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Issue 1320: August 16, 2017

Ask the Experts
Ask the Experts—Question of the Week: If a patient received Trumenba (Pfizer) meningococcal B vaccine . . . read more











National Immunization Awareness Month is here, with the third week focusing on vaccinations for adults

Every year in August, National Immunization Awareness Month (NIAM) provides an opportunity to raise awareness about the importance of immunization and the need for improving national vaccination coverage levels. NIAM is co-sponsored by CDC and the National Public Health Information Coalition (NPHIC). The third week, August 14–20, focuses on vaccinations for adults. The theme for the week is “Vaccines are not just for kids.”

From CDC:

There are many ways you can get involved. Below are some actions you can take to support and promote adult vaccinations for NIAM and beyond:

The 2017 edition of the NIAM communications toolkit, put out by NPHIC in collaboration with CDC, contains key messages, vaccine information, sample news releases and articles, sample social media messages, links to web resources from CDC and other organizations, and logos, web banners, posters, and graphics to use with social media. The website also includes a place for you to share your NIAM activities and view what others are doing for NIAM, using the hashtag #NIAM17.

The first week of NIAM focused on babies and young children, and the second week focused on pregnant women. The last week of August will focus on preteens and teens.

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CDC updates its immunization scheduling tool for children from birth through age 6 years

In June, CDC updated its online Catch-up Immunization Tool to follow the print 2017 catch-up immunization schedule for children ages birth through 6 years.

Using this tool, a parent or provider can:

  • Enter, update, or modify a child’s vaccination history
  • Load a previously saved vaccination history
  • Generate an accelerated vaccine schedule 
  • Save a child’s vaccination history to the computer for future use
  • Print a vaccination schedule

Access CDC's online Catch-up Immunization Tool.

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New Technically Speaking column: "Routine Schedules for MenACWY and MenB Vaccines—Make Sure You’re Giving Them on Time"

Technically Speaking, a monthly column written by IAC’s executive director Deborah Wexler, MD, covers practical topics in immunization delivery such as needle length, vaccine administration, cold chain, and immunization schedules. The most recent column is reprinted below. 

Routine Schedules for MenACWY and MenB Vaccines—Make Sure You’re Giving Them on Time
Published July 2017

At the Immunization Action Coalition (IAC), we receive many email questions from healthcare professionals each month indicating that there is confusion about the routine vaccination schedules for meningococcal conjugate (MenACWY) and meningococcal serogroup B (MenB) vaccines. What follows is simple guidance regarding CDC/AAP/AAFP/ACOG routine recommendations for the timing of administering these vaccines to your adolescent patients.

Important note: This brief summary article discusses only the routine schedule. It does not include catch-up schedules or recommendations for people in various risk groups.
Recommended schedules for routine vaccination

Meningococcal conjugate (MenACWY) vaccine
(Menactra®, Sanofi; Menveo®, GSK)

  • Dose #1: Age 11 to 12 years
  • Dose #2: Age 16 years

Unfortunately, most teens are behind on the 16-year-old dose of this two-dose series. According to the most recent CDC National Immunization Survey–Teen, only 33 percent of teens have received dose #2 before their 18th birthday.

Meningococcal serogroup B (MenB) vaccine
(Bexsero®, GSK; Trumenba®, Pfizer)

The preferred age range for routine* vaccination is 16 to 18 years, but MenB may be initiated up to age 25. Currently, there are two brands of MenB available in the United States:

Bexsero (GSK)

  • Dose #1: Age 16 to 18 years
  • Dose #2: ≥ one month after dose #1

Trumenba (Pfizer)

  • Dose #1: Age 16 to 18 years
  • Dose #2: Six months after dose #1**

Note: These two vaccine brands are not interchangeable. The series must be started and completed with the same MenB brand.

*MenB vaccine is recommended by CDC as category B, which means that you can either give it routinely or that you can inform patients about the availability of this vaccine so they can decide in consultation with you if they want this protection.

**This article does not discuss the recommendation for including a third dose of Trumenba, which is recommended for people at high risk of meningococcal serogroup B infection. Refer to the CDC schedule for additional information for high-risk individuals.

