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Issue 1457: November 6, 2019







CDC releases 10 updated Vaccine Information Statements

On October 30, CDC released new interim Vaccine Information Statements (VISs) for Hib, HPV, PCV13, polio, and rotavirus vaccines. CDC also released final VISs for cholera, PPSV23, typhoid, and zoster (both live and recombinant) vaccines. 

Access these VISs on their respective IAC web pages by clicking on the links below.

For both interim and final VISs, CDC encourages providers to begin using them immediately, but stocks of the previous editions may be used until exhausted.

IAC will provide its regular seven translations for PPSV23 and both zoster VISs; this process takes about a month. Other organizations and state health departments may provide additional languages. Translation of the interim VISs won’t occur until after the final VIS versions are released (in approximately 6 months). The availability of VIS translations will always be announced in IAC Express.

Translations of previous VIS versions may be used until new translations become available. CDC states that the corresponding up-to-date English-language VIS must also be supplied when providing an out-of-date translation.

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Two new studies find that measles infection causes an extended period of immunosuppression, increasing the possibility of secondary infections 

Two recently published studies have found that people can remain immunosuppressed for months to years after recovering from natural infection with measles virus, leaving them susceptible to other infections. Similar immunosuppression was not seen in vaccinated children.

Science published Measles Virus Infection Diminishes Preexisting Antibodies That Offer Protection from Other Pathogens (Mina et al.) on November 1. A summary of the study is reprinted below.

Many of the deaths attributable to measles virus are caused by secondary infections because the virus infects and functionally impairs immune cells. Whether measles infection causes long-term damage to immune memory has been unclear. This question has become increasingly important given the resurgence in measles epidemics worldwide. Using a blood test called VirScan, Mina et al. comprehensively analyzed the antibody repertoire in children before and after natural infection with measles virus as well as in children before and after measles vaccination. They found that measles infection can greatly diminish previously acquired immune memory, potentially leaving individuals at risk for infection by other pathogens. These adverse effects on the immune system were not seen in vaccinated children.

Science Immunology
published Incomplete Genetic Reconstitution of B Cell Pools Contributes to Prolonged Immunosuppression after Measles (Petrova et al.) also on November 1. An excerpt from the abstract is reprinted below.

Measles is a disease caused by the highly infectious measles virus (MeV) that results in both viremia and lymphopenia. Lymphocyte counts recover shortly after the disappearance of measles-associated rash, but immunosuppression can persist for months to years after infection, resulting in increased incidence of secondary infections....Our results show that MeV infection causes changes in naïve and memory B lymphocyte diversity that persist after the resolution of clinical disease and thus contribute to compromised immunity to previous infections or vaccinations. This work highlights the importance of MeV vaccination not only for the control of measles but also for the maintenance of herd immunity to other pathogens, which can be compromised after MeV infection.

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First influenza-related pediatric deaths for 2019–20 season reported; make sure all your patients are getting vaccinated

Influenza season has now begun. Nationally, flu activity is low and similar to what has been observed during recent previous seasons at the same time, but Louisiana and Puerto Rico are both continuing to experience high levels of influenza-like illness. Two influenza-associated pediatric deaths were reported to CDC during the week ending October 19; no new influenza-related pediatric deaths were reported during the week ending October 26.

Visit the CDC’s Weekly U.S. Influenza Surveillance Report, FluView, for details.

Influenza vaccination is recommended for everyone six months of age and older, so please continue to vaccinate all your patients in this age range. If you don't provide influenza vaccination in your clinic, please recommend vaccination to your patients and refer them to a clinic or pharmacy that provides vaccines or to the HealthMap Vaccine Finder to locate influenza vaccination services near them.

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IAC Spotlight: Just in case you missed them, these IAC materials and web pages were updated during September and October
In almost every issue of IAC Express, we provide readers with information about new and updated educational materials for healthcare professionals and handouts for patients that have been posted during the past week on IAC’s website for healthcare professionals, All these materials are CDC-reviewed and available free for you to download, print, copy, and distribute in your healthcare settings. We also announce major updates to the content on various web sections and pages on
Below you’ll find a listing of the new and updated items and web pages we’ve announced in IAC Express during the months of September and October, in case you’ve missed any of them.

Educational Materials for Healthcare Professionals

Influenza Educational Materials for Healthcare Professionals 

Other Staff Education Materials

Handouts for Your Patients

Updated Web Sections and Pages

Related Links

  • Visit IAC’s View All Materials web page to obtain a list of more than 300 staff educational materials and patient handouts on
  • Visit IAC’s Handouts main page to see the materials sorted by category
  • Visit IAC's Ask the Experts web section to access more than 1,000 Q&As answered by CDC experts
  • Visit IAC's Clinic Tools main page to access this web section and its seven specific topics
  • Visit the What's New at IAC: Handouts web page to view all new and updated handouts and other educational materials and the dates they were posted on
  • Visit the What's New at IAC: Web Sections to view all new and updated Vaccine Information Statements and dates they were posted on
  • Visit the What’s New at IAC: Vaccine Information Statements web page to view all new and updated Vaccine Information Statements and the dates they were posted on

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It's not too late to order IAC’s new "FLU VACCINE" buttons and stickers! 

