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Issue 1,561: April 21, 2021
Top Stories

Featured Resources

Journal Articles and Newsletters

Education and Training

Conferences and Meetings

Immunization PSAs from the Archive


Top Stories

ACIP discusses safety of Janssen COVID-19 Vaccine (Johnson & Johnson); recommendations for clinicians issued by CDC

On April 14, the Advisory Committee on Immunization Practices (ACIP) held an emergency meeting to review new information on adverse events following receipt of the Janssen COVID-19 Vaccine (Johnson & Johnson). The meeting was called in response to the April 13 joint statement issued by FDA and CDC calling for a pause in administration of the Janssen vaccine. The agencies recommended the pause due to reports of six women who developed a rare and severe type of blood clot (cerebral venous sinus thrombosis [CVST]) occurring in combination with low levels of platelets (thrombocytopenia) after receiving the Janssen vaccine. The pause was called to allow time to collect and review additional data and to prepare healthcare providers (HCPs) to recognize, diagnose, properly treat, and report patients exhibiting these symptoms after recent vaccination with Janssen COVID-19 Vaccine. On April 13, CDC also issued a Health Alert Network (HAN) statement outlining recommendations for clinicians, public health agencies, and the general public.

During the meeting, ACIP reviewed available data, including:
  • Use of the Janssen COVID-19 Vaccine began in the U.S. on March 2, and 6.85 million doses had been administered by April 12
  • Between March 19–April 8, 6 cases of CVST in combination with thrombocytopenia were reported to the Vaccine Adverse Events Reporting System (VAERS). All 6 cases occurred in white females age 18–48 years within 6–13 days of the Janssen vaccination. No obvious patterns of risk factors were noted among these women. The combination of CVST and thrombocytopenia is so rare that the background rate in the general population is not known.
  • Treatment with heparin is common for ordinary blood clots but worsens this condition: heparin should not be given to patients with CVST with thrombocytopenia
  • Similar reports of serious blood clots with low platelet counts have been reported after receipt of the AstraZeneca COVID-19 Vaccine in Europe; both the AstraZeneca and Janssen vaccines are based on an adenovirus vector platform
  • No reports of CVST with thrombocytopenia have been reported following receipt of the mRNA COVID-19 vaccines manufactured by Pfizer- BioNTech or Moderna; as of April 12, more than 182 million doses of these vaccines had been administered in the U.S. 

ACIP members favored extending the pause for up to 10 days to obtain additional information before voting on any changes to its recommendations for the use of Janssen COVID-19 Vaccine. As of April 13, 52% of Janssen vaccine recipients remained in the 2-week risk window after vaccination; additional cases are possible among these recipients. 

In the interim, HCPs should follow guidance outlined in the HAN:

  • Be alert for symptoms that may represent serious blood clots and/or low platelet counts in patients who recently received the Janssen vaccine; if suspected, consultation with a hematologist is strongly recommended
  • Evaluate patients with a blood clot and thrombocytopenia after Janssen vaccine with a screening PF4 antibody ELISA assay as would be performed for autoimmune heparin-induced thrombocytopenia (HIT)
  • Do not treat these patients with heparin unless the HIT testing is negative. See CDC guidance for treatment considerations, including non-heparin anticoagulants and high dose intravenous immune globulin.
  • Report serious adverse events such as these to VAERS 

ACIP will reconvene for further evaluation of the Janssen vaccine on Friday, April 23, from 11:00–5:00 p.m. (ET). Information on attending this meeting is posted on the ACIP website. ACIP also will meet on May 5 to discuss rabies and dengue vaccines. No registration is required to watch live ACIP meetings or listen via telephone. Opportunities for public comment are described on the website.

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New! Order IAC’s “I Got My COVID-19 Vaccine” buttons and stickers

IAC now offers “I Got My COVID-19 Vaccine” buttons and stickers for purchase. Place them on lab coats, uniforms, jackets, lanyards, ID badges, or backpacks to show your confidence in COVID-19 vaccination.
Buttons: Wear them to reassure your patients and remind those around you to protect themselves from COVID-19.

Stickers: Give away to COVID-19 vaccine recipients or vaccinated clinic staff!

