Issue 1835: October 1, 2025

Influenza-associated encephalopathy (IAE) is a rare, severe neurologic complication of influenza. . . .

During the high-severity 2024–25 influenza season, 109 U.S. pediatric IAE cases were identified; 55% of affected children were previously healthy. Thirty-seven IAE cases were subcategorized as acute necrotizing encephalopathy (ANE), a severe form of IAE characterized by rapid neurologic decline and a poor prognosis. Overall, 74% of IAE patients were admitted to an intensive care unit, and 19% died; 41% of ANE patients died. Only 16% of vaccine-eligible IAE patients had received the 2024–25 influenza vaccine. . . .

All children are at risk for severe neurologic complications of influenza. Annual influenza vaccination is recommended for all children aged ≥6 months to prevent influenza and associated complications, potentially including IAE.

Access the MMWR article in HTML or PDF.

Related Link

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

According to the 2023 ACIP recommendation for administration of nirsevimab (Beyfortus, Sanofi) and the 2025 recommendation for administration of clesrovimab (Enflonsia, Merck), RSV monoclonal antibodies for infants should generally begin on October 1 and continue through March 31 in jurisdictions with RSV seasonality typical of most of the contiguous United States.

Alaska and tropical climates have RSV circulation patterns that differ from most of the contiguous United States. Locations with tropical climates include southern Florida, Hawaii, Guam, Puerto Rico, U.S. Virgin Islands, and U.S.-affiliated Pacific Islands. Providers in these jurisdictions should follow state or territorial public health guidance on timing of RSV monoclonal antibody administration.

A preventive RSV antibody is recommended as a single dose for infants younger than age 8 months and 0 days whose mothers were not effectively vaccinated against RSV during pregnancy. Infants whose mothers were effectively vaccinated against RSV and those who received a dose of Beyfortus late last season should not receive a dose of RSV preventive antibody now, even if they are still younger than age 8 months.

A dose of Beyfortus is also recommended for certain children at high risk of severe RSV disease age 8 months through 19 months entering their second RSV season, regardless of their history of maternal vaccination or receipt of a preventive antibody during their first RSV season. These high-risk groups include American Indian and Alaska Native children (particularly those living in remote areas and with limited access to medical services), children with chronic lung disease of prematurity, severe immunocompromise, and cystic fibrosis with growth under 10th percentile.

CDC has published the following timeline infographic to make it easier for clinical staff to determine which RSV prevention measures are recommended at which times of year in most of the United States.

The American Academy of Pediatrics and the American Academy of Family Physicians share the same recommendations for the use of these RSV prevention products.

To review details of recommendations, including dosing criteria, and guidance for rare circumstances, view Immunize.org's:

• Standing Orders for Administering Nirsevimab RSV Preventive Antibody (Beyfortus, by Sanofi) to Infants and High-Risk Young Children
• Standing Orders for Administering Clesrovimab RSV Preventive Antibody (Enflonsia, by Merck) to Infants

• CDC: Use of Nirsevimab for the Prevention of Respiratory Syncytial Virus Disease among Infants and Young Children: Recommendations of the Advisory Committee on Immunization Practices—United States, 2023 (8/25/23)
• CDC: Use of Clesrovimab for Prevention of Severe Respiratory Syncytial Virus–Associated Lower Respiratory Tract Infections in Infants: Recommendations of the Advisory Committee on Immunization Practices—United States, 2025 (8/28/25)
• CDC: RSV Immunization Guidance for Infants and Young Children main page
• AAP: Recommendations for the Prevention of RSV Disease in Infants and Children: Policy Statement
• Immunize.org: Vaccine A–Z: RSV (Respiratory Syncytial Virus) main page
• Immunize.org: Ask the Experts: RSV (Respiratory Syncytial Virus) main page

On May 29, 2025, CDC updated VISs for PCV and PPSV23. Immunize.org recently posted new VIS translations, including:

To locate VIS translations for a particular vaccine on Immunize.org, click the top tab “Vaccines & VISs,” click on “VISs,” and then select a specific vaccine. Scrolling down the resulting page, you will see:

• The current English VIS (the official federal version)
• Current translations (i.e., translations of the current English VIS)
• Where applicable, out-of-date translations (i.e., translations of past English versions if no current translation is available)
• Sheets explaining how to use VISs

Families given any VIS translation should also receive the current official VIS, which is in English.

