IZ Express

Issue 1748: March 20, 2024

Top Stories
Immunize.org Website and Clinical Resources
Featured Resources
Notable Publications
Top Stories

CDC's Health Alert Network advisory urges clinicians to ensure children in the United States and those traveling internationally are up to date with MMR vaccination

On March 18, CDC issued a Health Alert Network (HAN) Health Advisory Increase in Global and Domestic Measles Cases and Outbreaks: Ensure Children in the United States and Those Traveling Internationally 6 Months and Older are Current on MMR Vaccination. The Summary section is reprinted below.

The Centers for Disease Control and Prevention (CDC) is issuing this Health Alert Network (HAN) Health Advisory to inform clinicians and public health officials of an increase in global and U.S. measles cases and to provide guidance on measles prevention for all international travelers aged ≥6 months and all children aged ≥12 months who do not plan to travel internationally. Measles (rubeola) is highly contagious; one person infected with measles can infect 9 out of 10 unvaccinated individuals with whom they come in close contact. From January 1 to March 14, 2024, CDC has been notified of 58 confirmed U.S. cases of measles across 17 jurisdictions, including seven outbreaks in seven jurisdictions compared to 58 total cases and four outbreaks reported the entire year in 2023. Among the 58 cases reported in 2024, 54 (93%) were linked to international travel. Most cases reported in 2024 have been among children aged 12 months and older who had not received measles-mumps-rubella (MMR) vaccine. Many countries, including travel destinations such as Austria, the Philippines, Romania, and the United Kingdom, are experiencing measles outbreaks. To prevent measles infection and reduce the risk of community transmission from importation, all U.S. residents traveling internationally, regardless of destination, should be current on their MMR vaccinations. Healthcare providers should ensure children are current on routine immunizations, including MMR. Given currently high population immunity against measles in most U.S. communities, the risk of widescale spread is low. However, pockets of low coverage leave some communities at higher risk for outbreaks.

Access the complete CDC HAN Health Advisory.

Remembering the remarkable life of polio survivor, attorney, author, and advocate, Paul Alexander, who spent 72 years in an iron lung

Paul “Polio Paul” Alexander, who spent 72 years in an iron lung after being paralyzed with poliomyelitis in 1952 at age 6, died at age 78 on March 11, a month following a hospital stay for COVID-19. A specific cause of death was not provided. The iron lung has long symbolized the terrifying consequences of polio. Patients in an iron lung lie within a sealed chamber containing a mechanical respirator that moves air in and out of their lungs by rhythmically changing air pressure inside the chamber.

As a child, Mr. Alexander developed the ability to breathe on his own for minutes and later hours at a time. But he spent most of each day inside that machine. The Guinness Book of World Records declared him the longest surviving iron lung patient in the world in March 2023.

Mr. Alexander was known for his positive outlook and accomplishments. He earned a law degree from the University of Texas, practiced law for decades, and wrote a book titled Three Minutes for a Dog: My Life in an Iron Lung. In January 2024, he launched a TikTok channel to share his life and accomplishments and to encourage perseverance in the face of disabilities. He had over 300,000 followers at the time of his death.

He was an advocate for vaccination. As CNN noted, in his first TikTok video, he said, “the millions of children not protected against polio. They have to be, before there’s another epidemic.”

Global efforts to eradicate polio through vaccination continue, fueled by hope of consigning polio and its consequences to the pages of history.

Related Links

“Measles Outbreak—Cook County, Illinois, October–November 2023” published in MMWR

CDC published Measles Outbreak—Cook County, Illinois, October–November 2023 on March 14 in MMWR. The outbreak highlights the extreme contagiousness of measles virus and the critical importance of vaccination to protect all children. A portion of the summary appears below.

During October 5–November 1, 2023, five measles cases occurred in unvaccinated, vaccine-eligible children aged 1–9 years who lived in the same apartment building but did not socialize with one another. During the outbreak, approximately 400 persons were exposed to measles, including 13 children aged <1 year. . . .

