A summary of presentations from the weekly Summit partner webinars
January 18, 2024 – The latest Summit Summary
- 2024 Updates to ACIP Recommended Adult Immunization Schedules – A. Patricia Wodi (CDC)
- Effectiveness of Maternal Influenza Vaccination during Pregnancy against Influenza-associated Hospitalizations & ED Visits in Infants <6 Months of Age – Samantha M. Olson (CDC)
- Current Landscape of Rural Vaccination – Megan C. Lindley (CDC)
- Announcements
2024 Updates to ACIP Recommended Adult Immunization Schedules – A. Patricia Wodi (CDC)
- Patricia Wodi, MD, Health Education and Communication Branch, Immunization Services Division, NCIRD, CDC gave a presentation on the 2024 Updates to the ACIP Recommended Adult Immunization Schedules.
Print or download the schedules on the CDC website at: www.cdc.gov/vaccines/schedules/index.html.
Download the mobile app at: www.cdc.gov/vaccines/schedules/hcp/schedule-app.html
Adult Immunization Schedule by Age
- Print or download the schedules on the CDC website at: cdc.gov/vaccines/schedules/index.html
- Adult schedule, see: cdc.gov/vaccines/schedules/hcp/imz/adult.html
- Download the mobile app at: cdc.gov/vaccines/schedules/hcp/schedule-app.html
- Adult immunization schedule changes for 2024: cdc.gov/vaccines/schedules/hcp/schedule-changes.html
- All versions of the schedule have instructions on how to use the schedule
- When using the schedule, providers need to use the cover page, table notes, appendix, and addendum, together to make vaccine recommendations
2024 updates to the schedule
Cover Page
- The instructions for how to use the schedule now includes a fifth step to review the addendum
- The addendum was added last year
- The addendum lists recommendations that ACIP makes after the schedule has been published
- Table of vaccine names
- Added abbreviations: pentavalent meningococcal vaccine, mpox vaccine, RSV vaccines
- Deleted vaccines because they are:
- No longer recommended: bivalent mRNA COVID-19 vaccines
- No longer distributed in the U.S.: MenACWY-D (Menactra)
Table One – Used to determine the recommended vaccinations by age
- Under COVID-19 row, overlaying text updated to say “one or more doses of the 2023–2024 updated formula) vaccine”
- Added a row for RSV
- Indicated for age 19–49 years for use during pregnancy
- Age 60 years and older, blue shading indicates shared clinical decision making
- Pneumococcal row
- Removed the overlaying text from 2023 – the recommendations have been revised to give specific recommendations for people who were previously vaccinated
- Added a row for Mpox
- Used purple shading to indicate that it’s a risk-based recommendation so there must be a risk factor to receive the vaccine
Table Two – Used to assess the need for additional recommended vaccinations by medical condition or other indication
- Revised the legend definitions to improve clarity of the recommendations
- Harmonized changes with the childhood schedule
- NOTE: Colors have changed from previous schedule. New legend definitions:
- Yellow is recommended for all adults who lack documentation
- Purple is not recommended for all adults, but recommended for some adults based on either age or increased risk for severe outcomes from disease
- Brown is a new color for adults who need additional doses of a vaccine based on medical condition or other indications
- Gray is changed to represent “no guidance or not applicable”
- Language has been added to the top of the table to say to always use table 2 in conjunction with Table 1 and the Notes. It also says medical conditions or indications are often not mutually exclusive, and if multiple medical conditions or indications are present, to refer to guidance in all relevant columns.
