A summary of presentations from the weekly Summit partner webinars

April 18, 2024 – The latest Summit Summary

• NCICP Conference Update – L.J Tan (Immunize.org, Summit)
• “Rise to Immunize” Campaign – Lisa Cornbrooks (AMGA Foundation) and Emily Nick (AMGA Foundation)
• Announcements

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NCICP Conference Update – L.J Tan (Immunize.org, Summit)

L.J Tan, MS, PhD, Chief Policy and Partnerships Officer, Immunize.org, and Co-Chair, National Adult and Influenza Immunization Summit, gave commentary on the NCICP conference.

National Conference of Immunization Coalitions and Partnerships (NCICP)

• Held every other year for the coalitions of the United States
• Tasked to an immunization coalition that organizes, manages, and runs the conference
• Pennsylvania Immunization Coalition (PAIC) was responsible for organizing 2024 NCICP
  • Planning committee chair: Angela Shen, PhD (CHOP). Much gratitude to her leadership in putting NCICP 2024 together.
• Conference divided into 3 tracks about growing and sustaining coalitions, developing new partnerships, and strategies and advocacy
• 2024 conference points:
  • Immunization coalitions are a snapshot within each state of how partners, such as healthcare provider organizations, payer organizations, public health organizations, patient advocacy organizations, and manufacturing partners, can come together to develop and sustain a coalition and collaborate to improve immunization coverage rates.
  • Opening plenary by Lena Sun, Pulitzer Prize winning journalist with The Washington Post
    • Pointed out some of the challenges in journalism
    • Explained that information is now moving toward the online environment and how to manage that environment
    • Talked about how the best time to release information is in the morning and to avoid Fridays
    • Lena Sun’s recent article on polio: washingtonpost.com/opinions/2024/04/08/polio-survivor-childhood-vaccines
  • Many of the coalition members pointed out that the environment of legislation at the state level is changing
    • Playing catch-up with regard to anti-vaccine state legislation activity that has decreased since early years of COVID, but is not going away
      • Banning vaccines in diverse ways, ex. TN bill requiring lettuce that has vaccines to be labeled. Ultimate intent is to draw negative attention to vaccination
      • Declaring vaccinations on blood bank donations—some legislation saying if you’ve received a COVID-19 vaccine, you should not be allowed to give blood
    • National legislation
      • Supreme Court interest in revisiting the Jacobson vs. Massachusetts precedent-setting decision in the early 1900s that allowed states to mandate smallpox vaccinations
    • Coalitions are developing new partnerships especially with community-based organizations (CBO)
      • CBOs are now established, important partners for delivering pediatric, COVID-19, and adult immunizations
      • Working with coalitions to identify partnerships that can be sustained
    • There was an interesting plenary panel featured multiple people from government as well as from private sector
      • Talked about post-pandemic preparedness
      • Explained working with dwindling funding and resources
      • Discussed the challenges of maintaining readiness both in terms of infrastructure as well as in terms of vaccine development

Comment from Susan Farrall, MPH (HHS) on CBOs

With regards to our CBOs, Synovia Moss from the National Council of Negro Women talked about their resources committed to immunization. There’s a lot of resilience in the Black community so it was nice to have them at the conference.

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“Rise to Immunize” Campaign – Lisa Cornbrooks (AMGA Foundation) and Emily Nick (AMGA Foundation)

Lisa Cornbrooks, Senior Director, and Emily Nick, MPH, Senior Manager, National Health Campaign, AMGA Foundation, gave an update on the “Rise to Immunize” campaign from the AMGA Foundation.

