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Issue 1,612: January 19, 2022
(Formerly IAC Express)
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Immunize​.org summarizes ACIP’s January 12 meeting on influenza, pneumococcal, hepatitis B, respiratory syncytial virus, cholera, and tick-borne encephalitis vaccines

The Advisory Committee on Immunization Practices (ACIP) met on January 12, 2022, to discuss updates on vaccines against influenza, pneumococcal disease, hepatitis B, respiratory syncytial virus, cholera, and tick-borne encephalitis. No votes were taken at this meeting; some topics may be voted on at the regular February ACIP meeting. Key discussion points and plans for each vaccine are outlined below.

Influenza – In recent years, the ACIP Influenza Work Group has evaluated the available evidence to inform ACIP’s consideration of a preferential recommendation for certain vaccines in older adults. Influenza vaccine effectiveness (VE) is generally lower among adults age 65 years and older. Three vaccine products are being assessed for “enhanced” effectiveness in this age group compared to standard influenza vaccines: high-dose inactivated (Fluzone HD, Sanofi Pasteur), adjuvanted inactivated (Fluad, Seqirus) and recombinant influenza vaccine (Flublok, Sanofi Pasteur). The nature and quality of evidence available to evaluate the performance of these products varies. Multiple viral and host factors make it challenging to compare VE among these vaccines. In light of this, ACIP has not expressed a preference for one vaccine over another for older adults. CDC experts provided background information on this topic, including a portion of a systematic review of randomized and observational studies. This discussion will continue at the February ACIP meeting.

Pneumococcal Disease – During its October 2021 meeting, ACIP recommended the use of either 20-valent pneumococcal conjugate vaccine (PCV20) or a series of 15-valent PCV (PCV15) followed by 23-valent pneumococcal polysaccharide vaccine (PPSV23) for all adults age 65 years and older. The same ACIP recommendation applies to adults age 19 years and older with certain underlying medical conditions or risk factors who had not previously received a PCV or whose previous vaccination history is unknown. ACIP’s Pneumococcal Vaccine Work Group (WG) was charged with developing clinical guidance to assist healthcare providers in implementing these recommendations. The WG determined that the previously adopted language was more restrictive than ACIP intended and suggested that more clarity and flexibility were needed. ACIP members agreed and also recommended a brief delay in publication of the guidance until additional information could be included on use of these vaccines in adults who previously received PCV13. During the discussion, the ACIP was informed that licensure of these vaccines for children is anticipated in 2022 (PCV15) and 2023 (PCV20). Discussions on these topics will continue at the regular February and June ACIP meetings. No change in ACIP recommendations for children will occur before the vaccines are licensed for those younger age groups.

Hepatitis B – PreHevbrio (VBI Vaccines) is an FDA-licensed recombinant hepatitis B vaccine that contains the S, pre-S2, and pre-S1 HBV surface antigens. It is licensed as a 3-dose series for people age 18 years and older. ACIP heard a presentation on the safety and relative immunogenicity of PreHevbrio. Clinical trials show that PreHevbrio is safe and produces higher rates of seroprotection than a 3-dose adult hepatitis B vaccine (Engerix-B, GSK) in certain adults, including people with diabetes or obesity. Further discussion will take place at the February ACIP meeting. No vote is planned, because the availability of this new product does not require a change in adult hepatitis B vaccine policy. 

Respiratory Syncytial Virus (RSV) – ACIP received an initial briefing from the new Maternal/Pediatric RSV Work Group. A separate WG has been established to consider RSV prevention in older adults and immunocompromised individuals. Several RSV vaccines and long-acting monoclonal antibodies are currently in Phase 3 trials, and at least two are likely to be submitted for FDA licensure consideration within the next 6–12 months. No votes are anticipated before 2023. 

Cholera – ACIP members received updates on Vaxchora (Emergent), a live, oral cholera vaccine licensed by FDA since 2016 for adults age 18 through 64 years and since 2020 for children and adolescents age 2 through 17 years. Following a structured review using the ACIP Evidence to Recommendation (EtR) framework, the Cholera Vaccine Work Group recommended extending recommendation of this vaccine for people age 2 through 17 years traveling to an area with active cholera transmission. ACIP is expected to vote on this recommendation at its February meeting. The Committee also reviewed studies demonstrating that the vaccine remained effective when diluted in a smaller volume of water and sweetened with sugar or Stevia to make this oral vaccine more palatable for young children. 