- Hepatitis B row
Added in the shared clinical decision making recommendation in blue shading for people with diabetes aged 60 years and older the s
- New RSV row
- Pregnancy in yellow to emphasize all pregnant persons should get RSV vaccine for infant
- Blue columns to indicate shared clinical decision making recommendation for those age 60 years and older
- Mpox row
- All purple because there is a sexual risk factor to get the vaccine no matter the underlying medical condition or lifestyle
Notes – Review vaccine types, dosing frequencies and intervals, and considerations for special situations
- Added additional information that includes helpful information on how to read the note pages
- Bullet 3 is very important, for example. It gives instructions on how to repeat a dose if needed
- Provides links to travel vaccines
- Added RSV and mpox to the list of vaccines that are not covered by the National Vaccine Injury Compensation Program (VICP)
- As a reminder, mpox and COVID-19 vaccines are covered by the Countermeasures Injury Compensation Program (CICP)
- Notes for COVID-19 vaccination
- Extensively revised based on the updated recommendations from September, 2023
- Routine Vaccinations section lists the recommendations for those who are not moderately or severely immunocompromised
- Special Situation section lists the recommendations for those who are moderately or severely immunocompromised
- In both sections recommendations listed based on the person’s previously vaccinated status
- Additional information:
- No preferential recommendations for use of one COVID-19 vaccine over another when more than one product is recommended for age
- Helpful links including where to find the interim clinical considerations
- At the end
- Definition of “previously vaccinated”
- For those who are moderately or severely immunocompromised, language included for how additional doses should be given
- Notes for hepatitis A vaccination
- Routine vaccination definition revised to align with ACIP policy clarifying that any adult who is not fully vaccinated should repeat vaccination even if there is no risk factor
- Tweak in how define those not fully vaccinated and at risk for hepatitis A infection
- Notes for hepatitis B vaccination
- Added a bullet to clarify that adults aged 60 years and older who request hepatitis B vaccination should receive it even if they don’t identify a risk factor
- Or patients with diabetes, vaccination is a shared clinical decision recommendation for those age 60 years and older
- Notes for HPV vaccination
- Under routine vaccination, bullet was kept and updated to say “No additional dose is recommended when any HPV vaccine series of any valency has been completed using recommended dosing intervals”
- Bullet deleted on interrupted HPV schedule
- Notes on influenza vaccination
- Update that persons who have egg allergy can receive any influenza vaccine, egg-based or not, appropriate for their age and health status
- Notes on meningococcal vaccination
- Added a link to more information section on the shared clinical decision making recommendation
- At end of the note, added recommendation for use of MenABCWY in adults: If need MenACWY and MenB on the same day, there is the option to use the pentavalent vaccine
- Notes on Mpox vaccination
- New for 2024
- Listed the sexual risk factors, number of doses, and the duration between doses
- More information at the end of the note:
- Pregnancy: no ACIP recommendations for use of Jynneos in pregnancy, but if a pregnant person has any risk factors they can receive the vaccine
- Healthcare personnel: not recommended for the vaccine unless they have the sexual risk factors
- Notes on pneumococcal vaccination
- Routine vaccination section
- for those age 65 years or older, the vaccination recommendation based on the patient’s previous history with pneumococcal vaccination is outlined.
- Special Situation section
- Risk factors are listed for those age 19–64 years who have risk factors for invasive pneumococcal disease
- Notes on polio vaccination
- New recommendation for routine use in adults: adults who are known as suspected to be unvaccinated or incompletely vaccinated should complete their three dose series with IPV
- Note: adults born and raised in the U.S. can be assumed to be vaccinated against polio as children
- Added the definition for what the completed primary series means: 3 doses of IPV or trivalent oral polio vaccine in any combination. Includes a link to more information about use of polio vaccines in adults
- Notes on RSV vaccination
- Recommendations for pregnant persons: vaccinate pregnant persons at 32–36 weeks gestation from September–January in most of the continental U.S.
- Abrysvo vaccine (Pfizer) is the only one that is recommended for pregnant persons
- Added a note here that some parts of the U.S. may differ in their September–January timeframe. Providers should follow guidance from their regional health centers or public health authorities.
- Clarify that to protect the infant from severe RSV disease, there are two options: maternal vaccination or use of long-acting monoclonal antibody in the infant.
- Added language also in Special Situations section that RSV vaccination with one dose for those age 60 years and older is a shared clinical decision making, and no further doses are recommended at this time
- Added helpful information about populations who have increased risk for severe RSV disease,
- Notes on Tdap vaccination
- Routine vaccination: clarified for those who previously did not receive Tdap at age 11 years; that they are to get one dose of Tdap, then Td or Tdap every 10 years
- For those who got their Tdap at age 10 years, it can count as the adolescent booster.
