A summary of presentations from the weekly Summit partner webinars
February 2, 2023 – The latest Summit Summary
- Grown-Up Shots: Selected Stories and Anecdotes about Vaccines for Adults – René Najera (Center for Public Health and the History of Vaccines)
- Mid-flu Season FFF Campaign Update – Michele Slafkosky (Families Fighting Flu)
- Announcements
Grown-Up Shots: Selected Stories and Anecdotes about Vaccines for Adults – René Najera (Center for Public Health and the History of Vaccines)
René Najera, MPH, DrPH, Director of the Center for Public Health and the History of Vaccines Project at the College of Physicians of Philadelphia, gave a presentation on the history of vaccines. See website: History of Vaccines.
(View slides.)
Vaccines for Children
- Schedule designed to prevent the greatest number of diseases and given at the time to protect children epidemiologically at risk for disease
- Study on the benefits of childhood vaccination in developing nations showing the economic impact of vaccinating children: https://bit.ly/3Y8P1Wl
Why should adults get vaccinated?
- Adults are a part of the chain of infection and come in contact with children
- Deadly diseases can be prevented, for examples, shingles
- It’s important all adults are vaccinated, if they are able to, for herd immunity
Epidemiological Transitions: Measles/Rubella/Chickenpox
- When you start a vaccination program with a very young population, the pyramid is very wide at the bottom
- Young people are getting disease
- The program sets up a cut-off rate for the mass vaccination campaign instead of vaccinating everyone (low on resources)
- Incidence of disease drops
- Unfortunately, those above cut-off age are at risk and the susceptible age distribution shifts upward, towards adults
- This transition is being seen in developing nations
- China currently with measles
- Must be careful when designing vaccination programs because of these transitions
Shingles at a younger age?
- Before the chickenpox vaccine, most people got chickenpox
- “Rite of passage”
- Many complications and deaths from disease
- After the vaccine, community level of circulating chickenpox dropped
- Those who have had the disease will continue to have latent virus in them
- Things like stress and medication can reactivate the virus, but immune system fights it off
- Immune system is also boosted through community exposure
- Immune systems that have not seen chickenpox virus in a while or are compromised can lead to shingles
- Disease may shift to younger age groups with less community boosting
- Disease may increase in frequency if there are more stressors that reactivate the virus
Chain of infection: The Japan Experience with the influenza vaccine
- 1962–1987: After waves of deadly flu seasons, most Japanese children were vaccinated against influenza due to school requirement
- Vaccination levels high between 50–85% of children vaccinated for flu
- 1988–1994
- Vaccination requirement relaxed in 1988
- The childhood vaccination recommendation was eventually repealed in 1994
- 1994–now: Increased morbidity and mortality in the grandparents of the children
- Conclusions
- High vaccination numbers in children kept older adults from getting sick from flu
- When school requirement dropped, number of cases rose across the entire population with more severity in elderly
- Vaccination of Japanese children prevented about 37–49 thousand deaths per year, or about 1 death for every 420 children vaccinated
- Vaccination of children also benefit adults
Cholera
Waldemar Haffkine Goes to India (Late 1800s)
- Born in Ukraine to a Jewish family and persecuted for his ethnicity by the Russian government
- Defended his community against the Jewish purge and became an Enemy of the state
- Escaped and went to France
- Befriended a university professor who also had also escaped to France, and they went to work at the Pasteur Institute
- They wanted to come up with a cholera vaccine
- CHaffkine convinced British government to allow him to go to India where they were having a large cholera outbreak
- Tries his vaccine on himself before giving it to others
- Hundreds of thousands of people got vaccinated with the cholera vaccine
- He alo began work on the tetanus vaccine
- Got contaminated
- Some injuries
- Went back to Eastern Europe and founded some schools for Jewish students
- Died in France in 1930
- His face is on a postage stamp in India
- Jewish Chronical of London characterized him, saying that he is a Ukraine Jew, trained in the school of European science and saved the lives of Hindus and Muslims.
- Descendant of William the Conqueror and Alfred the great
Middle East
- Right now, seeing a lot of cholera outbreaks around Lebanon, Syria, and in Africa
- If thinking about traveling to these places, consider the vaccine
SEE:
CDC: Cholera Vaccine: Recommendations of the Advisory Committee on Immunization Practices, 2022 (9/30/22)
HPV: A Natural Experiment
- Early 1980s: The link between HPV and cancer made
- Found DNA of HPV virus in cervical cancer specimens
- Through epidemiological investigations, data suggested that people who got HPV were more likely to get cervical cancer
- First U.S. vaccine licensed in 2006
- People saw it as a vaccine that would cause girls to be more promiscuous because they would not be as afraid of getting warts and cervical cancer. Research performed later would demonstrate that this was not happening
- “Two versions of the vaccine was available, one which protected against 2 strains responsible for cancer plus 2 other strains associated with genital warts, and another vaccine protected only against the two strains associated with cancer.
