September 13, 2016

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SUMMIT CALL RECAP – September 08, 2016

Special Announcement – L.J Tan (IAC)

The upcoming National Vaccine Advisory Committee (NVAC) meeting has been moved to September 20 and will last only one day. Angela Shen, co-chair of the Summit’s Quality and Performance Measures Workgroup, will be making a presentation during the meeting.

Influenza Surveillance Update – Stacy Davlin (CDC)

Sophie provided a summary of the published reports for week 35, ending September 3, 2016.

Influenza activity in the U.S. continues to remain low. Clinical lab percent positives have increased slightly in the past two weeks, with 1.5% of specimens submitted found to be positive. Influenza A viruses were most common during week 35, with H1N1 viruses predominating for the overall season. At 0.9%, influenza-like illness (ILI) activity were ingwell below the national baseline of 2.1% for the week.

The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold for both the NCHS and 122 Cities Mortality Reporting System.

No additional influenza-associated pediatric deaths was reported to CDC during the week, with a total of 85 pediatric deaths reported during the 2015–2016 season. Of the 71 for whom vaccination status was known, 5 were ineligible for vaccination due to age and 18 were fully vaccinated according to ACIP recommendations.

During the summer CDC’s reporting is abbreviated from the amount of data provided during the height of the influenza season. Therefore, data is not available on several of the reports routinely provided, including geographic spread, hospitalization rates, antiviral resistance, and antigenic characterization.

Technically, the 2016–2017 influenza season begins on October 1. Partners were encouraged to stress the importance of following the ACIP recommendations and be vaccinated as soon as vaccine is available.

Influenza Workgroup: Checklist of Best Practices and Pledge – Amy Behrman (ACOEM) and Amy Parker Fiebelkorn (CDC)

Amy and Amy presented information on two new items, Checklist of Best Practices for Vaccination Clinics Held at Satellite, Temporary, or Off-Site Clinics and Pledge for Organizations Implementing Vaccination Clinics Held at Satellite, Temporary, or Off-Site Clinics, which have been posted to the Influenza Workgroup page on the Summit website. They asked partners to use these tools and share them widely, as appropriate. They also asked that partners who have used the Checklist to complete a short survey designed to help gauge the usefulness of this new tool. Comments also can be submitted through the email address listed on the website.

L.J mentioned that another new tool on the website is the Editorial Calendar developed by members of the former Patient Education Workgroup. Although this Workgroup has now been disbanded, the Summit Organizing Committee will continue to ensure that communications about the Calendar continue to be shared with the entire Summit.

SUMMIT CALL RECAP – August 25, 2016

Influenza Surveillance Update – Stacy Davlin (CDC)

Sophie provided a summary of the published reports for week 33, ending August 20, 2016.

Influenza activity in the U.S. continues to remain low. Overall clinical lab percent positives were similar to the previous week, with 0.9% of specimens submitted found to be positive. The majority of the small number of influenza specimens submitted for the week were influenza A, predominantly A H1N1. ILI-Net national data indicated 0.6% of total outpatient visits were for influenza-like illness (ILI), which is well below the national baseline of 2.1%.

Seven (7) human infections with influenza H3N2v were reported during this period. Four of these infections were reported from Michigan, and the remainder were from Ohio. All cases were associated with exposure to swine in fair settings. During August, a total of 18 H3N2v cases were reported, with 12 from Michigan and 6 from Ohio. One person has been hospitalized. No human-to- human transmission has been found among these cases.

The proportion of deaths attributed to pneumonia and influenza (P&I) was below the system-specific epidemic threshold for both the NCHS and 122 Cities Mortality Reporting System.

No influenza-associated pediatric deaths were reported to CDC during week 33. A total of 85 pediatric deaths have been reported during the 2015–2016 season. Of the 71 for whom vaccination status was known, 5 were ineligible for vaccination due to age and 18 were fully vaccinated according to ACIP recommendations.

One Summit member asked about CDC’s plans to publish a table showing vaccine by indication. We note that IAC has this information here.

Upcoming Events and CDC Influenza Season Campaign – Sydney Devine (CDC)

Sydney provided a brief overview of CDC’s upcoming influenza campaign plans. Just prior to today’s call, CDC released the Prevention and Control of Seasonal Influenza with Vaccines Recommendations of the Advisory Committee on Immunization Practices —United States 2016–17 Influenza Season.