- Routine vaccination section
Appendix – reviews contraindications and precautions for vaccine types
- Added at the top the source for the information in the tables
- Added COVID-19 vaccines with a separate row for mRNA vaccines and one for protein subunit vaccines
- Added row for RSV vaccines
- Added row for pentavalent meningococcal vaccine
- Added row for mpox vaccine
- Deleted from Hib row: history of severe allergic reaction to dry natural latex as a contraindication to Hiberix, ActHib, and PedvaxHIB vaccination because this contraindication is no longer included in the package inserts of these vaccines
- Deleted Menactra from MenACWY row: it is no longer distributed in the U.S.
Addendum can be revised – new or updated ACIP guidance can be added as changes occur; this is a new section added this year.
Questions
Q: Where can I order the 2024 adult vaccination schedule?
Kelly Moore (Immunnize.org): Immunize.org is printing schedules now and will ship by the first of February. You can order them from the immunize.org shop. We have accounted for the addendum by custom designing QR codes that will allow you to easily scan those QR codes on the addendum page and go directly to either view or print the addendum for your laminated schedules throughout the year.
Link to purchase: https://shop.immunize.org/collections/laminated-immunization-schedules.
Q: What do you recommend for a child who receives monoclonal antibody for RSV when the pregnant person was vaccinated with RSV vaccine?
Patricia Wodi (CDC): If the child was given monoclonal antibody, there’s nothing we can do but we are hoping that doesn’t happen. If the pregnant person was vaccinated with RSV vaccine within the time window 32–36 weeks in September, the child should not have received it but if the child received it in error, I would say you should report that as an error. There’s no special monitoring for the child.
Effectiveness of Maternal Influenza Vaccination during Pregnancy against Influenza-associated Hospitalizations & ED Visits in Infants <6 Months of Age – Samantha M. Olson (CDC)
Samantha M. Olson, MPH, Epidemiologist Influenza Division, CDC, gave a presentation on the MMWR publication Maternal Vaccine Effectiveness Against Influenza-Associated Hospitalizations and Emergency Department Visits in Infants.
VIEW SLIDES
Background
- Flu virus infection during pregnancy is associated with severe disease and may be associated with some adverse birth outcomes
- Receipt of inactivated flu vaccine during pregnancy is safe and effective
- WHO and CDC recommends prioritizing vaccinating pregnant persons against flu
- Since the COVID-19 pandemic, flu vaccination uptake during pregnancy is about 5–15% lower than pre-pandemic and for this current flu season vaccination rates remain lower than in 2019–2020 season
- Vaccination rates have been decreasing despite the evidence that flu vaccination during pregnancy can protect not only mom but also infants <6 months of age who are not yet age-eligible for vaccination and are at high risk for serious influenza-related complications
- Randomized control trials conducted outside the U.S. showed maternal vaccine efficacy against laboratory confirmed influenza in infants of 30– 63%
- There’s a lack of real-world, multi-center, multi-season, and U.S. data on maternal vaccine effectiveness against medically-attended influenza in infants
- Data regarding the timing of vaccination during pregnancy on maternal vaccine effectiveness after the 2009 H1N1 pandemic, almost 15 years ago, are very limited.
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices
- Current ACIP recommendations for flu vaccination of pregnant persons as of the 2021–2022 flu season
- Vaccination during July and August can be considered for pregnant persons that are in the in their third trimester
- For pregnant persons that are in their first or second trimester during July and August, waiting to vaccinate until September or October is preferable unless there is concern that later vaccination for that group of pregnant persons might not be possible
Question: Does maternal influenza vaccination during pregnancy reduce influenza-associated hospitalizations and emergency department (ED) visits in infants <6 months of age?
