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Issue 1,611: January 12, 2022
(Formerly IAC Express)
Top Stories Pages and Handouts 
Vaccine Information Statements
Featured Resources
Notable Publications
Upcoming Events  
Top Stories
IZ Express welcomes 2022 with a new name and look; invite your colleagues to subscribe!

As we announced in our December 22, 2021, issue, we now come to your inbox as IZ Express. Our name and look may be new, but what has not changed is our commitment to support you with immunization news and resources to help you protect people of all ages from vaccine-preventable diseases. There’s never been a better time to encourage your colleagues to subscribe to IZ Express and get it delivered to their own inbox each Wednesday.​

Back to top summarizes the January 5 ACIP meeting, including updated CDC recommendations for Pfizer-BioNTech COVID-19 Vaccine affecting children age 5 through 17 years; ACIP meets again today to discuss other vaccines

The Advisory Committee on Immunization Practices (ACIP) met on January 5, 2022, to review the latest COVID-19 vaccine safety data and the FDA’s January 3 updates to its emergency use authorization (EUA) for Pfizer BioNTech COVID-19 Vaccine. Although three changes revised in the EUA were discussed, only the expanded use of a booster dose for all individuals age 12 through 17 years was presented to ACIP for a vote, and the Committee approved this recommendation.
At the meeting, CDC officials noted that, to facilitate a swift response to frequent incremental updates to FDA EUAs, the CDC Director would proceed to issue updated recommendations concerning small modifications to EUAs without convening the full ACIP. In line with this new policy, on January 4 CDC issued a statement announcing its recommendation that clinicians proceed to implement two of the January 3 changes: (1) adding a third primary-series dose at least 28 days after dose 2 for moderately or severely immunocompromised children age 5 through 11 years, and (2) shortening the interval between completion of the primary series and a booster dose from 6 months to 5 months. At the time of the meeting, the shortened booster dose interval applied only to the Pfizer-BioNTech vaccine. On January 7, FDA also updated the Moderna COVID-19 Vaccine EUA to shorten the interval between the primary series and booster dose from 6 months to 5 months. The booster dose minimum interval for the Janssen (Johnson & Johnson) COVID-19 Vaccine (2 months) has not changed.  
During the meeting, ACIP reviewed updated disease surveillance data showing a substantial increase in COVID-19 cases over the last month, along with data indicating cases and hospitalizations were 7–11 times higher in adolescents who were unvaccinated compared to those who were vaccinated. Studies conducted prior to the Omicron surge showed vaccine effectiveness (VE) against infection remained high in this age group, but showed evidence of waning over time. As has been observed in other age groups, VE against symptomatic illness is lower in the setting of Omicron. A review of vaccine safety surveillance systems identified no new or changing safety concerns beyond those previously identified and discussed. Observed rates of myocarditis among individuals age 12 through 15 years remain lower than those among individuals age 16 through 17 years. Based on preliminary data from Israel, the risk of myocarditis after a Pfizer-BioNTech COVID-19 vaccine booster dose may be lower than the risk after the 2nd dose in the vaccine primary series.
At the conclusion of the meeting, ACIP voted to expand its routine recommendation for a booster dose of Pfizer-BioNTech vaccine to include all eligible people age 12 through 17 years. Children age 16 through 17 years were previously permitted to have a booster dose based on an individual assessment of benefits and risks. In making this stronger routine recommendation for a booster dose for all eligible people age 12 through 17 years, ACIP’s intent was to provide more effective protection against symptomatic illness within this age group in the context of high rates of COVID-19 infection and evidence of waning protection against symptomatic illness following the primary series.
While fully supporting this booster recommendation, ACIP members emphasized that the most important way to prevent the serious consequences of COVID-19 infection remains vaccination of unvaccinated individuals age 5 years or older.
The next scheduled ACIP meeting will be held today (January 12) from 10:00 a.m. to 3:30 p.m. (ET) to discuss vaccines other than COVID-19. Links to the live stream, agenda, and presentation slides for today’s meeting are available on the ACIP home page. Information about past and future ACIP meetings can be found on the ACIP meetings website. 

