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Red Book Online News

February 7, 2024

The AAP Red Book is published every three years, but the pediatric infectious disease landscape is changing continuously. Red Book Online is consistently updated with the latest recommendations from the AAP. This approach ensures that pediatric healthcare professionals have access to the most current information, enabling them to deliver optimal care to children.

Check the Red Book Online News page often for breaking news related to pediatric infectious diseases and immunizations, including new vaccine recommendations, vaccine or antiviral shortages, product recalls, disease outbreaks, travel notices, and more. 


February 2024

Red Book Online Outbreaks Update: Listeria Outbreak Linked to Queso Fresco and Cotija Cheese Posted 1/16/24
Officials are currently investigating a multistate outbreak of Listeria monocytogenes outbreak linked to queso fresco and cotija cheese.

A new entry on this Listeria outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


January 2024

Measles Reported in Multiple States; Be Prepared to Take Infection-Control Steps Posted 1/26/24
Melissa Jenco, News Content Editor

Clinicians should be prepared to identify a possible case of measles and take infection-control measures as cases have been reported in at least six states.

Measles is a highly contagious disease and can be especially dangerous in young children. Symptoms include fever, cough, runny nose and watery eyes followed by a maculopapular rash that begins on the head and face and spreads downward. The disease can result in complications like pneumonia, brain damage and deafness, and can be fatal.

Cases have been reported recently in DelawareGeorgiaNew JerseyPennsylvaniaVirginia, and Washington state. In Virginia, officials warned that a traveler with measles may have exposed people at Dulles International Airport and Ronald Reagan Washington National Airport.

Measles is transmitted through contact with infectious droplets or by airborne spread when an infected person breathes, coughs or sneezes, according to the Centers for Disease Control and Prevention (CDC). The virus can remain in the air for up to two hours.

The AAP and CDC have guidance on preventing the disease from spreading in health care settings when there is a known or suspected case of measles. Health care personnel should have presumptive evidence of immunity from the disease through vaccination, laboratory evidence or birth before 1957. They also should take standard and airborne precautions, including wearing a fit-tested National Institute for Occupational Safety & Health-approved N95 or higher-level respirator.

Patients with a known or suspected case of measles should be placed in an airborne infection isolation room (AIIR). If one is not available, they should be in a private room with the door closed until they can be transferred to an AIIR. Patients 2 years and older and their family should wear well-fitting masks.

Clinicians also should routinely promote respiratory hygiene and cough etiquette, appropriately manage exposed and sick health care providers and implement environmental infection control. The AAP and CDC resources below have additional details.

When a patient is suspected of having measles, the CDC recommends clinicians collect a throat or nasopharyngeal swab and a blood sample for testing and report suspected measles cases to their local and/or state health department.

Measles vaccines are highly effective at preventing illness. Children should receive their first dose of measles, mumps and rubella (MMR) vaccine between 12 and 15 months of age and a second dose between 4 and 6 years. If traveling abroad, infants ages 6 months through 11 months should have one dose of MMR, and children 12 months and older should receive two doses at least 28 days apart.

recent CDC study found 93% of kindergartners were fully vaccinated against measles during the 2022-’23 school year, ranging from 81% in Idaho to at least 98% in Mississippi. It was the third consecutive year the vaccination rate was below the Healthy People 2030 target of 95%, and officials estimated about 250,000 kindergartners remain at risk.

Other countries also have been grappling with measles cases and inadequate vaccination rates. In the United Kingdom, health officials issued a warning last week about rising cases in some areas and said more than 3 million unvaccinated children in England are at risk. The World Health Organization’s European Region recently reported there were more than 42,000 cases in 2023, a 45-fold increase compared to 2022, and attributed the spike to decreased measles vaccine coverage during the COVID-19 pandemic.

Resources

This article was originally published January 25, 2024, in AAP News.


Salmonella Outbreak Linked to Charcuterie Meats Posted 1/16/24
Officials are currently investigating a multistate outbreak of Salmonella linked to charcuterie meats.

A new entry on this Salmonella outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


FDA Allows Import of Antibiotic during Bicillin Shortage Posted 1/12/24
Melissa Jenco, News Content Editor

Editor's note: For more coverage of drug, immunization and medical device shortages, visit https://bit.ly/AAPNewsDrugShortages.

The Food and Drug Administration (FDA) is temporarily allowing importation of an antibiotic that can be used to treat syphilis while there is a shortage of Bicillin L-A (penicillin G benzathine injectable suspension).

Extencilline (benzathine benzylpenicillin) is a powder and diluent for reconstituting for injection and is available in strengths of 1.2 million units and 2.4 million units. It can be used in neonates, children, adolescents and adults. The product from Laboratoires Delbert in conjunction with Provepharm Inc. and Direct Success Inc. is marketed in France and manufactured in Italy. It is not FDA approved.

Pfizer sent a letter to customers in June about supply issues impacting Bicillin L-A and Bicillin C-R (penicillin G benzathine and penicillin G procaine injectable suspension) prefilled syringes. Some presentations remain in limited supply and others are depleted, according to Pfizer.

Bicillin is used to treat pregnant women with syphilis, which helps protect their babies from the disease. Bicillin also is used to treat babies with congenital syphilis, which has been on the rise.

Ten times as many babies were born with syphilis in 2022 than a decade prior, bringing rates to their highest level in at least 30 years, according to a recent report from the Centers for Disease Control and Prevention (CDC).

There are several differences between the warning and instructional labels for Extencilline and Bicillin L-A that are detailed in a letter from Laboratoires Delbert to health care providers. The two also come in different forms (powder for reconstitution compared to a prefilled syringe). Instructions are available on how to prepare and administer Extencilline.

To place an order, contact Direct Success at Distribution@DSuccess.com or 877-404-3338.

Resources

This article was originally published January 11, 2024, in AAP News.


Erythromycin Ointment Shortage Posted 1/8/24
There is an ongoing shortage of erythromycin ointment. Erythromycin 0.5% ophthalmic ointment is the only recommended regimen to prevent ophthalmia neonatorum caused by N. gonorrhoeae.

If erythromycin ointment is not available, a birthing parent who is at risk for exposure to N. gonorrhoeae * or who had no prenatal care, should be tested for N. gonorrhoeae in the immediate peripartum setting using a nucleic acid amplification test (NAAT). If the birth parent’s test is positive for gonorrheal infection or if the test result is pending at time of discharge with concerns for lack of follow-up, the neonate should receive ceftriaxone, 25 to 50 mg/kg of body weight, IV or IM, not to exceed 250 mg in a single dose; if ceftriaxone is unavailable or contraindicated, a single dose of ceftazidime or cefepime may be substituted.2-4

The Centers for Disease Control and Prevention recommends notifying your local health department of any challenges in procuring the product. Additional information regarding the availability of erythromycin (0.5%) ophthalmic ointment is available on the FDA Drug Shortage page.

* Women < 25 years old, and those 25 years or older who have a new partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has a sexually transmitted infection (STI), or live in a community with high rates of gonorrhea; practice inconsistent condom use when not in a mutually monogamous relationship; have a previous or coexisting STI; have a history of exchanging sex for money or drugs; or have a history of incarceration.1,2

References:

  1. US Preventive Services Task Force. Screening for Chlamydia and Gonorrhea: US Preventive Services Task Force Recommendation Statement. 2021 Sept 14;326(10):949-956
  2. Sexually Transmitted Infections Treatment Guidelines, 2021. Centers for Disease Control and Prevention. Available at: www.cdc.gov/std/treatment-guidelines/gonorrhea-neonates.htm
  3. Nolt D, O’Leary ST, Aucott SW; AAP Committee on Infectious Diseases, AAP Committee on Fetus and Newborn. Risks of Infectious Diseases in Newborns Exposed to Alternative Perinatal Practices. Pediatrics. 2022;149(2):e2021055554
  4. American Academy of Pediatrics. Gonococcal Infections. In: Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH, eds. Red Book: 2021 Report of the Committee on Infectious Diseases. 32nd ed. American Academy of Pediatrics; 2021:338-34

Resources:

Availability of STI Testing & Treatment Products | Centers for Disease Control and Prevention
STI Treatment Guidelines, 2021  | Centers for Disease Control and Prevention
Erythromycin Ointment Drug Shortage  | US Food and Drug Administration
Red Book Online  | American Academy of Pediatrics
AAP News | American Academy of Pediatrics

Also refer to the Erythromycin Ointment Shortage page on RBO.


Nutramigen Infant Formula Recalled due to Possible Contamination Posted 1/2/24
Melissa Jenco, News Content Editor

Batches of Nutramigen Hypoallergenic Infant Formula Powder are being recalled due to possible bacterial contamination.

Manufacturer Reckitt/Mead Johnson Nutrition agreed to initiate a voluntary recall of 675,030 cans of formula after Cronobacter sakazakii bacteria was found in a batch being exported from the U.S. to Israel.

The Food and Drug Administration (FDA) has been investigating since mid-December and has not found Cronobacter in the samples it has tested.

Cronobacter sakazakii bacteria can cause sepsis or meningitis. Symptoms include poor feeding, irritability, temperature changes, jaundice, grunting breaths and abnormal movements. Cronobacter also may cause bowel damage. No illnesses have been reported in connection with the Nutramigen recall.

The recalled formula was distributed in June, July and August 2023 at retail stores nationwide. The affected products have a batch code of

  • ZL3FHG (12.6 ounce [oz] cans),
  • ZL3FMH (12.6 oz cans),
  • ZL3FPE (12.6 oz cans),
  • ZL3FQD (12.6 oz cans),
  • ZL3FRW (19.8 oz cans) and
  • ZL3FXJ (12.6 oz cans).

The products have a UPC Code of 300871239418 or 300871239456 and a use by date of Jan. 1, 2025. The recall does not affect any other Nutramigen batches or Reckitt products in the U.S.

Customers who have a recalled can should stop using the formula. They can throw it away or contact Reckitt/Mead Johnson Nutrition for a refund.

The recalled formula is used by infants who are allergic to cow’s milk. Substitute formulas are available, and the FDA recommends that parents and caregivers work with their health care provider to find one. Parents should never dilute infant formula or make their own. They also should not purchase imported formula online as it could be counterfeit.

The FDA said it does not expect major impact on the U.S. supply of powdered infant formulas, unlike a 2022 recall of Abbott Nutrition formula linked to Cronobacter. In that recall, the combination of a plant shutdown and supply chain issues left parents and caregivers struggling to find food for their infants.

Parents who have questions should consult their pediatrician or contact Reckitt/Mead Johnson at 866-534-9986 or consumer.relations@rb.com.

Resources

This article was originally published January 2, 2024, in AAP News.


December 2023

Red Book Online—Celebrating 20 Years! Posted 12/21/23
In the year's final celebration of the 20th anniversary of Red Book Online, we take one last look at the first edition of the Red Book published in 1938—a mere 8 pages covering a mix of 18 topics.

Take a look at the original 1938 Red Book chapter "Measles" and find out what has changed.

"RBO deftly shares the tradition of excellence as the “latest and greatest” definitive source for
child health professionals to get all the answers they need at point-of-care to treat, manage and
prevent infectious diseases in children, using the best available evidence gathered by the AAP."
David W. Kimberlin, MD, FAAP, Red Book Editor


Rocky Mountain Spotted Fever Outbreak Posted 12/15/23
The Centers for Disease Control and Prevention recently issued a Health Alert Network (HAN) Health Advisory to notify healthcare providers about an outbreak of Rocky Mountain spotted fever among people in the United States with recent travel to or residence in the city of Tecate, state of Baja California, Mexico.

This new outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impact for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


November 2023

New Salmonella and Listeria Outbreaks Linked to Fruit Posted 11/30/23
Officials are currently investigating two multistate outbreaks: Salmonella Outbreak Linked to Cantaloupes and Listeria Outbreak Linked to Peaches, Nectarines, and Plums.

These new outbreaks have been added to the Red Book Online Outbreaks page, providing information about the outbreaks and their impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


New Vaccine Status Table Updates Posted 11/22/23
Red Book Online Vaccine Status Tables contain current information about recently submitted, licensed, and recommended vaccines and biologics, including status of the US Food and Drug Administration (FDA) licensure process and related American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) recommendations. Information in the Vaccine Status Tables was just updated. Updates include the addition of the following two vaccines to Table 1. Status of Recently Submitted, Licensed, and Recommended Vaccines & Biologics. 

View all three Vaccine Status Tables on Red Book Online at https://publications.aap.org/redbook/resources/15449/.


Two New Salmonella Outbreaks Posted 11/15/23
Officials are currently investigating two multistate outbreaks: Salmonella Outbreak Linked to Dry Dog Food and Salmonella Outbreak Linked to Fresh Diced Onions.

These new outbreaks have been added to the Red Book Online Outbreaks page, providing information about the outbreaks and their impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


CDC: During Nirsevimab Shortage, Prioritize Infants at Risk, Encourage Maternal Vaccination Posted 11/10/23
Melissa Jenco, News Content Editor

Health officials acknowledged growing frustration among pediatricians who are struggling to stock the long-awaited respiratory syncytial virus (RSV) immunization nirsevimab (Beyfortus) and offered advice on managing increasingly limited supplies.

During an AAP webinar Wednesday, officials from the Centers for Disease Control and Prevention (CDC) continued to recommend prioritizing infants at highest risk, referring patients to other providers and encouraging vaccination during pregnancy.

"We are in a really important place right now where we finally have products that protect infants against the No. 1 cause of hospitalization in the United States, and we’re thrilled this is happening, but yet we have this supply issue," said Manisha Patel, M.D., M.S., M.B.A., chief medical officer for the National Center for Immunization and Respiratory Diseases. "I just want to acknowledge this is a challenge for all of us."

Sanofi stopped taking new orders for the 100 milligram (mg) doses in October saying supply had exceeded the high demand. In recent days, it also paused ordering for 50 mg doses but plans to reopen them Nov. 16 with limited allocation. Shipping on existing orders of both products will continue into December.

Ayanna Santos, Pharm.D., head of RSV Franchise, U.S. Vaccines for Sanofi, said during the webinar the company is "ensuring there is equitable distribution across the states and across settings, so that includes clinics, birthing hospitals, whether they’re independent or part of a large system."

Sanofi will contact providers who have allocations assigned this week and next week. Pediatricians also can talk to their field representative or call customer service at 855-BEYFORTUS (855-239-3678).

The CDC also is using an allocation system for the Vaccines for Children (VFC) program and has new allocations every two to three weeks. Pediatricians with questions on VFC distribution should contact their state immunization program.

In late October, the CDC released guidance on managing the shortage of 100 mg doses. The advice officials provided Wednesday followed many of the same themes.

  • Prioritize the youngest patients and those with underlying conditions like prematurity, congenital heart disease and chronic lung disease.
  • Refer patients to other providers with nirsevimab supply such as health departments.
  • Encourage maternal vaccination during 32-36 weeks of pregnancy. The CDC approved a new maternal vaccination in September, and while supplies still are ramping up, they are expected to be sufficient.
  • Consider limiting use of nirsevimab for infants who have tested positive for RSV because their risk of a second infection is lower.
  • Give available doses now. The RSV season has begun, and infants born later will have an opportunity to benefit from maternal vaccination.
  • Don’t use two 50 mg doses for children who need 100 mg. Doing so is not part of the Food and Drug Administration’s approval and may not be covered by insurance. It also would exhaust supply more quickly.

The CDC previously announced flexibilities in the VFC program, including bidirectional borrowing between public and private stock. However, Sarah Meyer, M.D., M.P.H., chief medical officer for the CDC’s Immunization Services Division, cautioned against borrowing from VFC stock if providers are unsure about their next commercial shipment. If they already have borrowed and can’t repay the doses, they should talk to Sanofi or other provider networks to get replacements. If that is not possible, providers should work with their state immunization program to document the borrowing and reimburse it immediately when supply increases, even if that is early next season, Dr. Meyer said.

The CDC also was asked about private insurers, which have a year to start covering the immunization. Charlene Wong, M.D., a senior adviser for health strategy at the CDC, said most of the major commercial insurance companies already indicated they will cover nirsevimab. The CDC is continuing to work with payers to encourage adequate payment for both nirsevimab and palivizumab, another RSV product for high-risk infants.

The Centers for Medicare & Medicaid Services recently announced it has established payment rates for nirsevimab similar to other pediatric immunization administration services.

Strict VFC requirements and payment issues are just a few of the logistical hurdles the AAP had been working to clear long before nirsevimab received final approval.

Supply was not anticipated to be a problem. Dr. Santos said Sanofi and its partner, AstraZeneca, looked at data from previous product launches for children as a guide for supply planning. She apologized for the shortage.

"Obviously, that approach was not sufficient for the demand that we’re seeing for Beyfortus," she said. "We missed the mark there."

Resources

This article was originally published November 9, 2023, in AAP News.



New Red Book Online Chapter
Update—Streptococcus pneumoniae (Pneumococcal) Infections Posted 11/2/23
The Streptococcus pneumoniae (Pneumococcal) Infections chapter in Red Book on Red Book Online was just updated to reflect the updated guidelines for the use of a new 20-valent pneumococcal conjugate vaccine (PCV20, Prevnar 20, Pfizer) for children.

Summary: On September 29, 2023, the Centers for Disease Control and Prevention (CDC) published updated guidelines for the use of a new 20-valent pneumococcal conjugate vaccine (PCV20, Prevnar 20, Pfizer) for children. The CDC recommends use of PCV20 as an option to PCV15 for: routine vaccination of all children aged 2–23 months; catch-up vaccination for healthy children aged 24–59 months who have not received age-appropriate doses; and children aged 24–71 months with certain underlying medical conditions at increased risk for pneumococcal disease who have not received age-appropriate doses.

See the full update in the Streptococcus pneumoniae (Pneumococcal) Infections chapter in Red Book on Red Book Online.


New Vaccine Status Table Updates Posted 11/2/23
Red Book Online Vaccine Status Tables contain current information about recently submitted, licensed, and recommended vaccines and biologics, including status of the US Food and Drug Administration (FDA) licensure process and related American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) recommendations. Information in the Vaccine Status Tables was just updated. Updates include the following:

Table 1. Status of Recently Submitted, Licensed, and Recommended Vaccines & Biologics

  • RSV Nirsevimab (Monoclonal Antibody) and RSV (Maternal): Updated guidance

Table 3. Sars-CoV-2 Vaccines

  • Pfizer mRNA
    • Addition of new 2023–2024 formulation and all new guidance and information for all indicated age groups
    • Removal of bivalent formulation (no longer authorized for use in the United States)
  • Moderna mRNA
    • Addition of new 2023–2024 formulation and all new guidance and information including updated FDA age indications
    • Removal of bivalent formulation (no longer authorized for use in the United States)
  • Novavax: Addition of new protein-based 2023–2024 formulation and all new guidance and information including updated FDA age indications

Next Respiratory Virus Series Webinar: Nirsevimab Supply and Prioritization Updates Posted 11/2/23
Join us on Wednesday, November 8 from 7 – 8 pm CT for a timely webinar, “Nirsevimab Supply and Prioritization Updates”, which is part of the AAP Respiratory Virus Webinar Series. Hear from CDC representatives and other experts about the current shortage of nirsevimab, what to anticipate in terms of supply for the 2023-2024 RSV season, and highlights from the recently released CDC Health Advisory Pediatricians, family physicians, practice managers, pediatric support staff, and others are encouraged to join. Pre-registration is required. 

