October 19, 2015

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Summit Call Recap – October 15, 2015

Special Announcements

IAC Chicago Workshop to Improve Implementation of Standing Orders for Adult Vaccines – Friday October 23, 2015
Summit’s IVATS Program Is Now Live for 2015–2016 to Assist Providers Locate Influenza Vaccine
RFP from HPV Roundtable Pharmacy Task Group

Information from CDC

Announcements

SUMMIT CALL RECAP – OCTOBER 15, 2015

Influenza Surveillance Update – Sophie Smith (CDC)

Sophie provided a summary of the published reports for week 39, ending October 3, 2015. This report represents the last week of the 2014–2015 influenza season. Influenza activity in the U.S. continues to remain low.

The ILI-Net national data indicated 1.1% of total outpatient visits were for influenza-like illness (ILI), which is well below the national baseline. Approximately 1.7% of specimens submitted for testing were positive. Of the deaths reported through the 122 Cities Mortality Reporting System during week 39, 5.6% were attributed to pneumonia and influenza (P&I), which is below the 5.9% epidemic threshold for the week.

There were no influenza-associated pediatric deaths reported to CDC during week 39. A total of 146 pediatric deaths have been reported during the 2014–2015 season. Of the 123 for whom vaccination status was known, 14 were ineligible for vaccination, 15 were fully vaccinated, and 94 were unvaccinated.

CDC will begin providing weekly surveillance updates for the 2015–2016 influenza season on October 15.

Influenza Vaccine Manufacturers Distribution Update for the 2015–16 Season

BioCSL – Chip Altman
Chip began his update by noting that, due to the imminent merger of BioCSL and Novartis, future reports from the two companies will be combined under the new company name of Seqirus. BioCSL began shipping Afluria on July 13. Currently the company has shipped 90% of pre-booked doses, though some pre-filled syringes are still available. They also have the Stratis jet injector which can be used with the company’s multi-dose vials. The company also has the 1-dose antiviral Peramivir available under the brand name Rapivab.

GlaxoSmithKline – Sonal Bauer
GSK is on track to deliver 38 million doses to the market. The company has received releases for 36 million, and all pre-book commitments were completed by early October. Currently GSK has both pre-filled syringes (Fluarix) and multi-dose vials (FluLaval) available for next day delivery. All GSK doses this year are quadrivalent.

MedImmune – Heather Richmond
To date MedImmune has shipped nearly 4 million doses of FluMist quadrivalent, which is approximately 35% of the total pre-orders. The company will continue to ship doses throughout the season. MedImmune has experienced some delays in manufacturing this season due to incorporating three new strains into this year’s vaccine. They hope to be shipping 2/3 of the demand by Thanksgiving. In response to a question, Heather noted that it is likely most of vaccine will reach providers during December due to the shipping process. A letter providing anticipated vaccine supply information has been shared with public health customers. MedImmune expects to have additional vaccine available throughout the influenza season. Heather noted that it is important for providers seeking vaccine to work with the distributors to determine product availability, as all vaccine outside of the CDC contract is available only through distributors.

Novartis – Aaron Rak
NVS Influenza has shipped over 39 million doses of product to date, which is greater than the estimate provided at the Summit last spring. Over 90% of pre-booked orders have been shipped, and shipments are continuing to fulfill all orders. The company is continuing to accept orders for all products and presentations, including Flucelvax in pre-filled syringes and Fluvirin in pre-filled syringes and multi-dose vials.

Protein Sciences – Wayne Hachey
All pre-orders have been shipped. Vaccine is still available through direct order with the company or from four distributors (FFF Enterprises, McKesson, Henry Schein, and Cardinal Health.)