Related Links

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Influenza activity and hospitalizations continue to increase; it's not too late to vaccinate

Influenza Surveillance
For week 52, ending on January 1, CDC's Weekly U.S. Influenza Surveillance Report, FluView summary reports that seasonal influenza activity in the United States is increasing, including indicators that track hospitalization. The high levels of acute respiratory illness reflected in the national map include both influenza and non-influenza (e.g., COVID-19) respiratory illnesses.

Influenza Vaccination Dashboard
CDC's new Weekly Flu Vaccination Dashboard shares preliminary vaccination data. This week’s key fact: based on vaccination coverage and intent estimates among adults age 18 and older as of mid-December, 70.5% of adults who are vaccinated or definitely plan to get a COVID-19 vaccine have received or intend to receive influenza vaccine this year. In contrast, 8.8% of adults who probably or definitely will not get COVID-19 vaccine have received or intend to receive influenza vaccine.

CDC recommends everyone age 6 months and older get an annual flu vaccine. Influenza and COVID-19 vaccines may be given at the same visit, if needed. COVID-19 vaccination alone provides no protection from influenza or any other respiratory virus. 

Vaccine Finder
If you don’t provide influenza vaccine at your site, please strongly recommend vaccination and refer people to sites that do vaccinate. Use VaccineFinder, a user-friendly website to help people of all ages find influenza, COVID-19, and other vaccines. Participating providers can update their vaccine inventory estimates on VaccineFinder. For questions or more information, contact

Related Links

Back to top updates its "Ask the Experts: COVID-19" and "Ask the Experts: Hepatitis A" web pages has updated two of its "Ask the Experts" web pages for COVID-19 and hepatitis A vaccines. The COVID-19 page was updated most recently on December 21 to address the CDC’s preferential recommendation for mRNA vaccines. The Hepatitis A page was reviewed and updated with current epidemiologic data; there have been no major policy changes since the last revision.'s Ask the Experts main page leads you to 29 distinct web pages on a variety of topics with more than 1,000 common or challenging questions and answers (Q&As) about vaccines and their administration.'s team of experts includes Kelly L. Moore, MD, MPH (team lead), Carolyn B. Bridges, MD, FACP, and Iyabode Beysolow, MD, MPH.

Related Links

Back to top posts two Spanish translations of screening checklists for influenza vaccine recently posted its Spanish translations of updated influenza screening checklists for 2021–2022:


Related Links

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January is Cervical Health Awareness Month; promote the importance of early detection and HPV vaccination

January is Cervical Health Awareness Month, so it’s a great time to spread the word about the human papillomavirus (HPV) vaccine. Most cervical cancers are caused by HPV types that can be prevented through vaccination. More than 13,000 women are diagnosed with invasive cervical cancer each year in the United States alone. In January, the  National Cervical Center Coalition (NCCC) and its local chapters across the country will highlight issues related to cervical cancer, HPV disease, and the importance of early detection. 

The NCCC and the American Sexual Health Association (ASHA) offer a range of resources to educate the public and healthcare personnel about cervical health including downloadable content, podcasts, videos, social media content, posters, and more. Many resources can be accessed on NCCC's Cervical Health Awareness Month web page. 
 Related Links 

Back to top ’s Hepatitis B Birth Dose Honor Roll recognizes 545 institutions, including one new honoree. Two previously honored institutions qualify for an additional year of honors. is pleased to announce that one new institution has been accepted into its Hepatitis B Birth Dose Honor Roll, for a total of 545 honorees. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.

