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Issue 1,549: February 17, 2021
Top Stories

World News

Featured Resources

Journal Articles and Newsletters

Education and Training

Conferences and Meetings

Top Stories

2021 U.S. recommended immunization schedule for children and teens released along with MMWR article detailing changes

On February 12, CDC posted the 2021 recommended immunization schedules for children and adolescents on CDC's Immunization Schedules for Healthcare Providers web page.

For children and adolescents

The immunization schedule for children and adolescents is available on the CDC web page titled Table 1: Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2021. Also updated are Table 2: Catch-up Schedule as well as Table 3: By Medical Indications.  

Access the full-color, 8-page PDF of the child/adolescent schedule.

View what has changed on the child schedule for 2021

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2021 U.S. recommended immunization schedule for adults released along with MMWR article detailing changes

On February 12, CDC also posted the 2021 recommended immunization schedules for adults on CDC's Immunization Schedules for Healthcare Providers web page.

The immunization schedule for adults is available on the CDC web page titled Table 1: Recommended Adult Immunization Schedule for Ages 19 Years or Older, United States, 2021. Also updated is Table 2: By medical indications

Access the full-color, 6-page PDF of the adult schedule.

View what has changed on the adult schedule for 2021.  

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CDC’s Dr. Shimabukuro and Janine Cory to present overviews of CDC’s safety monitoring and communications for the COVID-19 vaccines during IAC webinar on March 4; register today

IAC will host a webinar, “Overviews of CDC’s Post-authorization/Post-licensure Safety Monitoring and Communications for the COVID-19 Vaccines,” on March 4 from 1 p.m. to 2 p.m. (ET). Topics will include the COVID-19 vaccine safety monitoring systems, i.e., the Vaccine Adverse Events Reporting System (VAERS) and v-safe, as well as CDC’s COVID-19 vaccine communication products, and their Vaccinate with Confidence framework.
These important and timely topics will be addressed by speakers from the CDC Immunization Safety Office and CDC’s Vaccine Task Force. 
  • Tom Shimabukuro, MD, MPH, MBA, deputy director, Immunization Safety Office
  • Janine Cory, MPH, associate director for communications, Vaccine Task Force 

Kelly L. Moore, MD, MPH, IAC deputy director, will moderate the webinar. Speakers will be available to answer audience questions at the conclusion of the presentations.  

Register now to be sure you don’t miss this informative session.

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CDC updates guidance on transport of mRNA COVID-19 vaccines in its Vaccine Storage and Handling Toolkit and applies these principles to COVID-19 vaccination of homebound persons

On February 5, the CDC updated the COVID-19 Vaccine Addendum (pages 49–62) of its Vaccine Storage and Handling Toolkit to include vaccine-specific reference sheets summarizing storage and handling guidance for the Pfizer-BioNTech and Moderna COVID-19 vaccines. CDC also updated guidance on transport of mRNA COVID-19 vaccines.  

CDC does not recommend routine transport of mRNA COVID-19 vaccines beyond original shipping destinations. However, the guidance acknowledges circumstances where COVID-19 vaccine needs to be transported, such as to support off-site or satellite clinics, to vaccinate the homebound, or to prevent vaccine waste. 

In general, the routine storage and handling guidance outlined in “Section Six: Vaccine Transport” of the Toolkit should be followed. In addition, key highlights from the updated Addendum include:

  • CDC recommends transporting vaccine in their original vials. However, similar to the recently published guidance from the U.S Pharmacopeia (USP), the CDC Toolkit now states that “there may be instances when the only option is to transport vaccine in a predrawn syringe.” The USP document notes that such syringes must be maintained at appropriate temperatures and administered within 6 hours after the source vial is diluted (Pfizer-BioNTech) or punctured (Moderna). 
  • Punctured vials may be transported. However, a partially used vial cannot be transferred from one provider to another or across state lines. 
  • The vaccines should be handled with extreme care to minimize shaking and avoid breakage. 
    • Moderna COVID-19 vaccine: If individual vials are transported, they should be cushioned with padding material such as bubble wrap. Transport in a portable freezer is preferred. Doses that will be transported in a refrigerated state should begin transport in a frozen state, if possible.
    • Pfizer-BioNTech COVID-19 vaccine may be transported at ultra-cold temperatures (full trays only) or refrigerated temperatures (individual vials or partially filled trays)
    • For both the Pfizer-BioNTech and Moderna vaccines, take care to ensure thawed vaccines do not refreeze during transport