On September 29, CDC will partner with NFID for the annual influenza season kickoff press conference in Washington, DC. Dr. Frieden will join other experts participating in this event. At the same time, CDC will release two MMWR reports providing coverage rates for the 2015–16 season for the general population and for adults. Additional information will be forthcoming from NFID. A radio media tour will follow the press conference. Summit members are encouraged to share information about these events using #fightflu.

CDC’s campaign will target parents of children 6–11 months of age and older adults. The campaign will stress empowerment, containing messages such as “You have the power to protect your children and your family from the flu.” Healthcare personnel (HCP) will be targeted with messages stressing “You have the power to protect your patients.”

Additional planned activities include a Twitterchat on October 18 with Dr. Richard Besser of ABC News, as well as observance of National Influenza Vaccination Week (NIVW) on December 4–10. CDC established this annual event to highlight the importance of continuing flu vaccination through the holiday season and beyond. In conjunction with NIVW, CDC will release early coverage data for HCP, pregnant women, and the general population.

A full review of the campaign plans was provided during a VICNetwork webinar, Looking Ahead to the 2016–2017 Flu Season, Vaccine Options and Messages, scheduled for August 30.

Influenza Workgroup Checklist of Best Practices and Clinic Pledge – Amy Behrman (ACOEM)

The Summit’s Influenza Workgroup was charged with developing materials for best practices, especially in non-traditional locations such as workplace and temporary or off-site clinics. The workgroup recognized that recommendations on best practices for vaccine storage and administration were crucial to this mission, particularly in light of reported errors which occurred in non-traditional clinic settings during the 2015–2016 season. The workgroup concluded that employers and community groups would benefit from user-friendly tools that would provide training materials on these issues. They have spent the last year collaborating with public health experts, meeting with occupational health directors, and industry contractors to develop two new tools which have just been posted to the Summit website.

Checklist of Best Practices for Vaccination Clinics Held at Satellite, Temporary, or Off-site Locations
This six-page, step-by- step guide was developed for persons who are coordinating or supervising a clinic. It covers vaccine shipment, transport, storage and handling, preparation, administration, storage and handling after the clinic, and adverse event follow-up. It concludes with a user-friendly listing of links to CDC and IAC resources.

Pledge for Organizations Implementing Vaccination Clinics Held at Satellite, Temporary, or Off-site Locations
This pledge is to be completed and submitted annually by organizations that conduct clinics. It refers to and summarizes the principles of the Checklist. Organization completing the pledge will be identified on a Summit “supporting organizations” webpage.

Amy concluded by thanking everyone involved in this immense effort, including many CDC SMEs.

Other Items – L.J Tan (IAC)

The 47th National Immunization Conference will be held at the Hilton Hotel in Atlanta on September 13-15, 2016.

SPECIAL ANNOUNCEMENTS

2017 National Adult and Influenza Immunization Summit

Mark your calendars! The 2017 NAIIS in-person meeting will be held May 9–11, 2017 at the Hyatt Regency hotel in Atlanta, Georgia.

Alliance for Aging Research and the National Association of Area Agencies on Aging Webinar – September 15, 2016

Join the Alliance for Aging Research and the National Association of Area Agencies on Aging (n4a) at a webcast kickoff about a new FREE community leader kit: Our Best Shot: The Importance of Vaccines for Older Adults.

The organizations have created an easy-to- use, soup-to- nuts kit with all of the resources you need to conduct a successful workshop on vaccination in older adults. Hear from leaders who have already used this kit and can offer tips on using the resources, including the:

Leader’s Guide with tips and instructions on conducting the workshop
Short “pocket film’ highlighting how vaccines work and why they are important for older adults
Educational patient brochure that reinforces content covered during the workshop
Participant quizzes and answer sheets covering important points from the workshop
Slide presentation to use throughout the workshop to guide content and discussion.

Banners are also available for the Twitter Chat with the National Association of Area Agencies on Aging on Thursday, September 22 at 1 p.m. EST. They will be listing experts to participate, including Dr. Nancy Messonnier from the CDC. Let the Alliance know if your organization has an expert that would be willing to participate. Visit the Alliance’s resource page to see/download the vaccine pocket film and other materials.