  • St. Luke’s Elmore Medical Center, Mountain Home, ID (93%)

One institution is being recognized for a fifth year:

  • Phoenixville Hospital, Phoenixville, PA (95%)

Finally, one institution is being recognized for a seventh year:

  • Myrtue Medical Center, Harlan, IA (95%)

The Honor Roll now includes 545 birthing institutions from 44 states, the District of Columbia, Puerto Rico, Guam, Saipan, and a U.S. military base in England. One hundred twenty-two institutions have qualified for 2 years, 73 institutions have qualified three times, 42 institutions have qualified four times, 25 institutions have qualified five times, 23 institutions have qualified six times, nine institutions have qualified seven times, two institutions have qualified eight times and one institution has qualified nine times.

The Honor Roll is a key part of’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% 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 before hospital discharge.

Honorees are also awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IZ Express’s 52,000+ 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.

Related Resources

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Spotlight! “Ask the Experts” answers more than a thousand questions on vaccines and vaccinations   

In this week's Spotlight, we highlight the Ask the Experts main page at

Our Ask the Experts main page offers more than a thousand timely questions on vaccines and vaccine administration answered by our experts. Topics include specific diseases and their vaccines as well as vaccine delivery guidance (e.g., administration, billing, documenting).

The main page is one of the most visited destinations on Immunize​.org. Whether you're looking for vaccine delivery guidance (e.g., administration, billing, documenting) or information on a specific vaccine, you'll likely find what you're looking for on one of the 29 topic links. 

New and updated Ask the Experts Q&As are published in special editions of IZ Express five times per year. If you have a question that you think may be of interest to our readers, please send it to us using our online form

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Journalists interview experts

Journalists seek out experts to help explain vaccines to the public and policy makers. We help the media understand and communicate the complex work vaccinators do. Here is a selection of our recent citations.

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Vaccines in the News

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

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The Immunization Action Coalition (IAC) is now

As part of a comprehensive organization rebranding originally envisioned by our founder and executive director emerita, Dr. Deborah Wexler, IAC has taken the name of our flagship website, By rebranding with the name most familiar to the healthcare professionals we serve, we hope to make it easier for more frontline vaccinators to find us and our resources. 

Today, you will find the new look of on our social media pages on Facebook, Instagram, Twitter, LinkedIn, and YouTube. In coming months, you’ll also see our new look on a redesigned website with improved searchability to keep accurate, up-to-date resources at the fingertips of vaccinators and the public. We look forward to increasing our visibility and expanding our reach to serve even more frontline vaccinators through these changes planned for 2022.

Back to top Pages and Handouts updates its "Vaccine Timeline" main page's Vaccine Timeline main page was updated on December 28 to include new events related to vaccines and immunization. The chart on the main page displays many of the vaccine- and immunization-related events that have occurred since Edward Jenner's first smallpox vaccination in 1796. This list is by no means exhaustive.

If you would like to suggest an event to add, contact us at

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Recap: These updated educational materials for clinicians were released during November and December

IZ Express regularly provides readers with information about’s new and updated educational materials for healthcare professionals and handouts for patients. All materials are free to distribute.
In case you missed them during recent weeks, updates were made to these helpful materials: Updated Materials for Clinicians Updated Influenza-Specific Materials for Clinicians Related Links
  • Handouts main page to see educational materials sorted by category
  • Ask the Experts main page to access more than 1,000 questions answered by experts
  • Clinic Tools main page and its nine subtopics
  • Educational Materials for Patients and Staff—an alphabetical list of more than 300 ready-to-print staff educational materials and patient handouts

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Vaccine Information Statements
New VIS translation: posts Spanish translation of Dengue Vaccine Information Statement has posted a Spanish translation for the Dengue VIS issued on December 17, 2021. 


View the Dengue Vaccine VIS in Spanish

Related Links

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New VIS translations: posts 6 Karen translations of August 6 Vaccine Information Statements has posted Karen translations of Vaccine Information Statements (VISs) issued by CDC on August 6, 2021. These translations were generously donated by St. Peter’s Health Partners of Albany, NY.

All translations are available in print-ready PDF format. 