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

Related Links

• Immunize.org: Vaccine & VISs: Translations main page for access to all translations of VISs
• Immunize.org: Clinical Resources: VIS-related Resources web page
• CDC: What's New with VISs web page
• CDC: Current VISs web page

Immunize.org updated its clinician resource, You Must Provide Patients with Vaccine Information Statements (VISs) – It’s Federal Law! VISs are always required when administering vaccines included in the federal Vaccine Injury Compensation Program (VICP). Previously, VISs were also required when federally funded vaccines that were not covered by the VICP were administered. The resource was updated to state that CDC recommends providing a VIS when administering vaccines not included in the VICP, but it is not required for these vaccines, regardless of funding source. Examples of vaccines not covered by VICP include COVID-19, RSV, PPSV23, and zoster.



Related Links

• Immunize.org: Clinical Resources: VIS-Related Resources
• CDC: What's New with VISs web page
• CDC: Current VISs web page

To recognize World Meningitis Day (WMD) on October 5, the American Society for Meningitis Prevention (ASMP) invites you to visit its World Meningitis Day web page. This offers several ways to join the global movement to defeat meningitis:

• Hit the road with ASMP’s limited edition bumper sticker and be featured in its virtual WMD road trip
• Share ASMP graphics; stream “Anthems for Action,” its advocate-curated empowerment playlist
• Share the ASMP video about the importance of meningitis vaccines for college students

Share the meningitis vaccination video with your networks, especially student health professionals, campus leaders, and others who work directly with students. To obtain a copy of the video file or the vertical version of the video for social media, email info@meningitisprevention.org.

Related Links

• Immunize.org: Vaccines A–Z: Meningococcal ACWY main page
• Immunize.org: Vaccines A–Z: Meningococcal B main page

This week, our featured episode from the Ask the Experts Video Series is titled Pregnancy and Flu Vaccine. The video describes the importance of the influenza vaccine during pregnancy. Vaccination protects expectant mothers, who face higher risks of influenza illness, preterm labor, and pregnancy complications if infected. Vaccination also protects infants, who are especially vulnerable to influenza and flu-related hospitalization in their first six months of life.

The 1-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.

• Facebook at ImmunizeOrg
• Instagram at ImmunizeOrg
• LinkedIn at ImmunizeOrg
• YouTube at ImmunizeOrg

Now more than ever, vaccinators need accurate, up-to-date immunization news at their fingertips. Encourage your coworkers to subscribe to IZ Express so they get all the news that matters to vaccinators in their own inbox each Wednesday. It’s free! IZ Express, the weekly e-newsletter produced by Immunize.org, alerts our readers to the week’s important vaccine developments. IZ Express also features:

• Educational materials from Immunize.org, CDC, AAP, and others
• Newly posted VISs and their translations
• Notices about online and in-person educational opportunities, many offering free continuing education credit

    

Thank you for helping us get the latest vaccine news to every clinical and public health professional who needs to know.

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

• Washington Post: 4 Vaccines Linked to a Lower Risk of Dementia (9/26/25)
• KFF: Tracking State Actions on Vaccine Policy and Access (9/24/25)
• KFF Health News: Amid Confusion over US Vaccine Recommendations, States Try to ‘Restore Trust’ (9/24/25)
• CIDRAP: CDC Confirms 23 More US Measles Cases as 2025 Total Tops 1,500 (9/24/25)
• NBC: Measles Outbreak Growing in Parts of Arizona and Utah, Health Officials Say (9/24/25)
• AP: How to Get a COVID-19 Shot and Ensure It’s Covered by Your Insurance (9/20/25)

Immunize.org offers a variety of video content for staff development, presentations, and sharing on social media or your website. You will find these under the Clinical Resources tab on the menu bar at the top of every page. Simply select “Webinars & Videos” from the bottom of the left menu. From the “Webinars & Videos” home page, you can choose either the webinars or videos tab. 
 
