Issue 1864: March 11, 2026

CDC published Congenital Rubella Syndrome—Florida, 2025 on March 5 in MMWR. A single dose of rubella-containing vaccine (such as MMR) protects about 97% of recipients. A portion of the summary appears below. 

Rubella infection during early pregnancy can result in miscarriage, fetal death, and characteristic birth defects, referred to as congenital rubella syndrome (CRS). Although rubella was declared eliminated from the United States in 2004, the disease remains a leading cause of vaccine-preventable birth defects worldwide. . . .

An infant with CRS was born to a mother from a country that had not introduced rubella vaccine. The mother was likely infected during the first trimester of pregnancy, during travel to her home country. The infant had characteristic features of CRS at birth. . . .

Women of reproductive age (15–49 years) without documented rubella immunity should be offered a rubella-containing vaccine before pregnancy. Clinicians should maintain awareness about rubella, especially among patients who develop a febrile rash illness after travel to regions where rubella is endemic.



Infant with CRS: image from Immunize.org’s Image Library.

Access the MMWR article in HTML or PDF.

Related Link

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

On February 24, the American College of Physicians (ACP) released updated practice points for COVID-19 vaccines in adults who are not pregnant or immunocompromised, urging vaccination with an mRNA-based COVID-19 vaccine. ACP’s methods, including restrictive criteria for evidence eligible for inclusion in this rapid review, did not allow consideration of the protein subunit COVID-19 vaccine, Nuvaxovid (Sanofi-Novavax). Other organizations, including (traditionally) ACIP, consider a broader range of studies when making vaccination recommendations.

The following guidance applies to adults who are not pregnant or immunocompromised:

• Age 65 years or older: give an mRNA-based COVID-19 vaccine
• Age 18 to 64 years, at increased risk for severe COVID-19: give an mRNA-based COVID-19 vaccine
• Age 18 to 64 years, not at increased risk for severe COVID-19: consider giving an mRNA-based COVID-19 vaccine

• Annals of Internal Medicine: COVID-19 Vaccines for 2025–2026 in Adults Who Are Not Pregnant or Immunocompromised: Rapid Practice Points From the American College of Physicians (2/24/26)
• Immunize.org: Healthcare Professional Organization Vaccine Recommendations main page

Immunize.org updated its patient resource, Adult Immunization: Importance of Staying Up to Date with Vaccines. This 1-page document describes the reasons adults need to be vaccinated.

Changes include updated references, statistics, and hyperlinks to the American Academy of Family Physicians and Vaccinate Your Family.



Related Links

• Immunize.org: Clinical Resources: Adult Vaccination main page
• Immunize.org: Clinical Resources A–Z main page, where you can filter by topic, vaccine, language, or other criteria

It’s important to use current VISs and the most recent available VIS translations. There are two easy ways to check the dates of official CDC VISs. First, refer to the free Immunize.org handout, Dates of Current Vaccine Information Statements (VISs). Second, you may want to purchase the new laminated VIS QR code table from Immunize.org. These QR codes never expire; when a new VIS is issued, the QR code will automatically link to the current version.

CDC produces official VISs only in English. CDC does not produce or certify available translations, so the official CDC VIS should accompany any translation. Current Spanish translations are available on the new laminated QR code table for sale in the Immunize.org shop. You can also download and print a free PDF version of Spanish translation QR codes, as well as a table of QR codes for all translations available for injectable influenza vaccine. Our Translations landing page provides quick access to all VISs in any of dozens of languages.

Use these tools to ensure your immunization practice is up to date on VISs.

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
• Immunize.org: Orientation Video Series: Introducing VIS and VIS Translations (3:53 minutes)
• Immunize.org: Orientation Video Series: Introducing VIS and VIS Translations [Mobile View] (4:16 minutes)
• Immunize.org: Website Office Hours: Vaccine Information Statements (VISs) Website Section (32:47minutes)
• CDC: What's New with VISs web page

As of March 5, 12 new outbreaks were reported in 2026, and 89% of the 1,281 confirmed measles cases are outbreak-associated. In comparison, throughout 2025, 2,283 measles cases were reported in the United States. So far, 30 states reported measles cases in 2026.

