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.

_____________________________________

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.

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.

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!

Vaccine Price Changes

Sanofi Pasteur and Merck recently announced updated catalog pricing on many of their vaccines.  Please note that due to CPP’s contract negotiations with these vendors, CPP members can continue to purchase vaccines at the pre-increase price until the following:

Sanofi Pasteur:  1/1/2019 implementation date

Merck:  2/13/2019 implementation date

Also effective 1/1/2019, Sanofi Pasteur is eliminating the $25 service fee currently assessed on non-influenza vaccine shipments less than $600.  The policy change is a direct result of our strong partnership with Sanofi Pasteur and feedback from you.  They’ve made this change to better meet your needs.

For updated member pricing sheets, please contact the CPP office.

New CPP Discount Opportunity on Trumenba®

We are excited to announce a new partnership between CPP and Pfizer that will provide CPP members an opportunity to save on purchases of Trumenba®, a meningococcal group B vaccine! In order to receive the CPP discount, doses must be purchased directly from Pfizer using your Pfizer account.
For exact details regarding this savings opportunity and to obtain a copy of the opt-in form for this portion of the CPP program, please contact the CPP office at 614-722-2145 or cpp@nationwidechildrens.org.

Sanofi Vaccine Pricing Updates

Sanofi Pasteur has announced a pricing promotion on Menactra®!  CPP members will receive an additional 3% discount on orders of Menactra® placed before June 24th and shipped by June 28th.

In addition, the CPP contracted price for Adacel® has DECREASED 4% effective June 10, 2016.  For updated pricing sheets on all Sanofi Pasteur vaccines, please contact the CPP office.