October 5, 2018

HIGHLIGHTS

Just Announced: HHS National Vaccine Program Office Seeks Deputy Assistant Secretary

The Office of the Assistant Secretary for Health within the U.S. Department of Health and Human Services is pleased to announce its search for the Deputy Assistant Secretary of the National Vaccine Program Office.

In this role you will serve as the principal advisor to the Assistant Secretary for Health on vaccine policy and programs and ensure coordination and collaboration among the many partners involved in the U.S. vaccine system. As the lead for NVPO’s portfolio of immunization activities, you will oversee national policy and program efforts including the National Vaccine Plan, National Adult Immunization Plans, and provide leadership and strategic direction for the National Vaccine Advisory Committee and Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria. Learn more about NVPO’s core functions and responsibilities and the Office of the Assistant Secretary for Health.

Applications are due November 5, 2018. The position is open to all U.S. citizens and applications will be accepted from the public or from career professionals of the federal government.

New Alexa Skill – Flu Doctor to Support Families

This undertaking is a one-of-a-kind innovation partnership between Boston Children’s and Seattle Children’s Hospital aimed at building trust in the science and safety of vaccines. The team has created an Alexa skill called Flu Doctor, which includes about a dozen video responses for those who own an Alexa Show. The skill covers a variety of influenza topics (who should get the shot, when you should get it, potential side effects, efficacy data, etc.) Both hospitals hope to build trust in the vaccine by providing updates as flu season progresses, helping remind parents to schedule an appointment with their pediatrician, and integrating Vaccine Finder into the skill as well. Content was reviewed by CDC, AAP, and our WA State DOH. A YouTube video explaining the process is available, as are step-by-step instructions to enable the skill on your Alexa-enabled devices.

Women In Government Podcast: Influenza Vaccination

Are you ready for this year’s flu season? Each year, three to five million cases of severe flu are reported worldwide. Depending on the virus, influenza associated deaths can range from 290,000 to over 650,000 people. Last year, the number of those infected with the flu in the United States skyrocketed to levels we haven’t seen in more than a decade.

Is our country prepared for this year’s flu season? What is being done to protect our health in the medical and pharmaceutical communities? Are your state leaders on the front line and ready to battle the 2018 flu bug? And, what can you do to protect your family’s health?

Join Moderator and Alaska State Representative Geran Tarr on this podcast, as we find out who is most at risk of contracting the flu and what is the most effective defense against the virus.

“If you’ve seen one flu season…you’ve seen one flu season.” That’s because, season influenza evolves constantly, is unpredictable, disruptive, and too often deadly.

Featured Guests:

Kansas State Senator, Dr. Barbara Bollier
Monica Mercer, MD, Director, Scientific and Medical Affairs at Sanofi Pasteur
Elaine O’Hara, Chief Commercial Officer at Sanofi Pasteur

Summit Influenza Workgroup Holds Successful Meeting on Improving Influenza Vaccination of HCWs in Long-term Care Facilities (LTCFs)

On October 2 the Summit’s Influenza Workgroup held a meeting Increasing Influenza Vaccination Rates of Health Care Personnel in Long-Term Care Facilities, bringing together leaders and stakeholders in long-term care to discuss and identify what is needed to improve influenza vaccination rates and recommendations in these settings. This meeting follows upon the excellent initial work done at a meeting organized by the Gerontological Society of America (GSA) in May 2018. (See next story for additional information.)

Participants heard from experts on the following topics:

Influenza vaccination rates among health care personnel in long-term care facilities, and corresponding challenges, barriers, and opportunities for increasing influenza vaccination rates
AMDA’s (The Society for Post-Acute and Long-Term Care Medicine) updated policy statement on influenza vaccination of health care personnel, and NAIIS’ new resource guidance document to help organizations improve influenza vaccination rates among health care personnel in long-term care facilities
Case scenarios/best practices for improving influenza vaccination rates in long-term care facilities

After discussion of each topic, participants discussed existing resources and tools, additional support needed, partnerships to be formed or expanded, and actions needed to increase use of known solutions for raising influenza vaccination rates. The group ended the day by identifying and prioritizing next steps for action for stakeholders and for the Summit.