Resources from IAC

Resources from CDC

You can access the current and past issues of Technically Speaking from a box in the middle of the home page, from the "Guide to" at the bottom of every web page, or by going directly to

The column is featured in The Children's Hospital of Philadelphia Vaccine Education Center’s (VEC's) monthly e-newsletter for healthcare professionals. Check out the July 2017 issue of VEC's Vaccine Update for Healthcare Providers. The VEC e-newsletter keeps providers up to date on vaccine-related issues and includes reviews of recently published journal articles, media recaps, announcements about new resources, and a regularly updated calendar of events. To subscribe to this newsletter, go to the sign-up form.

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International Vaccine Access Center launches VoICE, a new digital tool that supports evidence-based advocacy

The International Vaccine Access Center (IVAC) has announced the launch of the Value of Immunization Compendium of Evidence, or VoICE, a new digital tool that supports evidence-based advocacy.
VoICE is an open-access, queryable online database that includes 95 "key ideas" that demonstrate the value of immunization and the impact of vaccine-preventable diseases. Each VoICE key idea includes references from peer-reviewed papers, white papers, expert commentaries, and other sources.
The evidence available through VoICE looks at the ripple effects of vaccine-preventable disease and immunization on the health, economic status, societal wellbeing, and equity of individuals, communities, and nations.

Access the VoICE website.

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The Lancet encourages people to remember the Yemen cholera crisis during World Humanitarian Day, August 19

On August 12, The Lancet published an editorial titled Yemen and cholera: a modern humanity test. The complete column is reprinted below.

Urgent warnings began in May as aid agencies called for an immediate response to the growing cholera outbreak in Yemen. By mid-July, over 330,000 cholera cases were reported, with 1,700 deaths. Since 2015, a civil war has left 14.5 million people (half the country's population) without access to clean water and sanitation. The UN has called it the “world's worst cholera outbreak in the context of the world's worst humanitarian crisis." The war, unpaid worker salaries, a decimated health system, controversies around the undeployed cholera vaccine stockpile, and slow global funding efforts are all somehow to blame. Pre-existing health indicators are grim and the estimated 400,000 severely malnourished Yemeni children are particularly vulnerable. Famine and other preventable communicable diseases are forecast. Indisputedly, a ceasefire is needed to allow access to humanitarian aid and abate further suffering and death.

As a collective humanity, the shame is ours to bear. The position of
The Lancet family of journals is that with all current knowledge and commitments to acting early on cholera outbreaks, such escalated death rates quite simply should not happen. Cholera has been ravaging communities for two centuries. Yet in 2017, outbreaks are entirely containable early with coordinated efforts to implement water, sanitation, and medical rehydration treatment. There is a vaccine and antibiotics exist. For workers who witnessed the 1994 cholera outbreak among the Rwandan refugees, which killed 12,000 people in Goma, eastern Zaire, this current humanitarian crisis echoes both the indignation and the slow response to an early warning. Unlike Goma, however, the Yemen crisis has unfolded under the global scrutiny of the internet.

On the eve of World Humanitarian Day, Aug. 19, Yemen must be foremost among priorities of every institution and government acting for global health. Containing the cholera crisis and reinstating health and personal security for 27 million Yemeni people is the high stakes sustainable development test for how humanity can and will organise around vocalised commitments to protect the most vulnerable among us today.

Access The Lancet editorial online: Yemen and cholera: a modern humanity test.

World Humanitarian Day is held every year on August 19 to pay tribute to aid workers who risk their lives in humanitarian service, and to rally support for people affected by crises around the world.

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Indiana mother promotes pertussis vaccination in memory of her baby who died of the disease

Indiana mother Katie Court Van Tornhout and her husband Craig lost their infant, Callie, to pertussis at age 37 days. Callie was too young to be vaccinated against this disease, and it is felt she became infected from an adult around her. Since Callie was born prematurely and had spent much of her life in the hospital, she was quite possibly infected by a healthcare worker.

Katie has made it her mission to prevent other infants from dying from this vaccine-preventable disease. She has started a nonprofit, Callie Cares, and prepared thousands of toiletry bags for other parents with hospitalized babies, including a note with Callie's story. More recently, she has testified at the Indiana State House in an attempt to get a law passed that would require Tdap vaccination for healthcare personnel. Although the House tabled the bill, Katie is not giving up, especially as Indiana is experiencing a surge in pertussis cases.

