Issue 1,683: March 22, 2023
Top Stories
Featured Resources
Notable Publications
Global News
Upcoming Events
Top Stories

FDA expands emergency use authorization of the bivalent Pfizer-BioNTech COVID-19 vaccine for children 6 months through 4 years as a single-dose booster; CDC issues limited updated recommendations for this age group

On March 14, FDA amended the emergency use authorization (EUA) of the Pfizer-BioNTech COVID-19 Vaccine, Bivalent. This allows for a single bivalent booster dose in children age 6 months through 4 years to be given after completing the 3-dose primary series of the Pfizer-BioNTech vaccine already authorized for this age group.

On March 16, CDC issued limited updated recommendations for the use of the bivalent Pfizer-BioNTech COVID-19 Vaccine as a booster dose in children age 6 months through 4 years. The updated recommendation for the use of bivalent Pfizer-BioNTech COVID-19 Vaccine appears below.

People ages 6 months and older are recommended to receive 1 bivalent mRNA booster dose after completion of any FDA-approved or FDA-authorized primary series or previously received monovalent booster dose(s) with the following exception: children ages 6 months–4 years who receive 2 primary series doses of a monovalent Pfizer-BioNTech vaccine and 1 bivalent Pfizer-BioNTech vaccine for the third primary series dose are not authorized to receive a booster dose at this time. Monovalent mRNA vaccines are not authorized as a booster dose.

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FDA and CDC respond to misinformation in public statement, explaining evidence for COVID-19 vaccine safety

On March 10, FDA and CDC issued a joint letter responding to the Florida Surgeon General's misinterpretations and misinformation about Vaccine Adverse Event Reporting System (VAERS) data. A portion of the press release appears below.

We stand firmly behind the safety and effectiveness of the mRNA COVID-19 vaccines, which are fully supported by the available scientific data. Staying up to date on vaccination is the best way to reduce the risks of death and serious illness or hospitalization from COVID-19. Misleading people by overstating the risks, or emphasizing the risks without acknowledging the overwhelming benefits, unnecessarily causes vaccine hesitation and puts people at risk of death or serious illness that could have been prevented by timely vaccination.

Unity Consortium prepares for Adolescent Immunization Action Week, April 3–7, releasing provider toolkit

Held April 3–7 this year, Adolescent Immunization Action Week (#AIAW23) is an annual observance urging parents, healthcare providers, and adolescents to help keep adolescents up to date on immunizations. The Unity Consortium created tools to help healthcare providers amplify messages to parents, adolescents, and young adults. Materials include ready-to-use graphics and a short article about the observance for emails, newsletters, or blogs.

On April 4, 12:00–1:00 p.m. (ET), Unity will host a webinar titled A Conversation about Vaccination with Young Advocates. During the webinar, Drs. Paul Offit and Chelsea Clinton will discuss challenges in closing the gap in adolescent vaccination and talk with teen health advocates about their needs and challenges.

Visit Unity’s AIAW campaign page for social media-ready materials you can use to draw attention to improving adolescent immunization coverage. Use the hashtag #AIAW23 to spread the word.

Influenza activity remains low nationally but is still circulating; vaccinate where virus circulates

CDC continues to recommend influenza vaccination for those not yet protected as long as influenza is circulating. Keep in mind young children who still need a second dose in their first vaccination season and those who need vaccination during pregnancy.

CDC’s Weekly U.S. Influenza Surveillance Report, FluView, provides a valuable snapshot of influenza activity state by state. For week 10, ending March 11, FluView reports that 2.4% of outpatient visits nationwide were due to respiratory illness that included fever plus a cough or sore throat (i.e., influenza-like illness [ILI]). The national baseline is 2.5%. Multiple respiratory viruses are co-circulating; the relative contribution of influenza virus infection to ILI varies by location. So far this season, 132 children died from influenza-associated causes.

Influenza Vaccination Dashboard
CDC’s Weekly Flu Vaccination Dashboard shows that for the 2022–23 season, adults received an estimated 1.1 million more doses in pharmacies compared with the same time in February 2022 (41.1 million compared with 40.0 million). Further, an estimated 2.84 million fewer doses were administered in physician medical offices this season so far, compared with the same time in February 2022 (27.3 million compared with 30.2 million).