Sanofi Pasteur – Corey Robertson
Sanofi Pasteur plans to deliver all doses for which they had committed this season. The company has already completed shipments of approximately 50 million doses, which is 75% of the anticipated total. Shipments of the two Fluzone presentations for children (quadrivalent 0.25 mL and 0.5 mL pre-filled syringes) is delayed 2–3 weeks beyond the company’s original estimated dates. Sanofi Pasteur has delivered approximately 50% of the 0.25 mL pre-filled syringes to healthcare providers and VFC providers. Delivery of the remaining doses is ongoing, and shipments will be completed in November. These timelines for the remainder of deliveries have been shared with providers and the VFC Program. The company has already completed delivery of all reserved Fluzone quadrivalent vaccine in multi-dose vials, and additional vaccine is available for immediate shipment. Dr. Robertson noted that this presentation may be used for persons as young as 6 months of age. Delivery of Fluzone High Dose vaccine is ongoing, and shipments are expected to be completed by the first week in November with additional doses available at that time. Shipments of Fluzone Intradermal quadrivalent for persons age 18–64 years have been completed with additional doses available for immediate shipment. Sanofi Pasteur is continuing to take orders for Fluzone High Dose and Fluzone Intradermal quadrivalent vaccines. Dr. Robertson noted that Sanofi Pasteur regrets any impact resulting from shipment delays that have occurred, but he emphasized that there is no shortage of vaccine this season. It is hoped that Summit partners and others will continue to publicize the need for vaccination, and he re-emphasized that ample vaccine will continue to be available after Thanksgiving, a traditional time of vaccination drop-off. The company has an ample supply of multi-dose vials available for immediate shipment and continues to take orders for the 0.25 mL presentation for delivery during November. Vaccination should continue in advance of the peak influenza season, which typically occurs from November through March.

L.J expressed appreciation to all the manufacturers for their transparency in providing this updated information, as this type of communication is one of the fundamental reasons the Summit exists.

Other Updates – L.J Tan (IAC)

Carolyn Bridges reminded Summit partners that the National Immunization Conference is scheduled for September 13–15, 2016 at the Hilton Hotel in Atlanta.

SPECIAL ANNOUNCEMENTS

IAC Chicago Workshop to Improve Implementation of Standing Orders for Adult Vaccines – Friday October 23, 2015

Please help IAC get the word out to Chicagoland 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 in putting standing orders into action. IAC is also delighted to announce that the City of Chicago’s Commissioner for Health, Dr. Julie Morita, will be presenting at the 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.

Registration information for the Chicago workshop, as well as general information about the initiative and additional workshop locations, is available on the project website.

Summit’s IVATS Program Is Now Live for 2015–2016 to Assist Providers Locate Influenza Vaccine

The Influenza Vaccine Availability Tracking System (IVATS) has a 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.

RFP from HPV Roundtable Pharmacy Task Group

The Pharmacy-Located Vaccination Task Group of the National HPV Vaccination Roundtable of the American Cancer Society will implement a project entitled “Identify the factors to success and the challenges impeding the development and implementation of an HPV Immunization Neighborhood.” The project seeks the development and implementation of collaboration, coordination and communication among community stakeholders that result in completion of the 3-dose HPV vaccination series. ACS is requesting help to circulate the Request for Proposals to potential applicants.

INFORMATION FROM CDC

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

The CDC weekly influenza surveillance report for week 40, 2015 (ending October 10, 2015) and region specific data are now available.

NCHS mortality surveillance data for week 38 (ending September 26, but available on October 15) indicate 5.5% of deaths were due to pneumonia and influenza (P&I). This percentage is below the epidemic threshold of 6.2% for week 38. During week 40, 5.3% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 5.9% for week 40.

During May 24–September 30, 2015, CDC characterized 219 influenza viruses [8 A (H1N1)pdm09, 149 A (H3N2), and 62 influenza B viruses] collected by U.S. laboratories. All 149 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 58 H3N2 viruses also were antigenically characterized; all 58 (100%) H3N2 viruses were A/Switzerland/9715293/2013-like by HI testing or neutralization testing.

All 8 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.Thirty-eight (61%) of the influenza B viruses characterized belonged to B/Yamagata/16/88 lineage, and the remaining 24 (39%) influenza B viruses characterized belonged to B/Victoria/02/87 lineage. All 38 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 24 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.

