October 29, 2014

[feather_share]

Summit Call Recap – October 23, 2014

Information from CDC

Announcements

SUMMIT CALL RECAP – OCTOBER 23, 2014

Influenza Surveillance Update – Sophie Smith (CDC)

Sophie provided a summary of the published reports for week 41, ending October 11. For week 41, all seasonal influenza indicators remain below baseline levels. Approximately 3.7% of specimens submitted for testing were positive, with a mixture of both A and B. The ILI-Net national data indicated 1.3% of total patient visits were for ILI, well below the national baseline of 2% and similar to the level reported during the previous week. No new pediatric deaths were reported during week 41.

As shown in CDC’s weekly influenza summary map, the geographic spread for influenza for week 41 is:

Widespread – Guam
Regional – none
Local – 4 states and Puerto Rico
Sporadic – 36 states and the District of Columbia, and the Virgin Islands
No activity – 10 states and the Virgin Islands

L.J noted that these fairly flat trends in influenza activity indicate that there’s still plenty of time to vaccinate!

IVATS Update – Diane Peterson (IAC)

Diane reported that the Influenza Vaccine Availability Tracking System (IVATS), which has been coordinated by the Immunization Action Coalition for the last 7 years, now incorporates information from fifteen vaccine distributors. The IVATS site includes a description of the system, a reporting and enrollment form for distributors and manufacturers, and a spreadsheet for providers indicating vaccine availability. IVATS is updated frequently; as we are approaching the height of the influenza season, the spreadsheet will be updated weekly. Diane and L.J reminded partners that participation in IVATS is completely voluntary. Distributors and manufacturers wishing to become part of the system should check the website for enrollment information.

**Influenza Vaccine Supply & Immunization NetConference – Carolyn Bridges (CDC)**

Carolyn reminded partners that CDC tracks and reports the total doses of seasonal influenza vaccine distributed. Through October 18, 117.8 million doses have been distributed. The site also contains trend data. This year’s level is slightly lagging behind the amount distributed by this time in recent years.

Earlier today (October 23, 2014) CDC conducted a Current Issues in Immunization NetConference (CIINC) covering the new pneumococcal vaccine recommendations and ways to improve overall adult vaccination coverage levels, including through implementation of the Standards for Adult Immunization Practice. Carolyn reminded callers that the information shared in today’s NetConference was very similar to information presented in late September during a call coordinated by the American Pharmacists Association. The link to the archived CDC NetConference on pneumococcal vaccines and on the adult vaccine implementation will be posted sometime in the next few weeks on the CIINC webpage.

Vaccine Finder #UberHealth – Jane Huston (HealthMap)

Jane provided a brief update on an exciting vaccine initiative being piloted today through a joint venture between HealthMap and Uber. From 10 am – 3 pm, users of “UberHEALTH” in New York City, Washington, DC, and Boston could text Uber to request a free flu shot. Uber drivers would then drive a registered nurse from the Passport Health and Pager programs to administer the vaccine to the person making the request.

This project began when HealthMap approached Uber about leveraging their driver network and mobile platform to increase influenza vaccine uptake. It also is hoped that this approach can serve as a model which can be applied in the future to other health situations, e.g., delivering antivirals to individuals during a pandemic. This potential led to the broad name of UberHEALTH being chosen for the activity.

During today’s pilot, persons could request flu vaccine for up to 10 people, as well as a flu prevention kit. The program was provided at no cost to the user, and, for every vaccine given, Uber was donating $5 to the Red Cross. Planners hoped to deliver at least 1,000 in each of the 3 cities, but they also had made preparations to deliver more vaccine if needed. Publicity about the event included links to the HealthMap Vaccine Finder site to provide information about vaccine availability for persons who were unable to use the Uber service.

Uber is known for conducting this type of special 1-day event. The desired element of surprise prevented HealthMap from sharing press releases, etc., that could have been used by partners to provide pre-event publicity. A Summit partner asked about the target audience for the program and whether Uber users would be more inclined to include the younger population we have trouble reaching with influenza vaccine recommendations. Jane responded that Uber has a wide range of users, though they definitely skew toward younger persons who are tech savvy.

Planners will analyze data from today’s event to determine whether the program will be repeated in other cities, for longer periods of time, etc. HealthMap will be sure to keep Summit members updated on the results of today’s event, as well as the potential for similar programs in the future.

Other Items – Litjen Tan (IAC)

Vaccine Supply Discussion

L.J facilitated a brief discussion about vaccine supply issues seen by partners. New York State noted they had seen early delays with MedImmune vaccine, and now Sanofi products. In particular, they were concerned about delays in the delivery of pediatric vaccine. As of this week, New York State has received only ½ of the amount of VFC vaccine needed.