The updated vaccine transport guidance was integrated into CDC’s new clinical guidance, Vaccinating Homebound Persons with COVID-19 Vaccine. Vaccination of people confined to their residence requires careful planning and preparation in several key areas, including:

  • Estimating the number of doses needed as accurately as possible, including making contingency plans for vaccination of caregivers or others in the home to avoid vaccine wastage
  • Mapping out travel plans to ensure vaccination takes place within the approved time frames for use of vaccine at different temperatures and after a vial is punctured
  • Monitoring, maintaining, and reporting appropriate vaccine storage temperatures from the time the vaccine is taken out of a clinic facility up to the time that vaccine is administered

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CDC updates clinical considerations for mRNA COVID-19 vaccines

CDC updated its Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States

Recent changes to the Clinical Considerations web page include:

  • New recommendations for preventing, reporting, and managing mRNA COVID-19 vaccine administration errors (Appendix A)
  • Clarification on contraindications and precautions
    • Contraindication: Persons with a known (diagnosed) allergy to PEG, another mRNA vaccine component, or polysorbate, have a contraindication to vaccination
    • Precaution: Persons with a reaction to a vaccine or injectable therapy that contains multiple components, one of which is PEG, another mRNA vaccine component or polysorbate, but in whom it is unknown which component elicited the immediate allergic reaction have a precaution to vaccination
  • Updated information on delayed, injection-site reactions after the first mRNA vaccine dose: these reactions are neither a contraindication nor precaution to the second dose
  • Updated quarantine recommendations for vaccinated persons. Fully vaccinated persons who meet criteria no longer are required to quarantine following an exposure to someone with COVID-19. Additional considerations for patients and residents in healthcare settings are provided.
  • Additional information and updated recommendations for testing for tuberculosis infection; TB testing may be done before or at the same time as mRNA COVID-19 vaccination or should be delayed for ≥4 weeks after the completion of mRNA COVID-19 vaccination

View CDC's Interim Clinical Considerations for Use of mRNA COVID-19 Vaccines Currently Authorized in the United States.

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IAC updates “Talking about Vaccines” gateway pages on alternative medicine and thimerosal

IAC has updated our Talking about Vaccines: Alternative Medicine and Talking about Vaccines: Thimerosal gateway pages. These pages lead to many resources from IAC, CDC, and others to help healthcare professionals communicate with parents and patients about important vaccine topics.

  • The Talking about Vaccines: Alternative Medicine gateway page includes a primer on complementary and alternative medicine, and resources addressing chiropractors, homeopathic products, and natural immunity. Children who receive care from complementary health practitioners are less likely to get recommended vaccinations and are more likely to be diagnosed with a vaccine-preventable disease.
  • The Talking about Vaccines: Thimerosal gateway page includes a summary on vaccines and autism, a timeline on thimerosal in vaccines, and other important vaccine safety resources. Numerous studies show that there is no relationship between vaccines, either with or without thimerosal, and the development of autism or other neurologic problems in children.

To easily locate these gateway pages on, go to the upper right corner of the page, and choose the "Talking about Vaccines" tab. You also can use the Guide to at the bottom of every web page.

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Becker's Hospital Review publishes "Lessons Learned from Influenza Mass Immunization Clinics Will Serve Us Well as COVID-19 Vaccination Efforts Ramp Up" by IAC authors—read it on IAC’s website

In its February issue, Becker's Hospital Review published Lessons Learned from Influenza Mass Immunization Clinics Will Serve Us Well as COVID-19 Vaccination Efforts Ramp Up, written by IAC's Drs. Carolyn Bridges and L.J Tan. A summary from the article is reprinted below.

Mass immunization clinics are a critical tool in the public health toolbox to rapidly and efficiently provide large numbers of influenza vaccinations. Experience gained from influenza mass immunization clinics will be beneficial as COVID-19 mass immunization efforts roll out across the country. 

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ACOG adds resources on COVID-19 vaccination for pregnant or lactating individuals

The American College of Obstetrics and Gynecology (ACOG) has augmented its guidance documents and resources on COVID-19 vaccines for pregnant or lactating individuals. 

The National Adult and Influenza Immunization Summit (NAIIS) has compiled a one-page document, COVID-19 Vaccines and Pregnancy: Resources from the American College of Obstetricians and Gynecologists (ACOG), to provide easy access to these recommendations. The Summit site also includes a summary of a presentation on this topic given by Sarah Carroll, ACOG’s director of immunization, infectious disease, and public health preparedness.
ACOG recommends that COVID-19 vaccines not be withheld from pregnant individuals who meet criteria for vaccination, and these individuals should be free to make their own decision regarding vaccination. Pregnant individuals are encouraged to discuss this decision with their healthcare team, but documentation of this discussion is not required.
ACOG also recommends that COVID-19 vaccines be offered to lactating individuals based on their prioritization group. There is no need to avoid starting nor to discontinue breastfeeding in people who receive a COVID-19 vaccine.
The following ACOG resources explain these recommendations. 

