Summit Call Recap – November 5, 2015
- Influenza Surveillance Update – Sophie Smith (CDC)
- Adult ACIP Update – Carolyn Bridges (CDC)
- Partner Updates
Summit Call Recap – October 29, 2015
- Influenza Surveillance Update – Sophie Smith (CDC)
- Immunization Best Practices and Influenza Vaccines – JoEllen Wolicki (CDC)
- Other Items – Carolyn Bridges (CDC)
- IAC Nashville (November 18) and Little Rock (November 19) Workshops to Improve Implementation of Standing Orders for Adult Vaccines
- Summit’s IVATS Program Is Now Live for 2015–2016 to Assist Providers Locate Influenza Vaccine
Information from CDC
- CDC/Influenza Division Weekly Influenza Surveillance Report and CDC Key Points
- Don’t Forget CDC’s Selfie Campaign
- Update: Shortened Interval for Postvaccination Serologic Testing (PVST) of Infants Born to Hepatitis B-Infected Mothers
- CDC Clinician Outreach and Communication Activity (COCA) information
- ACOG Announces Monthly Influenza Newsletter
- Med-IQ and IAC Offer Publications on Vaccinating Adults with Chronic Disease
- FDA Advisors: No Easy Answers in Maternal Immunization – Preventing Disease in Infants Could Mean Vaccinating Mom
- National Patient Safety Foundation Supports Mandatory Flu Vaccine for Healthcare Workers
- Edward Belongia’s September 2014 Article Revived in Recent Boston Globe
- Sanofi Unveils Its Work on Improving Influenza Vaccines
- Permanent Flu Vaccine Could Make Annual Shots A Thing Of The Past
- Vaccines in the Age of the Selfie
- Nice Story from California on Getting Vaccines as One Ages
- California Vaccine Refusers Cluster in Rich, White Areas
- Meningococcal Disease in MSM
- Influenza Virus in Breast Milk
- Flu Vaccine Earlier in Life May Help Stave Off Dementia Decades Later
- Don’t Forget the Summit Awards in your Immunization Programmatic Planning this Fall
- Please Help the Summit, AIRA, and CDC Engage EHR Vendors in Immunization IT
- Three Slide Decks Available to Support New Standards for Adult Immunization Practice
- Every Child By Two (ECBT) Compiles Media Information on Its Website
- Summit Website Offers Wonderful Resources on Influenza Vaccination
SUMMIT CALL RECAP – NOVEMBER 5, 2015
Influenza Surveillance Update – Sophie Smith (CDC)
Sophie provided a summary of the published reports for week 42, ending October 24, 2015. This report represents the second week of the 2015–2016 influenza season. Influenza activity in the U.S. continues to remain low.
CDC is now reporting separately on influenza specimens received from U.S. clinical laboratories and U.S. public health laboratories. For week 42, 1.2% of specimens submitted to clinical laboratories were positive for influenza. Of these, 71.8% were influenza A and 21.28% were influenza B. For public health laboratories, 34/638 (5.33%) of specimens were positive, with 97.1% influenza A and 2.9% influenza B.
No characterization data is currently available for specimens collected after October 1, 2015. However, updated information for May 24–September 30, 2015 indicates CDC characterized 297 influenza viruses collected by U.S. laboratories. Of these, 13 were A(H1N1), 219 were A(H3N2), and 65 were influenza B. The influenza B viruses were split between the Yamagata (38) and Victoria (27) lineages.
No antiviral resistance data is yet available for specimens collected after October 1, 2015.
Based on National Center for Health Statistics (NCHS) data available on October 29, 5.6% of deaths occurring during the week ending October 10 (week 40) were due to pneumonia and influenza (P&I.) (NCHS data has an approximate 2 week lag time for reporting.) This is below the national baseline of 6.1%. Similarly, data from the 122 Cities Mortality Reporting System for week 42 indicate 5.8% of deaths were due to P&I. During week 42, influenza-like Illness (ILI) activity levels, which are based on the percent of outpatient visits due to ILI, were at 1.3%, well below the baseline of 2.1% for the week.