• Alaska, Massachusetts, and Missouri joined the list of states with 2026 cases.
• South Carolina confirmed 990 measles cases since its outbreak began in October 2025.
• The Florida Department of Health confirmed 124 cases, most centered in Collier County, where Ave Maria University is the epicenter of an outbreak. Measles cases are surging as the country approaches spring break travel season. 

The Pan American Health Organization (PAHO) declared that Canada lost its measles elimination status in November 2025, after more than 12 months of uninterrupted measles transmission. An official declaration of the loss of measles elimination status in the United States and Mexico was to be considered by PAHO on April 13. PAHO postponed its decision until its November 2026 meeting.

CDC only requires reporting of laboratory-confirmed measles cases. Cases without laboratory testing for confirmation are not included in these numbers. Actual numbers of cases are, therefore, higher than confirmed case counts.

A map of 2025–26 measles cases in the United States, as of March 6, from the Johns Hopkins International Vaccine Access Center, appears below. Their U.S. Measles Tracker website includes state and county-level data.

Immunize.org offers measles-related resources for the public on several of our affiliated websites:

• VaccineInformation.org: Measles web page
• LetsGetRealAboutVaccines.org: Measles web page
• Immunize.org: Vaccines A–Z: Measles main page

• AAP: Fact Checked: The MMR (Measles, Mumps and Rubella) Vaccine Is Safe and Effective web page
• CDC: Measles Cases and Outbreaks main page
• Common Health Coalition: More Illness, Greater Cost: Spotlight Brief; Childhood Immunizations (PDF)
• Health Canada: Measles and Rubella Weekly Monitoring Report
• Immunize.org: Vaccines A–Z: Measles main page

Nationwide respiratory virus activity reported by CDC is highlighted below.

• Influenza (data through February 28):
  • Seasonal influenza activity remains elevated across the country, with high or very high levels of influenza-like illness (ILI) reported in 18 jurisdictions
  • There have been at least 25 million illnesses, 330,000 hospitalizations, and 20,000 deaths from flu so far this season according to CDC estimates
  • Children have the second highest cumulative influenza-associated hospitalization rate for that age group since the 2010–11 season
  • Deaths of 11 more children were reported during week 8, for a total of 90 child deaths with influenza reported so far this season
  • 85% of reported pediatric deaths this season occurred in children not fully vaccinated against influenza
• RSV:
  • The Epidemic Trends map shows that RSV activity is elevated and increasing in some regions of the country
  • Respiratory Illnesses Data Channel states that RSV activity started later than expected in most regions, and higher levels of RSV activity may continue into April in many regions
  • Those who administer RSV preventive antibodies to protect infants should look to state public health authorities for guidance about how long to continue its use in response to the late RSV season
• COVID-19: Activity is decreasing nationally but remains elevated in some areas

Level of Respiratory Illness Activity
Because influenza is leading the respiratory illness wave, the ILI map is shown below.

The Epidemic Trends map for RSV, with data through February 28, appears below. RSV rates are still growing or likely growing in some northern states.

Vaccination against COVID-19, influenza, and RSV reduces the risk of severe illness.

Administration of RSV preventive antibodies for all infants younger than 8 months who are unprotected provides them immediate protection. Consult guidance of state health officials for extending the use of RSV preventive antibody products beyond the end of March.

• CDC's Respiratory Illnesses Data Channel shows state and county level data on respiratory viral activity, associated ED visits and presence in wastewater.
• CDC's Weekly Flu Vaccination Dashboard shows that, as of February 14, among adults age 18 and older, 46.5% reported having received a flu vaccination, higher than last season at this same time (44.6%). 
• The National Immunization Survey – Fall Respiratory Virus Module shows that influenza vaccination coverage varied by age, health insurance status, poverty status, race and ethnicity, urbanicity, sex, and jurisdiction.

Our newest video in the Ask the Experts Video Series is titled Are COVID-19 Vaccines Helpful During Pregnancy? This video briefly describes the importance of COVID-19 vaccination during pregnancy, why COVID-19 vaccines are safe during pregnancy, and how vaccination protects both mother and newborn during the first 6 months of life.

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.

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

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

• CIDRAP: Vaccine Integrity Project Kicks Off Evidence Review of Tdap Vaccine in Pregnancy (3/4/26)
• New York Times: Parents Tried to Shield Their Children from Vaccines. Instead They Got Measles. (3/3/26)
• STAT: A Titan of Vaccine Development Sees His Field’s Achievements Slip Away (3/2/26)
• The Hill: Acting CDC Director Bhattacharya Urges Measles Vaccines (3/2/26)
• New York Times, Opinion: I Grew Up Unvaccinated. Now I’m an Immunologist. (2/27/26)

This week, we continue highlighting our popular Ask the Experts section. This resource provides more than 1,300 practical answers to questions from healthcare professionals about vaccines and vaccine administration. Content is divided into two categories:  

• Vaccine Topics—20 specific vaccine-preventable diseases 
• General Topics—10 vaccination-related categories  

Many topics feature subcategories to focus your search.    

In the left navigation menu, a carat (>) next to the topic shows that subcategories are available. Select a category, such as “COVID-19” to expand the list. Selecting “All COVID-19” will display all questions and answers for that topic, while selecting a subcategory such as “Vaccine Recommendations” will filter results. 
 


Browse the resulting questions or narrow your results with a keyword search or by choosing filters. Select the Show All Answers button to expand the answers to all displayed questions.   

For additional information, view these resources from Immunize.org:    

• Introducing Ask the Experts video (3:36)     
• Introducing Ask the Experts (Mobile View) video (3:36)     
• Ask the Experts Website Training video (13:39)     

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Recap: Immunize.org adds “State Public Health Immunization Recommendations” web page to link you to state vaccine recommendations

Immunize.org added a new page, State Public Health Immunization Recommendations, to its Official Guidance web section. This page links you to information from U.S. states and DC on their public health immunization recommendations. Beginning in mid-2025, vaccine guidance from CDC diverged from recommendations of healthcare professional organizations. For this reason, several state public health agencies offer supplemental guidance to help clinicians make evidence-based decisions and to support patient access to vaccines recommended by healthcare professionals.

Color-coding highlights three alliances formed to promote evidence-based decision making and vaccine access: West Coast Health Alliance, Northeast Public Health Collaborative, and Governors Public Health Alliance. See notes on website for more information about multistate alliances.



Related Links

• Immunize.org: State Public Health Immunization Recommendations main page
• Immunize.org: Healthcare Professional Organizations main page
• Immunize.org: State Immunization Websites web page

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Recap: Immunize.org updates "Leading Medical Organizations Endorse Strong School and Childcare Vaccination Requirements and Elimination of Non-Medical Exemptions"

Immunize.org updated Leading Medical Organizations Endorse Strong School and Childcare Vaccination Requirements and Elimination of Non-Medical Exemptions with the most current dates and references for medical organizations, including AAP’s 2025 update.

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Recap: Immunize.org updates "Vaccine Storage Emergency Response Worksheet"

Immunize.org updated its Vaccine Storage Emergency Response Worksheet to update manufacturer telephone numbers and product information. 

Keep this version in your vaccine storage emergency response plan for quick access to manufacturers when you need guidance on vaccine usability after a storage failure.

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Featured Resources

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New! Laminated VIS QR code tables deliver CDC VISs directly to your patients’ smartphone (Spanish translation version also available). Shipping begins mid-March.

The Immunize.org team is pleased to introduce durable, laminated tables of QR codes linking to VISs for vaccines given to children and adults. VISs explain both risks and benefits of vaccination. Federal law requires you to document provision of CDC’s current VIS before administering any vaccine covered by the Vaccine Injury Compensation Program. CDC recommends VISs accompany other vaccines, too. An easy, paperless way to comply with the law is for patients to scan a QR code and access the VIS from a smartphone or tablet. 

CDC produces official VISs only in English. CDC does not produce or certify available translations, so the official CDC VIS should accompany any translation.

These new tables belong in any room where vaccinations are given. Key features include: 

• Use as a booklet or poster: The laminated table arrives folded like a newspaper. It is suitable for desk use as an 8.5" x 11" booklet or wall mounted as an 11" x 17" poster.
• Durable quality: The tough laminate coating can be wiped down.
• Never out-of-date: Any time a VIS or translation is updated, the QR code will direct to the new VIS.  
• One version for official CDC VISs and one for Spanish translations: The table of official CDC VISs in English is sold individually. The table of Spanish translations is sold as a bundle with the table of official VISs, so it is easy to make both available.
• Spanish version usable by non-Spanish speakers: The Spanish QR code table has side-by-side text in English to support its use by non-Spanish speakers.
• Easy access to all available translations: Both versions include a QR code link to the Immunize.org index of all VIS translations available in dozens of languages.
• Bonus content: The reverse side of the QR code poster includes links to Immunize.org's “Addressing Vaccination Anxiety” resources and additional VIS content. 

Pricing (includes all shipping and handling costs)
Products will begin shipping mid-March.

Laminated CDC VIS QR Code Table (English)
1 copy: $14.00
2 copies: $9.00 each
3–4 copies: $6.50 each
5–9 copies: $5.00 each
10–19 copies: $4.00 each
20–59 copies: $3.00 each
60+ copies: $2.50 each

Bundle: Laminated CDC (English) + Spanish Translation VIS QR Code Tables
(each bundle includes 1 CDC VIS table and 1 table of Spanish translations)
1 bundle: $20.00
2 bundles: $16.00 each
3–4 bundles: $12.00 each
5–9 bundles: $8.50 each
10–19 bundles: $7.00 each
20–59 bundles: $6.00 each
60+ bundles: $5.00 each



Visit the Shop Immunize.org: Laminated VIS QR Code Tables web page to view images and order today! For additional information, call 651-647-9009 or email admininfo@immunize.org. 

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IZ Express keeps our 50,000+ readers up to date on evidence-based vaccine information every week; help us reach more subscribers

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 also features: 

• Educational materials from Immunize.org and other healthcare professional organizations 
• Newly posted VISs and their translations 
• Notices about 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. 

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Needle anxiety is common at any age. Use Immunize.org’s clinical resources to offer a positive vaccination experience.

In Clinical Resources: Improving the Vaccination Experience, Immunize.org provides print and video tools to create a positive vaccination experience and ease injection anxiety in children and adults. Links to additional resources from trusted partner organizations are also provided.

The web page links to eight printable resources on addressing vaccination anxiety (four for providers, four for recipients—also available in Spanish), two in-depth webinars, and six brief videos (listed below). As with all Immunize.org resources, these are free to download, link, copy, and share.



The video topics include:

• How to Administer Multiple Intramuscular Vaccines to Adults During One Visit
• Using Enhanced Screening Checklists for Contraindications to Vaccination
• Addressing Vaccination Anxiety for Infants: Strategies for Vaccine Recipients and Caregivers
• Addressing Vaccination Anxiety: Strategies for Healthcare Professionals
• Fainting Related to Vaccination: What You Need to Know
• Addressing Vaccination Anxiety for Children: Strategies for Vaccine Recipients and Caregivers

Related Link

• Immunize.org: Clinical Resources: Improving the Vaccination Experience web page

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

Confident healthcare provider recommendations for influenza vaccine are powerfully persuasive. As the nation faces a challenging influenza season, Immunize.org, in collaboration with CSL Seqirus, updated the 65+ Flu Defense website to help you maximize patient protection.



