NJIN Monthly Newsletter

June 2022

In this edition of the NJIN monthly newsletter, we discuss several vaccine-related topics, including pediatric and adolescent COVID vaccine updates, and a brief look at vaccine hesitancy and communication strategies.

FDA Advisers Endorse Emergency Use of Moderna, Pfizer Covid-19 Vaccine in Babies and Toddlers

The FDA’s independent vaccine advisers voted unanimously on Wednesday, June 15 to recommend the agency authorize two COVID-19 vaccines for babies, toddlers, and preschool-age children, putting the country’s youngest age group one step closer to immunizations nearly two-and-a-half years into the pandemic.

The panel comprised of pediatricians, infectious disease experts, and vaccine researchers — found that the benefits of vaccinating children under 5 against COVID outweigh the potential risks.

The FDA is expected to quickly authorize for emergency use the Pfizer-BioNTech vaccine for kids under 5 and the Moderna vaccine for kids under 6. Both options could be used in children as young as 6 months old.

The CDC’s panel of expert advisers will consider whether to recommend the shots’ administration during meetings on Friday and Saturday. Once CDC Director Rochelle Walensky signs off on a recommendation, children are expected to begin receiving shots by Tuesday. Children under 6 who receive the Moderna vaccine will get two 25-microgram doses, four weeks apart. The Pfizer vaccine is two 3-microgram doses three weeks apart, followed by a third dose eight weeks later.

As monkeypox cases grow throughout the United States with at least 45 confirmed cases, many are starting to wonder about a possible vaccine.

There are several modern vaccines available to help control the monkeypox virus family, however, not all of them are currently available and none are widely available to the public.

Today it was announced that the U.S. government put in an order for at least 500,000 doses of the JYNNEOS vaccine that can protect against both monkeypox and smallpox, according to the pharmaceutical company Bavarian Nordic.

British drugmaker GSK said on Monday, June 6th, its vaccine, Priorix, was approved by the U.S. Food and Drug Administration (FDA) for the prevention of measles, mumps, and rubella (MMR) in those aged one year and above.

The vaccine can be given as two doses and may also be administered as a second shot to individuals who were previously vaccinated with the first dose of another MMR-containing vaccine, GSK said.

Child vaccination rates in the United States fell during the COVID-19 pandemic as many children skipped doctor appointments and states eased vaccine requirements during remote learning, according to a government study released last month.

Health care workers are among the most trusted messengers of COVID-19 vaccine information, but many fail to leverage that trust on social media to encourage vaccination, according to a first-of-its-kind study led by scientists at the University of Pittsburgh School of Public Health that reveals vaccination motivations and hesitancies among health care workers and how those feelings are shared on social media.

The findings, published in the Journal of Community Health, point to new messages about COVID-19 vaccination—such as those involving freedom—that public health practitioners and clinicians can use to connect with patients, colleagues, and community members. Combined with techniques that foster constructive conversations, the Pitt researchers believe the insights gleaned from their study can turn the tide on vaccine hesitancy.

Ten million pediatric COVID-19 vaccine doses will be available for states, tribes, and other jurisdictions to pre-order in anticipation of vaccinations for kids ages 5 and younger beginning before the end of the month, the White House announced.

Administration officials outlining the plan said vaccines will be distributed across thousands of different sites, but they will put a focus on frontline providers like pediatricians and primary care doctors, as that is where they expect many families will want to go.

Education Opportunities

Free Online Learning Module:

Communicating About Vaccines – COVID-19 & More

This module was developed by the Vaccine Education Center and the Office of Community Engagement at the Children’s Hospital of Philadelphia (CHOP), in partnership with the Pennsylvania Chapter, American Academy of Pediatrics (PA-AAP), Pennsylvania Immunization Coalition (PAIC), and Philadelphia Department of Public Health (PDPH).

This free web-based, interactive session offers a two-hour training divided into three parts:

Part 1: Details the dangers of COVID-19 disease, explains the US system to authorize and approve vaccines, and highlights the safety & effectiveness of COVID-19 vaccines.

Part 2: Explores vaccine communication best practices.

Part 3: Reviews the module, offers additional resources, and explains how to receive continuing education credit or a certificate of attendance for training requirements. Continuing education credits are available for physicians, nurses, and pharmacists.

This module was developed for adult and pediatric providers, immunization champions, and community members. The module provides a better understanding of the facts around COVID-19 disease, how the vaccine approval process works, and how to communicate effectively about these topics so that stakeholders — and their constituents — have a solid, or reinforced, urgency regarding what the receipt of vaccines can do to protect people from COVID-19.