No pediatric influenza deaths have been reported for the season. However, a new report of a pediatric death occurring during the 2014–2015 influenza season was received. This brings the total number of pediatric deaths for that season to 147.
All 10 public health regions are reporting activity below baseline levels. The geographic spread of influenza as assessed by state and territorial epidemiologists indicates the following levels of influenza activity during week 42:
- Regional – Guam and 1 state
- Local – 6 states
- Sporadic – 35 states and Puerto Rico
- No activity – 8 states, the District of Columbia, and the Virgin Islands
In preparation for increasing activity during the coming weeks, Carolyn Bridges reminded partners that National Influenza Vaccination Week is December 6–12.
Adult ACIP Update – Carolyn Bridges (CDC)
Carolyn provided a brief update of the adult vaccine associated actions during the ACIP meeting held on October 21.
- Adult Schedule Update – As in prior years, the new adult immunization schedule will be published in the Annals of Internal Medicine during the first week of February 2016. The schedule will be accompanied by an editorial/introduction describing the changes from the 2015 schedule. Also in February, CDC will release a Notice to Readers (not the schedule itself) in the MMWR. The changes from the 2014–2015 schedule are relatively minor and include:
- A change in the intervals between PCV13 and PPSV23 for adults over age 65 years;
- The addition of a new row for meningococcal B vaccine recommendations:
- A footnote discussing the meningococcal B vaccine recommendations for high risk groups over age 10 years and a grade B recommendation for persons age 16–23 years.
- Child and Adolescent Schedule – ACIP approved the 2016 child and adolescent immunization schedule, which will be published at a future date.
- Updates – ACIP received updates on meningococcal disease in Chicago, the cost of high dose vs standard dose influenza vaccine for seniors, and a summary of work on an adjuvanted trivalent influenza vaccine.
Carolyn Bridges provided highly favorable comments about the recent meeting of the New Jersey Immunization Network. Efforts will be made to have representatives of the group present information on a future call.
SUMMIT CALL RECAP – OCTOBER 29, 2015
Influenza Surveillance Update – Sophie Smith (CDC)
Sophie provided a summary of the published reports for week 41, ending October 17, 2015. This report represents the second week of the 2015–2016 influenza season. Influenza activity in the U.S. continues to remain low.
CDC is now reporting separately on influenza specimens received from U.S. clinical laboratories and U.S. public health laboratories. For week 41, 1.7% of specimens submitted to clinical laboratories were positive for influenza. Of these, 73.2% were influenza A and 26.8% were influenza B. For public health laboratories, 19/444 (4.28%) of specimens were positive, with 94% influenza A and 5.3% influenza B.
No characterization data is currently available for specimens collected after October 1, 2015. However, during May 24–September 30, 2015, CDC characterized 225 influenza viruses collected by U.S. laboratories. Of these, 8 were A(H1N1), 155 were A(H3N2), and 62 were influenza B. The influenza B viruses were split between the Yamagata (38) and Victoria (24) lineages.
No antiviral resistance data is yet available for specimens collected after October 1, 2015.
Based on National Center for Health Statistics (NCHS) data available on October 22, 5.6% of deaths occurring during the week ending October 3 (week 39) were due to pneumonia and influenza (P&I.) (NCHS data has an approximate 2 week lag time for reporting.) This is below the national baseline of 6%. Similarly, data from the 122 Cities Mortality Reporting System for week 41 indicate 5.7% of deaths were due to P&I. During week 41, influenza-like Illness (ILI) activity levels, which are based on the percent of outpatient visits due to ILI, were at 1.4%, well below the baseline of 2.1% for the week.
All 10 public health regions are reporting activity below baseline levels. The geographic spread of influenza as assessed by state and territorial epidemiologists indicates the following levels of influenza activity during week 41:
- Widespread – Guam
- Local – 4 states
- Sporadic – 29 states and Puerto Rico
- No activity – 17 states, the District of Columbia, and the Virgin Islands
Immunization Best Practices and Influenza Vaccines – JoEllen Wolicki (CDC)
JoEllen provided a presentation on immunization best practices and the importance of proper vaccine storage, handling, and administration.