Provider Workgroup Conference Calls on Immunization Information Systems

L.J reminded partners about a series of informational conference calls on vaccine documentation in immunization information systems (IIS) being presented by the Provider and Access & Collaboration Workgroups. During May’s face-to-face meeting, Summit members requested more information on this area. In addition, this should prove helpful in dealing with meaningful use requirements and approaching deadlines.

The call-in number for the calls is: 866-893-6258, passcode 6258038. The scheduled times and topics are:

— October 24, 12:30 pm ET – Alison Chi (American Immunization Registry Association) and Gary Urquhart (CDC, IIS Branch) will provide background information on IIS and how they can be used to improve adult immunization rates.

— November 5, 3:00 pm ET – Jim Daniel (Office of National Coordinator for Health Information Technology) will discuss IIS and meaningful use.

— November 6, 1:00 pm ET – This session will allow participants to discuss information heard on the prior calls and determine the next action steps for the Summit.

Persons with questions should contact Susan Farrall.

INFORMATION FROM CDC

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

The CDC weekly influenza surveillance report for week 42 (ending October 18, 2014) and region specific data are now available. During week 42, 5.3% 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 6.0% for week 42.

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 (P&I) mortality.

Two influenza-associated pediatric deaths were reported to CDC during week 42. One death was associated with an influenza A (H3) virus and occurred during week 40 (week ending October 4, 2014.) This is the first influenza-associated pediatric death reported for the 2014–2015 season.

One death was associated with an influenza B virus and occurred during the 2013–2014 season and brings the total number of reported pediatric deaths occurring during that season to 109.

Nationwide during week 42, 1.4% 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 October 18, 2014.

The FluView report for week 42 and archives of previous FluViews are available from CDC. CDC also has released seasonal influenza key points for October 24, 2014.

More information from CDC

Information on Vaccine Supply

— Seven influenza vaccine manufacturers have projected that as many as 151 million to 156 million doses of influenza vaccine will be available for use in the United States during the 2014–2015 influenza season.

> This projection is similar to that provided by manufacturers before influenza vaccine distribution began for this year, with the difference being that the high end of the range is reduced by approximately 4 million doses.

— Of the overall flu vaccine supply projected for the 2014–2015 season, manufacturers estimate that 76 million doses will be available as quadrivalent flu vaccines.

> Of the total quadrivalent flu vaccine supply, as many as 18 million doses of the nasal spray influenza vaccine (LAIV) have been projected by the manufacturer to be available.

— Some manufacturers have reported delays in shipments that were originally anticipated in early fall; including those who develop flu vaccine approved for children in the U.S.

— Despite these early season shipping delays, however, manufacturers anticipate the majority of their flu vaccine distribution will occur by the end of October. While this is slightly later than vaccine was shipped last year, it is not an unusual pattern for seasonal flu vaccine distribution overall.

— These delays may impact certain vaccine products more than others, thus impacting some providers more than others. We understand that this can be very frustrating for providers and their patients who are experiencing these delays.

— Manufacturers anticipate the majority of their flu vaccine distribution will occur by the end of October; however, some providers will continue to receive shipments beyond October.

— As of October 17, 2014, manufacturers reported having shipped 8 million doses of flu vaccine.

— Some points to keep in mind:

> All nasal spray flu vaccine offered during the 2014–2015 season will be quadrivalent vaccine.

> Both quadrivalent and trivalent flu shots will be available.

> Don’t delay getting a flu vaccine if you want a quadrivalent vaccine and it is not available. Most of the flu vaccine offered this year will be trivalent. The important thing is to get vaccinated against the flu.

> More quadrivalent flu vaccine is expected to be available during future seasons.

For the latest information on flu vaccine supply, including projections and doses distributed, visit CDC’s Seasonal Influenza Vaccine & Total Doses Distributed webpage.

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. The most recent version of CDC’s key points on EV-D68 (October 27, 2014) is available. CDC will be updating these regularly until the disease incidence has declined.

Updated Information on Neurologic Disease with Limb Weakness of Unknown Etiology
CDC has released up-to-date (October 23, 2014) key points 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 Perspective on 2009 H1N1 and Pregnant Women Published in NEJM
On October 9, 2014, a perspective piece by CDC experts Sonja Rasmussen, MD, MS and Denise J. Jamieson, MD, MPH was published in the New England Journal of Medicine. The perspective, entitled 2009 H1N1 Influenza and Pregnancy — 5 Years Later, explores what experts have learned about how the influenza virus affects pregnant women and their unborn babies since the 2009 H1N1 influenza pandemic. An interview with Dr. Rasmussen and Dr. Jamieson was also posted as a Medscape Expert Commentary. (log-in may be required)

CDC and Professional Medical Organizations Publish Joint Letter on Flu Vaccination and Pregnant Women
CDC and a host of professional medical organizations and public health partners have jointly published a letter to health care professionals encouraging flu vaccination in pregnant women to protect them and their unborn babies.

