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Issue 1438: July 31, 2019










CDC releases “Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings”

In July, CDC released its Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings. The first section is reprinted below.

Fundamental Elements to Prevent Measles Transmission

Measles is most commonly acquired from persons in the household or community, but spread of measles can also occur in healthcare settings.

While the most important measure to prevent measles transmission in all settings is ensuring community immunization, core measles prevention in healthcare settings requires a multi-faceted approach including:

  • Ensuring HCP [healthcare personnel] have presumptive evidence of immunity to measles (see Recommendations section)
  • Rapidly identifying and isolating patients with known or suspected measles
  • Adhering to Standard and Airborne Precautions for patients with known or suspected measles
  • Routinely promoting and facilitating respiratory hygiene and cough etiquette
  • Appropriately managing exposed and ill HCP

This interim guidance should be implemented in the context of a comprehensive infection prevention program to prevent transmission of all infectious agents among patients, HCP, and visitors.

Access the complete document titled “Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings” in either format:

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August is National Immunization Awareness Month! 

August is National Immunization Awareness Month (NIAM). This annual observance highlights the efforts of healthcare professionals to protect patients of all ages against vaccine-preventable diseases through on-time vaccination.

CDC’s NIAM web page includes two toolkits, one for communicating with healthcare professionals and the other for communicating with parents and patients. Each includes key messages, sample social media content, and educational resources.


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Total number of U.S. measles cases for 2019 climbs to 1,164 with 16 new cases reported since last week

CDC has posted its latest update on 2019 measles cases in the U.S. on its Measles Cases and Outbreaks web page. The web page shows a preliminary estimate of 1,164 cases across 30 states as of July 25. This is the greatest number of cases reported in the U.S. since 1992 and since measles was declared eliminated from the U.S. in 2000.

The states that have reported cases to CDC are Arizona, California, Colorado, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Missouri, New Mexico, Nevada, New Hampshire, New Jersey, New York, Oklahoma, Oregon, Pennsylvania, Texas, Tennessee, Virginia, and Washington.

Access additional information about U.S. measles cases in 2019 on CDC's Measles Cases and Outbreaks web page.

Measles outbreaks (defined as 3 or more cases) are currently ongoing in 2019 in the following jurisdictions:

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The David J. Sencer CDC Museum requests items related to the study, control, and prevention of influenza or items of historical significance relating to influenza for their new show 

The David J. Sencer CDC Museum in Atlanta is planning an exhibition that surveys the historical significance of influenza spanning the 20th and 21st centuries. In order to gather items for the exhibition, the museum is seeking to collect a variety of materials relating to the study, control, and prevention of the influenza virus or items of historical significance relating to influenza.  

Examples of desired artifacts include, but are not limited to, the following items: 

  • Posters, pamphlets, buttons, and collected materials
  • T-shirts
  • Sound and video recordings
  • Signs
  • Photographs (both physical and digital)
  • Memorabilia

Nothing is too trivial or unimportant. Materials that are explicitly linked to CDC or that include the CDC logo, and pre-21st century, or visually appealing items would be especially appreciated.   

To submit artifacts for consideration in the exhibition, send photos of the items that you believe would be of interest to Heather Rodriguez, assistant curator, via email at You can also call (404) 718-7916 with any questions. The CDC Museum will need to be selective when considering the materials for the exhibition, but appreciates all submissions.

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Register now! Dr. Sharon G. Humiston, IAC's associate director for research, will present a webinar on adolescent immunization and the 16-year platform on August 14 at 1:00 p.m. (ET)

Join Sharon G. Humiston, MD, MPH, FAAP, IAC's associate director for research, for a 1-hour webinar titled "Adolescent Immunization Update and the 16-Year-Old Platform" on August 14, at 1:00 p.m. (ET). During her presentation, Dr. Humiston will review the “need-to-know” facts of adolescent immunization, including the recommendations for adolescent vaccination at 11–12 years of age and those at age 16. 

