National Vaccine Plan: From Strategy to Implementation

Transcription

1 National Vaccine Plan: From Strategy to Implementation July 26, 2011 Sarah Landry Senior Advisor, National Vaccine Program Office Office of the Assistant Secretary for Health Department of Health and Human Services

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3 Immunizations are important One of top medical/science achievements of all time Vaccines work and work well. They are really good at what they do preventing illness and death from diseases that often are hard to treat Many vaccine-preventable diseases are now very rare in the U.S.

4 Comparison of 20 th Century Annual Morbidity and Current Morbidity: Vaccine-Preventable Diseases Disease 20th Century 2009 Annual Morbidity Reported Cases Percent Decrease Smallpox 29, % Diphtheria 21, % Measles 530, > 99% Mumps 162, % Pertussis 200,752 13,506 93% Polio (paralytic) 16, % Rubella 47,745 4 > 99% Congenital Rubella Syndrome % Tetanus % Haemophilus influenzae 20, * 99% Source: JAMA. 2007;298(18): Source: CDC. MMWR January 8, 2010;58(51,52); (provisional, 2009 week 52 NNDSS data) * 25 type b and 218 unknown (< 5 years of age)

5 Vaccines protect us from more diseases than ever before

6 Vaccines Routinely Recommended in US Measles Rubella Mumps Diphtheria Tetanus Pertussis Polio Measles Rubella Mumps Diphtheria Tetanus Pertussis Polio Hib (infant) HepB Varicella Measles Rubella Mumps Diphtheria Tetanus Pertussis Polio Hib (infant) Hepatitis B Varicella Pneumococcal disease Influenza Meningococcal disease Hepatitis A Rotavirus HPV Herpes Zoster

7 Recommended Schedule for Persons Aged 0-6 Years, U.S. 2011

8 Increasing Vaccine-Specific Coverage Rates Among Preschool-Aged Children 2010 Target DTP / DTaP(3+) Hep B (3+) PCV 7 (4+) MMR(1+) Polio (3+) Hib (3+) Varicella (1+) Rotavirus (3+) Source: USIS ( ), NHIS ( ) CDC, NCHS, and NIS ( ), CDC, NIP and NCHS; No data from due to cancellation of USIS because of budget reductions.

9 National Vaccine Program Office CDC NIH FDA DoD VA National Vaccine Plan HRSA Indian Health Service USAID

10 2010 National Vaccine Plan Goals 1. Develop new and improved vaccines 2. Enhance the vaccine safety system 3. Support communications to enhance informed vaccine decision-making 4. Ensure a stable supply of recommended vaccines and achieve better use of existing vaccines to prevent disease, disability and death in the United States 5. Increase global prevention of death and disease through safe and effective vaccination

11 National Vaccine Plan: Priorities for Implementation

12 Priorities Develop a catalogue of priority vaccine targets of domestic and global health importance. Strengthen the science base for the development and licensure of new vaccines. Enhance timely detection and verification of vaccine safety signals and develop a vaccine safety research agenda. Increase awareness of vaccines, vaccine-preventable diseases, and the benefits/risks of immunization. Use evidence-based science to enhance vaccine-preventable disease surveillance, measurement of vaccine coverage, and measurement of vaccine effectiveness.

13 Priorities continued Eliminate financial barriers for providers and consumers to facilitate access to routinely recommended vaccines. Create an adequate and stable supply of routinely recommended vaccines and vaccines for public health preparedness. Increase and improve the use of interoperable health information technology and electronic health records. Improve global surveillance for vaccine-preventable diseases and strengthen global health information systems to monitor vaccine coverage, effectiveness, and safety. Support global introduction and availability of new and under-utilized vaccines.