- For this analysis, data from the New Vaccine Surveillance Network (NVSN), which monitors pediatric inpatient and emergency department visits for acute respiratory illness at 7 pediatric medical institutions across the country were examined
- NVSN conducts respiratory surveillance year-round for both infants and children through age 17 years by collecting clinical testing results and also conducting research testing at each of these sites
- Methods
- Enrollment: infants less than six months of age admitted to the hospital or emergency department during four flu seasons (fall 2016–spring of 2020) at seven sites within the NVSN
- Cases: tested positive for flu RT-PCR with acute respiratory illness (ARI) symptoms within 10 days of symptom onset
- Control: tested negative for flu with same ARI symptoms
- Design: Test-negative design
- Odds of maternal flu vaccination ≥14 days prior to delivery in case infants (those who were flu-positive) are compared with the control infants with non-influenza respiratory illness
- Vaccination status: Any flu vaccine received during pregnancy
- Documented sources or state immunization registries at each of the different sites; the sites also reached out to providers to try and see if moms were vaccinated during pregnancy
- Self-reported vaccination if the timing of vaccine could be provided. Study accepted either a date or a trimester, when the infant was enrolled.
- Data on maternal influenza infection during pregnancy was not collected
- Not able to assess as a confounder of the analysis
- Analysis: used the equation, vaccine effectiveness (VE) = (1 – adjusted odds ratio) x 100%
- Adjusted for infant age, NVSN site, and calendar time
- Study looked at other potential confounders including influenza season, sex, race, ethnicity, prematurity, underlying conditions in the infant, and also the mother,and education. Study found that none of those other confounders were significant
Timing of maternal influenza vaccination during pregnancy in the context of infant age and influenza seasonality
- Pregnancies with early opportunity to receive flu vaccine
- Pregnancies start in September or October of the prior flu season, at the same time that flu vaccine is recommended to the general public
- Infants born into these mothers will be older during the flu season; born in the summer months and will be about 4–6 months of age during flu season
- Hypothesize going into this analysis that this group might have lower vaccine effectiveness
- Pregnancies that have opportunity for vaccination later in pregnancy
- These are pregnancies that start in the spring of the same year as the flu season, such as March or April and end in the middle of flu season around December to February
- Vaccination would be received later for these pregnancies, and their infants would be 0–3 months of age during flu season
- Hypothesize that this group would have higher vaccine effectiveness
- Considering timing to protect both mom and baby against flu is complex and strategies for maternal flu vaccination will differ from vaccinations that protect against pathogens that don’t have a distinct seasonality
Results
- Had 4,049 infants <six months of age enrolled between the 2016–2017 through 2019–2020 flu seasons
- Had 285 infants that were excluded from this study
- Removed 92 infants born to mothers vaccinated less than 14 days prior to delivery
- Removed 193 infants that had unknown vaccination timing
- Remaining sample for the analysis was 3,764 infants
- 223 case infants tested positive for flu
- 3,541 control infants tested negative for flu
- 54% born to vaccinated mothers
- Gives good sense of what the vaccination coverage is in this population
- Similar to what was seen in other surveillance systems for these years
- Case-infants and those born to unvaccinated mothers were older than control-infants and those born to vaccinated mothers
- Infant case status and maternal vaccination status differed by race and ethnic group
- More infants born to vaccinated mothers were breastfeeding on enrollment, and more infants born to unvaccinated mothers had underlying conditions
- More infants born to unvaccinated mothers were born preterm
- Vaccination status differed by NVSN site and flu season of enrollment
- 54% born to vaccinated mothers
- Had 285 infants that were excluded from this study
Maternal Vaccine Effectiveness against Influenza-associated Hospitalizations and Emergency Department (ED) Visits in Infants <6 months
- Overall maternal vaccine effectiveness against flu hospitalizations and ED visits in infants less than six months of age was 34%
- Maternal vaccine effectiveness was higher among infants younger than three months of age among those born to mothers that were vaccinated during the third trimester of pregnancy, and also had higher effectiveness against hospital admission
- Maternal vaccine effectiveness was consistent with other vaccine effectiveness estimates by flu type and subtype for the 2016–17 through 2019–20 flu seasons
Summary
- Maternal vaccine update: flu vaccine uptake during pregnancy is nationally consistent but suboptimal
- Benefits to infants: maternal vaccination was associated with reduced odds of influenza hospitalizations & ED visits in infants <6 months of age
- Highest Vaccine Effectiveness: VE was greatest among infants <3 months of age, those born to mothers vaccinated during their third trimester of pregnancy, and against flu-associated hospitalizations
- Policy Implications: Currently, there are no anticipated changes to vaccination timing recommendations during pregnancy
Questions
Q: What’s the most common reason for denial of receipt of flu vaccine during pregnancy from pregnant mothers
Samantha M. Olson (CDC): We did not look at that in this study. I don’t know that I can say what the most common reason for denial is but what I can say is we know that if a provider recommends vaccination that’s one of the highest ways that we see good uptake in pregnant persons.