It was invigorating to have so many bright minds in the room working on overcoming the issues and barriers that are preventing us from reaching the Healthy People 2020 goal of ≥90% influenza vaccination coverage of health care personnel in LTCFs in the U.S. These are challenging issues, and it’s helpful to have concrete next steps to take, as well as distribution channels for disseminating materials that are currently available, such as the NAIIS guidance document:

Presentations are available from the overview session, the case study, and the findings from a published study–best practices and AMDA’s updated policy statement on influenza vaccination requirements for HCP:

Stay tuned for more follow up from this meeting, and congratulations to the Influenza Workgroup for developing and organizing the successful meeting. Any Summit partners interested in joining the NAIIS Influenza Workgroup may email Amy Parker Feibelkorn. The Influenza Workgroup meets the second Friday of every month at 11 am ET.

Experts Develop Guide for Getting More LTC Residents Immunized

A summit convened by The Gerontological Society of America (GSA) and the National Adult Vaccination Program (NAVP) has resulted in a roadmap for advancing immunization efforts in long-term care (LTC) facilities. A dozen recommendations — including five priority actions — have been outlined in a new white paper, Charting a Path to Increase Immunization Rates in the Post-Acute and Long-Term Care Settings. An additional story on this subject is available online.

National Foundation for Infectious Diseases (NFID) Hosts Successful and Well-received Media Conference on Influenza and Pneumococcal Disease Prevention

Although often underestimated by the public, influenza (flu) is a serious and highly contagious viral infection. In the US, millions of people get sick, hundreds of thousands are hospitalized, and thousands or tens of thousands of people die from flu and related complications every year.

NFID kicked off the 2018–2019 season its 2018 NFID Influenza/Pneumococcal News Conference on September 27 in Washington, DC.

A key goal of the news conference was to reset perceptions about flu and flu vaccines. Although flu vaccine can vary in how well it works against circulating strains each season, evidence shows that it reduces the severity of illness and helps prevent flu-related complications. If that weren’t reason enough to get vaccinated each year, there is another compelling reason: By getting vaccinated, we protect not only ourselves but also the people around us—our families, friends, and neighbors, many of whom could be severely impacted by flu, especially those with chronic health conditions including heart and lung disease as well as diabetes.

Panelists urged everyone age six months and older to get vaccinated annually against influenza, and also noted that flu season is a great time to ensure that you are up to date on pneumococcal vaccination as well. In the spirit of NFID’s Leading by Example initiative, news conference panelists and participants rolled up their sleeves to get vaccinated, including US Surgeon General Vice Admiral Jerome M. Adams, MD, MPH; FDA Commissioner of Food and Drugs Scott Gottlieb, MD; and Joe Thomas, former Cleveland Browns NFL player and NFID flu ambassador for the NFID/Outland Trophy partnership.

Featured panelists included Wendy Sue L. Swanson, MD, MBE, of Seattle Children’s Hospital, representing the American Academy of Pediatrics, who discussed the importance of keeping kids and families healthy this flu season; Laura E. Riley, MD, of Weill Cornell Medicine, representing the American College of Obstetricians and Gynecologists, who stressed the importance of flu vaccination during pregnancy to protect both mother and baby; and Daniel B. Jernigan, MD, MPH, of the Centers for Disease Control and Prevention, who shared final vaccination coverage estimates for children, healthcare workers, and pregnant women for the 2017–2018 flu season, noting that last year’s flu season was particularly severe, setting records for flu-related hospitalizations and deaths. NFID Medical Director William Schaffner, MD again moderated the well-attended media event. The complete news conference recording and related resources are available.

Many NFID partner organizations were also in attendance, including the National Adult and Influenza Immunization Summit, where Co-Chair L.J Tan got his flu vaccination as well.

