CDC Asks for Help

28 06 2012

(From the CDC and HHS)

June 26, 2012

Dear Pharmacists and Community Vaccinators,

Thank you all for your tremendous efforts this past year to raise immunization rates in the United States. Outbreaks of pertussis (“whooping cough”), influenza, and measles, and continued low vaccination rates for human papillomavirus (HPV), Tdap (tetanus, diphtheria, and pertussis), zoster vaccines and others are critical reminders of the ongoing efforts that are needed.

Pharmacists and community vaccinators are uniquely positioned to promote and provide vaccines to people in a wide range of communities. In addition, their extensive reach into diverse communities allows greater access to vaccines for those who may not have a medical home, and who traditionally have had lower rates of vaccine use.

The Centers for Disease Control and Prevention (CDC) and the Department of Health and Human Services (DHHS) ask for your continued support and efforts to help address vaccination needs in your communities. We know you are asked to do a lot to help your patients, but as trusted health care professionals, research shows that your recommendation to receive needed vaccines is vital.

As just one example, only about 10 percent of adults living with an infant report having had Tdap vaccination.1 But, a 2012 survey conducted by Harris Interactive found that 45% of unvaccinated adults who have been in contact with babies under 2 years in the past 5 years or expect to be in contact with them in the next 12 months would consider getting Tdap vaccine if a family member asked. However, 83% would consider getting Tdap vaccine if they were asked by their doctor or other healthcare professional.2 These results underscore the importance of your recommendation for protecting your patients and their families.

Specifically, CDC and HHS are asking pharmacists and other vaccine providers to:

1. Increase awareness among their patients about recommended vaccines, especially for adults and adolescents where vaccination rates are lagging.

2. Ensure that the people who visit your pharmacies or clinics are aware of which vaccinations they need by assessing their vaccine needs and offering those vaccines, e.g.:

a. Offer Tdap vaccine to replace one dose of Td. This is especially important for anyone who will be around infants given outbreaks of pertussis in the United States.

b. Inform pregnant women that they are recommended to receive Tdap vaccine after week 20 of pregnancy and influenza vaccine anytime during pregnancy.

c. Offer yearly influenza vaccine for everyone 6 months and older.

d. Offer zoster vaccine for adults 60 years and older.

e. Offer pneumococcal polysaccharide vaccine for everyone 65 years and older.

3. For patients with certain medical conditions, recommend and offer vaccinations specifically recommended based on their high risk conditions, e.g.:

a. Remind patients with diabetes that they need influenza vaccine, pneumococcal polysaccharide vaccine, and hepatitis B vaccine.

b. Consider targeting immunization messages to patients within your prescription database based on their medications and/or age.

c. Incorporate immunization reminders to patients and caregivers during counseling and medication therapy management (MTM) encounters.

4. Enter adult immunizations into vaccine registries (i.e. immunization information systems) in states where this is possible and provide documentation to the patient (consent form and/or immunization card) and/or their primary care provider to ensure appropriate recording of immunizations.

5. Partner with state and local health departments, immunization coalitions, medical providers, and others in your communities to increase collaboration and outreach to those who need vaccines.

Details about the vaccines recommended for adults and for children can be found at:

http://www.cdc.gov/vaccines/ and an adult scheduler and “quiz” for patients to find out which vaccines they may need can be found at http://www.cdc.gov/vaccines/schedules/Schedulers/adult-scheduler.html. Additional information about pertussis for patients and healthcare professionals can be found at www.cdc.gov/pertussis/index.html.

Additional links to find contacts for state and local health department immunization programs and coalitions, and educational resources for vaccine providers and patients are included below.

Thank you, again, for your energy, enthusiasm, and efforts in improving the health of our communities.

Sincerely,

Anne Schuchat, MD

RADM, US Public Health Service

Assistant Surgeon General

Director, National Center for Immunization and Respiratory Diseases

Immunization education and outreach resources and links to identify contacts in state immunization programs and immunization coalitions

State immunization program managers

These individuals are the state point of contact for immunization efforts and are usually housed within the state health departments.

Further information is available at the following link: http://www.immunizationmanagers.org/about/index_about.phtml

Vaccines for Children (VFC) Program

The VFC program is a federal program that provides vaccines to uninsured children at no cost to the child or their family.