L.J Tan (Immunize.org): I think one of the big ones is the persistent fear of side effects, of risk, and so on.
Carolyn Bridges (Immunize.org): Safety is always number one, but that provider recommendation is the best way to help vaccine hesitant pregnant mothers accept vaccination. That is the key.
Megan C. Lindley (CDC): We have just finished some qualitative research with pregnant people that’s interesting. Some providers are really emphasizing the protection to the mother. They’re not necessarily providing the recommendation that we know motivates pregnant people to receive vaccines like Tdap, protection to the fetus and infant. So, the article that Sam and her colleagues have published is such an amazing opportunity to be sure that we are messaging to all providers to let their patients know that the flu vaccine during pregnancy is very protective to the infant just like Tdap, RSV, and other vaccines.
Resources shared during question-and-answer session:
- JAMA Pediatrics: Maternal Vaccine Effectiveness against Influenza-Associated Hospitalizations and Emergency Department Visits in Infants
- CDC: Flu Vaccination during Pregnancy Decreases Flu Hospitalizations and Emergency Department Visits in Infants Younger than 6 Months
Current Landscape of Rural Vaccination – Megan C. Lindley (CDC)
Megan C. Lindley, MPH, Lead, Adult Vaccination Team, Applied Research, Implementation Science, and Evaluation Branch, Immunization Services Division, NCIRD, CDC, gave a presentation on the current landscape of rural vaccination.
Rural Health in Brief
CDC: NCHS Urban-Rural Classification Scheme for Counties
- Most of the counties in the U.S. are non-metropolitan
- Non-core counties (population of 10, 000 people or less)
- Metropolitan counties comprise about 15% of the U.S. population (50 million people)
- CDC received an appropriation to create a new agency level office of rural health to work across partners and other agencies to promote rural health in the U.S.
Barriers to Accessing Health Services in Rural Areas
- Distance: a lot of land and fewer providers
- Less public transportation
- People in rural areas tend to be less insured and older
- Tend to have a lower educational level
- Differences in health literacy
- Stigma and cultural issues around vaccination
- Workforce shortages; fewer providers
- Programs to promote providers working in these areas
Rural Adult Vaccination Coverage Disparities
- Flu vaccination trends – Rural vs. Urban in adults age 18–≥65 years (2017–2022)
- 2021–22 season saw some declines in flu vaccination across numerous populations including pregnant people
- Among urban adults from age 18–64 years, the coverage was maintained compared with the 2020-2021 season
- This drop in the rural adult population resulted in a wider gap between rural and urban adult coverage
- Influenza Vaccination Status and Intent Among Adults ≥18 Years of Age, NIS-ACM, December 24–30, 2023
- NIS Adult COVID-19 module is built on ISD’s National Immunization Survey Platform
- Wide gap between urban and rural adults who report received flu vaccine
- Eight percentage point difference in people who say they probably or definitely will not get vaccinated
About 48% of the adult rural population say they probably or definitely will not get vaccinated as compared to a little over 1/4 in the urban and suburban populations
- More hesitancy issues in rural areas
- Influenza Vaccination Differences Across Age Groups (2017–2022)
- Five years of data across four different age groups of the adult population
- Extremely consistent deficit when you compare the rural versus urban vaccination coverage rates for flu vaccination
- Tdap Vaccination Differences
- Behavioral Risk Factor Surveillance System
- Not asked every year so not a consecutive measurement (years 2016, 2019, 2022)
- Coverage for Tdap is equivalent
- Tdap coverage in adults age 18 –25 is a little higher in the rural population
- This may be due to higher proportion of people who are doing farm work or have other occupations that may place them at higher risk for tetanus exposure
- COVID-19 Vaccination Status and Intent Among Adults ≥18 Years of Age, NIS-ACM, September 24–December 30, 2023
- Vaccination coverage with the new monovalent vaccines is slowly rising
- Proportion who say they probably or definitely won’t get vaccinated is consistently higher among rural populations
