Search:

A summary of presentations from the weekly Summit partner webinars

October 12, 2023 – The latest Summit Summary

2022–2023 Flu Coverage Update – Carla Black (CDC)

Carla Black, MPH, PhD, Epidemiologist, Immunization Services Division, CDC, provided a 2022–2023 flu coverage update.

VIEW SLIDES

CDC: Flu Vaccination Coverage, United States, 2022–23 Influenza Season

Coverage among the general population

Data Sources

  • Data for adults age ≥18 years comes from Behavioral Risk Factor Surveillance System (BRFSS)
    • Large survey of adults, sample size about 300,000
    • Surveys conducted September–June
    • Kaplan-Meier survival analysis method to use all the data from September interviews and get cumulative coverage as of May
  • Data for children age 6 months–17 years comes from National Immunization Survey-Flu (NIS-Flu)
    • National random-dial cellular survey where parents are asked about child’s vaccination status
    • Interviews take place October–June
    • Sample size about 130,000
    • Self-reported numbers
  • Overall coverage for people age 6 months and older
    • Combination of adult and child estimates weighted by the population of each age group

Influenza vaccination coverage among persons age ≥6 months, U.S., 2010–2023

  • Final season coverage for children last season was 57.4%, similar to last season
    • Drop between 2019–2021 season
    • Coverage in children has not recovered since pandemic; past season, it was six percentage points lower than before pandemic
  • Coverage in adults had been increasing for several years before pandemic; post pandemic coverage increased
    • Decrease this season about 2.5 percentage points but basically back to pre-pandemic rates
  • Overall population (age 6 months and older) closely resembles adult coverage
    • This is because most of the population are adults

Influenza vaccination coverage by race/ethnicity, adults age ≥18 years, U.S., 2010–2023

  • Non-Hispanic Asian and White adults have consistently higher coverage

Influenza vaccination coverage by state, adults age ≥18 years, U.S., 2022–2023

  • State rates ranges between 34–67%

Influenza vaccination coverage by race/ethnicity, children aged 6 months–17 years, U.S., 2010–2023

  • Hispanic children had higher coverage compared to White and Black children
  • Black children had lower coverage than other races/ethnicities for past few season
  • White children have similar to coverage to Black children and coverage has been decreasing over the past three seasons
  • Lowest coverage among non-Hispanic Black children

Influenza vaccination coverage by urbanicity, children aged 6 months–17 years, U.S., 2019–2023

  • Children in rural areas have had consistently lower coverage than children in urban and suburban areas
  • Rural children now 15+ percentage points lower than urban children

Influenza vaccination coverage by state, children aged 6 months–17 years, U.S., 2010–2023

  • A lot of variation by state

Coverage among pregnant women

Data sources

  • Pregnant Women: Internet panel survey
    • End of March and early April
    • Includes women pregnant since August (Flu survey data is limited to women pregnant October–January)
    • Self-reporting
  • Pregnant Women: Vaccine Safety Datalink
    • Data source used to monitor coverage during the season
    • Eight integrated healthcare organizations
      • Not nationally-representative of population
      • Limited to women with private health insurance
    • Patterns typically mirror those patterns that we see from other data sources
    • One difference: data include vaccinations given after pregnancy
      • From medical records (not self-report)

Influenza vaccination coverage among pregnant women by race/ethnicity, U.S., Internet Panel Survey, 2019–2023

  • Coverage at 47.2% last season
  • Decrease since before the pandemic and bigger decreases since the 2019–2020 season
    • 10 percentage points lower
  • No differences between White and Black women
  • Hispanic and women of other races have higher coverage

Influenza vaccination coverage among pregnant women, Internet Panel Survey and Vaccines Safety Datalink (VSD), 2019–2023

  • Comparison between two data sources
  • Both sources show decreases since 2019–2020 season;
    • Internet Panel Survey shows 10 percentage point decrease
    • VSD shows 15 percentage point decrease
      • Include vaccinations after pregnancy

Coverage among healthcare personnel

Data source             

  • Internet Panel Survey
    • Recruited from WebMD
    • End of season; March 28–May 14, 2023
    • Self-reported

Influenza vaccination coverage among healthcare personnel (HCP), by occupation and work setting, U.S., 2020–2021 and 2021–2022 seasons

  • HCP coverage this season about 76%
    • Almost 5 percentage point decrease from last season
    • Had been around 80%
  • Too early to tell if it will keep decreasing
  • Decreased in both hospital and ambulatory care workers
  • Consistent pattern in HCP coverage, long term care facility HCP, and home healthcare HCP have lower coverage than those who work in hospitals and ambulatory care

Limitations

  • Vaccination coverage data rely on self-report and not validated with medical records
    • Parental report may overestimate coverage
  • Surveys subject to bias
    • Weighted to be more representative of U.S. population

Questions

Q: The data presented fails to mention large disparities in vaccination coverage among non-U.S. born persons, even when compared to populations of the same race/ethnicity. Do you look at that?