Each year CDC receives multiple reports of vaccine mishandling and administration errors, particularly in non-clinical settings. JoEllen emphasized that one of the best ways to prevent such errors is to assure all staff have received comprehensive competency-based training before they deliver vaccines. One method for doing this is through completion of a skills checklist (e.g., the skills checklist available from the Immunization Action Coalition) to assure all staff (including temporary and part-time) have sufficient knowledge and skills related to vaccine handling. Such training should be conducted routinely, as well as whenever vaccine changes occur.
CDC already has received vaccine error reports this influenza season, including both storage/handling and administration errors. JoEllen reviewed several best practices to prevent these errors from occurring.
CDC recommends use of stand-alone (i.e., separate units for refrigeration and freezing) or pharmacy grade/purpose-built units for vaccine storage. These units can vary in size, but they should be large enough to hold sufficient vaccine for the busiest times of year, such as during the back-to-school rush or influenza season. Dormitory-style refrigerators (compact combination freezer refrigerator with one door and an evaporator plate under a small freezer area) are unreliable and are never recommended for vaccine storage, even temporarily.
Temperature monitoring equipment
CDC recommends use of temperature monitoring devices that are calibrated (with a Certificate of Traceability/Report of Calibration) and which continuously monitor temperatures, such as with a digital data logger. These should be easily readable from outside the unit and have a probe stored in a thermal buffer such as glycol to protect it from fluctuations in air temperatures within the unit. Additional information on monitoring equipment may be found in CDC’s Vaccine Storage & Handling Toolkit.
Use of expired vaccine is a frequently reported error. From July 1, 2007 through June 30, 2014, CDC received 866 reports of administration of expired live attenuated influenza vaccine (LAIV.) In particular, staff should be aware the LAIV generally has an 18 week shelf life; 95% of expired LAIV reports occur during the first week in November, which is approximately 18 weeks after the vaccine manufacture date of July 1. Best practices to prevent use of any expired vaccine include checking vaccine expiration dates weekly, removing expired vaccines from inventory, and placing vaccines with the earliest expiration dates in front of those with later expiration dates. Package inserts should be checked for influenza vaccine products in multidose vials, as some of these have special information about “beyond use dates” (BUDs) after a multidose vial has been penetrated.
Special considerations for off-site clinics
If vaccine must be transported, it should be in a portable refrigerator or qualified container/packout. (Vaccine manufacturers do not recommend re-using the boxes in which the vaccine was delivered.) The vaccine container should be transported in the vehicle itself, i.e., not placed in the trunk. The amount of vaccine transported should be limited to only what is needed for that workday, and the TOTAL transportation and workday time should be no more than eight hours. A digital data logger should be used during transport and kept with the vaccine after it is transferred into an appropriate storage unit.
Vaccine administration best practices include maintaining proper infection control practices while preparing and administering vaccines; using proper hand hygiene; preparing vaccines in a clean, designated area; and preparing vaccines just prior to administration. Vaccine administration “don’ts” include never using the same needle or syringe on more than one patient; never entering a vial with a used needle or syringe; not using partial doses from two or more vials to obtain a full dose; not using a single-dose vial for more than one patient or dose; and not transferring vaccine from one syringe to another. Use of provider pre-drawn syringes is not recommended because it increases the risk of administration errors and administration syringes are not designed for vaccine storage. If vaccine must be pre-drawn at a large clinic, only one type of vaccine should be pre-drawn, and no more than 10 doses (one multidose vial) should be pre-drawn at a time. At the end of the workday, any remaining pre-drawn doses should be discarded.
Resources for staff education
Standing order templates serve as a great resource offering consistent guidance for all staff administering vaccine. Multiple education products also are available on the CDC education and training webpage. Other important resources include:
- Vaccine Storage & Handling Toolkit
- You Call the Shots (influenza module recently updated)
- Injection Safety
- Vaccine Administration
- Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book) – 13th Edition
State and local health departments also offer great resources.
Questions may be sent to NIP-INFO, and multiple CDC vaccine-related websites are available for consultation.