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Emily Nick 

Rise to Immunize – AMGA Foundation’s Adult Immunization Campaign

Nationwide reach of “Rise to Immunize” campaign

• RIZE is a four-year initiative launched in October of 2021
• The national campaign focuses on improving adult immunization rates to help reduce the burden of vaccine preventable disease and related death, particularly among vulnerable populations
• It is a free offering of AMGA membership
• There are 82 medical groups and health systems across the country enrolled in the campaign, spanning 29 States and representing over 50,000 FT physicians
• The engaged organizations are from coast to coast, and represent large and small healthcare systems
• The groups are a good representative mix of AMGA membership
• The campaign is always enrolling

Initial campaign goal

• Healthcare groups accepted the call to action to improve adult immunization rates
• The goal from campaign launch (2020–2021) was 25,000,000 vaccines documented or administered by 2025
• All participating groups agreed to report quarterly data to the campaign for the following vaccines: influenza, pneumococcal, Td/Tdap, and zoster
• The campaign has recently received funding to help support the inclusion of additional measures which impacted the campaign goal

Campaign planks

• To help the groups drive improvement, AMGA offers campaign planks, or evidence-based care processes, to help them move the needle
• The 15 campaign planks fall under one of the five domains from provider and staff education to financial management
  • Campaign points within each domain vary by difficulty (levels 1–3 for each domain)
  • Higher level (numbered) planks represent more advanced interventions
  • AMGA encourages groups to choose which campaign planks to implement based on areas of interest and resources available, offering flexibility

Campaign resources

• Groups are surveyed annually to make sure AMGA is meeting their needs
• There are a variety of resources to support the groups and implementation
• Major resources include:
  • A campaign toolkit that provides actionable guidance for how to implement each of the 15 campaign planks
  • Tools from AMGA members who have successfully implemented an intervention so groups can adapt and adopt the tools for use in their own organization
  • Closed community Listserv for groups to discuss or troubleshoot any challenges that they may be experiencing, or successes they may want to share
  • Monthly educational webinar series featuring programs and best practices from AMGA and members. Past recorded webinars are available.
  • Rise cast series which are short video success stories from AMGA groups, which cover a variety of topics like patient engagement, standing orders, equity, and more
  • Blinded comparative reports of reported data and analysis from each participating group to provide campaign participants motivation for improvement
  • Monthly newsletter with the latest resources and campaign updates
  • Rise Symposium, an in person interactive meeting (last meeting was held in November and a summary was provided to Summit partners) with the goal of having groups reflect on their immunization wins and challenges, leaving them with new strategies for improvement
• Resources available at RiseToImmunize.org

Year one and two impact by vaccine

• First two years of the campaign, the organizations administered or documented nearly 12 million adult vaccinations and provided comprehensive immunization care to an additional 105,000 adults age 66+ years plus

2023 NAIIS “Influenza Season” Immunization Champion

• Those participating groups in 2023 were recognized by NAIIS with a national award for AMGA participating groups’ performance on flu vaccine rates
• The award demonstrates the power of this campaign to mobilize health systems to learn from one another and make systemic changes to drive improvement

Statement of need for expansion and extension

• Groups are looking for guidance and to share best practices around navigating the increasingly complex adult immunization schedule
• Groups would like more time to continue the improvement that they’ve achieved, based on the feedback
• AMGA surveyed its members to gauge their interest in reporting on three additional measures: RSV, COVID-19, and hepatitis B
  • They have a strong interest in adding all three measures to the campaign

Value of expansion and extension

• Groups recognize value from the campaign expansion and extension
• This initiative will help the groups:
  • Extend their commitment to prioritizing adult immunizations
  • Utilize additional time to learn best practices and innovative approaches
  • Increase awareness of additional vaccines on adult immunization schedule
  • Establish a performance baseline
  • Gain data insights on newer vaccines
  • Build framework for peer-to-peer learning
  • Develop hardware infrastructure changes for sustainability

Revised campaign goal

• Rise is expanding the campaign to include the option of three additional measures: RSV, COVID-19, and hepatitis B
• The campaign will be extended through 2027
• All participating groups that continue their journey with the campaign will focus on the additional vaccines that they’re choosing and hardware improvements to implement these additional vaccines

Looking to the future

• Start of April 2024: AMGA announced the expansion and extension in the campaign newsletter, followed by an announcement at AMGA’s annual conference
  • AMGA will continue to promote this campaign update to members through emails publications and other in-person events
• May 2024: AMGA will send its annual survey to assess its participating groups
• May–July, 2024: AMGA will work on upgrading its current groups with the new measures (effective on July 1^st)
• October 2024: first data reports with expanded measures will be submitted
• November 2024: first blinded comparative report with the expanded measures included