Register here. See Respiratory Season Webinar Series for previous webinar recordings. 


October 2023

Seasonal Flu Resources from the CDC Posted 10/24/23
Visit the Centers for Disease Control and Prevention (CDC) Influenza (Flu) Communication Resource Center for everything you need to help communicate the importance of influenza vaccination. Included is the new digital campaign “Wild to Mild” which shows how flu vaccination can help “tame” flu symptoms (from “wild” to “mild”) in people who get vaccinated but still get sick.


Diagnosis Detective—New Feature on RBO! Posted 10/3/23
Diagnosis Detective is an exciting new feature on Red Book Online (RBO) that challenges you to solve a new infectious disease case every month. Developed by a dedicated subteam of the American Academy of Pediatrics Committee on Infectious Diseases, this new feature offers the following benefits:

  • Monthly Diagnostic Challenge: Return monthly to test your diagnostic skills with new infectious disease content and images.
  • Interactive Quiz: Actively participate and learn by solving real-world infectious disease cases.
  • Teaching/Learning: Use the valuable infectious disease educational content to learn, as well as reference as needed.
  • Social Sharing: Share your success on social media platforms—Facebook, LinkedIn, and Twitter/X.
  • Archived Cases: Challenge yourself with previous cases, which will be archived, for continued learning or if you missed a previous month’s case.

Solve this month’s infectious disease case on RBO at https://publications.aap.org/redbook/resources/24128.


Preterm Infants Given Probiotics at Risk of Fatal Disease: FDA Warning Letter Posted 10/3/23
Alyson Sulaski Wyckoff, Associate Editor

The Food and Drug Administration (FDA) is warning health care providers that preterm infants who are given probiotics are at risk of invasive, potentially fatal disease caused by the bacteria or fungi contained in probiotics.

An FDA letter to providers includes information about a preterm infant who was administered Evivo with MCT Oil as part of in-hospital care. The infant developed sepsis caused by the bacterium Bifidobacterium longum and subsequently died. 

In 2021, the AAP released the clinical report Use of Probiotics in Preterm Infants, from the Committee on Fetus and Newborn, that included discussion of the potential risks of their use and the evidence in prevention and treatment of necrotizing enterocolitis (NEC) and late-onset sepsis.

The FDA letter relays the following safety recommendations:

  • Microorganisms contained in probiotics have been reported in the medical literature as causing bacteremia or fungemia, sometimes with a severe clinical course, in very preterm or very low birth weight infants.
  • The FDA letter includes an excerpt from the AAP clinical report that states, “Given the lack of FDA-regulated pharmaceutical-grade products in the United States, conflicting data on safety and efficacy, and potential for harm in a highly vulnerable population, current evidence does not support the routine, universal administration of probiotics to preterm infants, particularly those with a birth weight of <1000 g.”
  • The FDA has not approved any probiotic product for use as a drug or biological product in infants. The FDA is aware that some unapproved, unlicensed probiotics are sold for use to treat or prevent a disease or condition in infants, including to reduce the risk of NEC in preterm infants. Health care providers should be aware that these products have not undergone the FDA’s premarket review evaluation for safety and effectiveness, nor have they been evaluated for compliance with the agency’s manufacturing and testing standards for drugs and biological products, including testing for extraneous organisms.
  • Health care providers who administer probiotics containing live bacteria or yeast to treat, mitigate, cure or prevent a disease or condition are required to submit an Investigational New Drug Application to the agency.

Resources

This article was originally published October 2, 2023, in AAP News.


September 2023

FDA OKs New Monovalent COVID-19 Vaccines Posted 9/13/23
Melissa Jenco, News Content Editor

The Food and Drug Administration (FDA) has authorized newly formulated COVID-19 vaccines from two manufacturers.

The monovalent vaccines from Moderna and Pfizer-BioNTech were authorized for everyone 6 months and older. The Centers for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices meets Tuesday to make clinical recommendations on use of the vaccines. Vaccination could begin shortly after approval from the CDC director.

“Vaccination remains critical to public health and continued protection against serious consequences of COVID-19, including hospitalization and death,” Peter Marks, M.D., Ph.D., director of the FDA’s Center for Biologics Evaluation and Research, said in a press release. “The public can be assured that these updated vaccines have met the agency’s rigorous scientific standards for safety, effectiveness, and manufacturing quality. We very much encourage those who are eligible to consider getting vaccinated.”

The FDA made the following authorizations:

  • Individuals 5 years of age and older regardless of previous vaccination are eligible to receive a single dose of an updated mRNA COVID-19 vaccine at least two months after the last dose of any COVID-19 vaccine.
  • Individuals 6 months through 4 years of age who previously were vaccinated against COVID-19 are eligible to receive one or two doses of an updated mRNA COVID-19 vaccine. Timing and number of doses to administer depend on the previous COVID-19 vaccine received (see resources).
  • Unvaccinated individuals 6 months through 4 years of age are eligible to receive three doses of the updated authorized Pfizer-BioNTech COVID-19 vaccine or two doses of the updated authorized Moderna COVID-19 vaccine.

The FDA said it expects side effects to be similar to previous versions of the vaccines.

The authorizations come as the CDC reports just over 17,000 COVID hospitalizations in the past week, an increase of 15.7%. Deaths rose 10.5% in the most recent week.

Following recommendations from its expert advisers, the FDA requested the new monovalent formulation with an XBB.1.5 strain in June, aiming to better match circulating virus variants. The original strain and other early variants no longer are circulating. Experts also noted most people have antibodies against the original strain from vaccination, infection or both.

Vaccine manufacturers presented data from animal studies showing updated XBB vaccine formulations elicit stronger neutralizing antibody responses against these strains than current vaccines. A Moderna study with 101 adults also showed improved neutralizing antibody response against XBB and a similar safety profile to previous COVID vaccines. Recent studies show the new vaccines also should be able to neutralize EG.5, which is the most commonly circulating variant, as well as the BA.2.86 strains, according to the FDA.

The new vaccines will be the first COVID vaccines sold on the commercial market. Monday’s actions mean the bivalent Moderna and Pfizer-BioNTech vaccines no longer are authorized for use.

Resources

This article was originally published September 11, 2023, in AAP News.


August 2023

New Red Book Online Webinar
Posted 8/24/23
The AAP created a new webinar—Pandemic Influenza Preparedness. In this short webinar, Dr Tim Uyeki provides an overview of what pandemic influenza is and how practices can be prepared in the event of a future pandemic. Access this webinar on Red Book Online. Find more information and resources on the AAP Pandemic Influenza web page.

All Red Book Online webinars are available at https://publications.aap.org/redbook/resources/15686


New Red Book Online Outbreaks Posted 8/24/23
Officials are currently investigating two multistate outbreaks: Salmonella illnesses linked to small turtles and Listeria illnesses linked to ice cream.

These new outbreaks have been added to the Red Book Online Outbreaks page, providing information about the outbreaks and their impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


COCA Call: AAP and CDC 2023-2024 Recommendations for Influenza Prevention and Treatment Posted 8/24/23
Join the AAP and the CDC for a Clinician Outreach and Communication Activity (COCA) Call to learn about the 2023-2024 recommendations for influenza prevention and treatment in children and adolescents. Speakers, Dr Kris Bryant (AAP) and Dr Fatimah Dawood (CDC) will also provide an overview of the 2022-2023 season, strategies to increase immunization rates, highlight important health disparities, and best practices for vaccine coadministration. The COCA Call will be held on August 31st from 2 pm to 3 pm ET. Save the date and join here!


New Recommendations for the Use of Nirsevimab for RSV Posted 8/17/23
Red Book Online (RBO) was just updated to include new guidance on the use of Nirsevimab, a long-acting monoclonal antibody product intended for use in newborns and infants, to protect against respiratory syncytial virus (RSV) disease.

Nirsevimab was approved by the US Food and Drug Administration last month and recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention early this month for:

  • All infants younger than 8 months born during or entering their first RSV season, including those recommended by the American Academy of Pediatrics (AAP) to receive palivizumab;
  • Infants and children aged 8 through 19 months who are at increased risk of severe RSV disease and entering their second RSV season, including those recommended by the AAP to receive palivizumab.

See these new recommendations on RBO, as well as additional guidance regarding palivizumab versus nirsevimab administration for high-risk infants.


Use these Tools from the AAP to Plan Your Flu Vaccine Clinic Posted 8/9/23
The flu season is right around the corner, begin planning for your vaccine clinic. A flu vaccine clinic is a great way to efficiently vaccinate your patient population and increase vaccination rates. The How to Set Up a Flu Clinic toolkit from the AAP includes resources for pediatric practices to plan and implement an in-office vaccination clinic. This flu clinic toolkit links to the communication toolkit with shareable social media graphics, editable posters, a one-pager for families, videos on influenza vaccination, as well as a Healthy Children article for families in multiple languages. Use these tools to promote your clinic and to remind parents about the importance of getting vaccinated. 


CDC Approves Monoclonal Antibody to Protect Infants from RSV Posted 8/4/23
A new monoclonal antibody to protect infants and high-risk toddlers from respiratory syncytial virus (RSV) is expected to be available this fall, following Thursday’s approval by the Centers for Disease Control and Prevention (CDC) director.

The CDC’s Advisory Committee on Immunization Practices (ACIP) voted 10–0 Thursday to recommend nirsevimab for infants younger than 8 months born during or entering their first RSV season and certain high-risk children ages 8–19 months entering their second season.

The AAP will review ACIP’s guidance and provide its own additional guidance in the near future.

See the full article in AAP News.


Red Book Online Outbreaks Update: Salmonella Outbreak Linked to Ground Beef Posted 8/2/23
Officials are currently investigating a multistate outbreak of Salmonella illnesses linked to ground beef.

A new entry on this Salmonella outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


NEW! Access the Systems-based Treatment Table on Your Mobile Device Posted 8/2/23
Red Book Online’s most-used resource, the Systems-based Treatment Table, is now available in a new mobile view that makes the content more easily viewable on your phone or tablet. Access empiric treatment recommendations for common conditions found in children and adolescents (including Cellulitis, Abscess, Lymphadenitis, Mastoiditis, Acute bacterial sinusitis, Acute otitis media, Streptococcal pharyngitis, and more.) Just visit the Table online and click into the Mobile-Friendly View for easy access. Don’t forget to use the “Add to Home Screen” feature to save the table to your device’s home screen for fast access. Questions or feedback


AAP Offers Free Media Training Course for Pediatricians Posted 8/2/23
The AAP is recruiting pediatricians to be part of the AAP Infection Prevention and Control Spokesperson ECHO. This ECHO serves as a forum for AAP members to improve knowledge, skills, and confidence around media interviewing, talking to communities, and engaging on social media, as it relates to pediatric-focused content, specifically, infection prevention and control. This ECHO will meet on Mondays from 10:00 – 11:00 am CT/11:00 am – 12:00 pm ET on the following dates: August 28, September 11, October 2, 16, 30, and November 13 for a total of 6 sessions. Apply here.


July 2023

Vaccine Status Table Updates Posted 7/5/23
Red Book Online Vaccine Status Tables contain current information about recently submitted, licensed, and recommended vaccines and biologics, including status of the US Food and Drug Administration (FDA) licensure process and related American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) recommendations. Information in the Vaccine Status Tables was just updated. Updates include the following:

Table 1: Status of Recently Submitted, Licensed, and Recommended Vaccines & Biologics

  • Removed vaccine listings for DTaP/IPV/Hep B/Hib (Vaxelis®), Ebola (Ervebo®), and HPV (Gardasil®)
  • PCV20 (Prevnar 20®) 
    • Updated FDA Licensure to April 27, 2023
    • Updated FDA Age Indications from “18 years and older” to “6 weeks and older”
    • Updated CDC/AAP Recommendations for use

Table 3: Sars-CoV-2 Vaccines

  • Removed vaccine listings for mRNA162b2 and mRNA-1273 (no longer FDA-approved)
  • Pfizer mRNA, bivalent (original and omicron BA.4/BA.5)
    • Updated guidance for ages 6 months to 11 years
  • Moderna mRNA, bivalent (original and omicron BA.4/BA.5)
    • New information on EUA 4/18/2023 for ages 6 months through 5 years
  • Removed the Janssen/Johnson & Johnson, non-replicating adenovirus vaccine which is no longer available in the United States

Red Book Online Outbreaks Update: Fungal Meningitis Outbreak Associated with Procedures Performed under Epidural Anesthesia in Matamoros, Mexico Posted 7/3/23
Officials are currently investigating a multinational outbreak of fungal meningitis among people who had procedures under epidural anesthesia in Matamoros, Mexico.

A new entry on this fungal meningitis outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


June 2023

Red Book Online Outbreaks Update: Two New Multistate Outbreaks of Salmonella Posted 6/30/23
Officials are currently investigating the following two multistate outbreaks:

New entries on these two outbreaks have been added to the Red Book Online Outbreaks page, providing information about the outbreaks and their impact for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits and keep an eye out for emails from Red Book Online alerting you to updates.


Red Book Online—Celebrating 20 Years! Posted 6/22/23
Red Book Online is celebrating its 20th anniversary this year. Red Book was one of the earliest medical books to have a distinct online site, just a few years after medical journals began to have an online presence. Red Book Online is the home to the latest infectious disease content, including important information about outbreaks and vaccines. Read more about RBO’s anniversary in the AAP News article Red Book Online marks 20 years as must-have pediatric infectious diseases resource.

"RBO deftly shares the tradition of excellence as the 'latest and greatest' definitive source for child health professionals to get all the answers they need at point-of-care to treat, manage and prevent infectious diseases in children, using the best available evidence gathered by the AAP." David W. Kimberlin, MD, FAAP, Red Book Editor


May 2023

Salmonella Infections Among Infants Gradually Rising Posted 5/25/23
Melissa Jenco, News Content Editor

Salmonella infections among infants have been rising gradually since the mid-2000s, and invasive infections are more common among Black and Asian infants, according to a new study.

Salmonella among infants continues to be associated with substantial morbidity and mortality,” authors wrote in “Epidemiology of Salmonellosis Among Infants in the United States: 1968-2015,” (Self JS, et al. Pediatrics. May 10, 2023).

Researchers from the Centers for Disease Control and Prevention used two surveillance systems to describe characteristics of nontyphoidal Salmonella infections (salmonellosis) over a 48-year period. They focused on infections in infants, the age group with the highest incidence rates and developing immune systems.

Data from the national surveillance system showed there were 190,627 confirmed Salmonella infections among infants from 1968-2015, although these infections are known to be underreported. Following declines in the 1990s, salmonellosis has been increasing gradually since the mid-2000s, according to the study.

During the 48-year span, about 86.7% of cases were gastroenteritis, 3.5% were bacteremia, 0.2% meningitis and 9.7% had another/unknown cause. Cases of gastroenteritis and bacteremia had a median age of 4 months, while infants with meningitis tended to be younger, with a median age of 2 months.

Data from 2004-’15 showed racial differences in invasive infections (bacteremia and meningitis). Infection rates were about 2.7 times higher for Black infants than White infants and 1.8 times higher for Asian infants than White infants.

The Typhimurium serotype caused the largest percentage of Salmonella infections among infants both overall and for gastroenteritis. The Heidelberg serotype was the most common serotype reported in bacteremia and meningitis cases, according to the study.

Hospitalization and death rates were highest for meningitis. About 96% of infants with meningitis, 70% of those with bacteremia and 26% of those with gastroenteritis were hospitalized. Deaths occurred in about 4% of meningitis cases, 1.6% of bacteremia cases and 0.1% of gastroenteritis cases.

Authors called for more research on risk factors for salmonellosis in infants.

“Many infants are probably exposed to Salmonella in the home; they might become infected from the same exposures that could infect other family members, including consumption of foods and contact with contaminated surfaces, or they might acquire illness from family members,” they wrote. “Food is the major source of salmonellosis for the general population, so the most effective control measure might be to decrease Salmonella contamination of food.”

Resources

This article was originally published on March 24, 2023, in AAP News.


Red Book Online Outbreaks Update: Hepatitis A Outbreak Linked to Frozen Organic Strawberries Posted 5/11/23
Officials are currently investigating a multistate outbreak of Hepatitis A linked to frozen organic strawberries.

A new entry on this Hepatitis outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


Red Book Online Outbreaks Update: Salmonella Outbreak Linked to Flour Posted 5/9/23
Officials are currently investigating a multistate outbreak of Salmonella illnesses linked to flour.

A new entry on this Salmonella outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


April 2023

New Webinar—Updates to the 2023 Child and Adolescent Immunization Schedule Posted 4/11/23
The following new PCO Webinar, presented by Henry (Hank) Bernstein, DO, MHCM, FAAP, is now available to view on the Webinars page of Pediatric Care Online (PCO) and Red Book Online.

Let’s Increase Vaccination Rates in Children: Updates to the 2023 Child and Adolescent Immunization Schedule
In this new webinar, Dr. Bernstein reviews the latest updates to the 2023 Recommended Childhood and Adolescent Immunization Schedule, discusses the update to COVD-19 vaccines for children, and highlights concern for vaccine hesitancy. View webinar

Resources

Henry (Hank) Bernstein, DO, MHCM, FAAP is a Professor of Pediatrics at the Zucker School of Medicine at Hofstra/Northwell in New York. He presently is a member of the Vaccines and Related Biological Products Advisory Committee of the FDA, an ex-officio member of the AAP Committee on Infectious Diseases, and an Associate Editor of Red Book Online. After completing his four-year term as a member of the Advisory Committee on Immunization Practices (ACIP) of the CDC, he now serves as a consultant to the ACIP’s COVID-19, Influenza, and Immunization Schedules Workgroups.


CDC: TB rates in children under 5 rose 29% in 2022 Posted 4/3/23
Tuberculosis (TB) rates dipped early in the COVID-19 pandemic but rose in 2022, especially among children under 5 years, according to a new study from the Centers for Disease Control and Prevention (CDC).

There were about 8,300 cases of TB in the U.S. in 2022, an incidence rate of about 2.5 per 100,000 people, according to provisional data in a new Morbidity and Mortality Weekly Report. The case rate per 100,000 people was up from 2.4 in 2021 and 2.2 in 2020, but not as high as the pre-pandemic level of 2.7 in 2019. While cases had been trending downward for years, authors said changes in people’s travel habits and health care access in the early days of the pandemic may have contributed a larger decline in 2020.

