HOME
ABOUT IAC
CONTACT
A-Z INDEX
DONATE
SHOP
SUBSCRIBE
Immunization Action Coalition
IAC Home
|
IAC Express
|
2020 Issues
|
Issue 1517
Issue 1,517: September 23, 2020
Top Stories


Featured Resources

Journal Articles and Newsletters


Education and Training


On the Lighter Side

 


Top Stories


HHS and DOD release CDC’s COVID-19 Vaccination Program Interim Playbook and Operation Warp Speed’s Strategy for Distributing a COVID-19 Vaccine

On September 16, U.S. Department of Health and Human Services (HHS) and Department of Defense (DOD) released two documents outlining the Nation’s detailed strategy to quickly and reliably deliver safe and effective COVID-19 vaccine doses to the American people. CDC's 57-page COVID-19 Vaccination Program Interim Playbook outlines for state, tribal, territorial, and local public health programs and their partners how to plan and implement a vaccination response to COVID-19 within their respective jurisdictions. Operation Warp Speed’s 11-page Strategy for Distributing a COVID-19 Vaccine provides a strategic overview of COVID-19 vaccination plans.

  

Detailed planning is ongoing to ensure rapid distribution of COVID-19 vaccine quickly after the FDA authorizes or approves one or more vaccines and CDC makes recommendations for who should receive initial doses. Engage with your community partners now.

Access the press release.

Related Links

Back to top
 


IAC is seeking guidance documents on mass vaccination strategies. Do you have any to share?

IAC's newest website, www.Mass-Vaccination-Resources.org, assists you in finding a wide range of ideas for developing your own mass vaccination clinics. Mass vaccination efforts will be useful for expediting flu vaccination this fall and may be needed after COVID-19 vaccines are released for use in large groups of people.

The website features a searchable list of links to guidance documents, toolkits, publications, webinars, and other resources that focus on a variety of venues, including curbside, drive-through, and walk-through clinics; mobile medical vans; pharmacies; and schools.


 
Many of the documents were written in the pre-pandemic era and will need modification to ensure that additional protections, such as social distancing and personal protective equipment, help safeguard against COVID-19 transmission.
 
If you have a resource to suggest for the website, please send a message to info@mass-vaccination-resources.org. Everything received will be considered for placement on the new website.
 
This new website is supported by a medical education grant from Seqirus, Inc.

Related Links

Back to top
 


IAC Spotlight! IAC’s History through Film web page features PBS documentary about 30 years of IAC titled Protecting Health: Saving Lives. Please share.

IAC's IAC History through Film web page (www.immunize.org/aboutus/iac-fil-history.asp) features Protecting Health: Saving Lives, a 30-minute film about IAC from the award-winning PBS television documentary series, Visionaries, hosted by Sam Waterston. The documentary follows IAC’s founder and executive director Dr. Deborah Wexler’s passion from IAC's origins in 1988–90 while she provided care to undervaccinated children in the Hmong community of St. Paul, through to her founding and continued leadership of IAC, a nationally renowned provider of immunization education resources. Also featured in the film are Patsy Stinchfield, CPNP, Children’s MN; Karen Ernst, Voices for Vaccines; and IAC’s Dr. L.J Tan and Dr. Mary Koslap-Petraco.  

Protecting Health: Saving Lives makes a powerful case for vaccination, addressing and defusing the fears that fuel the antivaccine movement, showcasing stories of vaccine-preventable disease, and recognizing the science that has saved millions of lives through vaccination.



IAC's IAC History through Film web page also houses, on the lower half of the web page, The Early Years at IAC, a 9-minute film from 1995 that captures some highlights of IAC's activities during the early 1990s. 

This web page, www.immunize.org/aboutus/iac-fil-history.asp, is easily accessed from the home page of www.immunize.org by clicking on the display box, third from the top, in the right-hand column. The display box is also available in the right sidebar of IAC Express issues.

Please share this page with your friends and colleagues.

Related Links: 

Back to top
 


IAC enrolls three new birthing institutions into its Hepatitis B Birth Dose Honor Roll; seven previously honored institutions qualify for additional years' honors

The Immunization Action Coalition (IAC) is pleased to announce that three new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll, for a total of 519 honorees. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.