Other Items – Carolyn Bridges (CDC)
- The 2016 National Adult and Influenza Immunization Summit is scheduled for May 10–12, 2016 in Atlanta, GA.
- The 47th National Immunization Conference which will be held at the Hilton Hotel in Atlanta on September 13–15, 2016. Abstracts will begin being accepted in late January/early February.
- The Influenza Vaccine Availability Tracking System (IVATS) is available on the Summit website. IVATS provides information from influenza vaccine distributors and manufacturers about the availability of vaccine.
IAC Nashville (November 18) and Little Rock (November 19) Workshops to Improve Implementation of Standing Orders for Adult Vaccines
Please help IAC get the word out to Tennessee and Arkansas medical practices on the availability of a workshop to help them implement standing orders for adult vaccinations. This workshop is part of a national initiative to assist medical practices put standing orders into action. IAC is delighted to announce that the national adult immunization thought leader, Dr. Bob Hopkins, will be presenting at the Little Rock workshop.
As part of the initiative, IAC is offering a full year of free follow up support to medical practices that participate in the workshop and implement standing orders for adult vaccines.
See the project website to register for the workshops in Nashville, Little Rock, and other locations, as well as to learn more about the initiative.
Summit’s IVATS Program Is Now Live for 2015–2016 to Assist Providers Locate Influenza Vaccine
The Influenza Vaccine Availability Tracking System (IVATS) has been a staple of the Summit for several years now. The 2015–2016 iteration is now live. Distributors are encouraged to submit their latest data via the IVATS submission form. Submission is entirely voluntary.
INFORMATION FROM CDC
CDC/Influenza Division Weekly Influenza Surveillance Report and CDC Key Points
The CDC weekly influenza surveillance report for week 44, 2015 (ending November 7, 2015) and region specific data are now available.
NCHS mortality surveillance data for week 42 (ending October 24, 2015, but available on November 7) indicate 5.8% of deaths were due to pneumonia and influenza (P&I). This percentage is below the epidemic threshold of 6.5% for week 42. During week 44, 5.7% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 6.2% for week 44.
During May 24–September 30, 2015, CDC characterized 335 influenza viruses 148 A (H1N1)pdm09, 250 A (H3N2), and 71 influenza B viruses] collected by U.S. laboratories. All 250 H3N2 viruses were genetically sequenced, and all viruses belonged to genetic groups for which a majority of viruses antigenically characterized were similar to A/Switzerland/9715293/2013, the influenza A (H3N2) component of the 2015–2016 Northern Hemisphere vaccine. A subset of 104 H3N2 viruses also were antigenically characterized; 103 of 104 (99%) H3N2 viruses were A/Switzerland/9715293/2013-like by HI testing or neutralization testing.
All 14 influenza A (H1N1)pdm09 viruses were antigenically characterized as A/California/7/2009-like, the influenza A (H1N1) component of the 2015–2016 Northern Hemisphere vaccine. Forty-four (62%) of the influenza B viruses characterized belonged to B/Yamagata/16/88 lineage, and the remaining 27 (38%) influenza B viruses characterized belonged to B/Victoria/02/87 lineage. All 44 B/Yamagata-lineage viruses were antigenically characterized as B/Phuket/3073/2013-like, which is included as an influenza B component of the 2015–2016 Northern Hemisphere trivalent and quadrivalent influenza vaccines. All 27 B/Victoria-lineage viruses were antigenically characterized as B/Brisbane/60/2008-like, the virus that is included as an influenza B component of the 2015–2016 Northern Hemisphere quadrivalent influenza vaccine.
Since October 1, 2015, CDC has characterized 10 influenza viruses [one A (H1N1)pdm09, eight A (H3N2), and one influenza B virus] collected by U.S. laboratories. The eight influenza A (H3N2) viruses collected since October 1, 2015 have been genetically sequenced and all viruses belonged to genetic groups for which a majority of viruses antigenically characterized were similar to A/Switzerland/9715293/2013, the influenza A (H3N2) component of the 2015–2016 Northern Hemisphere vaccine.
No influenza-associated pediatric deaths were reported to CDC during week 44. More detail is available on CDC’s Influenza-Associated Pediatric Mortality webpage.