No influenza-associated pediatric deaths were reported to CDC during week 40. 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 40, 1.2% 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 October 10, 2015. Many states and territories are beginning to report sporadic influenza activity.

CDC Influenza Division seasonal influenza key points for October 16 and 2015–2016 influenza season key points are now available, as is the FluView report for the week ending October 10. Archives of previous FluViews also may be found online.

Join 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). CDC posts weekly updates to the campaign timeline.

Update: Shortened Interval for Postvaccination Serologic Testing (PVST) of Infants Born to Hepatitis B-Infected Mothers

This 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: 40 – (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.

Recent COCA webinars/calls
How to Prevent and Control Pediatric Influenza
Date: Thursday, October 1, 2015

ANNOUNCEMENTS

Health Industry Distributors Association (HIDA) publishes their 2015–2016 Flu Distribution Report

The 2015 HIDA Influenza Vaccine Production & Distribution Market Brief provides new insights into the flu products supply chain and key information from the fifth annual HIDA Flu Products Survey of distributors. The survey demonstrates the roles that distributors will serve in the 2015–2016 flu season in helping healthcare facilities and patients access vaccines, hypodermic supplies, administration kits, diagnostic tests, and more.

Vaccinating Children May Be Cost-effective for Tackling Flu

Extending flu vaccination to UK children may be a cost-effective way to reduce the burden of the disease in the general population, according to research published in BMC Medicine. The study, carried out by researchers at the London School of Hygiene & Tropical Medicine and Public Health England, led to the UK government changing its vaccine policy to extend flu vaccination to children. The researchers found that the most cost-effective option is extending the vaccination program covering high risk and elderly individuals to children aged 5–16 years.

Review: Maternal Flu Shot Doesn’t Up Congenital Anomalies

Maternal influenza vaccination is not associated with increased risk of congenital anomalies, according to a review published online Oct. 7 in Obstetrics & Gynecology. Konstantinos A. Polyzos, M.D., from Iaso General Hospital in Greece, and colleagues conducted a systematic review on maternal influenza vaccination and the risk for congenital malformation. The risk of congenital anomalies after vaccination was reviewed using data from 15 studies (14 cohorts and one case-control study); eight studies reported on first-trimester immunization. The researchers found that risk for congenital anomalies was similar for vaccinated and unvaccinated (events per vaccinated versus unvaccinated, 2.6 versus 3.1 percent in the cohort studies; 37.3 versus 41.7 percent in the case-control study). Additional information is available online.

First Confirmed Influenza Cases In Kentucky, Delaware, and Oklahoma

The Kentucky Department for Public Health is reporting the first two laboratory-confirmed influenza cases this week, indicating the presence of flu circulating in Kentucky. The cases are from Jefferson and Kenton counties.

The Oklahoma State Department of Health (OSDH) is reporting three laboratory-confirmed cases of flu in Oklahoma, all of which were influenza A H3. Two of the confirmed cases were from Tulsa County, including one hospitalization, and one case was from Oklahoma County.

The Delaware Division of Public Health has reported the state’s first laboratory-confirmed case of influenza for the 2015–2016 flu season. The case involves a 26-year-old New Castle County man who visited an emergency room, DPH spokeswoman Emily Knearl said.

State Lawmaker Working to Ban Flu Shot Requirement

Wisconsin State Representative Jeremy Thiesfeldt (R-Fond du Lac) is considering pushing forward with a bill which would stop employers from requiring flu shots. Thiesfeldt said he knows hospitals and other healthcare systems are forcing employees to get the shot. He says if they don’t, then they risk suspension or losing their job.

Right now, his bill is still needs a public hearing before it can move forward. He says he’s meeting with the Wisconsin Hospital Association in hopes they will back off the policy which encourages hospitals to require doctors, nurses, and others to get flu shots. Thiesfeldt said, “I’m not against the influenza vaccination, I will probably get it myself this year, I’ve had it in the past. But I don’t believe people should be medicated against their consent in order to maintain their employment.”