  • AdventHealth Ottawa, Ottawa, KS (97%)
  • Coffey County Hospital, Burlington, KS (93%)
  • Women’s Hospital at Saint Joseph East, Lexington, KY (99%)

One institution is being recognized for a second year:

  • Hutchinson Regional Medical Center, Hutchinson, KS (95%)

One institution is being recognized for a third year:

  • Indiana University Health North, Carmel, IN (93%)

Three institutions are being recognized for a fourth year:

  • ChristianaCare Christiana Hospital, Newark, DE (94%)
  • Mercy Hospital Northwest Arkansas, Rogers, AR (94%)
  • UMass Memorial Medical Center, Worcester, MA (94%)

One institution is being recognized for a fifth year:

  • Guthrie Corning Hospital, Corning, NY (95%)

Finally, one institution is being recognized for a sixth year:

  • Highlands ARH Regional Medical Center, Prestonsburg, KY (98%)

The Honor Roll now includes 519 birthing institutions from 44 states, Puerto Rico, Guam, and an overseas U.S. military base. One hundred seventeen institutions have qualified for two years, 73 institutions have qualified three times, 39 institutions have qualified four times, 24 institutions have qualified five times, 18 institutions have qualified six times, seven institutions have qualified seven times, two institutions have qualified eight times and one institution has qualified nine times.

The Honor Roll is a key part of IAC’s major initiative urging the nation’s hospitals to Give Birth to the End of Hep B. Hospitals and birthing centers are recognized for attaining high coverage rates for administering hepatitis B vaccine at birth and meeting specific additional criteria. The initiative urges qualifying healthcare organizations to apply for the Hepatitis B Birth Dose Honor Roll online.

To be included in the Hepatitis B Birth Dose Honor Roll, a birthing institution must have: (1) reported a coverage rate of 90 percent or greater, over a 12-month period, for administering hepatitis B vaccine before hospital discharge to all newborns, including those whose parents refuse vaccination, and (2) implemented specific written policies, procedures, and protocols to protect all newborns from hepatitis B virus infection prior to hospital discharge.

Honorees are also awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IAC Express’s approximately 52,000 readers.

Please visit the Hepatitis B Birth Dose Honor Roll web page that lists these institutions and their exceptional efforts to protect infants from perinatal hepatitis B transmission.

Related IAC Resources

Back to top
 


Reminder: IAC’s gateway page “Vaccination and COVID-19” offers a collection of tools from many organizations to sustain routine vaccination services during the pandemic 

IAC’s Vaccination and COVID-19 gateway page assists healthcare professionals who are faced with challenges in providing routine and catch-up vaccination during the COVID-19 pandemic. At this gateway, IAC has assembled key links to help both new and experienced vaccinators deliver safe, effective vaccination to people of all ages, applicable in typical and nontraditional vaccination settings.

The site facilitates access to key pandemic resource pages from major clinical and public health organizations involved in immunization. The page will be updated frequently with new links and resources specific to catch-up vaccination, so be sure to check back regularly.  



To easily locate this gateway page from anywhere on immunize.org, go to the light blue band of tabs across the top, choose the "Clinic Tools" tab, and then select "Vaccination and COVID-19” from the drop-down menu. To link directly to the site, go to www.immunize.org/vax-and-covid-19. You also can use the Guide to immunize.org at the bottom of every web page.

Related Links

Back to top
 


Not-to-miss immunization articles in the news

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

Back to top
 


Featured Resources


In IAC’s “Video of the Week”: On August 25, 2020, WHO African Region was officially declared free of wild poliovirus

This August 2020 video from WHO, shows Africa's great efforts to eliminate polio. In the 1990s, wild polio paralyzed 75,000 children in Africa each year. On August 25, 2020, the WHO African Region was declared free of wild polio, thanks to heroic frontline workers and support from regional governments, partner organizations, and donors. Africa is now using the expertise and infrastructure from this elimination effort to achieve other public health goals.



