October 13, 2014

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Summit Call Recap – October 9, 2014

Information from CDC

CDC Releases Updated Key Points

Announcements

SUMMIT CALL RECAP – OCTOBER 9, 2014

Influenza Surveillance Update – Sophie Smith (CDC)

Sophie reported that for the week 39, ending September 27, seasonal influenza remains below baseline levels for all of our threshold values for the 2013–2014 season. For the most recent week, 2.54% of specimens submitted for testing were positive, with a mixture of influenza A and B. The ILI-Net national data indicated 1.1% of total patient visits were for ILI, well below the national baseline of 2%.

No new pediatric deaths were reported for week 39. To date, 108 lab-confirmed pediatric deaths have been reported in the 2013–2014 season. The vast majority of these deaths were associated with influenza A.

The last week of data reported for the 2013–2014 season was published on Friday, October 3. CDC will begin weekly publication of data for the 2014–2015 season on October 10.

A Summit partner asked whether CDC has seen increases in ILI reporting because of increased surveillance for Enterovirus D68 (EV-D68), which also has respiratory symptoms. However, Sophie was unsure about whether this has occurred.

Update on Influenza Vaccination in Pregnant Women & 2013–14 Influenza Vaccination Coverage – Erin Kennedy (CDC)

Erin provided an overview of several recently released publications on influenza vaccination.

CDC has updated its FluView webpage with multiple reports related to 2013–2014 influenza vaccine coverage for the general population. These reports indicate that 46% of persons age >6 months received influenza vaccine during the 2013–2014 season, an increase of just 1% over the previous (2012–2013) season. Coverage for children age 6 mos – 17 years was ~59%, a little over 2% higher than the previous season. In general, coverage for white and black non-Hispanic children (~55% and ~58%, respectively) was lower than that seen for Asian and American Indian/Alaska Native children (~71% and ~66%, respectively.) Only about one-third (~34%) of healthy adults age 18 – 64 years were vaccinated during the 2013–2014 season, an increase of 1% over 2012–2013. Erin noted that these 1–2% increases sound small, but they represent very large numbers in the entire population. However, she conceded that we still have a long way to go in increasing influenza vaccination rates to desired levels.

The September 19 MMWR contained an update on influenza coverage for healthcare personnel (HCP). Among occupational groups, nurses led the way in improvements over the previous year, with 90.5% of nurses vaccinated against influenza in 2013–2014, an almost 6% increase over their 2012–2013 results. Erin directed Summit members to the website for additional details on specific occupational groups. Among occupational settings, hospitals achieved almost 90% coverage, while long-term care facilities were lowest at ~63%.

Coverage for pregnant women (52%) was similar to last season. Although there has been a great increase in coverage for pregnant women since the 2009 H1N1 pandemic, rates have remained stagnant over the last few seasons. Multiple studies have shown that a provider recommendation accompanied by an offer to administer the vaccine is the best way to increase rates among pregnant women. In the 2013–2014 season, 71% of pregnant women receiving both a recommendation and an offer to administer influenza vaccine were vaccinated, while the rate fell to 32% for those receiving only a recommendation. Not surprisingly, only 10% of pregnant women who did not receive a provider recommendation were vaccinated. In general, 80% of pregnant women surveyed said they had received a provider recommendation.

Because of these stagnant immunization levels among pregnant women and the increasing recognition of the importance of a provider recommendation and offer to vaccinate, CDC has initiated several new communication efforts for outreach to pregnant women. A Dear Colleague letter encouraging healthcare providers to recommend both influenza and Tdap vaccination for their pregnant patients has been released. The letter was co-signed by NCIRD Director Anne Schuchat and 19 organizations representing medical professional associations of physicians, physician assistants, nurses, nurse midwives, and pharmacists, as well as non-profit groups such as the March of Dimes and the National Foundation for Infectious Diseases. In conjunction with this letter, a commentary in the New England Journal of Medicine, 2009 H1N1 Influenza and Pregnancy – 5 Years Later (available for subscribers), which was written by CDC’s Sonja Rasmussen and Denise Jamieson, discusses lessons that can be applied from the increase in vaccination of pregnant women seen during the 2009 pandemic. These lessons also are discussed in a Medscape Expert Commentary, How to Protect Pregnant Women from the Flu (available for subscribers.)

