November 17, 2014

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Summit Call Recap – November 13, 2014

Information from CDC

Announcements

SUMMIT CALL RECAP – NOVEMBER 13, 2014

Influenza Surveillance Update – Sophie Smith (CDC)

Sophie provided a summary of the published reports for week 44, ending November 1. For week 44, all seasonal influenza indicators remain well below baseline levels. Approximately 6% of specimens submitted for testing were positive, with a mixture of both A and B. The ILI-Net national data indicated 1.5% of total patient visits were for ILI, well below the baseline of 2% and slightly higher than the level reported during the previous week. Of the ILI-related deaths reported during week 44, 5.7% were attributed to pneumonia and influenza (P&I), below the 6.2% baseline level for week 44. No new pediatric deaths were reported during the week; 1 pediatric death has been reported so far during the 2014–2015 season.

As shown in CDC’s weekly influenza summary map, the geographic spread for influenza for week 44 is:

Widespread – Guam
Regional – 2 states
Local – 3 states and Puerto Rico
Sporadic – 40 states and the District of Columbia
No activity – 5 states
No report – Virgin Islands

No additional antigenic testing was conducted during the week. Since October 1, antigenic testing has determined 10 samples as influenza A (H3N2). Of these, 7 were characterized as A/Texas/50/2012-like, the influenza A (H3N2) component of the 2014–2015 Northern Hemisphere influenza vaccine. Three viruses showed reduced titers with antiserum raised against A/Texas/50/2012, but were antigenically similar toA/Switzerland/9715293/2013, the H3N2 virus selected for the 2015 Southern Hemisphere influenza vaccine. None of the six H3N2 specimens tested this season have shown resistance to antivirals.

NFID & Rite Aid U.S. Adult Women Survey – Marla Dalton (NFID)

Marla provided a brief overview of a survey conducted in September through a partnership between the National Foundation for Infectious Diseases (NFID) and Rite Aid. The telephone survey of 1,000 randomly selected U.S. adult women age 26–74 revealed that the majority of adult women in the United States do not believe they are up to date on vaccinations to protect against many vaccine-preventable diseases (VPDs).

According to the survey, most women recognize that VPDs pose health risks, but this knowledge does not necessarily lead them to take preventive actions. However, women were more interested in protecting their children. The survey participants reported needing greater access to accurate, easy-to-find and understand information. For example, almost 30% of women reporting they were not getting flu vaccine because of their misconception that the vaccine could give them flu. In the 2013–2014 season, over 25% of women who received vaccine did so at a pharmacy.

In response to questions, Marla noted that Rite Aid has created a new portal (www.riteaid.com/vaccinecentral) to ensure people have access to factual information about vaccines. The company also is providing additional training to pharmacists, who may be in a position to interact with women more frequently than their routine healthcare providers. This can be particularly important because women are more likely to ensure healthcare for other members of their family. Training tools for pharmacists, an infographic, and additional information on the survey are available on the Rite Aid website noted above. Persons with questions may contact Marla Dalton at NFID.

Other Items – L.J Tan (IAC)

Summit partners asked if additional information is available on the effectiveness of LAIV against H1N1 beyond what was presented at the October ACIP meeting. In particular, questions were raised about whether the vaccine effectiveness studies included information on adults rather than just children. L.J noted that, according to the handouts distributed at the ACIP meeting, the studies looked only at children through age 17 years, though this data could be differentiated for young children age 2–8 years versus older children age 9–17 years. Data available from studies of Air Force dependents also were only for children through age 17. MedImmune also shared data at the ACIP meeting indicating lots of vaccine shipped between weeks 4–9 appeared to be less effective than those shipped before or after this time period. This indicates the vaccine effectiveness possibly was affected due to thermal degradation. However, the data supporting this theory are unclear.

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

The CDC weekly influenza surveillance report for week 45 (ending November 8, 2014) and region specific data are now available. During week 45, 6.0% of all deaths reported through the 122 Cities Mortality Reporting System were due to pneumonia and influenza (P&I). This percentage was below the epidemic threshold of 6.3% for week 45.

For the 2014–2015 influenza season, CDC/Influenza Division and the National Center for Health Statistics (NCHS) are collaborating on a pilot project to use NCHS mortality surveillance data for the rapid assessment of pneumonia and influenza (P&I) mortality.

No influenza-associated pediatric deaths were reported to CDC during week 45. To date, one influenza-associated pediatric death has been reported for the 2014-2015 season.

