IZ Express

Issue 1722: November 8, 2023

Top Stories
Featured Resources
Notable Publications
Upcoming Events
Top Stories

Immunize.org is launching a redesigned website with new features to better serve you

Immunize.org announces the launch of our redesigned Immunize.org flagship website in the next 24 hours. Our new site will feature enhanced navigation while continuing to provide the timely, accurate resources developed and refined during our 32 years of experience providing educational support to public health professionals and the nurses, physicians, pharmacists, and medical assistants who administer vaccines.
You will continue to find:

  • Curated links to the latest clinical resources
  • Vaccination guidance from CDC, FDA, and major professional organizations
  • VIS translations in numerous languages
  • More than 1,200 Ask the Experts answers to practical clinical questions about vaccines
  • Access to your bookmarked materials—all of our links remain the same 
Our redesign streamlines navigation and enhances searchability on mobile devices and desktops. We’ve made it much easier for you to find exactly what you need.
New features of the redesigned Immunize.org website:
  • A homepage navigation guide to introduce you to new search options
  • New mobile responsive design: comfortable viewing and navigation from your phone 
  • Enhanced search tools: use built-in filters or enter keywords and phrases to narrow your search
  • Filters and keyword searches within our Ask the Experts question database
  • Featured resources showcased at a glance on our home page
  • A streamlined subscription process for IZ Express

Immunize.org's updated site goes live by November 9, and is designed to continue to support our longtime users while simplifying access to our resources by new visitors and the next generation of frontline vaccinators.
We hope our new site will make it easier for you to vaccinate with confidence. Explore it soon! We look forward to hearing what you think.

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Immunize.org posts new standing orders templates for use of RSV vaccine during pregnancy and RSV preventive antibody for infants

In recent weeks, ACIP has made routine recommendations for the prevention of RSV in infancy through either maternal RSV vaccination or infant immunization with nirsevimab preventive antibody. Immunize.org now offers two new standing orders templates: one for RSV vaccination during pregnancy, and one for nirsevimab for infants. The nirsevimab standing order template reflects the revised guidelines for eligibility for the 2023–24 season issued by CDC on October 23 in its Health Alert Network advisory concerning the shortage of nirsevimab in its initial season. The templates are: 


Related Links

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Immunize.org incorporates COVID-19 and RSV vaccine considerations in its popular child and adult screening checklists for contraindications to vaccines 

Immunize.org’s popular screening checklists for contraindications to vaccines for both children and adults have been updated to incorporate COVID-19-specific contraindications and precautions. The checklists may also be used for RSV vaccine. The screening checklists are: 


Related Links

“Addressing Vaccination Anxiety for Infants: Strategies for Vaccine Recipients and Caregivers”: watch the 3-minute video, part of the Improving the Vaccination Experience Video Series on YouTube

This week’s featured video shares how parents and caregivers can help infants better cope with vaccination distress in our 3-minute video, Addressing Vaccination Anxiety for Infants: Strategies for Vaccine Recipients and Caregivers, from Immunize.org’s new Improving the Vaccination Experience Video Series. It is available on our YouTube channel, along with our full collection of quick video answers to popular Ask the Experts questions.

This week's featured video focuses on our new 1-page resource for parents of infants: Addressing Vaccination Anxiety for Infants and Toddlers: Strategies for Parents and Caregivers.

Immunize.org’s series of short videos introduces you to different ways to improve the vaccination experience for infants, children, teens, and adults. Three are for a general audience, and three are for healthcare professionals. As with all Immunize.org resources, these videos are free to download, link, copy, and share.

Like, follow, and share Immunize.org’s social media accounts and encourage colleagues and others interested in vaccination to do likewise: Related Links
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FDA advises healthcare providers about administering correct dosage of Moderna COVID-19 Vaccine (2023–2024 Formula) to children age 6 months through 11 years

On November 1, FDA advised healthcare providers who administer Moderna COVID-19 Vaccine (2023–2024 Formula) to children age 6 months through 11 years to ensure that the correct volume of the vaccine (0.25 mL) is withdrawn from the vial to give to the vaccine recipient. A portion of the news release appears below.

FDA has become aware that some healthcare providers may not recognize that the single dose vial of Moderna COVID-19 Vaccine (2023–2024 Formula) for use in individuals 6 months through 11 years of age contains notably more than 0.25 mL of the vaccine.  Some healthcare providers may be withdrawing the entire contents of the vial to administer to an individual. However, the volume of a single dose of Moderna COVID-19 Vaccine (2023–2024 Formula) is only 0.25 mL.

Read the full news release.