Register now!

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Nominations open for the 2019 HPV Vaccine Is Cancer Prevention Champion Award

The HPV Vaccine Is Cancer Prevention Champion Award is given annually by CDC, the American Cancer Society (ACS), and the Association of American Cancer Institutes (AACI). This award recognizes clinicians, clinics, practices, groups, and health systems that are going above and beyond to foster HPV vaccination among adolescents in their communities. Up to one Champion from each of the 50 U.S. states, 8 U.S. Territories and Freely Associated States, and the District of Columbia will be recognized.

The 2019 award recipients will be announced in the fall of 2019. Champions will be featured on CDC’s website and in the #PreteenVaxNews e-newsletter. Champions will also receive a congratulatory letter from AACI, ACS, and CDC, an HPV Vaccine Is Cancer Prevention Champion plaque, and a digital web badge for their websites.

Click on the graphic below to find out more about nominating an HPV Champion.

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Help promote the legacy of Dr. Maurice Hilleman's work by nominating him for a Google Doodle

Dr. Maurice Hilleman was responsible for developing more than 40 vaccines, including measles, mumps, hepatitis A, hepatitis B, meningitis, pneumonia, Haemophilus influenzae bacteria, and rubella. Measles vaccine alone has prevented approximately a million deaths and, viewed together, Dr. Hilleman’s vaccines have been credited with saving many millions of lives.
A local Rotary Club in Spokane, WA, in partnership with their Regional Health District, has started a campaign to ask Google to create a Google Doodle to commemorate Dr. Maurice Hilleman's 100th birthday. Instructions from the club are reprinted below.

To nominate a Google Doodle, email
Here's the script we are having members of our large Rotary Club send:
To Whom It May Concern,
I respectfully nominate Maurice Hilleman for a Google Doodle on his 100th birthday: August 30, 2019.
His work is estimated to save 8 million lives each and every year—especially those of children—and yet almost no one knows his name.
Maurice Ralph Hilleman (August 30, 1919–April 11, 2005) was an American microbiologist who specialized in vaccinology and developed over 40 vaccines.

Of the 14 vaccines routinely recommended in current vaccine schedules, he developed eight: those for measles, mumps, hepatitis A, hepatitis B, chickenpox, meningitis, pneumonia and
Haemophilus influenzae bacteria. He also played a role in the discovery of the cold-producing adenoviruses, the hepatitis viruses, and the cancer-causing virus SV40.

He is credited with saving more lives than any other medical scientist of the 20th century.
It would be such a great affirmation of his contributions to humanity to feature him on a Google Doodle on his 100th birthday.
Documentary about him:
Thank you for your consideration.

If you feel the same way about Dr. Maurice Hilleman, email with your own short letter to request a Google Doodle to celebrate what would have been his 100th birthday on August 30.

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New! “FLU VACCINE” buttons and stickers now available for purchase from IAC

Start your preparations for the 2019–20 influenza season by ordering IAC's new “FLU VACCINE” buttons and stickers from SHOP IAC. These new resources are modeled after “I Voted” stickers, which are given to voters in many states as they leave the polls on Election Day. The flu vaccine buttons and stickers are bright red to help broadcast your important vaccination message. And the cost is low!


Demonstrate your clinic-wide support for protecting everyone from influenza by purchasing buttons for all staff to wear. Measuring 1.25" across, the button is understated in size but carries a bold message! Brightly colored red, round button with white text and a metal pin that clasps on the back.

Pin on your lab coat, uniform, other clothing, tote bags, or backpacks to show support for influenza vaccination. Wear it when flu vaccine is available in your clinic to remind patients and the public to protect themselves from influenza.
Buttons are delivered in bags of 10 buttons per bag. Click here for pricing and ordering.

These brightly colored red, round stickers measure 1.5" across. Printed on Avery labels, they adhere well to clothing and have an easy-peel-off back.
Wearing these brightly colored stickers, your patients will be letting their communities know that influenza vaccination is important.