Access the Learning Module Here

Vaccine Spotlight

Measles, Mumps, and Rubella

(MMR) Vaccination

mmr-vaccine-saturn-stillsscience-photo-library image

What is Measles?

Measles is an acute viral respiratory illness. It is characterized by a prodrome of fever (as high as 105°F) and malaise, cough, coryza, and conjunctivitis -the three “C”s -, a pathognomonic enanthema (Koplik spots) followed by a maculopapular rash. The rash usually appears about 14 days after a person is exposed. The rash spreads from the head to the trunk to the lower extremities. Patients are considered to be contagious from 4 days before to 4 days after the rash appears. Of note, sometimes immunocompromised patients do not develop the rash.

What is Mumps?

Mumps is a viral illness caused by a paramyxovirus, a member of the Rubulavirus family. The average incubation period for mumps is 16 to 18 days, with a range of 12 to 25 days.

Mumps usually involves pain, tenderness, and swelling in one or both parotid salivary glands (cheek and jaw area). Swelling usually peaks in 1 to 3 days and then subsides during the next week. The swollen tissue pushes the angle of the ear up and out. As swelling worsens, the angle of the jawbone below the ear is no longer visible. Often, the jawbone cannot be felt because of swelling of the parotid. One parotid may swell before the other, and in 25% of patients, only one side swells. Other salivary glands (submandibular and sublingual) under the floor of the mouth also may swell but do so less frequently (10%).

What is Rubella?

Rubella is a viral illness that can lead to complications and death. It is characterized by a mild, maculopapular rash along with lymphadenopathy, and a slight fever. The rash usually starts on the face, becomes generalized within 24 hours, and lasts a median of 3 days; it occurs in 50% to 80% of infected people, Lymphadenopathy, which may precede rash, often involves posterior auricular or suboccipital lymph nodes, can be generalized, and lasts between 5 and 8 days. About 25% to 50% of infections are asymptomatic.

Clinical diagnosis of rubella virus is unreliable and should not be considered in assessing immune status. Up to half of all infections may be subclinical or unapparent. Many rubella infections are not recognized because the rash resembles many other rash illnesses.

MMR Vaccination Recommendations

CDC recommends that people get the MMR vaccine to protect against measles, mumps, and rubella. Children should get two doses of MMR vaccine, starting with the first dose at 12 to 15 months of age, and the second dose at 4 through 6 years of age. Teens and adults should also be up to date on their MMR vaccination. Children may also get the MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Children

CDC recommends all children get two doses of MMR (measles-mumps-rubella) vaccine, starting with the first dose at 12 through 15 months of age, and the second dose at 4 through 6 years of age. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

Learn about the MMRV vaccine, which protects against measles, mumps, rubella, and varicella (chickenpox). This vaccine is only licensed for use in children who are 12 months through 12 years of age.

Students at Post-High School Educational Institutions

Students at post-high school educational institutions who do not have presumptive evidence of immunity need two doses of MMR vaccine, separated by at least 28 days.

Adults

Adults who do not have presumptive evidence of immunity should get at least one dose of MMR vaccine.

Certain adults may need 2 doses. Adults who are going to be in a setting that poses a high risk for measles or mumps transmission should make sure they have had two doses separated by at least 28 days. These adults include

Students at post-high school education institutions
Healthcare personnel
International travelers

International Travelers

People 6 months of age and older who will be traveling internationally should be protected against measles. Before any international travel—

Infants 6 through 11 months of age should receive one dose of MMR vaccine. Infants who get one dose of MMR vaccine before their first birthday should get two more doses (one dose at 12 through 15 months of age and another dose separated by at least 28 days).
Children 12 months of age and older should receive two doses of MMR vaccine, separated by at least 28 days.
Teenagers and adults who do not have presumptive evidence of immunity against measles should get two doses of the MMR vaccine separated by at least 28 days.

Healthcare Personnel

Healthcare personnel should have recorded presumptive evidence of immunity, according to the recommendations of the Advisory Committee on Immunization Practices Healthcare personnel without evidence of immunity should get two doses of MMR vaccine, separated by at least 28 days.

MMR Vaccination Resources for Healthcare Providers

Factsheets for Parents

Access the CDC's MMR Information Page Here

FDA Advisers Endorse Emergency Use of Moderna, Pfizer Covid-19 Vaccine in Babies and Toddlers

Monkeypox Vaccine: U.S. Orders 500,000 Jynneos Doses as Cases Rise

GSK Measles Vaccine Gets U.S. FDA Approval

Twitter Analysis and Healthcare Worker Surveys Give New Insights Into COVID-19 Vaccine Hesitancy

White House Unveils Plans to Roll Out COVID-19 Vaccines for Kids 5 and Under