Carla Black: That is something that we have looked at in the past. We don’t typically look at it every season but that is true and maybe it’s time to do another report about that. We recently presented COVID-19 data looking at foreign born status and you see the same thing.

 

Q: With regards to healthcare professional data, what does “weighted” mean?

Carla Black: What we mean by “weighted” is when we get respondents in the surveys that the distribution of people doesn’t look like the general population. With internet panel surveys for a healthcare personnel we oversample healthcare personnel working in long term care facilities so we get so we have enough sample size to look at. But then it makes the data uneven because in our sample there are more people who work in long term care facilities than would be in the normal population. So, we adjust the data so that the data from those overrepresented groups count for less. The data in the underrepresented groups count for more. That in theory makes the overall estimates look more like the general population or the how the general healthcare population should look.

 

Q: Pediatric coverage rates seem to have stagnated at a lower level. Is this spillover from COVID-19 impact? And it seems like there are widening disparities facing rural populations, not just for flu but for other vaccines. Any insights on what’s behind that?

Carla Black: We saw a drop in school required vaccinations. The flu season map for the pandemic was the year that almost all students started school virtually you know school vaccinations weren’t being enforced. Flu vaccine is not required by most schools, but it it’s kind of a trickle-down effect. You’re not going for other vaccines. We had very mild flu seasons those first few seasons after the pandemic. Perhaps people were not congregating and there wasn’t as much of a worry about flu. With flu vaccine especially, it’s a habit. One of the biggest predictors of getting a flu vaccine is whether you’ve got it in the previous season. I think related to the drop for rural populations, it’s just a lot of attitudes and increasing vaccine hesitancy as compared to in urban populations.

 

Q: You seem to see indicators with the adult rural populator that has not dropped so why the separation with regards to hesitancy?

Carla Black: I can’t really answer that. For the COVID-19 vaccine, we see a disparity for both children and adults and rural urban disparity in adults, but we have also seen that attitudes for COVID-19 vaccine don’t necessarily carry over to other routine vaccines.

 

Q: Preliminary data suggested that in the adult population, the age 65 and older climbed back above 70%. Did that turn out to be true in the final numbers?

Carla Black: For the final coverage among adults, it was 69.7%, so if you round up it was right at about 70%. That was an improvement from the previous season. For the age 65 and over, I know from the previous season it was about 74%. This data can be found on FluVaxView. We saw an increase in adults (age 65+) after the pandemic. They jumped up to about 75% after the pandemic and have slowly been going back to their normal baseline. Unfortunately, they did not keep increasing. This is true among children too but more so among adults. The trend is downwards but it’s 1–2 percentage points. But when you’re talking about overall coverage of 47%, it’s always been low. Perhaps not the downward trend we should be focusing on so much it’s just why can we never get it above 50%.

L.J Tan: Can you comment on maternal rates being so low?

Carla Black: There was an MMWR on pregnant woman coverage and a comparison article looking at attitudes towards COVID-19 and flu vaccines. There was increased hesitancy since the 2019–2020 season and a decrease in flu coverage among pregnant women even if there was not an increase in hesitancy. One theory is that pregnant women have had flu and Tdap for the past few years and now that we’ve introduced COVID-19 and introducing RSV, it may be too many vaccines.

 

Q: Could the increase in adults during the pandemic be attributed to the promotion of co-administration of no-cost flu along with COVID-19 vaccines?

Carla Black: We just saw the increase in age 65 and older. The group became eligible for the COVID-19 vaccine right at the tail end of the 2021 flu season. There was all the messaging that season about the “twindemic” and there was a of messaging about how we are going to have both circulating together and that it’s going to be terrible so get the vaccines. There’s the thought that that resonated a lot more with the older population than with younger adults.

BACK TO TOP

NFID Media Conference Update – Marla Dalton (NFID) and Diana Olson (NFID)

Marla Dalton, CAE, NFID Executive Director and CEO, NFID, and Diana Olson, NFID Senior Director, Strategic Communications, NFID, gave an update on the 2023 NFID Annual News Conference: Preventing Disease this Fall and Winter, hosted on September 28 in collaboration with CDC.

VIEW SLIDES

Marla Dalton

PSD from NFID on flu prevention, symptoms, and treatment: Are You That Person?