Two doses of appropriately spaced MMR vaccine are recommended for all children and other susceptible persons to prevent measles cases and outbreaks.

Access the MMWR article in HTML or PDF.

Related Link

  • CDC: MMWR main page providing access to the MMWR family of publications

Immunize.org updates "Pneumococcus: Questions and Answers"

Immunize.org updated our patient resource Pneumococcus: Questions and Answers. Answers incorporate recommendations for PCV20 vaccine for children and teens. Information about the CDC PneumoRecs Vax Advisor mobile app was added. This easy-to-use app helps healthcare professionals determine the pneumococcal vaccine doses needed for their patients, in accordance with current ACIP recommendations for children and adults.

Related Links

Immunize.org updates “Ask the Experts: HPV” web section

Immunize.org reviewed and updated its popular Ask the Experts: HPV web page, updating disease epidemiology and resource references, as needed.

Immunize.org’s Ask the Experts main page leads you to 30 web pages on various topics with more than 1,300 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

Influenza-like illness activity remains elevated nationally, with increases in some parts of the country; continue to offer flu vaccine

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 10, ending March 9, CDC’s Weekly U.S. Influenza Surveillance Report, FluView shows that 16 jurisdictions experienced persistent high or very high activity. Nationwide, 3.7% 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., ILI). The national baseline is 2.5%. Thirteen pediatric influenza-associated deaths were reported this week, bringing the total to 116 children who died of influenza thus far during the 2023–2024 season.

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 March 9, coverage estimates for pregnant persons 18 to 49 years for the 2023–2024 season are 2.3 percentage points lower this season compared with the same time last season (38.5% compared with 40.8%).

CDC recommends everyone age 6 months and older get annual influenza vaccination. Influenza and other vaccines (including COVID-19 and RSV vaccines) may be given at the same visit, if indicated. Infants age 6 months 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.

Related Links

“What Do I Do for Adult Patients Who Don’t Have Records of HepB Vaccination, but Are Sure They Were Vaccinated?” Watch the 2-minute answer, part of the Ask the Experts Video Series on YouTube.

This week, our featured episode from the Ask the Experts Video Series is What Do I Do for Adult Patients Who Don’t Have Records of HepB Vaccination, but Are Sure They Were Vaccinated? The video briefly shares CDC’s General Best Practice Guidelines for Immunization which state that, in general, you should only accept written records as proof of vaccination. If the person’s recollection is wrong, and the person is susceptible, then not vaccinating leaves them at ongoing risk.

The 2-minute video 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: Six popular Immunize.org handouts now available in seven additional languages

Barriers to vaccination come down when patients have access to information about vaccines in their preferred language. For this reason, Immunize.org posted seven translations of six of our popular patient handouts. The following tables provide direct links to the translations for each resource. Please download and use these with your patients.

All translations are available in print-ready format.

Recap: Immunize.org updates “Vaccines with Diluents: How to Use Them” resource for vaccinators

Immunize.org recently updated Vaccines with Diluents: How to Use Them to incorporate Valneva's Ixchiq vaccine to prevent disease caused by the chikungunya virus.

Related Links

Recap: Immunize.org updates “Screening Checklist for Contraindications to HPV, MenACWY, MenB, and Tdap Vaccines for Teens” handout for parents and guardians

Immunize.org recently updated its parent handout, Screening Checklist for Contraindications to HPV, MenACWY, MenB, and Tdap Vaccines for Teens, to note that RSV vaccine is recommended during pregnancy, along with other vaccines indicated during pregnancy.

Related Links

Featured Resources

Place your order! Sturdy, laminated versions of the 2024 U.S. immunization schedules from Immunize.org now shipping.

Laminated versions of the 2024 U.S. child and adolescent immunization schedule and the 2024 U.S. adult immunization schedule are now available for order in the Immunize.org shop. The schedules are shipping now.

While the schedules are available online from CDC at no cost, Immunize.org’s printed, laminated booklets are ideal for use in any busy healthcare setting where vaccinations are given.

