Issue 1,704: July 26, 2023
Top Stories Pages and Handouts
Featured Resources
Notable Publications
Global News
Upcoming Events
Top Stories

“Use of Respiratory Syncytial Virus Vaccines in Older Adults: Recommendations of the Advisory Committee on Immunization Practices—United States, 2023” published in MMWR                    

CDC published Use of Respiratory Syncytial Virus Vaccines in Older Adults: Recommendations of the Advisory Committee on Immunization Practices—United States, 2023 on July 21 in MMWR. The publication follows the June 21 ACIP discussion and vote to recommend RSV vaccination for adults age 60 years or older using shared clinical decision-making. It expands on the clinical considerations for determining whether to administer an RSV vaccine to an individual in this age group. A portion of the article appears below. 

For RSV vaccination, the decision to vaccinate a patient should be based on a discussion between the health care provider and the patient, which might be guided by the patient’s risk for disease and their characteristics, values, and preferences; the provider’s clinical discretion; and the characteristics of the vaccine.

As part of this discussion, providers and patients should consider the patient’s risk for severe RSV-associated disease. Epidemiologic evidence indicates that persons aged ≥60 years who are at highest risk for severe RSV disease and who might be most likely to benefit from vaccination include those with chronic medical conditions such as lung diseases, including chronic obstructive pulmonary disease and asthma; cardiovascular diseases such as congestive heart failure and coronary artery disease; moderate or severe immune compromise (either attributable to a medical condition or receipt of immunosuppressive medications or treatment); diabetes mellitus; neurologic or neuromuscular conditions; kidney disorders, liver disorders, and hematologic disorders; persons who are frail; persons of advanced age; and persons with other underlying conditions or factors that the provider determines might increase the risk for severe RSV-associated respiratory disease. Adults aged ≥60 years who are residents of nursing homes and other long-term care facilities are also at risk for severe RSV disease. It should be noted that the numbers of persons enrolled in the trials who were frail, were of advanced age, and lived in long-term care facilities were limited, and persons with compromised immunity were excluded (some of whom might have an attenuated immune response to RSV vaccination). However, adults aged ≥60 years in these populations may receive vaccination using shared clinical decision-making given the potential for benefit.

Access the MMWR article in HTML or PDF.

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FDA approves nirsevimab for prevention of RSV in infants and vulnerable children up to 24 months; watch ACIP meeting considering nirsevimab recommendations and inclusion in the Vaccines for Children program, August 3, 11:00 a.m. (ET)

On July 17, FDA announced the approval of Beyfortus (nirsevimab) for the prevention of respiratory syncytial virus (RSV) lower respiratory tract disease in neonates and infants born during or entering their first RSV season, and in children up to 24 months of age who remain vulnerable to severe RSV disease through their second RSV season. Nirsevimab was developed by AstraZeneca and will be distributed by Sanofi. A portion of the news release appears below. 

Beyfortus is a monoclonal antibody with activity against RSV. Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful pathogens such as viruses. One dose of Beyfortus, administered as a single intramuscular injection prior to or during RSV season, may provide protection during the RSV season. 

CDC will convene a meeting of the Advisory Committee on Immunization Practices (ACIP), 11:00 a.m.–3:30 p.m. (ET) on August 3 to discuss and vote on nirsevimab recommendations for RSV prevention in infants and its inclusion in the Vaccines for Children (VFC) program. 

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

View the agenda.

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National Immunization Awareness Month starts August 1; promote vaccination with CDC resources

August is National Immunization Awareness Month (NIAM). This annual observance highlights the efforts to protect people of all ages against vaccine-preventable diseases through on-time vaccination. This year, NIAM serves as a focal point to get back on track with routine vaccines.

During NIAM, encourage your patients to schedule appointments to ensure they are up to date on annual exams and recommended vaccines. Research shows that healthcare providers remain the most trusted source of vaccine information for parents and patients.

CDC’s NIAM web page includes two toolkits, one for reaching healthcare professionals and the other for reaching parents and patients. Each includes key messages, sample social media content, and educational resources. CDC encourages its partners to share these messages and resources throughout August using the hashtag #ivax2protect. Stay tuned for more resources to be released throughout the coming weeks.

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2023–2024 CDC influenza vaccination recommendations adopted

On June 27, 2023, CDC director Rochelle P. Walensky, MD, MPH, adopted the 2023–2024 CDC influenza vaccination recommendations.  Small changes were made to the annual influenza vaccination recommendations, including an acknowledgement of the updated flu vaccine composition for the 2023–2024 flu season and a change in the recommendations for vaccination of people with egg allergies. The CDC director’s adoption of the ACIP recommendations makes them official CDC policy, which will be published in an upcoming Morbidity and Mortality Weekly Recommendation Report later this summer.
This announcement provides additional details on the updated recommendations for this influenza season. Providers should begin vaccinating patients according to CDC’s recommended timing, which remains the same as last season.