Visit the VOTW archive.

Back to top
 


Use our website www.Give2MenACWY.org to enhance your efforts at increasing rates of MenACWY booster and other adolescent vaccinations

Last fall IAC unveiled a major upgrade to www.Give2MenACWY.org, promoting the importance of adolescent vaccination and administering a booster dose of MenACWY vaccine at age 16.

 

Aimed at healthcare professionals, the site was revised to incorporate updated materials and to highlight the importance of all recommended vaccines for 16-year-olds. A simplified navigation structure makes locating information a breeze.
 
The colorful Give2MenACWY.org website is divided into five easy-to-access sections: 

  • Vaccinate Teens – The tools included on this web page offer helpful information on teen vaccination schedules and tips for improving adolescent vaccination rates
  • Give 2 Doses – Just a little over half of teens have received a second dose of MenACWY vaccine; this web page offers tools to help improve second dose coverage
  • 16-Year-Old Visit – These resources help both providers and their patients remember the important vaccines recommended for 16-year-olds
  • Tools for Providers – These tools from CDC, IAC, and other organizations explain meningococcal ACWY vaccine recommendations and assist in improving coverage for all recommended adolescent vaccines
  • Resources – This section offers print materials, links to organizations involved in adolescent vaccination, personal stories about the importance of vaccination, and additional resources of interest

Additional time savings are provided by the site’s single location where all website materials are listed according to whether they are primarily of interest to providers or to patients/parents. Other sections relate to general adolescent immunization, as well as meningococcal disease and vaccine information.
 
Visit Give2MenACWY.org and enjoy browsing (and deploying) its bountiful resources, brought to you by IAC's collaboration with Sanofi Pasteur.
  
Related Links 

Back to top
 


IAC's comprehensive Vaccinating Adults: A Step-by-Step Guide is available for free download either by chapter or in its entirety (142 pages)

Download IAC's free book on all aspects of adult immunization, to help train your team and refresh your leaders: Vaccinating Adults: A Step-by-Step Guide (Guide).



This up-to-date, thorough "how to" guide on adult immunization provides easy-to-use, practical information covering essential adult immunization activities. It helps vaccine providers enhance their existing adult immunization services or introduce them into any clinical setting.

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.

The Guide is available to download/print either by chapter or in its entirety free at www.immunize.org/guide. The downloaded version is suitable for double-sided printing. The National Vaccine Program Office and CDC both supported the development of the Guide and provided early technical review.

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

Related Links

Back to top
 


It's time to vaccinate against flu. IAC’s bright red "FLU VACCINE" buttons and stickers can help. Order today! 

IAC “FLU VACCINE” buttons and stickers are flying out of IAC’s office by the thousands! Their bright red color helps broadcast your important message about the need for flu vaccination. And the cost is nominal.



“FLU VACCINE” BUTTONS

The button measures 1.25" across and carries a bold message! Pin on lab coats, uniforms, other clothing, tote bags, or backpacks to show support for flu vaccine.
 
Buttons are delivered in bags of 10 buttons per bag.

Click here for pricing and ordering information for "FLU VACCINE" buttons.

“FLU VACCINE” STICKERS
 
Measuring 1.5" across, these stickers adhere well to clothing and have an easy-peel-off back.
 
Stickers are delivered to you cut individually (not on rolls)—available in bundles of 100. 

Click here for pricing and ordering information for “FLU VACCINE” stickers.

Back to top
 


Journal Articles and Newsletters


CDC publishes “Decreased Influenza Activity during the COVID-19 Pandemic—United States, Australia, Chile, and South Africa, 2020” in MMWR

CDC published Decreased Influenza Activity during the COVID-19 Pandemic—United States, Australia, Chile, and South Africa, 2020 in the September 18 issue of MMWR

Getting a flu vaccine offers the best protection against flu during any flu season, and it is more important than ever during 2020–21 because of the ongoing COVID-19 pandemic. Data in this report suggest that actions to stop the spread of SARS-CoV-2, the virus that causes COVID-19, such as wearing a mask and social distancing, could reduce the spread of flu this fall and winter if widely practiced. However, it’s impossible to say with certainty what will happen during the upcoming flu season, making it important to prepare for both flu and COVID-19 outbreaks.


