Updated Vaccine Information Statements

Did you know that many Vaccine Information Statements were updated recently? This list below provides the current dates of VISs:

If your VISs are not current, these links will lead you to the current statements:

https://www.cdc.gov/vaccines/hcp/vis/index.html Is this CDCs main hub for Vaccine Information Statements. Find instructions for use, FAQs, and current statements here.

https://www.immunize.org/vis/ Provides quick links to all current VISs and access to multiple languages.

Vaccine Pins, Buttons, and Stickers

Immunization Action Coalition is offering several options to display your support for immunizations. The “Vaccines Save Lives” pin is black enamel with gold lettering and is small enough to fit on a lapel. Prices range from $20 for a single pin to $5.25 each when ordering 15 or more.

Flu Vaccine Buttons and Stickers are available for staff and patients. Order buttons for staff to show that flu vaccine is available in your clinic. Buttons are sold in bags of 10 and range from $20 for one bag to $55 for 10 bags. Purchase stickers for patients to wear after receiving their flu shot. Stickers are sold in bundles of 100 and range from $23 for one bundle to $67 for 10 bundles. All prices include shipping.

Visit https://www.immunize.org/shop/ for these and other immunization related products.

Creating a Culture of Immunization: Resources for Your Practice

All staff in a pediatric practice, including non-clinical staff, play an important role in supporting parents in their immunization decisions. Creating a culture of immunization in your office helps promote complete and timely immunizations. To that end, the CDC and Sanofi Pasteur have produced helpful resources to aid in building a pro-vaccination culture.

The CDC has created presentation available for download called “10 Ways to Create a Culture of Immunization Within Our Pediatric Practice.” The presentation is editable and designed to be customized by each medical practice. The objectives of the presentation are to enable office staff to

  • Understand why practices need a culture of immunization
  • Cite the practice’s current immunization coverage rates
  • Describe how all office staff play a part in creating a culture of immunization
  • Describe several ways to create a culture of immunization

The presentation is easy to customize and contains notes to help guide the discussion.

Another useful resource is the handout “Developing an Immunization Culture in Your Office” by Sanofi Pasteur. This handout breaks down broad ideas concerning immunization culture into succinct, actionable bullet points. It instructs staff to

  • Educate and Motivate Your Staff to Become Vaccine Advocates
  • Capture Every Opportunity to Immunize
  • Prioritize parental education and communication
  • Put technology to work as a tracking tool

Both of these resource will assist your practice in increasing immunization rates by creating an office-wide culture of vaccination.

2019/2020 Flu Immunization Guide

Flu vaccine efficacy varies from year to year depending on the similarity of the flu viruses the vaccine is designed to prevent and the flu viruses in the community. However, recent studies show that have supported the conclusion that flu vaccination benefits public health. The CDC recommends that everyone age 6 months and older receive a flu vaccine yearly by the end of October.  Benefits of vaccination include:

  • Preventing contracting the flu. In seasons where the vaccine is well matched, it reduces the risk of having to visit the doctor with flu by 40 percent to 60 percent.
  • Reducing the chance of flu-associated hospitalizations. Flu vaccines have reduced the number of adults hospitalized with flu by about 40 percent. A 2014 study showed the vaccine reduced the risk of flu-related pediatric intensive care unit admission by 74 percent.
  • Reducing the severity of flu if contracted. A 2018 study showed that among adults hospitalized with flu vaccinated patients were 59 percent less likely to be admitted to the ICU.

Fluzone Quadrivalent Influenza Vaccine is an injectable immunization approved for patients 6 months and up. Fluzone is an inactivated vaccine protecting against four strains of the flu. In addition, Fluzone is approved for pregnant women.

Another option for flu is FluMist Quadrivalent, which is a nasal-spray flu vaccine approved for ages 2 through 49. FluMist is a live attenuated influenza vaccine and is not for use in pregnant women.

Older Adults

For some, the flu is a mild illness. For older adults, especially those with chronic health conditions such as diabetes or heart disease, the flu can be far more serious. Older adults are at high-risk to develop serious complications from the flu such as pneumonia. It’s estimated that between 70 and 90 percent of flu related dates occurred in people over 65, and between 50 and 70 percent of seasonal-flu related hospitalizations occur in that age group. Adults age 50 to 64 can choose from any available flu vaccine. For adults 65 and older, the CDC recommends one of two vaccines developed specifically for that age group: the high dose flu vaccine and the adjuvanted flu vaccine.

The high dose vaccine, Fluzone High Dose, delivers 4X the amount of antigen as the regular dose Fluzone vaccine. Compared to Fluzone, Fluzone High dose provides between 24%1 and 51%2 better protection from influenza.

The adjuvanted vaccine, Flublok Quadrivalent, is approved for persons ages 18 and older. Flublok has 3X the HA of a standard-dose quadrivalent inactivated influenza vaccine. Flublock also prevents more cases of flu in adults 50+ than a standard-dose quadrivalent vaccine. People over 65 should talk to their doctor about the pneumococcal vaccination, which can help prevent pneumococcal pneumonia, a serious flu-related complication.

