HOME
ABOUT IAC
CONTACT
A-Z INDEX
DONATE
SHOP
SUBSCRIBE
Immunize.org logo formerly Immunization Action Coalition (IAC)
IAC Home
|
IZ Express
|
Issue 1685
Issue 1,685: April 4, 2023
 
Ask the Experts: As seen on social media
Immunize.org now regularly features both written and short video versions of clinical questions and answers (Q&As) from our popular Ask the Experts section on our social media channels: YouTube, Instagram, Facebook, Twitter, and LinkedIn. This issue introduces you to three of our new Ask the Experts videos, plus a selection of 7 Q&As recently shared on social media. Follow Immunize.org on your preferred social media channels for posts that make it easier for you to improve your vaccination practices a little every day.

Because COVID-19 vaccination recommendations and clinical guidance are updated frequently, Immunize.org reminds our readers to regularly visit CDC’s web page: Use of COVID-19 Vaccines in the United States.

You can also find these Q&As and more than a thousand other Q&As about vaccines and vaccine administration on our “Ask the Experts” main page at www.immunize.org/askexperts.

Immunize.org’s team of experts includes Kelly L. Moore, MD, MPH (team lead), Carolyn B. Bridges, MD, FACP, and Iyabode Beysolow, MD, MPH.
 
Video Q&As

Video Q&As

Q: How late in the season can I vaccinate patients with influenza vaccine?



A: Peak influenza activity generally occurs in the Northern Hemisphere in January or February. Providers should continue vaccinating patients through spring, as long as there is continued circulation of influenza viruses and they have unexpired vaccine in stock and unvaccinated patients in their office.

Because influenza occurs in many areas of the world during April through September, vaccine should be given to travelers who missed vaccination in the preceding fall and winter. Another late season use of vaccine is for children younger than age 9 years who needed 2 doses of vaccine but failed to get their second dose early in the season. For each of these situations, vaccine can be given through the month of June since most injectable influenza vaccine has a June thirty expiration date.


Q: What’s the difference between a contraindication and a precaution?



A:
A contraindication is a condition in a recipient that increases the risk for a serious adverse reaction to vaccination and is a condition under which vaccines should not be administered. In addition to contraindications found in prescribing information, ACIP may recommend against the use of a vaccine under certain conditions, such as a lack of data about use of a vaccine in a specific situation, such as pregnancy.

A precaution is a condition in a recipient that might increase the risk for a serious adverse reaction, might cause diagnostic confusion, or might compromise the ability of the vaccine to produce immunity. For example, not vaccinating a person who is moderately or severely acutely ill avoids diagnostic confusion between the underlying illness and side effects of vaccination. Vaccination may be deferred if a precaution is present, although a vaccination might be indicated in the presence of a precaution if the benefit of protection from the vaccine outweighs the risk for an adverse reaction.


Q: We frequently see patients who are febrile or have an acute illness and are due for vaccinations. We are uncertain if we should withhold the vaccines or not. What do you advise?

A: A “moderate or severe acute illness" is a precaution for administering any vaccine. A mild acute illness (such as diarrhea or mild upper respiratory tract infection) with or without fever is not a precaution, and vaccines may be given.

The concern in vaccinating someone with moderate or severe illness is that a fever following the vaccine could complicate management of the concurrent illness—it could be difficult to determine if the fever was from the vaccine or due to the concurrent illness. In deciding whether to vaccinate a patient with moderate or severe illness, the clinician needs to determine if deferring vaccination will increase the patient’s risk of vaccine-preventable diseases, as is the case if the patient is unlikely to return for vaccination or to seek vaccination elsewhere.

Back to top


Recent Social Media Q&As

Q: How does CDC define being “up to date" on COVID-19 vaccination?

A: CDC has used the term "fully vaccinated" to refer to people who have completed a primary COVID-19 vaccine series. CDC uses the term “up to date" (UTD) to refer to a person who has received all doses recommended for their age and health status. With the exception of children age 6 months through 4 years who have completed a 3-dose primary series with Pfizer-BioNTech COVID-19 Vaccine, for whom no booster dose is recommended, all other people age 6 months and older are considered UTD if they have completed a primary series and have received a bivalent COVID-19 booster dose. The definition of up-to-date vaccination of each age group is available here: www.cdc.gov/vaccines/covid-19/downloads/COVID-19-immunization-schedule-ages-6months-older.pdf.


Q: May I use Novavax COVID-19 protein subunit vaccine as a booster dose?

A: Yes, but only in limited circumstances. Patients age 18 years or older who have completed any COVID-19 vaccine primary series, but who have never received a booster dose, may be offered a single Novavax monovalent COVID-19 vaccine as a booster dose under one of the following conditions: (1) the recommended bivalent mRNA vaccine is contraindicated, or (2) the patient refuses the recommended bivalent mRNA vaccine booster dose (or it is unavailable) and would not otherwise be vaccinated. The Novavax monovalent vaccine is not authorized for use as a booster dose in a person who has received one or more COVID-19 vaccine booster doses in the past.


