the United Nations Foundation and others.


Related Links

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Global Polio Eradication Initiative publishes review of efforts toward polio eradication in 2017

On December 18, the Global Polio Eradication Initiative published Working Toward a Polio-Free Future: 2017 in Review on its website. The first two paragraphs are reprinted below.

The year’s end offers the chance to reflect on the polio programme’s milestones and challenges in 2017, and look ahead to what we can achieve in the coming year. 2017 saw the fewest wild polio cases in history—a total of 17 cases, or a 50% reduction from the year before—with these cases occurring in just two countries: Afghanistan and Pakistan. Yet the need to reach every last child is more important than ever, as demonstrated by surveillance gaps in Nigeria and outbreaks of vaccine-derived polio in Syria and the Democratic Republic of the Congo.

From programme strategies that helped protect progress and overcome obstacles, to commitments from donors and partners, 2017 demonstrated the resolve required to achieve a polio-free future. Accelerating progress in the new year and ending polio for good will require maintaining these political and financial commitments as well as building upon the programme’s efforts to find the virus wherever it exists.


Read the complete review for updates on innovations in disease surveillance and examples of overcoming a variety of challenges.

Related Link

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FEATURED RESOURCES



Vaccine Education Center at CHOP updates its Q&A piece for patients, "Shingles: What You Should Know," and related web pages

Following the recent approval of the zoster vaccine, Shingrix, and the ACIP vote on its use, the Vaccine Education Center (VEC) at Children's Hospital of Philadelphia has updated the following materials:

Because the new version of shingles vaccine is not made using fetal tissue, the following were also updated:

Related Link

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Influenza is spreading and serious; please keep vaccinating your patients

During week the week of December 10–16, influenza activity sharply increased in the United States. CDC reported the geographic spread of influenza in 23 states as widespread; Puerto Rico and 23 states reported regional activity; the District of Columbia and four states reported local activity; and the U.S. Virgin Islands reported sporadic activity. One influenza-associated pediatric death was reported.

Influenza vaccination is recommended for everyone six months of age and older. If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to a clinic or pharmacy that provides vaccines or to the HealthMap Vaccine Finder to locate sites near their workplaces or homes that offer influenza vaccination services.

Following is a list of resources related to influenza disease and vaccination for healthcare professionals and the public:

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JOURNAL ARTICLES AND NEWSLETTERS


December issue of CDC's Immunization Works newsletter now available

CDC recently released the December issue of its monthly newsletter Immunization Works and posted it on the website of the National Center for Immunization and Respiratory Diseases (NCIRD). The newsletter offers the immunization community information about current topics. The information is in the public domain and can be reproduced and circulated widely.

Related Links

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Vaccine Education Center publishes December issue of its newsletter for healthcare professionals

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia publishes a monthly immunization-focused newsletter titled Vaccine Update for Healthcare Professionals. The December issue includes the following articles:

Additional resources and articles are available in the full newsletter.

Access the sign-up form to subscribe to Vaccine Update for Healthcare Professionals.

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New study explores effect of 2011 Washington State mandate to require healthcare provider counseling–based interventions to address vaccine hesitancy 

The December edition of the journal Pediatrics includes an article titled Exemptions From Mandatory Immunization After Legally Mandated Parental Counseling, authored by Saad B. Omer, et al. Three sections of the abstract are reprinted below.

Background
The success of health care provider counseling–based interventions to address vaccine hesitancy is not clear. In 2011, Washington State implemented Senate Bill 5005 (SB5005), requiring counseling and a signed form from a licensed health care provider to obtain an exemption. Evaluating the impact of a counseling intervention can provide important insight into population-level interventions that focus on interpersonal communication by a health care provider.

Results
After SB5005 was implemented, there was a significant relative decrease of 40.2% (95% confidence interval: −43.6% to −36.6%) in exemption rates. This translates to a significant absolute reduction of 2.9 percentage points (95% confidence interval: −4.2% to −1.7%) in exemption rates. There were increases in vaccine coverage for all vaccines required for school entrance, with the exception of the hepatitis B vaccine. The probability that kindergarteners without exemptions would encounter kindergarteners with exemptions (interaction index) decreased, and the probability that kindergarteners with exemptions would encounter other such kindergarteners (aggregation index) also decreased after SB5005. Moreover, SB5005 was associated with a decline in geographic clustering of vaccine exemptors.

Conclusions
States in the United States and jurisdictions in other countries should consider adding parental counseling by health care providers as a requirement for obtaining exemptions to vaccination requirements.


Download the complete article in PDF format: Exemptions From Mandatory Immunization After Legally Mandated Parental Counseling.


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Study supports earlier findings that perception of lowered risk after HPV vaccination unlikely to lead to riskier sexual behaviors

On December 1, the Journal of Adolescent Health published Human Papillomavirus Vaccine-Related Risk Perceptions Do Not Predict Sexual Initiation Among Young Women Over 30 Months Following Vaccination, authored by Tanya L. Kowalczyk Mullins, et al. The researchers examined the relationship between HPV vaccine-related risk perceptions and initiation of sexual activity among 91 sexually-inexperienced adolescent women during the 30 months after HPV vaccination. The "Conclusions" section is reprinted below.

Conclusions
HPV vaccine-related risk perceptions were not associated with sexual initiation or age of sexual initiation, providing further support that HPV vaccine-related risk perceptions are unlikely to lead to riskier sexual behaviors.


