Immunization Works November 2019

December 2, 2019: Content on this page kept for historical reasons.


Immunization Works Newsletter November 2019

Top Stories

49th National Immunization Conference (NIC): The 49th NIC, Immunization 2020: Protecting Our Communities Together, will be held in Atlanta, Georgia, May 19–21, 2020.

Visit the conference registration siteexternal icon for meeting details, hotel information, session themes, and abstract submission instructions. We will be accepting abstractsexternal icon through December 16, 2019.

The NIC brings together around 1,500 local, state, federal, and private-sector immunization stakeholders and partners to explore science, policy, education, and planning issues related to immunization and vaccine-preventable diseases. The NIC mission is to offer information that will help participants provide comprehensive immunization services for all age groups. The conference also offers participants an opportunity to learn innovative strategies for developing programs and policies and advancing science to promote immunization among all ages today for a healthy tomorrow.

If you have questions, please contact


National Influenza Vaccination Week (NIVW): NIVW will be held December 1–7, 2019. Previous flu vaccination coverage data show that few people get vaccinated against influenza after the end of November. CDC established NIVW in 2005 to highlight the importance of continuing flu vaccination through the holiday season and beyond. As long as flu viruses are circulating, it’s not too late to get vaccinated.

A yearly flu vaccine is recommended for everyone 6 months and older. Flu vaccination is especially important for protecting people at high risk of serious flu complications, including:

  • Young children
  • Pregnant women
  • Adults 65 and older
  • Anyone with certain chronic health conditions like asthma, diabetes, or heart disease

CDC has developed tools and materials for organizations across the country to support their vaccination efforts during NIVW:

NIVW communication resources

Frequently asked flu questions 2019–2020 season

Video: How Does Flu Make You Sick? Flu isn’t a “bad cold” and can result in serious health complications, such as pneumonia and bacterial infections. Flu can also lead to hospitalization and sometimes even death. This short, animated video shows how flu viruses infect your body.

Publication: Risk of Severe Influenza among Adults with Chronic Medical Conditions:

A recently released CDC co-authored studyexternal icon, titled Risk of Severe Influenza among Adults with Chronic Medical Conditions, compared rates of hospitalization with influenza among adults from different age groups who had chronic medical conditions to those of otherwise healthy adults in the same age groups. The study confirmed that certain chronic medical conditions can dramatically increase a person’s risk of being hospitalized with an influenza infection.

  • For example, adults with congestive heart failure and those with chronic lung diseases, like asthma and chronic obstructive pulmonary disease (COPD), were consistently among those at greatest risk for influenza-associated hospitalizations for all age groups from 40 to 80 years old.
  • Chronic conditions included congestive heart failure, coronary heart disease, stroke, chronic obstructive pulmonary disease (COPD), asthma, diabetes, and end-stage renal disease.

The study provided some stark examples. Adults with congestive heart failure age 18 to 39 were 13 times more likely to be hospitalized from flu than their contemporaries without congestive heart failure. Among adults 18 to 64 years, those with diabetes had double the risk of being hospitalized from flu than their contemporaries who did not have diabetes.

These findings underscore the importance of influenza vaccination among people with certain medical conditions that place them at high risk of developing serious influenza complications.


Use of 13-Valent Pneumococcal Conjugate Vaccine and 23-Valent Pneumococcal Polysaccharide Vaccine among Adults Age 65 and Older: Updated ACIP Recommendations: Two pneumococcal vaccines are currently licensed for use in adults in the U.S.: a 13-valent pneumococcal conjugate vaccine (PCV13 [Prevnar 13, Pfizer, Inc.]) and a 23-valent pneumococcal polysaccharide vaccine (PPSV23 [Pneumovax 23, Merck and Co., Inc.]). In 2014, the Advisory Committee on Immunization Practices (ACIP) recommended routine use of PCV13 in series with PPSV23 for all adults age 65 and older based on demonstrated PCV13 safety and efficacy against PCV13-type pneumonia among adults age 65 and older. At that time, ACIP recognized that there would be a need to reevaluate this recommendation because it was anticipated that PCV13 use in children would continue to reduce disease burden among adults through reduced carriage and transmission of vaccine serotypes from vaccinated children (i.e., PCV13 indirect effects). On June 26, 2019, after having reviewed the evidence accrued during the preceding three years, ACIP voted to remove the recommendation for routine PCV13 use among adults age 65 and older and to recommend administration of PCV13 based on shared clinical decision-making for adults age 65 and older who do not have an immunocompromising condition, cerebrospinal fluid (CSF) leak, or cochlear implant, and who have not previously received PCV13. ACIP recognized that some adults age 65 and older are potentially at increased risk for exposure to PCV13 serotypes, such as persons residing in nursing homes or other long-term care facilities and persons residing in settings with low pediatric PCV13 uptake or traveling to settings with no pediatric PCV13 program. These adults might attain higher than average benefit from PCV13 vaccination. When patients and vaccine providers engage in shared clinical decision-making for PCV13 use to determine whether PCV13 is right for a particular person, considerations might include both the person’s risk for exposure to PCV13 serotypes and their risk for developing pneumococcal disease as a result of underlying medical conditions. All adults age 65 and older should continue to receive 1 dose of PPSV23. If the decision is made to administer PCV13, it should be given at least 1 year before PPSV23. ACIP continues to recommend PCV13 in series with PPSV23 for adults age 19 and older with an immunocompromising condition, CSF leak, or cochlear implant. Please read the November 22 MMWR for the full report.

