Immunization Works September 2020

September 29, 2020: Content on this page kept for historical reasons.

Top Stories

Meningococcal Vaccination, Recommendations of the Advisory Committee on Immunization Practices (ACIP) in the U.S., 2020: The September 25, 2020, report contains new recommendations for administration of booster doses of serogroup B meningococcal (MenB) vaccine for persons at increased risk for serogroup B meningococcal disease. These guidelines will be updated as needed on the basis of availability of new data or licensure of new meningococcal vaccines. ACIP recommends routine vaccination with a quadrivalent meningococcal conjugate vaccine (MenACWY) for adolescents age 11 or 12 years, with a booster dose at age 16 years. ACIP also recommends routine vaccination with MenACWY for persons age2 months and older at increased risk for meningococcal disease caused by serogroups A, C, W, or Y, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor (e.g., eculizumab [Soliris] or ravulizumab [Ultomiris]); persons who have anatomic or functional asplenia; persons with human immunodeficiency virus infection; microbiologists routinely exposed to isolates of Neisseria meningitidis; persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroups A, C, W, or Y; persons who travel to or live in areas in which meningococcal disease is hyperendemic or epidemic; unvaccinated or incompletely vaccinated first-year college students living in residence halls; and military recruits. ACIP recommends MenACWY booster doses for previously vaccinated persons who become or remain at increased risk.

In addition, ACIP recommends routine use of a MenB vaccine series among persons age 10 years and older who are at increased risk for serogroup B meningococcal disease, including persons who have persistent complement component deficiencies; persons receiving a complement inhibitor; persons who have anatomic or functional asplenia; microbiologists who are routinely exposed to isolates of N. meningitidis; and persons identified to be at increased risk because of a meningococcal disease outbreak caused by serogroup B. ACIP recommends MenB booster doses for previously vaccinated persons who become or remain at increased risk. In addition, ACIP recommends a MenB series for adolescents and young adults age 16–23 years on the basis of shared clinical decision-making to provide short-term protection against disease caused by most strains of serogroup B N. meningitidis.

The report also compiles and summarizes all recommendations from ACIP for use of meningococcal vaccines in the U.S. As a comprehensive summary and update of previously published recommendations, it replaces all previously published reports and policy notes.

Mass Vaccination Clinic Guidance: CDC has issued revised Guidance for Planning Vaccination Clinics Held at Satellite, Temporary, or Off-Site Locations. The purpose of the guidance is to assist with jurisdictional planning and implementation of satellite, temporary, or off-site vaccination clinics by public and private vaccination organizations.

The guidance is broken down into four categories:

• Planning activities
• Pre-clinic activities
• During the clinic activities
• Post-clinic activities

The guidance also provides information on additional considerations that are required during the COVID-19 pandemic, including physical distancing, personal protective equipment (PPE), and enhanced sanitation efforts.

Immunization Guidance During COVID–19: The COVID-19 pandemic has caused health care providers to change how they operate to continue providing essential services to patients. Ensuring that immunization services are maintained or reinitiated is essential for protecting individuals and communities from vaccine-preventable diseases and outbreaks and reducing the burden of respiratory illness during the upcoming influenza season.

CDC has issued Interim Guidance for Immunization Services During the COVID-19 Pandemic to help vaccination providers in a variety of clinical settings plan for the safe administration of vaccines during the COVID-19 pandemic. This guidance will be updated as the COVID-19 pandemic evolves.

Highlights include:

• Considerations for routine administration of all recommended vaccines for children, adolescents, and adults, including pregnant women
• General practices for the safe delivery of vaccination services, including considerations for alternative vaccination sites
• Strategies for catch-up vaccinations

We encourage you to share this guidance widely.