CDC Issues Reminder That Adults Need Vaccines, Too

Your need for immunization doesn’t end when you become an adult; the Centers for Disease Control and Prevention (CDC) reminds people to get vaccinated to protect yourself and your loved ones from serious diseases. The specific vaccines you need as an adult are determined by factors such as your age, job, lifestyle, health conditions, locations of travel, and vaccines you’ve received in the past.

Concomitant Tdap, influenza vaccines safe in pregnancy

A recently published article suggests that pregnant women who receive the tetanus, diphtheria, and acellular pertussis (Tdap) and influenza vaccines at the same time are not at greater risk of adverse health or birth outcomes compared with women who received the vaccines at different times. Additional information is available on Medscape.

Fatal Allergic Reactions, Anaphylactic Shock Rarely Triggered by Vaccines: CDC

The Centers for Disease Control and Prevention (CDC) issued a report that fatal allergic reactions and anaphylactic shock are rarely triggered by vaccines. The CDC reported that only 33 people have had a near life-threatening reaction from vaccines out of 25 million vaccines administered. A news article about the report also is available.

Measles A Travel Risk For Americans

Researchers said that although measles is not too much of a risk in the U.S., it still has a high risk factor for those who travel abroad. A study presented in the ID Week 2015 shows that the lack of pre-travel vaccination is a big factor of a virus outbreak in the country. According to data gathered from 57 travel and medical clinics all over six continents shows that between 2000 and 2014, there were 94 cases of measles reported with two-thirds occurring after 2010. Apparently, measles has directly affected travelers and tourists.

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.

HealthMap Vaccine Finder Needs Your Help

Given the impact of influenza during the 2014–2015 season, healthcare providers all over the country are already preparing for next year’s influx of patients seeking vaccines. It is important that the public be able to quickly find vaccines in their area when they need them.

HealthMap Vaccine FInder is a free, online service that provides users with the most reliable and current information on vaccine availability in their area. Providers must opt-in to participate, and listing your location is free. Over 50,000 pharmacies, clinics, and health departments are already registered in the system.

Vaccine Finder has recently added formulation information for meningococcal, pneumococcal, and HPV vaccines, in addition to the 7 influenza vaccine formulations and 10 routine adult immunizations previously featured. These improvements, along with a growing network of participating providers, have allowed over 1 million users to access life-saving vaccine information from over 50,000 locations!

And there’s more to come. HealthMap is partnering with the Centers for Disease Control and Prevention (CDC) and the National Association of County and City Health Officials (NACCHO) to develop Flu Med Finder, a new capability for use during an influenza pandemic. This tool will allow users to find antiviral medications in their area in near real-time.

Make sure your community knows about the vaccines that you offer. Register for HealthMap Vaccine Finder and put yourself on the map! If you would like to register as a new provider, please create an account. Once your account is confirmed, you can log in to the provider site and upload information to your account. For our existing partners, it may be time to update your listings.

Please send an email if you have questions. For the latest news, follow us on Twitter at @VaccineFinder.

About HealthMap
HealthMap is a team of researchers, epidemiologists and software developers at Boston Children’s Hospital.

NFID Fall 2015 Clinical Vaccinology Course Scheduled for November 13–15, 2015

Learn the latest immunization recommendations for all ages, as well as recommendations for special populations including international travelers and pregnant women. Speakers will also address effective strategies to ensure timely and appropriate vaccination among all patients.

View the preliminary course agenda.

Learn from expert speakers who will provide the latest information on current vaccines including ACIP immunization recommendations
Network with speakers and other healthcare professionals involved in vaccine administration across the US
Earn up to 20.0 hours of continuing education credit (CME, CNE*, CPE)

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.

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

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

Summit Website Offers Wonderful Resources on Influenza Vaccination

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

Reminder

Summit calls are now scheduled every other Thursday at 3 p.m. Eastern time, unless cancelled. We will resume the regular weekly call schedule as influenza activity increases. The next call is scheduled for October 29.