CDC published Technical Report: Highly Pathogenic Avian Influenza A(H5N1) Viruses summarizing the H5N1 bird flu situation in the United States.

CDC recommends everyone age 6 months and older get annual influenza vaccination. “” offers VaccineFinder, a service of Boston Children’s Hospital, to help people find influenza and COVID-19 vaccines for any age group. To be listed as a provider by VaccineFinder, see the information at this website.

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Spotlight! Check out staff training and in-service resources provided by

In this week's Spotlight, we summarize resources at that focus on staff training and in-services.

Key Vaccination Resources for Healthcare Professionals includes an annotated list of key training, education, and reference materials for people who vaccinate or oversee vaccination clinics.

Skills Checklist for Vaccine Administration is a tool to help supervisors assess staff members' skills.

Clinic Tools main page offers a one-stop source of practical information for vaccination providers. You will find "how-to" information about providing vaccinations in a medical office or non-traditional setting.

Clinic Tools: Storage and Handling main page features checklists, "Do Not Unplug" signs, how to avoid errors, temperature logs, storage troubleshooting records, and more. You'll find links to CDC's storage and handling training tools, along with other partner resources.

Clinic Tools: Administering Vaccines main page offers handouts on appropriate injection techniques, information on how to properly deliver intramuscular and subcutaneous injections, medical management of adverse reactions, summaries of vaccine recommendations, and how to use vaccines needing reconstitution.

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.

Featured Resources

Order today! Laminated versions of CDC’s 2023 immunization schedules now available and shipping.'s laminated versions of the 2023 U.S. child and adolescent immunization schedule and the 2023 U.S. adult immunization schedule are in stock and shipping now. Order while supplies last.

While the schedules are available online from CDC at no cost,’s laminated schedules are ideal for use in any busy healthcare setting. Their tough coating can be wiped down, and they’re durable enough to stand up to a year of use.

  • Length: Each schedule with appendices is 12 pages
  • Size: Standard 8.5” X 11” booklet format
  • Full Color: With color coding for easy reading, our laminated schedules replicate the original CDC formatting, including the essential tables and notes
  • Bonus: The adult schedule includes’s popular 1-page handout summarizing the dose, route, and needle length recommendations for all vaccines and recipients

Pricing for Each Schedule
$10.00: 1 copy
$9.50 each: 2–4 copies
$8.50 each: 5–19 copies
$7.50 each: 20–99 copies
$6.00 each: 100–499 copies 
$5.00 each: 500–999 copies
$4.00 each: 1,000–1,999 copies
$3.25 each: 2,000+ copies

Visit Shop Laminated Schedules to view images of each page and order today!

For additional information, call 651-647-9009 or email

Related Links's elegant "Vaccines Save Lives" black enamel pins make thoughtful tokens of thanks for hard-working colleagues’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 features a stick-through-post with the back 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.

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Notable Publications

Hepatitis B Foundation publishes "Call to Action: Eliminating HBV through Universal Screening and Vaccination"

The Hepatitis B Foundation published Call to Action: Eliminating HBV through Universal Screening and Vaccination, summarizing critical challenges and potential solutions to implementing new CDC recommendations for universal adult hepatitis B screening and vaccination.’s Dr. Kelly Moore served on the Advisory Council that developed the call to action. A portion of the executive summary appears below.

The Hepatitis B Foundation convened a diverse, multi-stakeholder Advisory Council to help plan and coordinate the dissemination and implementation of updated hepatitis B vaccination and screening recommendations. The recommendations offer a tremendous opportunity to make major advances in the mission to eliminate hepatitis B. Aligning and implementing these new recommendations will require a concerted national effort with collaboration among numerous stakeholders.