Information on contacts for the VFC program in each state and certain cities is available at the following link: http://www.cdc.gov/vaccines/programs/vfc/contacts-state.htm

Further information about Vaccines for Children Program is available at:

http://www.cdc.gov/vaccines/programs/vfc/default.htm.

Information addressing pharmacists and the VFC program is available at:

http://www.cdc.gov/vaccines/programs/vfc/projects/faqs-doc.htm#enroll

State vaccine registries/immunization information systems

Can your pharmacy participate in your state’s immunization registry? Contact the state immunization registry person to find out if this is an option in your state. Participating in state immunization registries can greatly help facilitate communication about vaccination between providers.

Further information is available at the following link:

http://www.cdc.gov/vaccines/programs/iis/contacts.htm

Immunization coalitions

There are numerous immunization coalitions around the country, pulling together partners from diverse sectors to unite efforts to improve immunization rates.

Further information about linking to coalitions is available at the following site:

http://www.izcoalitions.org/

Free communications resources

CDC produces a variety of resources to promote immunizations, such as print materials, audio/video tools and web tools that can be downloaded free of charge. Immunization campaign materials can be found at http://www.cdc.gov/vaccines/campaigns.htm and support childhood, adolescent and adult immunization with some materials also available in Spanish.

The Immunization Action Coalition has many different handouts on a variety of vaccines that can be downloaded free-of-charge from their website. More information can be found at: http://www.immunize.org/handouts/.

National, regional, and state Offices of Minority Health contact information

The US Department of Health and Human Services has both federal and regional Offices of Minority Health and states also have Offices of Minority Health.

Pharmacies interested in collaborating with these offices to reduce disparities in vaccination may contact these offices at the following links.

Office of Minority Health, Office of the Secretary:

http://www.minorityhealth.hhs.gov/templates/browse.aspx?lvl=1&lvlID=7

Offices of Minority Health in Regional Offices:

http://www.minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlid=188

Offices of Minority Health in States:

http://www.minorityhealth.hhs.gov/templates/browse.aspx?lvl=2&lvlID=187

Interactive adult and child schedulers

Do you know about the interactive adult and child schedulers? Immunization schedules are complex….and always changing. The CDC website has tools that allow you to enter key patient information and produce an individualized immunization schedule. Patients really like to see that one-of-a-kind individualized, customized set of immunization recommendations, along with their pharmacist’s recommendations.

Further information regarding the schedulers is available at the following link: http://www.cdc.gov/vaccines/programs/default.htm.

Preventing Vaccine Administration Errors

As a refresher for healthcare providers on correct vaccine administration technique and vaccine-related adverse events, please consult these resources:

1. Guidance from the Pink Book:

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/D/vacc_admin.pdf.

2. Quick Fact Sheet: http://www.immunize.org/catg.d/p3085.pdf.

3. Vaccine Administration Technique video: http://www.immunize.org/dvd/.

4. Institute of Medicine report on Adverse Effects of Vaccines: http://www.nap.edu/catalog.php?record_id=13164#toc.

To report adverse events, see the Vaccine Adverse Events Reporting System at: http://vaers.hhs.gov/index.

Immunization training offerings

CDC invites pharmacists to take advantage of CDC immunization training offerings. The most recent summary of all the new immunization developments and recommendations can be found in CDC’s Immunization Update 2012, scheduled for August 4, 2012.

Please visit the following link for further information:

http://www.cdc.gov/vaccines/ed/imzupdate/default.htm

These programs supplement pharmacist-specific immunization education programs provided by pharmacist associations. Check with your pharmacist association for additional training and support resources such as web-based immunization resources, discussion groups and electronic newsletters.

1 Centers for Disease Control and Prevention (CDC). Adult Vaccination Coverage — United States, 2010. Morb Mortal Wkly Rep 2012;61(04);66-72. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6104a2.htm.

2 Online survey of 4,247 adults ages 18 and older, of whom 237 were parents of children aged 2 and under, conducted by Harris Interactive on behalf of Sounds of Pertussis®, May 9-11 and May 11-15, 2012.


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