NFID Announces Thunderclap to Coincide with its Influenza/Pneumococcal National Media Briefing

The Centers for Disease Control and Prevention (CDC) and the National Foundation for Infectious Diseases (NFID) have launched a Thunderclap campaign to coincide with the 20th Annual NFID Influenza/Pneumococcal News Conference scheduled for September 29, 2016. NFID encourages you to support the #FightFlu initiative hosted by the @CDCFlu Twitter account. You can sign up to participate any time before September 29 at 10:30 AM ET—but why not do it now while you’re thinking about it?

Additional information for those new to Thunderclap is available online. Email CDC if you have any other questions about the campaign.

Once you’ve participated, please help spread the message even further:

Share with your friends and followers and encourage them to do the same.
Then, watch on September 29 as #FightFlu participants proclaim in unison their support for annual flu vaccination.

NVAC Meeting Now Scheduled for September 20, 2016

Please note that the National Vaccine Advisory Committee meeting is now on September 20, 2016 and is now a one-day meeting.

INFORMATION FROM CDC

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

The CDC weekly influenza surveillance report for week 35 (ending September 3, 2016) and region specific data are now available.

NCHS mortality surveillance data for week 33 (ending August 20, 2016, but available September 8, 2016) indicate 5.1% of deaths were due to pneumonia and influenza (P&I). This percentage is below the epidemic threshold of 6.0% for week 33. Region and state-specific NCHS data are available online.

During week 35, 5.2% of all deaths reported through the 122 Cities Mortality Reporting System were due to P&I. This percentage was below the epidemic threshold of 5.7% for week 35.

May 15–21, 2016 marks the final full influenza surveillance report for the 2015–2016 influenza season in the United States. Influenza surveillance in the U.S. will continue through the summer months with condensed reports available on the FluView website. Full publication of the complete FluView resumes on October 14, 2016.

No influenza-associated pediatric deaths were reported to CDC during week 35. A total of 85 influenza-associated pediatric deaths have been reported during the 2015–2016 season. More detail is available on CDC’s Influenza-Associated Pediatric Mortality webpage.

The Influenza Hospitalization Surveillance Network (FluSurv-NET) conducts population-based surveillance for laboratory-confirmed influenza-related hospitalizations in children younger than 18 years of age (since the 2003–2004 influenza season) and adults (since the 2005–2006 influenza season). Influenza hospitalization rates and virus characterization are available on the FluSurv-NET website.

Nationwide during week 35, 1.1% 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 May 21, 2016. Resumption of this reporting will occur in October 2016.

The final CDC/Influenza Division Weekly Influenza Surveillance Report (FluView) was issued on Week 20, and the final seasonal influenza key points document for the 2016–2017 influenza season was provided on May 27, 2016. After that point, seasonal influenza key points will no longer be released on a fixed schedule, but will be issued as they are warranted, such as in conjunction with the release of important flu-related publications or guidance or unexpected increases in flu activity. Full reporting for the 2017–2018 influenza season will begin in mid-October 2017, and will appear in FluView. Archives of previous FluViews are available online.

Novel Influenza Infections

No additional human infections with novel influenza A viruses were reported to CDC during week 35. To date, a total of 18 (Michigan [12] and Ohio [6]) human infections with H3N2v viruses have been identified during 2016, all reported during the month of August. One of the 18 persons were hospitalized as a result of H3N2v illness. No deaths have occurred. All variant virus infections have been associated with swine exposure in fair settings and no human-to- human transmission has been identified.

Early identification and investigation of human infections with novel influenza A viruses are critical to ensure timely risk assessment and so that appropriate public health measures can be taken. Additional information on influenza in swine, variant influenza infection in humans, strategies to interact safely with swine, and CDC talking points are available.

CDC Publishes Teen Immunization Coverage Data

On August 25, 2016, CDC announced results of the 2015 National Immunization Survey-Teen (NIS-Teen) in the Morbidity and Mortality Weekly Report. The results of this survey show that – while occurring at a slow pace – HPV vaccination is becoming more routine. Nationally, six out of 10 teen girls (63 percent) and five out of 10 teen boys (50 percent) have started the HPV vaccination series (i.e., received at least one dose of HPV vaccine), according to data from this report.