Webinars (longer form videos) cover a variety of subjects. Twenty-one webinars are available on the following topics:

• Communicating the benefits of immunization 
• Improving the vaccination experience 
• Vaccine safety 
• Website Office Hours

On the Videos tab you will find more than 120 short videos that can be sorted by subject into five groups:

• Ask the Experts (73 videos): Video versions of popular Ask the Experts questions and answers, these are also accessible through the “Ask the Experts” web section.
• Improving the Vaccination Experience (6 videos): Our brief science-based lessons cover ways to reduce pain and anxiety during vaccination visits.
• Orientation Video Series (18 videos): These introduce you to our organization and guide you through the most popular sections of our website. Videos show how the website looks on a desktop computer or a smartphone. 
• (NEW) Website Training Videos (12 videos): Adapted from our Office Hours webinars, these 10–20 minute videos offer in-depth tutorials on how to get the most from Immunize.org and our affiliated websites.
• Partner Videos (13 videos): Vaccine information from trusted organizations, such as the Vaccine Education Center of the Children’s Hospital of Philadelphia and CDC.

You can filter results on either tab by “Vaccine or Disease Name” and by “Subject.” Results can be sorted by Title and Date (newest or oldest first). 


 

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Recap: Immunize.org offers new Website Training Videos series of short demonstrations recorded during live Website Office Hours sessions

Our monthly Website Office Hours webinars include live demonstrations of efficient navigation of the Immunize.org website, followed by question-and-answer sessions with our website team. In response to participant requests, we edited recordings of the live sessions to include only the short demonstration portions and categorized them as our Website Training Videos series. Each training video is condensed to just 10- to 20-minutes, accessible for viewing at any time.

Current videos in the series include:

• Affiliated Websites
• Ask the Experts
• Clinical Resources
• Images, Webinars, Videos, & Social Media
• Let's Get Real About Vaccines Website
• News & Updates
• Official Guidance (State Resources)
• Official Guidance (CDC, FDA, WHO)
• Publication Archives, Vaccine Timeline, & About Us
• Travel Vaccines, Vaccine Confidence, & Addressing Concerns
• Vaccine Information Statements (VIS) Website Section
• Vaccines A–Z

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Summary: Updated Immunize.org clinical resources released in August and September 

IZ Express regularly provides readers with information about Immunize.org’s new and updated educational materials for healthcare professionals and handouts for patients. All Immunize.org materials are free to distribute.  

In case you missed them during recent weeks, the following updated materials were posted for clinicians: 

2025–26 influenza season-related web page and materials:   

• Ask the Experts: Influenza 
• Standing Orders Templates for Administering Influenza Vaccine to Children and Teens, and Adults 
• Screening Checklists for Contraindications to: 
  • Injectable Influenza Vaccine, also available in Spanish 
  • Live Attenuated Intranasal Influenza Vaccination, also available in Spanish 
• Influenza Vaccine Products for the 2025–2026 Influenza Season  
• Influenza: Questions and Answers 
• Talking with Your Patient About Contraindications and Precautions to Influenza Vaccination 
• Communicating the Benefits of Influenza Vaccination 
• Guide for Determining the Number of Doses of Influenza Vaccine to Give to Children Age 6 Months Through 8 Years 
• How to Administer Intramuscular and Intranasal Influenza Vaccines 
• How to Administer Intranasal and Oral Vaccinations 
• Not Sure If You Can Get an Influenza Vaccine? 
• Don't Take Changes with Your Family's Health — Make Sure You All Get Vaccinated 
• Declination of Influenza Vaccination 

Standing orders templates for administering:  

• Nirsevimab RSV Preventive Antibody (Beyfortus, by Sanofi) to Infants and High-Risk Young Children  
• Clesrovimab RSV Preventive Antibody (Enflonsia, by Merck) to Infants  
• Respiratory Syncytial Virus Vaccine (RSV) to Adults Age 50 Years and Older  
• Pfizer Respiratory Syncytial Virus (RSV) Vaccine (Abrysvo) During Pregnancy  
• Zoster Vaccine (Shingrix)  

Other materials to support immunization and administration: 

• Before You Vaccinate Adults, Consider Their “H-A-L-O” 
• Checklist of Current Versions of U.S. COVID-19 Vaccination Guidance and Clinic Support Tools  
• Meningococcal B Vaccine Recommendations by Age and Risk Factor 

Web pages: 

• Ask the Experts: RSV (Respiratory Syncytial Virus) 
• Ask the Experts: Zoster (Shingles) 
• Vaccine History Timeline 

Immunize.org webinars:   

• Website Office Hours: Official Guidance – State Resources  
• Website Office Hours: Vaccine Information Statements (VIS) 

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Featured Resources

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Vaccinate Your Family launches #RootedInProtection 2025 Respiratory Campaign toolkit to help spread pro-vaccine messages and answer questions

Vaccinate Your Family (VYF) recently launched its #RootedInProtection 2025 Respiratory Campaign toolkit that includes easy-to-share content to help answer the questions families are asking this season:  

• What are the recommendations for influenza, RSV, and COVID vaccines this year?  
• Do I need an updated COVID-19 vaccine?  
• Who is most at risk this respiratory season?  
• How do we know these vaccines are safe? What does the science show?

The social media graphics and copy are free to use and adapt across platforms. The campaign materials can be downloaded in both English and Spanish. Please tag @vaccinateyourfamily (@vaxyourfam on X and Bluesky) and use #RootedInProtection so VYF can amplify your posts.  



To co-brand these graphics, email Damaris at damaris@vaccinateyourfamily.org, and the VYF team will share the Canva files.  

Please share this content with your networks.

View the campaign materials.

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CHOP’s Vaccine Education Center curates vaccine recommendations from professional medical societies, sorted by age and by disease

The Children’s Hospital of Philadelphia’s (CHOP) Vaccine Education Center (VEC) offers its new web page, Locating the Latest Science-Based Vaccine Recommendations. VEC created a one-stop web page with the latest recommendations from professional medical societies. The web page will be updated as recommendations change or as new statements become available. 

The web page includes:

• Recommendations for birth to age 18 years, including links to AAP's schedule and recent policy statements
• Recommendations and statements related to vaccines for adults and during pregnancy, including a link to the January 2025 CDC adult schedule and summary recommendations with links to professional society statements
• Information about the Vaccine Integrity Project (VIP), including links to guidance on fall respiratory viruses

Immunize.org is developing a similar searchable database of professional medical society recommendations that will be announced when it is available in coming weeks.

View the web page. 

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Explore the www.Give2MenACWY​.org website to increase coverage for the MenACWY booster and other adolescent vaccinations

Immunize.org's www.Give2MenACWY.org website promotes the importance of adolescent vaccination, including the recommended MenACWY vaccine booster dose at age 16. Many teens are behind on vaccines, so vaccine outreach is more important than ever.

Materials on this colorful website for healthcare professionals incorporate the 2020 ACIP meningococcal vaccine recommendations and coverage statistics from CDC’s National Immunization Survey–Teen (NIS–Teen). One particularly popular resource on the site is the Algorithm for MenACWY Immunization in Adolescents 11 Through 18 Years of Age.

  

The website is divided into five easy-to-access sections:

• Vaccinate Teens: teen vaccination schedules and tips for improving vaccination rates
• Give 2 Doses: tools to help improve second dose coverage of MenACWY vaccine
• 16-Year-Old Visit: resources to help providers and patients remember the important vaccines recommended for 16-year-olds
• Tools for Providers: tools to explain meningococcal ACWY vaccine recommendations and improve coverage for all adolescent vaccines
• Resources: links to print materials, organizations involved in adolescent vaccination, personal stories about the importance of vaccination, and other resources of interest

The site also categorizes materials according to whether they are primarily of interest to providers, to adolescents, or to parents.

Visit Give2MenACWY.org and enjoy browsing (and deploying) its bountiful resources.

Related Links 

• MenACWY: You're Not Done If You Give Just One: Give 2 Doses to Strengthen Protection
• Recommending MenACWY: What to Say and How to Say It
• Top 10 Ways to Improve Adolescent Immunization Rates
• Developing an Immunization Culture in Your Office
• Know Your Rates: Measuring Immunization Success in Your Practice
• You're 16: We Recommend These Vaccines for You
• Dear Colleague Letter: 16-Year-Old Patients: Make Sure They Receive Their Annual Well Visit and Vaccinations, signed by six medical societies
• Ask the Experts: Meningococcal ACWY
• CDC: ACIP Meningococcal Vaccine Recommendations
• CDC: Vaccination Coverage Among Adolescents Aged 13–17 Years—National Immunization Survey–Teen, United States, 2024

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Help Immunize.org reach more vaccinators through your social media networks. Follow us and share our posts on Facebook, Instagram, and LinkedIn!

Immunize.org offers a social media program to highlight our educational resources for a widespread audience of vaccinators. Our social media channels now feature our most popular printable resources and Ask the Experts questions, as well as announcements important to frontline vaccinators. Please view and share our newest feature, the Ask the Experts Video Series.

