View this as a webpage

March 29, 2024

In This Edition

• New ACIP recommendations and resolutions from February meeting
• Bridge Access Program
• School and child care immunization data
• Varicella changes
• HPV vaccine prevents oral cancer!
•  HPV vaccination quality improvement project
• National Infant Immunization Week (NIIW)
• Nirsevimab season ending
• MIIC Webinar Series and Continuing Education Units (CEUs)

New ACIP recommendations and resolutions from February meeting

The Advisory Committee on Immunization Practices (ACIP) met on Feb. 28 and 29 and approved the following:

One more dose of COVID-19 vaccine for older adults

An additional dose of any updated 2023-2024 COVID-19 vaccine (i.e., Moderna, Novavax, Pfizer-BioNTech) should be administered to persons age 65 years and older. This additional dose should be given at least 4 months following the previous dose of the updated 2023-2024 COVID-19 vaccine. Additional information is available at CDC: Interim Clinical Considerations for Use of COVID-19 Vaccines. The CDC: Adult Immunization Schedule Addendum has been updated with this new recommendation.  

Chikungunya vaccine for travelers and lab workers

Chikungunya is a virus spread to people by the bite of an infected mosquito. Chikungunya virus disease cases and outbreaks have been identified in more than 100 countries. The ACIP voted to approve chikungunya vaccine for:

• Travelers:
  • Persons age 18 years and older traveling to a country or territory where there is a chikungunya outbreak.
  • Immunization may be considered for the following persons traveling to a country or territory without an outbreak but with evidence of chikungunya virus transmission among humans within the last 5 years:
    • Persons age > 65 years, particularly those with underlying medical conditions, who are likely to have at least moderate exposure to mosquitoes, OR
    • Persons staying for a cumulative period of 6 months or more.
• Laboratory workers:  
  • Recommended for lab workers with potential for exposure to chikungunya virus.

To learn more about areas at risk, visit CDC: Areas at Risk for Chikungunya | Chikungunya virus.

Td vaccine for children younger than 7 years old

The ACIP approved the Vaccines for Children (VFC) resolution for diphtheria, tetanus, and pertussis (DTaP) vaccines, which allows the addition of Tetanus, Diphtheria (Td) vaccine to the VFC program for children younger than 7 years old who have a contraindication to the pertussis component of DTaP. For more information on the ACIP recommendation and the use of Td in children younger than 7 years old, visit CDC: ACIP: Vaccines for Children's Program to Prevent Diphtheria, Tetanus and Pertussis - Resolution No. 02/24-1 and CDC: About Young Children with a Contraindication to Pertussis-Containing Vaccines.

The next ACIP meeting is scheduled for June 26-28. 

Bridge Access Program

Most Minnesotans have insurance that will cover the full cost of COVID-19 vaccines. However, adults age 19 years and older without health insurance and adults whose health insurance does not cover all COVID-19 vaccine costs can still receive free updated COVID-19 vaccines through the CDC’s Bridge Access Program.

The new COVID-19 recommendation for adults 65 and older means that some uninsured adults should receive additional doses, and thanks to the Bridge Access Program, there are plenty of COVID-19 vaccine doses available. Uninsured and Underinsured Adult Vaccine providers should order more vaccines as needed to serve uninsured and underinsured adults. Adults age 19 or older without insurance are eligible for the Bridge Access Program.

Adults without health insurance and those whose health insurance does not cover all COVID-19 vaccine costs can find more information below on where they can receive the vaccine at no cost:

• Call the COVID-19 Public Hotline at 1-833-431-2052 or contact them via the IDEPC Comment Form.
• Visit COVID-19 Community Coordinators for the organizations that connect Minnesotans to COVID-19 testing, vaccination, and other resources.
• Visit Vaccine.gov: Find COVID 19 vaccine locations near you to find a location near you to received COVID-19 vaccine.

Note that the program is not intended to cover the costs of vaccination for people whose insurance is out-of-network at a particular location.

School and child care immunization data

• The 2023-2024 school and child care immunization coverage data, including summaries for individual schools and child care centers, are now available at School Immunization Data and Child Care Immunization Data.
• Overall vaccination rates have continued to decline since the beginning of the COVID-19 pandemic.
• Coverage levels for kindergarten students have decreased more than 5 percentage points for most of the required vaccines since the 2019-2020 school year, leaving many students vulnerable to vaccine preventable diseases.
• Rates of students in the “in-progress or missing doses” category remain high, around 7% of all kindergarten students statewide since the start of the pandemic.
• Rates of non-medical exemptions have been increasing, with more than 5% of kindergarteners having a non-medical exemption for at least one required vaccine.
• Minnesota school immunization requirements are designed to help ensure kids are safe and healthy in school. Consider sending reminders or calling families into the clinic earlier this year to avoid a rush later this summer.