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

• Influenza in Adults 65+: The Facts
• Influenza Vaccination: Questions Patients Aged 65 and Older Frequently Ask Their HCP
• The Importance of Preventing Influenza and COVID-19

A clinician recommendation is the most important reason why a person will get vaccinated. Check out the updated 65+ Flu Defense website to assist your ongoing efforts in protecting this vulnerable population.

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Notable Publications

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Clinical Info updates “Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV”

On February 25, Clinical Info published Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV. Clinical Info is an online resource offered by the Office of AIDS Research, part of the National Institutes of Health. Major vaccine-related revisions in the last 6 months are summarized below:

• RSV vaccination age range (50–74 years) for people with comorbid conditions expanded and the recommendation rating updated
• Evidence summaries for zoster, measles, varicella, and COVID-19 vaccines updated; note added that people with advanced HIV may receive an additional dose of COVID-19 vaccine 6 months after their last dose
• Guidance for varicella post-exposure prophylaxis updated
• The recommended period after which the varicella vaccine may be administered to people who received antiviral post-exposure prophylaxis shortened from greater than 72 hours to greater than 24 hours

Related Links

• Clinical Info: Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV 
• Clinical Info: Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV: What's New in the Guidelines
• Clinical Info: Update to the Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV (press release)

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Global News

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WHO publishes "Recommended Composition of Influenza Virus Vaccines for Use in the 2026–2027 Northern Hemisphere Influenza Season" in Weekly Epidemiological Record

The World Health Organization (WHO) published Recommended Composition of Influenza Virus Vaccines for Use in the 2026–2027 Northern Hemisphere Influenza Season in the February 27 issue of its Weekly Epidemiological Record. 

Related Link

• WHO's Weekly Epidemiological Record (current issue and archives)

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Upcoming Events

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Virtual: March 18–19 ACIP meeting scheduled to discuss COVID-19 and ACIP recommendation methodology; submit public comments through March 12

CDC will convene the ACIP on March 18–19, starting at 8:00 a.m. (ET). The agenda includes updates on ACIP workgroups, discussions on adverse events after COVID-19 vaccination, Long-COVID, and ACIP recommendation methodology. Recommendation votes may be scheduled.

Register to make an oral public comment during the meeting or submit a written public comment to ACIP through March 12. Opportunities for public comment are described on the website.



No registration is required to watch webcasts of live ACIP meetings or listen via telephone.

View the agenda.

Related Links

• CDC: ACIP main page for access to webcast, agendas
• CDC: ACIP Meeting Information for presentation slides, content from previous meetings, and information about future meetings

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Virtual: NFID hosts webinar titled “Strengthening Vaccine Communications in Diverse Healthcare Settings” on March 18 at 1:30 p.m. (ET); CME credit offered

NFID will host a webinar titled Strengthening Vaccine Communications in Diverse Healthcare Settings at 1:30 p.m. (ET) on March 18. The panel includes NFID Medical Director Robert H. Hopkins, MD; Eva Stone, DNP, APRN, Jefferson County (KY) Public Schools; Olivia Kinney, PharmD, MS, Kroger Health; and Crystal L. Rambaud, MPH, RN, Pima County Health Department.  

Speakers will discuss the burden of vaccine-preventable diseases, vaccine coverage, and evaluate communication strategies to address vaccine hesitancy within various healthcare settings.

CME credit is 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 archived NFID webinars.

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Virtual: Register for Immunize.org Website Office Hours. Join a 30-minute discussion about our About Us, Publication Archives, and Vaccine Timeline web content on April 8 at 4:00 p.m. (ET) or April 9 at 12:00 p.m. (ET). Recorded sessions archived.

To learn simple tips and tricks for using our websites efficiently, please register for our next set of Website Office Hours on Wednesday, April 8, at 4:00 p.m. (ET) or Thursday, April 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 our About Us, Publication Archives, and Vaccine Timeline website sections. 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):

• Wednesday, April 8, at 4:00 p.m. (ET)
• Thursday, April 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.