Sponsors and partners

• AMGA is always interested in speaking with others around opportunities
• Rise is a multi-sponsor funded campaign
• Pfizer was the founding sponsor of the campaign
• AMGA continues to work with a range of national nonprofit organizations all of whom share the same goal of improving routine adult immunization rates
• Each partner offers great subject matter expertise and has helped extend the reach and impact of the campaign

 

Questions

Q: The expansion to include hepatitis B, both in terms of the routine CDC screening recommendation and the routine vaccination recommendation, is requiring us to assist our providers figure out the difference between how to vaccinate as well as implement the routine screening recommendations. Do you see how that is going to be managed within your healthcare systems? Is there a learning opportunity for your providers to broaden their test their screening as well as vaccination simultaneously because of this effort?

Lisa Cornbrooks (AMGA Foundation): I think there is, and it’s going to help advance in general provider and staff awareness. As one of the many campaign planks, a big piece of this is the provider and staff education. Our hope is that by including this measure it’s going to advance that in our participating organizations who choose to report on this measure. It will really help them on both fronts.

 

Q: What has the experience been coordinating your practices’ EMR systems with the ISS systems in the states? Has that continued to be a challenge? Is that improving?

Lisa Cornbrooks (AMGA Foundation): AMGA’s campaigns are always fed by topics and best practices from our collaboratives, which are smaller initiatives typically involving 10–20 AMGA member groups focusing on specific topics or chronic conditions. Rise To immunize started a long time ago through an AMGA’s smaller collaborative that was focused on adult flu and pneumococcal vaccination. Then we added a a 2.0 version to that pilot, because there was such strong interest and great progress made. We built on that effort and there were about 40 groups in total that ended up participating in one or the other collaborative to improve flu and pneumococcal coverage rates. Something that we learned through those efforts and continues to be a challenge into this campaign is the ability for groups to have a complete data picture. We’ve heard as time has gone on through the campaign,  starting back from the pilot collaboratives, there are more groups that now have bidirectional data feed and have been able to establish data communication between their groups’ EMRs and the state registry. That helps them have a more complete picture and informs point of care decision making. There’s been some improvement there, but getting complete data remains a very large hurdle for groups in general, so it is one of the campaign planks that we wanted to focus on, a data perspective.

 

Q: Along the lines of how to move forward with people outside your membership, are you thinking about how to integrate these campaign planks into standard medical practice among the AMGA members and providers that are not participating in the campaign or outside your membership?

Lisa Cornbrooks (AMGA Foundation): In working with the groups that are participating, the idea is that they integrate these campaign planks so they’re a part of their practice. It’s systemically incorporated. One of the values of AMGA is our medical groups and health systems are our members so when we work with them, we work with them at a system level. Per your point, we have just over 80 groups engaged in the campaign, over 400 AMGA members, so there is certainly an opportunity to expand those learnings to non-participating groups. That’s something we’re always working to do. We communicate and promote the best practices and learnings within the campaign but there’s a reason that RiseToImmunize.org is an open-source website. Nothing is password protected besides the closed community component, which is basically a listserv for campaign participants. We are doing our best to disseminate those best practices and lessons learned in the larger AMGA membership. Our hope is that it will continue, and we look for opportunities potentially to publish this knowledge gained. We have phenomenal partners whose reach goes well beyond AMGA and by leveraging their audiences and their communications channels we’re hoping to spread the best practices of the resident united campaign beyond AMGA’s membership.

 

Q: Did the other members of AMGA who are not participating give you any reasons as to why they decided to not participate in this six-year campaign?

Lisa Cornbrooks (AMGA Foundation): Something to note about the campaign is that we’re always building on the number of groups, so it is a rolling enrollment. We’re always talking to groups that are in our membership but are not yet in the campaign to encourage them to join. We hear a lot about the reasons why groups don’t join. Launching in 2021, we were very much amid COVID-19, so our two prior campaigns (one on hypertension and one on diabetes) recruitment looked very different than it does for this campaign. It’s the state of the world and some things have changed that won’t necessarily go back to the way they were. COVID-19 is a measure we’ve expanded. We know that often it’s primary care that’s going to be taking the lead in a program like this and it’s getting to the top of their docket when we know that they’re dealing with so many other conditions. There are so many other competing priorities. They have limited staff, staff are burnt out, limited resources, and difficulty reporting data. We encourage groups even if they can’t report data in those circumstances to still engage with us because we’d rather meet them where they are than have them not engaged at all. There are some groups that have their data reporting on hold while they’re engaging with the campaign and they’re not reporting data yet. The groups that make this a priority have leadership support, they have a champion on board, there are some things like that where we see success and we see improvement in rates over time.

