IZ Express

Issue 1733: December 20, 2023

Top Stories
Immunize.org Website and Clinical Resources 
Vaccine Information Statements
Notable Publications
Upcoming Events

Top Stories

CDC's Health Alert Network advisory urges clinicians to increase use of immunizations and therapeutics for influenza, COVID-19, and RSV

On December 14, CDC issued a Health Alert Network (HAN) Health Advisory titled Urgent Need to Increase Immunization Coverage for Influenza, COVID-19, and RSV and Use of Authorized/Approved Therapeutics in the Setting of Increased Respiratory Disease Activity during the 2023–2024 Winter Season. The Summary section is reprinted below.

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to alert healthcare providers to low vaccination rates against influenza, COVID-19, and RSV (respiratory syncytial virus). Low vaccination rates, coupled with ongoing increases in national and international respiratory disease activity caused by multiple pathogens, including influenza viruses, SARS-CoV-2 (the virus that causes COVID-19), and RSV, could lead to more severe disease and increased healthcare capacity strain in the coming weeks. In addition, a recent increase in cases of multisystem inflammatory syndrome in children (MIS-C) following SARS-CoV-2 infection in the United States has been reported. Healthcare providers should administer influenza, COVID-19, and RSV immunizations now to patients, if recommended. Healthcare providers should recommend antiviral medications for influenza and COVID-19 for all eligible patients, especially patients at high-risk of progression to severe disease such as older adults and people with certain underlying medical conditions. Healthcare providers should also counsel patients about testing and other preventive measures, including covering coughs/sneezes, staying at home when sick, improving ventilation at home or work, and washing hands to protect themselves and others against respiratory diseases.

Access the complete CDC HAN Health Advisory.

Immunize.org updates its staff training resource “Skills Checklist for Vaccine Administration”

Immunize.org updated its staff training resource, Skills Checklist for Vaccine Administration, a tool to help supervisors assess staff members' competencies. Changes include the addition of web links to CDC's "You Call the Shots" web-based training course and Immunize.org’s resources on vaccination anxiety. Vaccine preparation procedures were updated on how to check dating and labeling, including the beyond-use-date. A QR code linking to the online version of the document was added.

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Immunize.org updates two patient handouts: “Immunizations for Babies: A Guide for Parents” and “Human Papillomavirus (HPV): Questions and Answers”

Immunize.org staff recently reviewed and updated two of its resources, Immunizations for Babies: A Guide for Parents and Human Papillomavirus (HPV): Questions and Answers. Changes are described below.


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16th National Conference for Immunization Coalitions and Partnerships seeks nominations for 2024 recognition awards; deadline is February 9

The 16th National Conference for Immunization Coalitions and Partnerships (NCICP) is soliciting nominations for the 2024 recognition awards no later than February 9, 2024.

Nominate an immunization champion who is passionate about vaccines and who has worked to increase immunization rates in their community. Awards will be given in five categories:

  • Immunization Leadership
  • Equity in Immunization
  • Excellence in Immunization Advocacy
  • Excellence in Immunization Collaboration
  • Emerging Leader

Awards will be given during a luncheon at the 2024 NCICP Conference, April 9–11, in Philadelphia. Winners do not need to be present to accept their award.

Access the 2024 NCICP award nomination form.

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High and rising influenza-like illness rates support urgent need to vaccinate now

CDC’s Weekly U.S. Influenza Surveillance Report, FluView, provides a valuable picture of laboratory-confirmed influenza and influenza-like-illness activity state by state.

Influenza Surveillance
For week 49, ending December 9, CDC’s Weekly U.S. Influenza Surveillance Report, FluView shows that seasonal influenza activity is elevated in most parts of the country. Nationwide, 4.4% 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%. Two pediatric deaths were reported this week, bringing the total to 14 influenza-associated pediatric deaths during the 2023–24 season. Given the high ILI activity, low vaccination rates, and the 1 to 2 weeks it takes for vaccination to be fully effective, it’s crucial to vaccinate as soon as possible to reduce the strain on the healthcare system this winter.

