In This Edition:

Updated COVID-19 vaccine recommendation for people 65 years of age and older

Third case of measles confirmed in Minnesota

Stay one step ahead of measles

Nirsevimab season ending

Drive immunization improvement with IQIP

Pregnancy and Vaccination Pocket Guide updated

Get free 2024 recommended immunization schedules

Updated COVID-19 vaccine recommendation for people 65 years of age and older

On Feb. 28, the Advisory Committee on Immunization Practices (ACIP) voted in favor of the following recommendation: Persons 65 years of age and older should receive an additional dose of 2023-2024 formula COVID-19 vaccine. The recommendation acknowledges the increased risk of severe disease from COVID-19 in older adults, along with the currently available data on vaccine effectiveness. Visit CDC: Immunization Practices: ACIP February 28-29, 2024 Presentation Slides to find information shared during the ACIP meeting.

The Centers of Disease Control and Prevention (CDC) endorsed the recommendation in a formal statement: CDC Online Newsroom: Older Adults Now Able to Receive Additional Dose of Updated COVID-19 Vaccine. We anticipate updates to the CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines and the CDC: Adult Immunization Schedule Addendum for additional clinical information.

Note that some of the current 2023-2024 COVID-19 vaccine is expiring soon. Make sure to pay attention to expiration dates! Vaccine with longer expiration dates is still available.

Third case of measles confirmed in Minnesota

Three cases of measles have been confirmed in the metro area. Two of the children are siblings, unvaccinated, and had recently traveled internationally. The third child was an unvaccinated family member who had close contact with the first two cases. All cases required hospitalization. Recent national and international trends of increasing measles cases, coupled with the decreasing rates of the measles, mumps, and rubella (MMR) vaccination in Minnesota, put communities at risk for additional cases or even an outbreak of measles. It is important to be on heightened alert for measles in people presenting with fever, rash, cough, coryza, and conjunctivitis. Take time to talk to patients about the importance of the MMR vaccine.

Information on recognizing and reporting measles, including a pocket guide, can be found at Measles Information For Health Professionals and Measles (Rubeola) Pocket Guide (PDF). A Health Alert Network (HAN) summarizing the first case and other provider resources can also be found at Health Advisory: Travel-Associated Measles- MN At Risk for More (PDF).

Health care providers should also assess the MMR status of all pediatric patients and recall children that need MMR vaccination. Minnesota Health Care Programs providers can now bill Medical Assistance for stand-alone vaccination counseling visits, which includes MMR along with COVID-19 and other routine vaccines for children and adults. To learn more, visit the DHS: Child and Teen Checkups (C&TC).

Stay one step ahead of measles

Measles is one of the fastest spreading and most contagious vaccine preventable diseases. Here are some tips for staying one step ahead:

- Know what you are looking for: The telltale symptoms of measles are high fever, rash, and the 3 C’s: cough, coryza, and conjunctivitis. Koplik spots may be present inside the mouth. The maculopapular rash starts on the face, then spreads down the neck, trunk, upper extremities then lower extremities. Palms and soles are not affected.

- Recall unvaccinated children: Many children missed their one-year well child visit because of COVID. That means they missed the opportunity for their first dose of MMR. The Minnesota Immunization Information Connection (MIIC) recall is available if you would like assistance with reaching out to this group of children. If you would like to participate, reach out at [email protected].

- Revisit the choice: Even if a patient has refused MMR vaccine in the past, they may change their mind when there is an outbreak or case in their community. Always be open to offering the vaccine and having conversations that debunk myths surrounding vaccine safety.

- Vaccinate BEFORE travel: While measles is typically first given at 12 months old, it can be given as young as 6 months old to children who are traveling internationally. Consider delaying travel if someone in your family cannot yet be vaccinated. If travel cannot be delayed, ensure all family and people surrounding an infant are up to date on MMR vaccination or otherwise protected. For more information on traveler’s health use the CDC: Yellow Book 2024: Rubeola/Measles.

- Adults may need to be vaccinated: Double check adult vaccination history. Adults born in 1957 or later should have one dose of MMR. Adults traveling internationally should have two MMR doses. For those in childbearing years, assess their vaccination status and give MMR at least one month prior to pregnancy. 

- Post-exposure prophylaxis (PEP): In the unfortunate case of exposure to a measles case, MMR vaccine can be administered within 72 hours of the initial measles exposure to an unvaccinated person. Immunoglobulin can also be given for high-risk exposures for unvaccinated pregnant people, infants under one year and immunocompromised people. However, the window for administration is within six days, so it is important to act quickly. 

Don’t delay! Reach out to the Minnesota Department of Health (MDH) for assistance: If you suspect a measles case in your community, report it as soon as possible. The MDH phone number is 651-201-5414. Lab testing information, support and information are available at: Reporting Measles (Rubeola).

Nirsevimab season ending

Please continue using the available inventory of nirsevimab, the RSV immunization product for infants, until the recommendations for immunization end on March 31. Most current doses will not expire at the end of this season and can still be used next fall. Check expiration dates and any unused doses in the refrigerator between 36°F to 46°F (2°C to 8°C) to be used next season.

Drive immunization improvement with IQIP

Quality improvement (QI) programs can help with planning activities aimed at raising immunization rates. The Immunization Quality Improvement for Providers (IQIP) program analyzes current provider and clinic-wide practices and recommends systematic approaches to improve performance. This program is offered for all clinics enrolled in the Minnesota Vaccine for Children program. The program takes place over a 12-month cycle and starts with a conversation with an immunization consultant on current immunization workflows, a review of childhood and adolescent immunization coverage rates from MIIC, and resources and technical assistance for implementing improvement activities. Clinics then will check in with their consultant on a regular basis for additional help with their improvement plans. IQIP is a great way to drive improvement at the clinic level and to incorporate current research into ongoing QI work. If you are interested in IQIP, reach out to [email protected] to schedule a visit.

Pregnancy and Vaccination Pocket Guide updated

The Pregnancy and Vaccination Pocket Guide (PDF) has been updated and can be used as a guide for health care providers. It outlines vaccination decisions prior to, during and after pregnancy and in the baby’s first year. The pocket guide and other resources can be found on Pregnancy and Vaccination. Printed versions of the Pregnancy and Vaccination Pocket Guide can be ordered free of charge at Order Printed Immunization Materials.

Get free 2024 recommended immunization schedules

The 2024 Recommended Adult Immunization Schedule and the Recommended Child and Adolescent Immunization Schedule are available for order for free at Order Printed Immunization Materials.

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