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"COVID-19 Vaccination Intent, Perceptions, and Reasons for Not Vaccinating among Groups Prioritized for Early Vaccination—United States, September and December 2020" published in MMWR

CDC published COVID-19 Vaccination Intent, Perceptions, and Reasons for Not Vaccinating among Groups Prioritized for Early Vaccination—United States, September and December 2020 in the February 12 issue of MMWR. A portion of the summary is reprinted below.
From September to December 2020, intent to receive COVID-19 vaccination increased from 39.4% to 49.1% among adults and across all priority groups, and nonintent decreased from 38.1% to 32.1%. Despite decreases in nonintent from September to December, younger adults, women, non- Hispanic Black adults, adults living in nonmetropolitan areas, and adults with less education and income, and without health insurance continue to have the highest estimates of nonintent to receive COVID-19 vaccination.

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

Related Link

  • MMWR's gateway page provides access to MMWR Weekly, MMWR Recommendations and Reports, MMWR Surveillance Summaries, and MMWR Supplements

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Sawbones releases "How to Talk about Vaccine Hesitancy" podcast, a guide for using a kind, empathetic approach

Sawbones: A Marital Tour of Misguided Medicine is a one-of-a-kind podcast reaching adults of all ages with entertaining dialogue about the history of medicine, medical quackery, and current issues. Family physician Dr. Sydnee McElroy and her joke-cracking journalist husband Justin McElroy have produced weekly episodes of Sawbones since 2013. Their shows frequently include information about the importance of getting vaccinated.

In their January 26 episode, How to Talk about Vaccine Hesitancy, Dr. Sydnee and Justin provide a guide for talking with those who are vaccine hesitant and explaining how using a kind, empathetic approach can help them see the light (and the antibodies). They even give a kind nod to the Immunization Action Coalition (thank you!).

All recent and past podcasts of Sawbones are available online at, where you can also access "How to Listen."

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Vaccinate Your Family and the National Council of Negro Women have teamed up to launch Good Health WINs (Women’s Immunization Networks)

On February 10, Vaccinate Your Family (VYF) and the National Council of Negro Women (NCNW) launched a new collaboration to help African American and Latinx communities thrive through good health. This new program called Good Health WINs (Women’s Immunization Networks) pairs NCNW’s unparalleled network of two million American women and men of African descent with VYF’s deep knowledge of vaccines and immunization policy. The collaboration will work to ensure all communities have access to accurate vaccination information, in addition to vaccines. The final paragraph of the press release is reprinted below.

Vaccinate Your Family’s cofounders, former first lady Rosalynn Carter and former first lady of Arkansas Betty Bumpers, understood the power of women’s networks....Much has changed over the past three decades, but one thing has remained steadfast: women continue to be the stewards of good health for their families. Good Health WINs will activate those very networks to create a new future for families to live in good health.

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IAC experts called on by news media

With vaccines in the news so much lately, journalists have sought out IAC experts to communicate the intricacies of running a quality vaccination program. Our insights have helped explain vaccines to the public and policy makers. We want to help them understand the complex work vaccinators do. We've reached mass markets and local stations, across the U.S. and overseas, via print, radio, television, blogs, and more. Here is a selection of our recent citations:

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Not-to-miss immunization articles in the news

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

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World News

WHO offers "Vaccine Explainers" in seven languages: how they are developed, how they work, quality control

WHO has published a four-part series of “explainers”—plain language primers with instructive graphics—on vaccine development and distribution. Topics include:  

Most are available in seven languages (English, Arabic, Chinese, French, Russian, Spanish, and Portuguese).

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WHO issues news release on extraordinary meeting of the Strategic Advisory Group of Experts on Immunization (SAGE)

On February 8, the Strategic Advisory Group of Experts on Immunization (SAGE) met virtually to propose recommendations to WHO on the use of COVID-19 vaccine(s). The final agenda, list of participants, interim recommendations, background documents, and presentations are available online. During the meeting, SAGE issued interim recommendations for use of the Oxford/AstraZeneca COVID-19 vaccine. 

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Featured Resources

Pre-order available soon! Laminated versions of CDC's immunization schedules—great for exam rooms, with discounts for bulk purchases

IAC's laminated versions of the 2021 U.S. child/adolescent immunization schedule and the 2021 U.S. adult immunization schedule will soon be available for purchase.

These schedules are ideal for use in any busy healthcare setting where vaccinations are given. Their tough coating can be wiped down, and they’re durable enough to stand up to a year's worth of use.
The child/adolescent schedule is eight pages (i.e., four double-sided pages) and the adult schedule is six pages (i.e., three double-sided pages), but both schedules fold down to a convenient 8.5" x 11" size.

To inquire about pre-orders, call 651-647-9009 or email Stay tuned for more details in future issues of IAC Express.

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In IAC’s “Video of the Week,” Gregory Brown and Mitchell Moffit use illustrations and lively explanations to discuss COVID-19 mRNA vaccines

In this AsapSCIENCE podcast, What COVID-19 mRNA Vaccine Does in Your Body, Gregory Brown and Mitchell Moffit use illustrations and lively explanations to tell us about the mRNA vaccines for COVID-19. They explain how the vaccines help our immune system protect us from infection. 


Visit the whole collection at the VOTW archive.

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IAC’s “Vaccination and COVID-19” gateway page 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 faced with challenges in providing routine and catch-up vaccination during the pandemic. In this gateway page, 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. We will update this page frequently with new links and resources specific to catch-up vaccination, so be sure to check back regularly.  

To easily locate this gateway page on, go to the light blue band of tabs across the top, and choose the "Clinic Tools." You also can use the Guide to at the bottom of every web page.

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Organizing a new vaccination program? Use IAC's comprehensive Vaccinating Adults: A Step-by-Step Guide—free to download 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 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!

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Journal Articles and Newsletters

“Oral Human Papillomavirus Infection in Children during the First 6 Years of Life, Finland” published in Emerging Infectious Diseases

In the March 2021 issue, Emerging Infectious Diseases published Oral Human Papillomavirus Infection in Children during the First 6 Years of Life, Finland. The abstract is reprinted below. 

Human papillomavirus (HPV) infections are found in children, but transmission modes and outcomes are incompletely understood. We evaluated oral samples from 331 children in Finland who participated in the Finnish Family HPV Study from birth during 9 follow-up visits (mean time 51.9 months). We tested samples for 24 HPV genotypes. Oral HPV prevalence for children varied from 8.7% (at a 36-month visit) to 22.8% (at birth), and 18 HPV genotypes were identified. HPV16 was the most prevalent type to persist, followed by HPV18, HPV33, and HPV6. Persistent, oral, high-risk HPV infection for children was associated with oral HPV carriage of the mother at birth and seroconversion of the mother to high-risk HPV during follow-up (odds ratio 1.60–1.92, 95% CI 1.02–2.74). Children acquire their first oral HPV infection at an early age. The HPV status of the mother has a major impact on the outcome of oral HPV persistence for her offspring.

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Education and Training

NILE offers webinar titled "How Politicization and Disinformation Impacted the Mitigation of COVID-19" on February 23; CE available

On February 23 at 12:00 p.m. (PST), Nevada Immunization Learning Exchange (NILE) will offer a webinar titled How Politicization and Disinformation Impacted the Mitigation of COVID-19. This program will offer one free nursing, pharmacy, or CHW II CEU credit upon completion of the post-webinar survey.

Registration information.

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Conferences and Meetings

Watch virtual ACIP meetings on February 24–25; no registration required

Live, virtual meetings of the Advisory Committee on Immunization Practices (ACIP) will be held on February 24 and 25. The agenda is posted and will include a vote on rabies vaccine. No registration is required to watch the live ACIP meeting or listen via telephone. Opportunities for public comment are described at the website.

An ACIP meeting is anticipated in late February or early March to consider a Janssen (JNJ) COVID-19 Vaccine, which is based on an adenovirus vector. First, an EUA must be granted by the FDA, similar to the process followed for the Pfizer-BioNTech and Moderna mRNA vaccines. IAC Express will keep you informed.

Related Link

  • ACIP gateway page for recordings and content from previous meetings, as well as information about future meetings

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Immunize Nevada hosts 2021 Virtual Annual Nevada Health Conference on March 8–9; register today

The Annual Nevada Health Conference will be held virtually on March 8–9. This event will bring together practitioners and community partners from different health professions including Chronic Disease Prevention and Health Promotion; Immunizations; and Maternal, Child, and Adolescent Health. Continuing education credits are available for multiple healthcare-related fields. 

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

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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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