Access the MMWR article in PDF format or in HTML format.

Related Link
  • MMWR gateway page provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements

Back to top
 


“Postmarketing Safety of Vaccines Approved by the U.S. Food and Drug Administration” published in Annals of Internal Medicine 

In its September 15 issue, Annals of Internal Medicine published Postmarketing Safety of Vaccines Approved by the U.S. Food and Drug Administration. The study focused on a descriptive analysis of the prevalence and characteristics of safety-related changes to vaccine prescribing information from 1996–2015. Their secondary focus was to describe the distribution of data sources triggering these modifications. The conclusions section appears here.

Over a 20-year period, vaccines were found to be remarkably safe. A large proportion of safety issues were identified through existing postmarketing surveillance programs and were of limited clinical significance. These findings confirm the robustness of the vaccine approval system and postmarketing surveillance.

Access the full article by creating a free account. 

Back to top
 


“Trends in Human Papillomavirus Vaccination in Commercially Insured Children in the United States” published in Pediatrics 

In its September issue, Pediatrics published Trends in Human Papillomavirus Vaccination in Commercially Insured Children in the United States. The Healthy People 2020 vaccination goal is 80% by age 15 for the 2-dose HPV vaccine, recommended for girls in 2006 and for boys in 2011. This study looked at nationwide population-based data to describe the trends in HPV vaccination in children. Although they found increasing trends in HPV vaccine coverage among commercially insured children in the U.S., the authors found the nation still falls behind target, with substantial disparities by state. 

Access the full article in PDF format or in HTML format.

Back to top
 


Education and Training


CANVax and Immunize Canada offer webinar "Influenza in the Time of COVID: Hoping for the Best, Planning for the Worst" on September 24
 
CANVax and Immunize Canada will offer the webinar Influenza in the Time of COVID: Hoping for the Best, Planning for the Worst on September 24 from 1:00–2:00 p.m. (ET). The webinar will review influenza activity in the 2019–20 northern hemisphere season in Canada, and the 2020 season in the southern hemisphere. Additionally, the webinar will talk about the implications for the 2020–21 season, about NACI recommendations for vaccination in the fall of 2020, and about NACI recommended changes to programs to manage influenza vaccination during the pandemic. The speaker will be Allison McGreer, MD, FRCPC, professor at the Dalla Lana School of Public Health at the University of Toronto. 

Register today! 

This webinar will be recorded and the recording will be posted on Immunize Canada's YouTube channel and on the CANVax joint Immunize Canada and CANVax Webinar Series gateway page. 

Back to top
 


Immunize Nevada offers webinar “Challenges of Influenza Vaccination during the COVID-19 Pandemic: Racial and Ethnic Disparities” on September 24
 

Immunize Nevada will present a webinar titled Challenges of Influenza Vaccination during the COVID-19 Pandemic: Racial and Ethnic Disparities on September 24 at 12:00 p.m. (PT). Speaker Flor M. Muñoz, MD, associate professor of pediatrics, infectious diseases, molecular virology and microbiology at Baylor College of Medicine, will discuss the COVID-19 pandemic and how its disproportionate effect on communities of color has further highlighted persistent racial and ethnic disparities in both healthcare and public health. Recommendations for influenza vaccination for the 2020–21 season, the potential impact of COVID-19, and the importance of influenza vaccination will also be discussed. CE credit is offered.

Back to top
 


Immunize Nevada offers webinar “The Critical Importance of Flu Prevention: Insights from a Mother Whose Daughter Almost Didn't Survive” on September 25

Immunize Nevada will host a webinar titled The Critical Importance of Flu Prevention: Insights from a Mother Whose Daughter Almost Didn't Survive on September 25 at 12:00 p.m. (PT). The webinar will feature Shelle Allen, president for Families Fighting Flu. This program will share insights on the potential dangers of flu from a mother whose daughter was hospitalized for 93 days to treat her influenza illness. Highlights will include the value of personal storytelling in risk communication and the critical need to take flu 'off the table' this season.

