August 02, 2016

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Summit Call Recap – July 28, 2016

Information from CDC

Announcements

SUMMIT CALL RECAP – JULY 28, 2016

Influenza Surveillance Update – Sophie Smith (CDC)

Carolyn Bridges announced that this will be Sophie’s last time to participate in our Summit calls, as she is leaving CDC to pursue her degree in nursing. On behalf of the Summit, Carolyn expressed our sadness in seeing her go, but we also wish her well in this new chapter in her professional career.

Sophie provided a summary of the published reports for week 28, ending July 16, 2016.

Influenza activity in the U.S. continues to remain low. Approximately 0.83% of specimens submitted for testing were positive. The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold for both the NCHS and 122 Cities Mortality Reporting System.

One influenza-associated pediatric death was reported to CDC during week 28. This death was associated with influenza A virus for which subtyping was not completed. A total of 83 pediatric deaths have been reported during the 2015–2016 season. Of the 71 for whom vaccination status was known, 5 were ineligible for vaccination due to age, 7 were fully vaccinated, and 59 were unvaccinated.

ILI-Net national data indicated 0.8% of total outpatient visits were for influenza-like illness (ILI), which is below the national baseline of 2.1%.

During the summer CDC’s reporting is abbreviated from the amount of data provided during the height of the influenza season. Therefore, data is not available on several of the reports routinely provided by Sophie, including geographic spread, hospitalization rates, antiviral resistance, and antigenic characterization.

Pneumococcal Vaccine Resources for Providers – Miwako Kobayashi (CDC)

Miwako provided an overview of CDC’s new pneumococcal vaccine resources for providers. These materials were developed to help providers with the 2014 ACIP recommendation to use PCV13 in adults ages >65 years. These recommendations were perceived as complex, and providers have requested simplified fact sheets covering pneumococcal recommendations. CDC has developed materials that are available on the web, but it is unclear whether providers are aware of this.

The materials that have been developed include:

Pneumococcal Vaccine Timing for Adults (includes table summarizing vaccine indications by age and risk group)
Recommendations, Scenarios, and Q&As for Healthcare Professionals about PCV13 for Adults (Recommendations in text and table form)
Medscape Video: “Applying the ACIP Algorithms”
Other Materials: Matte Release, Adult Immunization Schedule

Miwako requested input from the Summit on ways to make the materials more visible, accessible, and useful. Summit members with additional ideas or comments may send an email to Miwako Kobayashi. She also would appreciate receiving information about existing channels to distribute the information, useful links through partner pages, etc.

Carolyn noted that CDC often receives question about insurance coverage for pneumococcal vaccine, and she asked whether any of the materials include information about this topic. Miwako stated that most of them do not, but insurance information is included on the general vaccine page. Carolyn also mentioned the importance of electronic medical record prompts. Clinical decision support, age-based recommendations (including pneumococcal vaccines) are currently available, but similar tools based on risk factors are not.

2016 National Immunization Awareness Month Update – Ian Branam (CDC)

Ian provided a brief update on National Immunization Awareness Month (NIAM), which begins next week with a focus on vaccines for adults. CDC will be promoting the Adult Vaccine Quiz and requests that partners do this also. CDC also requests that partners participate in next week’s NIAM Thunderclap. The Thunderclap theme is #vaxwithme. This theme, which also will be used throughout the month, focuses on bringing a personal aspect to vaccine messages across the lifespan. If you join the Thunderclap, the message will go out via your social media networks at 3 p.m. on August 17.

An additional “listicle” (article in list form) available this year is Six Things You Need to Know about Vaccines, which provides information that everyone should know about vaccines across the lifespan. The National Public Health Information Coalition (NPHIC) website also includes communication toolkits, social media messages, and a wealth of other helpful resources related to NIAM. This site also provides a location to document NIAM-related activities.

One Summit member expressed frustration at being able to access available resources. Ian offered to help with this. Anyone else having similar problems can email Carolyn Bridges or LaDora Woods for assistance. In addition, members can contact Ian Branam with questions or comments.

Other Items – Carolyn Bridges (CDC)

Carolyn reminded members that registration is open for the 47^th National Immunization Conference, which will be held at the Hilton Hotel in Atlanta on September 13–15.

The next Summit meeting will be held on August 4, when the Text4Baby project will be highlighted.

INFORMATION FROM CDC

CDC/Influenza Division Weekly Influenza Surveillance Report and CDC Key Points

The CDC weekly influenza surveillance report for week 29 (ending July 23, 2016) and region specific data are now available.