Suitable for clinic staff, too! Urge all staff (including receptionists!) to wear them at work during flu vaccination season. This sends a powerful reminder to patients to get vaccinated.
Stickers are delivered to you cut individually (not on rolls)—available in bundles of 100. Click here for pricing and ordering information.

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IAC Spotlight! IAC's Clinic Tools: Vaccine Recommendations web page provides resources from IAC and CDC to help you vaccinate your patients appropriately 

IAC's Clinic Tools: Vaccine Recommendations web page on is a collection of resources from IAC and CDC related to vaccine recommendations. This web page can be found by selecting the "Clinic Tools" tab (third from the left) in the blue banner across the top of every web page and then selecting "Vaccine Recommendations" in the drop-down menu.

In the left-hand column of the page, you will find IAC's educational materials related to vaccine recommendations. From here, you can access IAC's popular Summary of Recommendations for Child/Teen ImmunizationSummary of Recommendations for Adult Immunization, and Healthcare Personnel Vaccination Recommendations, as well as links to other related resources available on

The right-hand column of the page features resources from CDC, including links to ACIP recommendations, General Best Practice Guidelines for Immunization, and the Pink Book.

As shown above, the "Clinic Tools: Vaccine Recommendations" web page can be found by selecting the "Clinic Tools" tab (third from the left) in the blue banner across the top of every web page and then selecting "Vaccine Recommendations" in the drop-down menu.

Visit the Clinic Tools: Vaccine Recommendations page on

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IAC enrolls 3 new birthing institutions into its Hepatitis B Birth Dose Honor Roll; 1 previously honored institution qualifies for additional years' honors

The Immunization Action Coalition (IAC) is pleased to announce that 3 new institutions have been accepted into its Hepatitis B Birth Dose Honor Roll, for a total of 470 honorees. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.

  • Bridgeport Hospital, Bridgeport, CT (94%)
  • Covenant Children's Hospital, Lubbock, TX (96%)
  • Lehigh Valley Hospital–Hazleton, Hazleton, PA (97%)

The following institution is being recognized for a second year:

  • Maine Medical Center, Portland, ME (94%)

The Honor Roll now includes 470 birthing institutions from 44 states, Puerto Rico, Guam, and an overseas U.S. military base. One hundred fifteen institutions have qualified for two years, 52 institutions have qualified three times, 30 institutions have qualified four times, 19 institutions have qualified five times, 6 institutions have qualified six times, 3 institutions have qualified seven times, and 1 institution has qualified eight 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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IAC updates "Standing Orders for Administering Tdap/Td Vaccine to Children Age 7 Years and Older"

IAC recently revised Standing Orders for Administering Tdap/Td Vaccine to Children Age 7 Years and Older. An error in the routine vaccination schedule in Section 5 was corrected (it previously showed age 7 years as the minimum recommended age for Tdap; now changed to 11 years), a new "Note" was added to those tables, and several website URLs were updated.

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IAC makes minor revision to "Tips for Locating Old Immunization Records"

IAC recently made a minor change to its piece for parents and patients titled Tips for Locating Old Immunization Records. This resource provides direction to people who are trying to track down old vaccination records for their children or themselves.

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IAC revises "Quick Chart of Vaccine-Preventable Disease Terms in Multiple Languages"

IAC recently revised Quick Chart of Vaccine-Preventable Disease Terms in Multiple Languages to correct several Polish terms. This 2-page piece includes vaccine-preventable disease terms in the following languages: Bosnian, Croatian, Polish, Romanian, Russian, Serbian, Slovak, Ukrainian, Dutch, French, German, Italian, Norwegian, Portuguese, Spanish, and Swedish.

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CDC publishes "World Hepatitis Day—July 28, 2019" in this week’s MMWR

CDC published World Hepatitis Day—July 28, 2019 in the July 26 issue of MMWR  (page 637). Selections from the announcement are reprinted below.

