• Elevated Hand, Foot, and Mouth Disease Activity 
• Updates to CDC Immunization Schedule 
• Health in the Commonwealth Podcast series
• Maternal Mental Health Training 
• U.S. Antibiotic Awareness Week

Elevated Hand, Foot, and Mouth Disease Activity 

Hand, Foot, and Mouth Disease (HFMD) activity and outbreaks in Virginia are increased compared to previous years. While cases of HFMD typically increase during the summer and fall, emergency department/urgent care visits and outbreak reports in Virginia in 2025 have surpassed reports for previous years. The majority of outbreaks have been associated with K-12 schools and childcare centers. 

Children with HFMD should be excluded from school or childcare for at least 24 hours after fever is gone, without use of fever-reducing medicine, and there is no uncontrolled drooling or mouth sores. For additional information, refer to the Virginia Department of Health's Communicable Disease Reference Chart for School and Childcare Facility Personnel. 

Individual cases of HFMD are not reportable in Virginia, but outbreaks of HFMD (3 or more linked cases) are reportable.  Contact your local health department if you have questions or to report an outbreak of HFMD. Outbreaks can also be reported through the VDH Suspected Outbreak Reporting Portal.   

Updates to CDC Immunization Schedule 

Please take a moment to review the October 10th clinician letter from the Virginia Health Commissioner, Dr. Karen Shelton, which summarizes recent updates to the CDC immunization schedule. 

COVID-19 

• People aged 6 months and older can receive the vaccine based on shared clinical/individual-based decision making with a healthcare provider. 

• People aged 3 years and older may receive a COVID-19 vaccine at a pharmacy without a prescription.   

• Pharmacies may have different policies about the ages of patients they will vaccinate. Encourage parents to verify the acceptable age at their local pharmacy before making appointments or visiting a pharmacy for vaccination.  

MMRV (Measles, Mumps, Rubella & Varicella)   

• Children under the age of 4 years should receive the measles, mumps, and rubella vaccine and the varicella vaccine separately (MMR+V).  

• Children aged 4 years and older can still receive the combined MMRV vaccine. The recommendation for this age group has not changed.  

You can find additional guidance from the State Health Commissioner, Dr. Shelton, in the clinician letter and additional frequently asked questions about the COVID-19 vaccine recommendations on our website.  

Health in the Commonwealth: Advancing Health Equity Across the Lifespan. 

Together with VDH, the Virginia Department of Transportation (VDOT), and cross-sectoral teams from the Virginia Walkability Action Institute, Equitable Cities is supporting the development, implementation, and evaluation of projects and policies that expand access to active transportation for communities across Virginia. 

Produced in collaboration with Puddle Creative, the Health in the Commonwealth podcast takes you on an insightful journey into the people, partnerships, and initiatives shaping healthier, safer, and more connected communities.  

Listen now on the Virginia PATHS website, or wherever you get your podcasts, including Spotify and Apple Podcasts: https://virginiapaths.org/podcast/ 

Register Now: Maternal Mental Health Training 

The Virginia Health Care Foundation (VHCF) and Postpartum Support Virginia are offering virtual training on maternal mental health for healthcare professionals serving pregnant and postpartum Virginians. This special training is available at no cost to participants and is part of VHCF's maternal mental health initiative, It Takes a Village. 

You'll learn to: 

• Identify common perinatal mental health conditions 

• Recognize warning signs and symptoms 

• Approach clients with concerning behaviors 

• Connect families to treatment and support resources 

Perfect for: health safety net professionals, doulas, lactation consultants, community health workers, and others working with perinatal populations. 

Join VDH in Celebrating U.S. Antibiotic Awareness Week (USAAW), November 18-24!  

Check out the VDH USAAW website to see how you can participate.  

Activities include: 

• Wearing purple to show your support 
• Sharing resources with your patients 
• Learning more about hard-to-treat infections