Issue 1726: November 29, 2023

Immunize​.org remembers vaccine champion Rosalynn Carter and honors her legacy of tireless advocacy in support of immunization. A portion of Vaccinate Your Family's tribute to the former first lady is reprinted below.

When Mrs. Carter co-founded Every Child By Two (now known as Vaccinate Your Family) in 1991, a measles epidemic was raging that had sickened 55,000 people and killed over 120 here in the United States. Within two years, Rosalynn Carter and co-founder Betty Bumpers traveled to more than a dozen states—and ultimately to all 50 states—to foster immunization efforts and build immunization coalitions. It was on these trips that the access barriers to vaccines were uncovered and systemic changes were put into place to ensure that every child was immunized on time.

Carter and Bumpers’ work to bring attention to childhood vaccines at the federal level has been credited as the catalyst behind the Vaccines for Children (VFC) program, which provides access to free vaccines to our nation’s uninsured and underinsured children. Widespread access to childhood vaccines—thanks to the VFC program—will save more than 1 million lives of children vaccinated in the U.S. since the program’s launch in 1994. . . .

Mrs. Carter and Mrs. Bumpers spent decades fighting for and implementing a bipartisan approach to vaccine policy, education, and access that focused on children and prioritized underserved families and communities. Their efforts to secure a Presidential Directive from the White House in 2000 ensures that the children and pregnant people served by WIC [Women-Infants-Children program] are offered immunization screenings and guided to services as needed. . . .

Former First Lady Rosalynn Carter lived a life of service, and we are all better for it. . . .


Above: Betty Bumpers and Rosalynn Carter honor Immunize​.org founder and Executive Director Emerita Dr. Deborah Wexler in 2011 on behalf of Every Child by Two (now Vaccinate Your Family).

Thanks to CDC support, Immunize​.org continues to expand its repository of VIS translations. Recently, Immunize​.org posted Spanish translations for COVID-19 and RSV VISs and the RSV Preventive Antibody Immunization Information Statement (IIS). Twelve additional up-to-date translations of the three documents have now been posted. The following translations are now available:

All translations are available in print-ready PDF format.

The COVID-19 VIS and the RSV preventive antibody IIS are new translations. The RSV VIS was first issued July 24, 2023, and updated October 19 to reflect new pregnancy indications. Check the version date of your office copies of the RSV vaccine translations. Discard translations of the previous RSV VIS version now that a translation of the current version is available.

Navigation Tips

• To view VISs and their translations, go to the Vaccines tab, choose VISs, then choose the vaccine of interest
• To view VIS translations for a specific language, go to the Vaccines tab, choose VIS Translations, then use the Choose Language drop-down box

• Immunize​.org: Vaccine Information Statements overview page for VISs in 47 languages
• Immunize​.org: Dates of Current Vaccine Information Statements (PDF)
• Immunize​.org: VISs: COVID-19 vaccine page
• Immunize​.org: VISs: RSV vaccine page
• Immunize​.org: IIS: RSV preventive antibody page
• CDC: What's New with VISs web page
• CDC: Current VISs web page

National Influenza Vaccination Week (NIVW), observed December 4–8 this year, was established by CDC in 2005 to highlight the importance of continuing influenza vaccination activities through the holiday season and beyond. NIVW is a great time to post and share reminder messages and vaccinate all those who are not yet protected. As vaccination rates fall behind last season, many unvaccinated people risk preventable illness and hospitalization. Get the word out using CDC's 2023 NIVW Digital Media Toolkit, which includes the following assets.

1. Template Matte Release: use CDC’s article to encourage flu vaccination on your website, blog or other channels
2. Sample Newsletter Blurb: include CDC’s sample text copy in your email newsletter or other communications
3. Patient Reminder Messages: remind patients by sharing key messages through your patient portal or other reminders
4. Social Media Messages: use CDC’s suggested Twitter, Facebook, and Instagram graphics and copy to spread the word; schedule content to remind your networks about the importance of flu vaccination throughout the week

CDC encourages everyone to get their annual flu vaccine—especially those with chronic medical conditions and those who are pregnant. Parts of the country are already experiencing significant influenza activity, meaning there’s no time to waste for you, your patients, and your loved ones to be vaccinated against influenza.

Use #FightFlu to join the conversation all week and tag @CDCFlu on Twitter.

Immunize​.org reviewed and updated its popular Ask the Experts: HPV web page, updating disease epidemiology.

Immunize​.org’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. Immunize​.org’s team of experts includes Kelly L. Moore, MD, MPH (team lead), Carolyn B. Bridges, MD, FACP, and Iyabode Beysolow, MD, MPH.

Related Links

• Immunize​.org: Ask the Experts main page with more than 1,200 questions and answers
• Immunize​.org: Ask the Experts: HPV web page

This week’s featured video is Using Enhanced Screening Checklists for Contraindications to Vaccination: What You Need to Know. Four of Immunize​.org’s screening checklists for contraindications to vaccination have been enhanced to screen for a history of vaccination-related dizziness or fainting, and for vaccination-related anxiety. When screening is positive, you can support vaccine recipients with simple techniques to improve the vaccination experience and reduce the risk of fainting. This 3-minute video is part of 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 highlights these clinical resources:

• Screening Checklist for Contraindications to HPV, MenACWY, MenB, and Tdap Vaccines for Teens
• Screening Checklist for Contraindications to Injectable Influenza Vaccination
• Screening Checklist for Contraindications to Vaccines for Adults
• Screening Checklist for Contraindications to Vaccines for Children and Teens

• Facebook at ImmunizeOrg
• Instagram at ImmunizeOrg
• LinkedIn at ImmunizeOrg
• YouTube at ImmunizeOrg
• X (Twitter) at ImmunizeOrg

• To find all of Immunize​.org’s screening checklists, go to the Clinical Resources tab, click on Clinical Resources A–Z, and choose Screening Checklists from the menu options on the right.
• To find all of Immunize​.org’s clinical resources to manage vaccination-related anxiety, go to the Clinical Resources tab, click on Clinical Resources A–Z, and choose Addressing Vaccination Anxiety from the menu options on the right.

