October 19, 2018

HIGHLIGHTS

National HPV Roundtable Hosts Webinar on New HPV-9 Indication – October 29, 3PM Eastern

On October 5th, the FDA approved expansion of HPV vaccination with Gardasil 9 to men and women ages 27 through 45 years. The National HPV Vaccination Roundtable will convene two experts, Dr. Debbie Saslow (ACS) and Dr. Rebecca Perkins (ACOG), for a half-hour webinar to discuss the recently approved age expansion for Gardasil 9 and the implications for clinical practice. The presenters will answer some important questions, including:

What does the FDA label expansion do and what will it mean for clinical practice?
What are the next steps and timing for the Advisory Committee on Immunization Practices (ACIP) regarding potential changes to the recommended age ranges?
Will insurance companies cover the HPV vaccine for older ages?

NFID hosts Webinar on Pneumococcal Vaccines: Strategies to Increase Adult Immunization Rates – October 30 at Noon ET

Join the National Foundation for Infectious Diseases (NFID) for a discussion about the importance of pneumococcal vaccines in adults, with a focus on strategies for determining which pneumococcal vaccine to give to whom and when.

NFID Medical Director William Schaffner, MD, will moderate the webinar with a presentation by Thomas M. File, Jr., MD, MS, Chair, Infectious Disease Division of Summa Health and Professor, Internal Medicine; Master Teacher; Chair, Infectious Disease Section of Northeast Ohio Medical University; NFID Past President; and President-Elect of the Infectious Diseases Society of America.

At the conclusion of the webinar, participants will be able to:

Discuss the epidemiology, clinical manifestations, and outcomes of pneumococcal infection
Interpret current Advisory Committee on Immunization Practices (ACIP) recommendations regarding the use of PCV13 and PPSV23 in older adults
Identify strategies for implementation of ACIP recommendations into practice

New 65+ Flu Defense Website Features Tools and Resources for Healthcare Professionals Serving Adults Age 65 and Older

Annual influenza vaccination is the best way to prevent influenza, but vaccination coverage among older adults in the U.S. has stagnated, and in some years has declined significantly over the previous season’s rate. In the 2016–2017 season, only 65.3% of adults age 65 and older were vaccinated against the flu.

However, seniors are at greater risk of severe complications from influenza, due both to their increased likelihood of having chronic conditions and to the decline of their immune systems with aging.

As a healthcare provider (HCP), your strong, confident recommendation for flu vaccine is a very powerful and persuasive tool in determining if your patients are vaccinated. To assist you in this effort, the new 65+ Flu Defense website has been launched. This project, a collaboration between IAC and Seqirus, aims to reach HCPs with information, tools, and resources they need to better communicate the impact of flu and its complications in older adults, and to proactively discuss flu vaccination with their patients age 65 and older.

65+ Flu Defense is divided into several easy-to-use topic areas, including:

Two new patient handouts are also available on the website:

Be sure to check out the information and printable materials for your patients available on the website to help your efforts in protecting this vulnerable population.

American Lung Association Initiates New Consumer Flu Awareness Campaign, MyShot

Staff from the American Lung Association (ALA) will join the Summit call on November 1 to speak briefly about the new website, MyShot.

The ALA is urging adults 50 years of age and older to get their annual flu shot through its new MyShot campaign, which shares the personal stories of adults in their 50s, 60s and 70s, and why they prioritize getting a flu shot. MyShot stories illustrate the potential impact of flu (severe illness, worsening of chronic health conditions, hospitalization and leading to missed work days) on this vulnerable group. The campaign reinforces the need for adults 50 years of age and older to talk with their healthcare providers about flu shot options that may be right for them.

MyShot, a collaboration with Sanofi Pasteur, the vaccines division of Sanofi, speaks directly to adults 50 years of age and older, because by the time adults turn 50 they are more likely to have one or more chronic health condition such as lung disease, heart disease or diabetes. When combined with the flu, these conditions can become worse and lead to serious illness. Vaccination is the best way to help protect against the flu. Yet, despite these potential dangers, vaccination rates for those 50 years of age and older have stagnated, hovering around 45 percent for adults ages 50-64 and 65 percent for adults ages 65 and older.

A press release about the new campaign is available online.

CDC Expresses Concern over Mysterious Surge in Polio-like Paralysis Cases

CDC has expressed frustration and concern about a puzzling surge in cases of polio-like paralysis, mostly in children, being reported across the country this year.