NFID Webinar: Protecting Adults with Chronic Health Conditions Against Influenza

On October 11, join the National Foundation for Infectious Diseases (NFID) for a discussion about the impact of influenza on adults with chronic health conditions and the benefits of influenza vaccination. NFID Medical Director William Schaffner, MD will moderate the discussion that will include presentations by Margot Savoy, MD, MPH, Temple University School of Medicine, representing the American Academy of Family Physicians, and Allen J. Taylor, MD, MedStar Washington Hospital Center, representing the American College of Cardiology. Registration is available online.

Unity Consortium has Launched a New Campaign to Vaccinate Adolescents

The UNITY Consortium has developed a new, first-of-its-kind campaign (VAX@16) emphasizing the 16-year-old well-visit and the vaccines that can help protect teens at that age. The campaign aims to increase awareness among parents, teens, and health care providers of the vaccinations available for 16-year-olds, including meningococcal ACWY (MenACWY), meningococcal B (MenB), and flu (seasonally).

During this year’s back-to-school season, the VAX@16 educational campaign will be seen by parents and teens via monitors in approximately 40,000 primary care and pediatric physician office waiting and exam rooms throughout the nation. The campaign features videos, posters, infographics and more; many in both English- and Spanish-speaking versions for teen and parent audiences.

The VAX@16 educational resources for parents and teens are available via the Consumer Resources tab on Unity’s website:

Video Shorts:
- Prioritizing Adolescents: Vaccinate at Ages 11–12 & 16 (2 min & 4 min versions)
- Protection from Vaccine-Preventable Diseases
Teen Posters:
- “Protect Yourself(ie)” (English & Spanish versions)
- “Protection Is A Snap” (English & Spanish versions)
Parent Poster:
- “If Only You Could Vaccinate Via Text” (English & Spanish versions)

VAX@16 educational resources for health care professionals are available via the Professional Resources tab on Unity’s website:

VAX@16 Vaccination Opportunities (an overview of the 16-year-old immunization platform and actions health care providers can take to protect teens via vaccination)
VAX@16 Missed Opportunities (a guide to help health care providers recognize opportunities to vaccinate during health encounters, of all types, with 16-year-olds)

These materials are available in both English and Spanish. In addition, short educational videos addressing the 16-year-old immunization platform will also be available shortly..

Cold Cough Flu National Conference

On the Summit’s September 20^h call, we heard from Sickweather about their upcoming national Cold, Cough, Flu Conference, to be held on October 15.

Additionally, Sickweather is working on offering flu vaccines at the conference. The Kansas City Health Department is working on getting cooperation from Bird scooters to offer a discount code to their users who want to ride to the conference for a flu shot. They are seeking advice from Summit partners about previous experience on making something like this come together. Please email Laurel Edelman if you have advice or tips to share.

CDC Guidance to Providers Regarding Shingrix™ Vaccine Supply

CDC has issued guidance (see below) to providers who are experiencing difficulty receiving sufficient supplies of the Shingrix™ vaccine to meet demand.

SHINGRIX™ DELAYS. As you are aware there are some limits and delays with the Shingrix™ vaccine due to high demand. CDC has prepared the following statement for health care providers related to reminding them on considerations during this time as well as the importance of the 2^nd dose. The information is provided for your information and use as appropriate.

There are currently ordering limits and intermittent shipping delays for GlaxoSmithKline’s Shingrix™ vaccine (Recombinant Zoster vaccine) due to high demand. Until demand can be met, it is particularly important that vaccine providers educate patients about the importance of completing the series. In addition, CDC reminds health care professionals of proven strategies to help patients receive all their needed vaccinations on time, including Shingrix™:

Implement a vaccine reminder and recall system using phone, e-mail, or text messages to contact patients when you have Shingrix™ supply. Give first consideration to patients due for their second dose of Shingrix™. (The Community Guide – Vaccination Programs: Client Reminder and Recall Systems)
If you are out of Shingrix™ and a patient needs a second dose, refer the patient to another provider in the community (e.g., a pharmacy) that has Shingrix™ so the patient can complete the series. The immunization program at your state or local health department or vaccine finder can help identify other immunization providers. (HealthMap Vaccine Finder)
Be sure to enter your patients’ current vaccination information into your state’s immunization information system (IIS). This will ensure that every provider can access your patients’ immunization record, and it may help facilitate patient reminders to complete the Shingrix™ series.
As supply becomes less constrained, be sure to notify eligible patients so they can come in to get their first dose of Shingrix™.