World Hepatitis Day, observed each year on July 28, was established to raise awareness and promote understanding of viral hepatitis around the world. The theme of this year’s World Hepatitis Day is “Invest in Eliminating Hepatitis,” underscoring the need to increase commitment for hepatitis response. In 2015, an estimated 257 million persons were living with hepatitis B and 71 million with hepatitis C worldwide.

Persons who inject drugs are at highest risk for hepatitis C virus (HCV) infection. Globally, an estimated 15.6 million persons aged 15–64 years inject drugs, 52% of whom are HCV-antibody positive.... Additional information and resources about viral hepatitis are available at

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USPSTF publishes recommendation on “Hepatitis B Virus Infection in Pregnant Women: Screening”

In their Final Recommendation Statement, the U.S. Preventive Services Task Force (USPSTF) has reaffirmed its recommendation to screen pregnant women for hepatitis B virus infection at their first prenatal visit. They give this recommendation a grade of "A,” indicating that there is high certainty that the net benefit is substantial. This recommendation is available at the USPSTF website. Also, it can be downloaded from the Recommendation Summary web page by clicking on “Read Full Recommendation Statement.”
This recommendation was published in JAMA on July 23/30, 2019. The Conclusions and Recommendation section from the abstract is reprinted below.

Conclusions and Recommendation 
The USPSTF recommends screening for HBV infection in pregnant women at their first prenatal visit. (A recommendation)

Read the complete article in JAMAScreening for Hepatitis B Virus Infection in Pregnant Women: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement.

Access the USPSTF web page: Hepatitis B Virus Infection in Pregnant Women: Screening.

The U.S. Preventive Services Task Force (USPSTF) is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine. The panel's purpose is improving the health of all Americans by making evidence-based recommendations about clinical preventive services.

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CDC and WHO report on progress toward polio eradication in Nigeria in this week's MMWR and Weekly Epidemiological Record, respectively

CDC published Progress Toward Poliomyelitis Eradication—Nigeria, January 2018–May 2019 in the July 26 issue of MMWR (pages 642–646). On the same day, WHO's Weekly Epidemiological Record published a similar article titled Progress towards Poliomyelitis Eradication in Nigeria, January 2018–May 2019. A media summary of the MMWR article is reprinted below.

A new report describes the progress toward polio eradication in Nigeria during January 2018–May 2019. In addition to vigorous vaccination efforts, surveillance in insurgent-held areas has progressively improved. Nigeria’s last reported case of wild poliovirus occurred in September of 2016. With review of further improvements in immunization and surveillance in northeastern Nigeria and neighboring countries, the African Regional Certification Commission may be able to conclude in 2020 that WPV transmission has been interrupted in the WHO Region of Africa. However, since 2018, two outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) have affected 14 Nigerian states, Niger Republic, and Cameroon. To achieve interruption of all cVDPV2 transmission in Nigeria and other countries, the quality of subsequent polio mass campaigns must increase and include insurgent-held areas.

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CDC’s new “Can I Ask You a Question?” video series for parents features pediatricians answering questions about HPV vaccination

CDC’s new Can I Ask You a Question? video series for parents is now available for viewing. In the series, practicing pediatricians use their expertise to answer parents’ questions about the HPV vaccine and why it’s important for preventing cancer. 

Each video answers a different question. Some of these questions include:

  • Why do kids need protection against HPV?
  • Do boys need the HPV vaccine?
  • Does the HPV vaccine really prevent cancer?

You can find all the videos on the CDC website and on YouTube. A Spanish-language version of one of these videos can be accessed here.

Check out CDC's Can I Ask You a Question? video series and share with parents.

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University of Michigan School of Public Health releases podcast about vaccines

The University of Michigan School of Public Health just published an episode of a podcast series that featured several experts on infectious disease, vaccination, and herd immunity from the School of Public Health. The podcast series—Population Healthy—is aimed at educating the general public about important public health topics, including the importance of vaccines. 