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. Activity levels of each of these diseases are rising but are currently lower than during week 47 of 2022, when respiratory virus activity peaked remarkably early.

Influenza Vaccination Dashboard
CDC's Weekly Flu Vaccination Dashboard shows the most recent data available on flu vaccine administration. Vaccine uptake appears to be lagging behind this time in 2022. Of note, coverage for all children is 4.1 percentage points lower this season compared with the same time last season (41.6% compared with 45.8%) and coverage for pregnant people is 2.1 percentage points lower (33.9% vs 36.0%). 

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. Infants 6 months of age and older may receive influenza and COVID-19 vaccines at the same visit when they receive the RSV preventive antibody, nirsevimab. 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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“Why Should Healthcare Professionals Focus on Vaccinating All Adults against Hepatitis B Now?”: watch the 2-minute answer, part of the Ask the Experts Video Series on Facebook, LinkedIn, X, YouTube, and Instagram 

This week, our featured episode from the Ask the Experts Video Series answers the question: Why Should Healthcare Professionals Focus on Vaccinating All Adults against Hepatitis B Now? The 2-minute video describes the risk of hepatitis B, even among people who may not realize they are at risk, and the importance of universal vaccination as a safe and effective way to reach the goal of eliminating hepatitis B and the liver disease and cancer it causes. It is available on our YouTube channel, along with our full collection of quick video answers to popular Ask the Experts questions.

Like, follow, and share Immunize.org’s social media accounts and encourage colleagues and others interested in vaccination to do likewise:

Vaccines in the news

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

Immunize.org Website and Clinical Resources

Recap: Immunize.org posts translations in 11 additional languages for COVID-19 and RSV VISs, and RSV Preventive Antibody Immunization Information Statement 

Thanks to CDC support, Immunize.org continues to expand its repository of VIS translations. Last week, Immunize.org posted up-to-date translations in 11 more languages for COVID-19 and RSV VISs and the RSV Preventive Antibody Immunization Information Statement (IIS). The following table shows the languages available; the 11 new language translations appear in bold print.

All translations are available in print-ready PDF format.

COVID-19 Vaccine VIS         RSV Vaccine VIS for Adults       RSV Preventive Antibody IIS 
Arabic Arabic Arabic
Burmese Burmese Burmese
Armenian Armenian Armenian
Chinese–Simplified  Chinese–Simplified  Chinese–Simplified 
Chinese-Traditional Chinese-Traditional Chinese-Traditional
Farsi Farsi Farsi
French French French
German German German
Hindi Hindi Hindi
Italian Italian Italian
Japanese Japanese Japanese
Khmer Khmer Khmer
Korean Korean Korean
Pashto Pashto Pashto
Polish Polish Polish
Russian Russian Russian
Somali Somali Somali
Spanish PDF and RTF  Spanish PDF and RTF  Spanish PDF and RTF 
Swahili Swahili Swahili
Tagalog Tagalog Tagalog
Ukrainian Ukrainian Ukrainian
Urdu Urdu Urdu
Vietnamese  Vietnamese  Vietnamese 
Yiddish Yiddish Yiddish

To ensure you have the current translations, click on Vaccines & VISs at Immunize.org, then click on VISs, then select a specific vaccine. Scrolling down the resulting page, you will see the current English version, a list of languages with current translations (i.e., corresponding to the current English VIS), and then, if applicable, a list of any additional languages with out-of-date (yet best available) translations. Additional tips on using VISs appear at the bottom of the page.

For example, the RSV VIS page shows the English VIS dated October 19, 2023, then 23 languages with translations based on that October 19 version, and then five additional languages with out-of-date (yet best available) translations of the July 24, 2023, English version.

Check the version date of your inventory of VIS translations. Discard translations of previous versions as translations of current versions become available.

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Recap: Immunize.org updates parent handout "When Do Children and Teens Need Vaccinations?" to include RSV preventive antibody

Immunize.org recently updated When Do Children and Teens Need Vaccinations? handout to include a new column for RSV preventive antibody and an explanatory note. A QR code linking to the online version of the document was also added.