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“School-Based Interventions to Increase Student COVID-19 Vaccination Coverage in Public School Populations with Low Coverage—Seattle, Washington, December 2021–June 2022” published in MMWR

CDC published School-Based Interventions to Increase Student COVID-19 Vaccination Coverage in Public School Populations with Low Coverage—Seattle, Washington, December 2021–June 2022 on March 17 in MMWR. A portion of the summary appears below.

Vaccination decreases risk for COVID-19 illness, severe disease, and death. U.S. pediatric COVID-19 vaccination coverage remains low. . . .

Seattle Public Schools implemented a COVID-19 vaccination program through multiple community engagements. During December 2021–June 2022, completion of the primary COVID-19 vaccination series among Seattle Public Schools students aged 5–18 years increased from 56.5% to 80.3%. . . .

School health programs can provide critical information about and access to vaccinations. School health providers might also be able to leverage community partners and relationships with families to increase vaccination coverage.

The program included strategic messaging, school-located vaccination clinics, and school-led community engagement.

Access the MMWR article in HTML or PDF.

Related Link

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

“Prevalence of Previous Dengue Virus Infection among Children and Adolescents—U.S. Virgin Islands, 2022” published in MMWR

CDC published Prevalence of Previous Dengue Virus Infection among Children and Adolescents—U.S. Virgin Islands, 2022 on March 17 in MMWR. A portion of the article appears below.

Dengue seroprevalence in USVI [U.S. Virgin Islands] among age groups eligible for vaccination exceeds the 20% threshold that corresponds to a positive predictive value of ≥90% when implementing prevaccination screening with a test meeting ACIP-recommended performance standards. Dengue vaccination with prevaccination screening should be considered as part of a comprehensive dengue control and prevention strategy in USVI. Other U.S. jurisdictions with endemic transmission of dengue virus should evaluate the risks, benefits, and feasibility of incorporating the dengue vaccine into their local vaccine schedule and consider serosurveys to guide this evaluation.

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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"Maternal Preconception Hepatitis B Virus Infection and Risk of Congenital Heart Diseases in Offspring among Chinese Women Aged 20 to 49 Years" published in JAMA Pediatrics

In the March 13 issue, JAMA Pediatrics published Maternal Preconception Hepatitis B Virus Infection and Risk of Congenital Heart Diseases in Offspring among Chinese Women Aged 20 to 49 Years. The Conclusions and Relevance section appears below.

In this matched retrospective cohort study, maternal preconception previous HBV infection was significantly associated with CHDs in offspring. Moreover, among women with HBV-uninfected husbands, significantly increased risk of CHDs was also observed in previously infected women prior to pregnancy. Consequently, HBV screening and getting HBV vaccination-induced immunity for couples prior to pregnancy are indispensable, and those with previous HBV infection prior to pregnancy should also be taken seriously to decrease the CHDs risk in offspring.

Global News

WHO announces “The Big Catch-Up,” a year-long global push to catch up on childhood immunizations

On March 14, WHO published a message from Kate O'Brien, director of the World Health Organization (WHO) Department of Immunization, Vaccines and Biologicals, regarding "The Big Catch-Up" initiative. A portion of the article appears below.

In 2021 alone, 25 million children missed at least one essential vaccine and 18 million children received no vaccines at all. Our action on immunization in the years leading to 2025 will shape how the story of the pandemic is written. . . .

We commend the countries
[that] have made great strides in recovering immunization programmes during the height of the pandemic, while noting more remains to be done. Under the banner ‘The Big Catch-up’, WHO and partners, will coordinate a year-long global push to mobilize and amplify country plans and implementation for catching up on missed children, commitments and plans for catch up, recovery and strengthening. . . .

Upcoming Events

In Person: AIRA 2023 National Meeting to be held in San Diego on May 2–4; early bird registration ends on April 2

The American Immunization Registry Association (AIRA) is holding its 2023 national meeting on May 2–4 in San Diego. The AIRA national meeting provides an annual opportunity for partners to discuss the latest immunization information system (IIS) best practices.

Visit the meeting web page for information about conference and hotel registration, presentations, and more.

Register by April 2 to receive the early bird rate.

Related Links

For more upcoming events, visit our Calendar of Events.

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.

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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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