While we’re making incremental progress at protecting boys and girls through HPV vaccination, we still have a long way to go to protect our nation’s youth from HPV cancers. CDC awardees and partners are critical to raising awareness about the importance of vaccination, so CDC has attached some materials to assist with your communication efforts. Materials include:

MWWR article: National, Regional, State, and Local Area Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2015
Summary page on HPV Vaccination Coverage
Infographic: HPV Vaccination Coverage Maps

If you have any questions or would like any additional information, contact PreteenVaccines@cdc.gov for more information

CDC Clinician Outreach and Communication Activity (COCA) Information

Seasonal Influenza

Information for Health Professionals – (CDC)
The pages listed offer public health and health care professionals key information about vaccination, infection control, prevention, treatment, and diagnosis of seasonal influenza.

Weekly U.S. Influenza Surveillance Report: FluView – August 27 (CDC)
FluView is a weekly influenza surveillance report prepared by CDC’s Influenza Division. All data are preliminary and may change as CDC receives more reports.

Planning and Preparedness: Health Professionals and Seasonal Flu – (HHS)
Healthcare providers play an important role during flu season. The guidance and information available on this website will assist healthcare providers and service organizations to plan and respond to seasonal flu.

CDC Science Clips: Volume 8, Issue: 34 (September 13, 2016)
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.

Upcoming and Recent COCA Webinars/Calls

Zika Update: Clinical Laboratory Testing and Care of Infants with Congenital Zika Virus Infection
During this COCA Call, clinicians learned about these updated interim clinical guidelines, which include evaluation and management recommendations. This information can help pediatric healthcare providers better understand the appropriate tests and clinical approaches for evaluating and managing infants, born to mothers in the United States and its territories, with laboratory evidence of Zika virus infection.

Archived COCA conference calls are available, and free continuing education credits (CME, CNE, ACPE, CEU, CECH, and AAVSB/RACE) are available for most calls.

CDC Learning Connection

The CDC Learning Connection is your source for information about public health training developed by CDC, CDC partners, and other federal agencies. Through website features, social media, and an e-newsletter, CDC Learning Connection keeps you informed about training opportunities, including many that offer free continuing education (CE).

ANNOUNCEMENTS

Summit Influenza Workgroup Develops Checklist for Offsite Vaccination Clinics and Pledge for Providers of Offsite Vaccinations

Satellite, temporary, and off-site vaccination clinics play an important role in improving vaccination coverage rates and vaccinating hard-to- reach populations. However, vaccination clinics held in these settings also have unique challenges.

In an effort to standardize the process of holding clinics in these non-traditional settings, the Summit Influenza WG has developed a checklist and created a pledge for organizations that adhere to the checklist. For individuals who have used the checklist, the WG asks that you consider completing a short survey so that they can improve the checklist. The survey should take less than 5 minutes to complete.

NFID Plans ABC News/NFID/CDC Twitter Chat on Flu Prevention

Please join the National Foundation for Infectious Diseases (NFID) and the Centers for Disease Control and Prevention (CDC) on Tuesday, October 18, 2016 at 1:00 PM ET for the upcoming ABC News Twitter chat focused on Flu Prevention.

They would love to have you join the conversation! Richard Besser, MD, ABC chief health and medical editor, will moderate the discussion about flu prevention and this year’s flu season. Researchers, clinicians, bloggers, and patients themselves are encouraged to join the flu conversation. If you have interested colleagues, please let them know that they are welcome to join as well.

Details
Tuesday, October 18, 2016
1:00-2:00 PM ET
Hashtag: #abcDRBchat
Moderator @abcDRBchat

Let your followers know that joining the Twitter chat is easy. This link explains how to join the chat in 3 easy steps:

Step 1: Go to Twitter
Step 2: Search for the hashtag #abcDRBchat
Step 3: Follow the conversation — or chime in when you've got something to add! Tweet comments, facts, images, videos, vines as often as you like! Be sure to use the hashtag (#abcDRBchat) and the “T” for topic in each tweet. Please note that topics are not available ahead of the chat.