- Vaccine targeted at young females (males starting in 2015)
- S. states regulate requirements for vaccination
- Texas
- Governor Perry mandates the HPV vaccine but reverses the decision after political pressure
- The vaccine became an opt-in instead of an opt-out
- Texas is now at or below the national average HPV vaccine rate
- Rates of cervical cancer in Texas are 9/100K (2009)
- Governor Perry mandates the HPV vaccine but reverses the decision after political pressure
- Australia
- When they got the vaccine, they gave it nationally cost-free
- Requirement for females in 2007 and males in 2013
- Tied the vaccine to social benefits—“no jab, no pay”
- Only exemption is medical
- Rate of cervical cancer is 4/100K (elimination threshold)
- Projected to be less than 1/100K by 2060 if nothing changes
- Australia and Texas are different cultures, but similar population make up
- Shows the power of misinformation and messaging
- Females in Australia much less likely to worry about cervical cancer
College kids and meningitis
- Meningococcus serogroup B
- Spread via respiratory droplets
- Asplenic, complement deficient, HIV-positive are at highest risk
- Risk of disease is low, but the fatality rate is relatively high, at 4–20%
- Vaccine is available for serogroup B, and another vaccine is available to protect againstthe A, C, Y, and W serogroups
Vaccines for National Defense
- February 5, 1777: George Washington ordered troops to be variolated (inoculated with smallpox)
- Given less severe form of smallpox—variola minor
- Prevents against major smallpox
- Up to 1% would die compared to 10% of the non-inoculated
- Protected against the British soldiers with smallpox
- New recruits inoculated and if refused held down and got inoculated
- Given less severe form of smallpox—variola minor
- Yellow fever in Spanish-American War (Caribbean)
- Influenza in WWI
- Today – vaccination depends on deployment
- Now soldiers can opt-out on COVID-19 vaccine
- Only medical exemptions are accepted
Travelers, refugees, and immigrants
- Most countries in Latin America have childhood vaccination programs and refugees/immigrants from there are relatively young
- People not as skeptical of vaccination
- Higher rates of vaccination
- Loss of documentation if being chased out of your country
- Coming to U.S. and being put in crowded setting with exposure to disease
- Can get sick even if vaccinated
- Travelers, refuges, and immigrants from other parts of the world
- Eastern Europe (Ukraine) – multi-drug resistant tuberculosis (MDR-TB), there is a vaccine
- Middle East – Cholera
- Africa – Meningitis
- Influenza comes from anywhere, and crossover with animals
- Public health surveillance and data on emerging infectious diseases
- Contact tracing
I lost my shot record
- Check state health department
- If you moved, are an international traveler, immigrant, or refugee, check with the embassy or consulate for guidance
- Check with school systems
- Check with previous health providers
- Talk to your healthcare provider
- Some vaccine series can be started over again
Mid-flu Season FFF Campaign Update – Michele Slafkosky (Families Fighting Flu)
Michele Slafkosky, Executive Director, Families Fighting Flu (FFF) gave a mid-flu season Families Fighting Flu campaign update.
FFF was founded in 2004 by parents who had lost their children to influenza. The common denominator was that they were all under five. These families were instrumental in getting the recommendations changed so that everyone six months and older were recommended to get an annual flu vaccine. A lot of families are sharing their stories and have become the face of the flu. The goal is to increase vaccine confidence and reduce hospitalizations, deaths, and save lives. While doing that, FFF provides outreach and education in various communities across the nation. The messaging this year is about how serious the flu is, and the best prevention is to vaccinate.
Vaccinate, Test, and Treat
Messaging
- Influenza doesn’t discriminate; best prevention is to vaccinate
- Educate on the symptoms and test if showing influenza-like symptoms
- Get the appropriate treatment from a healthcare provider so you can best protect your health and the health of your children/loved ones
New Campaigns Expanding Outreach
FFF InFLUencer Campaign (SEE: The 2022 Families Fighting Flu Influencer Campaign)
- Researched to identify partners who could
- Reach a diverse audience
- Deliver the message
- Were onboard to personalize the message
- Identified 11 influencers (micro and macro) with a very strong presence with peers
- Diverse group
- Various demographics
Phase one: October–December 2022
- Focused on the message of the importance of getting the flu vaccine
- Garnered nearly 600K impressions and 70K video views
- Exceeded industry average engagement numbers on Instagram
Phase two: January–March 2023
- “It’s not too late” and “if you’re symptomatic, get tested” messaging
- Early posts resulted in followers vaccinating
Healthcare Professional Office Reels
- Reels were put in healthcare professional offices in six states: Louisiana, Alabama, Mississippi, Florida, and Tennessee
- 1,500 HCP offices
- 5,600 HCPs in the offices
- Played on 1,700 devices
- Two million ads were played
- 10 million patient visits
Published “Our Best Shot”
- Worked with pharmacies to help develop materials and get people to understand that a pharmacist is a friend and that going to a pharmacy to get vaccinated is an option
- “Our Best Shot” is a book about a first grader going to get a flu shot at a pharmacy
- Partnered with Dr. Alexandria Yarborough
- Available on Amazon
FFF Educational Resources
- In print and digital
- Childhood immunization schedule – shows when the child should be vaccinated
Announcements
- The 2023 NAIIS Adult Vaccine meeting will be held on May 9–11, 2023, at the Atlanta Marriott Perimeter Center in Atlanta, GA. Persons needing the password to register for this invitation-only event may contact info@izsummitpartners.org.
- Nominations are also being sought for the Summit’s Immunization Excellence Awards that are presented at the in-person meeting. Winners received free travel and lodging to the Summit meeting and the opportunity to present on their work at the Summit Awards luncheon. To nominate an organization of an individual, or to self-nominate, visit: https://fs29.formsite.com/uI8uzs/2023newNAIISAwards/index.html.
- Immunize.org, with pain mitigation expert, Anna Taddio, PhD, will host a free, 1-hour webinar, Improving the Vaccination Experience: Reducing Pain and Anxiety for Children and Adults, on February 28 at 1:00 p.m. (ET). All are welcome to register!
- If you are registered for the Summit not getting the emails from Mailchimp, please add “NAIIS” at info@izsummitpartners.org to your contact list.
- 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.