CDC updates clinical considerations for COVID-19 vaccines, including guidance on second booster doses and vaccination after SARS-CoV-2 infection
CDC updated their Interim Clinical Considerations addressing use of COVID-19 vaccines currently approved or authorized in the United States on April 21. This guidance provides important details on use of COVID-19 vaccines. All healthcare professionals administering or counseling patients on COVID-19 vaccination should review all changes on the web page.
CDC summarized the April 21 changes as follows:
- Added considerations for the option to receive a second COVID-19 vaccine booster dose
- Updated guidance for COVID-19 vaccination after SARS-CoV-2 infection
View the CDC’s Interim Clinical Considerations web page addressing use of COVID-19 vaccines currently approved or authorized in the United States.
Immunize.org is in the process of updating its Vaccines: COVID-19 page, its Ask the Experts: COVID-19 page, and its Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools to reflect the latest changes. Updates will be announced in IZ Express.
Immunize.org’s Hepatitis B Birth Dose Honor Roll recognizes 558 institutions, including 12 new honorees. Five previously honored institutions qualify for sustained honors.
Immunize.org is pleased to announce acceptance of twelve new institutions into its Hepatitis B Birth Dose Honor Roll, for a total of 558 honorees. The birthing institutions are listed below with their reported hepatitis B birth dose coverage rates in parentheses.
- Erlanger East Hospital, Chattanooga, TN (95%)
- Evans Army Community Hospital, Colorado Springs, CO (90%)
- Sanford Aberdeen Medical Center, Aberdeen, SD (90%)
- Sanford Bemidji Medical Center, Bemidji, MN (97%)
- Sanford Luverne Medical Center, Luverne, MN (90%)
- Sanford Medical Center, Bismarck, ND (97%)
- Sanford Medical Center Fargo, Fargo, ND (98%)
- Sanford Sheldon Medical Center, Sheldon, IA (95%)
- Sanford Thief River Falls Medical Center, Thief River Falls, MN (95%)
- Sanford USD Medical Center and Hospital, Sioux Falls, SD (97%)
- Sanford Vermillion Medical Center, Vermillion, SD (97%)
- Sanford Worthington Medical Center, Worthington, MN (93%)
Several institutions are being recognized for qualifying for an additional year:
The Honor Roll now includes 558 birthing institutions from 44 states, the District of Columbia, Puerto Rico, Guam, Saipan, and a U.S. military base in England.
- Community Hospital, Grand Junction, CO (90%) (2 years)
- Denver Health Medical Center, Denver, CO (93%) (6 years)
- Sabetha Community Hospital, Sabetha, KS (96%) (6 years)
- Joint Base Elmendorf-Richardson Hospital, Anchorage, AK (94%) (7 years)
- Arkansas Valley Regional Medical Center, La Junta, CO (97%) (8 years)
The Honor Roll is a key part of Immunize.org’s 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 for hepatitis B vaccine at birth and meeting additional criteria. Immunize.org urges qualifying healthcare organizations to apply for the Hepatitis B Birth Dose Honor Roll online.
To qualify for 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 awarded an 8.5" x 11" color certificate suitable for framing and their acceptance is announced to IZ Express’s 53,000+ readers.
Please visit the Hepatitis B Birth Dose Honor Roll web page that lists these institutions and celebrates their exceptional efforts to protect infants from perinatal hepatitis B transmission.
Related Immunize.org Resources
Influenza activity continues to increase in some areas and CDC reports a human case of avian influenza A(H5) in Colorado
For week 16, ending on April 23, CDC's Weekly U.S. Influenza Surveillance Report, FluView summary reports that seasonal influenza activity continues to increase in some areas of the country. The high levels of acute respiratory illness reflected in the national map include both influenza and non-influenza (e.g., COVID-19) respiratory illnesses.
In other influenza news, a human case of avian influenza A(H5) was reported by Colorado this week. The person had been in direct contact with infected poultry, developed mild symptoms of fatigue for a few days, and has fully recovered. This one H5-positive human case does not change the human health risk assessment associated with the current outbreak of avian H5N1 influenza currently reported among birds in 29 states.