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Institute for Safe Medication Practices warns of potential for vaccine errors related to packaging; remind staff of safety steps

The Institute for Safe Medication Practices (ISMP) warned of potential for errors involving manufacturer-filled syringes (MFS) in its October 19 issue of ISMP Medication Safety Alert. ISMP is a federally listed Patient Safety Organization. The error reports involve the following:

  • Inadequate labeling: MFS of diluent intended for reconstituting vaccine doses are typically labeled "diluent for reconstitution." Instructions for use call for the reconstituted vaccine to be drawn back into the syringe. Once drawn back into the syringe, reconstituted vaccine is indistinguishable from diluent alone unless the user adds a label to the syringe to indicate its contents. Products vulnerable to this problem include:
    • Merck's M-M-R II (MMR), Varivax (varicella), and ProQuad (MMRV)
    • GSK's Priorix (MMR)
    • Pfizer's Abrysvo (RSVpreF)
  • Using the wrong diluent: Instead of the sterile water diluent provided by the manufacturer, liquid influenza vaccine was placed into a vial of lyophilized RSV vaccine. Other lyophilized vaccines could be vulnerable to similar errors.

To prevent these errors, take the following steps:

  • Familiarize your staff with vaccine packaging and show them how lack of labels or look-alike packaging could predispose to errors
  • Create vaccine-specific auxiliary labels to make adding a label easy. Store these labels with relevant products.
  • Keep vaccines and corresponding diluents together whenever storage requirements permit
  • If patients need multiple vaccines, start with the vaccine that needs reconstitution. After preparing and labeling that dose, retrieve and prepare the other vaccines.
  • Invest time training all staff on new products and new staff on all products
  • Provide adequate lighting and counter space
  • Encourage distraction-free zones 

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“Vaccination Coverage by Age 24 Months among Children Born in 2019 and 2020—National Immunization Survey-Child, United States, 2020–2022” published in MMWR 

CDC published Vaccination Coverage by Age 24 Months among Children Born in 2019 and 2020—National Immunization Survey-Child, United States, 2020–2022 on November 3 in MMWR. A portion of the summary appears below. 

The Advisory Committee on Immunization Practices recommends vaccines against 15 potentially serious diseases by the age of 24 months. . . .

Estimated coverage with most childhood vaccines was similar among children born during 2019–2020 compared with those born during 2017–2018, with only a few exceptions. Disparities in coverage by race and ethnicity, poverty status, insurance status, and urbanicity persist, with a widening of the gap among some subgroups evident over time. . . .

Universal and equitable access to vaccination will require overcoming economic, logistic, and attitudinal obstacles to ensure that all children are protected from vaccine-preventable diseases.

Access the MMWR article in HTML or PDF.

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Immunize.org updates "Vaccinations Needed during Pregnancy" patient handout to include RSV prevention

Immunize.org, in partnership with American College of Obstetricians and Gynecologists (ACOG), updated Vaccinations Needed during Pregnancy, a 1-page handout for patients. This patient education resource now includes the need for RSV prevention through maternal vaccination or infant immunization. It also addresses the need for hepatitis B screening during every pregnancy, and routine HepB vaccination of unvaccinated, susceptible pregnant people. Download and share this important resource with pregnant patients.


Related Links

Review your COVID-19 resources with the latest version of Immunize.org’s “Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools”

Immunize.org reviews and updates the Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools at least monthly, prominently indicating when it was last revised at the top of the page. Changes on the November 6 version include the addition of the new COVID-19 mRNA VIS.

All COVID-19 vaccine providers should review the checklist regularly and download the latest CDC schedule and standing order documents. The checklist is posted on Immunize.org's Vaccines: COVID-19 main page to help practices stay up to date.

Related Links

Veterans Day is November 11. Encourage more veterans to protect themselves with new Health.mil’s seasonal respiratory illness vaccine communication toolkit.

Veteran's Day is observed on November 11. Encourage our service members, veterans, and their families to protect themselves from preventable health threats this year with communications resources from the Health.mil Seasonal Respiratory Illness Vaccine Toolkit: Influenza, COVID-19, and Respiratory Syncytial Virus. The toolkit offers many images with recommended content for quick and easy posting on social media.

View toolkit.

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Influenza activity is low nationally but continues to increase in most parts of the country; encourage vaccination now

CDC’s Weekly U.S. Influenza Surveillance Report, FluView, provides a valuable snapshot of influenza activity state-by-state.

Influenza Surveillance
For week 43, ending October 28, CDC’s Weekly U.S. Influenza Surveillance Report, FluView shows that, nationwide, 2.7% of patient visits reported through the Outpatient Influenza-Like Illness Surveillance Network (ILINet) 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%. The first influenza-associated pediatric death of the current season was reported.

Visit the CDC Respiratory Virus Hospitalization Surveillance Network (RESP-NET) for weekly reports of hospitalizations across the United States due to three vaccine-preventable seasonal respiratory viruses: COVID-19, influenza, and RSV.

Influenza Vaccination Dashboard
CDC's Weekly Flu Vaccination Dashboard shows that as of October 14, an estimated 19 million doses of flu vaccine were administered in pharmacies, and an estimated 10 million doses were administered in medical offices.