         

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

• Facebook at ImmunizeOrg
• Instagram at ImmunizeOrg
• LinkedIn at Immunize.org
• YouTube at ImmunizeOrg

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Notable Publications

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“Modeling the Impact of MMR Vaccination Strategies on Measles Outbreaks in Texas” published in JAMA Health Forum

This week, the United States surpassed 1,500 cases of measles reported to CDC this year, highlighting the critical importance of maintaining high MMR vaccination coverage. In its September 19 issue, JAMA Health Forum published Modeling the Impact of MMR Vaccination Strategies on Measles Outbreaks in Texas. Portions of the article appear below.

We developed a mathematical model . . . first calibrated using reported case data from Gaines County and local vaccination rates. . . .

In Texas, the kindergarten MMR vaccination rates fell from 98.5% in 2013 to 2014 to 94.3% in 2024 to 2025, and in Gaines County, it declined even more, dropping from 92.6% to 82.0% over the same periods . . .

Findings of this study highlight the critical role of improving MMR vaccination coverage to prevent large-scale measles outbreaks, particularly in regions with declining immunization rates.

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Global News

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“Interim Effectiveness Estimates of 2025 Southern Hemisphere Influenza Vaccines in Preventing Influenza-Associated Outpatient and Hospitalized Illness—Eight Southern Hemisphere Countries, March–September 2025” published in MMWR

CDC published Interim Effectiveness Estimates of 2025 Southern Hemisphere Influenza Vaccines in Preventing Influenza-Associated Outpatient and Hospitalized Illness—Eight Southern Hemisphere Countries, March–September 2025 on September 25 in MMWR. A portion of the summary appears below. 

Monitoring seasonal influenza vaccine effectiveness in Southern Hemisphere countries can guide health authorities in Northern Hemisphere countries about the potential protection provided from vaccination. . . .

During the 2025 Southern Hemisphere influenza season, seasonal influenza vaccination reduced influenza-associated outpatient visits by 50.4% and hospitalization by 49.7%. . . .

CDC recommends that all eligible persons aged ≥6 months receive the seasonal influenza vaccine. The 2025–26 Northern Hemisphere seasonal influenza vaccine composition is the same as that used during the 2025 Southern Hemisphere influenza season and might be similarly effective if the same viruses circulate in the coming season.



Access the MMWR article in HTML or PDF.

Related Link

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

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Upcoming Events

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Virtual: NFID hosts webinar, “2025–2026 US Respiratory Season Updates” on October 8 at 1:30 p.m. (ET); CE credit offered

NFID will host a webinar titled 2025–2026 US Respiratory Season Updates at 1:30 p.m. (ET) on October 8. The panel includes NFID Medical Director Robert H. Hopkins, Jr., MD; NFID Director Matthew M. Zahn, MD, pediatric infectious disease physician at Rady Children’s Health; Melody Butler, RN, BSN, founding executive director of Nurses Who Vaccinate; and Brigid K. Groves, PharmD, MS, vice president of professional affairs at the American Pharmacists Association.

Speakers will discuss current U.S. immunization recommendations for COVID-19, influenza, RSV, and pneumococcal disease, and will provide strategies to increase immunization rates. 

CME and CNE credit are available. There is no fee to participate in this activity, but preregistration is required.

Register for the webinar.



NFID hosts monthly webinars to increase awareness of the importance of infectious disease prevention and treatment. CME, CNE, and CPE credits are available for select recordings. View all archived NFID webinars.

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Register for Immunize.org Website Office Hours. Join a 30-minute discussion about the Clinical Resources web section on October 8 at 4:00 p.m. (ET) or October 9 at 12:00 p.m. (ET). Recorded sessions archived.

To learn simple tips and tricks for using our website efficiently, please register for our next set of Website Office Hours on Wednesday, October 8, at 4:00 p.m. (ET) or Thursday, October 9, at 12:00 p.m. (ET). The same content will be covered in both sessions.

We will open each 30-minute session with a short, live demonstration on navigating the popular Clinical Resources website section on Immunize.org. You can submit questions when you register or live on Zoom during the session.

Register today for Immunize.org Website Office Hours (content is the same for both sessions):

• Wednesday, October 8, at 4:00 p.m. (ET)
• Thursday, October 9, at 12:00 p.m. (ET)

The archive of previous Website Office Hours content is posted at Immunize.org’s "Webinars & Videos" page.

Mark your calendar for future Immunize.org Website Office Hours.

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For more upcoming events, visit our Calendar of Events.