AAP: No flu preference for 2020-21 season

In March of this year, the AAP released a statement saying that once again pediatricians can use either flu shots or nasal spray flu vaccines for their patients. This guidance applies to the 2020-21 flu season, and is the same recommendation issued for the 2019-20 season. The AAP and CDC did not recommend using the nasal spray in 2016-17 or 2017-18 due to poor effectiveness against H1N1 strains. LAIV manufacturer AstraZeneca has since changed the formulation of the vaccine.

According to a report issued by the CDC in April, 166 children died during the 2019-20 flu season. The CDC estimates about 39 million people have gotten sick with flu, 410,000 have been hospitalized and 24,000 have died this season. Hospitalization rates for children remain unusually high. Children ages 4 and under have been hospitalized at a rate of 94.1 per 100,000 children, the highest the CDC has on record for this age group. Last season’s vaccine was 55% effective for children and teens according to the CDC.

CDC Pink Book Webinars 2020

Beginning July 1, the CDC is offering weekly one-hour videos that provide an overview of vaccination principles, general best practices, immunization strategies, and specific information about vaccine-preventable diseases and the vaccines that prevent them. Each video will also include recent updates from the Advisory on Immunization Practices meetings.

The intended audience is all immunization providers, and continuing education will be available for each video. Due to COVID-19, the videos will be on demand and prerecorded rather than live. No registration is required, and videos will be released on Wednesdays through October 14. Videos can be accessed here.

The 2020 release schedule is below:

DateTopic
July 1Principles of Vaccination
July 8General Best Practice Guidelines, Part 1
July 15General Best Practice Guidelines, Part 2, and Vaccine Safety
July 22Immunization Strategies
July 29Vaccine Storage and Handling and Vaccine Administration
August 5DTaP/Tdap
August 12Rotavirus and Hepatitis A
August 19Meningococcal Vaccine
August 26Mealses, Mumps, Rubella

WellConnect Automated Patient Reminders

With the current challenges of getting patients back into the office, it’s a great time to look into resources to help connect with families. Sanofi Pasteur offers a helpful tool to deliver important reminders to your patients. WellConnect is available at VaccineShoppe.com and has both text and voice messaging capabilities.  Sanofi Pasteur created a helpful information sheet.

WellConnect can be used for:

  • Flu and other immunization reminders
  • Patient wellness checks and physicals
  • Appointment reminders
  • Back-to-School health reminders
  • Medical screenings and health clinics

In addition, WellConnect has a number of helpful features such as survey capabilities and analytics. You can create an account at VaccineShoppe.com as well as access free resources and training materials. For more information, reach out to your Vaccine Specialist.

Webinar: Hepatitis B Overview and Innovations in Immunization

Dynavax is hosting a webinar on Hepatitis B presented by: John Youhanna, PharmD, RPh, Regional Medical Director, Dynavax Technologies.

Now more than ever, it is important to prioritize the protection of healthcare workers who are at risk from infectious diseases, particularly hepatitis B, a potentially deadly virus that is spread through contact with infected blood and bodily fluids and can live on surfaces for at least seven days.1,2,3

Please join us to discuss why Hepatitis B is a current threat to our healthcare community and learn more about innovations in protection through vaccination.

This educational presentation will include a live Q & A session.

Click below to register!

June 18th

1pm – 2pm EST

June 23rd

2pm – 3pm EST

June 25th

12pm – 1pm EST

1 Centers for Disease Control and Prevention. Hepatitis B. In: Hamborsky J, Kroger A, Wolfe S, eds. Epidemiology and Prevention of Vaccine-Preventable Diseases. 13th ed. Washington, DC: Public Health Foundation; 2015:149-174. https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/hepb.pdf. Accessed October16, 2017.

2. Walayat S, Ahmed Z, Martin D, Puli S, Cashman M, Dhillon S. Recent advances in vaccination of non-responders to standard dose hepatitis B virus vaccine. World J Hepatol.2015;7(24):2503-2509. doi:10.4254/wjh.v7.i24.2503

3. Than TT, Jo E, Todt D, et al. High environmental stability of hepatitis B virus and inactivation requirements for chemical biocides. J Infect Dis. 2018 Oct 24. doi: 10.1093/infdis/jiy620. [Epub ahead of print].

AAP Releases “Policies to Preserve the Vaccine Delivery System for Children”

In response to declining vaccination rates due to the COVID-19 pandemic and to a forthcoming COVID-19 vaccine, the AAP released policies leaders say need to be enacted to preserve the vaccine delivery system. In addition to maintaining routine immunizations in order to prevent an outbreak of a vaccine preventable disease, a strong vaccine delivery system is critical to administering influenza vaccine for the critical 2020-21 flu season and to delivering the COVID-19 vaccine when it becomes available.

