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Issue 1,629: April 27, 2022
Top Stories Pages and Handouts
Vaccine Information Statements
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Global News
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Top Stories summarizes April 20 ACIP meeting on use of second COVID-19 vaccine booster doses

The Advisory Committee on Immunization Practices (ACIP) met on April 20, 2022, to discuss COVID-19 vaccine booster doses. No votes were taken at the meeting.

The ACIP meeting followed the FDA’s March 29 authorization of a second mRNA (Pfizer-BioNTech or Moderna) booster dose for individuals age 50 and older and for certain immunocompromised people age 12 years and older. Evidence from Israel indicated gradually waning protection against serious outcomes from COVID-19 in older and immunocompromised individuals beginning at least 4 months after the first booster dose of mRNA vaccine. Additional data suggested a second booster dose helps increase protection from serious outcomes for these higher-risk individuals. Also on March 29, CDC issued Emergency Use Instructions (EUI) for use of a booster of either Pfizer-BioNTech or Moderna mRNA vaccine in people age 18 through 49 years who had received Janssen COVID-19 vaccine as both the primary dose and booster dose. Janssen vaccine is not authorized for use as a second booster. 

Through April 11, 2022, over 93 million people in the United States have received a first booster or an additional dose (if immunocompromised) of COVID-19 vaccine since this dose was authorized in August 2021. At the April 20 meeting CDC experts presented information on the safety of these first booster doses, as well as available evidence on the vaccine effectiveness for first and second booster doses. 

CDC monitors the safety of first booster doses through its extensive network of surveillance systems, including the Vaccine Safety Datalink (VSD), v-safe, and the Vaccine Adverse Event Reporting System (VAERS). In general, systemic and injection-site reactions to the booster were similar to or less frequent than those seen after the primary series. They did observe a small increased risk of myocarditis or pericarditis, verifying 139 cases among 4.7 million first booster dose recipients monitored in VSD within the first 21 days following the booster dose. Most cases occurred within 5 days of booster receipt. The majority of cases were clinically mild and have fully recovered. Within VAERS, myocarditis after the first booster was reported most frequently among males 12 through 29 years of age. However, the reported rates were not as high as after the second dose in the primary series. 

CDC experts presented information on vaccine efficacy (VE) during the Omicron surge. Data from February 2022 indicate that, when compared to people vaccinated with a primary series and single booster dose, unvaccinated people age 12 years and older were 20 times more likely to die from COVID-19. In addition, data indicated that three mRNA doses provided protection against hospitalization but showed waning protection against any infection beginning about 2 months after the last dose. No evidence was found to support theoretical concerns that giving booster doses might lead to immune tolerance or a reduced ability for the immune system to respond to variants that differ from the vaccine strain.  

The ACIP’s COVID-19 Vaccine Workgroup recommended that a decision on whether to receive a second booster dose should reflect current conditions in the pandemic, including wide availability of vaccine, high protection against severe disease from earlier doses, low rates of COVID-19 cases and hospitalizations, and the availability of antivirals and monoclonal antibodies for SARS-CoV-2. ACIP discussed general guidance to assist eligible people in deciding whether to get a second booster dose as soon as possible or to wait. These factors are listed in the updated interim clinical considerations for use of COVID-19 vaccines, as follows:

Eligible people who may consider getting the second booster dose as soon as possible

  • People with certain underlying medical conditions that increase the risk of severe COVID-19 illness
  • People living with someone who is immunocompromised, at increased risk for severe disease, or who cannot be vaccinated due to age or contraindication
  • People at increased risk of exposure to SARS-CoV-2, such as through occupational, institutional, or other activities (e.g., travel or large gatherings)
  • People who live or work in or near an area where the COVID-19 community level is medium or high or are traveling to such an area

Eligible people who may consider waiting to receive a second booster dose

  • People who have had a SARS-CoV-2 infection within the past 3 months
  • People who may be hesitant about getting another recommended booster dose in the future, as a booster dose may be more important in the fall or if a variant-specific vaccine is needed

The meeting concluded with ACIP members discussing what will be needed to inform recommendations on future doses of COVID-19 vaccines. 

The next scheduled ACIP meeting will be held June 22–23, 2022. However, ACIP may hold additional meeting(s) before then to discuss COVID vaccines. Information about past and future ACIP meetings may be found on the ACIP website. 