Last year, the highest case count was in California, which had 1,843 cases, while the highest rate was in Alaska, which had about 13 cases per 100,000 people.

About 73% of cases were among people not born in the U.S., according to the report. Among U.S.-born people with TB, people who are Native Hawaiian, other Pacific Islander, American Indian and Alaska Native had the highest incidence rates.

People ages 65 and older had the highest TB rates in 2022. However, there was a 29% increase among children under 5 years and a 24% increase among people ages 15-24 years.

In addition to racial disparities, people who are homeless or reside in congregate settings like a correctional facility or long-term care facility are at higher risk. The CDC is partnering with community health clinics and other organizations to address disparities and raise awareness of TB.

See the full article, as well as related resources, in AAP News.

Also refer to the Tuberculosis chapter in the AAP Red Book on Red Book Online.


AAP Offers Free Learning Opportunities to Improve COVID Vaccination Rates For Kids Under 5  Posted 4/1/23

AAP is offering free 1.25-hour webinars to help you counter COVID vaccination disinformation in social media. Attendees are eligible to receive CME credits for each webinar.

Click the links to register:

  • April 4  (10–11 am CST) - COVID Vaccination Disinformation 101: Understanding the Ecosystem
  • April 11 or April 18 (10–11 am CST) - COVID Vaccination Disinformation 201: How to Identify and Respond to Specific Threats
  • April 25 (10–11 am CST) - Countering COVID Vaccination Disinformation in Hispanic and Latino Communities

In addition, AAP is hosting free workshops with interactive faculty discussions on improving COVID vaccination confidence.

Click the links to take the pre-workshop survey and register:

  • April 4  (11:30–12:30 pm CST) - Increasing Vaccination Rates Through Quality Improvement, Eliza Varadi, MD, FAAP
  • April 17  (2–3 pm CST) - Leveraging Partnerships to Increase Vaccine Confidence, Cynthia R. McReynolds, MBA
  • May 12  (12–1 pm CST) - Strategies to Improve Vaccine Confidence, Rajiv M. Naik, MD, FAAP

March 2023

FDA Authorizes Bivalent Pfizer COVID Vaccine Boosters for Children Under 5 Posted 3/17/23
Melissa Jenco, News Content Editor

Update: On March 16, the CDC updated its clinical guidance on boosters to match the expanded authorization from the FDA. For the latest news on COVID-19, visit http://bit.ly/AAPNewsCOVID19.

Children under 5 years who received the monovalent Pfizer-BioNTech COVID vaccine series soon may be eligible for a bivalent booster.

The Food and Drug Administration (FDA) has amended emergency use authorization for a bivalent booster in this age group at least two months after the primary series. The Centers for Disease Control and Prevention (CDC) will decide whether to recommend this use.

Peter Marks, M.D., Ph.D., director of the FDA’s Center for Biologics Evaluation and Research, said the move will give eligible families "an opportunity to update their children’s protection."

"Currently available data show that vaccination remains the best defense against severe disease, hospitalization and death caused by COVID-19 across all age groups, and we encourage all eligible individuals to make sure that their vaccinations are up to date with a bivalent COVID-19 vaccine," Dr. Marks said in a press release.

The bivalent booster includes the original SARS-CoV-2 strain plus an omicron BA.4/5 spike protein. Only children who received a primary series of three monovalent doses would be eligible. Those who received a bivalent dose as the third dose of their primary series are not eligible.

Vaccine uptake among young children has been low. Just 4% of children under 2 years and 6% of children ages 2-4 years have completed a primary series with any vaccine, according to CDC data.

The bivalent booster was tested in 60 children in this age group who had completed a monovalent Pfizer-BioNTech primary series. The clinical study found the booster elicited an immune response to both the original strain and BA.4/5.

The FDA assessed safety from several clinical studies. In a study that included 24 participants 6 months through 23 months who received a three-dose primary series of monovalent Pfizer-BioNTech vaccine and a bivalent booster dose, the most common side effects included irritability, drowsiness, injection site redness, pain and swelling, decreased appetite, fatigue and fever. Among 36 participants age 2-4 years, the most common side effects included fatigue, injection site pain, redness and swelling, diarrhea, vomiting, headache, joint pain and chills.

This article was originally published on March 14, 2023, in AAP News.


New Red Book Online Chapter Update—Influenza Posted 3/16/23
The American Academy of Pediatrics (AAP) Red Book is published every three years, but the pediatric infectious disease landscape is changing continuously. The AAP has approved a process to update chapters on Red Book Online between publication years to help pediatric health care professionals provide the best possible care for children.

Summary: In September 2022, the AAP published its annual influenza policy statement, providing its recommendations for the routine use of influenza vaccine and antiviral medications in the prevention and treatment of influenza in children during the 2022–2023 influenza season. This update aligns this Red Book chapter with this AAP policy statement.

See this update in the Influenza chapter in Red Book on Red Book Online.

See other Red Book updates since its publication in 2021: Cholera, Dengue, Human Immunodeficiency Virus Infection, Rabies, Streptococcus pneumoniae (Pneumococcal Infections), and Tuberculosis.

Also, refer to the continually updated Red Book Online Influenza News and Resources page for the most recent influenza information.


February 2023

Extensively Drug-resistant Shigella Infections on the Rise: CDC Posted 2/27/23
Alyson Sulaski Wyckoff, Associate Editor

Health care providers should be vigilant about suspecting — and reporting — extensively drug-resistant (XDR) Shigella infections amid a recent increase, according to an advisory from the Centers for Disease Control and Prevention (CDC).

Shigellosis should be considered in the differential diagnosis of acute diarrhea. Young children are among the patients at higher risk.

Strains of XDR Shigella bacteria are resistant to all commonly recommended empiric and alternative antibiotics: azithromycin, ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole and ampicillin. Hence, the CDC does not have recommendations for optimal antimicrobial treatment of these infections.

In the U.S., the percentage of Shigella infections caused by XDR strains has increased from zero in 2015 to 5% in 2022. Since 2015, the CDC has received reports of 239 XDR Shigella isolates. Of 232 patients with available information, 5% were children.

While shigellosis has mostly affected young children (ages 1-4 years) in the U.S., there has been in increase in antimicrobial-resistant Shigella infections among adults, especially gay, bisexual and other men who have sex with men; people experiencing homelessness; international travelers; and those living with HIV.

It usually causes inflammatory diarrhea that can be bloody and may lead to fever, abdominal cramps and tenesmus. Infections generally are self-limiting.

Shigellosis is a nationally notifiable disease.

Consult the CDC advisory for additional guidance.

This article was originally published on February 24, 2023, in AAP News.


New Red Book Online Webinar Posted 2/24/23
The following webinar is now available to view on Red Book Online and the American Academy of Pediatrics (AAP) Influenza Pre-booking page.

Tips and Strategies for Pre-Booking Influenza Vaccines for the 2023-’24 Season
Pre-booking has begun for the 2023-’24 influenza season. The AAP has updated its pre-booking webinar which provides an overview of what to consider when pre-booking influenza vaccines. This short webinar covers tips and strategies on pre-booking, as well as integrating lessons learned from the current influenza season. Access the webinar and find more information on the Influenza Pre-booking page. The webinar can also be viewed on Red Book Online.

All Red Book Online webinars at https://publications.aap.org/redbook/resources/15686


New Red Book Online Resource Pages Posted 2/24/23
Immunization Strategies and Resources – The AAP Committee on Infectious Diseases (COID) has compiled a comprehensive list of resources on strategies to improve immunization rates. This news and resource page is updated frequently. AAP membership or subscriber login may be required to access some links.

Antimicrobial Resistance and Stewardship Resources – Antibiotic resistance is one of the biggest threats to our health causing more than 2.8 million antibiotic-resistant infections and 35,000 related deaths in the United States each year. Antibiotic-resistant infections are becoming more common in children and adolescents.

Antibiotic stewardship helps ensure that patients receive the right treatment—prescribing antibiotics only when they are needed and prescribing the right antibiotic at the correct dose, frequency, and duration. Learn more about how to be a good steward of antibiotics with the resources and information on this web page.

COID Policy Statements, Clinical Reports, and Technical Reports – The AAP COID has published a collection of infectious diseases and immunization policy statements, clinical reports, and technical reports in Pediatrics. These policy statements are complementary and expand on the information and recommendations found in the Red Book.


CDC Launches Webinar on Dengue Vaccine Posted 2/9/23
CDC launched the “Dengvaxia: What Healthcare Professionals Need to Know” webinar about the newly approved dengue vaccine. The dengue vaccine was approved and recommended for use in children 9–16 years old who have laboratory-confirmed evidence of a previous dengue virus infection and who live in areas of the United States where dengue is common (this includes US territories of American Samoa, Puerto Rico, and the US Virgin Islands, and the freely associated states, including the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau). This 30-minute learning activity provides an overview of the vaccine’s eligibility criteria; pre-vaccination screening recommendations; and vaccine storage, handling, and administration.

Professionals will be able to get free continuing education credits after completing the webinar, which you can find online.


January 2023

New Red Book Online Chapter Update—Streptococcus pneumoniae (Pneumococcal) Infections Posted 1/27/23
The American Academy of Pediatrics (AAP) Red Book is published every three years, but the pediatric infectious disease landscape is changing continuously. The AAP approved a process to update chapters on Red Book Online between publication years to help pediatric health care professionals provide the best possible care for children.

Update: The Streptococcus pneumoniae (Pneumococcal) Infections chapter in Red Book on Red Book Online was just updated to reflect the updated guidelines for the use of a new 15-valent pneumococcal conjugate vaccine.

Summary: The Centers for Disease Control and Prevention (CDC) published updated guidelines in September 2022 for the use of a new 15-valent pneumococcal conjugate vaccine (PCV15, Vaxneuvance, Merck) in children. The CDC recommends routine use of PCV15 for children ages 6 weeks and older as an option for pneumococcal conjugate vaccination, including children who are at increased risk for serious pneumococcal disease. PCV13 and PCV15 can be used interchangeably, and there is no preference for one over the other.

See this update in the Streptococcus pneumoniae (Pneumococcal) Infections chapter in Red Book on Red Book Online.

See the AAP News article New pneumococcal conjugate vaccine a preview of things to come.

See other Red Book updates since its publication in 2021: Cholera, Dengue, Human Immunodeficiency Virus Infection, Rabies, and Tuberculosis.


New Vaccine Status Table Updates Posted 1/27/23
Red Book Online Vaccine Status Tables contain current information about recently submitted, licensed, and recommended vaccines and biologics, including status of the US Food and Drug Administration (FDA) licensure process and related American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) recommendations. The Vaccine Status Tables were just updated with the following:

Table 1. Status of Recently Submitted, Licensed, and Recommended Vaccines & Biologics

  • Cholera and Tick-borne encephalitis vaccines: Added
  • Hepatitis B (Recombinant): Updated age recommendation and information
  • Measles, Mumps, Rubella: Updated information

Table 2. Status of Recently Submitted, Licensed, and Recommended Influenza Vaccines

  • Influenza vaccines: Updated information on AAP and CDC guidance

Table 3. Sars-CoV-2 Vaccines

  • mRNA162b2: Updated recommended dose number, interval, and vaccine presentation
  • mRNA-1273: Updated dose number, interval, and vaccine presentation
  • Moderna mRNA, bivalent vaccine (original and omicron BA.4/BA.5) and Pfizer/BioNTech mRNA, bivalent vaccine (original and omicron BA.4/BA.5): Added
  • NVX-CoV2373: Updated FDA status and age indication; dose number and interval; and usage guidance

CDC Provides Guidance to Clinicians as Pediatric Invasive Group A Streptococcal Infections Rise Posted 1/3/23
Health officials are providing guidance to clinicians to combat an increase in pediatric invasive group A streptococcal (iGAS) infections.

While case counts were low during the early part of the COVID-19 pandemic, they have been rising over the past few months, according to a health advisory issued Thursday by the Centers for Disease Control and Prevention (CDC). It is unclear if the increase is above pre-COVID seasonal patterns. Increased iGAS cases also have been reported in France, Ireland, the Netherlands, Sweden, and the United Kingdom, most of which are affecting children under 10 years, according to the World Health Organization.

Group A Streptococcus bacteria is spread primarily by the respiratory route. Infections typically are most prominent in December through April and when flu activity is high, as it is now. GAS can cause pharyngitis (strep throat) and skin and soft tissue infections, according to the CDC. It also can cause severe invasive diseases such as sepsis, streptococcal toxic shock syndrome, and necrotizing fasciitis.

People at increased risk for iGAS include those with concurrent or preceding viral infections like flu or varicella, people 65 and older, American Indian and Alaska Native populations, residents of long-term care facilities, people with certain underlying medical conditions, people with wounds or skin disease, people who inject drugs and people experiencing homelessness.

The CDC provided the following recommendations for health care providers:

  • Vaccinate eligible patients against influenza and varicella.
  • Consider iGAS as a possible cause of severe illness in children and adults with concomitant viral respiratory infections.
  • Educate patients on signs and symptoms of iGAS requiring urgent medical attention, especially necrotizing fasciitiscellulitis, and toxic shock syndrome.
  • Obtain culture for suspected iGAS infections, including blood, wound and pleural fluid cultures as clinically indicated.
  • Follow clinical practice guidelines for diagnosis and treatment of GAS pharyngitis.
  • Be mindful of AAP recommendations for alternative antibiotics for treating GAS pharyngitis in children during the amoxicillin suspension shortage.
  • Notify local or state public health departments as soon as possible about unusually aggressive or severe iGAS cases in children or clusters of iGAS infections in people of any age.
  • Ask laboratories to hold iGAS isolates or send them to the state public health laboratory for temporary storage.

The CDC is encouraging the public to learn about the symptoms of necrotizing fasciitisstreptococcal toxic shock syndrome, and cellulitis, and seek care quickly if they think they or any family members may have one of these infections. Everyone is encouraged to stay up to date on flu and varicella vaccines.

Resources

See the original article in AAP News.


December 2022

New RBO Webinar Now Available Posted 12/12/22
A new webinar, "2022 Monkeypox (mpox) Outbreak and Children," by Athena P. Kourtis, MD, PhD, MPH, FAAP, is now available to view on Red Book Online.

In this 8-minute webinar, Dr Kourtis provides a brief overview of monkeypox (mpox) in children and adolescents. Topics include a review of the epidemiology, clinical features, prevention, and treatment of mpox in children and adolescents.

See all RBO Webinars at https://publications.aap.org/redbook/resources/15686.


Bivalent COVID Vaccines Authorized for Children as Young as 6 Months Posted 12/12/22
Health officials have authorized bivalent COVID-19 vaccines for children as young as 6 months, a move that comes as hospitalizations are rising.

The Food and Drug Administration amended emergency use authorization of the bivalent Pfizer-BioNTech and Moderna vaccines Thursday, December 8, and the Centers for Disease Control and Prevention (CDC) provided the following clinical guidance on Friday, December 9.

  • Children ages 6 months through 4 years who complete a Moderna primary series (two doses separated by four to eight weeks) can receive one bivalent Moderna booster dose at least two months after completion of their primary series.
  • Children 5 years of age who complete a Moderna primary series may receive either a bivalent Moderna booster or a bivalent Pfizer-BioNTech booster at least two months after completion of the primary series.
  • Children ages 6 months through 4 years who are being vaccinated with the Pfizer-BioNTech vaccine should receive the Pfizer-BioNTech monovalent vaccine for their first two doses (separated by three to eight weeks) followed by the bivalent Pfizer-BioNTech vaccine as their third primary series dose at least eight weeks after the second monovalent primary series dose. Children in this age group who have received three Pfizer-BioNTech monovalent primary series doses are not eligible for a booster dose.

The AAP supports administration of all COVID vaccine primary series and booster doses recommended by the CDC.

See AAP News for the full article and additional resources.


Second MMR Vaccine Formulation Available Posted 12/12/22
Adam J. Ratner, MD, MPH, FAAP
For more than 40 years, only a single measles, mumps and rubella (MMR) vaccine formulation (M-M-R-II from Merck) has been available in the United States. In June 2022, a second MMR vaccine (Priorix from GlaxoSmithKline) was approved by the Food and Drug Administration and unanimously recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention.

No change to AAP policy was required based on ACIP’s recommendation because specific MMR formulations are not mentioned in relevant Red Book chapters (see resources). Existing AAP recommendations apply to both available MMR vaccines.

ACIP concluded that Priorix is safe, immunogenic and noninferior to M-M-R-II based on data from four randomized trials and several observational studies. It recommended that Priorix and M-M-R-II should be considered fully interchangeable for all indications for which MMR is recommended. These indications include those listed on the vaccine package inserts and specific off-label recommended uses, including vaccination of children ages 6-11 months prior to international travel or during a measles outbreak; as a third dose for at-risk children during a mumps outbreak; or as measles postexposure prophylaxis.

Dr. Ratner is a member of the AAP Committee on Infectious Diseases.

 Resources


Red Book Updated with Recommendations for Use of Cholera Vaccine in Children Posted 12/12/22
Adam J. Ratner, MD, MPH, FAAP
The cholera chapter of the AAP Red Book has been updated to include recommendations for use of a vaccine in children ages 2–18 years who are traveling to areas with active transmission.

CVD 103-HgR (Vaxchora) is a live-attenuated strain of Vibrio cholerae O1 given orally as a single dose. In 2016, it was approved by the Food and Drug Administration (FDA) and recommended by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) for adults ages 18–64 years.

In December 2020, the FDA expanded use of the vaccine to include children ages 2–17 years based on data from pediatric trials that demonstrated safety and immunogenicity. ACIP voted in February 2022 to recommend CVD 103-HgR for prevention of cholera among travelers ages 2–64 years to an area with active cholera transmission. The AAP endorses this recommendation.

Cholera is a potentially life-threatening disease caused by toxin-producing strains of V. cholerae. Infection causes acute, watery diarrhea that can lead to severe dehydration. Without prompt rehydration, cholera can be fatal within hours of symptom onset. Cholera usually occurs as the result of ingestion of contaminated food or water. Individuals, including children from areas where cholera is infrequent, may be exposed during travel to areas of active transmission, including areas with endemic (ongoing) transmission and those with current or recent outbreaks.

The CDC has identified a global increase of cholera infections, with large outbreaks occurring in Haiti, Malawi, and Syria. Currently, the CDC considers 25 countries to have active cholera transmission. In addition, eight travelers with cholera have returned to the United States from Pakistan, Iraq, and Bangladesh in 2022.

CVD 103-HgR should be given 10 or more days prior to travel, requires reconstitution of a buffer solution with bottled or spring water, and may be given with certain sweeteners (stevia or sucrose) to enhance palatability. Details regarding administration, compatibility with other medications, and potential contraindications are available in the CVD 103-HgR package insert.

Hygienic practices also are encouraged to prevent travel-associated cholera.