CDC Influenza Division Posts Q & A on Ebola and Influenza
CDC Influenza Division has posted a Q&A related to seasonal influenza and Ebola virus infection. The Q&A may be used to answer inquiries related to influenza and Ebola.

ANNOUNCEMENTS

New Application Form Now Available to Indicate Your Organization’s Official Support for the Standards for Adult Immunization Practice

Join the growing list of Summit partners who have formally endorsed the National Vaccine Advisory Committee’s Standards for Adult Immunization Practice. By submitting your organization’s information via the Summit’s NEW online application form, you agree to:

Announce your support of the Standards via regular communication channels;

Identify one or more actions your organization is taking/can take to enhance adoption the Standards by your members.

While visiting the website, be sure to check out the actions the currently listed partners are undertaking. These can provide great ideas for similar activities that might work in your organization.

First Serogroup B Meningococcal Vaccine Approved by FDA

On October 29, the FDA announced that it has approved the first vaccine to prevent serogroup B meningococcal disease. Trumenba (Pfizer) is licensed for individuals 10–25 years of age. The manufacturer has issued a press release outlining the FDA approval.

Age Indication Expanded for Flublok Vaccine

On October 29, the FDA approved Flublok influenza vaccine for all adults 18 years of age and older. This expands upon Flublok’s previous indication for ages 18 – 49 years.

Australia’s CSL Buys Novartis Influenza Vaccine Unit for $275 Million
(from Reuters, October 26, 2014)

Australia’s CSL Ltd, the world’s largest blood products company, said on Monday it had agreed to buy Novartis AG’s global influenza vaccine business (announcement letter and press release) for $275 million.

Combining the Novartis unit with CSL subsidiary bioCSL will create the No.2 player in the $4 billion global influenza vaccine industry, CSL said in a statement to the Australian stock exchange. CSL said it would fund the deal with surplus cash and estimated integration costs at $100 million, while synergies were seen at $75 million a year by 2020.

Webinar on November 4: Immunization Laws – Impact of Non-Medical Exemptions

The Network for Public Health Law and The Immunization Partnership will present the following webinar:

Immunization Laws: Impact of Non-Medical Exemptions
Tuesday, November 4 @ 1 pm ET

Immunizations are one of the most significant public health accomplishments of our time, preventing millions of cases of diseases globally every year. All 50 U.S. states have adopted compulsory immunization laws for school children and also established some type of exemption for the immunizations. The types of exemptions include medical, religious, and philosophical or personal belief exemptions. In recent years there has been an increase in the number of parents seeking exemptions from vaccines for personal beliefs, leading to concerns from those in public health about the potential spread of vaccine-preventable diseases. Learn about the history of this movement, the impact of non-medical exemptions, and the development of a collaborative effort to address this important issue.

Presenters:

Allison N. Winnike, J.D., Research Assistant Professor, Health Law & Policy Institute at the University of Houston Law Center

Dorit Rubinstein Reiss, Ph.D., Professor of Law at the University of California Hastings College of the Law

Anna Draegsback, J.D., President and CEO at the Immunization Partnership

Moderator:

Daniel G. Orenstein, J.D., Deputy Director, Network for Public Health Law – Western Region at the Sandra Day O’Connor College of Law at Arizona State University

This webinar is free to attend, and registration is available on the website indicated above. Please help spread the word!

**PKIDS presents Your Choice for Teens and Young Adults!**

Babies and little kids rotate in and out of pediatricians’ offices for years to complete their scheduled immunizations. On the other end of the age range, grandmas and grandpas are sure to immunize as recommended to boost their waning immune systems.

But, when it comes to older teens and 20-somethings, proactively calling a provider or stopping at a clinic to see if any immunizations are needed—well, that thought doesn’t always occur.

As a reminder, PKIDs’ Your Choice campaign brings together all of the information teens and young adults need to make a choice to protect themselves against preventable infections.

The information is presented through whiteboard animation, videos, blog posts, posters, FAQs, and print ads, and all created for consumption by this particular age group.

“There’s a checklist of immunizations our young people should have which can be found on the Your Choice webpage,” said Trish Parnell, director of PKIDs (Parents of Kids with Infectious Diseases). “They need to make sure they received all of their childhood immunizations, and if not, get caught up. Plus, get the recommended immunizations for their age group and for their personal risk factors.”

Immunization is a way to prevent infections, and just as critical to good health as clean hands. For more information on disease prevention through immunization, visit Your Choice, the Centers for Disease Control and Prevention, and the Immunization Action Coalition.

Anyone may use the materials to promote vaccination in their clinic or on their websites/social media sites.

CIIC Shareable Social Media Flu Visuals.

With flu season underway, the Childhood Influenza Immunization Coalition (CIIC) is excited to share a new tool with its partners to encourage them to help spread the message about the importance of vaccinating children against flu each year.

