A summary of presentations from the weekly Summit partner webinars

September 21, 2023 – The latest Summit Summary

Announcement from L.J Tan (Immunize.org)
UPDATE ON DELIVERABLES FROM AUGUST 2 WORKSHOP
Announcements

Announcement from L.J Tan (Immunize.org)

The summit held a workshop on August 2, 2023, to discuss the best way to assist in implementation of the three vaccines against respiratory pathogens in addition to other appropriate adult vaccines that could be given at the same time.

Challenges

Introduction of RSV immunizations for older adults, infants, and pregnant people
New COVID-19 vaccine and recommendations
Lower influence vaccination coverage rates last year
Need to catch up on all the missing adult vaccines as a result of the pandemic on top of the already low adult vaccination rates for most adult vaccines.

The August 2, 2023 meeting website houses

Agenda for the August 2 workshop
Full Report of the entire discussion
Executive Summary truncated version of the full report
The three deliverables discussed at the meeting which were determined to be the highest priority by partners

Three deliverables

Fall 2023 Respiratory Season Vaccination Decision Making for People 60 Years and Older
- Talking points regarding billing
- Presumptive vaccine recommendations
- Highlights the following suggestions
  - How to coadminister flu and COVID-19 vaccines along with RSV vaccines as appropriate and other vaccines such as pneumococcal vaccine
- Talking with Adults about Vaccines to Prevent Respiratory Illnesses during Cold and Flu Season
  - Key talking points offering education on how to make a vaccine recommendation to adults
  - Provides key information to providers about COVID-19, flu, and RSV with links to authoritative sources of information so provider feels confident in knowledge when making recommendations
- My One-Year Vaccination Action Plan
  - Personalized immunization action plan for patient developed at a provider visit
  - Opportunity for provider and patient to plan when and where they can get the recommended vaccines for the upcoming year

Other products that workgroups may pursue

Brochure about billing for vaccine counseling administration and coding for vaccines
Brochure about better immunization practices that have emerged during the pandemic
- Using information systems
- Top five things to keep doing after the pandemic
- Guidance for making business case for adult immunizations
- Compilation of promising immunization practices from different types of clinical practices

UPDATE ON DELIVERABLES FROM AUGUST 2 WORKSHOP

Talking with Adults about Vaccines to Prevent Respiratory Illnesses during Cold and Flu Season – Carolyn Bridges, MD (Immunize.org) stepping in for Amy Harrington, DNP, RN, (Kentucky Department of Health)

Talking with Adults about Vaccines to Prevent Respiratory Illnesses During Cold and Flu Season

Key points for providers talking with their patients about influenza, RSV, and COVID-19 vaccines for the cold and flu season
Based on information provided by CDC’s Influenza Division , using the term “cold and flu seasons,” which CDC found in their focus groups was the term that was most acceptable to patients in focus group testing
Document borrows from one co-developed by AIM and Immunize.org: Communicating the Benefits of Influenza Vaccination
Information together for influenza, RSV, COVID-19 and pneumococcal vaccine now in a single document that is convenient for providers, and patient and community advocates who are trying to improve awareness about these diseases and the vaccines to prevent them.
Strategies to improve patient awareness and acceptance of vaccines is also included and adopted from SHARE
A table at the end is included to help with the shared clinical decision making for the RSV vaccines
- Includes a list of conditions and other factors that providers and patients may want to think about when they’re discussing RSV vaccination

Fall 2023 Respiratory Season Vaccination Decision Making for People 60 Years and Older – Tirsit Makonnen, MD, MHS (National Consumers League)

Fall 2023 Respiratory Season Vaccination Decision Making for People 60 Years and Older