14 Implementation Plan Complement the National Vaccine Plan Develop during 2011 Address priorities identified in the NVP Identify barriers to achieving priority Develop indicators for measuring progress Involve stakeholders 10 meeting being planned with guidance from HHS, RHAs, ASTHO and NACCHO

15 Implementation in progress IOM Committee for Vaccine Prioritization Vaccines.gov Confidence /Vaccine hesitancy Public health financing/reimbursement Adult immunization/role of pharmacists Maternal Immunization Vaccine safety research agenda

16 Setting Priorities for Vaccine Development

17 IOM Committee on Identifying and Prioritizing New Preventive Vaccines Charge: Develop an evidence-based approach and methodology for identifying and prioritizing the needs for developing new preventive vaccines of domestic and global importance. Considerations: International and domestic priorities Burden of illness and costs Scientific opportunities and platform technologies Stakeholder perspectives

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19 Goal 3: Support Communications to enhance informed decision-making Launched March 31 Single-subject consumer website addressing vaccines, VPDs, and tools to learn critical behavioral info Partners: HHS-wide (CDC, FDA, NIH, HRSA) with support from VA and DoD

20 Message Models Organized by consumer needs Tools featured Content driven by partners/consumer news

21 Tabbed format links vaccine, disease, action Tools in context

22 Native American/Alaskan Indian Vaccination successes Compared to the general U.S population, AI/AN people seen at IHS, Tribal, or Urban Indian (I/T/U) facilities have: Similar childhood vaccination coverage levels Higher adolescent vaccine coverage Higher pneumococcal coverage for adults 65+ Higher influenza vaccine coverage for healthcare personnel (HCP)

23 IHS coverage estimates vs. U.S. Coverage estimates IHS U.S. 2 year old coverage ( series)* 79% 78% Tdap yrs** 65% 56% Mening yrs** 70% 54% 3 doses HPV ** 32% 27% Pneumo % 61% HCP Influenza 72% 62% * IHS data: 2010 IHS GPRA report; U.S. data : 2009/2010 National Immunization Survey (NIS) results ** IHS data: FY 2009 Q4 IHS Immunization Report; U.S. data: 2009 NIS-Teen survey IHS data: 2009 IHS GPRA report; U.S. data: 2009 National Health Interview Survey IHS data: IHS HCP report for influenza season; U.S. data: CDC internet HCP panel survey, results Nov. 2010

24 * IHS data: FY 2010 Q2 Immunization report; U.S. data: from CDC FluVaxView as of Feb Some Challenges Adult vaccines Inconsistent provision of adult vaccines (e.g. HPV, Zoster) among I/T/U facilities Flu vaccine coverage for AI/AN population lower than coverage for general U.S. population * 35% vs. 43% Vaccine Coverage Monitoring Lack of data on AI/AN people served outside the I/T/U system IHS data limited to AI/AN served by I/T/U facilities U.S. data insufficient (small sample sizes) to monitor coverage in AI/AN population Differences in coverage monitoring methodologies IHS data based on immunizations administered; Some U.S. data (e.g. flu ) based on self-report

25 Implementing the National Vaccine Plan Defining actions Measuring outcomes Documenting progress Identifying barriers

26 Next Steps with National Vaccine Plan: Development of an Implementation Plan Development of an Implementation Plan in 2011 Includes stakeholder input Focused on 10 priorities Identifies barriers Provides indicators that will be used for measuring progress Short-term (1-3 years) Mid-term (4-9 years) Long-term (10 years) Aspirational

27 Planned Stakeholder Engagement Efforts in 2011 Goal is to engage stakeholders on development of an Implementation Plan plan Working at both national and regional levels Target audiences Stakeholder organizations, including cbos Regional and local public health Faith-based organizations

28 Implementation Questions for Consideration by Stakeholders National Vaccine Plan Measuring Progress How should we measure the overall progress in meeting the goals and objectives of the National Vaccine Plan? How can progress in addressing the goals of the National Vaccine Plan (including that of the non-fed stakeholders) best be captured and shared broadly? Priorities What actions can partners (national, state, Tribal, local, and Territorial governments, non-profit, and private) take to address the goals and priorities in the National Vaccine Plan? Barriers What are the barriers to achieving these priorities? What can the government and partners do to address these barriers?

29 Next steps: Discussions in breakout groups tomorrow Feedback through a planned stakeholder meeting

30 The 2010 National Vaccine Plan

31 Questions?