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“Minimum Interval When Repeating Expired Live Vaccine Dose”: watch the 1-minute answer, part of the Ask the Experts Video Series on Facebook, LinkedIn, Twitter, YouTube, and Instagram’s social media program highlights our educational resources for today’s vaccinators. This week, our featured episode from the Ask the Experts Video Series is Minimum Interval When Repeating Expired Live Vaccine Dose. This is available on our YouTube channel, along with our full collection of quick video answers to popular Ask the Experts questions.

Our social media channels feature our most popular printable resources, our Ask the Experts Video Series, and announcements important to frontline vaccinators. Like, follow, and share’s social media accounts. Encourage colleagues and others interested in vaccination to do likewise:

Back to top’s MenB Vaccination Honor Roll recognizes one new institution that protects its students is pleased to announce that one new post-secondary institution earned recognition on its MenB Vaccination Honor Roll for requiring or recommending serogroup B vaccine for students.

The newly added institution appears below. Clicking on an institution’s name takes you to the place on the school's website that details their vaccination policy.

Currently, there are 271 honorees, with 41 colleges and universities requiring MenB vaccination for their students and 230 recommending it. launched the MenB Vaccination Honor Roll in 2020 to recognize institutions that establish immunization policies to protect the health of their students.

Please help us to grow the honor roll by notifying us of colleges or universities that require or recommend MenB vaccination for students. Institutions may apply for the honor roll, or you can alert us at

Please visit the MenB Vaccination Honor Roll web page to find resources such as news stories about meningitis B outbreaks, personal stories from families affected by meningitis B, journal articles, and links to organizations that work to prevent meningitis.

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World Hepatitis Day occurs July 28; share’s resources all year long

World Hepatitis Day is recognized annually on July 28. This commemorates the birthday of Baruch Blumberg, MD, PhD, who discovered the hepatitis B virus in 1967 and developed the basis for the first hepatitis B vaccine in 1969.

This year’s theme, “We're Not Waiting," calls us to accelerate viral hepatitis elimination efforts by heralding the urgent need for prevention, testing, and treatment.’s July 13 webinar, Hepatitis B-Gone: Implementing Universal Adult Screening and Vaccination. Your Practical Questions Answered., is now archived for viewing and explains in useful ways how healthcare providers can engage in these important efforts to eliminate hepatitis B.

Get involved by using World Hepatitis Day digital resources and the hashtag #WorldHepatitisDay with your social media posts. It's also important to spread hepatitis awareness, prevention, testing, and treatment resources throughout the year.

Help your colleagues understand the recommendations using resources:

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Spotlight:'s “Clinic Tools: Administering Vaccines” main page provides practical tools based on authoritative sources's Clinic Tools: Administering Vaccines main page is a collection of resources from, CDC, and other organizations. To find it, select the "Clinic Tools" tab in the middle of the blue banner atop every web page and then select "Administering Vaccines." 

On the "Clinic Tools: Administering Vaccines" main page, you will find educational materials such as: 

The right-hand column of the page features partner resources, links to vaccine administration guidelines, and The Epidemiology and Prevention of Vaccine-Preventable Diseases ("The Pink Book"). 

Visit the Clinic Tools: Administering Vaccines main page on

Vaccines in the news

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination. Pages and Handouts updates its “Ask the Experts” web pages on combination vaccines, meningococcal ACWY vaccines, and meningococcal B vaccines recently reviewed and updated three of its popular Ask the Experts web pages with current epidemiology and new hyperlinks to resources, as needed. Take this opportunity to refresh your knowledge with a review of the clinical questions and answers available from on these topics.’s Ask the Experts main page leads you to 30 web pages on various topics with more than 1,200 common or challenging questions and answers 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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Featured Resources

CDC issues 2024 edition of CDC Yellow Book: Health Information for International Travel 

CDC’s 2024 edition of CDC Yellow Book: Health Information for International Travel is now available in hard copy and online. The CDC Yellow Book provides information for health professionals on pre- and post-travel care for international travelers. It compiles the U.S. government’s most current travel health guidelines, including pretravel vaccine and safety recommendations, destination-specific health advice, and easy-to-reference maps, tables, and charts.

The 2024 edition of the CDC Yellow Book includes:
  • Precautions for international travelers during the COVID-19 pandemic
  • Updates on providing travel health and travel medicine in a virtual environment
  • New standalone vaccine tables for bacterial and viral diseases
  • Updated travel health recommendations for highly allergic, immunocompromised, and chronically ill travelers, travelers with substance-use disorders, and medical tourists
  • Country-specific mosquito avoidance, yellow fever vaccine, and malaria prevention recommendations

The CDC Yellow Book chapters and appendices are available at no charge on the CDC Yellow Book Table of Contents main page. 