VIS translations in Karen:

  • Diphtheria, tetanus, pertussis (DTaP) VIS PDF (view in English)
  • Haemophilus influenzae type b (Hib) VIS PDF (view in English)
  • HPV (human papillomavirus) VIS PDF (view in English)
  • Influenza, inactivated or recombinant VIS PDF (view in English)
  • Influenza, live intranasal VIS PDF (view in English)
  • Meningococcal ACWY VIS PDF (view in English

These join the other languages previously announced in IZ Express: Arabic, Burmese, Chinese (Simplified and Traditional), Dari, French, Pashto, Russian, Somali, Spanish, Turkish, and Vietnamese.

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.   

Related Links

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Recap: These new VISs and VIS translations were released during November and December

IZ Express regularly provides readers with information about Vaccine Information Statements (VISs) and translations of VISs. 

CDC released updated final versions of 14 VISs in August, four more in October, and the new Dengue Vaccine VIS in December. During November and December, posted 50 translations of many of these VISs in the following languages and you can access up-to-date VIS translations on these pages:

Additionally, two handouts related to VISs were updated: Related Links

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Featured Resources
CDC launches new interactive COVID-19 vaccine training module to give healthcare personnel effective communication tools

CDC, in partnership with the U.S. Department of Veterans Affairs, launched its Interactive COVID-19 Vaccine Conversations Module for Healthcare Professionals to aid healthcare personnel in effective COVID-19 vaccine conversations with patients. The module includes:

  • Tips for Having Effective Vaccine Conversations with Patients  
  • Five COVID-19 Vaccine Conversations in Practice: Case Scenarios 

View the training module to learn how to build confidence in COVID-19 vaccination among patients, which is critical to setting expectations, ensuring vaccine uptake, and helping protect the community. 

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CDC Train offers free vaccine training designed for entry-level medical assistants

CDC Train offers a 1-hour on-demand training course designed for entry-level medical assistants titled  Vaccine Training for Medical Assistants. Learning objectives include: 

  • Explain the importance of proper storage and handling of vaccine and list key equipment requirements
  • Summarize forecasting and locate the most up-to-date vaccine schedule for adults and children
  • Describe the most common errors related to vaccine administration
  • List the seven rights of vaccine administration
  • Describe best practices for administering subcutaneous and intramuscular vaccine to adults and children
  • Describe the relationship between trust and professionalism as it relates to patient experience

Register for the course.

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FREE! offers "Me Vacuné Contra el COVID-19” and “I Got My COVID-19 Vaccine” buttons and stickers. Free shipping! Available in English and Spanish.

As COVID-19 vaccination programs vaccinate children age 5 through 11 years and offer booster doses to more people, now is the time to stock up on’s FREE “I Got My COVID-19 Vaccine” buttons and stickers, provided at no cost for product or shipping thanks to support from CDC. Available in English and Spanish, these buttons and stickers are perfect for people of all ages who want to show their confidence in COVID-19 vaccination. 

Click the picture to place your order now:

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FREE! Order’s popular red "Vacuna Contra LA GRIPE" buttons and stickers. Free shipping! Available in Spanish only. still has a limited supply of our popular “Vacuna Contra LA GRIPE” buttons and stickers, available at no charge for product or shipping, thanks to funding from Seqirus. Now more than ever, it is important to remind everyone of the importance of influenza vaccination. This bright red button does the trick.
Due to supply chain and manufacturing constraints, once all available supplies are reserved, we will not be making more this season. Currently, we only have the Spanish version available.

Click the picture to place your order now:


The buttons measure 1.25" across and are delivered in bags of 10 buttons per bag.


Measuring 1.5" across, these stickers adhere well to clothing and have an easy-peel-off backing.

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Explore the updated website to increase coverage for the MenACWY booster and other adolescent vaccinations's website promotes the importance of adolescent vaccination, including administering the recommended booster dose of MenACWY vaccine at age 16. Many teens are behind on vaccines because of the pandemic, so adolescent vaccination is more important than ever.