Help providers decide how to give the three vaccines during the season when they’re used to giving one or maybe two vaccines
Giving a third vaccine, RSV, may complicate decision making
One-page informational flyer
First table has providers consider what types of vaccines they have in stock
- Based on the four vaccines listed (including pneumococcal), there are four different scenarios that could happen based on probability
- The group chose to include pneumococcal vaccines given relatively new recommendations for adults for pneumococcal vaccine and because viral infection, especially influenza, can be associated with bacterial coinfection or secondary bacterial infections.
Second table provides strategies that should be implemented for the population of people age 60+
Addresses what to do if hesitancy or if vaccine unavailable
References included for additional information for decision-making
Coding information included, as well as information on the Bridge Access Program

Carolyn Bridges (Immunize.org): Melinda Wharton from CDC was on last week’s NAIIS call and talked about the ACIP recommendations for COVID-19 last week. Coadministration questions have been common. Melinda reiterated that it is acceptable to give these vaccines at the same visit. But its also okay if the patients do not want them together, and vaccines can be scheduled over time.

Trist Makonnen (National Consumers League): In the different scenarios, if the provider does not have the vaccines on site, then they need to refer the patient to another place that has the vaccine, such as a nearby pharmacy

Q: For this document, was there a discussion by the working group around including a reference for the age 65+ preferential category for the flu vaccines?

Trist Makonnen (National Consumers League): We did not have this discussion but seeing how we were including the age 60+ population in general, the population is included in that discussion.

Carolyn Bridges (Immunize.org): We struggled for brevity and did not include in this version. That’s something we could consider for the next versions.

Q: What are the alternative sites other than the deltoids for giving four vaccines at the same time?

Trist Makonnen (National Consumers League): There are two deltoids, so they can be split between the two arms. The side effects are minimal. There may be soreness in the arms but that should resolve. I haven’t heard of using alternative sites for the vaccine injections because we haven’t tried to inject people with the four vaccines at once.

Carolyn Bridges: Immunize.org has a resource about how to get multiple injections at once time. For children they use the anterolateral thigh, but this can also be used for adults.

My One-Year Vaccination Action Plan – Synovia Moss (Good Health WINS) and Susan Farrall (HHS)

Synovia Moss, MPA (Good Health WINS)

My One-Year Vaccination Action Plan

Personalized vaccination action planning tool is to be completed between the provider (primary care physician or pharmacist) and the patient
Designed to help patients plan when and where to get the vaccines
First page
- All of the vaccines are listed then the doctor/provider would check which vaccines are needed, then the patient and provider together come up with a vaccine action calendar for the year
Page two
- List of the different diseases that adult vaccines prevent plus references for additional information

Susan Farrall, MPH (DHHS)

How to make the vaccination schedule easier for adults was a goal of this action plan

The action plan was shared with a group of vaccination and wellness activists that work with the National Council of Negro Women
They conducted a focus group to get feedback on what people thought about the action plan as a resource
- All professionals and patient advocates thought the resource was simple
- For a patient or general population, the resource looks complicated, though
  - Gave suggestions on how to make it more simple
  - Good tool for having a conversation with the provider, but a non-clinician would not likely know how to use it
- May shorten the document after this season
- Appreciate any feedback on how to make this better
- May be able to create different sizes and templates of this tool

Carolyn Bridges (Immunnize.org): This current document plan is for one year and we don’t know if the RSV vaccine will be a one year or two-year vaccine. There’s still some discussion and recommendations may change. We want your feedback—particularly the medical, nursing, and pharmacy colleagues. We want to know if these are usable in the clinics to help guide patients. We would like to hear about ways to make the adult vaccination schedule and recommendations less overwhelming.

Q: Why not start the calendar in September?

Carolyn Bridges (Immunnize.org): That would be a great idea to coincide with the start of respiratory season.

Susan Farrall (DHHS): Another product that we are working on through the Summit equity workgroup is a document of information that is titled “Community-Based Organizations and Trusted Messengers: An Approach to Eliminating Immunization Disparities. This will be posed soon on the Immunize.org website. The document talks about reducing disparities for COVID-19 vaccination and makes the case for working more with trusted messengers and community-based organizations in the future to end disparities.

Announcements

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