Order a hard copy from the Oxford University Press ($65 plus shipping).

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Notable Publications
“Safety of COVID-19 Vaccines during Pregnancy: A Systematic Review and Meta-Analysis” published in Vaccine

In the June 7 issue, Vaccine published Safety of COVID-19 Vaccines during Pregnancy: A Systematic Review and Meta-Analysis. The conclusion section appears below.

We found no safety concerns for currently administered COVID-19 vaccines during pregnancy. Additional experimental and real-world evidence could enhance vaccination coverage. Robust safety data for non-mRNA-based COVID-19 vaccines are still needed.

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“Reflections from School Communities in Underserved Populations on Childhood COVID-19 Vaccination” published in Pediatrics

In the July 2023 issue, Pediatrics published Reflections from School Communities in Underserved Populations on Childhood COVID-19 Vaccination. The conclusions section appears below.

School settings offered unique access to youth and family perspectives in underserved communities. Our studies highlighted several factors contributing to COVID-19 vaccine hesitancy in school communities, which align with existing literature on vaccine hesitancy. These concerns centered primarily on potential harm of vaccines, as well as misinformation, mistrust, and timing of vaccines. Related recommendations for increasing vaccination rates are provided. Developing specific strategies that address parent and child concerns will be critical to reducing health inequities related to COVID-19 vaccination.

Global News

“Progress toward Hepatitis B Control and Elimination of Mother-to-Child Transmission of Hepatitis B Virus—World Health Organization African Region, 2016–2021” published in MMWR         

CDC published Progress toward Hepatitis B Control and Elimination of Mother-to-Child Transmission of Hepatitis B Virus—World Health Organization African Region, 2016–2021 on July 21 in MMWR. A portion of the summary appears below. 

In 2019, the World Health Organization African Region (AFR) accounted for 66% of all new chronic hepatitis B virus (HBV) infections. Chronic HBV infection is the leading causes of cirrhosis and liver cancer. . . .

By 2021, all 47 AFR countries provided 3 doses of hepatitis B vaccine (HepB3) to infants, and 14 (30%) provided a birth dose (HepB-BD). By December 2021, 16 (34%) countries achieved ≥90% HepB3 coverage; two (4%) achieved ≥90% timely HepB-BD coverage. Four countries achieved hepatitis B control; none achieved elimination of mother-to-child transmission (EMTCT). . . .

Introduction of HepB-BD, improving HepB3 and HepB-BD coverage, and monitoring implementation of EMTCT interventions are essential to accelerating progress toward hepatitis B control and EMTCT in AFR.

Access the MMWR article in HTML or PDF.

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“The Pan American Health Organization: 120 Years Promoting Public Health in the Region of the Americas” (commentary) published by Pan American Journal of Public Health                       

In the July 14 issue, Pan American Journal of Public Health published The Pan American Health Organization: 120 Years Promoting Public Health in the Region of the Americas. This commentary was written by Jarbas Barbosa da Silva Jr., MD, PhD, director of the Pan American Health Organization. A portion of the article appears below.      

The Region was especially hard hit by the COVID-19 pandemic . . . [yet] our Region worked together to vaccinate more than 700 million people. . . .   

Over the past decades, I have witnessed Member States work in partnership to eliminate measles, rubella, and neonatal tetanus. . . . 

Time and time again, I have found that the key to overcoming our Region’s health challenges is through taking collective actions to find solutions. This requires maintaining close partnerships across country governments and health systems, and openly sharing data, advice, and expertise. 

Upcoming Events

Today! Virtual: North Dakota State University hosts webinar titled “Vaccines under the Microscope: How Can We Know They Are Safe?” on July 26, 1:00 p.m. (ET).

North Dakota State University's (NDSU) Center for Immunization Research and Education (CIRE) will host a webinar titled Vaccines under the Microscope: How Can We Know They Are Safe? at 1:00 p.m. (ET) on July 26. During the event, Paul Carson, MD, FACP, medical director, NDSU CIRE, will provide an in-depth look at the vaccine safety surveillance systems used in the United States.

Submit questions for Dr. Carson at

Register for the webinar
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Virtual: Montgomery County (Pennsylvania) Immunization Coalition hosts webinar titled “Back to School Vaccines” on August 15, 7:00 p.m. (ET)

Montgomery County Immunization Coalition (MCIC) will host its second expert Q&A webinar titled Back to School Vaccines, 7:00–8:00 p.m. (ET) on August 15. With so many vaccine questions, it can be hard to know who or what to believe. Join a panel of healthcare experts for answers to your questions on back-to-school vaccines.

Register for the webinar.

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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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