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"Vaccination Coverage with Selected Vaccines and Exemption Rates among Children in Kindergarten—United States, 2020–21 School Year" published in MMWR

CDC published Vaccination Coverage with Selected Vaccines and Exemption Rates among Children in Kindergarten—United States, 2020–21 School Year in the April 22 issue of MMWR. CDC points are summarized below.

  • Data just published by CDC show national vaccination coverage among kindergarten children getting their required vaccines during the 2020–2021 school year, dropped from 95% to below 94%.
    • This amounts to at least 35,000 more children across the United States entering kindergarten without documentation of complete vaccination against common diseases. 
  • About 400,000 fewer children entered kindergarten than expected based on jurisdictions reporting enrollment data for both years.
    • Those children, too, might not be up to date on their routine vaccinations, further evidence of how pandemic-related disruptions to health care and education could have lingering consequences for school-age children.
  • The good news is routine vaccination coverage remains high and we can recover ground lost during the COVID-19 pandemic.
  • With most schools back to in-person learning, it’s important that providers, schools, and immunization programs increase efforts to follow up with students who are not fully vaccinated to maintain the high level of coverage necessary to protect children, families, and communities against vaccine-preventable diseases.
Access the MMWR article in HTML or  PDF.

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Visit's “Vaccines: COVID-19” main page to locate the latest information on COVID-19 vaccines

Be sure to bookmark's Vaccines: COVID-19 main page for quick access to links to key COVID-19 vaccine resource pages from, CDC, and other partners.

As policies for 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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National Infant Immunization Week is here! Before the week is over, use CDC's 2022 digital media toolkit to spread the word.

National Infant Immunization Week (NIIW), April 24–30, highlights the importance of protecting infants from vaccine-preventable diseases and celebrates the achievements of immunization partners. This year, it’s particularly critical to ensure that families get back on track for routine checkups and recommended vaccinations following disruptions from the COVID-19 pandemic.

Public health officials have been tracking a troubling drop in routine childhood vaccination as a result of families missing many in-person clinical visits during the pandemic. Many children remain behind schedule.

Before the week is over, use CDC's 2022 NIIW Digital Media Toolkit for your NIIW activities. The toolkit includes updated logos, sample social media content, social graphics, and key messages. Please share them, using the hashtags #NIIW and #ivax2protect. 

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CDC reports COVID-19 as third leading cause of death in United States again in 2021

In its April 22 issue of MMWR Early Release, CDC published two related articles:

Part of CDC’s media statement appears below.

The [first] study found that the overall age-adjusted death rate increased by almost 1% in 2021 from 2020. Overall death rates were highest among non-Hispanic American Indian/Alaskan Native and non-Hispanic Black or African American people. For the second year, COVID-19 was the third leading cause of death after heart disease and cancer.

The second report shows that from 2020 to 2021, differences in COVID-19 death rates decreased among most racial and ethnic groups. This report found disparities in the age-adjusted COVID-19 death rates decreased by 14%–40% for most racial and ethnic groups, including non-Hispanic White people, who accounted for 60%–65% of all people who died; and increased non-significantly (7.2%) for non-Hispanic Native Hawaiian and other Pacific Islander persons (0.2%–0.3% of people who died) compared with non-Hispanic multiracial people.

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As masks come off, influenza activity continues its gradual climb nationally; keep offering vaccine if influenza is in your area

Influenza Surveillance
For week 15, ending on April 16, CDC's Weekly U.S. Influenza Surveillance Report, FluView summary reports that seasonal influenza activity in the United States varies by region. Influenza activity is highest in the northeast, south-central, and mountain regions of the country.

Influenza Vaccination Dashboard
CDC's new Weekly Flu Vaccination Dashboard shares preliminary vaccination data. This week’s key fact: flu vaccination coverage for children age 6 months to 17 years is 2.3 percentage points lower for all children this season as of week ending March 19, 2022, compared with last season week ending March 20, 2021 (54.7% compared to 57.0%).

CDC recommends everyone age 6 months and older get an annual influenza 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

Spotlight: Review of resources grouped by age cohorts

In this week's Spotlight, we summarize resources at grouped by age cohorts. 

Our CDC Schedules main page provides print PDFs of the recommended immunization schedules for children and adolescents and for adults. 

Our Schedules for Patients main page contains links to informational sheets on vaccines recommended for people with varying needs based on their age and/or underlying medical conditions. 

Within our Handouts: Topic Index we feature (in alphabetical order):

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 recent citation.

Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination. Pages and Handouts updates “Before You Vaccinate Adults, Consider Their
“H-A-L-O”! recently updated its resource for healthcare professionals titled Before You Vaccinate Adults, Consider Their “H-A-L-O”! H-A-L-O stands for four factors:

  • Health condition
  • Age
  • Lifestyle
  • Occupation

Changes were made to incorporate the newest updated ACIP recommendations for:

  • Hepatitis B vaccine – expanded to include routine vaccination of all adults through age 59 years
  • Pneumococcal vaccine – expanded to include the use of PCV15 in series with PPSV23 or PCV20 vaccines alone
  • Zoster vaccine – expanded to include vaccination of immunocompromised adults beginning at age 19

Related Links revises "Notification of Vaccination Letter Template" recently revised its Notification of Vaccination Letter Template. Revisions include the addition of newly recommended vaccines for hepatitis B and pneumococcal disease.

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Reminder: “Ask the Experts: Hepatitis B” web page updated with new recommendation for universal vaccination of adults through age 59 and added information about PreHevbrio updated its popular Ask the Experts: Hepatitis B web page. This extensive list of clinical questions and answers incorporates the new recommendation for universal vaccination of adults through age 59 and adds information about PreHevbrio (manufactured by VBI). PreHevbrio is licensed and recommended as a hepatitis B vaccine option for people age 18 and older. It is administered as a 3-dose series.'s Ask the Experts main page leads you to 30 distinct web pages on a variety of topics with more than 1,100 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.

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Vaccine Information Statements posts Turkish translations of six Vaccine Information Statements updated in August and October 2021 posted Turkish translations of Vaccine Information Statements (VISs) issued by CDC on August 6, 2021 and October 15, 2021. These translations were generously donated by Betül Polatdemir, MD, Ankara, Turkey, and Nur Polatdemir Çevik, Near East University, Nicosia, Cyprus.

All translations are available in print-ready PDF format. 

VIS translations in Turkish:

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

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Featured Resources

Recognize colleagues and students with's elegantly designed "Vaccines Save Lives" black enamel pins’s elegantly designed “Vaccines Save Lives” pins are meaningful gifts for people who care about vaccination. The pin makes a refined statement in hard black enamel with gold lettering and edges, measuring 1.125" x 0.75".

The pin is a stick-through-post variety with the back end covered by a round rubber cap that holds the pin securely. A gold metal spring-lock clasp is also provided.

Wear these pins on clothing, uniforms, and white coats to show that you value vaccines!


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

Order’s redesigned child, adult, and lifetime immunization record cards—wallet-sized, designed to last!'s personal immunization record cards, printed on rip-proof, smudge-proof, water-proof paper, are designed to last a lifetime. They’re sized to fit in a wallet when folded. The record cards are for you to give to your patients as a permanent and personal vaccination record and are sold in boxes of 250.

Order Immunization Record Cards

Make bulk purchases and receive quantity discounts. For quotes on larger quantities or customizing, or to request sample cards, call 651-647-9009 or email

Global News

"Impact of the SARS-CoV-2 Pandemic on Vaccine-Preventable Disease Campaigns" published in International Journal of Infectious Diseases

In its April 6 issue, International Journal of Infectious Diseases published Impact of the SARS-CoV-2 Pandemic on Vaccine-Preventable Disease Campaigns. The findings section appears below.

Mass vaccination campaigns across all vaccines were disrupted heavily by COVID-19. In May 2020, 105 of 183 (57%) campaigns were postponed or canceled in 57 countries due to COVID-19, with an estimated 796 million postponed or missed vaccine doses. Campaign resumption was observed beginning in July 2020. In December 2021, 77 of 472 (16%) campaigns in 54 countries, mainly in the African Region, were still postponed or canceled due to COVID-19, with about 382 million postponed or missed vaccine doses.

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Upcoming Events

Virtual: National Minority Quality Forum hosts “Champions for Total Health: Black Maternal Health and Vaccines” webinar on April 29

The National Minority Quality Forum's (NMQF) Center for Sustainable Health Care Quality and Equity, along with the Association of Immunization Managers (AIM), and the Institute for Research and Education to Advance Community Health (iReach) will offer a webinar titled Champions for Total Health: Black Maternal Health and Vaccines on April 29 at 12:00 p.m. (ET). As part of a webinar series that will explore the intersections of total health and vaccinations in historically excluded populations, April's webinar will focus on flu and COVID-19 vaccination rates among pregnant people of color. 

Click on the image below to register today.

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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