Original materials on this colorful website for healthcare professionals have been updated to incorporate the 2020 ACIP meningococcal vaccine recommendations and the most recent vaccine coverage statistics from CDC’s National Immunization Survey–Teen (NIS–Teen). One particularly popular resource on the site is the updated Algorithm for MenACWY Immunization in Adolescents 11–18 Years of Age.


The website is divided into five easy-to-access sections:

The site also categorizes materials according to whether they are primarily of interest to providers, to adolescents, or to parents.

Visit and enjoy browsing (and deploying) its bountiful resources.

Related Links 

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“” can help you excel at mass vaccination activities's website assists you in finding ideas for developing your own high-volume clinics. Mass vaccination efforts are useful for influenza and COVID-19 vaccination.

Many of the documents were written in the pre-pandemic era and need modification to ensure that additional protections (e.g., social distancing, personal protective equipment) help safeguard against COVID-19 transmission.

More resources have been added, including:

In addition,'s on-demand full-length webinar (1 h. 46 min.) highlighting best practices and offering practical information, Mass Vaccination Clinics: Challenges and Best Practices, can be viewed on

The website includes a Related Resources web page linking to three articles by authors that appeared in Becker’s Hospital Review.

If you have a resource to suggest for the website, please send a message to

The webinar and the website are supported by a medical education grant from Seqirus.

Related Links

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Notable Publications
“Characteristics and Outcomes of Hospitalized Pregnant Women with Influenza, 2010 to 2019” published in Annals of Internal Medicine

In the December 28 issue, Annals of Internal Medicine published Characteristics and Outcomes of Hospitalized Pregnant Women with Influenza, 2010–2019 that analyzed U.S. data. The conclusions section appears below.

Over 9 influenza seasons, one third of reproductive-aged women hospitalized with influenza were pregnant. Influenza A H1N1 was associated with more severe maternal outcomes. Pregnant women remain a high-priority target group for vaccination.

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“COVID-19 Vaccine Safety in Children Aged 5–11 Years—United States, November 3–December 19, 2021” published in MMWR

CDC published COVID-19 Vaccine Safety in Children Aged 5–11 Years—United States, November 3–December 19, 2021 on December 31 in MMWR. A portion of the summary appears below. 

In preauthorization trials for Pfizer-BioNTech (BNT162b2) COVID-19 vaccine, vaccinated children aged 5–11 years reported mild to moderately severe local and systemic reactions; no serious vaccination-related events were noted....

After authorization of Pfizer-BioNTech COVID-19 vaccine for children aged 5–11 years during October 2021, and administration of approximately 8 million doses, local and systemic reactions after vaccination were commonly reported to VAERS and v-safe for vaccinated children aged 5–11 years. Serious adverse events were rarely reported....

Parents and guardians of children aged 5–11 years should be advised that local and systemic reactions are expected after vaccination with Pfizer-BioNTech COVID-19 vaccine and are more common after the second dose.

Access the MMWR article in HTML or PDF.

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“Interim Estimate of Vaccine Effectiveness of BNT162b2 (Pfizer-BioNTech) Vaccine in Preventing SARS-CoV-2 Infection among Adolescents Aged 12–17 Years—Arizona, July–December 2021” published in MMWR

CDC published Interim Estimate of Vaccine Effectiveness of BNT162b2 (Pfizer-BioNTech) Vaccine in Preventing SARS-CoV-2 Infection among Adolescents Aged 12–17 Years—Arizona, July–December 2021 on December 31 in MMWR. A summary appears below

A new CDC analysis found that the Pfizer-BioNTech mRNA vaccine was highly effective in protecting adolescents aged 12–17 years against COVID-19 in real-world settings during a period of Delta variant predominance and the return to in-person learning, reducing the risk of infection by 92%. To confirm the real-world benefits of the Pfizer-BioNTech mRNA vaccines in adolescents, researchers reviewed COVID-19 infections in a group of 243 adolescents ages 12–17 years from Arizona during a period of Delta variant predominance (July 25, 2021–December 4, 2021). Following the recommended two-dose Pfizer-BioNTech mRNA primary vaccination series, the adolescents’ risk of COVID-19 infection was reduced by 92%. Adolescents who developed a SARS-CoV-2 infection reported a lower percentage of time masked in school and time masked in the community. These findings support CDC’s recommendation that adolescents get fully vaccinated against COVID-19.