The agency said 127 cases of acute flaccid myelitis (AFM) have been reported so far in 2018. To date, 62 of those cases, from 22 states, have been confirmed; investigations of the others are ongoing.

Here are some resources from the CDC:

Strategies to Eliminate HCV in Veterans: Webinar November 29

The National Viral Hepatitis Roundtable is pleased to announce an upcoming webinar to discuss chronic hepatitis C among U.S. veterans, a population that is disproportionately affected by the hepatitis C virus (HCV).

The event will feature presentations from the Veterans Healthcare Administration (VHA), the New England Center and Home for Veterans, and Boston Health Care for the Homeless. The webinar aims to provide an update on the VHA initiative to treat all Veterans living with HCV, discuss strategies to provide HCV treatment through the VHA and in community settings, and highlight programs to treat hard-to-reach Veteran populations.

ANNOUNCEMENTS

MIPS Quality Data Submitted via Claims: 2018 Performance Feedback

CMS updated the Quality Payment Program website so individual eligible clinicians who choose to submit their Quality performance category data via claims can access performance feedback for the 2018 performance year on an ongoing basis.

For more information:

2018 Claims Data Submission Fact Sheet
For questions, contact the Quality Payment Program Service Center or at 866-288-8292 (TTY: 877-715-6222)

CMS has Revised its Annual Wellness Visit Booklet

The revised Annual Wellness Visit Booklet is available. Learn about:

Health risk assessment
Initial and subsequent components
Coding, diagnosis, and billing

CMS Has Revised Its Initial Preventive Physical Examination Educational Tool

The revised Initial Preventive Physical Examination Educational Tool is available. Learn about:

Components
Coding, diagnosis, and billing

NEWS

CDC Influenza Updates

The FluView report for Week 41 (ending October 13, 2018) is available on CDC’s website. A synopsis of this report follows below:

Influenza activity in the United States remains low. Influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B viruses continue to co-circulate, with influenza A(H1N1)pdm09 viruses reported most commonly by public health laboratories during the most recent three weeks. The first influenza-associated pediatric death occurring during the 2018-2019 season was reported this week.

Below is a summary of the key influenza indicators for the week ending October 13, 2018.

Viral Surveillance: Influenza A viruses have predominated in the United States since the beginning of July. The percentage of respiratory specimens testing positive for influenza in clinical laboratories was low.
Virus Characterization: The majority of influenza viruses characterized antigenically and genetically are similar to the cell-grown reference viruses representing the 2018–2019 Northern Hemisphere influenza vaccine viruses.
Antiviral Resistance: All viruses tested since late May show susceptibility to the antiviral drugs oseltamivir, zanamivir, and peramivir.
Influenza-like Illness Surveillance: The proportion of outpatient visits for influenza-like illness (ILI) remained low at 1.4%, which is below the national baseline of 2.2%. All regions reported ILI below their region-specific baseline level.
ILI State Activity Indictor Map: New York City, the District of Columbia, and 49 states experienced minimal ILI activity, and Puerto Rico and one state had insufficient data.
Geographic Spread of Influenza: The geographic spread of influenza in Guam and two states was reported as local activity; the District of Columbia, the U.S. Virgin Islands and 40 states reported sporadic activity; eight states reported no activity; and Puerto Rico did not report.
Pneumonia and Influenza Mortality: The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold in the National Center for Health Statistics (NCHS) Mortality Surveillance System.
Influenza-associated Pediatric Deaths: One influenza-associated pediatric death that occurred during the 2018-2019 season was reported to CDC

Also available are CDC’s influenza summary and technical key points from October 19, 2018.

CDC Digital Media Toolkit on Influenza

CDC has issued a Digital Media Toolkit for the 2018–2019 influenza season.

Third Trimester Immunization with Tdap Vaccine Optimal for Pertussis Toxin Antibody Concentrations in Newborns

Immunization with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine during the third trimester of pregnancy is associated with higher concentrations of pertussis toxin antibodies in newborns compared with no immunization, according to a study published in JAMA. The full news story is available online.

Should Pregnant Women Get the Flu Shot?

Ah, fall—the season of apple picking, pumpkin spice, and…flu shots. The Centers for Disease Control and Prevention (CDC) recommend that every single person six months and older get the influenza vaccine every single year (barring those who are allergic to the flu shot itself, of course).

But here’s the thing: What if you’re pregnant? Children under six months shouldn’t get a flu shot, per the CDC—so…is it safe for moms with babies growing in their uteri to get the prick?

A full news story on this topic may be found in Women’s Health.