Timely series completion is key to the success of any vaccination program and critical to ensuring patients receive the full benefit of their vaccinations.

ANNOUNCEMENTS

Public Health Informatics Institute (PHII) is Offering a FREE Email Course on the Basics of IIS

The Welcome to IIS email course delivers a broad foundation of knowledge on immunization information systems (IIS) in an easy, accessible format: one email a day delivered to your inbox for 18 weekdays. Each email takes five to ten minutes to read and contains a brief lesson, resources for further study, and interactive activities so you can apply what you’ve learned to your system and jurisdiction. Over the course of the training, you’ll learn what IIS are, how they work and how they’re staffed and supported.

FDA Approves Accelerated Vaccination Schedule for Ixiaro

The Food and Drug Administration (FDA) has approved an alternate primary immunization schedule for Ixiaro (Japanese encephalitis vaccine, inactivated, adsorbed; Valneva), a vaccine indicated for the prevention of disease caused by Japanese encephalitis virus (JEV). Ixiaro acts by inducing antibodies that neutralize live JEV.

The accelerated schedule now allows for adult travelers (18-65 years old) to get 2 doses of Ixiaro 7 days apart.

New from the Adolescent Immunization Initiative (AII)

The first Adolescent Immunization Initiative (AII) fact sheet, The Importance and Potential of the 16-Year-Old Immunization Visit, is now available. A second AII fact sheet, Implementing the 16-Year-Old Immunization Visit: A How-To Tool for Health Care Practices, is expected soon.

The fact sheets help raise awareness of the adolescent 16-year-old immunization platform and provide practical implementation strategies for practices. Please feel free to share the fact sheets with peers, as well as associations and organizations with which you are affiliated. Fact sheets will be posted on the AII website.

Families Fighting Flu Releases Updated Influenza Resource for 2018

Families Fighting Flu (FFF) has partnered with the National Association of Pediatric Nurse Practitioners (NAPNAP) and HealthyWomen to develop a Do You Know the Flu? comprehensive toolkit for pediatric healthcare professionals in an effort to increase annual flu vaccination rates in the pediatric population.

FFF realizes that as healthcare professionals, you have a lot of responsibilities when it comes to your patients, only one of which is flu prevention. However, we know you understand how serious the flu can be, even for healthy people. And we want to help you make a difference in the fight against flu.

In this toolkit, you will find the following educational resources:

A personal note from a pediatric nurse practitioner that highlights why healthcare professionals are so important for flu prevention
Family stories that illustrate just how serious flu can be for children, even healthy children
Benefits of flu vaccination to share with your patients
A Do You Know the Flu? quiz to test your flu knowledge
Key flu messages for patient/parent conversations
A conversation road map on how to address tough flu-related questions
Flu facts
A public service announcement called Play It Safe
Resources to share with parents, including two infographics

Clinical Vaccinology Course Sponsored by the National Foundation for Infectious Diseases and Emory University School of Medicine, November 9-10, 2018

The 2-day Clinical Vaccinology Course (CVC) sponsored by the National Foundation for Infectious Diseases (NFID) and Emory University School of Medicine focuses on new developments and issues related to the use of vaccines across the lifespan. Poster presentations and interactive sessions led by expert faculty provide the latest information on updated vaccine recommendations and innovative and practical strategies for ensuring timely and appropriate immunization. The 2018 course is scheduled for November 9-10, 2018 in Bethesda, MD.

GSK Urges Proper Storage, Reconstitution, and Administration of RZV

GSK is seeking assistance from partners to reinforce important education and communication about the storage, reconstitution, and administration of RZV.

