Immunization Works December 2020

January 4, 2021: Content on this page kept for historical reasons.

Immunization Works Newsletter - December 2020 - CDC

Top Stories

Guidance for Shingles Vaccination During the COVID-19 Pandemic: CDC recently updated its Shingrix frequently asked questions (FAQs) web page for health care providers with guidance on shingles vaccination during the COVID-19 pandemic. Shingles vaccination is an essential preventive care service for older adults that should not be delayed or discontinued because of the COVID-19 pandemic, unless a patient is suspected or confirmed to have COVID-19. CDC recommends health care providers counsel patients about potential shingles vaccination side effects. This is especially important during the COVID-19 pandemic, since some shingles vaccination side effects may be similar to symptoms of COVID-19. See the FAQs for additional guidance.

COVID-19 Vaccination Communication Toolkit for Medical Centers, Clinics, and Clinicians: This new toolkit includes ready-made materials that can be used to build confidence in COVID-19 vaccination among health care teams and other staff. Materials include:

  • A guide for building vaccine confidence within health systems, medical offices, and clinics
  • Turnkey slide decks for immunization coordinators, health care teams, and other health care personnel, with information about COVID-19 vaccines, tips for building vaccine confidence, and tips for having effective vaccine conversations with patients
  • Posters, fact sheets, FAQs, and social media
  • Printable buttons/stickers for staff to wear once they’ve been vaccinated
  • A video describing how ACIP makes recommendations and advises CDC on the use of vaccines in our country

Zostavax Reminder: The shingles vaccine Zostavax is no longer available for use in the United States. All remaining stock of Zostavax expired on November 18, 2020. Health care providers who have any remaining Zostavax vaccine in stock should discard the vaccine following medical waste disposal requirements. CDC continues to recommend 2 doses of Shingrix, separated by 2 to 6 months, to prevent shingles and its complications in adults age 50 years and older.

New COVID-19 Vaccine Web Pages for Pfizer-BioNTech and Moderna Vaccines: CDC has released two new web pages provding information on Pfizer-BioNTech and Moderna COVID-19 vaccines. The pages provide information on storage, handling, and administration information as well as useful tools for health care providers such as pre-vaccination checklists, standing order templates, storage unit temperature tracking logs and more. Also visit the general COVID-19 Vaccination page for overall clinical resources related to COVID-19 vaccine, including training, safety and requirements for vaccination providers participating in the program.

New COVID-19 Vaccine Web Pages: CDC has added vaccine-specific content to its extensive COVID-19 website. CDC’s new resources include information on vaccination planning and vaccine safety, as well as frequently asked questions. These resources are intended to build trust and confidence in future COVID-19 vaccines by clarifying how COVID-19 vaccine recommendations will be made and how the vaccines will be monitored for safety.

Look for frequent updates to this website and CDC’s Vaccines and Immunization website as more information becomes available and as vaccines are authorized or approved and recommended for use in the United States. CDC is committed to ensuring jurisdictions and federal entities that will be receiving vaccine have the information and guidance needed to implement an effective COVID-19 vaccination program.


Weekly United States Influenza Surveillance Report: CDC’s Influenza Division compiles and analyzes information on influenza activity year-round in the United States. Influenza activity remains low in the United States; however, the first flu-related pediatric death of the 2020–2021 season was reported recently.

Flu Vaccination Coverage Estimates from the 2020–21 Season Show Widening Disparities: CDC released data on flu vaccination coverage during the 2020–2021 flu season, suggesting that many people remain unvaccinated. Notably, while less than half of children overall had been vaccinated, only a third of Black, non-Hispanic children were vaccinated, which is 11 percentage points lower than last season. If you have not yet gotten a flu vaccine, there’s still time.

Add “Get a Flu Shot” to Your Holiday To-Do List: As you begin to plan responsibly for the holidays, flu vaccination is the most important step you can take to protect yourself, your loved ones, and your community from flu. Make plans today to get vaccinated because it can take up to two weeks after vaccination for antibodies to develop in your body and provide protection against flu.