  • Video being shared with PSA directors around the country
  • Share widely throughout the season
  • Intending to create multi-language versions

Building awareness and sustaining strong momentum throughout 2023–2024 fall and winter season

  • Planning activities throughout respiratory season
  • Many include partner engagement, sharing resources and toolkits, media activations, and leveraging health observances and awareness events
  • Continued collaboration with all partners to communicate clearly, with ‘one strong voice’

Expert panel delivered impactful messages

  • Held news conference virtually on September 28th in collaboration with CDC as official kickoff to respiratory virus season
  • Have been hosting an annual news conference to launch flu season for more than 25 years
  • This year was different in terms of expanding beyond just flu
  • Messages focused on the importance of getting vaccinated against flu, COVID-19, RSV, and pneumococcal disease as recommended
  • Moderator: NFID president, Patsy Stinchfield
  • CDC director presented the final vaccination coverage data
  • Results from a new national NFID survey to better understand awareness about these diseases as well as attitudes and behaviors around vaccination

Diana Olson

NFID National Survey Results

  • Survey conducted August 10–14, 2023
  • Included 1,000 responses from U.S. adults age ≥18 years from all states and D.C.
  • Data showed:
    • Fewer than one in four U.S. adults are concerned about themselves or somebody in their family getting infected this season with flu, COVID-19, pneumonia, or RSV
    • 65% of U.S. adults agree that vaccination is the best way to prevent flu-related hospitalizations and deaths
    • 43% of U.S. adults do not plan to or are unsure if they will get vaccinated against flu during the 2023–2024 season
    • About one in four U.S. adults who are at higher risk for flu-related complications said that they were not planning to get vaccinated this season
    • 40% of adults plan to get an updated COVID-19 vaccine
    • Among U.S. adults aged 60 years and older, only 40% plan to get an RSV vaccine
    • At the time of the survey, there were no recommendations for pregnant women receiving the RSV vaccine
    • 38% of respondents said that they would be willing to get a COVID vaccine and a flu vaccine at the same time if they were offered that option
    • Among those who do not plan to get vaccinated, the consistent top reasons cited include concerns about potential side effects from the vaccines or a general distrust of vaccines
      • There continues to be significant mis- and disinformation about vaccines
      • There’s a greater need for education and awareness

Secured far-reaching top-tier media coverage

  • News conference generated a significant amount of attention both in the media and beyond
    • 350 attendees watching live
    • 760 stories secured
  • Outreach resulted in top tier media coverage
  • As of beginning of October, media placements had resulted in more than 6.5 billion impressions which surpassed last year

Coverage emphasized availability of vaccines to help protect against flu, COVID-19, and RSV

  • Coverage emphasized that this is the first fall and winter with vaccines available to help protect against three major respiratory viruses
  • Underlying message for most of the coverage

Social media coverage generated 25+ million impressions

  • Able to secure an impressive amount of social media coverage
    • 25+ million impressions generated across more than 1,700 social media posts
    • 1,500 unique authors using the hashtags: #FightFlu, #PreventRSV, #PreventPneumo, #GetVaccinated, or #StopTheSpread
  • A number of media outlets extended reach of messaging on social media with expert quotes or survey data points within posts

“Leading By Example” Initiative

  • Last week NFID hosted a flu vaccine clinic as part of the “Leading by Example” initiative
  • Goal is to show public commitment to disease prevention by sharing photos of organizational leaders getting vaccinated against flu, COVID-19, and RSV this season
  • Join the “Leading by Example” initiative: nfid.org/lbe

Thank you to partners who shared their “Leading by Example” photos on social media:

National Association of School Nurses, Association of Immunization Managers, Families Fighting Flu, AVAC, SHEA, National Council of Negro Women Good Health WINs, and others

For additional information, including a recording of the news conference, visit: www.nfid.org/2023flunews.

Additional resources:

 Questions

Q: Do you have any suggestions about our future vaccine promotion approaches: promoting flu, COVID-19, pneumococcal, and RSV? Seems like it could be a bit silo-ed. Any suggestions about how we might unite our messaging for adult vaccination?

Diana Olson: It was a challenge this year. This has always been the flu news conference and we have historically tried to promote pneumococcal disease and the rationale that flu season is a great time to make sure you’re up to date on the pneumococcal vaccine. Now the message is much broader. There are three major vaccines and we are aggressively trying to promote them at the same time. The news conference was focused on respiratory diseases, and you are right in terms of we need to figure out how to overcome those silos and unite in our messaging. We need clear, consistent messages and timely messaging from CDC so that all of us advocates can be united in our response.

Marla Dalton: We need to be mindful of some of the coadministration messaging, because although it’s convenient and it works so well for us, we see from the survey that it does not necessarily work so well for the adults whom we’re trying to immunize. It may not be the silver bullet and might have an unintended consequence. The other thing that I think is kind of interesting is one of our board members who had said that it would be nice if we could somehow tie all these fall and winter respiratory virus vaccines into this pumpkin spice latte campaign. Certainly, everyone knows it’s fall, it’s pumpkin spice latte, but wouldn’t it be nice if they also said it’s a good time for me to check all of my vaccines?

 

BACK TO TOP

Announcements
  • 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.

BACK TO TOP

Print Friendly, PDF & Email

Search: