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.
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
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:
Principles of Vaccination
General Best Practice Guidelines, Part 1
General Best Practice Guidelines, Part 2, and Vaccine Safety
Vaccine Storage and Handling and Vaccine Administration
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
WellConnect can be used for:
Flu and other immunization
Patient wellness checks and
Back-to-School health reminders
Medical screenings and health
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
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.
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].
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
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 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.”
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
Analyze office procedures to reduce missed
opportunities to vaccinate.
Identify CDC educational resources for
healthcare professionals and patients.
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
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
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
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
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:
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
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.
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