Feel free to share this information widely!

Summit’s Updated Editorial Calendar

The Summit’s Patient Education Workgroup maintains an editorial calendar of immunization-related events. This calendar will be updated regularly, so please feel free to send any information of upcoming events to L.J Tan or LaDora Woods.

The Hill Publishes the Adult Vaccine Access Coalition Op-Ed on Quality Measurement and Adult Vaccines

Consider the following numbers: 49,000. 200,000. 10.4 billion. 1.

49,000 is the number of deaths each year in the United States due to flu-related complications.
200,000 is the number of annual flu-related hospitalizations.
10.4 billion dollars is the annual cost to the US healthcare system due to flu.
And 1 is the vaccine recommended annually for all individuals age 6 months and older to prevent flu.

Then why is it less than half of Americans get the flu vaccine each year? Find out in a must read op-ed published in The Hill, by Michael Hodin, Ph.D, CEO of the Global Coalition on Aging, and William Schaffner, M.D., Medical Director of the National Foundation for Infectious Diseases and professor of preventive medicine at Vanderbilt University’s School of Medicine.

UNITY Consortium Reveals New Adolescent Vaccination Infographic

Every year, tens of thousands of individuals get sick from diseases that could have been prevented by vaccines. As children move into adolescence and gain new independence, parents sometimes feel they have less influence over their child's behaviors and decisions. But research shows parents play an important role in helping their children form and maintain healthy habits as they transition into adolescence and adulthood. UNITY has developed a factsheet that provides tips to help parents communicate with their teen, and empower teens to be more active in managing their own health.

Could Influenza Vaccination Prevent More Than Just the Flu?

Currently, only low-quality evidence exists to support efficacy of influenza vaccination to prevent seasonal influenza in patients with diabetes. There is even less information regarding the impact of influenza vaccination on cardiovascular events or all-cause mortality in this population. A recent study published in the Canadian Medical Association Journal was designed to evaluate the impact of seasonal influenza vaccination on admission to the hospital for acute myocardial infarction, stroke, heart failure, or pneumonia, and all-cause mortality in patients with type 2 diabetes.

Conducted over a 7-year time period from 2003–2009, the study analyzed retrospective patient data from the Clinical Practice Research Datalink in England. The analysis included 124,503 adult patients diagnosed with type 2 diabetes. At baseline, characteristics such as age, sex, smoking status, BMI, cholesterol labs, HbA1c, blood pressure, medications, and comorbidities were compared between patient groups. Vaccination rates of the included participants ranged from 63.1% to 69.0% per year. In general, unvaccinated participants were younger, had lower rates of pre-existing comorbidities, and were taking fewer medications.

Antibody Discovery Could Help Create Improved Flu Vaccines

Dana-Farber Cancer Institute investigators report they have discovered a type of immune antibody that can rapidly evolve to neutralize a wide array of influenza virus strains — including those the body hasn't yet encountered.

The novel infection-fighting protein, named 3I14 mAb, is a “broadly neutralizing antibody,” so-called because it can recognize and disable a diverse group of the 18 different strains of influenza virus that circulate around the globe. Marasco reported the discovery of broadly neutralizing antibodies in 2009. According to the new report, the 3I14 antibody demonstrated it could neutralize the two main types of influenza A virus, group 1 and 2, and protected mice against lethal doses of the virus.

An additional story is available online.

Mortality Risk Greater for Children Hospitalized with Influenza B vs Influenza A

Although morbidity rates for children hospitalized with influenza A and B infections were similar, those with influenza B had twice the risk for influenza-attributed death and should be targeted for vaccination, according to results of a Canadian study. An additional story is available online.

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.

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 now scheduled every Thursday at 3 p.m. Eastern time, unless cancelled. The next call is scheduled for September 22. Please email L.J Tan or LaDora Woods if you have any updates on activities to provide to the Summit.

Summit Call Recap – September 8, 2016

Summit Call Recap – August 25, 2016

Special Announcements

Information from CDC

Announcements

SUMMIT CALL RECAP – September 08, 2016

SUMMIT CALL RECAP – August 25, 2016

SPECIAL ANNOUNCEMENTS

INFORMATION FROM CDC

ANNOUNCEMENTS