Ohio Mom Urges Families to Have Kids Vaccinated After 4-Year-Old Son Dies of the Flu

An Ohio mom is urging other families to have their children vaccinated against the flu after her 4-year-old son died from the disease. Anywhere from dozens to hundreds of children die from flu-related complications every year, the Center for Disease Control and Prevention (CDC) reports.

“That number doesn’t seem like a lot until it’s your child,” Laura Sidari told InsideEdition.com.

In Flu Epidemic, Vaccinating at Pharmacies Could Save $100 Billion

In the event of an influenza epidemic caused by a novel virus, vaccinating people at pharmacies in addition to traditional locations has the potential to alleviate up to 23.7 million symptomatic cases, saving society $99.8 billion and third-party payers $2.8 billion, researchers found.

According to Bruce Y. Lee, MD, MBA, associate professor of international health and director of operations research in the International Vaccine Access Center at the Johns Hopkins Bloomberg School of Public Health, pharmacies have not been a focus of vaccine distribution plans in any influenza pandemic, including the last one in 2009.

The full publication is available in Vaccine.

Novel DNA Vaccine Design Offers Broad Protection Against Influenza-A H3N2

Researchers developed a novel DNA influenza vaccine based on four micro-consensus antigenic regions selected to represent the diversity of seasonal H3N2 viruses across decades. The DNA vaccine protected mice against a lethal challenge with more than one influenza-A H3N2 virus and protected them from severe H3N2-related illness despite the lack of an exact sequence match between the vaccine immunogen and H3 immunogen. The findings are reported in a new Special Issue on DNA Vaccines in Human Gene Therapy.

Unvaccinated Child Dies from the Flu in Florida, First Pediatric Death of the Flu Season

An unvaccinated child in Florida died from the flu, officials said, marking the first pediatric death of the 2018–2019 flu season in the U.S. The Florida Department of Health announced the child’s death on Monday, but did not release their name, age, gender or location due to privacy issues; just that the child had not received a flu shot and did not have any other health issues, the New York Times reports.

The child died between Sept. 30 and Oct. 6, early in the flu season. Health officials found this unusual, as there have been no outbreaks and flu season typically peaks in the coldest months..

High-Dose Influenza Vaccination May Benefit Transplant Recipients

Double-dose influenza vaccine is safe and may increase antibody response in solid-organ transplant recipients, according to a study published in Vaccine.

Influenza infection increases the risk for bacterial pneumonia, intensive care admission, and death in patients who have received solid-organ transplants. Further, evidence links influenza infection with an increased risk for allograft rejection and inferior allograft survival. Thus, as a preventative strategy, an annual vaccination containing 15 µg of hemagglutinin antigen per viral strain is strongly recommended.

To improve vaccine immunogenicity in solid-organ transplant recipients, high-dose vaccine containing 60 µg hemagglutinin antigen per influenza strain enhances immunogenicity.

A news article on the study is available in Infectious Disease Advisor.

Forecasting the Shape of Flu Viruses to Come

The effort to pick new vaccines to block ever-evolving flu viruses requires both science and serendipity. Because it takes so long to manufacture the millions of doses required, world flu experts meet twice a year — six months in advance of flu season for the Northern and Southern hemispheres — to pick the best possible match of vaccine to virus. It is high-stakes, educated guesswork.

At Fred Hutchinson Cancer Research Center in Seattle, a team of scientists led by Drs. Jesse Bloom and Trevor Bedford is working to take some of the guesswork out of the process. The team is doing so via a deep analysis of the constant evolutionary changes in the flu virus and by building computer models to anticipate influenza’s next tricky move — like the way weather forecasters use computers to plot the most likely paths of hurricanes.

A publication and news story about this effort is available online.

Can an Influenza Vaccine Deliver Protection During a Mismatched Flu Season?

FluGen, Inc. announced in a press release that it has completed dosing in a first-of-its-kind clinical study which challenged subjects with an influenza virus that was intentionally mismatched by 6 years from the influenza strain utilized in its novel intranasal M2SR vaccine.

“This is a bold study which, if successful, would significantly advance our progress towards developing a flu vaccine which could provide broader protection against influenza,” said Dr. Robert Belshe, chair of the FluGen, Inc., clinical advisory board and the Diana and J. Joseph Adorjan Endowed Professor of Infectious Diseases and Immunology, Emeritus, at Saint Louis University.

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

Summit calls are held weekly on Thursday at 3 pm ET throughout the influenza season unless cancelled. Call information and an agenda generally are sent the morning of the 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.

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