NCHS mortality surveillance data for week 27 (ending July 9, 2016, but available July 28, 2016) indicate 5.3% of deaths were due to pneumonia and influenza (P&I). This percentage is below the epidemic threshold of 6.3% for week 27. Region and state-specific NCHS data are available online. During week 29, 5.4% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 5.8% for week 29.

May 15–21, 2016 marks the final full influenza surveillance report for the 2015–2016 influenza season in the United States. Influenza surveillance in the U.S. will continue through the summer months with condensed reports available on the FluView website. Full publication of the complete FluView resumes on October 14, 2016.

One influenza-associated pediatric deaths were reported to CDC during week 29. This death was associated with an influenza B virus and occurred during week 19 (ending May 14, 2016). A total of 84 influenza-associated pediatric deaths have been reported during the 2015–2016 season. More detail is available on CDC’s Influenza-Associated Pediatric Mortality webpage.

The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003–2004 influenza season) and adults (since the 2005–2006 influenza season). Influenza hospitalization rates and virus characterization are available on the FluSurv-NET website.

Nationwide during week 29, 0.8% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet) were due to influenza-like illness (ILI). This percentage is below the national baseline of 2.1%. ILI is defined as fever (temperature of 100°F [37.8°C] or greater) and cough and/or sore throat.

An Influenza Summary Update of the influenza activity reported by state and territorial epidemiologists, which indicates geographic spread of influenza viruses but does not measure the intensity of influenza activity, is available. This currently reflects data from May 21, 2016. Resumption of this reporting will occur in October 2016.

The final CDC/Influenza Division Weekly Influenza Surveillance Report (FluView) was issued on Week 20, and the final seasonal influenza key points document for the 2016–2017 influenza season was provided on May 27, 2016. After that point, seasonal influenza key points will no longer be released on a fixed schedule, but will be issued as they are warranted, such as in conjunction with the release of important flu-related publications or guidance or unexpected increases in flu activity. Full reporting for the 2017–2018 influenza season will begin in mid-October 2017, and will appear in FluView.

CDC Variant Influenza Information

The latest CDC Influenza Division key points regarding human infections with influenza A H1N2 variant (H1N2v) virus in the United States in 2016 are now available.

CDC NIAM Maternal Vaccination Week Resources

The National Immunization Awareness Month week of August 9–15 will highlight maternal vaccinations. The theme for the week is “Protect yourself and pass protection on to your baby.” To help you with your planning efforts, CDC wanted to remind you of the resources they have available for this audience.

The Centers for Disease Control and Prevention (CDC), in partnership with the American Academy of Family Physicians (AAFP), the American Academy of Pediatrics (AAP), the American College of Nurse-Midwives (ACNM), and the American College of Obstetricians and Gynecologists (ACOG), recently launched a new campaign to educate pregnant women about the importance of Tdap vaccine during pregnancy. The campaign is based on extensive formative research with pregnant women and prenatal care providers.

In addition to Tdap resources, CDC also has a variety of materials about the importance of flu vaccine during pregnancy. You can find all of Tdap and flu resources online (links and descriptions below). CDC hopes that they will be useful as you plan your NIAM outreach and beyond.

Access resources for healthcare professionals:

Tdap

Pregnancy recommendation fact sheets covering both the importance of prenatal Tdap vaccination and how to make a strong referral if an office does not stock the vaccine
Updated continuing education webcast that reviews the clinical presentation of whooping cough (pertussis), how to test and treat appropriately, and who to vaccinate and when
Additional materials including Vaccine Information Statements, instructional videos, and more

Flu

Infographic with latest flu vaccination coverage estimates among pregnant women, from 2013-2014 season
Letter to providers about the importance of vaccinating pregnant women
Customizable cards to help ob-gyns remind pregnant women to get vaccinated
- 2 English versions available for Caucasians and African Americans, similar to prescription pads
- Spanish customizable posters are also available
Podcast discussing why pregnant women need the flu vaccine

Share resources for pregnant women:

Tdap

Posters featuring the new “Born with Protection against Whooping Cough” message, in English and Spanish, encouraging women to talk with their doctor or midwife about Tdap vaccination during their 3^rd trimester of pregnancy
- Protect Your Baby from the Start (also available in Spanish)
- Protect your Baby Starting at Her First Breath (English only)
- Mom, You’ll Always Protect Your Little Miracle (Spanish Only)
A fact sheet, in English and Spanish, explaining that when pregnant women receive the Tdap vaccine during their 3^rd trimester they can pass antibodies to their babies before birth, providing them with protection from whooping cough until they are old enough to receive their own vaccination
A radio PSA (also available in Spanish) encouraging women to get the Tdap vaccine during their 3^rd trimester
“Born with Protection against Whooping Cough” podcast (also available in Spanish) featuring a CDC medical officer who is also a pediatrician and mom of a new baby girl

Flu

Pregnant women and the flu fact sheet in English and Spanish
Posters and flyers showing the risks associated with getting the flu while pregnant
An animated image for pregnant women that can be shared on social media
Other pregnancy and flu web tools including buttons and eCards

Free Print Materials for Order: Visit this page and search in the drop-down box for “Immunization & Vaccines”. Allow 4-6 weeks for shipping.

Use Social Media to Promote the Messages

Please help CDC get the word out about what they have available. They have prepared some social media messages to assist you:

For healthcare professionals:

CDC recommends 3^rd trimester #whoopingcough vaccine for women during each of their pregnancies. Learn more: http://1.usa.gov/1N7YCmC
CDC recommends the #flu shot (not the nasal spray) for pregnant women at any point during their pregnancy. http://go.usa.gov/37Cmc
Ob-gyns & midwives: Don’t carry Tdap in your office? See CDC’s tips for making a strong vaccine referral http://1.usa.gov/1xdml0S
Ob-gyns & midwives: Encourage your patients to get the 3^rd trimester Tdap vaccine with new posters & fact sheets http://1.usa.gov/1CPbvin
You are your patients’ most trusted source of vaccine info. Here’s info you can trust when you talk to them: http://1.usa.gov/1l92LXR
Pregnant women can receive the #flu shot at any time, during any trimester, while pregnant http://1.usa.gov/1lVNXPl
#Flu is more likely to cause severe illness in pregnant women than in women who are not pregnant http://1.usa.gov/1lVNXPl
Pediatricians: Encourage 3rd trimester Tdap during each pregnancy to protect babies until DTaP at 2 mos. http://1.usa.gov/1CPbvin

For pregnant women:

Get vaccinated and your baby can be born with protection against #whoopingcough and the #flu
3^rd trimester #whoopingcough vaccine passes antibodies to your baby, helping protect her until she gets vaccinated http://1.usa.gov/1N7XgIs
#Whoopingcough can be deadly for babies. Learn how to help protect your baby with a vaccine in your 3^rd trimester http://1.usa.gov/1N7XgIs
Vaccine protection starts before birth. Make sure to get #whoopingcough and #flu vaccines http://1.usa.gov/1N7XgIs
When pregnant women get #flu shots, they and their babies (after birth) get the flu less often.
Studies show that the #fluvax helps protect women and their babies during pregnancy and up to 6mos after they’re born. #getafluvax

Use CDC’s website to stay up-to-date
You can visit CDC’s new Pregnancy and Whooping Cough Webpage to see all of the new content reorganized by audience to make it easier for you to access the resources you need.

On CDC’s Flu Vaccine Resources for Pregnant Women webpage, you can quickly access, download, and print flu materials.

CDC also encourages you to syndicate its content on your website. Syndication gives you the ability to add CDC content directly to your website. When CDC updates content, those updates will automatically appear on your site. This will save you valuable time and ensure that your site is as up to date as possible. Below are links to syndicated content related to pertussis, flu, and pregnant women:

Pertussis Syndicated Content
Pertussis Vaccine (Tdap) Syndicated Content
Pregnancy Syndicated Content
Flu Syndicated Content (English)
Flu Syndicated Content (Spanish)

Please let us know if you have any questions or additional requests for information. Also, we’d like to know what you are doing to promote maternal vaccination and to educate your membership about whooping cough (pertussis) and the flu. Please send us an e-mail and let us know. Thank you for your continued support and assistance!

CDC Clinician Outreach and Communication Activity (COCA) Information

CDC Science Clips: Volume 8, Issue: 26 – (CDC)

Each week select science clips are shared with the public health community to enhance awareness of emerging scientific knowledge. The focus is applied public health research and prevention science that has the capacity to improve health now.

Seasonal Influenza Information for Healthcare Professional

Please visit: http://www.cdc.gov/flu/professionals/index.htm. The CDC’s Long Term Care toolkit is also available at his website.