• Immunize​.org: YouTube channel
• Immunize​.org: Clinical Resources: Addressing Vaccination Anxiety main page
• Immunize​.org: Improving the Vaccination Experience: Reducing Pain and Anxiety for Children and Adults on-demand webinar (2/28/23)
• Immunize​.org: Improving the Vaccination Experience: Accessible Vaccination for Neurodiverse People at Any Age on-demand webinar (12/13/22)
• Immunize​.org: Clinical Resources: Screening Checklists main page (includes questions to screen for a history of fainting or for vaccination-related anxiety)

These recent articles convey the potential risks of vaccine-preventable diseases and the importance of vaccination.

• Barron’s: Golden Age of Vaccines Is Here. What It Means for You. (11/21/23)
• Nature: Polio Is on the Brink of Eradication. Here’s How to Keep It from Coming Back. (11/21/23)
• STAT: Respiratory Viruses, Thrown Out of Whack by COVID, Appear to Be Falling Back into Seasonal Order (11/20/23)
• WebMD: This Season’s Flu Shot Is Shaping Up to Be Very Effective (11/20/23)
• The Hill: One-Third in New Survey Worried about Catching Flu, COVID, RSV in Next Three Months (11/20/23)
• Washington Post: Seniors Made Up 63 Percent of COVID Hospitalizations Earlier This Year (11/20/23)
• NBC: “Sustained Increases” Reported in Flu Nationwide, as RSV Hits Kids Hard (11/17/23)

We hope you are learning your way around our redesigned website! As noted in last week’s IZ Express, some elements of the site’s search functions are not yet working properly. We are pleased to report that the slow response times to keyword searches and filters is now near normal (about 3 seconds instead of 7 seconds).

We continue to recommend that you start keyword searches only on the “All Questions” page of Ask the Experts or the “Search All Clinical Resources” page of Clinical Resources. In addition, the selection of a filter subcategory will also return everything in the category (not just the subcategory).

We will continue to keep our IZ Express readers up to date as these remaining technical issues are resolved. Thank you for your support.

Related Links

• Immunize​.org: Ask the Experts: View All Questions
• Immunize​.org: Clinical Resources: Search All Clinical Resources

In a break with its tradition of publishing the new annual schedule each February, on November 16, CDC posted the 2024 recommended immunization schedule for children and adolescents on CDC's Immunization Schedules for Healthcare Providers web page. The schedule includes an addendum page (currently empty) that will be filled later as ACIP issues updates to its recommendations throughout 2024. The MMWR publication of the schedule will occur in January. The purpose of publishing the schedule earlier is to allow more time for immunization providers to train and prepare their teams.

The updated schedule for children and adolescents includes:

• Table 1: Recommendations for Ages 18 Years or Younger, United States, 2024
• Table 2: Catch-Up Immunization Schedule for Children and Adolescents Who Start Late or Who Are More than 1 Month Behind
• Table 3: Child and Adolescent Immunization Schedule by Medical Indication

Access the full-color, 15-page PDF of the child/adolescent schedule.

View what changed on the child/adolescent schedule for 2024.

As in previous years, Immunize​.org will produce sturdy, waterproof, laminated copies of these schedules for sale in early 2024. Preordering information will be shared in a special Shop Edition of IZ Express as soon as it is available.

Related Links

• CDC: Schedule-Related Resources for Healthcare Providers web page
• CDC: For You and Your Family: Parent-Friendly Schedules and More Vaccination Resources web page (pending update)
• CDC: Resources for Healthcare Providers web page

In the November 20 issue, JAMA Pediatrics published Multilevel Implementation Strategies for Adolescent Human Papillomavirus Vaccine Uptake: A Cluster Randomized Clinical Trial. The study evaluated the individual and combined impact of two evidence-based interventions on HPV vaccination rates among 11- and 12-year-old children. Parents of eligible patients were mailed reminder or recall messages following their children’s birthdays. Healthcare professionals received confidential feedback on their personal in-office success with HPV vaccine uptake via intracampus mail. A portion of the results section appears below.

Parent reminder/recall resulted in 34.6% receiving a dose of HPV vaccine, health care professional audit/feedback, 30.4%, both interventions together resulted in 39.7%—all contrasted to usual care, 21.9%. Compared with usual care, the odds of HPV vaccination were higher for parent reminder/recall (odds ratio [OR], 1.56 . . .) and for the combination of parent reminder/recall and health care professional audit/feedback (OR, 2.03 . . . ). Health care professional audit/feedback alone did not differ significantly from usual care. . . .

CDC published Risk House-to-House Campaign Administration of Inactivated Poliovirus Vaccine—Sokoto State, Nigeria, November 2022 on November 24 in MMWR. The preliminary conclusions and actions section appears below.

This pilot study demonstrated that administering an injectable vaccine in a house-to-house campaign with needle-free jet injector devices is feasible and can achieve high coverage. Intensification of RI, including increasing immunization sessions, provision of supportive supervision, and ensuring vaccine availability, will be needed to complete vaccination of children in the pilot ward with the second fIPV dose. Additional pilot studies targeting larger populations should be conducted before this approach can be applied in other low-IPV coverage areas.



The map of IPV coverage in Nigeria is shown above. Access the MMWR article in HTML or PDF.

Related Link

• MMWR's main page provides access to the MMWR family of publications