Morbidity and Mortality Weekly Report (MMWR)

Cancers Associated with Human Papillomavirus (HPV) in American Indian and Alaska Native (AI/AN) Populations in the U.S., 2013–2017: Human papillomavirus (HPV) causes most cervical cancers and some cancers of the penis, vulva, vagina, oropharynx, and anus. Cervical precancers can be detected through screening. HPV vaccination with the 9-valent HPV vaccine (9vHPV) can prevent approximately 92% of HPV-attributable cancers. Previous studies have shown lower incidence of HPV-associated cancers in non-Hispanic AI/AN populations compared with other racial subgroups; however, these rates might have been underestimated as a result of racial misclassification. Previous studies have shown that cancer registry data corrected for racial misclassification resulted in more accurate cancer incidence estimates for AI/AN populations. In addition, regional variations in cancer incidence among AI/AN populations suggest that nationally aggregated data might not adequately describe cancer outcomes within these populations. These variations might, in part, result from geographic disparities in the use of health services, such as cancer screening or vaccination. CDC analyzed data for 2013–17 from central cancer registries linked with the Indian Health Service (IHS) patient registration database to assess the incidence of HPV-associated cancers and to estimate the number of cancers caused by HPV among AI/AN populations overall and by region. During 2013–17, an estimated 1,030 HPV-associated cancers were reported in AI/AN populations. Of these cancers, 740 (72%) were determined to be attributable to HPV types targeted by 9vHPV; the majority were cervical cancers in females and oropharyngeal cancers in males. These data can help identify regions where AI/AN populations have disproportionately high rates of HPV-associated cancers and inform targeted regional vaccination and screening programs in AI/AN communities. Read the September 18 MMWR for the full report.

Resources and Information

Zostavax is No Longer Sold in the US: Zostavax vaccine, which has been in use since 2006, is no longer being sold in the U.S. as of July 1, 2020. Some pharmacies and clinics may still have Zostavax in stock. This vaccine is safe and may be used until the supply expires, before or by November 18, 2020. Shingrix continues to be recommended for adults 50 years and older to prevent shingles and its complications.

Strengthening Vaccine Confidence in Pediatric and Family Practice Offices During the COVID-19 Pandemic Webinar: On August 19, 2020 CDC and the Public Health Foundation hosted a webinar about how to strengthen vaccine confidence among parents, ensure safe well visits, and implement CDC guidance for immunization during the COVID-19 pandemic. Speakers included CAPT Sarah Schillie and Jessica MacNeil from NCIRD’s Immunization Services Division. View the archived webinar.

Epidemiology and Prevention of Vaccine-Preventable Diseases (the Pink Book) 2020 Video Series: CDC is offering a series of weekly, one-hour, web-on-demand videos that provide an overview of vaccination principles, general best practices, immunization strategies, and specific information about vaccine-preventable diseases and the vaccines that prevent them. Each video will include updated information from recent Advisory Committee on Immunization Practices (ACIP) meetings and votes. The series started on July 1, 2020, and a new video will be released most Wednesdays through October 14, 2020. This year, because of limited staff availability during the ongoing COVID-19 response, the videos will be prerecorded rather than live webinars. Visit the Pink Book video series page for the schedule and additional information. Continuing Education (CE) will be available for each video.

Vaccine Administration e-Learn: An e-Learn on vaccine administration is now available. Proper vaccine administration is critical for ensuring that vaccines are both safe and effective. Vaccine administration errors happen more often than you might think. Of the average 36,000 reports received annually by the Vaccine Adverse Event Reporting System (VAERS), about 1,500 are directly related to administration error. Some of the most common vaccine administration errors include:

• Not following the recommended immunization schedule
• Administering improperly stored or expired vaccine and/or diluent
• Administering the wrong vaccine—confusing look-alike or sound-alike vaccines such as DTaP/Tdap or administering products outside age indications

The e-Learn is a free, interactive, online educational program that serves as a useful introductory course or a great refresher on vaccine administration. The self-paced e-Learn provides comprehensive training, using videos, job aids, and other resources to accommodate a variety of learning styles. A certificate of completion and/or Continuing Education (CE) is available for those that complete the training.