  • Durable: their tough coating can be wiped down, and they’re durable enough to stand up to a year's worth of use
  • Format: each schedule is produced in a 16-page, 8.5” X 11” booklet format; with color coding for easy reading, our laminated schedules replicate the original CDC formatting, including all tables and notes
  • Easy access to CDC updates: CDC added an online addendum page to the schedule, where new recommendations from ACIP made during 2024 can be posted. The laminated schedule addendum pages include custom QR codes you can scan to view or print the current CDC addendum from CDC's website, as needed.
  • Adult schedule bonus content: the adult schedule includes a bonus page with Immunize.org’s popular 1-page handout summarizing the dose, route, and needle size recommendations for all vaccines and recipients


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

Visit the Shop Immunize.org: Laminated Schedules web page to view images of all the pages, to download the order form, and to order today!

For additional information, call 651-647-9009 or email admininfo@immunize.org.

Related Links

Updated 65+ Flu Defense website offers resources for healthcare professionals serving older adults

Confident recommendations for influenza vaccine from healthcare providers are powerfully persuasive. To assist you in maximizing protection for your patients, Immunize.org, in collaboration with CSL Seqirus, updated the 65+ Flu Defense website.

Older adults are at increased risk of severe influenza and COVID-19 illness, including hospitalization and death, especially if they are not up to date on these vaccinations. An updated fact sheet on the website, The Importance of Preventing Influenza and COVID-19, offers responses to help guide discussions with patients on the importance of preventing influenza and COVID-19.

This helpful site includes information, tools, and tips for communicating with adults age 65 and older about the scope and severity of influenza. Resources include:

Notable Publications

"The Role of COVID-19 Vaccines in Preventing Post-COVID-19 Thromboembolic and Cardiovascular Complications" published in Heart

In the January 24 issue, Heart published The Role of COVID-19 Vaccines in Preventing Post-COVID-19 Thromboembolic and Cardiovascular Complications. The study included 10.17 million vaccinated and 10.39 million unvaccinated people. Vaccination was associated with reduced risks of heart failure (HF), venous thromboembolism (VTE), and arterial thrombosis/thromboembolism (ATE) after SARS-CoV-2 infection. The effect was greatest for the first 30 days after SARS-CoV-2 infection but persisted for the year after SARS-CoV-2 infection for HF and VTE.

In summary:

  • COVID-19 vaccination reduced the risk of post-COVID-19 cardiac and thromboembolic outcomes
  • These effects were more pronounced for acute COVID-19 outcomes, consistent with known reductions in disease severity following SARS-CoV-2 infection among vaccinated people compared to unvaccinated people

To see a graphic display of the results, see this figure.

"The Effectiveness of COVID-19 Vaccines to Prevent Long COVID Symptoms: Staggered Cohort Study of Data from the UK, Spain, and Estonia" published in Lancet Respiratory Medicine

In the January 11 issue, Lancet Respiratory Medicine published The Effectiveness of COVID-19 Vaccines to Prevent Long COVID Symptoms: Staggered Cohort Study of Data from the UK, Spain, and Estonia. The interpretation and added value sections appear below.

Vaccination against COVID-19 consistently reduced the risk of long COVID symptoms, which highlights the importance of vaccination to prevent persistent COVID-19 symptoms, particularly in adults. . . .

To our knowledge, this is the first multinational study to assess population-level vaccine effectiveness to prevent long COVID symptoms. Our study of more than 10 million vaccinated people and 10 million unvaccinated people, showed that COVID-19 vaccination reduces the risk of developing long COVID. Our findings were consistent across three different European countries and four databases, covering different health-care settings and national health-care policies. All vaccines reduced the risk of developing long COVID symptoms, with BBNT162b2
[the mRNA vaccine from Pfizer-BioNTech] showing slightly better effectiveness than ChAdOx1 [the adenovirus-vector vaccine from AstraZeneca, not distributed in the United States].

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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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