Immunization Works December 2019

December 19, 2019: Content on this page kept for historical reasons.


Immunization Works Newsletter December 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. 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. Conference participants will have 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.

Visit the conference registration siteexternal icon for meeting details, hotel information, session themes, and additional information.

If you have questions, please contact


Flu Forecasting (2019–2020 Season): CDC, through its Epidemic Prediction Initiative (EPI), is updating the “FluSight” website weekly with forecasts about the current flu season. Visitors to the site can view current and past forecasts for the start and peak week, peak intensity, and the near-term activity at national and regional levels. The most recent flu forecasts of the 2019–2020 season indicated that as of December 9, nationally:

  • Flu activity is likely to increase and remain elevated over the next few weeks.
  • Flu activity will likely peak between December and February, with a 45% chance of a peak in late December, a 30% chance of a peak in January, and a 20% chance of a peak in February.

For the seventh year in a row, CDC’s Influenza Division is engaging with members of the scientific community to develop these forecasts. In the first year, 11 teams participated. This year, more than 20 teams are expected to participate. The forecasts are generally available each Wednesday on the “FluSight” flu forecasting website.

Flu Burden In-Season Estimates: CDC provides weekly preliminary estimates of the cumulative, in-season numbers of flu illnesses, medical visits, hospitalizations, and deaths in the U.S. For a number of years, CDC has used a mathematical model to make these estimates based on observed rates of laboratory-confirmed influenza-associated hospitalizations. The numbers had been provided after the end of the season. However, last season, for the first time, preliminary burden estimates were provided in-season.

The latest in-season estimates for the 2019–2020 flu season were released on December 13 and showed that from October 1, 2019, to December 7, 2019, there were:

  • 6 million to 3.7 million flu illnesses
  • 2 million to 1.8 million flu medical visits
  • 23,000 to 41,000 flu hospitalizations
  • 1,300 to 3,300 flu deaths

These estimates are preliminary and may change as additional data are reported to CDC. You can find the weekly in-season estimates on the preliminary-in-season web page.


Use of Anthrax Vaccine in the U.S.: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2019: The December 13 MMWR updates the 2009 recommendations from ACIP regarding use of anthrax vaccine in the U.S. The report: 1) summarizes data on estimated efficacy in humans using a correlates of protection model and safety data published since the last ACIP review, 2) provides updated guidance for use of anthrax vaccine adsorbed (AVA) for preexposure prophylaxis (PrEP) and in conjunction with antimicrobials for postexposure prophylaxis (PEP), 3) provides updated guidance regarding PrEP vaccination of emergency and other responders, 4) summarizes the available data on an investigational anthrax vaccine (AV7909), and 5) discusses the use of anthrax antitoxins for PEP.

These updated recommendations can be used by health care providers and guide emergency preparedness officials and planners who are developing plans to provide anthrax vaccine, including preparations for a wide-area, aerosol release of B. anthracis spores. The recommendations also provide guidance on dose-sparing options, if needed, to extend the supply of vaccine to increase the number of persons receiving PEP in a mass-casualty event.

Progress toward Regional Measles Elimination—Worldwide, 2000–2018: In 2010, the World Health Assembly (WHA) set the following three milestones for measles control to be achieved by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) among children age 1 year to more than 90% at the national level and to more than 80% in every district, 2) reduce global annual measles incidence to less than five cases per 1 million population, and 3) reduce global measles mortality by 95% from the 2000 estimate. In 2012, WHA endorsed the Global Vaccine Action Plan, with the objective of eliminating measles in five of the six World Health Organization (WHO) regions by 2020. The December 6 MMWR updates a previous report and describes progress toward WHA milestones and regional measles elimination during 2000–2018. During 2000–2018, estimated MCV1 coverage increased globally from 72% to 86%; annual reported measles incidence decreased 66%, from 145 to 49 cases per 1 million population; and annual estimated measles deaths decreased 73%, from 535,600 to 142,300. During 2000–2018, measles vaccination averted an estimated 23.2 million deaths. However, the number of measles cases in 2018 increased 167% globally compared with 2016, and estimated global measles mortality has increased since 2017. To continue progress toward the regional measles elimination targets, resource commitments are needed to strengthen routine immunization systems, close historical immunity gaps, and improve surveillance. To achieve measles elimination, all communities and countries need coordinated efforts aiming to reach at least 95% coverage with 2 doses of measles vaccine.

Progress toward Measles Elimination in China, January 2013–June 2019: In 2005, the World Health Organization (WHO) Western Pacific Region countries, including China, resolved to eliminate measles by 2012 or as soon as feasible thereafter. As of 2018, nine of the 37 Western Pacific Region countries or areas had eliminated measles. China’s Measles Elimination Action Plan 2006–2012 included strengthening routine immunization; conducting measles risk assessments, followed by supplementary immunization activities (SIAs) with measles-containing vaccine (MCV) at national and subnational levels; strengthening surveillance and laboratory capacity; and investigating and responding to measles outbreaks. Most recently, progress toward measles elimination in China was described in a 2014 report documenting measles elimination efforts in China during 2008–2012 and a resurgence in 2013. The December 6 MMWR describes progress toward measles elimination in China during January 2013–June 2019. Measles incidence per million persons decreased from 20.4 in 2013 to 2.8 in 2018; reported measles-related deaths decreased from 32 in 2015 to one in 2018 and no deaths in 2019 through June. Measles elimination in China can be achieved through strengthening the immunization program’s existing strategy by ensuring sufficient vaccine supply; continuing to improve laboratory-supported surveillance, outbreak investigation, and response; strengthening school entry vaccination record checks; vaccinating students who do not have documentation of receipt of 2 doses of measles-rubella vaccine; and vaccinating health care professionals and other adults at risk for measles.

Resources and Information

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. During the latest webinar on December 11, 2019, Dr. Lauri Markowitz gave 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.

Five Things to Know about Rotavirus Vaccines: Rotavirus vaccination coverage in the U.S. is lower than that of other childhood vaccines. You can play a critical role in making strong recommendations to parents for rotavirus vaccination and ensuring that eligible infants get vaccinated on schedule. Learn more from this Medscape articleexternal icon.

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

Pink Book Trainingexternal icon, Indiana Immunization Coalition and CDC, April 14–15, 2020, Plainfield, IN

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 19, 2019