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.
Recently, Sanofi Pasteur provided an update for the distribution of influenza vaccine for the 2019-2020 flu season. Due to late-emerging A/H3N2 viruses that delayed the strain selection for the upcoming flu season, it is anticipated that the delivery of Sanofi Pasteur influenza vaccines will be approximately 3-4 weeks behind the shipping commitments previously communicated. Sanofi Pasteur fully expects to manufacture and deliver every dose reserved by their customers, beginning with partial shipments to all customers in late-August or September, with all shipments completed by the end of November.
Each year, the World Health Organization (WHO) and U.S. Food
and Drug Administration (FDA), with help from epidemiologists around the world,
select the virus strains to be included in influenza vaccines for the upcoming
season. This year, due to late-emerging A/H3N2 viruses that circulated
globally, the WHO and FDA decided to delay selection of the A/H3N2 strain by
one month. This allowed health authorities to collect additional data to
help improve the match of the vaccine strain to the A/H3N2 strain anticipated
to circulate during the 2019-2020 season.
Sanofi Pasteur fully supports
this decision by health authorities to collect additional data and make a more
If you have any questions, please feel free to contact the CPP office at 614-722-2145 or your Sanofi Pasteur representative.
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 inaugural CPP Buying Group – Vaccine Management Summit
on May 2 was a great success. More than 100 vaccine professionals from across
the state attended the conference to gain knowledge from industry leaders. Dr.
Kristen Feemster, Director of Research for the Vaccine Education Center at
Children’s Hospital of Philadelphia, kicked off the summit with a comprehensive
review of vaccines on the horizon.
The first round of breakout sessions focused on Central Ohio
Primary Care’s efforts to improve pediatric and adult vaccination rates, a
presentation about maximizing savings when purchasing vaccines, and a
discussion on vaccine documentation and coding.
The second group of breakout sessions included a panel
discussion between representatives of Pediatric Associates and the Ohio AAP on
creating a culture of vaccination, a presentation by Mount Carmel Health on
inventory management and 2D barcoding, and information from the Ohio Department
of Health concerning vaccine storage guidelines and updates.
Attendee feedback was overwhelmingly positive. CPP staff and planning committee members are
already working to make the next summit even better.
On March 14, 2019, the AAP issued a press
release stating it does not recommend the inactivated flu vaccine,
which is injected, over the quadrivalent live attenuated influenza vaccine,
which is given via nasal spray to healthy patients ages 2 through 49. This
recommendation for the 2019-2020 flu season reverses a prior preference for the
CPP members can take advantage of our partnership
with AstraZeneca and receive a discount on doses of FluMist®. Please
contact the CPP office at email@example.com
or 614-722-2145 to obtain a declaration form that needs to be completed to
access this discount. Members can pre-book their FluMist doses by contacting an
authorized distributor (McKesson or FFF Enterprises) by June 30, 2019.
Please join us on May 2, 2019 for the first ever Vaccine Management Summit hosted by CPP at the Renaissance Hotel Westerville-Polaris. This half-day conference will feature keynote speaker, Dr. Kristen Feemster, who will provide insight into vaccines on the horizon and the potential impact to your practice.
The remainder of the time will be spent engaging in lively user discussions through breakout sessions:
Storage Guidelines & Updates
Inventory Management & 2D Barcoding
Linking Quality, Performance, and Incentives
Coding, Documentation & Other Operational Issues
Financial Analysis & Minimizing Cost
Creating a Culture of Vaccination
Come ready to share your experiences and learn what is working well for others!
The 0.5mL dose of Sanofi Pasteur’s Fluzone Quadrivalent vaccine has been newly approved to be used in children 6 months of age and older. This new option offers health care providers the simplicity of using the same 0.5mL dose for all eligible children when immunizing against the flu. Fluzone Quadrivalent 0.25mL dose will still be available to order for children ages 6-35 months for the 2019-2020 season.
If you have already confirmed your 2019-2020 Sanofi Pasteur influenza vaccine reservation, you have the ability to adjust these quantities based on this new approval.
Contact your representative from Sanofi Pasteur or click here for more information.
CPP is pleased to announce a new partnership with AstraZeneca that provides our members a discount opportunity on doses of FluMist®, an intranasal influenza vaccine, for the upcoming 2019-2020 flu season. Members who opt into this contract will receive a discount off the list price of doses ordered through an authorized distributor throughout the entire 2019-2020 flu season. Authorized distributors of FluMist currently include McKesson Medical-Surgical Inc. and FFF Enterprises Inc.
To access this discount, please contact the CPP office at firstname.lastname@example.org or 614-722-2145 to obtain pricing details, updated terms and conditions as well as a declaration form. If you participated in the FluMist discount in prior flu seasons under CPP-MedImmune contract, we will still need an updated declaration form to show your acceptance of the new agreement under AstraZeneca.
Members who are interested in pre-booking FluMist doses should place their reservations with an authorized distributor prior to March 31, 2019.
We hope this will be of interest to your practice as we are always trying to find ways to provide more value to our members!