HPV VACCINATION IN MICHIGAN

Transcription

1 HPV VACCINATION IN MICHIGAN Michigan Cancer Consortium Annual Meeting November 9, 2016

2 HPV IMMUNIZATION COVERAGE LEVELS Michigan Care Improvement Registry

3 100% 90% 80% Adolescent Vaccination Coverage, year olds Michigan Care Improvement Registry, % 2+Var/Imm 89.4%, 1+ Tdap 89.6%, 1+ MCV4 Percent Vaccinated 70% 60% 50% 40% 30% 20% 10% 0% 56.7%, 1+ HPV-F 46.2%, 1+ HPV-M 35.3%, 3+ HPV-F 23.2%, 3 + HPV-M 1/1/2007 1/1/2008 1/1/2009 1/1/2010 1/1/2011 1/1/2012 1/1/2013 1/1/2014 1/1/2015 1/16/2016 U.S. Census used for Denominator

4 100% 90% 80% 70% 60% 50% 58.8% HPV Vaccination Rates in Michigan MCIR Data as of August 2016 Children Aged Years 50.7% Female Male Both 54.7% 40% 30% 37.1% 27.5% 32.2% 20% 10% 0% 2015 US Census Population used as Denominaotor 1+ Doses 3+ Doses

5 13-17 year old 3+ HPV (Males & Females) Vaccination Coverage by Zip Code, MCIR data, June 2016

6 HPV Vaccination Coverage by Selected Characteristics, National Data Coverage estimates for each HPV dose were higher among Hispanic adolescents compared with non-hispanic white adolescents Estimates for each HPV dose were higher among adolescents living below the poverty level compared with those at or above the poverty level Coverage with 1 or more doses of HPV was higher among non-hispanic black and American Indian/Alaska Native adolescents compared with non-hispanic white adolescents Similar to 2013, non-hispanic black female adolescents had lower HPV series completion compared with non-hispanic white female adolescents National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged Years United States, 2014, Morbidity & Mortality Weekly Report, July 31, 2015 / 64(29); ,

7 National, Regional, State, and Selected Local Area Vaccination Coverage Among Adolescents Aged Years United States, 2014, Morbidity & Mortality Weekly Report, July 31, 2015 / 64(29); ,

8 WHAT WORKS Evidence-Based Strategies

9 Letters to Parents/Guardians of Overdue Adolescents: Summary of Successes 683,093 letters were sent through 5 rounds Adolescents were more likely to get caught up on HPV vaccine doses (2 nd and 3 rd dose) than to initiate the series (1 st dose) as a result of recall letters Between 14.71% (n=5,132) to 19.17% (n=11,647) returned for series completion (3 rd or 2 nd dose) Only 3.81% (n=15,239) presented for series initiation (1 st dose) Adolescents were vaccinated with other needed vaccines, in addition to HPV vaccine 12.66% (n=80,714) of adolescents who received a recall letter were vaccinated with other overdue vaccines Mailings helped to raise awareness of HPV recommendations at physician offices

10 Health Care Provider Education & Training Physician Peer Education (PPEPI) and Immunization Nurse Education (INE) Modules Physician program: Connie DeMars at Nurse program: Carlene Lockwood at Regional Immunization Conferences AFIX Quality Improvement Sessions Clinician-2-Clinician and Lunch & Learn Meetings Listserv with late-breaking immunization information To subscribe: with subscribe in the subject line Websites:

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12 HPV VACCINE RESOURCES

13 Info for Parents Order Free Copies for Your Practice: Info for Older Adolescents HPV-specific flyers Download at Health Care Professionals Patient Education Gallery (available in multiple languages)

14 HPV Brochure for Young Adults

15 Joint Letter Urging Strong HPV Provider Recommendation Purpose: Encourage health care personnel to give a strong recommendation for HPV vaccine Download at health care personnel additional resources

16 LATE-BREAKING HPV NEWS: CHANGES TO VACCINE RECOMMENDATIONS & HEDIS MEASUREMENTS

17 Rationale for Moving to 2-Dose Schedule 2-dose schedule should be easier to implement, might facilitate vaccine initiation and series completion 2-dose schedule more cost effective Other countries have switched to a 2-dose schedule, high vaccination rates 2-dose schedule would allow flexibility and coincide with preventive health care visits Slides adapted from October 19, 2016 Advisory Committee on Immunization Practices (ACIP) meeting Press Release:

18 New 2-Dose HPV Schedule For persons initiating vaccination series before the 15 th birthday 2 doses of HPV vaccine are recommended Dose 2 should be administered 6 to 12 months after the first dose (0, 6-12 month schedule) For persons initiating the vaccination series on or after the 15 th birthday 3 doses of HPV vaccine are recommended Dose 2 should be administered 1-2 months after the first dose, dose 3 should be administered 6 months after the first dose (0,1-2, 6 month schedule) Routinely recommended at years of age May be given as early as 9 years of age Slides adapted from October 19, 2016 Advisory Committee on Immunization Practices (ACIP) meeting Press Release:

19 New Healthcare Effectiveness Data and Information Set (HEDIS) HPV Measures National Committee for Quality Assurance (NCQA) previously assessed the receipt of adolescent vaccines using two separate measures: HPV for Females: Proportion of female adolescents who had received three doses of the HPV vaccine by age 13 Immunizations for Adolescents: Assessed all adolescents receipt of the meningococcal and Tdap vaccines by age 13 New Measure for 2017: Combined Measure: Receipt of all recommended vaccines (meningococcal, Tdap, HPV) for female and male adolescents by 13 These vaccines are recommended for routine administration for adolescents and are important for preventive health and cancer prevention. Refer to the full measure specifications in HEDIS 2017, Volume 2

20 HPV VACCINATION WORKS!

21 Impact of HPV Vaccines Decrease in prevalence of HPV in 6 years of HPV4 vaccine use in females: Aged years, 64% reduction (from 11.5% to 4.3%) Aged years, 34% reduction (from 18.5% to 12.1%) 1 st national evidence of impact among females in their 20s In clinical trials of 9vHPV, efficacy with 3 doses for HPV serotype 31, 33, 45, 52 & 58 = 96.7% Among HPV-associated cancers, CDC estimates that: 30,700 (79%) can be attributed to HPV 28,500 (73%) of these are attributable to HPV types that are preventable with the 9-valent HPV vaccine Markowitz, et al, Prevalence of HPV after Introduction of Vaccination Program in U.S., Pediatrics March 2016, Use of 9-Valent Human Papillomavirus (HPV) Vaccine: Updated HPV Vaccination Recommendations of the ACIP, MMWR March 27, 2015, Vol. 64/No.11 Viens LJ, Henley SJ, Watson M, et al. Human Papillomavirus Associated Cancers United States, MMWR Morb Mortal Wkly Rep 2016;65: DOI:

22 Today s Presenters & Session Goals Nelia Afonso, MD; Professor, Oakland University William Beaumont School of Medicine Mary Wisinski, RN; Immunization Coordinator, Kent County Health Department Goals: How can MCC Member Organizations work to increase HPV vaccination uptake? What strategies work? This session will focus on helpful strategies currently utilized within the community and the healthcare industry.

23 Michigan s HPV Grant Team: Courtnay Londo, MA Adolescent & Adult Immunization Coordinator LondoC1@michigan.gov Stephanie Sanchez AFIX Coordinator SanchezS@Michigan.gov