CIIC has created a series of 12 visuals, Flu Fact of the Week, that can be accessed and shared online. They encourage you to share these throughout the season, along with the sample social media content below. Make sure to tag CIIC on Twitter at @NFIDvaccines and on Facebook at Childhood Influenza Immunization Coalition.

If you have any questions or need additional assistance, please email Ellyn Terry or call her at 301-656-0003.

Sample Social Media Posts:

RT to share Flu Fact of the Week to raise awareness during #flu season! #FightFlu http://bit.ly/ZO2h5n

We’re 100% committed to childhood #vaccination this #flu season. http://on.fb.me/1rerIZI

Have you gotten your #flu #vaccine this season? Learn more with Flu Facts of the Week. #FightFlu http://bit.ly/ZO2h5n

Get in the know about #flu with the Flu Fact of the Week. #FightFlu http://bit.ly/ZO2h5n

Follow the Childhood Influenza Immunization Coalition to learn more about #flu #vaccination: http://on.fb.me/1rerIZI

NAIIS initiative on Immunization Documentation: Three-Part Series for Provider and Access Workgroups and Other Interested Persons

Dial-in: 1-866-893-6258
Passcode: 6258038#

PART ONE: Documenting Vaccinations in Immunization Information Systems (IIS)
October 24, 2014 – 12:30 to 1:30 pm ET

Informational presentation on:
> Examples of how systems or states or practices have used immunization information systems to improve adult immunization rates.

Speakers:
Alison Chi, American Immunization Registry Association (AIRA)
Amanda Bryant, CDC’s Immunization Information Systems Branch

Participants are encouraged to bring their own examples of how immunization registries have helped improve adult immunization rates in their settings. There will be a Q&A segment at the end.

PART TWO: Immunization Registries and Meaningful Use
November 5, 2014 – 3 pm ET

Informational presentation on:
> The landscape of health IT as it relates to adult immunization.

> What is meaningful use and how is it working?

> How are immunization information systems being used to achieve meaningful use?

> Highlights from ASTHO’s IIS Interstate Data Sharing Meeting

Speakers:
Jim Daniel, Office of the National Coordinator for Health Information Technology
Kim Martin, ASTHO

PART THREE: Discussion Session on IIS and Health IT with Provider Workgroup and Access Workgroup
November 6, 2014 – 1 pm ET

Discussion Session Focus:
Following the two informational presentations from Parts One and Two, the Access and Provider workgroups will have the opportunity to discuss issues related to immunization documentation and identify potential action steps that the Summit can take.

For further information, contact Susan Farrall.

APIC Launches Website on EV-D68

The Association for Professionals in Infection Control and Epidemiology (APIC) has established a website with information on Enterovirus D68. The content is reproduced here:

What is enterovirus D68?
There are more than 100 types of enteroviruses. Enterovirus D68 (EV-D68) is a non-polio enterovirus. Uncommonly reported in the U.S., this virus was first identified in California in 1962.

What are the symptoms of EV-D68 infection?
Mild to severe respiratory symptoms are associated with the EV-D68 infection, including fever, runny nose, sneezing, coughing, and body and muscle aches.

How does the virus spread?
Similar to other cold and flu viruses, EV-D68 spreads from person to person when an infected person coughs, sneezes, or touches contaminated surfaces.

How many people in the United States have been confirmed to have EV-D68 infection?
From mid-August through October 15, 2014, the Centers for Disease Control and Prevention and state public health facilities have confirmed a total of 780 cases of respiratory illness caused by EV-D68 in 46 states and the District of Columbia.

Who is at risk?
EV-D68 primarily affects infants, children, and teenagers because they do not have immunity from previous exposure to these viruses. Children with asthma have a higher risk for severe respiratory illness.

How is it diagnosed?
EV-D68 is diagnosed only through specific tests on specimens from a person’s nose and throat.

What are treatments?
There are no specific treatments other than over-the-counter medications for pain and fever. As usual, aspirin should not be given to children. Some people with severe respiratory illness may need to be hospitalized. Currently, there are no antiviral medications available to treat EV-D68.

How can I protect myself?

> Wash your hands often with soap and water for at least 15 seconds.

> Avoid touching eyes, nose, and mouth with unwashed hands.

> Avoid kissing, hugging, and sharing cups or utensils with people who are sick.

> Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.

> Cover your cough and sneezes with a tissue or your shirt sleeve, don’t use your hands. If you do use your hands, make sure you promptly wash your hands to avoid spreading the germs to yourself, others, and the environment.

> Stay home when you are sick!

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. There will NOT be a Summit call on Thursday October 30, 2014 due to the ACIP meeting. Please email L.J Tan or LaDora Woods if you have any updates on activities to provide to the Summit.