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IAC enrolls five new birthing institutions into its Hepatitis B Birth Dose Honor Roll; one previously honored institution qualifies for an additional year

The Immunization Action Coalition (IAC) is pleased to announce that five new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.
  • North Texas Medical Center, Gainesville, TX (96%)
  • Seton Medical Center Williamson, Round Rock, TX (92%)
  • South Central Kansas Medical Center, Arkansas City, KS (92%)
  • South Coast Global Medical Center, Santa Ana, CA (97%)
  • William Beaumont Army Medical Center, El Paso, TX (96%)

In addition, the following institution is being recognized for a second year:

  • St. Mary's General Hospital, Passaic, NJ (99%)

The Honor Roll now includes 349 birthing institutions from 39 states, Puerto Rico, and Guam. Seventy-six institutions have qualified for two years, 40 institutions have qualified three times, 10 institutions have qualified four times, and 3 institutions have qualified five 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 50,000 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.

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Two healthcare organizations join IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination

There are 634 organizations now enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, medical practices, professional organizations, health departments, and government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel.

Since August 2, when IAC Express last reported on the Influenza Vaccination Honor Roll, two additional healthcare organizations have been enrolled.

IAC urges qualifying healthcare organizations to apply.

Newly added healthcare organizations, hospitals, government agencies, and medical practices

  • Mercy Health, Cincinnati, OH
  • Mercy Health West Hospital, Cincinnati, OH

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Did your July 26 issue of IAC Express (#1317) arrive?

It has come to our attention that there might have been a problem with the transmission of the July 26 issue of IAC Express (#1317). Specifically, the Mail Chimp system may have shut down before all subscribers received their copy. If you didn't receive this issue, you can access it on IAC's website at

You can always look up any archived issue on the IAC Express index web page.

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IAC posts Influenza (IIV) VISs in Dari, Karen, Kinyarwanda, Kiswahili, Oromo, Pashto, and Nepali 

IAC recently posted Dari, Karen, Kinyarwanda, Kiswahili, Oromo, Pashto, and Nepali translations of the Influenza (IIV) VIS. IAC thanks the Minnesota Department of Health for the translations.

Note: The English version of the Influenza (IIV) VIS dated 8/7/15 is current, and should be used for the 2017–18 season.

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CDC publishes "Summary of Notifiable Infectious Diseases and Conditions—United States, 2015" in MMWR

CDC published Summary of Notifiable Infectious Diseases and Conditions—United States, 2015 in a special August 11 volume of MMWR. This annual report is prepared by CDC in collaboration with the Council of State and Territorial Epidemiologists.

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WHO reports on deployments from the oral cholera vaccine stockpile

The World Health Organization (WHO) published Deployments from the oral cholera vaccine stockpile, 2013–2017 in the August 11 issue of its Weekly Epidemiological Record. Selections from the first two paragraphs are reprinted below.
The oral cholera vaccine (OCV) stockpile was created in 2013 for emergency response, to reduce the extent of cholera outbreaks or prevent their occurrence in the context of humanitarian crises where risk of cholera is estimated as high....A minimum safeguard quantity (currently set at 1 million doses) is reserved for emergencies; doses are allocated to non-emergency situations depending on availability at any given time....To draw lessons from OCV use in different contexts, this report describes OCV deployments and related campaigns conducted in the requesting countries in terms of setting (endemic, humanitarian crisis, or outbreak), population targeted, campaign timelines, and vaccine coverage since creation of the stockpile. 

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WHO reports on yellow fever in Africa and the Americas, 2016

The World Health Organization (WHO) published Yellow fever in Africa and the Americas, 2016 in the August 11 issue of its Weekly Epidemiological Record. The introductory paragraph is reprinted below.
In 2016, a total of 7,509 suspected and 1,080 laboratory-confirmed cases of yellow fever (YF), including 171 deaths, were reported to WHO during YF outbreaks in 6 countries. In the WHO African Region, outbreaks were reported from Angola, the Democratic Republic of the Congo (DRC), and Uganda. Most notably, 2 urban outbreaks in Angola and DRC reemphasized the threat of YF, and resulted in 963 laboratory-confirmed cases and 137 confirmed deaths. In the Region of the Americas, YF outbreaks were reported from Brazil, Colombia, and Peru. The number of confirmed and probable cases reported from Peru has been the highest for the past 10 years; Brazil reported the beginning of a major outbreak in December 2016.

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Colorado Refugee Immunization Provider Resource Hub shares a compilation of resources related to refugee-specific immunization guidelines

The Colorado Children’s Immunization Coalition, in collaboration with members of the Colorado Refugee Immunization Taskforce, have developed a new immunization resource for providers who see refugee patients. The Colorado Refugee Immunization Provider Resource Hub serves as a centralized compilation of resources related to refugee-specific immunization guidelines and additional screening, data, contact, and cultural information.  