- Uptake of the new COVID-19 vaccine was around 20% among urban adults versus 14% among rural adults
Understanding the Rural Adult Immunization Landscape
- Rural Adult Immunization Listening Session conducted
- Literature review – uses the behavioral and social drivers framework; has to do with both the issues of perception, attitudes and social norms, as well as practical issues of access and availability
- Findings from the preparatory work: rural adults who have not been vaccinated can be considered initially in two broad groups requiring different approaches to increase coverage
- Those who reject vaccination
- Limited trust in government and providers
- Messaging doesn’t work
- Need long-term efforts
- Those who are hesitant about vaccination
- Barriers can be overcome
- The right messages can be effective
- Access can facilitate vaccination
- Short- and long-term strategies can promise results
- February 2023 Rural Adult Immunization Listening Session
- 36 subject matter experts representing providers in rural health care, public health, academics, and community leaders
- Effective strategies identified, the most notable are:
- Use of trusted messengers
- Public speaking engagements
- Meeting people where they are (mobile vaccination)
- Incorporating whole person health (not just vaccines alone)
- Rural Adult Immunization Pilots
- Partnership between the Extension Foundation and National Rural Health Association
- Three states that will implement and evaluate the identified strategies above: Minnesota, North Carolina, and Virginia
- Working with people with substance abuse disorder, pregnant people, and Hispanic adults
- CDC State of Vaccine Confidence (SoVC) Report: Special Rural Edition (released September 2023)
- Produced during the pandemic to talk about vaccination attitudes relative to COVID-19 vaccines
- Report methods are social media and categorization of themes
- Includes actionable strategies to address issues
- Themes
- Residents in rural areas of the U.S. are more concerned about safety, long-term side effects, vaccine effectiveness, and necessity to be vaccinated when compared to residents in urban areas
- Rural communities reported lower levels of vaccine access and vaccine confidence than suburban and urban communities
- Lower vaccine uptake in rural areas may be due to the lack of government trust and politicization of science. However, community outreach and utilizing trusted messengers can and has increased vaccine confidence in rural America.
- Those who reject vaccination
CDC Initiatives to Improve Adult Vaccination Rates
Bridge Access Program – Extending Access to COVID-19 Vaccines
- Provides no-cost COVID-19 vaccines to adults without insurance or with insurance that does not cover all of the costs
- Will end at the end of the year (12/31/24)
- Vaccines for Adults (VFA) program, proposed in the FY 2023 and 2024 Presidential Budget, would be a long-term solution to ensure all adults have access to recommend vaccinations, including COVID-19 vaccines, at no cost
- Adults age 18 and older without health insurance or who are underinsured can get a covered COVID-19 vaccine at sites that are in-network for their health insurance (see gov to find a vaccine)
CDC Partnerships to Increase Vaccine Confidence and Equity
- Extension Collaborative on Immunization Teaching & Engagement (EXCITE)
- Partnership with USDA’s Cooperative Extension System (CES), which is affiliated with land grant institutions (trusted partners): academic centers and rural areas
- Use the relationships to provide COVID-19-specific messaging
- Washington State University conducted surveys among the extension staff to learn about their issues and concerns related to vaccine education and to provide some related training
- Outcomes from the EXCITE project
- 18 million people reached through various engagement activities
- 26,000 vaccine doses given from over 1,100 clinics
- Over 170,000 total engagement activities
- Partnerships for Vaccine Equity (P4VE) Program
- Provided funding to over 500 partners from the national level to the individual community level
- Partnerships addressed specific populations and concerns relevant for their areas
- Partnering for Vaccine Equity: Vaccine Resource Hub
- Stories from the field
What can be done?