Registration information

Back to top
 


On the Lighter Side

Dr. John Clarke’s creative rap video during the 2009 H1N1 flu pandemic puts a fresh spin on flu prevention education from HHS

In this 1-minute PSA titled H1N1 Rap, Dr. John Clarke of Baldwin, NY, winner of HHS’s 2009 H1N1 PSA Contest, put a fresh spin on flu prevention education during the 2009 H1N1 flu pandemic. It remains relevant today. This is part of a PSA collection curated by vaccine expert William L. Atkinson, MD, MPH.



Previous PSAs mentioned in “On the Lighter Side” are available when viewing this Vimeo video.

Back to top

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.

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 Disclaimer
ISSN: 1526-1786

Our mailing address is
Immunization Action Coalition
2550 University Avenue West, Suite 415 North
Saint Paul, MN 55114
Subscribe today to IAC Express: the up-to-date immunization information you need
IAC Express
IAC Express Home
2021 Issues
2020 Issues: July - December
2020 Issues: January - June
2019–1997 Issues
Coronavirus (COVID-19) Information from IAC
Video of the Week
Protect Tomorrow: In this powerful video from the American Academy of Pediatrics' Protect Tomorrow program, several grandparents tell what it was like before vaccines were available to protect against deadly diseases. They want to protect grandchildren by convincing their parents to get them vaccinated. Pediatric vaccinations have been delayed by the pandemic, and parents need to get their children caught up on vaccines so the diseases do not come back.
Visit the VOTW archive
immunize.org homepage
Shop IAC
Follow Us
Follow IAC on Facebook
Follow IAC on Twitter
Follow IAC on YouTube
Read Dr. Wexler's monthly column for practical advice on vaccination topics
COVID-19 buttons and stickers
Try IAC's Facebook Frame
Vaccinating Adults:
A Step-by-Step Guide
Vaccinating Adults: A Step-by-Step Guide
IAC's 142-page book available for free download.
Calendar of Events
Conferences, meetings, and training opportunities
Conferences, meetings, and training opportunities
Patient Record Cards
Purchase IAC's patient record cards today!
Record cards for patients – child and teen, adult, and lifetime – are printed on durable paper and sized to fit in a wallet when folded
DVD Immunization Techniques
Purchase Immunization Techniques DVD
Every practice should have this award winning, "how-to" training video
Protect Newborns Guidebook
Protect Newborns Guidebook
Comprehensive guide Hepatitis B: What Hospitals Need to Do to Protect Newborns
Editorial Information
Editor-in-Chief
Kelly L. Moore, MD, MPH
Managing Editor
John D. Grabenstein, RPh, PhD
Associate Editor
Sharon Humiston, MD, MPH
Writer/Publication Coordinator
Taryn Chapman, MS
Courtnay Londo, MA
Style and Copy Editor
Marian Deegan, JD
Web Edition Manager
Sheila M. Franey, MA
Contributing Writer
Laurel H. Wood, MPA
Technical Reviewer
Robin VanOss
 
- Guide to immunize.org -
A-Z INDEX
ABOUT IAC
IAC in the News
Staff
IAC History through Film
ACIP
RECOMMENDATIONS
ADOLESCENT VACCINATION
ADULT VACCINATION
ADULT VACCINATION GUIDE
ASK THE EXPERTS
Administering Vaccines
COVID-19
COVID-19 & Routine Vac
Hepatitis B
MMR
Storage and Handling
>> view all
BECKY PAYNE AWARD
BILLING & CODING
BIRTH DOSE GUIDEBOOK
CALENDAR OF EVENTS
CDC INFORMATION
CDC SCHEDULES
CLINIC TOOLS
Administering Vaccines
Adolescent Vaccination
Adult Vaccination
Screening for Contraindications
Storage & Handling
Vaccination and COVID-19
Vaccine Recommendations
>> view all
COALITIONS FOR
IMMUNIZATION
CONTRIBUTE TO IAC
COVID-19 RELATED
Ask the Experts: COVID-19
Ask the Experts: COVID-19
   & Routine Vac
Clinic Tools: Vaccination and
   COVID-19
Repository of Resources
Vaccines: COVID-19
DEAR COLLEAGUE LETTERS
16-year-old Visit
HPV
MenACWY Dose #2
DONATE TO IAC
EDUCATIONAL MATERIALS
EMAIL NEWS SERVICES
E-NEWSLETTER: IAC EXPRESS
EXEMPTIONS
FAQs
FAVORITES
FDA PACKAGE INSERTS
FILMS ABOUT IAC
GIVE BIRTH TO THE
END OF HEP B
HANDOUTS FOR
PATIENTS & STAFF
View All Materials
Administering Vaccines
Adolescent Vaccination
Adult Vaccination
Contraindications / Precautions
Documenting Vaccination
Healthcare Personnel
Managing Vaccine Reactions
Parent Handouts
Pregnancy and Vaccines
Q&As: Diseases and Vaccines
Q&As: Easy-to-Read
Schedules for Patients
Screening Checklists
Standing Orders Templates
Storage & Handling
Strategies & Policies
Temperature Logs
Top Handouts
Vaccine Confidence
Vaccine Recommendations
>> view all
HEP B BIRTH DOSE
HONOR ROLLS
Hep B Birth Dose
Mandatory Flu Vaccination for HCP
MenB Vaccination for Colleges
IAC EXPRESS
Subscribe to IAC Express
IMAGE LIBRARY
LAWS AND MANDATES
MANUFACTURERS
MASS VACCINATION
RESOURCES
NATIONAL ADULT &
INFLUENZA
IMMUNIZATION SUMMIT
NEWS & INFORMATION
NEWSLETTER SIGN UP
OFFICIAL RELEASES
ACIP
CDC
FDA
PACKAGE INSERTS
PARTNERS
PHARMACISTS
PHOTOS
POWERPOINT SLIDE SETS
PREGNANCY AND
VACCINES
PRESS ROOM
PROTECT NEWBORNS
FROM HEP B
PUBLICATIONS
IAC Express
Vaccinating Adults:
   A Step-by-Step Guide
Hepatitis B What Hospitals
   Need to Do to
   Protect Newborns
Needle Tips Archive
Vaccinate Adults Archive
Vaccinate Women Archive
REGISTRIES
SCHOOL VACCINATION REQUIREMENTS
SHOP IAC
DVD Immunization Techniques
Laminated Schedules
Patient Record Cards
Flu Vaccine Buttons and Stickers
"Vaccines Save Lives" Pins
SITE MAP
SLIDE SETS
STANDING ORDERS
STATE INFORMATION
Immunization Websites
Laws and Mandates for School Entry
Immunization Program Managers
SUBSCRIBE TO IAC EXPRESS
SUPPORT IAC
TALKING ABOUT VACCINES
Adjuvants & Ingredients
Autism
Importance of Vaccination
MMR Vaccine
Religious Concerns
Vaccine Safety
>> view all
TECHNICALLY SPEAKING
TRANSLATIONS
IAC Handouts
VISs
TRAVEL (INTERNATIONAL)
UNPROTECTED PEOPLE
STORIES
Chickenpox
Hepatitis B
Measles
Whooping Cough
>> view all
VACCINATING ADULTS:
A STEP-BY-STEP GUIDE
VACCINE INFORMATION
STATEMENTS
Translations
VACCINE
MANUFACTURERS
VACCINE POLICY &
LICENSURE
ACIP
FDA
WHO
VACCINE SAFETY
VACCINE TIMELINE
VACCINES
COVID-19
Hepatitis B
HPV (Human papillomavirus)
Influenza
Pertussis
Varicella
>> view all
VIDEO OF THE WEEK
VIDEO LIBRARY
VISs
Translations
WHAT'S NEW OR UPDATED AT IAC
Handouts
VISs and Translations
Web Pages
 
Immunization Action Coalition  •  2550 University Avenue West  •  Suite 415 North  •  Saint Paul, Minnesota  •  55114
tel 651-647-9009  •  fax 651-647-9131
 
 
 
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.