The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts all age population-based surveillance for laboratory-confirmed influenza-related hospitalizations in select counties in the Emerging Infections Program (EIP) states and Influenza Hospitalization Surveillance Project (IHSP) states. FluSurv-NET estimated hospitalization rates will be updated weekly starting later this season. Nationwide during week 44, 1.4% 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 November 7, 2015. Puerto Rico is reporting regional activity, 4 states are reporting local activity, and most other states are reporting sporadic activity.
CDC Influenza Division seasonal influenza key points for November 13 are now available, as is the FluView report for week 44, for week 44, ending November 7. Archives of previous FluViews also may be found online.
Don’t Forget CDC’s Selfie Campaign
CDC has launched the #VaxWithMe selfie campaign as an innovative way to capture and share flu vaccination promotion activities posted with the #VaxWithMe hashtag across various digital platforms (Twitter, Facebook, Instagram, YouTube). Want to get involved? Just post a selfie getting your flu vaccine and use the hashtag! CDC posts weekly updates to the campaign timeline.
Check out our interactive timeline for #VaxWithMe. The United States Surgeon General, Dr. Vivek Murthy, is leading by example!
Update: Shortened Interval for Postvaccination Serologic Testing (PVST) of Infants Born to Hepatitis B-Infected Mothers
This MMWR report provides a CDC update recommending shortening the interval for PVST from age 9–18 months to age 9–12 months. Providers should order PVST (consisting of hepatitis B surface antigen [HBsAg] and antibody to HBsAg [anti-HBs]) for infants born to HBsAg-positive mothers at age 9–12 months (or 1–2 months after the final dose of the vaccine series, if the series is delayed). This recommendation was prompted by the discontinuation of production of Hib/HepB vaccine (Comvax) and new data from the Enhanced Perinatal Hepatitis B Prevention Program supporting PVST 1–2 months after receipt of the last HepB vaccine dose, and at age ≥9 months.
CDC Clinician Outreach and Communication Activity (COCA) information
CDC Science Clips: Volume 7, Issue: 44 – (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.
CDC Emergency Response – CDC Response to 2014 Ebola in the United States and West Africa
UPDATE: Case Counts
Seasonal Influenza Information for Healthcare Professional
CDC’s Long Term Care toolkit is also available at his website.
Recent COCA webinars/calls
How to Prevent and Control Pediatric Influenza
Date: Thursday, October 1, 2015
ACOG Announces Monthly Influenza Newsletter
ACOG’s Immunization Team is excited to announce a monthly influenza newsletter that will run from October through early Spring 2016. The influenza newsletter will contain up to date information on this year’s flu season as well as links to pertinent flu resources from ACOG and immunization partners. The newsletter will be emailed to all ACOG members and archived on ACOG’s Immunization for Women website. We welcome suggestions for topics and resources to include in future newsletters. Our first two newsletters, “Prepare for Flu” and “Protect Patients Before the Holidays” can be viewed on our website.
Med-IQ and IAC Offer Publications on Vaccinating Adults with Chronic Disease
Med-IQ and the Immunization Action Coalition (IAC) are offering two new CME/CPE publications that provide frontline perspectives and practical strategies to help primary care clinicians overcome the challenges of vaccinating adults with chronic disease.
In Vaccinating Adults With Chronic Disorders: Insights for the Primary Care Clinician, learn new frontline perspectives and practical strategies to help primary care clinicians effectively address this growing public health concern.
In the CME publication Vaccinating Adults With Chronic Disorders: The Specialist’s Role, learn new frontline perspectives and practical strategies regarding the critical role specialists play in effective vaccination of patients with chronic disease.
FDA Advisors: No Easy Answers in Maternal Immunization – Preventing Disease in Infants Could Mean Vaccinating Mom
An advisory panel to the FDA found that developing a single framework to study the potential of maternal immunizations to protect infants from disease is simply not possible. “I think the overall consensus was that there is no one size that fits all,” said Marion Gruber, PhD, director of Vaccines Research and Review for the Center for Biologics Evaluation and Research (CBER) at the FDA.