RZV was approved for use by the US Food and Drug Administration (FDA) on October 20, 2017. As this new vaccine begins to reach clinics and pharmacies, and ultimately patients, GSK has received a small number of reports from the field of maladministration of RZV. These reports of observed usage of RZV suggest that the root cause of maladministration has been the utilization of the storage requirements and route of administration established for ZVL. Since ZVL and RZV have different storage requirements and routes of administration, GSK is asking that Summit partners include in your communications regarding RZV the specific storage and administration requirements of RZV.

This will help ensure that the storage and administration of RZV is executed according to the instructions outlined in the FDA approved product labeling. Please include and emphasize the following information in your education and communications on RZV to reinforce its proper storage, reconstitution and administration:

Storage, Reconstitution and Administration of RZV

RZV is to be stored in the REFRIGERATOR ONLY. RZV must be discarded if frozen.
RZV MUST BE reconstituted with the ADJUVANT LIQUID SUSPENSION (AS01) provided.
RZV is to be administered INTRAMUSCULARLY ONLY. It is NOT to be administered subcutaneously.

INFORMATION FROM CDC

CDC Influenza Updates

The FluView report published for Week 39 (ending September 29, 2018) is available on CDC’s website. Also available are CDC’s summary and technical seasonal influenza key points from September 28, 2018, as well as the Influenza Technical Key Points for the 2018–2019 Season.

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2018–19 Influenza Season appeared in an MMWR dated August 24, 2018. CDC recommends annual influenza vaccination for everyone 6 months and older with any licensed, age-appropriate flu vaccine (IIV, RIV4, or LAIV4), with no preference expressed for any one vaccine over another. More information about the 2018–2019 upcoming season is available on the CDC website. More information about the 2018–2019 upcoming season is available.

Full FluView reporting for the 2018-2019 season will resume on October 12, 2018. Regular distribution of key points by email will resume in the fall as well.

OTHER NEWS OF INTEREST

SELF Magazine: No, the Flu Shot Is Not 100 Percent Effective. Yes, You Still Need It

I study infectious diseases for a living. I’m also a mom of three kids. So every fall, I schedule an appointment with the pediatrician for my youngest and drag the older kids with me to a pharmacy, and we all get our flu shots. I do this even though I know that, most years, the vaccine is generally only about 40 to 60 percent effective at preventing the development of illness from the influenza virus.

These stats make some people wonder, so why bother? For anyone skeptical about getting a flu shot due to its shortcomings, there are two things you should think about: influenza vaccination is not just about protecting yourself against acute infection, but also from ongoing complications if you do fall ill. Secondly, it’s not just about you.

Oral Influenza Tablet Vaccine Protects Against Infection, Induces Unique Immune Response

Investigators have found that an oral tablet for influenza vaccination can protect against infection just as well as—if not better than—a commercial injectable quadrivalent influenza vaccine.

Results from the phase 2 trial were presented at the 2018 Annual ID Week Meeting in San Francisco, CA, this week by investigators from Vaxart, Inc, the clinical-stage biotechnology company that developed the tablet, which was manufactured using standard recombinant techniques rather than in eggs.

“According to recent studies, the common practice of growing influenza vaccine in chicken eggs can render the flu vaccine less effective in humans,” David Liebowitz, MD, said in a recent statement. “Our vaccines are not vulnerable to this issue.

Upstate Medical University Flu Crew Launches Cute Video on Getting Vaccinated Against Influenza – Especially for You Imagine Dragons Fans

Flu season is upon us, and it’s time to roll up those sleeves. The Upstate Medical University Flu Crew encourages everyone eligible to get their flu shot. Influenza is a serious illness that can have serious repercussions. In fact, 80,000 people died in the US last year from flu-related complications. The flu vaccination is safe, covered by health plans and available through your primary care doctor or local pharmacy. For more information, please visit the Medical University website.