Visit, and share this resource with your colleagues.

If you have questions or need further information, please contact the Colorado Children’s Immunization Coalition at

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Hepatitis B Foundation releases new video in its storytelling project: #justB

In January, the Hepatitis B Foundation launched its new storytelling campaign: #justB: Real People Sharing their Stories of Hepatitis B. The volunteers sharing their stories do so to put a human face on this serious disease, decrease stigma and discrimination, and promote the importance of testing and treatment for hepatitis B. A new story will be featured each month throughout 2017. 

Watch the August video, Kenson: #justB There for Others, about a man originally from the Marshall Islands who moved to Hawaii to receive medical treatment when he became ill with hepatitis B. He and his wife are working with their communities to inform others at risk of hepatitis B virus infection and the benefits of testing, vaccination, and treatment.

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Free app of The Vaccine Handbook available from the Immunization Action Coalition

A new app of The Vaccine Handbook is now available from the Immunization Action Coalition. The free app, which is available for Apple iPhones and iPads only, contains the complete 2017 (6th) edition of The Vaccine Handbook (“The Purple Book”), by Dr. Gary Marshall, professor of pediatrics and chief of the Division of Pediatric Infectious Diseases at the University of Louisville. The app is fully searchable, with functionality that includes bookmarking, highlighting, user annotation, and links to important vaccination resources.
"The Purple Book" is a comprehensive source of vaccine information, drawing together vaccine science, guidance, and practice into a user-friendly resource for the private office, public health clinic, academic medical center, classroom, and hospital. The first section provides background on vaccine immunology, development, infrastructure, policy, standards, implementation, special circumstances, and—perhaps most importantly—addressing concerns. The second section contains details about every vaccine currently licensed in the U.S., including the burden and epidemiology of the respective disease, history of the immunization program, vaccine constituents, efficacy, safety, and recommendations.

The free app may be found by searching the iTunes App Store for “The Vaccine Handbook App” or clicking on the following link:

Print copies of the book ($34.95 each; bulk discounts are available from the publisher) can be ordered from the Immunization Action Coalition website at

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Still available! IAC's sturdy laminated versions of the 2017 U.S. child/teen immunization schedule and the 2017 U.S. adult immunization schedule—order a supply for your healthcare setting today!

IAC's laminated versions of the 2017 U.S. child/teen immunization schedule and the 2017 U.S. adult immunization schedule are covered with a tough, washable coating; they will stand up to a year's worth of use in every area of your healthcare setting where immunizations are given. Both schedules are eight pages (i.e., four double-sided pages) and are folded to measure 8.5" x 11". 

Laminated Child and Teen Laminated Schedule

Adult Laminated Immunization Schedules

Laminated schedules are printed in color for easy reading, come complete with essential tables and footnotes, and include contraindications and precautions—a feature that will help you make an on-the-spot determination about the safety of vaccinating patients of any age.

1–4 copies: $7.50 each
5–19 copies: $5.50 each
20–99 copies: $4.50 each
100–499 copies: $4.00 each
500–999 copies: $3.50 each

For quotes on customizing or placing orders for 1,000 copies or more, call (651) 647-9009 or email

You can access specific information on both schedules, view images of both, order online, or download an order form at the Shop IAC: Laminated Schedules web page.

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New issue of WHO's Vaccine Safety Net Newsletter is now online

In June, the World Health Organization (WHO) published a new edition of its Vaccine Safety Net (VSN) Newsletter. In this edition, you will have the opportunity to learn about the VSN web analytics project, VSN members’ latest news, and WHO tools and resources. As with each edition, a special focus is given to one of the VSN members: in this issue, VSN shines the spotlight on Vaccines Today, a respected hub of vaccine information for the general public in Europe.

The Vaccine Safety Net Newsletter aims to disseminate news and information regarding the VSN, foster communication and synergy among VSN members, and promote good information practices for websites providing information on vaccine safety.

Subscribe to the VSN newsletter.