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Recap: Immunize.org updates "How to Administer Multiple Intramuscular Vaccines to Adults during One Visit" 

Immunize.org recently updated How to Administer Multiple Intramuscular Vaccines to Adults during One Visit to incorporate RSV into the list of vaccines commonly administered to adults.

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Recognize talented team members with Immunize.org’s “Save Lives. Immunize.” branded T-shirts and pins

Show your vaccination support with Immunize.org's new "Save Lives. Immunize." branded T-shirts and pins. 

Immunize.org is pleased to offer new T-shirts in three different designs (unisex, women’s, and baseball). Each T-shirt features our logo on the front and, on the back, our tag line: “Save Lives. Immunize.” These T-shirts are fashioned in a super soft, premium tri-blend fabric that doesn’t shrink or wrinkle with washing. Designed with frontline vaccinators in mind, they pair perfectly with scrub pants for vaccination clinics and make a pro-vaccine statement whenever you or your team want to show your support for immunization. Perfect for the gym, clinic, or anywhere you like!

Click the pictures for more detailed information and to place your order.

Immunize.org's gold and black enamel “Vaccines Save Lives” pins are meaningful gifts for people who value vaccination. The pin makes a refined statement in black enamel with gleaming gold lettering and edges, measuring 1.125" x 0.75".

Our pin features a stick-through-post design. The post is covered by a round rubber cap that holds the pin securely. A gold metal spring-lock clasp is also provided.

These pins are a striking statement of vaccination support. Wear these pins on lab coats, uniforms, or street clothes to show that you value vaccines.


Click here for "Vaccines Save Lives" pin pricing and ordering information.

Related Link
Vaccine Information Statements

Recap: CDC releases Tick-Borne Encephalitis VIS

On December 7, CDC released the first VIS for tick-borne encephalitis. Immunize.org added the Tick-Borne Encephalitis (TBE) VIS to our website. TBE vaccine is indicated for certain travelers at risk of tick exposure in regions of central Europe or Asia where TBE is endemic.

Immunize.org updated its corresponding reference documents related to the use of VISs:

Related Links

Notable Publications

“What U.S. Obstetricians Need to Know about Respiratory Syncytial Virus” published in Obstetrics and Gynecology

In the December 8 issue, Obstetrics and Gynecology published What U.S. Obstetricians Need to Know about Respiratory Syncytial Virus. The abstract section appears below.

Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infections in neonates, infants, and children worldwide. The virus is estimated to infect 97% of this population in the United States by the age of 2 years, leading to hospitalization for severe lower respiratory tract disease in 2–3% of infants younger than age 6 months. Two preventive options, prenatal administration of a maternal vaccine and administration of a long-acting monoclonal antibody to the infant, are now available for the prevention of RSV-associated lower respiratory tract infection in infants in the United States. The U.S. Food and Drug Administration (FDA) has approved and the Centers for Disease Control and Prevention (CDC) has recommended a new maternal vaccination, RSVPreF, to be administered between 32 0/7 and 36 6/7 weeks of gestation to reduce the risk of RSV-associated lower respiratory tract infection in infants in the first 6 months of life. The monoclonal antibody nirsevimab was approved by the FDA and recommended by the CDC for prevention of RSV-associated lower respiratory tract infection in infants younger than age 8 months who are born during or entering their first RSV season and for infants and children aged 8–19 months who are at high risk for RSV-associated lower respiratory tract infection and entering their second RSV season. Either maternal vaccination during pregnancy or monoclonal antibody administration to the infant is recommended to prevent RSV-associated lower respiratory tract infection among infants, but both are not needed for most infants. Given that the availability of these products may vary as these recommendations are implemented, it is important that obstetricians and other prenatal practitioners have the information they need to counsel their pregnant patients about both options. We review the safety and efficacy of these products, current recommendations for their use, and relative advantages and disadvantages of both newly approved options for the prevention of RSV-associated lower respiratory tract infection in infants to assist obstetricians and other prenatal practitioners in their counseling of pregnant patients.