Upcoming and Recent COCA Webinars/Calls

Updated Interim Zika Clinical Guidance for Pregnant Women and Data on Contraceptive Use to Decrease Zika-affected Pregnancies

CDC’s top priority for the Zika response is to protect pregnant women and their fetuses from the adverse effects of Zika virus infection during pregnancy. As a result, CDC continues to evaluate all available evidence and update recommendations as new information becomes available. CDC has updated its interim guidance for U.S. healthcare providers caring for pregnant women with possible Zika virus exposure on Tuesday, July 26 based on emerging evidence about laboratory testing for the diagnosis of Zika.

On August 2, 2016, CDC published contraceptive use data for states where mosquito-borne transmission of Zika is possible. A primary strategy to reduce Zika-related pregnancy complications is to prevent pregnancy among women who want to delay or avoid pregnancy. During this COCA Call, clinicians will learn about the updated CDC interim guidance for caring for pregnant women with possible Zika virus exposure, and strategies for increasing access to contraceptive methods and services to minimize the number of pregnancies affected by Zika.

Identification and Care of Patients with Hantavirus Disease During this COCA Call, clinicians learned about the epidemiology, diagnosis, and clinical care of patients with hantavirus disease in the United States. Earn free continuing education.

Archived COCA conference calls are available. Free continuing education credits (CME, CNE, ACPE, CEU, CECH, and AAVSB/RACE) are available for most calls. For more information about free CE is available online.

ANNOUNCEMENTS

HPV Resource Center for Pharmacists has Information, Practice Tools, and Resources

APhA and the National Association of Chain Drug Stores (NACDS) have partnered to create a resource for pharmacists seeking guidance in speaking to patients about the benefits of immunizing children and adolescents against HPV.

Please Help the Summit, AIRA, and CDC Engage EHR Vendors in Immunization IT

The Summit has been active and interested in improving interoperability and utilization of EHRs and immunization information systems (IIS) for several years. Indeed, for the past two years, there has been a lot of prioritization of IIS and health information technology (HIT) activity within the Summit workgroups.

However, engagement by vendors of EHRs remains difficult. We hope that, with the Summit’s support, we can begin to change that in little steps. If you are connected with an EHR vendor, perhaps you can start by encouraging them to simply join in two activities in the IIS community that are not demanding on their time.

The first is the AIRA Standards & Interoperability Steering Committee (SISC). SISC provides technical support and guidance to interoperability efforts of AIRA members and the IIS community. They act as a liaison between national organizations involved with interoperability, such as the Office of the National Coordinator (ONC) and others, and serve as a technical resource for AIRA members and the IIS community. SISC meets the 2nd Wednesday of every month from 1–2 pm ET. Participation of EHR, pharmacy, health information exchange (HIE), and other IIS partners trading perspectives is welcomed to help drive forward increased interoperability. For more information, please connect with Mary Beth Kurilo.

The second is the CDC Clinical Decision Support for Immunization (CDSi) project. This project provides a single, authoritative, implementation-neutral foundation for development and maintenance of CDS engines. It captures ACIP recommendations in an unambiguous manner and improves the uniform representation of vaccine decision guidelines, as well as the ability to automate vaccine evaluation and forecasting. Interested parties can reach out to Eric Larson.

Three Slide Decks Available to Support New Standards for Adult Immunization Practice

The Summit’s Access and Collaboration workgroup has developed three separate slide decks with talking notes to support partners and others who wish to present on the Standards to their peers and colleagues. The three audiences targeted by the decks are: healthcare providers; patients/public; and public health. These are now available, along with tips and tools on how to use them, at the Summit website.

Also do not forget that Medscape has produced two modules to support the implementation of the Standards:

Providing a strong recommendation (with video vignettes)
Assessing the patient for adult vaccines.

Every Child By Two (ECBT) Compiles Media Information on Its Website

On a daily basis, ECBT assembles significant news media coverage on immunizations in their “Daily Clips.” Summit partners may find this effort useful.

Summit Website Offers Wonderful Resources on Influenza Vaccination

Remember to visit the Summit website for the latest on influenza immunization resources. You also can find archived copies of The Summit Buzz there.

Reminder

Summit calls are now scheduled every Thursday at 3 p.m. Eastern time, unless cancelled. The next call is scheduled for August 4. Please email L.J Tan or LaDora Woods if you have any updates on activities to provide to the Summit.