Tick-borne Encephalitis (TBE) – TBE is a rare, but serious, viral illness transmitted by ticks in certain parts of Europe and Asia. In August 2021, FDA licensed Ticovac (Pfizer), a TBE vaccine used for many years in Europe. The ACIP TBE Vaccine Work Group presented draft language that the vaccine be recommended as a 3-dose primary series for two groups: (a) people age 1 year and older traveling to or residing in TBE risk areas (based on shared clinical decision making), and (b) laboratory workers with a potential for exposure to TBE virus. ACIP will vote on this recommendation at its February meeting. 

The next scheduled ACIP meeting will be held February 23–24, 2022. Information about past and future ACIP meetings may be found on the ACIP website. 

Related Links

  • ACIP main page for content from previous meetings, as well as information about future meetings
  • CDC: ACIP Presentation Slides: January 12, 2022 Meeting web page

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Newly updated “65+ Flu Defense” website offers resources for healthcare professionals serving older adults

Confident recommendations for influenza vaccine from healthcare providers are powerfully persuasive. To assist you in maximizing protection for your patients,, in collaboration with Seqirus, has updated the "65+ Flu Defense" website at

A new fact sheet on the site, The Importance of Preventing Influenza during a Pandemic, offers responses to help guide discussions with patients on the increased importance of flu vaccination during the COVID-19 pandemic. Age increases risks associated with COVID-19 infection including hospitalization and death. Preliminary studies suggest coinfection with influenza B and SARS-CoV-2 may elevate the risk of poor outcomes.

This helpful site includes information, tools, and tips for communicating with these adults about the scope and severity of influenza, for example:

Check out the updated "65+ Flu Defense" website at to assist your efforts in protecting this vulnerable population.

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CDC study, published in Clinical Infectious Diseases, shows influenza vaccination prevents severe flu illness in U.S. children; use CDC's resources designed for parents 

On January 13, CDC issued a press release CDC Study Shows Flu Vaccination Prevents Severe Flu Illness in U.S. Children: Vaccine Protects, Even When Vaccine Virus and Circulating Viruses Are Different. It described a new study, Vaccine Effectiveness Against Life-Threatening Influenza Illness in U.S. Childrenpublished in the January 13 issue of Clinical Infectious Diseases. A portion of CDC's press release appears below.

The CDC study reports that flu vaccination reduced the risk of severe flu in children by 78% against similar flu A viruses and 47% against flu A viruses that had drifted from the vaccine virus. Further, the vaccine was 76% effective at preventing life-threatening influenza, which included invasive mechanical ventilation, CPR, and other severe complications including death. This study adds to evidence showing that some people who are vaccinated still get sick, but the vaccination can decrease illness severity.

CDC has launched their influenza digital media toolkit, which includes social media content and a new poster aimed at parents of young children, to help share critical messages about the importance of flu vaccination.

Related Links

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Influenza activity and hospitalizations continue to increase; keep vaccinating

Influenza Surveillance
For week 1 of 2022, ending January 8, CDC's Weekly U.S. Influenza Surveillance Report, FluView summary reports that seasonal influenza activity in the United States declined slightly this week but remains elevated and is expected to continue for several weeks. The amount of activity varies by region. 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: as of December 13, CDC-sponsored omnibus surveys indicated that 47.7% of adults 18 and older had received an influenza vaccine while 9.5% of adults definitely planned to receive it but had not yet done so. It is critical to continue to offer influenza vaccination in order to reach the 1 in 10 who want to be vaccinated but have not had the opportunity.

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

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Ice, floods, tornadoes, disasters: 'Tis the season to exercise your emergency plan 

Severe weather, natural disasters, or power outages can create emergency conditions that damage your valuable vaccine inventory. For this reason, every clinic that stocks vaccines needs an emergency plan for inventory protection. Every clinic in the CDC’s Vaccines For Children program (VFC) is required to have one. Follow section 7 of CDC’s Vaccine Storage and Handling Toolkit to create an emergency plan for your clinic and then practice your plan this month. Build redundancy, flexibility, and communication into your plan. 