Access the MMWR article in HTML or PDF.

Related Link

  • MMWR's main page provides access to MMWR Weekly and its companion publications

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“Risk Factors for Severe COVID-19 Outcomes among Persons Aged ≥18 Years Who Completed a Primary COVID-19 Vaccination Series—465 Health Care Facilities, United States, December 2020–October 2021” published in MMWR

CDC published Risk Factors for Severe COVID-19 Outcomes among Persons Aged ≥18 Years Who Completed a Primary COVID-19 Vaccination Series—465 Health Care Facilities, United States, December 2020–October 2021 on January 7 in MMWR. A summary appears below.

The article reports that a recent study of a U.S. healthcare database found that severe COVID-19-associated outcomes and deaths were rare among adults who were fully vaccinated. Odds of severe outcomes were higher among those who were ages 65 years and older, immunocompromised, or who had other underlying conditions. Data from the large U.S. healthcare database were analyzed to assess the frequency of and risk factors for severe COVID-19 outcomes among adults who completed a primary vaccination series, defined as 14 or more days after receiving a second dose of an mRNA COVID-19 vaccine (Pfizer-BioNTech or Moderna) or one dose of the Johnson & Johnson Janssen COVID-19 vaccine.

Severe COVID-19-associated outcomes (18 per 10,000 vaccinated people) and death (1.5 per 10,000 vaccinated people) were rare after primary vaccination. Risk factors for severe outcomes included older age (65 years and older), immune compromise, or presence of any of six other underlying conditions. All people with severe COVID-19 outcomes after primary vaccination had at least one risk factor and 78% of those who died had four or more risk factors. People who are at risk of severe COVID-19 outcomes after primary vaccination should talk to their doctor about managing their chronic health conditions, continue to wear a mask and practice social distancing, get additional vaccine doses, and be given effective pharmaceutical therapy as needed.

Access the MMWR article in HTML or PDF.

Related Link

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Upcoming Events
Watch today (January 12 at 10:00 a.m. [ET]): ACIP meeting on cholera, hepatitis B, influenza, pneumococcal, respiratory syncytial virus, and tick-borne encephalitis vaccines

CDC will convene its Advisory Committee on Immunization Practices (ACIP) today, January 12, from 10:00 a.m.–3:30 p.m. (ET). The meeting will include ACIP discussion of cholera, tick-borne encephalitis, influenza, hepatitis B, pneumococcal, and respiratory syncytial virus vaccines.

No registration is required to watch webcasts of live ACIP meetings or listen via telephone. Opportunities for public comment are described at the website.

View the agenda.

Related Links

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Virtual: Today! Nevada Immunization Learning Exchange offers webinar “An Overview for Parents and Caregivers Considering the COVID-19 Vaccine for Children 5–11”

Nevada Immunization Learning Exchange (NILE) will offer a webinar titled An Overview for Parents and Caregivers Considering the COVID-19 Vaccine for Children 5–11 on January 12 at 6:00 p.m. (PT). During this program, there will be a discussion on the risks verses benefits of vaccinating your children against COVID-19, the impact COVID-19 has had on children, and the safety of COVID-19 vaccination. The webinar will also cover how to help children before, during, and after vaccination, and discuss guidelines for vaccinating children, as well as evidence-based ways of preventing the spread of COVID-19. The webinar will address frequently asked questions.

For more upcoming events, visit our Calendar of Events.
About IZ Express welcomes redistribution of this issue of IZ Express or selected articles. When you do so, please add a note that is the source of the material and provide a link to this issue.

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

IZ Express Disclaimer
ISSN 2771-8085

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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