“Keys to Storing and Handling Your Vaccine Supply” Video: Two of the most important safeguards for the nation’s vaccine supply are proper vaccine storage and handling. An updated web-on-demand video, titled “Keys to Storing and Handling Your Vaccine Supply,” is designed to decrease vaccine storage and handling errors by demonstrating recommended best practices and addressing frequently asked questions. Continuing Education (CE) is available.

Vaccine Storage and Handling Toolkit: The Vaccine Storage and Handling Toolkit is a comprehensive guide that describes best practices for vaccine storage and handling from ACIP recommendations, product information from vaccine manufacturers, and scientific studies.

Current Issues in Immunization Webinars: The latest Current Issues in Immunization webinar on August 4, 2020, focused on maintaining routine vaccination and preparing for influenza vaccination during the COVID-19 pandemic. Current Issues in Immunization webinars, held several times during the year, are designed to provide clinicians with the most up-to-date information on immunizations. The webinars are live, one-hour events combining an online visual presentation with simultaneous audio via telephone conference call, along with a live question-and-answer session. Registration, Internet access, and a separate phone line are needed to participate. View the webinar web page for additional information and the archived webinars.

Vaccines for Children (VFC) Fact Sheet for Providers: CDC has posted a new VFC fact sheet for health care providers. This accompanies the updated VFC fact sheet for parents that was recently posted in English and Spanish.

New “#HowIRecommend” Videos: CDC has posted 19 new “#HowIRecommend” videos featuring three new health care professionals. In these short, one-minute videos they discuss how to address parents’ questions about vaccine safety, how they recommend flu vaccine, how they foster support for immunization in the practice, and more. View videos by Neonatologist Dr. Shetal Shah, Registered Nurse Andrea Polkinghorn, and Certified Medical Assistant Virginia Chambers.

Redesigned HPV Vaccine Website for Health Care Professionals: As part of its effort to optimize digital content for use on multiple devices, CDC has redesigned the HPV vaccine website for health care professionals. The new website includes HPV cancer statistics, continuing education resources, tips for answering parents’ questions, and more. It also features a new page on HPV vaccine safety and effectiveness data, which outlines the key data that health care professionals need to know as they address questions from parents. Please share this new resource with colleagues or members of your health care professional association.

Updated Infographic: HPV is the Best Protection Against 6 Types of Cancer: CDC has updated its “HPV iceberg” infographic to include the latest data about HPV cancers. Share it on social media or download and print it to post in provider offices.

Promising Practices for Adolescent Immunization: In July, the National HPV Vaccination Roundtable invited health systems and immunizers to join facilitated conversations on adolescent vaccination during the pandemic. These conversations were summarized in a new promising practices document for all organizations looking to get adolescent immunization back on track. Related messaging in videos and infographics is available on the National HPV Vaccination Roundtable web page. Please share these materials with your colleagues, including quality improvement and population health leaders.

CDC and Medscape: This special series of commentaries, part of a collaboration between CDC and Medscape, is designed to deliver CDC’s authoritative guidance directly to Medscape’s physicians, nurses, pharmacists, and other health care providers. In this series, CDC experts offer video commentaries on current topics important to practicing clinicians. NCIRD has contributed to a variety of commentaries. You will need to sign up and log in as a member to view the commentaries and registration is free.

Immunization Resources: Various publications are available for ordering at CDC-INFO On Demand. You can search for immunization publications by using the “Programs” drop-down menu and selecting “Immunization and Vaccines,” or you can search by “Title.” Free hard copies of the 2020 recommended immunization schedules are now available for ordering.

CDC Job Openings: CDC is committed to recruiting and hiring qualified candidates for a wide range of immunization and other positions. Researchers, medical officers, epidemiologists, and other specialists are often needed to fill positions within CDC. For a current listing, including international opportunities, please visit CDC’s employment web page.

Calendar of Events

ACIP Meeting, October 28–29, 2020, Atlanta, GA

NCIRD Calendar of Events

Immunization Action Coalition (IAC) Calendar