Nationwide during week 45, 1.6% 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 2.0%. 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 8, 2014.

The FluView report for week 45 and archives of previous FluViews are available from CDC. CDC also has released seasonal influenza key points for November 14, 2014.

INFORMATION FROM CDC

National Influenza Vaccination Week

Don’t forget to check the NIVW website, as materials have been recently updated, with more expected next week!

Updated Key Points on EV-D68 Infections and Disease

The United States has been experiencing a nationwide outbreak of enterovirus D68 (EV-D68) associated with severe respiratory illness. Updated EV-D68 key points, current as of November 13, 2014, include the weekly update of EV-D68-like illness activity in states and specimens that tested positive for EV-D68 from patients who died.

Updated Information on Neurologic Disease with Limb Weakness of Unknown Etiology

Up-to-date key points from November 13, 2014 are now available about the investigation of neurologic illness with limb weakness of unknown cause in children, including the weekly update of CDC-verified neurologic illness cases reported by states that meet the case definition.

CDC Develops Social Media Messages for Influenza

Per requests from partners, CDC’s Influenza Division has developed the following social media messages that your organization may use to help communicate about influenza and flu activity. These can be tweeted using your organization’s Twitter handle, or disseminated on other social media platforms. We will share suggested social media messages every two weeks.

#FluFact: Most circulating #flu viruses so far this season are influenza A (H3N2) and influenza B viruses. http://1.usa.gov/1dgiUJY

FluView: Seasonal #flu activity remains low, but there are early signs that flu activity is increasing. http://1.usa.gov/17AHK

Get a #flu vaccine now if you haven’t yet this season. It takes 2 wks for #fluvax to provide protection. #fightflu
Don’t delay getting vaccinated if a certain type of #flu vaccine isn’t available. The most important thing is to get vaccinated.

#FluTip: If you’re at high risk for #flu complications, seek medical care quickly if you think you have the #flu http://1.usa.gov/1enjDvN

CDC Provides Ebola Key Points

CDC has developed Ebola key messages, as of November 5, 2014. CDC is sharing these key messages in case there’s interest in situational awareness for Ebola and related response efforts.

ANNOUNCEMENTS

Vaccine Facts and Policy Website Launches

George Washington University (GWU), the Association of Immunization Managers (AIM), and the Immunization Action Coalition (IAC) are pleased to announce the launch of the interactive vaccinefactsandpolicy.org website that displays immunization infrastructure, environment, and policy information for each of the 64 state, cities and territories. The Vaccine Facts and Policy (VFAP) project partners (GWU, AIM, and IAC) seek to provide relevant and meaningful data in one place for immunization programs, partners, researchers, government and the general public.

An FAQ document includes more information about the VFAP project, such as:

How does the project benefit my organization?

How does the online database work?

What kind of information is being reported?

Where does the data come from?

What are the plans to update the site?

Are there plans to add more categories of data?

How is VFAP funded?

Partners are urged to communicate the VFAP project to stakeholders through newsletters, emails and social media. The FAQ and VFAP flyer can be used in these communications.

Please contact Katelyn Wells at AIM know if you have any questions, suggestions or would like a presentation of the site to your collaborators, committees or workgroups.

SAVE THE DATE: ACOG Immunization Webinar – December 3, 2014

The American College of Obstetricians and Gynecologists (ACOG) is presenting a webinar, Give It Your Best Shot – Adult Vaccinations for Ob-Gyn Providers, on Wednesday, December 3, 2014, from noon –1 p.m. ET. This free, 1 CME credit webinar will give an overview of general immunization recommendations and explain the importance of immunizing patients for all necessary vaccines, particularly those who are pregnant. The presentation will detail ACOG and CDC’s immunization recommendations, address the most common concerns and misconceptions around vaccines, and explain the importance of immunizations for adults and pregnant women. Continuing Medical Education credit is provided through joint providership with The American College of Obstetricians and Gynecologists.

Registration information is now available. Please contact Valerie Echeveste of ACOG if you have questions.

Using Mobile Technology to Overcome Jurisdictional Challenges to a Coordinated Immunization Policy

On March 20, 2014, the Government of Canada and the federal Minister of Health announced the release of ImmunizeCanada (ImmunizeCA), a smart phone application (app) designed to both provide accurate information on immunization for Canadians and allow them to track their and their family members’ immunizations. Based on a prototype developed for parents in Ontario and in partnership with the Canadian Public Health Association, our development team received funding from the Public Health Agency of Canada to build a national immunization app. Our task was to build an Apple- and Android-compatible app, containing all 13 provincial/territorial schedules and vaccine information from each jurisdiction in both Canadian official languages (French and English).