The CVD 103-HgR manufacturer paused production in 2020 as a result of decreased demand due to the COVID-19 pandemic, and the vaccine currently is unavailable. Information on shortages is available at https://bit.ly/3FlUL8N.

Dr. Ratner is a member of the AAP Committee on Infectious Diseases.

Resources


November 2022

New Online Red Book Chapter Updates Posted 11/29/22
The American Academy of Pediatrics (AAP) Red Book is published every three years, but the pediatric infectious disease landscape is changing continuously. The AAP has approved a process to update chapters between publication years to help pediatric health care professionals provide the best possible care for children.

Updates are posted on Red Book Online when new recommendations are published by the AAP as policy statements or by other national or international organizations such as the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Diseases Society (PIDS), and the World Health Organization (WHO).

Since publication of the 2021 Red Book, four chapters have been updated:

  • Dengue. The CDC’s Advisory Committee on Immunization Practices (ACIP) recommended Dengvaxia vaccine for children ages 9 through 16 years who have evidence of a previous dengue infection and live where dengue is endemic.
  • Human Immunodeficiency Virus Infection. The NIH updated its HIV perinatal guidelines to add neviripine dosing for infants 32-34 weeks’ gestational age.
  • Rabies. ACIP liberalized preexposure prophylaxis recommendations from three doses to a two-dose schedule at 0 and 7 days. People who interact with animals that could be rabid and selected travelers can have either a one-time antibody titer check during years 1 to 3 after completion of the two-dose primary vaccine series (with a booster dose given if the antibody titer is <0.5 IU/mL) or a one-time preemptive booster dose administered no sooner than day 21 and no later than three years after completion of the two-dose primary vaccine series.
  • Tuberculosis. The WHO updated guidance on the management of tuberculosis in children and adolescents with nonsevere tuberculosis disease to provide a four-month treatment option. It consists of rifampin, isoniazid, pyrazinamide and ethambutol daily for the first two months, followed by isoniazid and rifampin daily for two months.

Visit Red Book Online for other infectious disease updates, news, and information.


CDC Stresses Importance of Measles Vaccination as Cases Reported in U.S.
Health officials are calling on pediatricians to make sure patients are up to date on measles vaccines and to consider measles when evaluating patients with a fever and rash.

The call from the Centers for Disease Control and Prevention (CDC) comes as 51 cases have been reported in the U.S. this year including an ongoing outbreak in Ohio.

The CDC advises health care providers to

  • Consider measles in patients with fever and rash and other symptoms like cough, runny nose or conjunctivitis, especially if the person recently traveled internationally or was exposed to a person with fever and rash.
  • Promptly isolate patients with suspected measles and report suspected cases to the local or state health department.
  • Obtain specimens for testing from patients with suspected measles, including viral specimens for genotyping.

Measles vaccines are highly effective at preventing illness from one of the most contagious human viruses. Children should receive their first dose of measles, mumps and rubella (MMR) vaccine between 12 and 15 months of age and a second dose between 4 and 6 years. If traveling abroad, infants ages 6 months through 11 months should have one dose of MMR, and children 12 months and older should receive two doses at least 28 days apart, according to the CDC.

While nearly 94% of U.S. kindergartners had received two doses of MMR during the 2020-'21 school year, some communities have lower rates that can leave children vulnerable to infection. Measles can result in complications like pneumonia, brain damage and deafness, and can be fatal.

Last year, nearly 40 million children worldwide missed a measles vaccine dose, according to a joint study from the CDC and World Health Organization published in a recent Morbidity and Mortality Weekly Report. First dose coverage was 81%, the lowest since 2008. There were about 9 million measles cases and 128,000 deaths worldwide.

"The record number of children under-immunized and susceptible to measles shows the profound damage immunization systems have sustained during the COVID-19 pandemic," CDC Director Rochelle P. Walensky, M.D., said in a press release. "Measles outbreaks illustrate weaknesses in immunization programs, but public health officials can use outbreak response to identify communities at risk, understand causes of under-vaccination, and help deliver locally tailored solutions to ensure vaccinations are available to all."

Resources


Red Book Online Outbreaks Update: Listeria, E. coli, and Salmonella Outbreaks Posted 11/22/22
Officials are currently investigating multistate outbreaks, including Listeria linked to Enoki mushrooms and deli meat and cheese, E. coli linked to frozen falafel, and Salmonella linked to pet bearded dragons and fish.

New entries on these outbreaks have been added to the Red Book Online Outbreaks page, providing information about the outbreaks and their impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


Amoxicillin Shortage Posted 11/22/22
There is a national shortage of amoxicillin suspensions that is anticipated to last several months. For additional information and alternative therapies during the shortage, see the table Amoxicillin Shortage: Antibiotic Options for Common Pediatric Conditions on Red Book Online.


Updated RSV Interim Guidance Posted 11/18/22
The interim guidance on respiratory syncytial virus (RSV) has been updated to allow for additional administration of palivizumab doses in regions experiencing prolonged, elevated circulation of RSV in their communities.

Please see the following: Updated Guidance: Use of Palivizumab Prophylaxis to Prevent Hospitalization From Severe Respiratory Syncytial Virus Infection During the 2022-2023 RSV Season (aap.org)

"If RSV disease activity persists at high levels in a given region through the fall and winter, the AAP supports providing more than 5 consecutive doses of palivizumab to eligible children. Although there is a paucity of data on the provision of more than 5 consecutive doses, there is no evidence of increased frequency or severity of adverse events with later doses in a 5-dose series nor with doses beyond 5 doses in the few published studies.5,6,7,8 Given this information, together with the known efficacy of palivizumab and unpredictable epidemiology of RSV since the summer of 2021, the AAP recommends programmatic consideration of providing more than 5 consecutive doses of palivizumab depending on the duration of the current RSV surge in a given region of the country."

Also see the AAP News article “AAP updates interim guidance on preventing severe RSV, handling surge of patients.”


Flu Antiviral Oseltamivir Unavailable From Some Manufacturers as Virus Surges and Vaccination Lags Posted 11/16/22
Pediatricians may need to check with several pharmacies to find influenza antiviral oseltamivir due to supply constraints. If none is available, an AAP expert said several other treatments may be considered, adding that vaccination remains the best way to protect children as the virus surges.

Several manufacturers are reporting limited or no supply of certain oseltamivir formulations, according to lists maintained by the Food and Drug Administration (FDA) and the American Society of Health-System Pharmacists. However, the FDA has not declared a nationwide shortage, indicating that it believes other manufacturers can meet overall market demand. Supply constraints among some manufacturers may be resolved later this month, according to the FDA data.

The AAP recommends antiviral treatment be offered as early as possible to any child hospitalized with confirmed or suspected influenza; any child with severe, complicated or progressive influenza in any setting; and any child with confirmed or suspected influenza of any severity who is at high risk for influenza complications.

Treatment also can be considered in an outpatient setting for any child with confirmed or suspected influenza who is not at high risk for complications, if treatment can be initiated within 48 hours of illness onset, and any child with suspected or confirmed influenza whose siblings or household contacts are younger than 6 months or at risk for complications.

If oseltamivir is not available, pediatricians may be able to use baloxavir or inhaled zanamivir depending on the patients’ age and underlying conditions, according to Dr. Bryant. The AAP policy has detailed information on indications for each of these drugs. However, oseltamivir is the only oral treatment indicated for children under 5 years.

See the full article, including resources, in AAP News.

Also see Red Book Chapter: Influenza and Red Book Online Influenza News and Resources.


Expert: Using Antibiotics Judiciously Will Help Maintain Supply During Amoxicillin Shortage, Prevent Resistance Posted 11/1/22
Melissa Jenco, News Content Editor

Pediatricians grappling with a shortage of amoxicillin have other antibiotic options but should be judicious in using them to prevent resistance, according to an expert.

"About half of antibiotic prescriptions for acute respiratory tract infections are unnecessary," Jeffrey S. Gerber, MD, PhD, FAAP, a member of the AAP Committee on Infectious Diseases, said via email. "More judicious diagnosis is critical for reducing overuse."

His guidance comes as several manufacturers are reporting limited supplies of amoxicillin oral powder for suspension. Some of the companies are citing increased demand, according to information compiled by the Food and Drug Administration (FDA).

"The FDA is aware of some intermittent supply interruptions of amoxicillin products in the US, and is currently working with the approved manufacturers," the agency said in an emailed statement.

Manufacturer Sandoz reported some presentations are available in limited quantity. Other presentations are unavailable, but a limited supply is expected later this year or in early 2023. Aurobindo Pharma and Teva Pharmaceuticals report the antibiotic is available "on allocation," which the American Society of Health System Pharmacists defines as limited distribution. Hikma Pharmaceuticals has availability for current customers. Rising Pharma is listed as having available product.

Amoxicillin is the recommended antibiotic for infections, including acute otitis media, strep throat, sinus infections and pneumonia, according to Dr. Gerber, a lead author of the AAP policy Antibiotic Stewardship in Pediatrics.

While Dr. Gerber hasn’t seen data verifying an increase in demand, he said the viral respiratory infections that have hit many parts of the country may be mistaken for bacterial infections or occasionally lead to bacterial infections, driving up antibiotic prescribing.

Clinicians should be sure their patient needs antibiotics before prescribing them, Dr. Gerber said. Most infections in children are caused by viruses, not bacteria. If antibiotics are indicated, pediatricians can consider other formulations of amoxicillin not impacted by the shortage. They also can choose another antibiotic depending on the type of infection, age of the child and antibiotic allergies.

"Unfortunately, these are often broader-spectrum antibiotics that we prefer not to use too often. So if the shortage continues, this can drive the development of antibiotic-resistance," Dr. Gerber said.

The Centers for Disease Control and Prevention estimates there are nearly 3 million antibiotic-resistant infections in the US each year, resulting in more than 35,000 deaths. The agency calls antibiotic resistance "one of the most urgent threats to the public’s health."

The FDA did not provide an estimate of how long the amoxicillin shortage is expected to last but said it is working with manufacturers to reduce the impact.

Resources

This article was originally published on November 1, 2022, in AAP News.


October 2022

Public Health Success Story: 25 Years of Varicella Vaccination Program Posted 10/24/22
José R. Romero, MD, FAAP, and David W. Kimberlin, MD, FAAP

In 1995, the United States was the first country to introduce varicella vaccination into its routine childhood immunization program. More than 25 years later, morbidity and mortality from chickenpox has declined substantially, but continuing efforts are needed to ensure vaccination coverage remains high. 

Disease burden
Prior to vaccine introduction, varicella represented an important societal and medical health burden, affecting almost everyone during childhood. There were approximately 4 million cases a year in the United States, with 10,500-13,500 hospitalizations and 100-150 deaths. More than 90% of these cases, two-thirds of hospitalizations and about half of the deaths occurred in children.

Varicella infection during the first 20 weeks of pregnancy can lead to severe birth defects and complications for the fetus, known as congenital varicella syndrome. In addition, varicella-zoster virus (VZV), which causes varicella, remains dormant in the body and can reactivate to cause zoster (shingles). One in three people will suffer from shingles later in life.

Before the vaccine, pediatricians routinely saw serious cases of varicella. The biggest concern for these patients were complications such as secondary infections, especially invasive group A Streptococcus and pneumonia, or neurologic complications. Some children underwent long treatments with antibiotics and several surgeries to treat necrotizing fasciitis.

During the 1960s and ’70s, varicella became a feared illness among immunosuppressed children treated for leukemia or other cancers. Many developed severe or fatal varicella. During the 1980s, before effective HIV therapy was available, serious varicella cases were seen in immunodeficient infants with underlying HIV infection, some of whom died quickly from pneumonia triggered by varicella.

Effects of vaccination program
During the first 25 years of the U.S. vaccination program (1995-2019), the greatest decline in VZV disease has been among people younger than 21 years, with a 97% decrease in hospitalizations and 99% drop in varicella deaths. In this age group, varicella hospitalization has become extremely rare, and varicella deaths have been nearly eliminated.

While significant declines in disease have been seen in all age groups, an underappreciated benefit of the program is its impact on pediatric shingles. The risk of shingles is lower among both healthy and immunocompromised children (approximately 80% lower risk among healthy vaccinated children vs. unvaccinated children). It is anticipated that childhood varicella vaccination also will protect against shingles later in life by preventing infection with the wild-type virus and thus its dormancy, giving pediatricians the chance to protect patients across the lifespan.

Breakthrough cases
While two doses of the vaccine are more than 90% effective at preventing varicella, breakthrough cases can occur. However, the symptoms of a breakthrough case usually are milder than among those who are unvaccinated, with fewer or no vesicles and mild or no fever.

Because of this milder presentation, breakthrough cases pose diagnostic challenges. For example, clinicians might suspect hand, foot and mouth disease and not consider varicella. To recognize a breakthrough case, clinicians should keep varicella in the differential diagnosis when seeing a vesicular or maculopapular rash.

Importance of vaccination
While varicella frequently is perceived as a benign disease of childhood, most pediatricians know it can be serious, affecting not just the individual but the entire family. It also can put people in the community who are immunocompromised or pregnant at risk.

Even one case of varicella, be it in a hospital or school, is disruptive. Parents lose income if they have to miss work, and those with the disease are at high risk of shingles later in life.

While antiviral treatment exists for varicella, it is effective only when administered early in the disease course and is recommended only for high-risk patients. Vaccination is the primary means of controlling this disease.

High vaccination coverage has been critical in reducing the varicella burden in the United States over the past 25 years. However, opportunities remain to increase coverage and reduce disease burden.

The COVID-19 pandemic caused delays in many routine vaccinations. Therefore, pediatricians should make every effort to ensure patients are up to date, including adolescents who have not received a second dose of varicella vaccine. Adolescent visits are one of the last chances to screen and vaccinate before adulthood, when disease usually is more severe and can cause devastating complications during pregnancy.

Thanks to a safe and effective routine vaccination program, varicella is rare in the United States. This is a public health victory. Pediatricians have been and continue to be on the front lines.

Dr. Romero is director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention. He also is a member of the AAP Committee on Infectious Diseases. Dr. Kimberlin is editor of the AAP Red Book.

Resources

This article was originally published on October 21, 2022, in AAP News.


Red Book Online Outbreaks Update: E. coli and Listeria Posted 10/20/22
Officials are currently investigating two multistate outbreaks—an outbreak of E. coli linked to ground beef and an outbreak of Listeria linked to Brie and Camembert cheese.

New entries on these two outbreaks have been added to the Red Book Online Outbreaks page, providing information about the outbreaks and their impact for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits and keep an eye out for emails from Red Book Online alerting you to updates.


CDC COCA Call: Update on Monkeypox in Children, Adolescents, and People Who are Pregnant or Breastfeeding Posted 10/19/22
During this Centers for Disease Control and Prevention (CDC) Clinician Outreach and Communication Activity (COCA) Call, presenters will focus on current information about monkeypox as it relates to children, adolescents, and people who are pregnant or breastfeeding. Presenters will address clinical considerations for diagnosis, treatment, and post-exposure prophylaxis; vaccination; contact and breastfeeding recommendations; infection prevention and control measures; and resources available to care for these patient populations.

Date: Thursday, October 27, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_102722.asp.


New Webinar to View on Red Book Online! Posted 10/19/2022
The following webinar, presented by Dawn Nolt, MD, MPH, FAAP, is available to view on Red Book Online (RBO).

Head Lice – Focus on Treatment
In this RBO Webinar, Dr. Nolt, lead author of the new American Academy of Pediatrics (AAP) clinical report "Head Lice,” published in the October 2022 issue of Pediatrics, provides a brief overview of the updated clinical report in a newly recorded webinar (only 8 minutes). Topics include a review of available medications and the use of a new algorithm to aid with decision-making in the treatment of head lice.

To view the webinar, click here or go to the PCO Webinars page at https://publications.aap.org/redbook/resources/15686.

View other webinars on RBO, such as Improving Human Papillomavirus (HPV) Vaccination Rates and Now More Than Ever: Updates to the 2022 Children and Adolescent Immunization Schedule.


September 2022

CDC COCA Call: What Clinicians Need to Know about Dengue in the United States Posted 9/23/22
During this COCA Call, presenters will discuss the current global and domestic dengue epidemiology and its relevance for clinicians in the United States. Presenters will also review dengue clinical classification, diagnosis, and general treatment guidelines based on World Health Organization and Centers for Disease Control and Prevention (CDC) recommendations.

Date: Thursday, September 29, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_092922.asp


CDC Advisory Reports Increase in Enterovirus D68, Which Has Been Linked to AFM Posted 9/14/22
Health care providers should consider enterovirus D68 (EV-D68) as a possible cause of acute, severe respiratory illness in children — with or without fever, according to a new advisory from the Centers for Disease Control and Prevention (CDC). They also should be aware that cases of acute flaccid myelitis (AFM) may increase in the coming weeks.

Several regions of the U.S. have seen increases recently in children hospitalized for severe respiratory illness who also tested positive for rhinovirus (RV) and enterovirus (EV). In addition, sentinel surveillance sites are reporting a higher proportion of EV-D68 positivity in children who are RV/EV positive compared with previous years.

EV-D68 primarily causes acute respiratory illness but also has been associated with AFM, a rare but serious neurologic complication involving limb weakness.

Between April and August, EV-D68 was detected in some children and adolescents with acute respiratory illness across seven surveillance sites, with the number of detections greater than in the same period of the previous three years. While the CDC has not received increased reports of AFM cases with onset in 2022, increases in EV-D68 respiratory illnesses typically have preceded cases of AFM.

The advisory includes recommendations for health care providers, laboratories, infection preventionists, public health departments and the public.

See the full article, including resources, in AAP News.


Webinar: Influenza Prevention and Control Strategies in Early Education and Child Care Settings – September 21 Posted 9/13/22
The AAP is hosting a free webinar on Influenza Prevention and Control Strategies in Early Education and Child Care Settings for the 2022-23 influenza season. Speakers Renuka Verma, MD, FAAP, and Hilda Loria, MD, FAAP, will present AAP influenza recommendations, the importance of influenza immunization in early education and child care centers, and strategies on how these centers can prepare for the influenza season during COVID-19. The webinar will be held on September 21 from 6:30 to 7:30 pm ET. Register now!


CDC COCA Call: AAP and CDC 2022-2023 Recommendations for Influenza Prevention and Treatment Posted 9/9/22
Join the AAP and the CDC for a Clinician Outreach and Communication Activity (COCA) Call to learn about AAP and CDC recommendations for influenza prevention and treatment in children and adolescents for the 2022-2023 influenza season. Speakers will also provide an overview of the 2021-2022 season, strategies to increase immunization rates, and highlight important health disparities. The COCA Call will be held on September 15th from 2 pm to 3 pm ET.