National Patient Safety Foundation Supports Mandatory Flu Vaccine for Healthcare Workers
The National Patient Safety Foundation has re-issued a position statement initially released in 2009 in support of mandatory influenza vaccination for healthcare workers. The statement reads as follows:
The National Patient Safety Foundation recognizes vaccine-preventable diseases as a matter of patient safety and supports mandatory influenza vaccination of healthcare workers to protect the health of patients, healthcare workers, and the community. NPSF appreciates that where vaccination is not possible for any reason, due to unavailability or medical contraindications of potential vaccine recipients, hospitals and healthcare professionals must use all available alternatives to avoid transmission to patients and coworkers, including use of masks and adjustment of job responsibilities.
The Centers for Disease Control and Prevention (CDC) recommends that all U.S. healthcare workers get influenza vaccinations annually. NPSF formally adopted this position in November 2009 in light of strong evidence showing that requiring the flu vaccine contributes to patient and staff safety. Since then, NPSF and the NPSF Lucian Leape Institute have elevated influenza vaccination to the level of a “must do” activity for healthcare workers.
According to CDC survey data, healthcare personnel who did not intend to get vaccinated during the 2014-2015 flu season most commonly gave as reasons that (1) they don’t think that flu vaccines work; and (2) they don’t need the vaccine.
In fact, everyone is susceptible to flu infection, including those who are otherwise healthy. Furthermore, those who are infected can spread the disease a full day before they themselves show symptoms. While the effectiveness of the flu vaccine can vary from year to year, vaccination reduces the risk of more serious flu outcomes and may make the illness milder in those who were vaccinated but still get sick.
Another persistent myth is that people who receive the influenza vaccination may get sick from it. The influenza vaccine cannot give anyone the flu. Vaccines are made with inactivated (i.e., not infectious) flu vaccine viruses or with no flu vaccine viruses at all (called recombinant influenza vaccine). In randomized, blinded studies, other than increased soreness/redness at the site of the vaccine, there was no difference in outcomes among those who received a flu vaccination and those who received a saline injection.
The full story is available online in Infection Control Today.
Edward Belongia’s September 2014 Article Revived in Recent Boston Globe
Dr. Belongia’s study, published in Clinical Infectious Diseases in September 2014, has recently been the subject of a story in the Boston Globe’s Stat. The story, headlined “Getting a Flu Shot Every Year? More May Not Be Better,” has been picked up by a few social media outlets. The article, while featuring a less than flattering headline, is well articulated.
It begins: If you’ve been diligent about getting your flu shot every year, you may not want to read this. But a growing body of evidence indicates that more may not always be better. The evidence, which is confounding some researchers, suggests that getting flu shots repeatedly can gradually reduce the effectiveness of the vaccines under some circumstances. That finding is worrying public health officials in the US, who have been urging everyone to get a flu shot each year — and who still believe an annual vaccination is better than skipping the vaccines altogether.
Sanofi Unveils Its Work on Improving Influenza Vaccines
This week at the World Vaccine Congress in Spain, Sanofi Pasteur announced http://www.fiercevaccines.com/story/sanofi-unveils-its-work-improving-flu-vaccines/2015-11-11 that, in collaboration with the University of Georgia, it has developed a candidate vaccine through genetic sequencing of many flu viruses. The vaccine, dubbed Cobra, is designed to protect against multiple strains over several years using common sequences the strains share.
Permanent Flu Vaccine Could Make Annual Shots A Thing Of The Past
It took years of hard work, but researchers are claiming that they are closer to developing a universal, and perhaps even a permanent, influenza vaccine. Two separate researches published in both Science and Nature Medicine were able to successfully hone in on a stable part of the virus that, if targeted by vaccines, could mean more effective immunization for a wider spectrum of influenza viruses. This should then eliminate the need for repeated shots every year.
Vaccines in the Age of the Selfie
Here’s a blog on LinkedIn advocating for influenza vaccination in our modern day culture from bioCSL’s Steve Christy. Check it out.