The application uses demographic information entered by the user and the most recent recommended provincial vaccination schedule to create a custom profile for multiple family members. It allows parents to track and carry their children’s immunizations records on their mobile device. The application also permits the creation of adult-specific schedules and includes information on travel vaccines. It is also possible to sync the app with your smartphone calendar, generate appointment reminders, print or share an immunization record by email, and access answers to common questions.

The full article is available in a Health Affairs blog.

New Report from AADE and GSK on Hepatitis B Vaccination and Diabetes

The American Association of Diabetes Educators (AADE) and GSK are sharing with Summit partners, during National Diabetes Month, new findings on the barriers and gaps in educating people with diabetes on the importance of Hepatitis B vaccination. This is particularly important as people with diabetes are an at-risk population and are twice as likely to get this contagious virus. The press release is included in the link below and it details the survey results. Some highlights include:

In 2011, the CDC and the Advisory Committee on Immunization Practices (ACIP) recommended the hepatitis B vaccine for people with diabetes. Despite these recommendations, less than 1/3 of U.S. adults with diabetes have been vaccinated against hepatitis B. In fact, 52% of diabetes educators surveyed were unaware of the CDC recommendations.

Time is a limitation for diabetes educators and they prioritize educating their patients on lifestyle and behavior management versus vaccinations. Specifically, seventy-two percent say setting goals and improving patient self-care habits are their priorities. Likewise, just seven percent say that ensuring that patients receive the recommended vaccinations is a priority they have for their patients.

The full report and infographic, as well as a press release, are now available. Please feel free to share these materials with your constituents and/or other stakeholders as you see appropriate.

New Publication in NEJM Documents Impact of Pneumococcal Vaccination in South Africa

In South Africa, a 7-valent pneumococcal conjugate vaccine (PCV7) was introduced in 2009 with a three-dose schedule for infants at 6, 14, and 36 weeks of age; a 13-valent vaccine (PCV13) replaced PCV7 in 2011. In 2012, it was estimated that 81% of 12-month-old children had received three doses of vaccine.

The researchers conclude that rates of invasive pneumococcal disease among children in South Africa fell substantially by 2012. Reductions in the rates of disease caused by PCV7 serotypes among both children and adults most likely reflect the direct and indirect effects of vaccination.

The full article, Effects of Vaccination on Invasive Pneumococcal Disease in South Africa, is available in the New England Journal of Medicine.

Canada Begins Domestic Trial of Experimental Ebola Vaccine

Canada has launched a clinical trial of an experimental Ebola vaccine developed at its national microbiology laboratory and expects to have the results in early 2015, the government said on Friday.

The experimental vaccine, known as VSV-EBOV, was developed over several years at the laboratory in Winnipeg, Manitoba, and has shown promising results in animal research.

Could Flu Raise Risk of Fatal Artery Tear?

Influenza might increase a person’s risk of suffering a life-threatening tear in the body’s most important artery, a new study suggests. During flu season, an increased number of people land in the hospital with a potentially fatal leak in their aorta, the major artery that carries blood from the heart to the body, report researchers from the University of Texas Health Science Center at Houston.

The study findings are to be presented Sunday at the American Heart Association’s annual meeting, in Chicago.

New Alaska Vaccine Program to Go Into Effect in January, Makes Access Easier

The first year of the Alaska Vaccine Assessment Program will go into effect in January. With this program, health care insurers will fund an account directly to help pay for the cost of vaccines in the state. The Department of Health and Social Services will determine the vaccine assessment rate for each payer, i.e., a health care insurer or health benefit plan, based on the covered people they serve.

The Alaska announcement and a full press story are now available.

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 can also find archived copies of the Summit Buzz there.

Reminder

Summit calls are scheduled every Thursday at 3 p.m. ET, unless cancelled.

During the regularly scheduled Summit call on November 20, Brendan Flannery from CDC will provide a presentation on LAIV vaccine effectiveness. Additionally, we are working out details for AIM to present on the recent launch of the Vaccine Facts and Policy website. (See more information above under “Announcements”.)

Please email L.J Tan or LaDora Woods if you have any updates on activities to provide to the Summit.