These policies include:

  • Prospective Medicaid Vaccine Payments
  • Increasing Regional Maximum VFC Vaccine Administration Fees
  • Appropriately Valued Vaccine Codes
  • Allow Borrowing Between Public and Private Vaccine Stock
  • Prioritize Delivery of Seasonal Flu Vaccine to VFC Providers
  • Reduced Regulatory Burden and Collaboration with Providers on Quality Initiatives

The AAP’s new policies can be found here. They have also released a one pager “Strengthening Immunization Delivery for Children: Preparing for a COVID-19 Vaccine.” Additional resources include:

AAP Launches social media campaign to encourage parents to #CallYourPediatrician

The American Academy of Pediatrics (AAP) launched a campaign on May 20 urging parents to call their pediatricians to schedule check-ups and vaccines in light of falling immunization rates. The #CallYourPediatrician campaign aims to help parents understand the importance of vaccinating and urges parents to keep pediatric check-ups and routinely vaccinate their children.

The AAP is sharing the graphics, videos, and messages on its social media platforms using the hashtag #CallYourPediatrician. Campaign materials can be downloaded in many formats and for various social media platforms, and include light hearted and humorous images. One campaign shows children jumping on the bed or making a mess with the message, “Dear parents: We’ll take them off your hands for 20 minutes. Love, Your pediatrician.”

All messages and images can be found on the AAP’s website.

Webinar: Vaccinating Adults with Chronic Conditions

The CDC’s National Center for Immunization and Respiratory Diseases (NCRID) is hosting a webinar on Vaccinating Adults with Chronic Conditions. The webinar is Thursday, May 28, 2020, at 3:00pm ET. Three physicians will discuss strategies for increasing immunization rates among adults with conditions such as heart disease, lung disease, and diabetes. Adults with these and other chronic health conditions are at increased risk for complications from certain vaccine-preventable diseases and, as such, it is important that they are up-to-date on recommended vaccinations.

Objectives of the webinar are:

  • Explain why vaccines are important for adults with chronic conditions.
  • Describe adult vaccination coverage rates and vaccines recommended for adults with chronic conditions.
  • Effectively communicate with adult patients about the importance of getting recommended vaccines to help manage their chronic condition.
  • Analyze office procedures to reduce missed opportunities to vaccinate.
  • Identify CDC educational resources for healthcare professionals and patients.

Register here.

Increase Outreach to Families to Maintain Childhood Immunizations

The data is clear: childhood immunization rates have plummeted due to the COVID-19 pandemic and associated stay-at-home orders. With the uncertainty of the pandemic’s timing, health care providers must take action to maintain vaccinations among patient populations that are wary of leaving their homes. The CDC’s Morbidity and Mortality Weekly Report (MMWR) released May 8, states the urgency of the situation:

Reminding parents of the vital need to protect their children against serious vaccine-preventable diseases, even as the COVID-19 pandemic continues, is critical. As social distancing requirements are relaxed, children who are not protected by vaccines will be more vulnerable to diseases such as measles. In response, continued coordinated efforts between health care providers and public health officials at the local, state, and federal levels will be necessary to achieve rapid catch-up vaccination.

Last week, we examined the current vaccination data. The situation is dire, however there is some good news. Examining the VSD doses administered shows an uptick in vaccine administration to children aged ≤24 months beginning in late March. This increase might reflect the success of strategies to promote childhood vaccinations in the context of the pandemic.

Below are strategies that have shown early success. These include practice management resources, talking points, and social media images to share.

Practice Management and Resources for Providers

By now, providers are well aware of the guidelines for continuing to see patients for well visits. The CDC recommends

  • Scheduling sick visits and well-child care visits during different times of the day
  • Reducing crowding in waiting rooms, by asking patients to remain outside (e.g., stay in their vehicles, if applicable) until they are called into the facility for their appointment, or setting up triage booths to screen patients safely
  • Collaborating with healthcare providers in the community to identify separate locations for providing well visits for children.

The CDC’s page on caring for children during the COVID-19 pandemic includes up to date information on maintaining childhood immunizations. The IAC has an “Ask the Experts” page titled “COVID-19 and Routine Vaccination.”

Talking Points

Vaccinate Your Family has put together two helpful guides for providers. The first, “Call, Don’t Cancel: Talking to People about Vaccinations during the COVID-19 Pandemic,” contains talking points for providers to use in communications to families. These include sections on new practice policies, setting reminders to follow-up on missed immunizations, links to help uninsured children, and information on why vaccines are still critical during this time.