Nice Story from California on Getting Vaccines as One Ages
There are many things I find myself thinking about now that I am on the other side of 50. Since I am a registered nurse, finding the best ways to protect myself from illness tops my list. Three diseases – influenza, pneumonia and shingles – are vaccine-preventable diseases, meaning you can protect yourself simply by getting immunized. The full article is available online.
California Vaccine Refusers Cluster in Rich, White Areas
California’s anti-vaccine sentiment tends to concentrate in wealthier, largely white areas of the state—a pattern that has left certain communities with childhood vaccination rates as low as 50 percent, a new study finds. The study, published online on November 12 in the American Journal of Public Health, is the latest to delve into the issue of personal belief exemptions for vaccines.
Right now, 20 U.S. states permit the exemptions, which allow parents to opt out of routine childhood vaccinations based on philosophical objections. California is technically still one of those states, but a law passed earlier this year will end personal belief exemptions in that state in July 2016, according to the National Conference of State Legislatures (NCSL).
Two stories related to the article are available in HealthDay and MedicalXpress.
Meningococcal Disease in MSM
Three U.S. outbreaks of meningococcal disease in men who have sex with men (MSM) in recent years prompted the Centers for Disease Control and Prevention (CDC) to request reports from states on the disease in this population. They noted at least 74 cases since 2012 concentrated in large cities, according to a report today in Morbidity and Mortality Weekly Report (MMWR). An additional story on this subject may be found in CIDRAP.
Influenza Virus in Breast Milk
During breastfeeding, mothers provide the infant with nutrients, beneficial bacteria, and immune protection. Fluids from the infant may also enter the mammary gland through retrograde flux of the nipple. Studies in a ferret model reveal that influenza virus replicates in the mammary gland, is shed in breast milk and transmitted to the infant. Virus may also travel in the opposite direction, from infant to mother. A full story is available online.
Flu Vaccine Earlier in Life May Help Stave Off Dementia Decades Later
A research team at McMaster University in Hamilton suggests that getting vaccinated regularly now can protect us from other diseases later. Prof. Dawn Bowdish, who holds a Canada Research Chair on Aging and Immunity, has been digging into the reasons older people are more prone to other illnesses after getting the flu. She concludes the inflammation linked to the flu and other respiratory illnesses doesn’t really go away, and contributes to things like dementia, cardiovascular disease and Type 2 diabetes.
Don’t Forget the Summit Awards in your Immunization Programmatic Planning this Fall
The National Adult and Influenza Immunization Summit (NAIIS) is soliciting candidates for the 2016 NAIIS Immunization Excellence Awards. The 2016 awards recognize individuals and organizations that have made extraordinary contributions toward improving vaccination rates within their communities during 2015. The awards focus on individuals and organizations that exemplify the meaning of the “immunization neighborhood” (collaboration, coordination, and communication among immunization stakeholders dedicated to meeting the immunization needs of the patient and protecting the community from vaccine-preventable diseases).
National Awards will be presented in the following categories: 1) Influenza Season Campaign (Laura Scott NAIIS Immunization Excellence Award for Outstanding Influenza Season Activities); 2) “Immunization Neighborhood” Champion; 3) Adult Immunization Champion; 4) Corporate Campaign; 5) Adult Immunization Publication Award. A National Winner will be selected for each award category, and, where appropriate, an Honorable Mention recipient.
Additional award to be presented: “Influencer Award” – Selected by the NAIIS Summit Organizing Committee to recognize an individual or organization in the media, legislature, or community whose activities, contributions and/or willingness to go above and beyond have advanced adult and/or influenza immunization implementation. There is no nomination application, but the Organizing Committee would be interested in receiving input on individuals or organizations to consider.
The winners will be presented with their awards at the National Adult and Influenza Immunization Summit meeting (to be held in May 10–12, 2016, location TBD). The national winner in each category will be invited to present their programs at the National Adult and Influenza Immunization Summit meeting. Submit nominations online by February 15, 2016.
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.
Summit calls are now scheduled every Thursday at 3 p.m. Eastern time, unless cancelled. Please email L.J Tan or LaDora Woods if you have any updates on activities to provide to the Summit.