A summary of presentations from the weekly Summit partner webinars
November 10, 2022 – The latest Summit Summary
- Flu Coverage Update – Carla Black (CDC)
- Ad Council Update – Conor Toomey (Ad Council) and Nicholas Sugai (Ad Council)
- Flu Surveillance Update – Alicia Budd (CDC)
- Questions
- Announcements
Flu Coverage Update – Carla Black (CDC)
Carla Black, PhD, Epidemiologist, Immunization Services Division, CDC, gave a brief update on flu vaccination coverage so far this season. The information largely came from the FluVaxView Seasonal Influenza (Flu) dashboard at CDC.
Through October 15, the country has reported about 4.5 million fewer influenza vaccination claims this year compared to at the same time last season, according to data from pharmacies and physician offices. This claims data doesn’t include all flu vaccines given but still signals that the nation is behind in administering flu vaccines this season. Influenza disease is showing up much earlier this season, so it is very alarming that coverage is low and currently does not appear to be increasing.
Overall seasonal coverage was increasing annually for adults up until the 2020–2021 season, including a small increase after the pandemic years. However, the coverage went down last season and ended up about 0.8 percentage points lower than last season as compared to the previous season. It looks like the coverage is currently not going back up.
Looking at last season, there was consistently higher coverage among white and Asian adults, compared to Black, Hispanic, American Indian, Alaska Native, and adults of other race ethnicities. However, last season there was a significant decrease among white adults.
According to Vaccine Safety Datalink data which is derived from nine managed healthcare organizations, at the end of September of this season, about 21% of pregnant women were vaccinated compared to 26% at the same time last season. There has been a consistent decrease in coverage for pregnant persons over the past four seasons. See Vaccine Safety Datalink (VSD).
VSD estimating coverage of pregnant women shows there was a decrease from the previous seasons in all race/ethnicity groups; the lowest coverage is among Black women. CDC’s Internet Panel Survey shows last year’s coverage for women was about 8 percentage points lower compared to two seasons ago. The CDC survey shows smaller differences by race/ethnicity compared to the VSD data. In the CDC survey, Black women ended up with similar coverage to white women last year, however, there was a decrease in overall coverage among pregnant women last season as was seen with all adults, including white pregnant women. Hispanic and non-Hispanic Other (i.e., not white or black non-Hispanic) pregnant women had the highest coverage.
Data from the National Immunization Survey through October 20 of this season found that coverage for children was very similar to where it was last season – at around 21%. But last season there were decreases in coverage for children compared to the two prior years. For this season, child coverage is about six percentage points lower than it was pre-pandemic. As of October 22, this season’s trends, compared to the same time last season, are very similar to last season but lower than the past two seasons. For children, there is not much variation by race/ethnicity like we see for adults.
From the National Immunization survey, there was a decrease among children of all age groups after the pandemic in 2021 compared to 2019–2020. Children are now 8 percentage points lower than the previous season. Asian children consistently have the highest coverage. The only racial/ethnic group with lower coverage in 2021-22 compared with the prior season was among white non-Hispanic children.
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Ad Council Update – Conor Toomey (Ad Council) and Nicholas Sugai (Ad Council)
Connor Toomey, Campaign Manager, Ad Council, and Nicholas Sugai, VP, Group Campaign Director, Ad Council, gave a presentation on the Ad Council’s 2022 flu vaccination campaign.
Ad Council is a nonprofit marketing firm that uses communications to tackle the country’s toughest issues that can be impacted by awareness, education, and individual actions. The Ad Council partners with CDC, CDC Foundation, and AMA to help individuals take a small but important step to protect themselves and others by getting vaccinated.
The objective of the campaign is to motivate all adults to get the flu shot to protect themselves, their families, and their communities. The core audience is Black and Hispanic communities as these tend to have lower vaccination rates than other groups.
The campaign started in the fall of 2020, and in the fall of 2021, the council did a creative online resource update. From 2020 to now, the Ad Council has received 20 million dollars of donated media and over 600K visits to the campaign website. With every Ad Council campaign, there are continuous tracking research surveys used to understand the actions and attitudes of the target audience. These surveys are put out every few months specifically for the flu campaign. This happens three times during flu season. For the flu campaign, Ad Council specifically looks at vaccine uptake attitudes towards flu vaccines as well as where the target audience is looking for information about flu and vaccines.