IAC's new “FLU VACCINE” buttons and stickers are ready to ship! The buttons and stickers are bright red to help broadcast your important vaccination message. And the cost is nominal.


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.

Measuring 1.5" across and printed on Avery labels, theses 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.

Visit Shop IAC for additional items, including "Vaccines Save Lives" enamel pins, patient record cards, and a vaccine administration training video.

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IAC's elegantly designed "Vaccines Save Lives" enamel pins make great gifts!

IAC has designed an elegant new “Vaccines Save Lives” pin on hard black enamel with gold lettering and edges. 

The pin is a stick-through-post variety with the back end covered by a round rubber cap that holds the pin securely. A gold metal spring-lock clasp is also provided. The pin makes a refined statement, measuring 1.125" x 0.75". 

Wear these pins on clothing, uniforms, lab coats, tote bags, and backpacks to show that you value vaccines!

Click here for "Vaccines Save Lives" pins pricing and ordering information.

Visit Shop IAC for additional items, including "FLU VACCINE" buttons and stickers, patient record cards, and a vaccine administration training video.

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There are now 1,109 organizations enrolled in IAC's Influenza Vaccination Honor Roll for mandatory healthcare worker vaccination

There are now 1,109 organizations enrolled in IAC's Influenza Vaccination Honor Roll. The honor roll recognizes hospitals, long-term care facilities (LTCFs), medical practices, pharmacies, professional organizations, health departments, and other government entities that have taken a stand for patient safety by implementing mandatory influenza vaccination policies for healthcare personnel.

Since October 2, when IAC Express last reported on the Influenza Vaccination Honor Roll, 162 additional healthcare organizations have been enrolled.

The Evangelical Lutheran Good Samaritan Society implemented a system-wide mandatory influenza vaccination policy August 1, 2019, in 156 agencies in 22 states (including long-term care, rehabilitation/skilled care, senior living, and home care agencies).

Other newly added healthcare organizations include:

  • Kaweah Delta Healthcare District, Visalia, CA
  • Los Angeles Jewish Home, Reseda, CA
  • Lakeland Regional Health, Lakeland, FL
  • Church Home Rehabilitation and Healthcare LLC, Ft. Valley, GA
  • Decatur County Memorial Hospital, Greensburg, IN
  • Weisman Children's, Marlton, NJ

IAC urges qualifying healthcare organizations to apply by visiting the Application page.

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IAC updates its staff education materials: "Current Dates of Vaccine Information Statements" and "You Must Give Your Patients Vaccine Information Statements (VISs)—It’s Federal Law!"

IAC recently revised Current Dates of Vaccine Information Statements as well as You Must Give Your Patients Vaccine Information Statements (VISs)—It’s Federal Law! to reflect the 10/30/2019 date of the recently updated Cholera, Hib, HPV, PCV13, PPSV23, Polio, Rotavirus, Typhoid, Zoster–live, and Zoster–recombinant VISs.

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WHO reports on validation of maternal and neonatal tetanus elimination in the Democratic Republic of the Congo

On November 1, WHO's Weekly Epidemiological Record published an article titled Validation of Maternal and Neonatal Tetanus Elimination in the Democratic Republic of the Congo. The first paragraph is reprinted below.

As of March 2019, 46/59 (78%) countries with a high burden of maternal and neonatal tetanus (MNT) had been validated as having eliminated this major cause of neonatal deaths; 13 countries remain to be validated, of which 11 are in the African and Eastern Mediterranean regions. Elimination of MNT is defined as <1 case of neonatal tetanus (NT) per 1000 live births (LBs) per district over 1 year.

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Reminder: Visit IAC's recently updated website,, to enhance your efforts at increasing rates of the MenACWY booster and other adolescent vaccines

In August, IAC implemented a major upgrade to its collaborative website promoting the importance of receiving a booster dose of meningococcal ACWY (MenACWY) vaccine.


Aimed at healthcare professionals, the site has been revised to incorporate newly 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 new 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 immunization rates.
  • Give 2 Doses – Fewer than half of teens have received the recommended second dose of MenACWY vaccine. This web page offers tools to help providers 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 adolescent coverage for all recommended vaccines.
  • Resources – This section contains a wealth of information to assist provider efforts to improve adolescent immunization rates. The materials are subdivided into subsections for print materials, links to organizations involved in adolescent immunization, 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 and enjoy browsing (and hopefully deploying) its terrific resources, brought to you by our collaboration with Sanofi Pasteur.
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CDC updates the Hib chapter of its Manual for the Surveillance of Vaccine-Preventable Diseases

CDC recently updated the Haemophilus influenzae invasive disease chapter of its Manual for the Surveillance of Vaccine-Preventable Diseases

The Manual for the Surveillance of Vaccine-Preventable Diseases provides current guidelines for those directly involved in surveillance of vaccine-preventable diseases, especially personnel at the local health departments.

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

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

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

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ISSN: 1526-1786
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Copyright (C) 2019 Immunization Action Coalition
All rights reserved.

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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