 

Q: What was an unexpected hurdle that you faced while you were trying to carry out this scope of this campaign?

Lisa Cornbrooks (AMGA Foundation): Recruitment, it is a big piece of in working with our groups and trying to make sure that this makes the top of their priority list. We were just talking about the challenges at our annual conference and something we heard from groups that they’d like to see and hear is the ROI for vaccines and demonstrating how engaging and improving their vaccination rates has economic implications. We’re working on that internally, but if others have data to support that ROI and demonstrate to folks that when you have flu vaccinations, for example, you’re going to avoid hospital admission rates, please let us know. Another piece of it is changing [vaccination] recommendations midstream in the in the campaign. The pneumococcal guidelines changed so we updated our measurement specifications to move from a new pneumococcal vaccine to a pneumococcal conjugate vaccine because we wanted to encourage our groups to work toward best practice and reflect the current ACIP recommendations.

Emily Nick (AMGA Foundation): I would second the recruitment aspect of it.

 

Q: What are you hearing about from your members about changes in vaccine confidence as they go through this platform from 2021–now? Is there a difference in overall vaccine hesitancy? Do you see differences by vaccine type? Have you seen improvement in access now that the inflation reduction act has passed and Medicare part B as well as Medicare part D vaccines are now at no copay for patients?

Lisa Cornbrooks (AMGA Foundation): From a vaccine hesitancy perspective I think there are two components to that. One is patient vaccine hesitancy, and another is provider vaccine hesitancy, and both are an issue. We have heard from our groups there is increased fatigue around COVID-19, patient hesitancy around COVID-19, and the impact of that on flu vaccines. When we look at the improvement rates for groups participating in the campaign, flu is where they’re struggling, whereas other vaccines like zoster have improved significantly. We’ve seen great improvement across the board and in the campaign, so it does seem that some vaccines may be a little bit more susceptible to hesitancy from the perspective of both the patient and the provider. But I would say the one overarching theme has been the challenge with COVID-19.

There’s the difference between the IRA becoming effective and its implementation at the state level. Groups haven’t really been able to bear fruit from that legislation. I think there’s still some confusion about it. We’ve even worked to raise awareness and make sure that our members are aware of this change. Across the board we hear from our members that the challenges associated with Medicare part D vaccines include where they need to be administered and the idea that they need to happen in a pharmacy unless they have certain software to help them adjudicate that claim.

 

Q: Emily, what is your goal? How many million vaccines? 

Emily Nick (AMGA Foundation): 30 million doses by 2027.

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Announcements

• The Summit is soliciting nominations for awardees for the 2024 NAIIS Immunization Excellence Awards. Nomination deadline is May 1. For information, visit: https://fs29.formsite.com/uI8uzs/2024NAIISAwards/index
• Summit will host two webinars for its Virtual Flu days, May 16 and 23, to help partners plan for the respiratory virus season ahead of August, when the Summit’s in-person meeting will follow the National Immunization Conference (NIC). For information on these webinars and to register for one or BOTH, see: Setting the Stage for 2024–2025 Respiratory Virus Season.
• The Summit in person meeting has been moved to August to accommodate the National Immunization Conference (NIC), which is being held in Atlanta, GA, on August 12–14. Register for NIC.
• The Summit in person meeting, focusing on adult immunizations, will be held August 15 (full day) and August 16 (half day). Registration is being coordinated with the NIC registration and should be available soon.
• There is a new Zoom link for the 2024 Summit meetings. If you do not have the new link, please contact info@izsummitpartners.org.
• If you have agenda items you are interested in sharing with the Summit, please tell us and we can add you to an upcoming call as a speaker or panelist. Contact information: info@izsummitpartners.org

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