AAP Recommendations

Earlier this month, the AAP released their updated recommendations for the use of influenza vaccines and antiviral medications in children. These include no preference for the inactivated or live attenuated vaccine, updated guidelines for children receiving their first flu vaccine, and information about a new antiviral medication. The recommendations can be viewed online.

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1 24.2% Primary endpoint: the occurrence of laboratory-confirmed, protocol-defined, influenza-like illness caused by viral strains regardless of their antigenic similarity to vaccine components.

2 51.1% Secondary endpoint: the occurrence of culture-confirmed influenza caused by viral types/subtypes antigenically similar to those contained in the respective annual vaccine formulations in association with a modified Centers for Disease Control and Prevention-defined influenza-like illness.

Adolescent Immunization Resources

The Immunization Action Coalition and Sanofi Pasteur have collaborated a project to raise awareness of the low immunization rates for the meningococcal (MenACWY) vaccination. The project, titled “MenACWY: You’re Not Done if You Give Just One,” can be found at https://www.give2menacwy.org/ and contains a wealth of resources for medical practices.

The facts are stark: Meningococcal disease can be deadly, and survivors can suffer lifelong disabilities from contracting the disease. Unfortunately, the majority of administration opportunities are missed. Even during vaccine only visits, 86% of adolescents were not given MenACWY. 1

The recommended administration guidelines are to give the initial dose at 11-12 years of age and the second dose at 16 years of age. This factsheet provides important information about recommending and administering MenACWY.

Another helpful resource from the MenACWY project is the “Top 10 Ways to Improve Adolescent Immunization Rates” handout. The top 10 are:

  1. Immunize at every opportunity by considering every visit an opportunity to vaccinate.
  2. Use reminder and recall systems to automatically remind families of needed immunizations.
  3. Implement standing orders to allow nurses, pharmacists, and other healthcare personnel to vaccinate.
  4. Take part in an immunization registry to access comprehensive immunization records for every patient.
  5. Review your patients’ vaccination histories prior to visits and flag charts as indicated.
  6. Follow the U.S. recommended immunization schedule.
  7. Schedule vaccination-only quick visits to increase access for patients.
  8. Make vaccination education a priority, for parents as well as patients.
  9. Establish rapport with your adolescent patients by taking a nonjudgmental approach and being ready to listen and answer questions.
  10. Create a culture that values well-adolescent care by maintain the same set of high expectations you take with well-child visits.

Visit the “MenACWY: You’re Not Done if You Give Just One” website at https://www.give2menacwy.org/   for these and other great resources.

In the upcoming months, CPP will continue posting resources on increasing adolescent immunization rates and creating a culture of vaccination in your practice. Subscribe to our blog to stay up to date.

1. Wong CA. Taylor JA, Wright JA, et al. Missed opportunities for adolescent vaccination, 2006–2011. J Adolesc Health. 2013;53(4):492–497.

CDC Webinar – Strategies for Addressing Vaccine Misinformation in the Practice

On Wednesday, August 28, the CDC will be hosting a webinar from 1-2pm to assist providers in recommending vaccines and addressing vaccine hesitancy.

Speakers for the webinar include:

  • Dr. Amanda Cohn, Acting Chief Medical Officer, Vaccine Policy, Preparedness, Global Health, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention
  • Chanie Sternberg, President & CEO, RefuahHealth Center
  • Dr. Corinna Manini, Chief Medical Officer, RefuahHealth Center
  • Dr. Todd Wolynn, CEO, Kids Plus Pediatrics

RefuahHealth is a health center in New York that serves patients in communities affected by ongoing measles outbreaks. They have worked to cultivate trust with parents concerning the safety and efficacy of vaccines.

Follow this link for more information and to register. Don’t wait to register for this timely and relevant information. And stay tuned to the CPP Blog. In the next few months, we will be posting a series on addressing vaccine hesitancy in your practice. Subscribe to our blog to stay up to date!

2019-2020 Flu Season Coding Help

Sanofi Pasteur has put together a wealth of coding resources for the 2019-2020 flu season. Coding and billing for vaccinations can be complicated, so these resources are designed to save your practice time.

Coding Webinars

Sanofi has scheduled two webinars to assist in flu coding. One is targeted at coding for patients of any age, and the other is specifically for pediatric patients. The all ages webinar is scheduled for August 20 and September 12, 18, and 19. The pediatric webinar is scheduled for August 21 and September 10. The webinar will cover essential coding and billing information, Medicaid billing and VFC, Medicare billing, and payment benchmarks.

More information can be found here, and registration is available at http://www.crackingthecodestraining.com/

Coding Guides

Sanofi has put together two coding guides to help with this year’s influenza season. The first is The Code to Success: Your Complete Guide to Coding and Billing for Sanofi Pasteur Influenza Vaccinations. This detailed guide will help you understand coding and billing, roster billing, Medicare payment and timelines, and quality reporting measures.