Date: Thursday, September 15, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_091522.asp


CDC COCA Call: Recommendations for Bivalent COVID-19 Booster Doses in People Ages 12 Years and Older Posted 9/9/22
During this COCA Call, presenters will discuss CDC’s new guidance on bivalent COVID-19 booster doses for people ages 12 years and older, including those who are moderately or severely immunocompromised. COVID-19 vaccination provides protection against serious illness and outcomes associated with COVID-19, including emergency department or urgent care visits, hospitalizations, and death. Updated COVID-19 vaccines add an Omicron BA.4/5 spike protein component to the previous monovalent composition. These bivalent booster doses help restore protection that has waned since previous vaccination by targeting more transmissible and immune-evading variants. These boosters also broaden the spectrum of variants that the immune system is ready to respond to.

Date: Tuesday, September 13, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_091322.asp


Red Book Online Outbreaks Update: E. coli Outbreak from Unknown Source Posted 9/6/22
Officials are currently investigating a multistate outbreak of E. coli infections linked to an unknown source.

A new entry on this E. coli outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


CDC COCA Call: 2022-2023 Influenza Vaccination Recommendations and Guidance on Coadministration with COVID-19 Vaccines Posted 9/1/22
During this COCA Call, presenters will provide updates on the Advisory Committee on Immunization Practices (ACIP) recommendations for the 2022-2023 influenza vaccination season, including information on a new preferential vaccine recommendation for adults ages 65 and older. In addition, presenters will outline guidance for the co-administration of the influenza and COVID-19 vaccines.

Date: Thursday, September 8, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_090822.asp


August 2022

CDC COCA Call: Polio in New York - How to Recognize and Report Polio, and Reinforce Routine Childhood Polio Vaccination Posted 8/26/22
During this COCO Call, presenters will discuss the history of polio in the United States and the current New York state outbreak. They will also review clinical aspects of poliovirus infection, how to report suspected cases, and recommendations for polio vaccination in the United States.

Date: Thursday, September 1, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_090122.asp


Webinar: Meet the Red Book Committee, Influenza Update – September 7 Posted 8/23/22
The AAP Red Book committee is hosting a free 1-hour webinar on the AAP and CDC recommendations on the prevention and treatment of influenza in children and adolescents. Panelists will speak on current issues related to the upcoming 2022-23 influenza season during the COVID-19 pandemic, vaccine hesitancy, disparities in vaccination rates, and strategies to improve catch-up on childhood vaccination rates in practice settings. The webinar will be held on September 7 from 7:00 to 8:00 pm CT. Register now!


CDC: Bivalent COVID Vaccine Boosters Could be Available for Adolescents, Adults in September Posted 8/23/22
A bivalent COVID-19 vaccine booster targeting the omicron variant could be available next month for children as young as 12 years.

The Centers for Disease Control and Prevention (CDC) has released a guide to help clinicians and jurisdictions prepare for a fall booster campaign.

Both Pfizer-BioNTech and Moderna have created bivalent boosters in anticipation of a possible fall/winter virus surge. The Food and Drug Administration advised the companies to use both the original SARS-CoV-2 strain and the omicron BA.4/5 spike protein. About 89% of the circulating strains are BA.5, and nearly all the rest are BA.4, according to the CDC.

People would be eligible for a single-dose booster if they have completed a primary series regardless of how many boosters they have received, if enough time has passed since the last dose.

The U.S. has procured 175 million doses of bivalent boosters, which jurisdictions and pharmacies can pre-order. Storage and handling rules are the same as the original products.

See the full article, including resources, in AAP News.


CDC COCA Call: CDC and FDA Update—Interim Clinical Considerations for Monkeypox Vaccination Posted 8/11/22

During this COCO Call, presenters from FDA and CDC will provide updates on FDA’s EUA of the JYNNEOS vaccine and CDC’s Interim Clinical Considerations for using the JYNNEOS and ACAM2000 Vaccines during the 2022 U.S. Monkeypox Outbreak. Presenters will also provide training on how to administer the vaccines using the interim clinical considerations.

Date: Thursday, August 11, 2022
Time: 3:00 – 4:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_081122.asp


Red Book Online Outbreaks Update: Small Turtles – Salmonella Infections Posted 8/2/22
Officials are currently investigating a multistate outbreak of Salmonella infections linked to small turtles.

A new entry on this Salmonella outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


July 2022

CDC COCA Call: Recommendations for the Novavax COVID-19 Primary Series in Adults Ages 18 and Older Posted 7/21/22
During this COCA Call, presenters will discuss CDC’s new guidance on the Novavax COVID-19 vaccine for adults ages 18 years and older, including adults who are moderately or severely immunocompromised.
Free Continuing Education (CE) will be offered for this COCA Call. Registration is not required.

Date: Thursday, July 28, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_072822.asp


Updates to RBO Vaccine Status Tables Posted 7/14/22
Red Book Online (RBO) Vaccine Status Tables contain current information about recently submitted, licensed, and recommended vaccines and biologics, including status of the US Food and Drug Administration (FDA) licensure process and related American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) recommendations.

Information in the Vaccine Status Tables was just updated. Updates include the following:

Table 1. Status of Recently Submitted, Licensed, and Recommended Vaccines & Biologics

  • Measles, Mumps, Rubella: New entry
  • PCV15
    • New AAP/CDC recommendations
    • Updated FDA age indication and licensure date

 Table 2. Status of Recently Submitted, Licensed, and Recommended Influenza Vaccines

  • IIV4 (Fluzone High-Dose Quadrivalent) and IIV4 (Fluad Quadrivalent): Updated comments regarding age preference
  • RIV4 (Flublock Quadrivalent): New vaccine

 Table 3. Sars-CoV-2 Vaccines

  • mRNA162b2
    • Updated storage requirements
    • New guidance for ages 6 months through 4 years
    • New Biologics License Application (BLA) status for ages 12 through 15 years
  • mRNA-1273: New guidance for ages 12 through 17 years, 6 through 11 years, and 6 months through 5 years

CDC Issues Advisory on Parechovirus Infections in Infants Posted 7/13/22
Health officials are asking clinicians to be on the lookout for infants with parechovirus (PeV) infection following reports of infections in multiple states.

PeV should be considered in infants with fever, sepsis-like syndrome, or neurological illness such as seizures or meningitis without another known cause (see the health advisory from the Centers for Disease Control and Prevention [CDC]).

Clinicians should test for PeV in children with symptoms. Testing is available at commercial clinical laboratories and state public health laboratories. Hospitals also may use multiplex meningitis and encephalitis panels for cerebrospinal fluid testing that include PeV. The CDC can test samples in some cases, but clinicians should work with their state officials and email PicornaLab@cdc.gov before submitting specimens.

See the full article, including resources, in AAP News.

Also see AAP Red Book Chapter: Parechovirus Infections.


Red Book Online Outbreaks Update: Listeria Outbreak Linked to Ice Cream Posted 7/6/22
Officials are currently investigating a multistate outbreak of Listeria monocytogenes linked to ice cream.

A new entry on this Listeria outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


June 2022

Red Book Online Outbreaks Update: Meningococcal Disease and Monkeypox Posted 6/30/22
Officials are currently investigating two outbreaks—an outbreak of meningococcal disease in Florida and an outbreak of monkeypox infections in the United States.

New entries on these two outbreaks have been added to the Red Book Online Outbreaks page, providing information about the outbreaks and their impact for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


CDC COCA Call: Monkeypox – Updates about Clinical Diagnosis and Treatment Posted 6/27/22
This COCA Call will present what clinicians need to know about monkeypox including guidance about the typical clinical presentation, treatment options, pre- and post-exposure prophylaxis, and reporting to public health authorities.

Date: Wednesday, June 29, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_062922.asp


AAP COVID-19 Town Hall: Special White House Guest Posted 6/27/22
Join the next AAP Town Hall on Thursday, June 30 at 7 pm CT for a session focused on COVID-19 vaccines. We are delighted to announce that B. Cameron Webb, MD, JD, Senior Advisor on the White House COVID-19 Response Team will be joining as a special guest.

This bi-weekly series of virtual town halls links members with leading experts to discuss emerging issues related to the COVID-19 pandemic.

Expert Panelists
James Campbell, MD, MS, FAAP
Member, AAP Committee on Infectious Diseases
Professor, Center for Vaccine Development and Global Health, University of Maryland School of Medicine

Bonnie Maldonado, MD, FAAP 
Chairperson, AAP Committee on Infectious Diseases 
Professor, Departments of Pediatrics and of Epidemiology and Population Health;
Chief, Division of Infectious Diseases; and Senior Associate Dean of Faculty Development and Diversity, Stanford University School of Medicine 

Register here.


CDC COCA Call: Recommendations for Pfizer-BioNTech and Moderna COVID-19 Vaccine Primary Series in Children 6 Months through 5 Years Old Posted 6/21/22
While children have a lower risk for severe COVID-19 compared to adults, they can get COVID-19, spread it to others, and become seriously ill. COVID-19 vaccination provides protection to children and adolescents against severe illness and outcomes associated with COVID-19, including emergency department or urgent care visits, hospitalizations, and death.

During this COCA Call, presenters will discuss CDC’s new guidance on the pediatric COVID-19 vaccine primary series for children ages 6 months through 4 years old for Pfizer-BioNTech and ages 6 months through 5 years old for Moderna, including children who are moderately or severely immunocompromised.

Date: Wednesday, June 22, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_062222.asp


Red Book Online Outbreaks Update: Backyard Poultry – Salmonella Infections Posted 6/15/22
Officials are currently investigating a multistate outbreak of Salmonella infections linked to backyard poultry.

A new entry on this Salmonella outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Red Book Online Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


Updates to RBO Vaccine Status Tables Posted 6/1/22
Red Book Online (RBO) Vaccine Status Tables contain current information about recently submitted, licensed, and recommended vaccines and biologics, including status of the US Food and Drug Administration (FDA) licensure process and related American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) recommendations.

Information in the Vaccine Status Tables was just updated. Updates include the following:

Table 1. Status of Recently Submitted, Licensed, and Recommended Vaccines & Biologics

  • Hepatitis B Vaccine, PreHevbrio: New information

 Table 3. Sars-CoV-2 Vaccines

  • mRNA162b2, mRNA-1273, and Ad26COV51: Extensive dose number and interval updates; includes updates for all ages and immunocompromised
  • mRNA162b2: FDA status update: booster authorized for emergency use (“EUA 5/17/2022—booster”)
  • mRNA-1273: Update to presentation

Red Book Online Outbreaks Update: Salmonella Infections Linked to Peanut Butter Posted 6/1/22
Officials are currently investigating a multistate outbreak of Salmonella Senftenberg infections linked to Jif brand peanut butter.

A new entry on this Salmonella Senftenberg outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


May 2022

AAP COVID-19 Town Hall Posted 5/23/22
Join the next AAP Town Hall on Thursday, May 26 at 7 pm CT. This bi-weekly series of virtual town halls links members with leading experts to discuss emerging issues related to the COVID-19 pandemic.   

Expert Panelists
Elizabeth Alderman, MD, FAAP
Chairperson, Committee on Adolescence 
Chief, Division of Adolescent Medicine at the Children’s Hospital at Montefiore and founder of the Montefiore Adolescent Primary Care Initiative 

James Campbell, MD, MS, FAAP
Member, AAP Committee on Infectious Diseases
Professor, Center for Vaccine Development and Global Health, University of Maryland School of Medicine

Kimberly Montez, MD, MPH, FAAP 
Assistant Professor of Pediatrics, Assistant Program Director, Pediatrics Residency, Associate Director of Integrating Special Populations, Maya Angelou Center for Health Equity at Wake Forest School of Medicine; 
Vice Chair, Council on Community Pediatrics, American Academy of Pediatrics 

Register here.


CDC Adds 71 Cases of Pediatric Hepatitis to Investigation Posted 5/20/22
The Center for Disease Control and Prevention (CDC) is investigating an additional 71 cases of hepatitis without a known cause in children, bringing the total to 180.

Many of the 71 cases are newly reported but occurred months ago. The CDC is looking into cases dating back to October 2021. Those under investigation come from 36 states and territories.

About 9% have required liver transplants, down from 15% as reported earlier this month. At least five children have died, but no deaths have been reported since February.

In April, the CDC issued a health advisory regarding nine pediatric hepatitis cases of unknown etiology in Alabama from October 2021 through February 2022. None had documentation of a previous COVID-19 infection or COVID-19 vaccine. All were positive for adenovirus.

Among the 180 cases nationwide now under investigation, nearly half have had an adenovirus infection, and the CDC said it “continues to be a strong lead.” It also is looking at other possible pathogens including SARS-CoV-2.

For the full article and additional resources, please see AAP News.

Find more information about the hepatitis cases and clinical guidance on Red Book Online Outbreaks


CDC COCA Call: Clinical Recommendations for Adenovirus Testing and Reporting of Children with Acute Hepatitis of Unknown Etiology Posted 5/12/22
The Centers for Disease Control and Prevention (CDC) is investigating a cluster of children identified with hepatitis and adenovirus infection. The CDC has recommended that US clinicians who encounter pediatric patients with hepatitis of unknown etiology consider adenovirus testing and report such cases to state public health authorities and the CDC. While there have been case reports of hepatitis in immunocompromised children with adenovirus type 41 infection in the past, adenovirus type 41 is not known to be a cause of hepatitis in otherwise healthy children. More common causes for hepatitis have been ruled out.

During this COCA Call, presenters will discuss the unknown etiology of patients under investigation, progress of the investigation, and how clinicians can continue to support these efforts through testing and reporting.

Date: Thursday, May 19, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_051922.asp.


Red Book Online—New Content, New Resources Posted 5/12/22

RBO Influenza Resources Page—New Format, New Content
The Red Book Online (RBO) Influenza Resources page is updated weekly to include the most recent influenza information from the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention. This page was reformatted to find pertinent information quickly by breaking up the content into the following sections:

  • Influenza News
  • Policy & Clinical Guidance
  • Implementation Resources
  • Professional Education & Resources
  • Social Media Resources
  • Patient Education

The AAP Committee on Infectious Diseases compiled this comprehensive list of influenza resources to serve as a centralized point of reference for the latest influenza-related news, vaccine guidance, prevention, treatment, policies, and other influenza information pertaining to infants, children, adolescents, and young adults.

New RBO Outbreak—Hepatitis Cases Possibly Associated with Adenoviral Infection
Officials are currently investigating a cluster of children in the US who have been diagnosed with hepatitis possibly associated with an adenoviral infection.

This outbreak has been added to the Red Book Online Outbreaks page, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Outbreaks page is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark this page for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.

New Red Book Online Webinars
Two new webinars were posted to the Red Book Online Webinars page and are available to view.

  • Now More Than Ever: Updates to the 2022 Children and Adolescent Immunization Schedule
    Henry "Hank" Bernstein, DO, MHCM, FAAP discusses the Recommended Childhood and Adolescent Immunization Schedule: United States, 2022, including review of the schedule and rationale for the latest updates to it, as well as COVID-19 vaccines in children.
  • Planning for the Next Influenza Season: Pre-Booking
    Sheri Burnett, RN, Clinical Director at Plateau Pediatrics, provides an overview on what to consider when pre-booking influenza vaccines. This short webinar covers tips and strategies on pre-booking, such as reviewing vaccine manufacturer policies and considering lessons learned from the current influenza season to inform what vaccines to order for the next influenza season.

Systems-based Treatment Table
The Systems-based Treatment Table on Red Book Online assists pediatricians in using antibiotic agents appropriately and only when needed for the listed common pediatric conditions. To quickly access this table, go to the RBO home page and click on any of the three options provided (top dropdown Resources menu, Red Book 2021 box, or Systems-based Treatment Table box).


April 2022

Information on Hepatitis Cases Possibly Linked to Adenoviral Infection Posted 4/29/22
On April 21, 2022, the CDC issued a Health Alert Network advisory about a cluster of children in the U.S. who have been diagnosed with hepatitis possibly associated with an adenoviral infection. Find more information about the cases and clinical guidance on Red Book Online. Find information about other outbreaks on the Red Book Online Outbreaks page.


NEW PediaLink Course: Infection Prevention and Control for Pediatric Clinics Posted 4/26/22
Experience with COVID-19 has underscored the importance of infection prevention in the office. This includes applying Standard Precautions for all patient care, regardless of the patient’s suspected or confirmed infection status. All healthcare facilities should ensure that infection prevention and control actions are taken to minimize the risk of exposure to infectious diseases.

The purpose of this free course is to train pediatric practice managers on infection prevention and control (IPC) basics, and how to create safer environments for pediatric care teams, patients, and their families. Effective IPC measures start with a solid understanding of how infections are transmitted. Knowing how germs spread can help you to take action. This course will provide the tools and resources needed to develop and implement IPC practices in your office setting.

For more information and to register, go to shopAAP.


AAP COVID-19 Town Hall Posted 4/25/22
Join the next AAP Town Hall on Thursday, April 28th at 7 pm CT. This bi-weekly series of virtual town halls links members with leading experts to discuss emerging issues related to the COVID-19 pandemic.

Register here.


March 2022

PCO Webinar—Now More Than Ever: Updates to the 2022 Children and Adolescent Immunization Schedule Posted 3/25/22
We invite you to join us on Friday, April 8, at 1:00 pm ET when Henry (Hank) Bernstein, DO, MHCM, FAAP discusses the Recommended Childhood and Adolescent Immunization Schedule: United States, 2022. Objectives of this webinar include:

  • Review the Recommended Childhood and Adolescent Immunization Schedule for 2022.
  • Share the rationale for the latest updates to the immunization schedules.
  • Discuss COVID-19 vaccines in children.

To view the webinar on Friday, April 8, please click here or use the following url: https://event.webcasts.com/starthere.jsp?ei=1539525&tp_key=35cf7cb778

Henry (Hank) Bernstein, DO, MHCM, FAAP is a Professor of Pediatrics at the Zucker School of Medicine at Hofstra/Northwell in New York. He presently is a member of the Vaccines and Related Biological Products Advisory Committee (VRBPAC) of the FDA, an ex-officio member of the AAP’s Committee on Infectious Diseases (Red Book Committee), and Associate Editor of Red Book Online. After recently completing his 4-year term as a member of the Advisory Committee on Immunization Practices (ACIP) of the CDC, he serves as a consultant to the ACIP’s COVID-19, Influenza, and Immunization Schedules Workgroups.

Dr. Bernstein taps into his extensive 37-year experience as a general pediatrician in private practice, the National Health Service Corps, and as Chief of General Academic Pediatrics at urban, suburban, and rural children’s hospitals to promote the health and well-being of children, their families, and communities.

His private, community-based primary care (generalist) experiences, in combination with academic leadership responsibilities, have provided him with a value-added, translational science perspective, unique from many others in academia.

This tacit knowledge enables him to fulfill a lifelong passion of communicating, educating, and translating science into clinical settings, educational venues, policymaking, and media interactions to advance the health of children.


AAP COVID-19 Town Hall Posted 3/14/22
Join the next AAP Town Hall on Thursday, March 17th at 7 pm CT. This bi-weekly series of virtual town halls links members with leading experts to discuss emerging issues related to the COVID-19 pandemic.

Expert Panelists

Sara Bode, MD, FAAP
Chairperson-elect, AAP Council on School Health
Medical Director, Nationwide Children's Hospital's Care Connection School-Based Health and Mobile Clinics

Bonnie Maldonado, MD, FAAP 
Chairperson, AAP Committee on Infectious Diseases 
Professor, Departments of Pediatrics and of Health Research and Policy;
Chief, Division of Infectious Diseases; and Senior Associate Dean of Faculty Development, Stanford University School of Medicine 

Carol Weitzman, MD, FAAP
Co-Director Autism Spectrum Center
Division of Developmental Medicine Boston Children's Hospital
Professor of Pediatrics at Yale

Register here.


2022 Childhood and Adolescent Immunization Schedule Now on RBO Posted 3/3/22
The Recommended Child and Adolescent Immunization Schedule, United States, 2022 is now available on Red Book Online (RBO). Approved by the Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics, American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, American Academy of Physician Assistants, and National Association of Pediatric Nurse Practitioners, the schedules are revised annually to reflect current recommendations for the use of vaccines licensed by the US Food and Drug Administration.

  • Table 1 contains the recommended immunization schedule from birth to 18 years of age.
  • Table 2 is the catch-up immunization schedule for persons 4 months to 18 years of age who start late or who are more than 1 month behind the recommended age for vaccine administration.
  • Table 3 lists the vaccines that may be indicated for children and adolescents 18 years of age or younger on the basis of medical conditions.

The following changes (in alphabetical order) were made to individual vaccine footnotes on the schedule:

  • Dengue: A new section was added that contains information regarding routine recommendation for use of dengue vaccine.
  • Haemophilus influenzae type b (Hib): Text was edited to include recommendations for use of Vaxelis for routine and catch-up vaccination.
  • Hepatitis A: The note was updated to clarify the age for routine vaccination.
  • Human papillomavirus vaccination (HPV):
    • The note was updated to clarify when an HPV series is complete, and no additional dose of HPV is recommended.
    • The Special Situations section was updated to clarify persons with immunocompromising conditions (including HIV infection) should receive 3 doses of HPV vaccine, regardless of the age at initial vaccination.
  • Measles, mumps, and rubella (MMR): The section on routine vaccination was updated to include recommendations for the use of the combination measles, mumps, rubella, and varicella vaccine (MMRV).
  • Meningococcal serogroup A, C, W, and Y vaccines (MenACWY):
    • Text was added to clarify MenACWY vaccines can be simultaneously administered with serogroup B meningococcal (MenB) vaccines if indicated but at different anatomic sites, if feasible.
    • In the Special Situations section, the language for the dosing schedule for Menveo in infants was edited for clarity.

To see these and other notable changes to the 2022 Immunization Schedule, visit Red Book Online.

Additional Resources


Second Infant Death May Be Linked to Contaminated Formula Posted 3/2/22
A second infant death may be linked to contaminated powdered infant formula prompting another lot of Similac formula to be recalled, according to the U.S. Food and Drug Administration.

Some Similac, Alimentum and EleCare formulas are being recalled after four infants have had Cronobacter sakazakii infections and one had a Salmonella Newport infection after consuming the formula. The Abbott Nutrition powdered infant formulas were produced at the company’s Sturgis, Michigan, facility and distributed nationwide and internationally.

Consumers who have one of these powdered formulas should look for the code printed on the product packaging near the expiration date. They should not use the formula if it meets three criteria:

  • the first two digits of the code are 22 through 37; and
  • the code on the container contains K8, SH or Z2; and
  • the expiration date is 4-1-2022 (APR 2022) or later.

In addition, Similac PM 60/40 with lot code 27032K80 (can) / 27032K800 (case), is being recalled. It was distributed in the U.S. and Israel. Consumers can check if their formula is being recalled by visiting the company’s website and entering the lot code.

For the full article and additional resources, please see AAP News.


AAP COVID-19 Town Hall Posted 3/1/22
Join the next AAP Town Hall on Thursday, March 3, at 7:00 pm CT. This bi-weekly series of virtual town halls links members with leading experts to discuss emerging issues related to the COVID-19 pandemic.

Expert Panelists
David W. Kimberlin, MD, FAAP
Editor, AAP Red Book
Sergio Stagno, MD Endowed Chair in Infectious Diseases
Co-Director of the Division of Pediatric Infectious Diseases; and Vice Chair for Clinical and Translational Research at University of Alabama at Birmingham

Ruth Lynfield, MD, FAAP
Associate Editor, AAP Red Book 
State Epidemiologist and Medical Director at the Minnesota Department of Health

Register here.


February 2022

AAP COVID-19 Town Hall Posted 2/11/22
Join the next AAP Town Hall on Thursday, February 17, at 7:00 pm CT. This bi-weekly series of virtual town halls links members with leading experts to discuss emerging issues related to the COVID-19 pandemic.

Expert Panelists
James Campbell, MD, MS, FAAP
Member, AAP Committee on Infectious Diseases
Professor, Center for Vaccine Development and Global Health, University of Maryland School of Medicine

Ruth Lynfield, MD, FAAP
AAP Red Book Associate Editor
State Epidemiologist and Medical Director at the Minnesota Department of Health

Sean O’Leary, MD, MPH, FAAP
Vice Chairperson, AAP Committee on Infectious Diseases 
Professor, Pediatrics, Sections of Pediatric Infectious Diseases and General Academic Pediatrics,
University of Colorado Anschutz Medical Campus, Children’s Hospital Colorado

Register here.


RBO Vaccine Status Table Updates and Red Book Errata Posted 2/3/22

Updates to RBO Vaccine Status Tables
Red Book Online (RBO) Vaccine Status Tables contain current information about recently submitted, licensed, and recommended vaccines and biologics, including status of the US Food and Drug Administration (FDA) licensure process and related American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) recommendations.

Information in the Vaccine Status Tables was just updated. Updates include the following:

Table 1. Status of Recently Submitted, Licensed, and Recommended Vaccines & Biologics

  • Dengue: Center for Disease Control and Prevention/American Academy of Pediatrics (CDC/AAP) recommendations
  • Hepatitis B Vaccine: Newly added
  • PCV20 and PCV15: CDC/AAP recommendation; Further information

Table 2. Status of Recently Submitted, Licensed, and Recommended Influenza Vaccines

  • ccIIV4: FDA licensure; FDA age indications

Table 3. Sars-CoV-2 Vaccines

  • mRNA162b2: All criteria
  • mRNA-1273: Dose number and interval; Presentation
  • Ad26COV51: Dose number and interval; Further information
  • NVX-CoV2373: FDA status

Errata for Current Edition of Red Book on Red Book Online
The American Academy of Pediatrics has posted the following new errata for the current edition of Red Book on Red Book Online.

Section 1: Active and Passive Immunization
Pages 32-33: In the second paragraph of the “Multiple Vaccines Administered at the Same Time” section of the Active Immunization chapter, the following correction has been made.

Corrected Text: “therefore, injectable and nasally-administered live-virus vaccines not administered on the same day should be given at least 28 days (4 weeks) apart whenever possible (Table 1.9). Live oral vaccines…”

Original Text: “therefore, live-virus vaccines not administered on the same day should be given at least 28 days (4 weeks) apart whenever possible (Table 1.9). This restriction does not apply to the nasally administered live attenuated influenza vaccine, which does not interfere with immune responses to MMR or varicella vaccination. In addition, live oral vaccines…”

Section 4. Antimicrobial Agents and Related Therapy

Page 982: In Table 4.11, in the Neurocysticercosis section, the following correction has been made to the Adult Dosage.

Corrected Text: “15 mg/kg/day (max 800 mg/day OR 1200 mg/day, depending on number and characteristics of lesions as detailed in IDSA guideline) for 10-14 days (take with food)”.

Original Text: “≥60 kg: 400 mg, orally, 2 times/day for 10–14 days (take with food) <60 kg: 15 mg/kg/day (max 1200 mg/day), orally, divided 2 times/day for 10–14 days (take with food)”

Page 982: In Table 4.11, in the Neurocysticercosis section, the following correction has been made to the Pediatric Dosage.

Corrected Text: “15 mg/kg/day (max 800 mg/day OR 1200 mg/day, depending on number and characteristics of lesions as detailed in IDSA guideline) for 10–14 days (take with food)”

Original Text: “15 mg/kg/day (max 1200 mg/day), orally, in 2 divided doses for 8–30 days (take with food)”

Page 989: The following corrections have been made to footnote 66.

Corrected Text: “The Centers for Disease Control and Prevention recommends 15 days of therapy, and suggests that more prolonged treatment courses (e.g. 30 days of albendazole, which may be repeated) may be needed for extraparenchymal or extensive disease.”

Original Text: “Longer courses may be needed for subarachnoid disease.”

Corrected Text: “Regimens such as dexamethasone (adult dose: 6 mg per day) for 10 days, beginning before starting anti-parasitic therapy, have been used.”

Original Text: “Regimens such as dexamethasone 6 mg/kg/day for 10 days, beginning before starting anti-parasitic therapy, and prednisone 1–1.5 mg/kg/day during therapy have been used.”

The full text of all new Red Book errata, including a PDFs from which pages can be printed and placed in print copies, is posted on Red Book Online. All users of the Red Book are encouraged to go to the Red Book Online errata page to view the errata. The errata are freely accessible to all visitors to the site. 


January 2022

AAP COVID-19 Town Hall Posted 1/31/22
Join the next AAP Town Hall on Thursday, February 3, at 7:00 pm CT. This bi-weekly series of virtual town halls links members with leading experts to discuss emerging issues related to the COVID-19 pandemic.

The February 3 event will feature experts in infectious diseases, sports medicine, and post-COVID conditions (long COVID).

Expert Panelists
Susannah “Suz” Briskin, MD, FAAP
Executive Committee Member, AAP Council on Sports Medicine and Fitness
Associate Professor of Pediatrics in the Division of Sports Medicine at Rainbow Babies and Children’s Hospital
Head Team Physician for Hathaway Brown School and Assistant Team Physician for Case Western Reserve University

Sarah Risen, MD, FAAP
Faculty, Department of Pediatric Neurology and Meyer Center for Developmental Pediatrics, Texas Children’s Hospital
Assistant Professor, Baylor College of Medicine

José R. Romero, MD, FAAP, FAAAS, FIDSA, FPIDS
Member, AAP Committee on Infectious Diseases
Immediate Past Chairperson, CDC Advisory Committee on Immunization Practices
Arkansas Secretary of Health; Director, Arkansas Department of Health
Professor of Pediatrics, Pediatric Infectious Diseases, University of Arkansas for Medical Sciences

Register here.


AAP COVID-19 Town Hall Posted 1/18/22
Join the next AAP Town Hall on January 20 at 7:00 pm CT. This bi-weekly series of virtual town halls links members with leading experts to discuss emerging issues related to the COVID-19 pandemic. During this event, we will address the latest related to the COVID-19 pandemic.

Join us for this informative session where you will hear from leading experts and connect with your peers.

Sara Bode, MD, FAAP
Chairperson-elect, AAP Council on School Health
Medical Director, Nationwide Children's Hospital's Care Connection School-Based Health and Mobile Clinics

Bonnie Maldonado, MD, FAAP 
Chairperson, AAP Committee on Infectious Diseases 
Professor, Departments of Pediatrics and of Health Research and Policy;
Chief, Division of Infectious Diseases; and Senior Associate Dean of Faculty Development, Stanford University School of Medicine 

Joelle Simpson, MD, MPH, FAAP
Executive Committee Member, AAP Council on Children and Disasters
Chief of Emergency Medicine and Medical Director for Emergency Preparedness, Children’s National Hospital

Register here.


CDC COCA Call: COVID-19 Quarantine and Isolation Recommendations Posted 1/12/22
On Thursday, January 13, at 2:00 pm ET, the Centers for Disease Control and Prevention will host a COCA Call to review the recently updated COVID-19 quarantine and isolation recommendations for healthcare and non-healthcare settings. During this COCA Call, presenters will discuss the science supporting these changes, the populations and settings to which these changes apply, and additional precautions people should take at the end of quarantine or isolation.

Date: Thursday, January 13, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the Centers for Disease Control and Prevention Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_011322.asp


CDC COCA Call: What Clinicians Need to Know About the New Oral Antiviral Medications for COVID-19 Posted 1/11/22
The emergency use authorizations (EUAs) for the new oral antiviral medications molnupiravir and Paxlovid™ (nirmatrelvir/ritonavir) supplement current therapeutic efforts to decrease hospitalizations and prevent severe COVID-19 and death. During this COCA Call, presenters from the Centers for Disease Control and Prevention, Office of the Assistant Secretary for Preparedness and Response, U.S. Food and Drug Administration, and the National Institutes of Health (NIH) will describe the recent EUAs and NIH treatment guidelines, patient prioritization, and resources for healthcare providers. Subject matter experts will review when to prescribe antiviral medications including patient assessment, how to have a risk-benefit discussion to address patient questions or concerns, and how to prioritize patients if medications are in short supply.

Date: Wednesday, January 12, 2022
Time: 2:00 – 3:00 PM ET

For additional information and to view this session, please visit the Centers for Disease Control and Prevention Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2022/callinfo_011222.asp


Red Book Online Outbreaks Feature—New Format! Posted 1/6/22
Red Book Online Outbreaks continues to provide up-to-date information and resource links on current infectious disease outbreaks affecting the US pediatric population. This feature was recently reformatted and streamlined to quickly find pertinent and current outbreak information.

Overseen by members of the AAP Committee on Infectious Diseases, Red Book Online Outbreaks is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect the US pediatric population, along with links to explore further, and related Red Book chapters for additional information.

Visit Red Book Online to view all the current outbreaks, including the most recently posted Listeria outbreak linked to packaged salads by Dole and Fresh Express.

Red Book Online Outbreaks is regularly updated with new outbreaks and new information as each outbreak develops, as well as removal of outbreaks that have concluded.

Bookmark this feature for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


CDC Reports First Pediatric Flu-related Deaths of 2021-’22 Season Posted 1/5/22
The first two pediatric influenza-associated deaths for the 2021-’22 season have been reported to the Centers for Disease Control and Prevention (CDC), according to Flu View, the CDC’s weekly surveillance report. Both deaths were reported in mid-December.

The first pediatric death was associated with an influenza A (H3) virus and occurred during the week ending December 11, 2021. The second pediatric death was associated with an influenza A virus, for which no subtyping was performed, and occurred during the week ending December 18, 2021.

The majority of viruses detected continue to be A(H3N2), according to the report. Most influenza A(H3N2) virus infections have occurred in children and young adults ages 5-24 years. However, the number of infections is increasing in other age groups as well.

While preliminary data suggest that vaccine effectiveness against currently circulating H3N2 viruses may be reduced this season, vaccination is still likely to offer some protection, including against serious flu illness and death.

The American Academy of Pediatrics (AAP) and CDC recommend everyone 6 months and older get vaccinated each year. Physicians with high-risk patients who have contracted the virus should treat them promptly with antivirals.

Read the full article in AAP News.


AAP COVID-19 Town Hall Posted 1/5/22
The AAP is proud to host the first Town Hall of 2022 on January 6th at 7:00 pm CT. This bi-weekly series of virtual town halls links members with leading experts to discuss emerging issues related to the COVID-19 pandemic. During this event, we will address the latest related to the COVID-19 pandemic. Join us for this informative session where you will hear from leading experts and connect with your peers.

James Campbell, MD, MS, FAAP
Member, AAP Committee on Infectious Diseases
Professor, Center for Vaccine Development and Global Health, University of Maryland School of Medicine

Bonnie Maldonado, MD, FAAP 
Chairperson, AAP Committee on Infectious Diseases 
Professor, Departments of Pediatrics and of Health Research and Policy;
Chief, Division of Infectious Diseases; and Senior Associate Dean of Faculty Development, Stanford University School of Medicine 

Sonja O’Leary, MD, FAAP
Chairperson, AAP Council on School Health
Assistant Professor, Pediatrics University of Colorado School of Medicine;
Medical Director, Denver Health, School-Based Health Centers

Register here.


December 2021

AAP COVID-19 Town Hall Posted 12/14/21
The AAP hosts a bi-weekly series of virtual town halls linking members with leading experts to discuss emerging issues related to the COVID-19 pandemic. The next session will be held on Thursday, December 16, 2021 at 7:00 pm CT. During this event, we will address the latest related to the COVID-19 pandemic. Join us for this informative session where you will hear from leading infectious disease experts and connect with your peers.

Expert Panelists
Kristine (Kris) Bryant, MD, FAAP
Member, AAP Committee on Infectious Diseases
Hospital Epidemiologist, Norton Children’s Hospital; Professor of Pediatrics, University of Louisville School of Medicine

James Campbell, MD, MS, FAAP
Member, AAP Committee on Infectious Diseases
Professor, Center for Vaccine Development and Global Health, University of Maryland School of Medicine

Bonnie Maldonado, MD, FAAP 
Chairperson, AAP Committee on Infectious Diseases 
Professor, Departments of Pediatrics and of Health Research and Policy; Chief, Division of Infectious Diseases; and Senior Associate Dean of Faculty Development, Stanford University School of Medicine 

Register here.


New Webinars on Red Book Online Posted 12/9/21
Visit Red Book Online (RBO) to view the following two new webinars!

Red Book Webinar on Increasing Influenza Vaccination Rates During the COVID-19 Pandemic
Annika M. Hofstetter, MD, PhD, MPH, FAAP provides an overview on increasing influenza vaccination rates during the COVID-19 pandemic in this webinar. This short webinar describes current influenza vaccination rates in children, common barriers to influenza vaccination, and strategies to improve timely influenza vaccination. View Webinar

Red Book Webinar on Tuberculosis Testing and Treatment in Children and Adolescents
Dawn Nolt, MD, MPH, FAAP, lead author of the AAP clinical report, "Tuberculosis Infection in Children and Adolescents: Testing and Treatment” published in the December 2021 issue of Pediatrics provides an overview of the recommendations on a newly recorded webinar. Topics include a change in terminology for tuberculosis infection (TBI), strategies for testing children and adolescents with suspected infection, and options for treatment for TBI. View Webinar

Find all AAP infectious disease-related webinars on the Red Book Online Webinars page, including “Red Book 2021 Key Updates” by David Kimberlin, MD, FAAP, Red Book Editor.


November 2021

Now Live—Red Book Online on New Unified Site Posted 11/30/21
All your trusted AAP resources, including Journals, News, Point-of-Care Solutions, and Books, are now all on one unified site, AAP Publications, offering unparalleled innovation with quick access to essential pediatric titles all in one place.