Morbidity and Mortality Weekly Report (MMWR)

The Advisory Committee on Immunization Practices’ Interim Recommendation for Use of Moderna COVID-19 Vaccine — United States, December 2020: On December 18, 2020, the Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) for the Moderna COVID-19 (mRNA-1273) vaccine (ModernaTX, Inc; Cambridge, Massachusetts) The Moderna COVID-19 vaccine is a lipid nanoparticle-encapsulated, nucleoside-modified mRNA vaccine encoding the stabilized prefusion spike glycoprotein of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). This vaccine is the second COVID-19 vaccine authorized under an EUA for the prevention of COVID-19 in the United States. Vaccination with the Moderna COVID-19 vaccine consists of 2 doses (100 μg, 0.5 mL each) administered intramuscularly, 1 month (4 weeks) apart. On December 19, 2020, the Advisory Committee on Immunization Practices (ACIP) issued an interim recommendation for use of the Moderna COVID-19 vaccine in persons aged ≥18 years for the prevention of COVID-19. To guide its deliberations regarding the vaccine, ACIP employed the Evidence to Recommendation (EtR) Framework, using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Use of all COVID-19 vaccines authorized under an EUA, including the Moderna COVID-19 vaccine, should be implemented in conjunction with ACIP’s interim recommendations for allocating initial supplies of COVID-19 vaccines. The ACIP recommendation for the use of the Moderna COVID-19 vaccine under EUA is interim and will be updated as additional information becomes available. Read the full report in the December 20 MMWR.

Telehealth Practice Among Health Centers During the COVID-19 Pandemic — United States, July 11–17, 2020: Early in the coronavirus disease 2019 (COVID-19) pandemic, in-person ambulatory health care visits declined by 60% across the United States, while telehealth visits increased, accounting for up to 30% of total care provided in some locations. In March 2020, the Centers for Medicare & Medicaid Services (CMS) released updated regulations and guidance changing telehealth provisions during the COVID-19 Public Health Emergency, including the elimination of geographic barriers and enhanced reimbursement for telehealth services. The Health Resources and Services Administration (HRSA) administers a voluntary weekly Health Center COVID-19 Survey to track health centers’ COVID-19 testing capacity and the impact of COVID-19 on operations, patients, and staff. CDC and HRSA analyzed data from the weekly COVID-19 survey completed by 1,009 HRSA-funded health centers for the week of July 11–17, 2020, to describe telehealth service use in the United States by United States Census region, urbanicity, staffing capacity, change in visit volume, and personal protective equipment (PPE) supply. Among the 1,009 health center respondents, 963 (95.4%) reported providing telehealth services. Health centers in urban areas were more likely to provide >30% of health care visits virtually (i.e., via telehealth) than were health centers in rural areas. Telehealth is a promising approach to promoting access to care and can facilitate public health mitigation strategies and help prevent transmission of SARS-CoV-2 and other respiratory illnesses, while supporting continuity of care. Although CMS’s change of its telehealth provisions enabled health centers to expand telehealth by aligning guidance and leveraging federal resources, sustaining expanded use of telehealth services might require additional policies and resources. Read the full report in the December 2 MMWR.

Resources and Information

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.

The toolkit has been updated for 2020 to clarify language, including:

  • Beyond use date (BUD)
  • Routine maintenance for vaccine storage units
  • New definition added to the glossary

The toolkit also contains a COVID-19 Vaccine Storage and Handling Addendum with information on storage and handling best practices for COVID-19 vaccines. This addendum will be updated with specific storage and handling information for each COVID-19 vaccine product.

“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.

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 July 1, 2020, and ended October 14, 2020. This year, because of limited staff availability during the ongoing COVID-19 response, the videos were prerecorded rather than live webinars. Visit the Pink Book video series web page for the videos and additional information. Continuing Education (CE) is 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.

Current Issues in Immunization Webinars (CIIW): The latest webinar on October 21, 2020, offered an update on the recommendations for the 2020–21 influenza season. The webinars, held several times during the year, are designed to provide clinicians with the most up-to-date information on immunization. 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. The latest webinar, archived webinars, and additional information are available on the CIIW web page.

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.

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 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.

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.”

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, February 24–25, 2021, Atlanta, GA

Vaccine Summit Ohio, March 1–3, 2021, Columbus, OH

Massachusetts Adult Immunization Conference, April 13, 2021, Framingham, MA

North Dakota Immunization Conference, June 22–23, 2021, Bismarck, ND

ACIP Meeting, June 23–24, 2021, Atlanta, GA

ACIP Meeting, October 20–21, 2021, Atlanta, GA

NCIRD Calendar of Events

Immunization Action Coalition (IAC) Calendar