Related Links

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EDUCATION AND TRAINING


CDC to host January 9 webinar in commemoration of the 100th anniversary of the 1918 flu pandemic
 
Nancy Messonnier, MD, director, National Center for Immunization and Respiratory Disease (NCIRD), CDC, and Dan Jernigan, MD, MPH, director, Influenza Division, NCIRD, will host a webinar on January 9 from 12:00–1:00 p.m. (ET) to commemorate the 100th anniversary of the 1918 flu pandemic.

Drs. Messonnier and Jernigan will discuss the significance of the historic 1918 flu pandemic, highlight achievements made over the last 100 years to detect, prevent, and respond to pandemic influenza, and discuss future opportunities to improve pandemic influenza preparedness. They will also provide details on some special events being planned to commemorate this historic event, and share ideas and resources for your involvement.

No advanced registration is necessary; you just need to log in as a guest on the Adobe Connect site at the start time. If you have any questions, please contact chj8@cdc.gov.

Related Links

National AHEC Organization to sponsor January 10 webinar featuring Dr. Gary Marshall speaking on vaccine hesitancy

The National AHEC Organization is sponsoring a webinar titled "Perspectives on Vaccine Hesitancy" on January 10 at 3:00 p.m. (ET). Gary S. Marshall, MD, professor of Pediatrics and chief, Division of Pediatric Infectious Diseases, University of Louisville School of Medicine, will explore the subject as described below:

How can we explain vaccine hesitancy given the self-evident truth that vaccines have unburdened mankind from so many serious diseases? This program begins with that self-evident truth but moves through the character and epidemiology of vaccine hesitancy to exploring the root causes, which lie deep within the nature of being human. Discussion topics include the power of anecdote, the ubiquity of (mis)information, celebrity-ism, confusion, the human tendency towards heuristic thinking and the decline of altruism. Risk-benefit communication is explored and thoughts are offered on how we can better deal with this threat to public health. The lecture is replete with impactful illustrations and anecdotes.

Registration information

The National AHEC Organization supports and advances the Area Health Education Center (AHEC) Network to improve health by leading the nation in recruitment, training, and retention of a diverse health work force for underserved communities.

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CDC and American Bar Association to sponsor webinar about Medicaid funding for adult vaccinations on January 16

The American Bar Association and CDC’s Public Health Law Program will co-host a webinar on January 16, 1:00–2:30 p.m. (ET) titled "Adults Need Immunizations Too! Medicaid Coverage, Cost Sharing & Provider Reimbursement for ACIP-Recommended Adult Vaccinations." The webinar will provide an overview of the burden of vaccine-preventable diseases among adults, and discuss Medicaid’s vaccination benefit policy for adult enrollees. 

Registration information

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CDC's August 2017 webinar about positive vaccine conversations with parents now available for viewing at your convenience

On August 25, 2017, CDC sponsored a webinar titled "Getting Parents to Yes! Vaccine Conversations That Work for Providers & Parents." During this session, Dr. Sharon Humiston of the Academic Pediatric Association moderated a panel with pediatrician Dr. Nathan Boonstra and family physician Dr. Margot Savoy. These physicians shared their best practices for effective vaccine recommendations and also gave tips for what to do when parents decline or delay vaccines.

This session is now archived on YouTube so you can view it at your convenience.

Related Links
About IAC Express
The Immunization Action Coalition welcomes redistribution of this issue of IAC Express or selected articles. When you do so, please add a note that the Immunization Action Coalition is the source of the material and provide a link to this issue.

If you have trouble receiving or displaying IAC Express messages, visit our online help section.

IAC Express is supported in part by Grant No. 6NH23IP922550 from the National Center for Immunization and Respiratory Diseases, CDC. Its contents are solely the responsibility of IAC and do not necessarily represent the official views of CDC. IAC Express is also supported by educational grants from the following companies: AstraZeneca, Inc.; Merck Sharp & Dohme Corp.; Pfizer, Inc.; and Sanofi Pasteur.

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Global Task Force Wants to Reduce World's Cholera Burden: In this Infectious Disease News video, Dr. Louise Ivers, director of the Center for Global Health at Massachusetts General Hospital, describes the launch of a global task force to reduce cholera deaths by 90% worldwide by 2030. Cholera, which affects the most vulnerable, is now active in 47 countries but is preventable through vaccination, access to clean water, and sanitation.
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Editor:
Deborah L. Wexler, MD
Managing Editor:
Teresa Anderson, DDS, MPH

Consulting Editors:
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Jane Myers, EdM

Assistant Managing Editor:
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Issue Abbreviations
AAFP: American Academy of Family Physicians
AAP: American Academy of Pediatrics
ACIP: Advisory Committee on Immunization Practices
CDC: Centers for Disease Control and Prevention
FDA: Food and Drug Administration
IAC: Immunization Action Coalition
MMWR: Morbidity and Mortality Weekly Report
NCIRD: National Center for Immunization and Respiratory Diseases
VIS: Vaccine Information Statement
WHO: World Health Organization
 
 
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This website is supported in part by a cooperative agreement from the National Center for Immunization and Respiratory Diseases (Grant No. 6NH23IP22550) at the Centers for Disease Control and Prevention (CDC) in Atlanta, GA. The website content is the sole responsibility of IAC and does not necessarily represent the official views of CDC.