The second guide, 2019-2020 Proper Codes of Sanofi Pasteur Products, includes product codes, NDCs in billing format, IDC-10 codes, administration codes, and CVX codes for each vaccine. It has been updated to include this year’s flu vaccinations.

We hope these resources help you have a successful flu season. As always, feel free to reach out to CPP for more information or to find out how we can save you money on your vaccine purchases.

Group purchasing: Save money by aligning with other physicians

Medical Economics recently published an article highlighting the benefits of partnering with a group purchasing organization (GPO) or physician buying group (PBG). Practices can expect savings ranging from 5 percent to 25 percent by joining such a group. Highlights include:

  • Don’t base your GPO choice on what your hospital uses. Physician offices have different needs than hospitals. Find a group that fits your specific needs.
  • Revisit pricing every year or two and compare groups. The needs of a practice can change over time, and there is no one size fits all solution.
  • Know the difference between a GPO and PBG. GPOs are membership organizations that offer discounts on most everything involved in a medical practice such as capital equipment, supplies, and services. PBGs also offer discounts on supplies and services, but they primarily serve as vaccine buying groups. Due to their vaccine focus, PBGs are able to provide superior pricing.
  • Let your vendors do the work of pricing. Put your top purchased items out for bid to ensure you are getting the best price.
  • Check if your distributor performs additional services like stocking and ordering supplies.

To read more, visit Medical Economics online.

CPP 2nd Dose Grant

This post is the second in a series on increasing adolescent immunizations. For a case study on how one health system increased their overall adolescent vaccination rates, see our previous post.

The CPP 2nd Dose Program provides an opportunity to examine your practice’s 2nd dose immunization rates for vaccines that require more than one dose to complete the series, access resources to help implement a strategy in your office to raise those rates, and share successful strategies with other CPP members. Applicable vaccines include meningococcal ACWY, HPV, adult pneumococcal and/or adult hepatitis B (Heplisav-B only). 

The tables below show immunization rates for these vaccines for the most recent year available from the CDC:

National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 Years—United States, 2017

Vaccine Coverage Among Adults in the United States, National Health Interview Survey, 2016

Participants in CPP’s 2nd Dose Program have already seen successes. Over 77% of member participants reported that their 2nd dose immunization rates were lower than they expected when they pulled the initial data from their EMR. After implementing an intervention in their practice to help improve these rates, participants saw a rise in their HPV and MCV4 completion rates by an average of 29% and 41%, respectively! 

Some best practices that were shared by the group include:

Check out the CPP 2nd Dose Program website for updated resources and details on how your practice can participate in this $1,000 grant opportunity!

How a Large Health System Increased Adolescent Vaccination Rates

This post is the first in a series on adolescent vaccination.

When Sanford Health, a rural not-for-profit health system based in the Dakotas, Minnesota, and Iowa, took a look at their adolescent vaccination rates, they were shocked by what they found. Baseline rates for the completion of the HPV series ranged from 15%-29% in their clinics, and rates for completion of the Meningococcal series ranged from just 8%-38%. Sanford decided to make system-wide changes to improve their adolescent vaccination rates.

Sanford began by creating an immunization strategy department lead by the Immunization Strategy Manager. A cross-department team gathered to form an enterprise immunization committee and craft a plan. The initial stage focused on increasing administration of the HPV vaccine at a test group of seven clinics. The strategy consisted of three parts:

  • Providers were given their immunization rates as well as those of their colleagues. This put accurate data into the providers’ hands and engendered a sense of competition between staff.
  • Sanford emphasized a “no missed vaccination opportunity” culture, encouraging providers to assess immunization status for every patient at every encounter.
  • The system sent reminder and recall letters to parents of adolescents.

Over the two year test period, HPV completion rates increased by an average of 15%, and zero-dose rates decreased an average of 22%. Armed with this data, Sanford made plans to expand the program. The organization added standing orders for most vaccines, enabling RNs, LPNs, and MAs to administer immunizations. These orders eliminated more missed opportunities and empowered staff to own their immunization rates.

Sanford, with the help of the Immunization Action Coalition and Sanofi Pasteur, also created a curriculum to train people to become immunization champions. The VAX Champ program created immunization champions content experts for each clinic. The program also trained its students to examine current vaccination rates and create plans to improve them. These interventions saw first and second dose rates for MenACWY climb steadily. In some clinics, second dose rates more than doubled.

Sanford Health’s efforts helped to not only increase adolescent vaccination rates but also advanced their mission to improve patient health. These steps can be applied to healthcare systems or offices of any size. Sanford’s success shows that with dedication and a solid plan adolescent immunization rates can improve.

Next in this series is a guide to CPP’s 2nd Dose Program that rewards members for improving second dose rates of several immunizations, including those that Sanford highlighted. For more information, visit our website.