Finally, Erin provided a brief overview of expectations for influenza vaccine availability during the 2014–2015 season. To date, 98.9 million doses of vaccine have been distributed, which is more than half of the 151–159 million doses anticipated. This is somewhat lower than the vaccine levels shipped by this time last year, but it is not an unusual pattern for seasonal influenza vaccine distribution overall. No vaccine shortages are expected, though there may be some distribution delays that could cause temporary issues in local areas. Manufacturers report that the majority of vaccine distribution will be completed by the end of October. CDC maintains a website providing details on current vaccine distribution in the United States.

Other Items – Carolyn Bridges (CDC)

Carolyn announced that ACOG will be sponsoring a webinar on the ob-gyn’s key role in influenza prevention on Wednesday, October 22 from 12 – 1 pm ET. The webinar is open to anyone interested in participating (ACOG membership is not required), and CME credit will be available.

INFORMATION FROM CDC

CDC Releases Updated Key Points

CDC has released updates to two previously released key points documents:

Investigation of Neurologic Illness with Limb Weakness of Unknown Cause in Children (10/10/2014)
Enterovirus D68 in the United States, 2014 (10/10/2014)

ANNOUNCEMENTS

William Schaffner Honored as 2014 Jeryl Lynn Hilleman Lecturer at the National Immunization Conference in Atlanta, Georgia

A longtime friend and partner of the Summit, Dr. Bill Schaffner, was honored at the recent National Immunization Conference as the 2014 Jeryl Lynn Hilleman Lecturer. With his bully pulpit, Dr. Schaffner delivered an impassioned plea that “when it comes to immunization, adults are not just grown up children.” Details of his presentation and his wonderful call to action on adult immunization are now available..

ACOG Holds Webinar on Role of Ob-Gyns in Influenza Prevention

The American College of Obstetricians and Gynecologists (ACOG) is presenting a webinar, The Ob-Gyn’s Key Role in Influenza Prevention, on Wednesday, October 22, 2014, from noon-1pm ET. This free, 1 CME credit webinar will cover influenza immunization recommendations, including the importance of vaccinating pregnant women, the 2014–15 vaccine formulations, vaccine safety, burden of disease, and strategies for integrating immunizations into standard practice. With Influenza season upon us and the recent publication of ACOG Committee Opinion 608, which urges ob-gyn’s and other health care providers to improve the rate of influenza vaccination among pregnant women, this webinar is the perfect opportunity to learn more about how you can improve influenza immunization rates. Continuing Medical Education credit is provided through joint providership with The American College of Obstetricians and Gynecologists. Registration information is now available.

Michigan Department of Community Health Hosts 2014–15 College and University Flu Vaccination Challenge

The Michigan Department of Community Health (MDCH) is teaming up with colleges and universities this fall to challenge students to get vaccinated against the flu. The 2014-15 College and University Flu Vaccination Challenge is a call-to-action to increase flu vaccination rates among college-aged young adults. Enrolled schools are challenging their students to get vaccinated and report their vaccinations through a self-reported survey link. The schools with the highest flu vaccination coverage (percent of student population vaccinated against the flu) will win the challenge, with awards for small, medium, and large-sized institutions.

Fourteen schools have stepped up and taken the challenge, and MDCH has been meeting regularly with these schools during monthly webinars, as well as communicating via challenge newsletters, websites, and e-mails. Schools leading the pack will be posted on MDCH’s Facebook and Twitter accounts on a bi-weekly basis, and awards will be presented to winning schools during National Influenza Vaccination Week (NIVW) in December. Additional awards will be given in the spring for the best late season campaign push.