CDC’s guide helps you consider equipment backup options, alternate storage options, and vaccine transport plans, in case of emergency. Your plan should identify at least one facility that is able to receive and properly store your vaccine inventory in case it must be relocated. CDC’s guide provides detailed instructions on monitoring temperatures during a power outage and what to do once proper conditions are restored. Prevent avoidable vaccine waste by training your staff on emergency procedures, including after-hours roles and responsibilities. Then run an exercise to check understanding.

Related Links

Back to top's “Vaccines: COVID-19” main page fully updated with educational materials and information on booster doses and childhood vaccination's Vaccines: COVID-19 main page has been completely updated to include the latest CDC materials on COVID-19 vaccine booster doses and childhood vaccination, including information on the gray cap formulation of Pfizer-BioNTech's COVID-19 Vaccine for individuals age 12 years and older. This page also provides links to key COVID-19 vaccine resource pages from, CDC, and other partners.

As policies for booster doses of other COVID-19 vaccines are updated and new CDC materials are released,'s Vaccines: COVID-19 main page and resources will continue to be updated. 

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Spotlight: Review of resources at focused on vaccination during pregnancy

In this week's Spotlight, we summarize resources at that focus on vaccination during pregnancy.

Our Handouts: Pregnancy and Vaccines main page offers free access to pregnancy and vaccination-related handouts and fact sheets for healthcare professionals and the public. All items are ready to print, copy, and distribute widely.

Our CDC Schedules main page provides print PDFs of the recommended immunization schedules for adults. The first column in Table 2 of the adult schedule describes the vaccines to give or defer during pregnancy. 

Our Adult Vaccination main page contains all of the handouts that pertain to adult vaccinations. These include the Summary of Recommendations for Adult Immunization that contains many call outs of vaccination during pregnancy.

Our Screening Checklists about Vaccine Contraindications and Precautions main page links you to forms that patients fill out to expedite assessment of vaccination needs and contraindications. These include the labor and delivery HBsAg admission checklist. 

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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. 

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.

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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

Featured Resources
NFID posts new resources for social media, including Flu is Not a Game and humorous infectious-disease images to engage your audience

NFID has released new resources, including animated videos, graphics, and fun infectious disease memes for use on social media. 

National surveys of healthcare professionals and patients with chronic health conditions underscore the importance of doctor-patient conversations about flu vaccination for adults with chronic health conditions. The Flu is Not a Game animated videos and supporting graphics promotes annual flu vaccination as the best way to help #FightFlu and #LowerYourFluRisk. Visit
to download graphics and sample posts to share on social media channels.

As part of the Keep Up The Rates campaign, NFID has developed fun infectious disease memes to help spread awareness, not disease. Download and view the memes at and be sure to tag or mention @NFID_vaccines on Instagram or @NFIDvaccines on Twitter. When you share on social media, use the hashtags #GetVaccinated, #GiftOfHealth, or #FightFlu.

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Organizing a new vaccination program? Use’s Vaccinating Adults: A Step-by-Step Guide—free to download by chapter or in its entirety.

Download’s free 142-page book on adult vaccination, to help build your program and train your team: Vaccinating Adults: A Step-by-Step Guide (Guide).


This thorough "how to" guide on adult vaccination provides easy-to-use, practical information covering all essential activities. It helps vaccine providers enhance their existing adult vaccination services or introduce them into any clinical setting.

The Guide is available to download/print either by chapter or in its entirety free at The National Vaccine Program Office and CDC both supported the development of the Guide and provided early technical review.

The Guide is a valuable resource to assist providers in increasing adult vaccination rates. Be sure to get a copy today!

Please note: this guide was produced in 2017, before the COVID-19 era, and reflects the recommendations of that time.

Related Links

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

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. These buttons and stickers are perfect for people of all ages who want to show their confidence in COVID-19 vaccination. 