You can check out the episode about vaccination here: Invisible Impact: How Vaccines Seem to Make Diseases Disappear.

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Still available! IAC’s sturdy laminated 2019 U.S. child/adolescent immunization schedules—order some for your exam rooms today! Bulk purchase prices available.

IAC's laminated 2019 U.S. child/adolescent immunization schedule is still available. The adult schedules have sold out. These schedules are covered with a tough coating you can wipe down; they will stand up to a year's worth of use in every area of your healthcare setting where immunizations are given. The child/adolescent schedule is eight pages (i.e., four double-sided pages) and is folded to measure 8.5" x 11". 

Adult Laminated Immunization Schedules

Laminated schedules are printed in color for easy reading. They come complete with essential tables and notes, and they replicate the newly designed CDC schedule format.

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 the schedule, view an image, order online, or download an order form at the Shop IAC: Laminated Schedules web page.

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

In late 2017, the Immunization Action Coalition (IAC) announced the publication of its new book, Vaccinating Adults: A Step-by-Step Guide (Guide).

This completely updated "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. Topics include:

  • 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.

The Guide is available to download/print either by chapter or in its entirety free of charge at 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 immunization rates. Be sure to get a copy today!

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Vaccine Education Center at Children's Hospital of Philadelphia publishes July issue of its newsletter Vaccine Update 

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

Additional articles and resources are available in the full newsletter.

Access the sign-up form to subscribe to Vaccine Update.

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Vaccine Education Center plans Current Issues in Vaccines webinar on September 18

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia, together with the Pennsylvania chapter of the American Academy of Pediatrics, will present a 1-hour webinar, beginning at 12:00 p.m. (ET) on September 18. Part of its Current Issues in Vaccines series, the webinar will feature Paul Offit, MD, director of VEC. Dr. Offit's topics for this webinar will be:
  • HPV vaccine for 27- to 45-year-olds: Routine recommendation?
  • PCV13 vaccine for older adults: Is it making a difference?
  • Influenza vaccine: A rough year
  • Meningococcal B vaccine: When do you need a booster dose?

Free continuing education credits (CME, CEU, and CPE) will be available for both the live and archived events. 

Registration (required) is open now.

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NASTAD to sponsor August 8 webinar titled "Hepatitis A and B Vaccination for Gay and Bisexual Men: Innovative Practices and New Resources"

NASTAD (National Alliance of State and Territorial AIDS Directors) will be sponsoring a webinar at 2:00 p.m. (ET) on August 8 titled Hepatitis A and B Vaccination for Gay and Bisexual Men: Innovative Practices and New Resources. The description is provided below.

While hepatitis A and B vaccines are specifically recommended for gay, bisexual and other men who have sex with men (GBM), vaccine rates among this group remain low. With outbreaks of hepatitis A happening across the country and a rise in acute hepatitis B in a number of states, it is critical that hepatitis vaccinations reach the right communities. This webinar will provide an update on the multi-state hepatitis A outbreak, an overview of new and existing hepatitis A and B vaccination recommendations, highlight Colorado’s response to a hepatitis A outbreak in their GBM community, and introduce new resources and outreach materials developed by CDC.

Registration information

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Reminder: Weekly CDC webinar series on "The Pink Book" chapter topics runs through September 25; register now 

Register for CDC's 15-part, live CE-accredited series of 1-hour webinars designed 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"). Topics include specific vaccines and the diseases they prevent, general recommendations for vaccines, vaccination principles, and immunization strategies for providers.  
All sessions begin at 12:00 p.m. (ET). This series began on June 5 and will run through September 25, 2019. The next two webinars are scheduled as follows:
  • August 7: Meningococcal Vaccines
  • August 14: Measles, Mumps, Rubella
Recordings of sessions will be available online within 2 weeks after each webinar.

Information on registration and program details are 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.

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.

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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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Copyright (C) 2019 Immunization Action Coalition
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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.

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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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