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 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.
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.
On Wednesday, August 28, the CDC will be hosting a webinar
from 1-2pm to assist providers in recommending vaccines and addressing vaccine
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,
Dr. Corinna Manini, Chief Medical Officer,
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.
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!
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
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.
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:
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!
best practices that were shared by the group include:
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.
The Food and Drug Administration recently
approved the Adacel (Tdap) vaccine to be administered as soon as 8 years
after a previous dose. Adacel, manufactured by Sanofi Pasteur, provides
immunity to tetanus, diphtheria, and pertussis. The vaccine is approved for
patients ages 10-64, and is available in a syringe made without natural rubber
Adolescents should receive a single dose,
preferably at age 11 or 12
women should receive a single dose during pregnancy, preferably between
weeks 27 and 36. By receiving this vaccine, pregnant mothers pass antibodies to
their babies, reducing the risk of whooping cough.
Adults should receive a single dose of Tdap
followed by a booster Td every 10 years.
FDA approval was based on clinical data from a study that
showed no significant differences in adverse events when adults received Adacel
versus Td 8-12 years after a previous dose of Adacel. The approval of Adacel administration every 8
years provides more flexibility for physicians in both vaccine purchasing
decisions and immunizations scheduling. Sanofi has provided study results to
the CDC for consideration in future recommendations.
For more information or to purchase Adacel or any other
immunization, visit our website
or send us an email.
At CPP’s recent Vaccine Management Summit, 2D barcoding
stood out as a topic of interest among attendees. CPP members will find a new
AAP guide helpful as they continue to learn about this technology.
The AAP recently released a guide
for pediatricians with information on two key information technology topics:
immunization information systems and two dimensional barcoding. In addition,
the AAP provides a detailed website for both topics that summarizes the
information found in the new guide and provides relevant links.
Information Systems, also known as vaccine or immunization registries, are
confidential computerized systems that capture vaccination data across the
lifespan within a certain geographical area. The use of these systems can
reduce healthcare costs and improve patient care. The benefits to pediatric
practices of using these systems include minimizing duplicate vaccine
administration, aiding in recalling patients overdue for vaccinations,
reminding patients of upcoming immunizations, and identifying vulnerable
patients during a disease outbreak.
Dimensional Barcode Scanning Technology can be used with the majority of
pediatric vaccines. Recent studies show that the use of 2D scanning increase
accuracy in vaccine documentation and reduces documentation time by an average
of 21 seconds. 2D barcode scanning improves practice efficiency, increases
vaccine inventory accuracy, and assists in proper billing. In addition, the
technology benefits patients by improving safety and documentation, reducing
errors, and identifying expired vaccines before they are administered to
patients. The AAP’s 2D
barcoding resources include practice uses, choosing a scanner, and getting
the scanner to “work.”
For practices not yet ready to implement 2D barcoding, CPP
has other resources to help manage your vaccine inventory including a Vaccine
Inventory Reconciliation Sheet. These resources can be found on our website.
The Immunization Action Coalition has put together a helpful guide for influenza vaccination coding for the 2018-2019 flu season. Doses are starting to be shipped out by the vaccine manufacturers so make sure you are ready to start vaccinating by having the appropriate CPT and Medicare codes in your system!