Update on Vaccine-Derived Poliovirus Outbreaks—Worldwide, January 2018–June 2019: Certification of global eradication of indigenous wild poliovirus type 2 occurred in 2015 and of type 3 in 2019. Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988 and broad use of live, attenuated oral poliovirus vaccine (OPV), the number of wild poliovirus cases has declined 99.99%. Genetically divergent vaccine-derived poliovirus (VDPV) strains can emerge during vaccine use and spread in underimmunized populations, becoming circulating VDPV (cVDPV) strains, and resulting in outbreaks of paralytic poliomyelitis. In April 2016, all oral polio vaccination switched from trivalent OPV (tOPV; containing vaccine virus types 1, 2, and 3) to bivalent OPV (bOPV; containing types 1 and 3). Monovalent type 2 OPV (mOPV2) is used in response campaigns to control type 2 cVDPV (cVDPV2) outbreaks. The November 15 MMWR presents data on cVDPV outbreaks detected during January 2018–June 2019 (as of September 30, 2019). Compared with January 2017–June 2018, the number of reported cVDPV outbreaks more than tripled, from nine to 29; 25 (86%) of the outbreaks were caused by cVDPV2. The increase in the number of outbreaks in 2019 resulted from VDPV2 both inside and outside of mOPV2 response areas. GPEI is planning future use of a novel type 2 OPV, stabilized to decrease the likelihood of reversion to neurovirulence. However, all countries must maintain high population immunity to decrease the risk for cVDPV emergence. Cessation of all OPV use after certification of polio eradication will eliminate the risk for VDPV emergence.

Resources and Information

2019 HPV Vaccine is Cancer Prevention Champion Award Announced: CDC, the American Cancer Society, and the American Association of Cancer Institutes are proud to announce the winners of the 2019 HPV Vaccine is Cancer Prevention Champion Award. The Champion Award was established in 2017 to recognize health care professionals who are going above and beyond to foster HPV vaccination in their communities. This year’s champions come from 25 states in both urban and rural communities and include physicians, nursing teams, small and large clinics, and community health centers. You can learn more about each champion and how they achieved high HPV vaccination coverage on the HPV is Cancer Prevention Champion Award website.

Pediatricians Answer Parents’ HPV Vaccine Questions in New “Can I Ask You a Question” Videos: CDC’s new “Can I Ask You a Question” video series for parents is now available for viewing. In the series, real pediatricians use their expertise to answer parents’ questions about the HPV vaccine and why it’s important for preventing cancer. The videos feature pediatricians answering friends’ questions about the HPV vaccine in a casual setting and reflect some of the most common questions parents have about the HPV vaccine.

You can find all the videos on the CDC website and on YouTube. There is a Spanish version of one of the videos on YouTube, too.

Epidemiology and Prevention of Vaccine-Preventable Diseases, 13th Edition (the Pink Book): Published by CDC, NCIRD, and the Public Health Foundation (PHF), the Pink Book provides health care professionals with the most comprehensive information available on vaccines and vaccine-preventable diseases. The Pink Book is available for purchase from the PHF Learning Resource Centerexternal icon, and the chapters and appendices can be viewed or downloaded from the NCIRD vaccines site.

2019 Pink Book Webinar Series: This 2019 online series of 15 webinars, which concluded on September 25, 2019, provides an overview of vaccination principles, general recommendations, immunization strategies, and specific information about vaccine-preventable diseases and the vaccines that prevent them. Each webinar explored a chapter from the 13th edition of the Pink Book. The webinars can be viewed online at the Pink Book webinar web page. Continuing Education (CE) is available for each webinar.

“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 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)external icon, 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, and offers a certificate of completion and/or Continuing Education (CE) for those that complete the training.

For more information, please contact

Current Issues in Immunization Webinars: Immunization 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. The next webinar will be on December 11, 2019. Dr. Lauri Markowitz will give an update on HPV vaccination recommendations. View the webinar web page for additional information and the archived webinars.

You Call the Shots Modules: You Call the Shots is a series of interactive, web-based training courses developed through the Project to Enhance Immunization Content in Nursing Education and Training. These courses are ideal for medical or nursing students, new vaccination providers, or seasoned health care providers seeking a review. The polio and influenza modules have recently been updated. Please visit the You Call the Shots web page to view all the modules. Continuing Education (CE) is available for viewing a module and completing an evaluation.

Measles and Mumps Resources: CDC aims to continue increasing awareness of measles and mumps among individuals and families and to encourage MMR vaccination. To support disease prevention and vaccination educational efforts, CDC has developed a variety of measles and mumps resources, including fact sheets, podcasts, and matte articles. Some of the measles graphics are also available in Spanish.

CDC and Medscape: This special series of commentariesexternal icon, 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.” The 2019 recommended immunization schedules are 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

Annual Conference on Vaccinology Research (ACVR)external icon, National Foundation for Infectious Diseases (NFID), March 23–25, 2020, Washington, DC

Northern Utah Immunization Coalition (NUIC) Annual Conferenceexternal icon, April 23, 2020, Ogden, UT

49th National Immunization Conference (NIC), May 19–21, 2020, Atlanta, GA

NCIRD Calendar of Events

Immunization Action Coalition (IAC) Calendarexternal icon

Page last reviewed: December 2, 2019