The second resource from Vaccinate Your Family is designed for vaccine advocates. “Raising Vaccination Rates During a Pandemic” has steps and resources for advocates to use that may encourage people to reach out to their providers and receive routine vaccinations. These include:

  • Share talking points with your governor’s office and your state’s Secretary of Health.
  • Work with local medical professional societies to help spread the word.
  • Submit opinion pieces and letters to the editor to your local papers.
  • Consider how your community receives information.

Social Media/Images to Share

An excellent strategy to encourage vaccination during the pandemic is by communicating with families via social media or email. Many of the talking points in the “Call, Don’t Cancel” resource can be posted in a social media message or including in email or website content. The CDC has created a social media image with an important message for providers to share.

The CDC also recommends directing families to

In addition, the CDC has created sample text to share via social media with links to their easy to read schedule:

 The Ohio AAP created a handout that can be shared digitally or in print.

Hopefully by using these resources, immunization rates will rise in all age groups and we can prevent outbreaks of vaccine preventable diseases.

Childhood Immunization Rates Plummet After Stay-at-Home Orders

For weeks, public health experts have warned about the effects of stay-at-home orders on routine childhood vaccines. New data confirms those fears. In the CDC’s Morbidity and Mortality Weekly Report (MMWR) released May 8, data shows vaccine orders and administration have plummeted. The CDC analyzed data from two sources: the first is Vaccines for Children Program (VFC) provider order data from CDC’s Vaccine Tracking System. VFC is a national program that provides federally purchased vaccines to approximately 50% of U.S. children. Researchers analyzed VFC orders of noninfluenza vaccines between January 7, 2019–April 21, 2019 (period 1) and January 6, 2020–April 19, 2020 (period 2).

The other data source is Vaccine Safety Datalink (VSD) vaccine administration data. VSD is a collaborative project between CDC’s Immunization Safety Office and eight U.S. health care organizations serving publicly and privately insured patients. VSD data was analyzed for measles-containing vaccine doses administered between January 6, 2020 and April 19, 2020 for two age groups: children aged ≤24 months and those aged >24 months through 18 years.

The chart below displays the plummet in vaccine orders and administrations after a national emergency was declared on March 13.

VFC purchases dropped sharply in the weeks after the March 13 declaration, while vaccine administration dropped immediately. Vaccinations among children 24 months and younger have not seen as large of a decrease as those given to older children.

Other data sources show similar results. On April 23, The New York Times reported on data gathered by PCC, a pediatric electronic health records company.

(PCC) gathered vaccine information from 1,000 independent pediatricians nationwide. Using the week of February 16 as a pre-coronavirus baseline, PCC found that during the week of April 5,  the administration of measles, mumps and rubella shots dropped by 50 percent; diphtheria and whooping cough shots by 42 percent; and HPV vaccines by 73 percent.

This is especially worrying as many children in the United States were not receiving the recommended vaccinations on time prior to the pandemic. In a March 2020 study published in the journal Pediatrics, researchers found that only 58% of children were up-to-date with all Advisory Committee on Immunization Practices (ACIP) recommended immunizations by 19 to 35 months. A further decline in vaccination rates could put many children at risk for life-threatening diseases such as measles and whooping cough.

So far, attempts to increase vaccination rates during the pandemic have centered on children 24 months and younger. However, as the stay-at-home orders stretch on, experts are looking at older children’s immunization rates. 4- and 5-year-olds received booster shots for measles, mumps, and rubella, and 11-year-olds for tetanus and whooping cough. A prolonged delay of these boosters will cause immunity to these diseases to wane.

What can be done to prevent a second health crisis caused by these plummeting vaccination rates? Next week, we will post detailed recommendations, resources, and best practices gathered from public health organizations to assist health care providers in increasing vaccination rates.

Additional COVID-19 Vendor Updates

Pfizer has announced an update to their payment terms for vaccine invoices dated January 1, 2020 or later. This update applies to Pfizer vaccines purchased through primevaccines.pfizer.com or through Pfizer Customer Service by physicians, clinics, and group practices.  Invoice payment due dates will be automatically extended to August 31, 2020 or will receive 75-day payment terms, whichever is later. The 2% prompt-pay discount will continue to apply to payments made within these terms.  No action is required on your part. No new invoices will be issued; therefore, we recommend you simply make note of the updated payment due date on your current invoice.

These temporary payment terms will apply to any new vaccine orders placed either online at primevaccines.pfizer.com or via Pfizer Customer Service at 1-800-666-7248 through August 31, 2020.  Starting September 1, 2020, payment terms of 2% 75 days, net 76 days will resume.

To help keep track of the frequent vaccine manufacturer updates, CPP has created a grid to summarize the most current payment terms. Since updates are happening regularly, bookmark this page to keep up on the latest details! https://www.cppdocs.org/covid-19-practice-management-resources.php