Influenza Vaccination Dashboard
CDC's new Weekly Flu Vaccination Dashboard shares preliminary vaccination data. This week’s key fact: as of April 9, 2022, flu vaccination coverage for children age 6 months to 17 years among states and DC ranges from 32.9% to 79.7%; national coverage is 55.3%. Coverage for most jurisdictions this season as of April 9, 2022, is similar to the same time last season; coverage for most jurisdictions this season is lower compared with pre-pandemic coverage at the same time during the 2019–20 flu season.
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.
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 firstname.lastname@example.org.
Spotlight: Review of Immunize.org resources focused on enhancing clinic and practice operations
In this week's Spotlight, we summarize Immunize.org resources that focus on enhancing clinic and practice operations.
Our topic index on our Clinic Tools main page is a one-stop source of practical information for vaccine providers. You will find "how-to" information about vaccinating in any setting.
Our Clinic Tools: Storage and Handling main page offers printable temperature logs to monitor freezers and refrigerators. This site also includes a troubleshooting record to document the occurrence and resolution of questionable or unacceptable vaccine storage events.
Our Clinic Tools: Documenting Vaccination main page offers forms to document vaccination or declination of vaccination, as well as various forms and checklists useful to healthcare personnel.
Our free downloadable book, Vaccinating Adults: A Step-by-Step Guide, is a "how to" guide that provides easy-to-use, practical information covering essential adult immunization activities.
Our Key Vaccination Resources for Healthcare Professionals is a 5-page annotated list of resources for people who vaccinate or oversee vaccination clinics. The document lists foundational content with which every vaccinator should be familiar, supplemental content useful after completing foundational training, and additional tools to help providers grow in vaccination expertise.
These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.
Immunize.org Pages and Handouts
Immunize.org updates “Should You Be Vaccinated against Hepatitis B?”
Immunize.org updated its Should You Be Vaccinated against Hepatitis B? handout for adults. Changes were made to incorporate the newest ACIP recommendations for routine hepatitis B vaccination of all adults through age 59 years, in addition to children and older adults at increased risk.
Immunize.org updates “When Do Children and Teens Need Vaccinations?”
Immunize.org updated its 1-page patient handout titled When Do Children and Teens Need Vaccinations? It now includes COVID-19 vaccine, dengue vaccine (for certain children, as indicated in the footnote), and a new footnote that reminds that HPV vaccine may be started at age 9 years.
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Reminder: “Ask the Experts: Diphtheria, Tetanus, Pertussis” web page updated with recent pertussis trends and evidence on effectiveness of Tdap during pregnancy
Immunize.org updated its popular Ask the Experts: Diphtheria, Tetanus, Pertussis web page on March 31. Updates include the following:
- Recent epidemiological trends of pertussis
- Evidence that Tdap vaccination during pregnancy is highly effective at protecting newborns from pertussis illness or hospitalization
- When considering post-exposure chemoprophylaxis or symptom monitoring, healthcare personnel vaccinated with Tdap who are at high risk themselves or likely to expose patients at high risk of pertussis complications should be managed like those who have not had Tdap
Note: The original article announcing these Ask the Expert updates
stated in error that the practice of cocooning (Tdap vaccination of previously unvaccinated close contacts of newborns) is not recommended. In fact, cocooning alone may not be effective and is difficult to implement; however, it remains recommended in combination with Tdap vaccination of the mother during pregnancy and on-time DTaP vaccination of the infant.
Immunize.org'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 about vaccines and their administration. Immunize.org's team of experts includes Kelly L. Moore, MD, MPH (team lead), Carolyn B. Bridges, MD, FACP, and Iyabode Beysolow, MD, MPH.
Immunize.org updates its "Vaccine Timeline" main page
Immunize.org's Vaccine Timeline main page was updated on April 1 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 occurred since Edward Jenner's first smallpox vaccination in 1796.
If you would like to suggest an event to add, contact us at email@example.com.
Explore the updated www.Give2MenACWY.org website to increase coverage for the MenACWY booster and other adolescent vaccinations
Immunize.org's www.Give2MenACWY.org website promotes the importance of adolescent vaccination, including administering the recommended MenACWY vaccine booster dose at age 16. Many teens are behind on vaccines because of the pandemic, so vaccination is more important than ever.
Materials on this colorful website for healthcare professionals incorporate the 2020 ACIP meningococcal vaccine recommendations and 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 through 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 Give2MenACWY.org and enjoy browsing (and deploying) its bountiful resources.
"Impact of Population Mixing between Vaccinated and Unvaccinated Subpopulations on Infectious Disease Dynamics: Implications for SARS-CoV-2 Transmission" published in Canadian Medical Association Journal
In the April 25 issue, Canadian Medical Association Journal published Impact of Population Mixing between Vaccinated and Unvaccinated Subpopulations on Infectious Disease Dynamics: Implications for SARS-CoV-2 Transmission. Portions of the abstract appear below.
We found that the risk of infection was markedly higher among unvaccinated people than among vaccinated people under all mixing assumptions. The contact-adjusted contribution of unvaccinated people to infection risk was disproportionate, with unvaccinated people contributing to infections among those who were vaccinated at a rate higher than would have been expected based on contact numbers alone.…
Although risk associated with avoiding vaccination during a virulent pandemic accrues chiefly to people who are unvaccinated, their choices affect risk of viral infection among those who are vaccinated in a manner that is disproportionate to the portion of unvaccinated people in the population.
Recap: Articles regarding mortality data and COVID-19 age-adjusted death rates by race and ethnicity
CDC recently published several articles first distributed as MMWR Early Releases:
- Provisional Mortality Data—United States, 2021 (MMWR, April 29, HTML or PDF)
- Provisional COVID-19 Age-Adjusted Death Rates, by Race and Ethnicity—United States, 2020–2021 (MMWR, April 29, HTML or PDF)
- MMWR main page provides access to MMWR Weekly and its companion publications
“Public Health Actions to Control Measles among Afghan Evacuees during Operation Allies Welcome—United States, September–November 2021” published in MMWR
CDC published Public Health Actions to Control Measles among Afghan Evacuees during Operation Allies Welcome—United States, September–November 2021 in the April 29 issue of MMWR. A portion of the media summary appears below.
This report describes the successful whole-of-government effort to contain measles among Afghan evacuees during Operation Allies Welcome through rapid mass vaccination campaigns. A coordinated response that included a 21-day quarantine and a pause in incoming flights led to high vaccination coverage among evacuees. Measles transmission among evacuees was very limited, and there were no measles cases among the staff or volunteers at the military bases or hotel used for isolation and quarantine, and importantly, no spread into the surrounding communities.
- MMWR main page provides access to MMWR Weekly and its companion publications
“Response to Measles among Persons Evacuated from Afghanistan—Joint Base McGuire-Dix-Lakehurst, New Jersey, August–October 2021” published in MMWR
CDC published Notes from the Field: Response to Measles among Persons Evacuated from Afghanistan—Joint Base McGuire-Dix-Lakehurst, New Jersey, August–October 2021 in the April 29 issue of MMWR. A portion of the media summary appears below.
This report describes how the spread of measles among Afghan evacuees was successfully prevented during Operation Allies Welcome at Joint Base McGuire-Dix-Lakehurst (JBMDL). Several guests were exposed to a measles case during their inbound flight and a rapid mass vaccination campaign, quarantine, and flight pauses prevented further spread of infectious diseases.
Virtual: NFID hosts "COVID-19 Updates: Booster Doses" webinar on May 5
The National Foundation for Infectious Diseases (NFID) will offer a webinar titled COVID-19 Updates: Booster Doses on May 5 at 12:00 p.m. (ET). During this program, current recommendations for COVID-19 vaccines and booster doses will be discussed, along with strategies for healthcare professionals to effectively communicate COVID-19 vaccination recommendations. Speakers will also address audience-submitted questions.
There is no fee to participate in this activity, but registration is required.
Virtual: Hep Free Hawaii and other partners host "Hep Free Talk Story #2: Hepatitis B Vaccine Updates" webinar on May 18
Hep Free Hawaii is collaborating with the Hawaii Immunization Coalition, the Hawaii Comprehensive Cancer Coalition, the UH Cancer Center, and Dynavax Technologies to offer a webinar titled Hep Free Talk Story #2: Hepatitis B Vaccine Updates on May 18 at 6:00 p.m. (ET). This webinar is part of a series on hepatitis B vaccine updates, including new universal adult recommendations, two-dose options, and co-administration opportunities with other vaccines. During this program, there will be a discussion on the new CDC recommendations on hepatitis B vaccines for all adults age 19 through 59.