Q: What proof do I need for COVID-19 vaccination of a patient who says he is moderately or severely immunocompromised?

A: CDC states that no additional medical documentation is required before vaccination. People may simply affirm that they are moderately or severely immunocompromised and receive COVID-19 vaccine doses wherever vaccines are offered. Vaccinators should not deny COVID-19 vaccination to a person due to lack of documentation.

Back to top


Q: Does CDC recommend restarting the hepatitis B vaccine series in the event the series is interrupted?

A: No. The series should not be restarted. Continue the series from where you left off.


Q: Several physicians in our group have no documentation showing they received hepatitis B vaccine. They are relatively sure, however, that they received the doses many years ago. What do we do now?

A: Because there is no documentation of vaccination, a vaccination series should be administered and postvaccination testing should be performed 1–2 months after the final dose of vaccine. There is no harm in receiving extra doses of vaccine. Postvaccination anti-HBs testing results should also be documented, including the date testing was performed. All healthcare settings should develop policies or guidelines to assure valid hepatitis B immunization.


Q: I'm a nurse who received the HepB series more than 10 years ago and had a positive follow-up titer (at least 10 mIU/mL). At present, my titer is negative (less than 10 mIU/ mL). What should I do now?

A: Do nothing. Data show that vaccine-induced anti-HBs levels might decline over time; however, immune memory (anamnestic anti-HBs response) remains intact following immunization. People with anti-HBs concentrations that decline to less than 10 mIU/mL are still protected against HBV infection. For healthcare professionals with normal immune status who have demonstrated adequate anti-HBs (at least 10 mIU/ mL) following full vaccination, booster doses of vaccine or periodic anti-HBs testing are not recommended.


Q: If dose #1 of HPV vaccine was given before the 15th birthday and it has been more than a year since that dose was given, would the series be complete with just one additional dose?

A: Yes. Adolescents and adults who started the HPV vaccine series prior to the 15th birthday and who are not immunocompromised are considered to be adequately vaccinated with just one additional dose of HPV vaccine.


Suggest a question for "Ask the Experts"

If you have a question that you think may be of interest to our readers, please send it to us using our online form. We will consider it for inclusion in a future update of the “Ask the Experts” feature.

About IZ Express
Immunize.org welcomes redistribution of this issue of IZ Express or selected articles. When you do so, please add a note that Immunize.org is the source of the material and provide a link to this issue.

IZ Express is supported in part by Grant No. 1NH23IP922654 from the National Center for Immunization and Respiratory Diseases, CDC. Its contents are solely the responsibility of Immunize.org and do not necessarily represent the official views of CDC.

IZ Express Disclaimer
ISSN 2771-8085
Subscribe today to IZ Express: the up-to-date immunization information you need
IZ Express
IZ Express Home
2023 Issues: January - June
2022 Issues: July - December
2022 Issues: January - June
2021 Issues: July - December
2021 Issues: January - June
2020–1997 Issues
Follow Us
Follow Immunize.Org on Facebook
Follow Immunize.Org on Twitter
Follow Immunize.Org on YouTube
Follow Immunize.Org on Instagram
Follow Immunize.Org on LinkedIn
immunize.org homepage
Shop IAC
Coronavirus (COVID-19) Information from IAC
2023 Laminated Immunization Schedules
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 G. Humiston, MD, MPH
Writer/Publication Coordinator
Taryn Chapman, MS
Courtnay Londo, MA
Style and Copy Editor
Marian Deegan, JD
Web Edition Managers
Arkady Shakhnovich
Jermaine Royes
Contributing Writer
Laurel H. Wood, MPA
Technical Reviewer
Kayla Ohlde
 
- 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
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
Vaccine Recommendations
>> view all
COALITIONS FOR
IMMUNIZATION
CONTRIBUTE TO IAC
COVID-19 RELATED
Ask the Experts: COVID-19
Vaccines: COVID-19
DEAR COLLEAGUE LETTERS
16-year-old Visit
HPV
MenACWY Dose #2
DONATE TO IAC
EDUCATIONAL MATERIALS
EMAIL NEWS SERVICES
E-NEWSLETTER: IZ 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
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
IZ EXPRESS
Subscribe to IZ 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
PREGNANCY AND
VACCINES
PRESS ROOM
PROTECT NEWBORNS
FROM HEP B
PUBLICATIONS
IZ 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
STANDING ORDERS
STATE INFORMATION
Immunization Websites
Laws and Mandates for School Entry
Immunization Program Managers
SUBSCRIBE TO IZ EXPRESS
SUPPORT IAC
TALKING ABOUT VACCINES
Adjuvants & Ingredients
Autism
Importance of Vaccination
MMR Vaccine
Religious Concerns
Vaccine Safety
>> view all
TECHNICALLY SPEAKING
(ARCHIVE)
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
Monkeypox (mpox)
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
 
Immunize.org  •  2136 Ford Parkway  •  Suite 5011  •  Saint Paul, Minnesota  •  55116
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. 1NH23IP922654) 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.