  • Available in Spanish – Buttons and stickers
  • Available in English – Stickers, only

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.
English language materials are no longer available. Spanish buttons and stickers are available to support your efforts to increase influenza vaccination rates in Spanish-speaking communities.

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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Notable Publications
“High-Grade Vulvar, Vaginal, and Anal Precancers among U.S. Adolescents and Young Adults after Human Papillomavirus Vaccine Introduction” published in American Journal of Preventive Medicine

In the January 1 issue, American Journal of Preventive Medicine published High-Grade Vulvar, Vaginal, and Anal Precancers among U.S. Adolescents and Young Adults after Human Papillomavirus Vaccine Introduction. The results section of the abstract appears below.

High-grade vulvar precancer rates declined by 21.0% per year after human papillomavirus vaccine introduction among females aged 15–19 years. In addition, high-grade vaginal precancer rates declined by 19.1% per year among females aged 15–29 years after human papillomavirus vaccine introduction. Compared with that in the prevaccine period when high-grade anal precancer rates were increasing, anal precancer rates after human papillomavirus vaccine introduction were stable among females aged 15–29 years and among males aged 30–39 years. Among males aged 15–29 years, the rates increased over the entire period but less so after human papillomavirus vaccine introduction.

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"Estimating the Early Impact of the U.S. COVID-19 Vaccination Programme on COVID-19 Cases, Emergency Department Visits, Hospital Admissions, and Deaths among Adults Aged 65 Years and Older: An Ecological Analysis of National Surveillance Data" published in Lancet

In the November 3 issue, Lancet published Estimating the Early Impact of the U.S. COVID-19 Vaccination Programme on COVID-19 Cases, Emergency Department Visits, Hospital Admissions, and Deaths among Adults Aged 65 Years and Older: An Ecological Analysis of National Surveillance Data. The authors concluded, “the initial roll-out of the U.S. COVID-19 vaccination programme was associated with reductions in COVID-19 cases, emergency department visits, and hospital admissions among older adults.”

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"Association between Menstrual Cycle Length and Coronavirus Disease 2019 (COVID-19) Vaccination" published in Obstetrics & Gynecology

In the January 5 issue, Obstetrics & Gynecology published Association between Menstrual Cycle Length and Coronavirus Disease 2019 (COVID-19) Vaccination: A U.S. Cohort.  The results are summarized below. 

  • Vaccination was not associated with changes in menses length. Menses length is the number of days of menstrual bleeding.
  • Vaccinated people had a cycle length increase of less than 1 day compared to unvaccinated people. Cycle length is the interval between menstrual periods.

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MMWR Recap: “Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA Vaccination against Multisystem Inflammatory Syndrome in Children among Persons Aged 12–18 YearsUnited States, July–December 2021”

An article previously published by CDC as an MMWR Early Release, is now published in the weekly MMWR:

  • Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA Vaccination against Multisystem Inflammatory Syndrome in Children among Persons Aged 12–18 Years—United States, July–December 2021 (MMWR, January 14, HTML or PDF)

Related Link

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

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Upcoming Events
Virtual: Today! NFID offers webinar “COVID-19: Myths and Facts”; CME available

NFID will offer a webinar titled COVID-19: Myths and Facts on January 19 at 12:00 p.m. (ET). The program will cover common misconceptions around COVID-19 and COVID-19 vaccines, and will provide strategies for healthcare professionals to clearly communicate the facts about the disease and vaccines to help prevent it.

To register, click here. NFID designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit.

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Virtual: CDC Foundation's Community COVID Coalition and Vaccine Equity Cooperative offer webinar “COVID-19 and Social Media: Best Practices to Reach Your Communities” on January 20

CDC Foundation's Community COVID Coalition, together with Vaccine Equity Cooperative, will offer a webinar titled COVID-19 and Social Media: Best Practices to Reach Your Communities on Thursday, January 20, at 4:00 p.m. (ET). During this interactive webinar, experts will answer your most pressing questions on effective social media communication strategies and share the best practices for leveraging social media in your community—especially with limited resources and small budgets. Two local communities will also highlight equity centered approaches that ensure public health communications reach our most vulnerable populations, feature culturally competent content and resources, and combat misinformation.

To register, click here.

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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