As part of Point-of-Care Solutions, Red Book Online (RBO) is on this unified site. Newly streamlined for ease of use and quick answer finding, RBO now has a new fresh look, including a redesigned home page where you will find pertinent features and key content at a glance, including the Red Book, COVID-19 Resources, Outbreaks, Influenza Resources, the Visual Library, and more.

Visit RBO today and discover newly enhanced layouts and functionality, such as split-screen viewing—view Red Book chapter text on the left and figures, images, tables, references, and related content and articles on the right.

Visit the new unified site or learn more at https://www.aap.org/pubscentral.


AAP COVID-19 Town Hall Posted 11/30/21
The AAP hosts a bi-weekly series of virtual town halls linking members with leading experts to discuss emerging issues related to the COVID-19 pandemic. The next session will be held on Thursday, December 2, 2021 at 7:00 pm CT. During this event, we will address the latest related to the COVID-19 pandemic and its impact on children, adolescents and families. Join us for this informative session where you will hear from leading experts and connect with your peers. Register here.   


AAP COVID-19 Town Hall Posted 11/15/21
Join us for our next AAP COVID-19 Town Hall on Thursday, November 18, at 7:00 pm CT to hear the latest about COVID-19 in children. This session will begin with a brief presentation from a National Institute for Child Health and Human Development (NICHD) pediatric leader, Dr. Robert Tamburro, who will provide a pediatric COVID-19 research update. The presentation will be followed by a time of facilitated Q&A. Join us for this informative session where you will hear from leading experts and connect with your peers. 

Register here. Previous town halls are available for viewing here.   

Expert Panelists
James Campbell, MD, MS, FAAP
Member, AAP Committee on Infectious Diseases
Professor, Center for Vaccine Development and Global Health
University of Maryland School of Medicine

Karen Puopolo, MD, PhD, FAAP
Chief, Section on Newborn Medicine, Pennsylvania Hospital
Associate Professor of Pediatrics
University of Pennsylvania Perelman School of Medicine

Robert F. Tamburro, MD, MSc, FAAP
Senior Advisor for Clinical Research, Division of Extramural Research
Eunice Kennedy Shriver National Institute of Child Health and Human Development


COCA Call: What Clinicians, Pharmacists, and Public Health Partners Need to Know about Antibiotic Prescribing and COVID-19 Posted 11/11/21
The Centers for Disease Control and Prevention (CDC) has published several studies characterizing antibiotic prescribing during the COVID-19 pandemic in outpatient, nursing home, and hospital settings. Findings from these studies and others inform opportunities to improve antibiotic use and guide the development of resources to support healthcare professionals and health systems. Case studies representing common clinical scenarios will be discussed to support decisions related to antibiotic prescribing.

During this COCA Call, clinicians, pharmacists, and public health partners will learn about the impact of the COVID-19 pandemic on antibiotic prescribing and strategies for optimizing antibiotic prescribing.

Date: Thursday, November 18, 2021
Time: 2:00 PM – 3:00 PM ET

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2021/callinfo_111821.asp.


AAP COVID-19 Town Hall Posted 11/3/21
Join us at a special time this Thursday, November 4, at 5:00 pm CT to connect with AAP infectious disease leaders to hear the latest about COVID-19 in children, including vaccines for 5-11 year olds.

View this and previous AAP Town Halls here.

Expert Panelists:  
Bonnie Maldonado, MD, FAAP 
Chairperson, AAP Committee on Infectious Diseases 
Professor, Departments of Pediatrics and of Health Research and Policy; Chief, Division of Infectious Diseases; and Senior Associate Dean of Faculty Development, Stanford University School of Medicine

Sean O’Leary, MD, MPH, FAAP
Vice Chairperson, AAP Committee on Infectious Diseases 
Professor, Pediatrics, Sections of Pediatric Infectious Diseases and General Academic Pediatrics,
University of Colorado Anschutz Medical Campus, Children’s Hospital Colorado


Red Book Online Outbreaks Update: Salmonella Infections Posted 11/2/21
Officials are currently investigating two multistate outbreaks of Salmonella infections linked to onions and salami sticks.

Two new entries on a Salmonella outbreak linked to onions and a Salmonella outbreak linked to salami sticks have been added to the Red Book Online Outbreaks section, providing information about the outbreaks and their impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Outbreaks section is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the section for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


October 2021

The Next AAP COVID-19 Town Hall Posted 10/26/21
The AAP hosts a bi-weekly series of virtual town halls linking members with leading experts to discuss emerging issues related to the COVID-19 pandemic. The next session will be held on Thursday, October 28, 2021 at 7:00 pm CT. During this event, we will address the latest related to the COVID-19 pandemic and its impact on children, adolescents and families. We will also cover the vaccine roll-out for 5-11 year olds. Join us for this informative session where you will hear from leading experts and connect with your peers.

View this and previous AAP Town Halls here.


Red Book Online Outbreaks Update: Seafood – Salmonella Thomson Posted 10/21/21
Officials are currently investigating a multistate outbreak of Salmonella Thomson infections linked to seafood.

A new entry on this Salmonella Thomson outbreak has been added to the Red Book Online Outbreaks section, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Outbreaks section is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the section for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


The Next AAP COVID-19 Town Hall Posted 10/13/21
The AAP hosts a bi-weekly series of virtual town halls linking members with leading experts to discuss emerging issues related to the COVID-19 pandemic. The next session will be held on Thursday, October 14, 2021 at 7:00 pm CT. During this event, we will address the latest related to the COVID-19 pandemic and its impact on children, adolescents and families. Join us for this informative session where you will hear from leading experts and connect with your peers.

Expert Panelists
Benson Hsu, MD, MBA, FAAP, FCCM
Chair-Elect, AAP Section on Critical Care
Professor of Pediatrics, University of South Dakota Sanford School of Medicine
Chief Scientific Officer, Preparedness Treatment and Equity Coalition

Kimberly Montez, MD, MPH, FAAP
Vice Chair, AAP Council on Community Pediatrics
Assistant Professor of Pediatrics; Associate Program Director, Pediatrics Residency; and Associate Director of Integrating Special Populations, Maya Angelou Center for Health Equity at Wake Forest School of Medicine

José R. Romero, MD, FAAP, FAAAS, FIDSA, FPIDS
Member, AAP Committee on Infectious Diseases
Immediate Past Chairperson, CDC Advisory Committee on Immunization Practices
Arkansas Secretary of Health; Director, Arkansas Department of Health
Professor of Pediatrics, Pediatric Infectious Diseases, University of Arkansas for Medical Sciences

View this and previous AAP Town Halls here.


New PediaLink Course: Influenza During the COVID-19 Pandemic Posted 10/13/21
This four-part course series provides key information about the 2021-2022 flu season. The purpose of this PediaLink module is to educate pediatric health care professionals on the current American Academy of Pediatrics policy recommendations for routine use of seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in infants, children, and adolescents. The recommendations for the prevention and treatment of influenza are updated annually.

Pediatricians continue to have a leadership role in the prevention of influenza and its complications through vaccine use and public education. In addition, pediatricians should promptly identify influenza infections to provide timely treatment when indicated to reduce childhood morbidity and mortality. Recommendations for treating egg-allergic patients are discussed along with requirements and importance for all health care personnel to be immunized annually.

Unit 1 Influenza: Clinical Presentation and Complications
Unit 2: Influenza: Diagnostic Testing
Unit 3: Prevention of Influenza
Unit 4: Influenza: Treatment for the Clinician

AVAILABLE: 10/11/2021 - 10/10/2022
https://shop.aap.org/influenza-during-the-covid-19-pandemic/

Faculty
Flor Munoz, MD, FAAP
Tim Uyeki, MD, MPH, MPP, FAAP
Claudette Poole. MD, FAAP
Julie A. Boom, MD, FAAP
Sean O'Leary, MD, MPH, FAAP
John M. Kelso, MD, FAAP,
Min Jung Lee, MD, FAAP
Suchitra Rao, MBBS, MSCS, FAAP
John Bradley, MD, FAAP


New PediaLink Course: Effective COVID-19 Vaccine Conversations Posted 10/12/21
The coronavirus disease 2019 (COVID-19) pandemic has caused tremendous burden to the U.S. population, including children and adolescents. Vaccines are safe and effective in protecting individuals and populations against infectious diseases, including COVID-19, and vaccines are currently available to provide protection against COVID-19. This course aims to improve knowledge and competency among pediatricians and non-physicians to have effective COVID-19 vaccine conversations with patients and families, including the sharing of credible COVID-19 vaccination information and responding to misinformation.

Module 1: Science of Vaccines & Common Myths
Module 2: COVID-19 Vaccine Basics: The Science of Vaccines
Module 3: Disinformation and Misinformation: Knowing the Difference—Coming Soon!
Module 4: Not Your Routine Vaccines, Not Your Routine Circumstances: Engaging with Patients and Parents About COVID-19 Vaccines in these Extraordinary Times
Module 5: Cognitive Biases, Behavior Change, and Putting the Evidence Into Action

Available: 10/8/21 – 12/31/21
https://shop.aap.org/effective-covid-19-vaccine-conversations/

Faculty
Rupali J. Limaye, PhD, MPH, MA
Sean O’Leary, MD, MPH, FAAP
Heidi J. Larson, PhD
Douglas J. Opel MD, MPH, FAAP

Learning Objectives

  •  Describe the science of vaccines and how they are developed, including COVID-19 vaccines.
  • Communicate effectively with adolescents and families who have questions or express hesitancy, providing them with accurate, succinct, and compelling responses to myths and frequently asked questions about COVID-19 vaccines.
  • Describe the difference between disinformation and misinformation and use strategies to address both.
  • Recognize and address cognitive biases about vaccines among patients and families by using effective messages and communication strategies to foster behavior change.

Acknowledgements
This program is supported by Cooperative Agreement Number 6-NU38OT000282-03-05, funded by the Center for State, Tribal, Local, and Territorial Support National Partnership Branch, Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Center for Disease Control and Prevention of the Department of Health and Human Services.


Coming Soon—Red Book Online on New Unified Site! Posted 10/6/21
Coming in November, all your trusted AAP resources, including Journals, News, Point-of-Care Solutions, and Books, are moving to one unified site offering unparalleled innovation with streamlined access to essential pediatric titles all in one place.

As part of Point-of-Care Solutions, Red Book Online (RBO) will be on this unified site. Newly streamlined for ease of use and quick answer finding, RBO will also have a new fresh look, including a redesigned home page and split screen content viewing. See below for a sneak peek.

New RBO Home Page—Find pertinent features and key content at a glance, including the Red Book, COVID-19 Resources, Outbreaks, Influenza Resources, the Visual Library, and more.

New Split Screen Functionality—View Red Book chapter text on the left and figures, images, tables, references, and related content and articles on the right.

Learn more about the new and exciting unified site at https://www.aap.org/pubscentral. And, be on the lookout for additional messaging about RBO on this new site.


Influenza Prevention and Control Strategies in Early Child Care Settings Posted 10/5/21
Influenza remains a serious threat to children due to its potential to cause severe morbidity and
mortality. Each year, millions of children get sick with seasonal flu, thousands are hospitalized, and
some die from complications. The best way to protect children against the flu is to get vaccinated,
along with implementing and teaching infection control practices. Join this webinar to learn how
child care settings can prepare for seasonal flu during the COVID-19 pandemic.

Thursday, October 7, 2021
5:00–6:00 pm ET

Register Online Now!

Presenter
Andrew Hashikawa, MD, MS, FAAP, Clinical Associate Professor of Emergency Medicine
and Pediatrics, Michigan Medicine, University of Michigan, Ann Arbor, MI

Target Audience

  • Head Start and child care center directors
  • Child care health consultants
  • Education services staff members
  • Health managers and specialists
  • Parent leaders

How to Register
Participation is free, but registration is required. Space is limited. Select this link to register.
After registering, participants will receive a confirmation email with details on how to join the
webinar. This webinar will be recorded and archived for later viewing.

Certificate of Participation
Participants will receive a certificate of participation upon completion of an online evaluation. A link
to the form will be available at the end of the webinar. Participants must complete the form in order
to receive a certificate.


COCA Call: 2021-2022 Recommendations for Influenza Prevention and Treatment in Children: An Update for Pediatric Practitioners Posted 10/5/21
During this Clinician Outreach and Communication Activity (COCA) Call, subject matter experts from the American Academy of Pediatrics (AAP) and CDC will discuss strategies primary care providers and medical subspecialists can use to improve, prevent, and control influenza among children this season.

Date: Thursday, September 7, 2021
Time: 2:00 - 3:00 pm (ET)

Click here to watch this COCA Call.

 


September 2021

COCA Call: 2021-2022 Influenza Vaccination Recommendations and Guidance on Coadministration with COVID-19 Vaccines Posted 9/16/21
During this Clinician Outreach and Communication Activity (COCA) Call, presenters will provide updates on the Advisory Committee on Immunization Practices (ACIP) recommendations for the 2021-2022 influenza vaccination season and guidance for coadministration of influenza and COVID-19 vaccines.

Date: Thursday, September 9, 2021
Time: 2:00 - 3:00 pm (ET)

For additional information and to view this session, please visit the Centers for Disease Control and Prevention Emergency Preparedness and Response website at
https://emergency.cdc.gov/coca/calls/2021/callinfo_090921.asp


Red Book Online Updates! Posted 9/7/21

RBO Vaccine Status Tables
The vaccine information in the Red Book Online Vaccine Status Tables (1 and 3) was updated to include new vaccines, usage recommendations, age indications, and US Food and Drug Administration (FDA) approval.

The Vaccine Status Tables contain current information about recently submitted, licensed, and recommended vaccines and biologics, including status of the FDA licensure process and related American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC)

  • Table 1: Status of Recently Submitted, Licensed, and Recommended Vaccines & Biologics
  • Table 2: Influenza Vaccines
  • Table 3: Sars-CoV-2 vaccines

See what’s new and visit often to stay updated on the latest vaccine information!

RBO Influenza Resource Page
The Influenza Resource Page was just updated to include the most recent influenza information from the AAP and CDC, including the just released AAP policy statement and technical report “Recommendations for Prevention and Control of Influenza in Children, 2021-2022.”

The AAP Committee on Infectious Diseases compiled this comprehensive list of influenza resources to serve as a centralized point of reference for vaccine guidance, prevention, treatment, payment, policies, news, and other information pertaining to influenza for infants, children, adolescents, and young adults.

This resource is updated frequently as needed, including pertinent information related to seasonal, H1N1, avian, and pandemic influenza.


The Next AAP Town Hall: COVID – How are the Children? Posted 9/7/21
The AAP hosts a bi-weekly series of virtual town halls linking members with leading experts to discuss emerging issues related to the COVID-19 pandemic. The next session will be held on Thursday, September 9, 2021 at 7:00 pm CDT. During this event, we will address the variety of impacts that COVID-19 is having on children and adolescents. Join us for this informative session where you will hear from leading experts and connect with your peers.

View this and previous AAP Town Halls here.


August 2021

AAP Town Hall: COVID – What's the Latest? Posted 8/31/21
The AAP hosts a bi-weekly series of virtual town halls linking members with leading experts to discuss emerging issues related to the COVID-19 pandemic. The next session will be held on Thursday, September 2, 2021 at 7:00 pm CT and will address the COVID-19 variants, monoclonal antibody treatment, vaccinations, back-to-school, and other pressing topics. Join us for this informative session where you will hear from leading experts and connect with your peers.

View this and previous AAP Town Halls here.


Available on RBO: AAP Interim Guidance on Use of Palivizumab During Unusual RSV Season
Posted 8/24/21
The American Academy of Pediatrics (AAP) recently released new interim guidance on the treatment of serious lower respiratory tract infections caused by respiratory syncytial virus (RSV). The guidance comes in response to an uncharacteristic rise in cases over the spring and summer. The AAP recommends consideration of the use of palivizumab, a monoclonal antibody directed against the fusion protein of RSV, in infants at increased risk of severe disease.

For complete information on RSV, refer to the Respiratory Syncytial Virus chapter in Red Book on Red Book Online.

Additional resources:


COCA Call: Additional mRNA COVID-19 Vaccines for Moderately to Severely Immunocompromised People Posted 8/16/21
The U.S. Food and Drug Administration (FDA) has issued Emergency Use Authorizations (EUA) for additional doses of mRNA COVID-19 vaccines for moderately to severely immunocompromised people. People with immunocompromising conditions or who take immunosuppressive medications or therapies are at increased risk for severe COVID-19. Studies indicate that some immunocompromised people have a reduced immune response following a primary COVID-19 vaccine series compared to vaccine recipients who are not immunocompromised. Studies have further demonstrated that an additional mRNA COVID-19 vaccine dose after an initial 2-dose primary mRNA COVID-19 vaccine series in some immunocompromised populations may enhance immune response.

During this COCA Call, presenters will discuss the current data on COVID-19 vaccines in immunocompromised people; the role of additional doses of mRNA COVID-19 vaccines, patients who should be considered to receive these additional COVID-19 vaccine doses, results from the August 13, 2021, Advisory Committee on Immunization Practices (ACIP) meeting, and CDC’s guidance on additional COVID-19 doses in immunocompromised people.

Date: Tuesday, August 17, 2021
Time: 2:00 pm - 3:00 pm (ET)

For additional information and to view this session, please visit the Centers for Disease Control and Prevention Emergency Preparedness and Response website at
https://emergency.cdc.gov/coca/calls/2021/callinfo_081721.asp.


AAP Town Hall: COVID-19 Hot Topics Posted 8/13/21
The AAP hosts a bi-weekly series of virtual town halls linking members with leading experts to discuss emerging issues related to the COVID-19 pandemic. The next session will be held on Thursday, August 19, 2021 at 7:00 pm CT and will address the COVID-19 variant, vaccinations, back-to-school, and other pressing topics. Join us for this informative session where you will hear from leading experts and connect with your peers.

View this and previous AAP Town Halls here.

Expert Panelists:
Sara Bode, MD, FAAP
Chairperson-elect, AAP Council on School Health
Medical Director, Nationwide Children's Hospital's Care Connection School-Based Health and Mobile Clinics

David W. Kimberlin, MD, FAAP
Editor, AAP Red Book
Sergio Stagno, MD Endowed Chair in Infectious Diseases
Co-Director of the Division of Pediatric Infectious Diseases; and Vice Chair for Clinical and Translational Research at University of Alabama at Birmingham

Bonnie Maldonado, MD, FAAP 
Chairperson, AAP Committee on Infectious Diseases 
Professor, Departments of Pediatrics and of Health Research and Policy; Chief, Division of Infectious Diseases; and Senior Associate Dean of Faculty Development, Stanford University School of Medicine


Guidance on Use of Palivizumab During Unusual RSV Season Posted 8/12/21
An atypical summer spike in respiratory syncytial virus (RSV) has prompted the AAP to recommend clinicians consider using palivizumab for high-risk infants in affected areas.

A typical RSV season runs from fall through spring with a peak in February. However, RSV activity was low from May 2020 to early March 2021, possibly due to COVID-19 mitigation measures. Instead, some parts of the country have seen rising rates over the last several months, prompting a health advisory from the Centers for Disease Control and Prevention (CDC).