Before the campaign, the Ad Council first looks at vaccine uptake. Looking at the beginning of this flu season, the core audience was Black and Hispanic populations, 21-23% of whom were only somewhat likely/somewhat unlikely/unsure about getting a flu vaccine. The target audience was found to be less concerned about the side effects of the flu, which means they are comfortable getting vaccinate against flu. But there was an increased concern about how flu vaccines interact with COVID-19 vaccines and boosters. That shows that people are comfortable getting the shots but there needs to be more accessible and clear information about them. Lastly, Ad Council looked at where the target audience is getting their information about flu and flu vaccines. The survey showed that the primary sources of information were doctors, nurses, and other healthcare providers. This shows the importance of trusted messengers needing to convey this information.
In the spring of 2022, the Ad Council started conducting in-person focus groups to better understand the target audience. What they found in their research is that first, people tend to have a lot of do-it-yourself home remedies to treat the flu. This is mostly because they felt they could treat it themselves and wanted to avoid costly medical treatment. They also felt that doctors were a trusted source of information, but they weren’t inclined to seek their help. Lastly, they felt that the flu is not very serious in contrast to COVID-19.
Ad Council also found that statistics like mortality rates and hospitalizations of people who were affected by flu were important and that there is a considerable amount of misinformation out there about the flu, how it’s contracted, and flu vaccinations in general. Lastly, the target audience felt that if they were going to receive messaging, it should be hard-hitting so as to increase their sense of urgency and seriousness about the flu.
Keeping those things in mind, the Ad Council settled on four main components for a new creative concept:
- Use a serious tone in the overall creative
- Feature real doctors as trusted messengers
- Reinforce facts about flu and flu vaccines
- Push on the idea that while the home remedies are nice, the best protection is the vaccine
From those components, the Ad Council used two doctors: Dr. Teresa Smith, and Dr. Angelica Cifuentes Kottkamp, to provide straightforward information, PSAs, and flu facts in both English and Spanish. Their videos will be used for both social media and broadcast TV. In addition to the videos, Ad Council created a number of outdoor PSAs, social media graphics, and other ads. These will go out to the public on TV, radio, donated space, outdoor print vendors, and digital ad vendors. The Ad Council has vendors that help get ads on bus shelters (located near pharmacies), doctor offices, and digital placements where people are searching online for information. Several PR tactics are also used for the PSAs, such as press releases, media tours on morning TV shows and radio shows, and the use of social media influencers.
All the materials drive viewers to the website, getmyflushot.org, where consumers can find factual information about flu and flu vaccines, including where to get a vaccine.
Summit partners can support the effort by promoting the messaging materials, press releases, and talking points. Partners can amplify the PSAs across social media channels and encourage employees to get vaccinated and spread factual information. The PSAs have an expiration date due to talent agreements. They can run for the rest of the season until the end of April 2023. They also have to be run in donated time and space and can’t be altered. For online video placements, please use the YouTube links provided on the website. Videos cannot run directly on corporate or for-profit web properties.
Coming up is National Influenza Vaccination week, which is December 5–12. There will be a partner toolkit available on the website.
Flu Surveillance Update – Alicia Budd (CDC)
Alicia Budd, MPH, Influenza Division, CDC, gave an update on influenza activity for week 43, ending October 29, 2022.
Influenza Virologic Surveillance: Clinical Laboratories
Flu activity in all of the regions across the country is increasing, with the earliest and sharpest increases being in the southeast and the south-central parts of the country. The Atlantic is now overtaking some of the other regions in the Midwest. The central area of the west coast is seeing sharper increases in the last couple of weeks. Flu is everywhere, it’s spreading, and it’s increasing.
Influenza Virologic Surveillance: Public Health Laboratories
This is predominately an influenza A season so far. Currently, there is around 80% H3 and 20% H1, with a little bit of influenza B Victoria. Most of the viruses tested are in the same genetic group and antigenically similar to the vaccine reference virus. This means that there seems to be a good match between the circulating strains and what’s in the vaccine.
Percentage of Outpatient Visits for Respiratory Illness [Influenza-Like Illness (ILI)], ILINet, U.S.
The outpatient Influenza-like Illness Surveillance Network (ILINet) monitors outpatient visits for influenza-like illness (ILI). ILI is not strictly related to influenza virus activity but refers to someone who has a fever and cough or sore throat. These are symptoms that are found with many respiratory illnesses that are often circulating at the same time of year. ILI cases are not laboratory-confirmed cases of influenza.
ILI continues to be the highest in the age 0–4 group. The number of states with high or very high ILI is increasing, and it’s particularly concerning in the southeast and southcentral part of the country, but also expanding westward and up into the northeast, as well. ILI increase matches the areas with the highest levels of flu activity. We are also seeing a lot of RSV as well as rhinovirus and norovirus. The numbers are not an influenza-specific indicator, but it does highlight the increases in flu activity.