Varicella changes

• In January, the national surveillance case definition for varicella-zoster virus was revised due to the changing epidemiology in a population with high vaccine coverage.
  • Patients who have rashes without vesicular lesions are now accounted for in the clinical case definition.  
  • Cases diagnosed by a health care provider as varicella without a rash description must have epi-linkage or laboratory confirmation/evidence to be considered a probable case.  
  • The outbreak definition for varicella is defined as three or more epi-linked cases, to help with national consistency of classifying and understanding outbreak trends.  
• The reporting requirements for varicella have NOT changed. Only epidemiological classifications of cases have changed to better describe trends in varicella and public health response.
• All suspect cases of varicella should continue to be reported to MDH through the Chickenpox and Shingles Reporting Form.
• Additionally, laboratory confirmation is encouraged due to the challenges around clinical diagnosis of varicella. MDH recently published an MMWR highlighting laboratory findings among those clinically diagnosed with suspect varicella CDC: MMWR: Notes from the Field: Expanded Laboratory Testing for Varicella — Minnesota, 2016–2023.

For more information on the varicella updates, visit ymaws.com: Council of States and Territorial Epidemiologists: 23-ID-09_Varicella.pdf.

HPV vaccine prevents oral cancer!

April is Oral Cancer Awareness Month. HPV-associated oropharyngeal cancers of the mouth and throat are growing in Minnesota. Recent data from MDH shows HPV oropharyngeal cancers predominantly affect American Indian, White, and Black males in Minnesota.   

Routine HPV vaccination at ages 9-12 years can prevent 6 types of cancers later in life, including oral cancers. On-time HPV vaccination rates in Minnesota remain low. For more information on adolescent vaccination coverage data and gaps visit Adolescent Immunizations.  

Participate in oral cancer awareness and prevention. To increase HPV vaccination rates, providers can:  

• Provide a strong recommendation for HPV vaccination. 
• Start the conversation about HPV vaccine beginning at age 9. 
• Vaccinate as early as age 9 and promote on-time completion of HPV vaccine series by age 13. 
• Share HPV cancer prevention messages with families. 

For more information on strategies for improving HPV vaccination rates in your clinic, visit For Health Care Providers Serving Adolescents.

 HPV vaccination quality improvement project

Join the HPV vaccination quality improvement project and increase your clinic’s HPV vaccination rates. Watch the Boosting HPV Vaccination Rates Webinar presented by Dr. Robert Jacobson, M.D., of Mayo Clinic. Participating clinics will receive resources from MDH and the American Cancer Society on best strategies and practices for improvement, how to use available interactive data tools on Minnesota HPV cancer data and vaccination data, and technical assistance on MIIC quality improvement tools. For more information, email health.iqip.mailbox@state.mn.us.

Join us on May 15 from noon to 1 p.m. for a second webinar on the IQIP HPV Vaccination Improvement Project. Hear about new strategies to increase HPV vaccination rates and how to address barriers and challenges from Dr. Vanessa Slots, M.D., M Health Fairview. All clinic staff, immunizers, and immunization advocates are welcome and encouraged to join. To register for the webinar, visit Addressing Barriers to HPV Vaccination: MDH/ACS Quality Improvement Project.

National Infant Immunization Week (NIIW)

NIIW is April 22 -29. The purpose of the week is to highlight the importance of protecting children two years and younger from vaccine preventable diseases. To learn more, visit CDC: NIIW (National Infant Immunization Week) for key messages and a digital media toolkit to get the word out about the importance of immunizing infants in your community.

Nirsevimab season ending

The recommendation for administration of nirsevimab (infant RSV monoclonal antibody immunization product) ends 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 store all unused doses in the refrigerator to be used next October.

MIIC Webinar Series and Continuing Education Units (CEUs)

Please join us for a Minnesota Immunization Information Connection (MIIC) webinar series! Four separate sessions will be held on Tuesdays from 11 a.m. to noon starting April 23.  

No registration is required. MIIC staff will be covering several aspects of MIIC and will save time for questions at the end of each session. We hope you are able join us.

Continuing Education Units (CEUs) will be available to providers who participate in MIIC webinar sessions, either the live events or the recordings. Please stay tuned for further information and meeting links.  

Webinar 1: Introduction to MIIC

• April 23 from 11 a.m. to noon.
• Learn about participating and logging into MIIC, changing your password, and managing clients. 
• Join MIIC Webinar 1

Webinar 2: Reviewing Client Immunization Histories

• April 30 from 11 a.m. to noon.
• Learn more about searching for a client, reviewing their immunization history, and the MIIC forecaster. 
• Join MIIC Webinar 2

Webinar 3: Getting Data In and Out of MIIC

• May 14 from 11 a.m. to noon.
• Learn about electronic data exchange, editing immunizations, Bulk Query, and special reports.  
• Join MIIC Webinar 3

Webinar 4: MIIC tools to Increase Immunization Coverage 

• May 21 from 11 a.m. to noon.
• Learn more about assessment reports for understanding immunization coverage and client follow up (for obtaining information about overdue/recommended immunizations. 
• Join MIIC Webinar 4

For questions about the webinar series reach out to health.miichelp@state.mn.us.

Download version for print

Find previous newsletters at Got Your Shots? News.

Manage Preferences  |  Unsubscribe  |  Help  |  health.state.mn.us/immunize