The AAP interim guidance on administration of palivizumab during this delayed season is the same as for a typical season: Consider administering the humanized monoclonal antibody in up to five monthly doses to prevent RSV in high-risk infants and children in areas experiencing high rates of the virus.

Eligible children include premature infants, especially those born at less than 29 weeks’ gestation, infants with chronic lung disease of prematurity, infants with certain types of hemodynamically significant congenital heart disease, infants and young children with certain immunodeficiency states, and infants with pulmonary abnormalities or neurological and neuromuscular conditions that impair ability to clear secretions from the upper airway.

Clinicians should reassess the need for palivizumab at least monthly.

See the full article in AAP News.

Resources


July 2021

Neonates, Breastfeeding Infants Included in New CDC Guidance on Plague Posted 7/30/21
A new report offers recommendations on the antimicrobial treatment and prophylaxis of plague, both naturally occurring and in a bioterror attack, including guidance related to neonates and breastfeeding infants.

The evidence-based guidance published in Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention is aimed at clinicians, public health professionals and first responders. Organizations, hospitals and communities can use the information for treating patients and in a mass casualty.

Yersina pestis, the agent that causes plague, is in the highest risk category of biologic agents and toxins. An attack would require rapid and informed decision-making by clinicians and public health agencies, according to the report Antimicrobial Treatment and Prophylaxis of Plague: Recommendations for Naturally Acquired Infections and Bioterrorism Response.

New data have become available and the Food and Drug Administration has approved additional countermeasures since plague guidelines were published in 2000. American Academy of Pediatrics experts were among those in clinical medicine, bioterrorism preparedness and public health who took part in forums beginning in 2018 and contributed to the updated publication.

See the full article in AAP News.

Also refer to the AAP Red Book Plague chapter on Red Book Online.


June 2021

What’s the Latest with the Flu Posted 6/17/21
Know Your Community Prevalence of Influenza and COVID-19
The number of influenza positive specimens reported by public health labs has remained unusually low, likely due to the COVID-19 mitigation measures in place. One pediatric influenza-associated death has been reported to CDC since October 2020. Influenza-like illness (ILI) has remained below the national baseline of 2.6%. ILI surveillance may be impacted by the COVID-19 pandemic and should be interpreted with caution (Weekly U.S. Influenza Surveillance Report | CDC). Influenza is unpredictable, and it is not possible to know how severe the next flu season will be.

The best way to be protected against the flu and its potentially serious complications is to get vaccinated with the influenza vaccine each fall.

Data on COVID-19 Among Children
Data on COVID-19 among children are updated on a weekly basis and can be found here.

Data on Community Prevalence of COVID-19
CDC COVID Data Tracker is regularly updated with information on community prevalence of COVID-19, data about testing and vaccination rates, demographic trends, and other information at the national and state level.

The Community Profile Report provides a plain language summary of key indicators for all regions, states, core-based statistical areas (CBSAs), and counties across the United States. It provides a snapshot that focuses on recent outcomes in the last seven days and changes relative to the weeks prior, and provides contextual information at the county, CBSA, state, and regional levels.

Address Missed Immunizations among the Pediatric Population
As we head into summertime, it is a good time for practices to ensure their pediatric patient population is caught up on routine childhood and adolescent immunizations that were missed due to the COVID-19 pandemic. According to CDC, public sector vaccine orders dropped 14% in 2020-2021 compared with 2019.

Clinicians and practices can employ the following strategies and resources to increase immunization rates at their practices:

  • Send reminders to families about school immunization requirements.
  • Implement provider prompts; electronic prompts in Electronic Health Records (EHRs) or notes/flags in paper charts.
  • Hold family friendly office hours.
  • Assign an Immunization Champion who can lead practice-based efforts on catch-up for your practice.
  • Provide a strong recommendation for all vaccines on the current immunization schedule.
  • Help address health beliefs and barriers about influenza and other routinely recommended vaccines.
  • Educate patients and their parents.
  • Include all recommended vaccinations at every visit. Co-administration of the COVID-19 vaccine with other vaccines is acceptable.
  • Do not miss any opportunity to vaccinate!

Click here for more information on how practices can address missed immunizations.

The AAP offers several toolkits where clinicians and providers can access sample texts, videos, and photos sized for social media platforms to promote immunization catch-up:

Apply Expertise with Flu Vaccination Clinics to COVID-19 Vaccination
Offering flu vaccination clinics for patients, and even members of patients' families, is not new for pediatricians. In fact, the COVID-19 pandemic prompted more practices to adopt new flu clinic models such as drive thru or curbside clinics, or expanded hours of existing clinics.

Pediatric practices can apply this experience to offering COVID-19 vaccination clinics. With the Emergency Use Authorization (EUA) of the Pfizer-BioNTech COVID-19 vaccine for 12–15 year olds, pediatric practices that sign up to be providers of this vaccine may consider holding a COVID-19 vaccination clinic for adolescents. The AAP offers information, resources, and tips to help your practice host a successful vaccination event. Check out the information here.

Action Steps for Pediatricians
The Pfizer-BioNTech COVID-19 vaccine is now authorized and recommended for persons 12 years of age and up. Distribution of COVID-19 vaccine to pediatric practices is handled at the state level. States are now distributing to primary care practices. Pediatricians and their teams can prepare by doing the following:

  • Administer catch-up routine vaccinations to patients who are behind.
  • Promote COVID-19 vaccine confidence.
  • Know the COVID-19 vaccination sites in your community.

Practices that want to administer COVID-19 vaccines can consider the following:

  • Enroll to administer COVID-19 vaccine in your state
  • Learn more about providing COVID-19 vaccine to adults for those who wish to do so, including enrolling in Medicare to provide COVID-19 vaccine to seniors.

Click here for more information on what pediatricians can do now.

Additional Information
See the AAP Red Book Online Influenza Resource page, AAP Red Book Online COVID-19, and CDC FluView.

This message is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $200,000 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.


New 2021 Edition of Red Book now on Red Book Online! Posted 6/7/21
The newly revised and updated Red Book: 2021–2024 Report of the Committee on Infectious Diseases, 32nd Edition is now available on Red Book Online—the go-to resource for the most current information on infectious diseases.

Click "Red Book" to go directly to the Table of Contents. And, refer to the Summary of Major Changes to quickly see all the new and updated content in the Red Book 2021.

Start using the new edition of the Red Book on Red Book Online today!

Webinar—Red Book 2021 Key Updates
Dr Kimberlin, Red Book Editor, provides an overview of key updates in the 32nd edition of the Red Book in this newly recorded webinar. Topics discussed include updated vaccination recommendations (Meningococcal, Tdap/DTaP, Hepatitis A, Rotavirus), commonly treated conditions in children (eg, head lice, molluscum), travel medicine, new figures and tables to help guide the care and management of many infectious diseases (Helicobacter pylori, HIV, Hepatitis B, Measles, Tuberculosis), and much more, including a new systems-based antibiotic table that guides empiric antibiotic selection prior to knowing what the causative pathogen is! Find this new webinar on Red Book Online.

AAP Member Benefit!
Eligible AAP members can request one print copy of the 2021 Red Book® at shop.aap.org/getredbook.

AAP medical students members, international members, corresponding members, and lapsed members are not eligible. A $17 shipping and handling fee will be applied.


May 2021

Red Book Online Outbreaks: Ground Turkey – Salmonella Hadar Posted 5/14/21

This outbreak is now over.

Officials are currently investigating a multistate outbreak of Salmonella infections linked to ground turkey.

A new entry on this Salmonella Hadar outbreak has been added to the Red Book Online Outbreaks section, providing information about the outbreak and its impacts for the pediatric population.

Overseen by members of the AAP Committee on Infectious Diseases, the Outbreaks section is intended to provide pediatric health care professionals with a quick resource to get up to speed on current outbreaks and how they affect children, along with links to explore further.

Bookmark the section for regular visits, and keep an eye out for emails from Red Book Online alerting you to updates.


Mobile Apps Retirement: Red Book® Online and Pediatric Care Online™ Posted 5/14/21
On June 1, 2021, the AAP mobile apps Red Book Online (RBO) and Pediatric Care Online (PCO) will be retired to align with our efforts to provide the most updated content with the best user experience to our members and customers.

Please see the FAQs for more details about the plan as well as the best ways to access RBO and PCO content on a mobile device going forward.


American Academy of Pediatrics Calls for Children and Teens Age 12 and Up to Get the COVID-19 Vaccine Posted 5/12/21
Itasca, Ill.—In a new policy statement today, the American Academy of Pediatrics (AAP) recommends vaccinating all children ages 12 and older who are eligible for the federally authorized COVID-19 vaccine.

The AAP policy statement comes amid a discussion by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC) on the Pfizer-BioNTech vaccine for adolescents 12 years and older, including a review of the data provided by clinical trials. Earlier this week, the U.S. Food and Drug Administration granted an Emergency Use Authorization for use of the vaccine in the 12- to 15-year age group. Both steps were part of a long-standing, rigorous and transparent process that leads to the development of all vaccines.

The AAP recommends that all eligible children, teens, family and household members be vaccinated as soon as possible. Pediatricians are especially concerned about communities disproportionately impacted by the COVID-19 pandemic and are working to ensure equity in the vaccine’s distribution.

Click here for the full press statement.

AAP Policy Statement: COVID-19 Vaccines in Children and Adolescents

AAP News article: AAP, CDC recommend COVID-19 vaccine for ages 12 and older

HealthyChildren.org article: Getting Your Child Ready for the COVID-19 Vaccine


COCA Call: What Clinicians Need to Know About Pfizer-BioNTech COVID-19 Vaccination of Adolescents Posted 5/12/21
This COCA Call will give clinicians an overview of the Pfizer-BioNTech COVID-19 vaccination in adolescents who are 12-to-15 years of age. Clinicians will learn about the safety and efficacy of the vaccine, vaccine recommendations, and clinical guidance for using the Pfizer-BioNTech COVID-19 vaccine in adolescents in this age group.

Date: Friday, May 14, 2021
Time: 2:00 pm – 3:00 pm ET

Presenters
Sara Oliver, MD, MSPH

LCDR, U.S. Public Health Service
Co-lead, Advisory Committee for Immunization Practices COVID-19 Vaccines Work Group
COVID-19 Response
Centers for Disease Control and Prevention

Kate Woodworth, MD, MPH
Medical Officer, Clinical Guidance Team
COVID-19 Response
Centers for Disease Control and Prevention

Tanya Myers, PhD, MSc
v-safe Team Co-Lead
COVID-19 Response
Centers for Disease Control and Prevention

For additional information and to view this session, please visit the CDC Emergency Preparedness and Response website at https://emergency.cdc.gov/coca/calls/2021/callinfo_051421.asp


Pediatrics Research Roundup, Preview of the Red Book—Ep. 59 Posted 5/7/21
Pediatrics On Call – In this episode Lewis First, MD, MS, FAAP, editor-in-chief of Pediatrics, is back for another edition of “First Up.” He joins hosts David Hill, MD, FAAP, and Joanna Parga-Belinkie, MD, FAAP, with a bird’s-eye view of what’s in the May issue of the journal. The hosts also talk to David Kimberlin, MD, FAAP, editor of the Red Book about what to expect in the 2021 edition coming to Red Book Online June 3. Episode Website


COCA Call: Lyme Disease Updates and New Educational Tools for Clinicians Posted 5/7/21
Lyme disease is the most commonly reported vector-borne disease in the United States. The number of confirmed and probable reported cases more than doubled from 1998 to 2018. Understanding Lyme disease’s epidemiology and clinical features is valuable for clinicians in emerging areas, clinicians in endemic regions who need a refresher course, and healthcare providers in non-endemic regions who see travel-related cases.

During this COCA Call, presenters will review updates in Lyme disease epidemiology, diagnosis, treatment, and prevention and share new educational tools for both healthcare providers and their patients.

Date: Thursday, May 20, 2021
Time: 2:00 pm - 3:00 pm (ET)

Presenter
Grace Marx, MD, MPH
LCDR, U.S. Public Health Service
Medical Epidemiologist, Bacterial Diseases Branch
Division of Vector-Borne Diseases
Centers for Disease Control and Prevention

For additional information and to view this session, please visit the Centers for Disease Control and Prevention Emergency Preparedness and Response website at
https://emergency.cdc.gov/coca/calls/2021/callinfo_052021.asp.


April 2021

Next AAP Town Hall: Ask the Red Book About COVID-19 – Part 3 Posted 4/20/21
The American Academy of Pediatrics (AAP) has launched a series of virtual town halls linking members with leading experts to discuss emerging issues related to the COVID-19 pandemic. The 16th in the series, Ask the Red Book About COVID-19 – Part 3, will be held on Thursday, April 22, at 7:00 pm CT. Hear the latest on the Janssen COVID-19 vaccine pause, strategies for addressing vaccine hesitancy, SARS-CoV-2 variants, and more by leaders from the AAP Red Book Committee. Join us to hear from our experts and to connect with your peers.

View this and previous AAP Town Halls here.

Expert Panelists
David W. Kimberlin, MD, FAAP
Editor, AAP Red Book
Sergio Stagno, MD. Endowed Chair in Infectious Diseases; Co-Director of the Division of Pediatric Infectious Diseases; and Vice Chair for Clinical and Translational Research at University of Alabama at Birmingham

Bonnie Maldonado, MD, FAAP 
Chairperson, AAP Committee on Infectious Diseases 
Professor, Departments of Pediatrics and of Health Research and Policy; Chief, Division of Infectious Diseases; and Senior Associate Dean of Faculty Development, Stanford University School of Medicine

Sean O’Leary, MD, MPH, FAAP
Vice Chairperson, AAP Committee on Infectious Diseases 
Professor, Pediatrics, Sections of Pediatric Infectious Diseases and General Academic Pediatrics,
University of Colorado Anschutz Medical Campus, Children’s Hospital Colorado


The Science behind COVID-19, Antibiotic Stewardship – Episode 56 Posted 4/16/21
In this episode Sean O’Leary, MD, MPH, FAAP, vice chair of the AAP Committee on Infectious Diseases (COID), describes the characteristics of SARS-CoV-2 and what it might take to end the pandemic. Hosts David Hill, MD, FAAP and Joanna Parga-Belinkie, MD, FAAP also talk to Jeffrey S. Gerber, MD, PhD, FAAP, chair of the Antimicrobial Resistance and Stewardship Subcommittee of COID, about his efforts to end unnecessary prescribing of antibiotics in pediatrics. Click here to view.


March 2021

PCO Webinar—Hit Me with Your Best Shot: Immunizations in 2021 Posted 3/1/21
We invite you to join us on Monday, March 8, at 12:00 pm EST when Henry Bernstein, DO, MHCM, FAAP discusses the Recommended Childhood and Adolescent Immunization Schedule: United States, 2021. Objectives of this webinar include:

  • Highlight the current Recommended Childhood and Adolescent Immunization Schedule: United States, 2021.
  • Understand the rationale for the latest updates to the 2021 universal immunization schedule.
  • Understand the process for approval of COVID19 vaccine in children.

To view the webinar on Monday, March 8, please click here or use the following url:
https://event.webcasts.com/starthere.jsp?ei=1430886&tp_key=b56e77e2b2

Henry Bernstein, DO, MHCM, FAAP is a Professor of Pediatrics at the Zucker School of Medicine at Hofstra/Northwell in New York. He presently is a member of the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention and the Associate Editor of Red Book Online. He is an ex-officio member of the American Academy of Pediatrics Committee on Infectious Diseases.

Dr. Bernstein taps into his extensive 36-year experience as a general pediatrician in private practice, the National Health Service Corps, and as Chief of General Academic Pediatrics at urban, suburban, and rural children’s hospitals to promote the health and well-being of children, their families, and their communities.

His private, community-based primary care (generalist) experiences, in combination with academic leadership responsibilities, have provided him with a value-added, translational science perspective, unique from many others in academia.

This tacit knowledge enables him to fulfill a lifelong passion of communicating, educating, and translating science into clinical settings, educational venues, policymaking, and media interactions to advance the health of children.


February 2021

CIIW Webinars: Updates on the 2021 Child/Adolescent and Adult Immunization Schedules Posted 2/24/21
There will be a Current Issues in Immunization Webinars: Updates on the 2021 Child/Adolescent and Adult Immunization Schedules on March 3, 2021 from 12:00-1:00 pm EST.

Moderator: Andrew Kroger, MD, MPH, Medical Officer, Communications and Education Branch, Immunization Services Division, NCIRD, CDC

Topic: Updates on the 2021 Child/Adolescent and Adult Immunization Schedules

Speakers:

  • Mark S Freedman, DVM, MPH, Veterinary Medical Officer, CDC/NCIRD
  • Patricia Wodi, Public Health Physician, CDC/NCIRD

View the recording of this webinar here.


New RBO Vaccine Status Table Posted 2/11/21
A new vaccine status table—Sars-CoV-2 vaccines—was added to the Red Book Online (RBO) Vaccine Status Table page.

This new table provides current information about five Sars-CoV-2 vaccines and pertinent information about each, including:

  • Manufacturer
  • Vaccine type
  • US Food and Drug Administration (FDA) status
  • FDA age indication
  • Dose number and interval
  • Presentation
  • Comments and links to further information

Visit the RBO Vaccine Status Table page for the latest information about recently submitted, licensed, and recommended vaccines and biologics, including status of the FDA licensure process and related American Academy of Pediatrics and Centers for Disease Control and Prevention recommendations.


January 2021

New Policy Statement on Antibiotic Stewardship in Pediatrics Posted 1/8/21
Antibiotics are among the most commonly used medications in pediatric care, but they are frequently overused, contributing to the public health crisis of antibiotic resistance. In a new policy statement, “Antibiotic Stewardship in Pediatrics,” the American Academy of Pediatrics (AAP) and Pediatric Infectious Diseases Society (PIDS) discuss the rationale for programs that monitor and evaluate the appropriate prescribing of antibiotics in inpatient and outpatient settings. The statement published in the January 2021 Pediatrics (published online Dec. 28) cites growing evidence demonstrating that antibiotic stewardship programs can reduce antibiotic overuse while improving patient outcomes. In addition to highlighting the importance of inpatient antibiotic stewardship programs, the statement emphasizes that most antibiotic prescribing occurs in the outpatient setting, and that studies show at least half of these prescriptions are considered inappropriate. AAP and PIDS note that antibiotic use can also lead to unintended, harmful effects to the patient, including Clostridioides difficile infections (CDIs), and other drug-related adverse events, such as end-organ toxicities, diarrhea, rashes, cytopenia, and anaphylaxis. In the statement, AAP and PIDS provide recommendations on personnel, infrastructure and activities required for inpatient and outpatient antibiotic stewardship programs, as well as approaches to evaluating their effectiveness.

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