CDC recommends everyone age 6 months and older get annual influenza vaccination. Influenza and other vaccines (e.g., COVID-19 vaccine, RSV vaccine) may be given at the same visit, if needed. Locate influenza and COVID-19 vaccines in your area by entering your zip code in the VaccineFinder on Vaccines.gov or Vacunas.gov. To be listed as a provider by VaccineFinder, see the information on this website.

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Journalists interview Immunize.org experts

Journalists seek out Immunize.org 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

CDC updates its website on how to implement ACIP’s shared clinical decision-making recommendations, including links to job aids for vaccinators

CDC updated its Shared Clinical Decision-Making Recommendations (SCDM) web page, which includes links to job aids for vaccinators. The website also includes answers to frequently asked questions to clarify the ACIP’s shared clinical decision-making recommendations.

Related Links

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CDC adds customizable frames for “Wild to Mild” social media campaign to promote influenza vaccination  

CDC's Wild to Mild social media images are a lighthearted way to promote influenza vaccination. CDC now offers customizable graphic frames you can add to your photos, sample social media graphics, and printable materials. 

Encourage your patients, friends, loved ones, and followers on social media to get themselves and their families an annual influenza vaccine with social media graphics and customizable frames.

Download the social media frames and social media graphics.

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Hepatitis B Foundation releases guide for implementation of adult universal hepatitis B vaccination and screening 

The Hepatitis B Foundation issued a 17-page document titled Guidance on the Clinical Implementation of Adult Universal Hepatitis B Vaccination and Screening. The document contains a summary of the updated recommendations, strategies for implementation in different settings, downloadable resources and handouts for providers, and connections to helpful patient and clinical resources. 

View and download a copy of the document

Related Links

NFID posts podcast episode featuring Peter Marks, PhD, MD, of the FDA

Infectious IDeas, a podcast series from the NFID, brings leading experts together for thought-provoking conversations. The latest entry in the series, Operation Warp Speed: Transforming Disease Prevention, features Peter Marks, PhD, MD. A description from the web page appears below.

In this episode, hosts Marla Dalton, PE, CAE, and William Schaffner, MD, talk with Peter Marks, MD, PhD, director of the Center for Biologics Evaluation and Research (CBER) at the US Food and Drug Administration. He shares his insights on the origin of Operation Warp Speed during the COVID-19 pandemic, efforts to transform the FDA approach to approval and licensure of new vaccines and other prevention tools, and his thoughts on how artificial intelligence can improve future work in disease prevention.

Notable Publications

“A Prospective Cohort Study of Preconception COVID-19 Vaccination and Miscarriage” published in Human Reproduction

In the October 20 issue, Human Reproduction published A Prospective Cohort Study of Preconception COVID-19 Vaccination and Miscarriage. A portion of the abstract appears below. 

Among 1815 eligible female participants, 75% had received at least one dose of a COVID-19 vaccine by the time of conception. Almost one-quarter of pregnancies resulted in miscarriage, and 75% of miscarriages occurred <8 weeks’ gestation. . . . COVID-19 vaccination was not associated with increased risk of either early miscarriage (GW [gestational week]: <8) or late miscarriage (GW: 8–19). There was no indication of an increased risk of miscarriage associated with male partner vaccination.

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Upcoming Events

Virtual: Children’s Hospital of Philadelphia hosts Current Issues in Vaccines webinar titled “Making the Broadest, Longest-Lasting COVID-19 Vaccine” on December 6 at 12:00 p.m. (ET); CE credit offered

The Vaccine Education Center (VEC) at Children's Hospital of Philadelphia (CHOP) will present a 1-hour webinar titled Making the Broadest, Longest-Lasting Covid-19 Vaccine beginning at 12:00 p.m. (ET) on December 6. Part of its Current Issues in Vaccines series, the webinar will feature Paul Offit, MD, director of the VEC.

Free continuing education credits (CME, CEU, and CPE) will be available for both the live and archived events.

Register for the webinar.

Virtual: Clinical Care Options hosts webinar “Ready, Set, Vaccinate! Clinical Implementation of RSV Vaccination for Older Adults” on December 6 at 12:30 p.m. (ET); CE credit offered 

Clinical Care Options will host a webinar titled Ready, Set, Vaccinate! Clinical Implementation of RSV Vaccination for Older Adults, 12:30–2:00 p.m. (ET) on December 6. This webinar, sponsored by GSK, is intended to improve healthcare professionals’ knowledge and competence regarding RSV infections and vaccines for older adults, including burden of disease, clinical manifestations, risk factors for severe disease, vaccine candidacy, and overcoming vaccination barriers.

Free CME, CE, and CPE credits offered.

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 Immunize.org and do not necessarily represent the official views of CDC.

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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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