Percent of Long-Term Care Facilities (LTCF) with at least One Confirmed Influenza Case among Residents, Reported to CDC National Healthcare Safety Network (NHSN), National Summary
The percentage of LTCFs with at least one confirmed influenza case among residents has been increasing in recent weeks.
FluServ-NET Hospitalization Rates
The cumulative rates as of week 43 are higher than they previously had been, which indicates an early start. The rate this week is higher than the rate of any past ten seasons at this point.
Influenza-Related Mortality in the United States
Deaths from pneumonia, influenza and COVID-19 (PIC) still indicate that COVID-19 is still causing the largest number` of deaths, with flu trending behind. There have been five pediatric deaths reported so far this season.
There has been an increasing level of RSV right now. Since there isn’t a vaccine for RSV, we can all do our part to minimize the healthcare impact by making sure people get their flu vaccine.
Questions
Q: What are the healthy people 2023 goals for influenza?
A: 70%. See: health.gov/healthypeople/objectives-and-data/browse-objectives/vaccination
Q: Connor, are there also options for Tik Tok length?
Connor Toomey: The videos being made right now are 1×1 and 9×16 format. Those are both social media formats. The lengths will vary. Some will be under 30-seconds and some a little longer. There are options and I think they should work on Tik Tok.
Q: Do we have any information about flu antiviral effectiveness?
Alicia Budd: We keep a close eye on and do surveillance for antiviral resistance. So far, we are not seeing any antiviral resistance this year and have not heard any anecdotal reports here or internationally that would give us any concern. So, antivirals seem to be an effective tool.
Carolyn Bridges (Immunize.org): Given the early rise in flu and late vaccine uptake, the ask is for all Summit partners to reach out to their constituencies and let them know that the time to get vaccinated is now. The incubation period for flu is one to four days, usually two, so it’s a fast-moving virus. If you are in a region that hasn’t seen a big uptake, it’s going to be coming very quickly. Make sure to get the word out.
Q: Do you anticipate a second peak of influenza later in the winter?
Alicia Budd: There’s really no way of knowing. Looking at the southern hemisphere over their winter, it was a mixed bag. We have year-round surveillance, and we will keep that going. We will keep you updated as the year goes on.
Q: What are the most effective strategies for reaching patients?
Carolyn Bridges: Emails, phone calls, and other contacts from your provider and reminders from your neighborhood pharmacists. Patients want to know what’s in it for them and why is it good for them. Tailoring messages to specific audiences can specifically improve vaccination rates.
Q: How do pharmacies get involved on the vaccine.gov locator?
Carolyn Bridges: There is a portal on the vaccine stock page to request to be a provider. See: www.vaccine-resources.gitbook.io/vaccines.gov-provider-resources
Q: Are there any supply issues?
Carolyn Bridges: There are no supply problems. There should be plenty of vaccines in offices and pharmacies to meet demand.
Q: Is there a list of pharmacies that will come out to CBOs to do flu vaccine clinics?
Carolyn Bridges: Contact the State Pharmacy Association or your local or pharmacy. You may want to try your local health department and immunization program, as well.
Erin Burns (CDC): There’s a serious level of concern about the coverage we have seen so far and we are pulling out every stop we can think of. A letter was sent out by Dr. Romero to partner groups asking us to share. Along with the email came options for handouts and things partners can pass on to their network. There are letter templates customized to specific audiences. Note: This email was sent out to Summit partners following the call.
Announcements
- Thank you to everyone who helped with organizing, who participated, and who attended the NAIIS in person Summit last week. You should have received an email from Casey Pauly with a survey and we would love to have your feedback.
- The Summit released Get Adults’ Vaccinations Back on Track, a 2-page clinician tip sheet on new CDC recommendations and tools to help adults catch up on needed vaccinations. NAIIS is a large coalition of public and private organizations dedicated to increasing immunization rates, co-led by Immunize.org, CDC, and the Health and Human Services Office of Infectious Disease and HIV/AIDS Policy.
- If you are not getting the emails from Mailchimp, please add “NAIIS” at info@izsummitpartners.org to your contact list. Also, make sure that our email address isn’t blocked or going to spam/junk. The last thing you may need to do is reach out to your organization’s IT department to determine if there is an internal firewall that might be blocking our Mailchimp emails.
- If you have any agenda items that you are interested in sharing with the Summit, please let us know and we can add you to an upcoming call as a speaker or panelist. Contact information: info@izsummitpartners.org