“Motivational Interviewing for Maternal Immunizations: Intervention Development” published in Vaccine

In the December 12 issue, Vaccine published Motivational Interviewing for Maternal Immunizations: Intervention Development. A portion of the results section appears below.

Three virtual, asynchronous training components were created: a video and two interactive modules. This virtual format was favored due to challenges attending group meetings; however, participants noted opportunities to practice skills through role-play were lacking. Training modules were adapted to include common challenging vaccine conversations and live-action videos. Participants liked interactive training components and use of adult learning strategies. Some participants initially resisted the presumptive approach but later found it useful after applying it in their practices. Overall, participants reported that MI4MI [Motivational Interviewing for Maternal Immunizations] training fit well with the prenatal context and recommended more inclusion of non-clinician staff.

"Maternal Varicella Antibodies in Children Aged Less than One Year: Assessment of Antibody Decay" published in PLoS ONE

In the November 10 issue, PLoS ONE published Maternal Varicella Antibodies in Children Aged Less than One Year: Assessment of Antibody Decay. The conclusions section appears below.

We found that varicella maternal antibody levels wane rapidly in infants, leaving most infants susceptible by four months of age. Our findings have implications for the timing of first dose of varicella-containing vaccine, infection control measures, and infant post-exposure prophylaxis recommendations.

"Influenza Vaccine Effectiveness against Influenza-A-Associated Emergency Department, Urgent Care, and Hospitalization Encounters among U.S. Adults, 2022–2023" published in Journal of Infectious Diseases

In the December 2 issue, Journal of Infectious Diseases published Influenza Vaccine Effectiveness against Influenza-A-Associated Emergency Department, Urgent Care, and Hospitalization Encounters among U.S. Adults, 2022–2023. This study estimated that influenza vaccination reduced the risk of flu-related emergency department and urgent care (ED/UC) visits by almost half and hospitalizations by more than a third among U.S. adults during the 2022–2023 season. In this analysis, flu vaccination reduced the risk of influenza-A-associated hospitalizations by 35% and ED/UC visits by 44%, with vaccine effectiveness varying by age group and care setting as follows:

  • People age 18–64 years who were vaccinated were 23% less likely to be hospitalized with flu
  • People age 65 years and older who were vaccinated were 41% less likely to be hospitalized with flu
  • Similar vaccine effectiveness (VE) was also observed among hospitalized groups of people who are at higher risk for severe complications from flu, including:
    • Older adults
    • Those with immunocompromising conditions
    • Those with multiple underlying chronic medical conditions
Emergency Department or Urgent Care
  • VE against ED/UC encounters was similar among people age 18–64 years (45%) and age 65 years and older (41%)
  • VE against ED/UC encounters was also similar among those without and with immunocompromising conditions (44% and 38%, respectively)

Even in seasons with moderate vaccine effectiveness like the 2022–2023 season, flu vaccination is likely to prevent millions of flu-related medical visits, tens of thousands of hospitalizations, and thousands of deaths.

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"Maternal Vaccine Effectiveness against Influenza-Associated Hospitalizations and Emergency Department Visits in Infants” published in JAMA Pediatrics

In the December 18 issue, JAMA Pediatrics published Maternal Vaccine Effectiveness against Influenza-Associated Hospitalizations and Emergency Department Visits in Infants. The study showed that influenza vaccination during pregnancy protected infants against flu-related hospitalizations and emergency department (ED) visits in the first 6 months of life, when infants were too young to be vaccinated themselves.
Other key findings from the JAMA Pediatrics study included:

  • Flu vaccination during pregnancy reduced flu hospitalizations and ED visits in infants younger than 6 months by about 40% and 20%, respectively
  • Flu vaccination during pregnancy provided the greatest protection to infants during their first three months of life, reducing the risk of flu-related hospitalizations or ED visits by half in this age group


Share these findings widely to help encourage pregnant people to get a flu vaccine this season.

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Upcoming Events

Happy holidays from everyone at Immunize.org! IZ Express will return on January 10.

Thank you for making this a great year for IZ Express, which now serves 55,000 subscribers each week. May 2024 bring you and your loved ones peace, health, and happiness.

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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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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