Influenza Surveillance Update – Alicia Budd (CDC)
Alicia provided highlights of the influenza surveillance report from week 3, ending January 20, 2018. Although influenza activity has continued to increase nationally, we are beginning to see some signs that activity may be declining, particularly along the west coast. The percentage of respiratory specimens testing positive for influenza in clinical laboratories was 26.7%, up slightly from the 25.9% positive reported in the previous week. The percentage of specimens testing positive for influenza A (78.5%) has been holding roughly steady over the past month, while the percentage of influenza B specimens (21.5%) is beginning to increase. Data from public health laboratories indicates 84% of tested viruses were influenza A and 16% were influenza B. Of the subtyped influenza A viruses, 86% were H3 of the variety, and 94% of the B viruses for which lineage information was available were B Yamagata. When compared with previous weeks, these percentages indicate that the amount of B viruses and H1 viruses are increasing overall. Specimens characterized since May continue to be antigenically and genetically similar to the reference virus for this season’s vaccine. Of the several hundred viruses that have been tested, only 2 have shown any antiviral resistance. Both of these virus samples were H1N1, which is not the predominant strain this season.
Nationwide, influenza-like illness (ILI) activity was at 6.6%, up from the 6.2% reported in the prior week. This is the 9th consecutive week that we have been at or above baseline ILI levels. This is the highest ILI level we have seen since the 2009 pandemic. All 10 HHS regions are above their region-specific baselines. ILI information also is available on a state level, with activity summarized as high, moderate, low, or minimal. Last week, 39 states, New York City, and Puerto Rico reported high ILI activity, 5 states and the District of Columbia reported moderate ILI activity, 3 states and reported low ILI activity, and 3 states reported minimal ILI activity.
Based on reports from the National Center for Health Statistics (NCHS) surveillance system available for the week ending January 6, 9.1% of deaths were due to pneumonia and influenza (P&I). This system has been above the epidemic threshold for three consecutive weeks.
Information from the Influenza Hospitalization Surveillance Network (FluSurv-NET) indicates an overall hospitalization rate of 41.9 per 100,000 population. The highest rate (183.1 per 100,000) was among adults aged >65 years, followed by adults aged 50–64 (44.2 per 100,000 population) and children aged 0–4 years (27.0 per 100,000 population). This season’s hospitalization rates for all age groups for week 3 fall between the rates for the 2014–2015 and 2012–2013 seasons, our most recent H3 predominant seasons, However, this season’s rates for persons 18–49 years and 50–59 years are higher than both of the comparable seasons.
Seven (7) influenza-associated pediatric deaths were reported during week 3. For the 2017–2018 season, the total number of reported pediatric deaths is 37. Of these, 73% were associated with influenza A and 27% were influenza B. Of the influenza A viruses for which subtyping information was available, 35% were H3 viruses and 65% were H1 viruses.
In terms of geographic spread of influenza within a state (characterized as regional, local, sporadic, or no activity) as reported by state and territorial epidemiologists, 49 states and Puerto Rico reported widespread activity, 0 states and Guam reported regional activity, 1 state (Hawaii) and the District of Columbia reported local activity, and 0 states and the U.S. Virgin Islands reported sporadic activity.
Alicia noted that this is the third consecutive week in which all states in the continental U.S. have reported widespread activity at the same time.
Topics for February NVAC Meeting and Upcoming Comment Period on New Quality Measures – Angela Shen (NVPO)
The National Vaccine Advisory Committee (NVAC) meeting will be held on February 7–8. Sessions at the meeting will feature three main topics:
- Innovation – Angela noted we’ve made tremendous progress in biomedical research, including new vaccine licensures for Shingrix, Heplisav-B, and adjuvanted hepatitis B vaccines.
- HPV Implementation – Multiple panelists will be speaking on this topic at the NVAC meeting. The speakers will represent long term partners such as AAP and AAFP, as well as newer partners including the American Dental Association and cancer control partnerships. Discussion will include a presentation about the trial for 1-dose HPV vaccine.
- Disparities in Adult Immunization – Topics to be covered include the need for improved surveillance, studies conducted on knowledge, attitudes, and behaviors, and strategies to improve implementation.
Immunization Quality Measures
The Summit’s Quality and Performance Measures (QPM) Workgroup (assisted by work conducted by NVPO and CDC) will soon be sharing a link to two quality and performance measures the group has suggested. Composite measures for prenatal immunization and an age-appropriate composite have been successfully voted to proceed to the public comment stage. This is a critical step in getting the measures incorporated into HEDIS reporting requirements. The comment period will be open for approximately one month beginning in mid-February. The opening of the comment period will be shared with Summit members as soon as it is available. Angela also reminded callers that anyone wishing to join the QPM Workgroup should contact LaDora Woods or Angela Shen.
L.J emphasized that the development and movement of these quality measures to this stage is an important part of the Summit’s work. He thanked Angela and all the QPM Workgroup members for their tremendous efforts to reach this point. He also reminded partners that the Summit has shared (via email) a letter to CMS on end stage renal disease measures that may be signed by partners who wish to do so.
Survey of Influenza Vaccine and Antiviral Medication Availability – L.J Tan (IAC)
Due to reported spot shortages of influenza vaccine and antiviral medications, the Summit is conducting a short survey to assess the availability of these products. The closing date to submit responses is Friday, February 2 until 11:59 pm.
Vaccinating Adults: A Step-by-Step Guide – Deborah Wexler (IAC)
IAC has published an updated version of its 2004 adult immunization guide. Vaccinating Adults: A Step-by-Step Guide, was made possible through funding support from NVPO and CDC. This practical Guide is tabbed and filled with color photos. It is geared toward any healthcare setting providing immunizations for adults. The Guide is available free on IAC’s website. Information also is available on the website about how to order a hard copy version, which includes a copy of Immunization Techniques: Best Practices with Infants, Children, and Adults, a 25-minute training DVD developed by the California Department of Public Health.
Shingles Vaccine Recommendations Have Been Released
L.J reminded callers that CDC has now released a summary statement, New Shingles Vaccine Recommendations Become Official Policy.
2018 Summit In-Person Meeting
L.J reminded callers that the 2018 Summit in-person meeting will be held in conjunction with the National Immunization Conference (NIC) in Atlanta, Georgia. The NIC will be May 15–17, and the Summit will be May 17–18. Attendees are encouraged to participate in both events.
Information on registration and submission of poster abstracts for the Summit is now available online. (Persons needing to receive the password to access the site may contact L.J Tan.) The poster/networking session will be held on Thursday evening, May 17.
L.J requested that persons registering also use the Summit link to make hotel reservations through the Summit site. A block of rooms at a competitive rate is being held for Summit attendees.
2018 Immunization Excellence Awards Nominations Deadline Extended to FEBRUARY 8
Summit members are encouraged to submit nominations for the 2018 Immunization Excellence Awards, which will be presented at the annual Summit meeting. Awards will be presented in the following categories:
- Non-Healthcare Employer Campaign
- Laura Scott NAIIS Immunization Excellence Award for Outstanding Influenza Season Activities Campaign
- “Immunization Neighborhood” Adult Immunization Champion
- Corporate Campaign
- Adult Immunization Publication Award
New nominations are especially encouraged in the Corporate Campaign and Adult Immunization Publication categories. The deadline for submission of nominations has been extended to February 8, 2018.