Learn more about the challenge at the MDCH Influenza Website (click on 2014-15 College and University Flu Vaccination Challenge). While there, don’t forget to check out the College and University Flu Vaccination Toolkit with strategies to increase rates, key messages, email templates, news release templates, social media messages, and websites, plus an assortment of posters and flyers.

ACOG Examining Issue of Medicaid Coverage of Tdap and Influenza for Pregnant Women

ACOG is part of a small coalition that is trying to address the issue of Medicaid coverage in pregnancy, particularly for Tdap and influenza. They are currently fact gathering the issue across the states and then will identify some strategies. To assist ACOG, please share their request below:

Trouble with Medicaid Reimbursement for Tdap and Flu Vaccines for Pregnant Women?

Tdap and flu vaccines are not a covered benefit for pregnant Medicaid beneficiaries in Florida, Georgia, and Louisiana. Ob-gyns in California do not typically get reimbursed for administering these immunizations, even though these vaccines are a covered benefit.

Are you having difficulty getting either Tdap and flu (both seasonal and pandemic) vaccines reimbursed for pregnant Medicaid participants in your State, too? Email Betsy Wieand, Health Policy Analyst, to share your experiences. The more information we have, the better we can help solve the problem.

Screening of Invisible Threat in Minnesota. Please share widely!

If any Summit partners are in Minnesota, please consider attending a screening of Invisible Threat at the Children’s Hospital of Minneapolis. Details are shown below. Please share this information widely!

Date: Thursday, October 16

Location: Children’s Hospital of Minneapolis, second floor education center

Schedule of Events:

6:00 pm – Influenza vaccines will be provided by MVNA thanks to a generous grant from the Kohl’s Cares and Children’s Influenza Prevention Project.

7:00 pm – Gather, enjoy some popcorn

7:15 pm – Showing of Invisible Threat

8:00 pm – Panel discussion with Patsy Stinchfield, PNP, Robert Jacobsen, MD, and 2 parents who tell their heart-breaking stories.

8:30 pm – Adjourn

Sponsored by the Minnesota Childhood Immunization Coalition, Voices for Vaccines, and Children’s Hospitals and Clinics of Minnesota.

Questions can be directed to Joseph Kurland.
#invisiblethreatMN
#invisiblethreat

Candidate H7N9 Avian Flu Vaccine Works Better with Adjuvant

An experimental vaccine to protect people against H7N9 avian influenza prompted immune responses in 59 percent of volunteers who received two injections at the lowest dosage tested, but only if the vaccine was mixed with adjuvant. Without adjuvant, immune responses produced by the investigational vaccine were minimal regardless of vaccine dosage, according to findings from a clinical trial sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. A news story also is available.

Additional details about this clinical trial are available at ClinicalTrials.gov using the using the identifier NCT01938742.

Association of Professionals in Infection Control (APIC) Announces New Learning Opportunity!

APIC is presenting a new educational opportunity in infection prevention. APIC announces the October 27 start of the EPI Analytics Virtual Learning Lab and seeks help also to inform the broader infection prevention community about this foundational course

The Data Learning Lab, as APIC calls it, is the organization’s first online, instructor-led course. Structured in six modules, everything in the Data Learning Lab will be done virtually, from listening to speakers to completing assignments.

The class is designed to help novice infection preventionists build competency in the use and application of a variety of types of data, including integrating NHSN into a comprehensive data management approach, and strengthening HAI prevention and reduction metrics.

Effectively using data is an area where infection preventionists and healthcare professionals alike have sought assistance and instruction. APIC requests your support in sharing news of this course with your colleagues and your regional healthcare community through use of a sample media story appropriate for an electronic news story or web update, as well as two options of online banners (banner 1 and banner 2) with links to the appropriate APIC web pages.

APIC is proud to offer valuable, timely education in a new format to infection prevention professionals. If you have any questions regarding this APIC educational offering, please email: education@apic.org.

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