The Vaccine Safety Net is a WHO initiative that aims to improve global dissemination of balanced evidence-based vaccine safety information via the internet. Through the VSN, WHO identifies websites that provide information on vaccine safety and evaluates them against good information practices criteria established by the Global Advisory Committee on Vaccine Safety. The VSN project now includes 50 websites in 12 languages, and recently unveiled a new website at

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Reminder: Weekly CDC webinar series on "The Pink Book" chapter topics runs through October 11; register now 

CDC is presenting a 15-part webinar series to provide a chapter-by-chapter overview of the 13th edition of Epidemiology and Prevention of Vaccine-Preventable Diseases (also known as "The Pink Book"). This is a live series of weekly 1-hour webinars that started June 14 and will run through October 11. Recordings of sessions will be available online within 2 weeks after each webinar. All sessions begin at 12:00 p.m. (ET). Continuing education will be available for each event.

The webinar series will provide an overview of vaccines and the diseases they prevent, general recommendations for vaccines, vaccination principles, and immunization strategies for providers. 

Registration and more information is available on CDC's Pink Book Webinar Series web page.

All the sections of "The Pink Book" (i.e., chapters, appendices, 2017 supplement) are available to download at no charge at

You can also order this resource from the Public Health Foundation for $40 plus shipping and handling. This print version does not include the 2017 supplement.

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Joint symposium on oropharyngeal cancer sponsored by ADA and MD Anderson Cancer Center to be held October 18 in Atlanta

The American Dental Association (ADA) and the University of Texas MD Anderson Cancer Center are combining their expertise to focus on increasing human papillomavirus (HPV) vaccinations and tobacco cessation for oral cancer prevention. Their goal is to help improve patient outcomes through programs aimed at dental and medical professionals and the public. As part of this initiative, they are sponsoring a joint symposium titled Working Together Against Oropharyngeal Cancer on October 18, preceding the ADA 2017 conference in Atlanta. 

Speakers from ADA, MD Anderson, CDC, and University of Chicago Medicine will present the latest information on the rising epidemic of oropharyngeal cancer and the global impact of HPV-related cancers, the potential for the HPV vaccine and eliminating tobacco use to prevent cancer, an update on emerging techniques to treat oropharyngeal cancers, and an overview of the major long-term side effects of current therapies. Key components of the symposium will focus on opportunities for dentists and other providers to enhance oropharyngeal and oral cavity cancer prevention and earlier diagnosis as well as to facilitate treatment of these cancers and management of treatment side effects. 

Access the agenda as well as registration information.

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NFID Clinical Vaccinology Course scheduled for November 3–4 in Bethesda; submissions for poster presentations due by September 6

The National Foundation of Infectious Disease's (NFID) Fall 2017 Clinical Vaccinology Course will be held November 3–4 in Bethesda, MD. This 2-day course focuses on new developments and issues related to the use of vaccines. Expert faculty provide the latest information on vaccines, including updated recommendations for vaccinations across the lifespan, and innovative and practical strategies for ensuring timely and appropriate immunization. Continuing education credit is available for attendees.

New for 2017—NFID is inviting abstract submissions of original research and clinical practices for poster presentation. The deadline for submissions is September 6.

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Question of the Week

If a patient received Trumenba meningococcal B vaccine (Pfizer) 2 months ago and Bexsero meningococcal B vaccine (GSK) yesterday, should they complete the series with Trumenba or with Bexsero since the two brands are not interchangeable? What would be the intervals from the Bexsero dose to the subsequent dose(s)?   

The patient can complete the series with either vaccine. If Bexsero is chosen, the second and final dose should be administered at least 1 month after yesterday’s dose. If Trumenba is chosen and the patient is healthy (i.e., does not have a high-risk condition for meningococcal B disease such as asplenia), the second and final dose of Trumenba should be administered at least 5 months after yesterday’s Bexsero dose. If the person is at increased risk for meningococcal B disease and Trumenba is being used, a second Trumenba dose should be administered 1 month after yesterday’s Bexsero dose and a third dose should be administered 4 months after the second Trumenba dose.

About IAC's Question of the Week

Each week, IAC Express highlights a new, topical, or important-to-reiterate Q&A. This feature is a cooperative venture between IAC and CDC. William L. Atkinson, MD, MPH, IAC's associate director for immunization education, chooses a new Q&A to feature every week from a set of Q&As prepared by experts at CDC’s National Center for Immunization and Respiratory Diseases.

We hope you enjoy this feature and find it helpful when dealing with difficult real-life scenarios in your vaccination practice. Please encourage your healthcare professional colleagues to sign up to receive IAC Express at

If you have a question for the CDC immunization experts, you can email them directly at There is no charge for this service.

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About IZ Express

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

IZ Express Disclaimer
ISSN 2771-8085

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

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