Metropolitan versus Small-town Influenza

Every year, influenza epidemics occur during winter in regions with temperate climates. The duration, size, and precise timing of influenza epidemics vary from season to season—the numbers of hospitalizations and deaths can be substantial. The influenza epidemic in the winter of 2017–2018 in the United States was extraordinarily severe and long, straining the health care system capacity. Various external factors have been proposed to explain the duration, size, and precise timing of seasonal influenza epidemics, including weakened immune systems during winter, increased social crowding indoors, school leave during the Christmas holiday, and the lower humidity in winter. Inferring the relative importance of each of those factors is difficult because they act on a dynamic process that responds sensitively to changes and that is only observable with a measure of error.

How can we determine what is driving influenza epidemics? In the October 5 issue of Science, Dalziel et al. demonstrate how influenza epidemics in a city are driven by fluctuations in humidity, modulated by the population size. This implies that influenza control measures could work differently in large metropolitan areas compared to small towns.

Additional MMR Doses During Outbreak Unsupported by Parents

Most parents of teenagers at a high school in Texas where a mumps outbreak occurred did not support providing a third dose of the measles, mumps and rubella immunization, or MMR, for their children, as recommended in outbreak scenarios, according to research presented at IDWeek 2018. A third dose of the vaccine is recommended by the Advisory Committee on Immunization Practices (ACIP) during outbreaks.

New CDC-funded Project in Five States Hopes to Boost Vaccine Rates for Low-income Families

A new five-state project funded by the federal government aims to improve vaccination rates among low-income children and pregnant women, using statewide registries intended to track the immunization histories of all residents. The hope is that new ways of collecting and analyzing data identified during the project eventually will spread to all states.

The $880,000, three-year U.S. Centers for Disease Control and Prevention effort in Colorado, Hawaii, Kentucky, Montana and New Mexico faces numerous obstacles, including privacy and technological issues.

But public health officials are optimistic that immunization registries, which are already operational to various extents in all states except New Hampshire — which is in the process of launching one — can help reduce the disparities in vaccination rates based on income, geography and race or ethnicity. Officials would like to not only identify patients who are due for vaccinations, but also to reveal population groups whose immunization rates could be improved using targeted campaigns.

The project aims to do that with children and pregnant women in Medicaid. And the techniques it reveals may enable registries to be used as a tool to ensure that all Americans are up to date in their vaccinations.

Seqirus Presents Data at IDWeek Demonstrating Cell-Derived Viruses Have a Closer Match to Circulating Influenza Viruses

Seqirus announced data to be presented at IDWeek 2018 on Saturday, October 6, showing that higher levels of mismatch have consistently occurred with egg-derived influenza vaccine viruses compared with cell-derived vaccine viruses. The results are reported from a retrospective analysis that evaluated the degree of match between circulating influenza viruses and candidate viruses that were derived from egg-based and cell-based technologies over multiple influenza seasons.

Flu Vaccinations Can Protect Indirect Contacts

While vaccination ensures the best protection for individuals against the influenza virus, investigators have discovered a second protective function provided by the flu vaccination for those who are unvaccinated. This was presented at the IDWeek meeting.

From their results, study authors concluded that the incidence of influenza in unvaccinated members of a community can be reduced by unvaccinated individuals’ close contact with vaccinated individuals. The authors also concluded that clearer evidence for global vaccine recommendations may be provided by the collected data as they indicate protective effects of the seasonal influenza vaccination in household contacts of unvaccinated individuals.

Active Choice Intervention Effective in Increasing Influenza Vaccination Rates at Primary Care Practices

Influenza vaccination rates decline as the clinic day progresses, according to quality improvement data published in JAMA Network Open. Additionally, an active intervention that prompted medical assistants to ask patients about vaccination status was associated with a significant increase in vaccine uptake. Additional information is available online.

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

Weekly Summit calls will resume in October 11, 2018, which is also the date of the next Summit call.

Call summaries are available shortly after each call on the Summit website. Please email L.J Tan or LaDora Woods if you have any updates on activities to provide to the Summit.

Highlights

Announcements

Information from CDC

Other News Of Interest