- Rural healthcare providers are trusted messengers
- Strong, persistent provider recommendations
- Vaccines promoted as a broad “whole person” approach, not just vaccines
- Vaccine technology innovations like microneedle patches can be useful for low access communities
- Employ long-term strategies to rebuild trust
- Develop partnerships with organizations and messengers that are already trusted in the community
- Build vaccine confidence
Resources:
- CDC Office of Rural Health
- Vaccinate with Confidence
- State of Vaccine Confidence Rural Insights Report
- VCD 12 Strategies – Rural Focus
- NORC Rural Health Mapping Tool
- Bridge Access Program
- Extension Collaborative on Immunization Teaching & Engagement (EXCITE)
- Partnering For Vaccine Equity (P4VE)
Questions
Q: What is considered rural is different in the Midwest and is different in the southwest. We have a lot of different cultures mixed in across the country. Were you able to tease those things out at all? Were there different approaches that worked in different regions?
Megan C. Lindley (CDC): I think we were able to tease it out, not necessarily in a formal way. If you look at some of the partnering for vaccine equity stories, and I think that’s going to be another value of those follow-up projects that I mentioned from our work with the National Rural Health Association,we have the three sites selected that are different. So I think while it’s going to be challenging to compare them head-to-head,we have a couple different efforts in my branch going on right now that are related to trusted messengers, and while I don’t think either of them actually were explicitly designed to address hesitancy in rural populations, they’re both occurring in kind of a diverse slate of rural areas. So, I hope that we’ll be able to share some insight there including for those that are of the same activity in different sites, kind of addressing what you were talking about—the differences that are occurring in different rural populations.
Q: You did a nice survey where they found that some of the differences were mostly COVID-19 vaccine-related, and significantly less. For other vaccines, disparities differ among the different vaccines. Do you have any insights, other than what you’ve already recommended, about how we don’t let some of those differences transition over to other vaccines, or how we bring COVID-19 vaccines out of the controversial so they’re more in line with other vaccines?
Megan C. Lindley (CDC): No, it’s not just an issue of rural adults. We’ve seen with some of the work that’s being done like CDC’s “Let’s Rise” campaign, we are seeing that bleed over of concerns about pediatric COVID-19 vaccination to uptake of the more routine pediatric vaccines where we didn’t have a problem before.
Resources mentioned during question-and-answer session:
- Public Health Reports: Design and Implementation of a Federal Program to Engage Community Partners to Reduce Disparities in Adult COVID-19 Immunization Uptake, United States, 2021-2022
- Health Affairs Scholar: Increasing Equity in Adult Immunization through Community-Level Action
Announcements
- The Summit email system is having technical difficulties. If you have not received an email this January with updated Zoom information for the weekly Summit update meetings, please contact info@izsummitpartners.org. Thank you for being patient with us as we work out this issue.
- January 24 at 3:00 p.m. (ET) the Sustaining Community-Based Organizations/Equity Task Group will hear from Michelle Rodgers of the Excite Program, which works in rural communities through 644 local partnerships and the land grant universities network. There will be opportunity for more discussion to develop further potential action items for the Summit. If you would like an invitation to join the discussion session on rural immunization disparities on January 24, please contact Susan Farrall at farrall@hhs.gov.
- Please put on your calendars the Summit in person meeting that has been moved to August to accommodate the National Immunization Conference (NIC), which is being held in Atlanta, GA, on August 12–14. The Summit in person meeting, focusing on adult immunizations, will be held August 15 (full day) and August 16 (half day). Stay tuned for further information.
- The Summit workshop developed tools to address challenges in providing multiple adult vaccines along with COVID-19, flu, and RSV vaccines. See the Summit’s Operationalizing Adult Immunizations in the 2023 Fall Season and Beyond Workshop web page for the deliverables.
- There is a new zoom link for the Summit meetings for 2024. If you do not have the new link, please contact info@izsummitpartners.org.
- 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