  • Description: Bright yellow stickers on a roll with an easy-peel-off back and perforations between stickers to make them easy to tear off and share
  • Packaging: Roll of 200 stickers
  • Dimension: 1.5" across
  • To order: See Shop IAC: COVID-19 Vaccine Buttons and Stickers for quantity and pricing options

Please note: Through a separate program supported by CDC, public health departments and selected CDC nonprofit Vaccinate with Confidence campaign partners have been notified about how to receive limited supplies of these items at no cost.
For questions, call 651-647-9009 or email
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Reminder: National Infant Immunization Week is April 24–May 1; prepare using CDC's 2021 digital media toolkit

National Infant Immunization Week (NIIW), April 24–May 1, highlights the importance of protecting infants from vaccine- preventable diseases and celebrates the achievements of immunization partners. This year, because of the pandemic, it’s critical to ensure that families stay on track for their children’s routine checkups.

Since 1994, hundreds of U.S. communities have joined together during NIIW to celebrate the critical role vaccination plays in protecting our children, communities, and public health. Giving babies and toddlers the recommended vaccinations by age two is the best way to protect them from 14 serious childhood diseases.

Save time by using CDC's 2021 NIIW Digital Media Toolkit to plan and implement your organization's NIIW activities. The toolkit includes updated logos, sample social media content, social graphics, and key messages. Please share them, using the hashtag #ivax2protect. 

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World Immunization Week is the last week of April; this year's theme is "Vaccines Bring Us Closer"

World Vaccination Week (WIW) is traditionally celebrated the last week of April. A portion of WHO's press release about WIW appears below. 

Immunization saves millions of lives every year and is widely recognized as one of the world’s most successful health interventions. Yet, there are still nearly 20 million children in the world today who are not getting the vaccines they need, and many miss out on vital vaccines during adolescence, adulthood and into old age.

Using the theme ‘Vaccines bring us closer,’ World Immunization Week 2021 will urge greater engagement around immunization globally to promote the importance of vaccination in bringing people together, and improving the health and wellbeing of everyone, everywhere throughout life.

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AAP launches new PSA urging parents to get their children caught up on all vaccinations

On April 6, AAP launched a new PSA as part of their Call Your Pediatrician campaign that urges parents to get caught up on all their child’s vaccinations as soon as possible. This new video features a parent taking their child to the pediatrician to be vaccinated, and then turning into an animated superhero. This is a superhero moment!

PSAs are available in English and Spanish. View the Call Your Pediatrician campaign toolkit to download graphics for social media, videos, and sample social media posts. Be sure to utilize the campaign hashtag, #CallYourPediatrician.

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AAP announces that 2021–22 influenza vaccination guidance remains unchanged from last season

On March 18, AAP announced that no changes will be made to their influenza vaccination recommendations for the 2021–22 season. A portion of the announcement appears below.

The Academy is making the announcement now to help inform pediatric practices as they pre-book vaccine orders for the upcoming season. The AAP policy statement on influenza immunization in children will be published later this year in Pediatrics....

The AAP influenza policy for the 2021–22 season remains as follows:

  • Annual influenza vaccination is recommended for all children 6 months of age and older.
  • Any licensed influenza vaccine appropriate by age and health status can be used for influenza vaccination in children and youths.
  • There is no preference for any influenza vaccine product for children with no contraindications to influenza vaccination and for whom more than one licensed, age-appropriate product is available.
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Licensed yellow fever vaccine is again available for purchase in the U.S.; CDC updates Health Information for International Travel ("The Yellow Book") accordingly

On April 5, CDC updated Health Information for International Travel (also known as "The Yellow Book") with the following statement:

Sanofi Pasteur announced that YF-VAX (yellow fever vaccine) is once again available for purchase in the United States. Providers with a current Yellow Fever Vaccination Stamp issued by their state or territorial health department may now order YF-VAX from the manufacturer.

Health Information for International Travel is published every 2 years as a reference for those who advise international travelers about health risks. "The Yellow Book" is written primarily for healthcare professionals, but is a useful resource for anyone interested in healthy international travel. The fully revised and updated edition codifies the U.S. government's most current travel health guidelines, including pre- travel vaccine recommendations; destination-specific health advice; and easy-to-reference maps, tables, and charts.

The current edition of "The Yellow Book" is available online at The full list of updates to the print version are posted at this web page.

The print version of Health Information for International Travel 2020 is also available for sale from Oxford University Press, and can also be ordered from major online booksellers.

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National Immigration Law Center posts “Answers to Common Questions about Immigrants’ Access to the COVID-19 Vaccines”

The National Immunization Law Center posted an article titled Answers to Common Questions about Immigrants’ Access to the COVID-19 Vaccines. A portion of the article appears below.

People in immigrant communities and advocates have expressed concern about barriers that many people face when attempting to access COVID- 19 vaccines. These barriers frequently are related to the concerns immigrants generally have when trying to access health care—concerns about documentation requirements, data privacy, eligibility, cost, and whether resources are available in their native language. This article provides answers to common questions regarding such concerns.

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Fifteen colleges and universities announce they will require COVID-19 vaccination for staff and students this fall. Do you know of others?

Colleges and universities across the nation are announcing that they will mandate COVID-19 vaccine to protect staff and students.

IAC is aware of 15 institutions of higher education that will require COVID-19 vaccine this fall: American University, Boston University, Brown University, Cleveland State University, Cornell University (3 campuses), Duke University, Ft. Lewis College, Georgetown UniversityJohns Hopkins University, Manhattanville College, Northeastern University, Nova Southeastern University, Rutgers University, St. Edward's University, and University of Notre Dame.

If you know of additional colleges or universities that require COVID-19 vaccination, please send the name of the institution, as well as a link to the relevant policy (if available) to

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Ready to ship! Order IAC’s laminated versions of CDC’s 2021 immunization schedules today!

IAC's laminated versions of the 2021 U.S. child/adolescent immunization schedule and the 2021 U.S. adult immunization schedule are available for order.

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.


With color coding for easy reading, our laminated schedules replicate the original CDC formatting, including the essential tables and notes.

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 of 1,000 copies or more, call 651-647-9009 or email

Visit the Shop IAC: Laminated Schedules web page for more information on the schedules, to view images of all the pages, and to download the order form today!

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IAC Spotlight! IAC’s recently updated Vaccine Timeline web page features historic dates and events related to vaccines and immunization

The IAC Vaccine Timeline web page is a wonderful resource to use when updating immunization presentations, documents, and websites.

Not too many years ago, we celebrated the 200th anniversary of Edward Jenner's first smallpox vaccination in 1796. The development of vaccines continued at a fairly slow rate until the 1960s, when new scientific discoveries and technologies led to rapid advances in virology, molecular biology, and vaccinology.

The timeline displays many of the vaccine-related events that have occurred since Jenner's critical discovery. This list is by no means exhaustive.

The web page can be easily accessed at

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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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Featured Resources

In IAC’s “Video of the Week,” California's VFC Program shares helpful information on intramuscular injections for adults

California's Vaccines For Children program developed this brief video, Intramuscular Injections for Adults, showing how to identify the deltoid muscle and administer intramuscular (IM) injections to adults. Produced before the COVID-19 pandemic, the video does not show the vaccinator and patient wearing masks, but all the other content applies to COVID-19 vaccine IM injection.

Vaccinated against COVID-19? Encourage friends to follow your lead by adding IAC’s “I Got My COVID-19 Vaccine” Facebook profile photo frame!

Share your excitement about COVID-19 vaccination and inspire your friends! When you have received your COVID-19 vaccine, add IAC's new "I Got My COVID-19 Vaccine" Facebook photo frame to liven up your profile picture!

You can obtain the frame in two ways:

Together we can end the COVID-19 pandemic!

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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

“Differences in Administration of Influenza Vaccine to Elderly Adults by Physician Sex, 2006–2016” published in JAMA Internal Medicine

In the April 12 issue, JAMA Internal Medicine published Differences in Administration of Influenza Vaccine to Elderly Adults by Physician Sex, 2006–2016. A portion of the article appears below. 
Female physicians spend more time with patients during outpatient visits than their male counterparts. Some of this difference may be due to differences by physician sex in time spent on patient counseling, including discussions about vaccinations, such as influenza vaccination. The influenza vaccination rate among minority patients, particularly Black patients, is significantly lower than among White patients, and more time may be needed with minority patients to discuss vaccine concerns. Using nationwide Medicare data, this study estimated differences in influenza vaccination rates by patient race and sex between patients of female and male physicians working in the same outpatient practice.

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“SARS-CoV-2–Specific Antibodies in Breast Milk after COVID-19 Vaccination of Breastfeeding Women” published in JAMA
In the April 12 issue, JAMA published SARS-CoV-2–Specific Antibodies in Breast Milk after COVID-19 Vaccination of Breastfeeding Women. A portion of the discussion section appears below. 

This study found robust secretion of SARS-CoV-2 specific IgA and IgG antibodies in breast milk for 6 weeks after vaccination. IgA secretion was evident as early as 2 weeks after vaccination followed by a spike in IgG after 4 weeks (a week after the second vaccine). A few other studies have shown similar findings in women infected with COVID-19. Antibodies found in breast milk of these women showed strong neutralizing effects, suggesting a potential protective effect against infection in the infant.

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“Progress in Immunization Safety Monitoring—Worldwide, 2010–2019” published in MMWR

CDC published Progress in Immunization Safety Monitoring—Worldwide, 2010–2019 in MMWR on April 16. A portion of the summary appears below.

What is already known about this topic?
Assessing vaccination safety is important to maintaining public confidence in immunization programs. Reporting of adverse events following immunization (AEFI) can be hampered by uncoordinated action between national regulatory authorities and national Expanded Programmes on Immunization.

What is added by this report?
During 2010–2019, countries with AEFI review committees increased from 94 (48.5%) to 129 (66.5%) of 194, and those reporting ≥10 AEFI per 100,000 surviving infants increased from 80 (41.2%) to 109 (56.2%). In 2019, however, only 46 (23.7%) reported combined data from national regulatory authorities and Expanded Programmes on Immunization.

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

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Education and Training

Immunize Colorado hosts “The Impact of Climate Change on Vaccine-Preventable Diseases” webinar on May 5 at 12:00 p.m. (ET)
Immunize Colorado will present a webinar titled The Impact of Climate Change on Vaccine-Preventable Diseases on May 5 from 12:00–1:00 p.m. (ET). 

During this webinar, Mary Hayden, Ph.D., research professor, Lyda Hill Institute for Human Resilience, University of Colorado, will present an overview of climate change and its impact on vaccine distribution and increased transmission of certain vector-borne diseases such as Lyme disease, malaria, dengue, Zika, and chikungunya.

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Unity Consortium to offer "The Imperative to Vaccinate Adolescents and Young Adults Now" discussion, moderated by Chelsea Clinton, on May 6 at 12:00 p.m. (ET); IAC's L.J Tan to serve as a panelist
Unity Consortium is hosting a thought-leader discussion titled The Imperative to Vaccinate Adolescents and Young Adults Now on May 6 from 12:00–1:00 p.m. (ET). Moderated by Chelsea Clinton, PhD, panelists will discuss the urgency of getting adolescents and young adults vaccinated now, before summer when most may be broadly eligible for COVID-19 vaccines.

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Conferences and Meetings

AIRA 2021 National Meeting scheduled on August 3–5 in Portland and online; registration open; content submissions due by May 16

The American Immunization Registry Association (AIRA) is inviting content submissions for its 2021 National Meeting. The meeting will be a hybrid event with both in-person and virtual components on August 3–5 in Portland, Oregon. The AIRA National Meeting provides an annual opportunity to bring partners together to discuss the latest immunization information system (IIS) best practices on a national stage.

Visit the meeting web page for information about conference and hotel registration, presentations, and more. The deadline for submitting content is May 16.

Register to attend.

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Immunization PSAs from the Archive

In this fun, animated PSA from the California Department of Health Services in 1999, "California Kids" are urged to get their adolescent vaccines
In this fun, 1999 public service announcement (PSA) from the California Department of Health Services, "California Kids" are urged to get their adolescent vaccines. This PSA is part of a collection curated by vaccine expert William L. Atkinson, MD, MPH.

Previous PSAs featured in “From the Archives” are available when viewing this Vimeo video

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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.

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

Our mailing address:
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.

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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