Adult Immunizations. Business Health Care Group (BHCG) April 25, Cathy Edwards. Immunization Program Advisor

Transcription

1 Adult Immunizations Business Health Care Group (BHCG) April 25, 2012 Cathy Edwards Immunization Program Advisor Wisconsin Department of Health Services Division of Public Health 1

2 Adult Immunizations WHY Immunize? Vaccine preventable diseases cause significant illnesses that can be easily spread to others Immunizations are needed across the age spectrum Indications change as age and/or health status changes Vaccinations are an important part of maintaining a healthy workforce 2

3 Immunization Goal for Children Completion Primary Series National Goals 90% completion of primary series by age 2 Wisconsin (WI) coverage 84% complete by age 2 ** WI received highest coverage rates award by National Immunization Survey (NIS) 2012) Milwaukee County-59% completion rate * *Wisconsin Immunization Registry (WIR) 2009 Birth Cohort **National Immunization Survey

4 National Immunization Rates Adolescents ages years 49%- one dose of Human Papilloma Virus(HPV) 32%- for completion of HPV series 63%- for Meningococcal 69% -for *Tdap *Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Source: 2010 National Health Interview Survey 4

5 Adult Immunization Rates 8.2% of adults have received a Tdap (pertussis, whooping cough) 14.8% of adults had received zoster vaccine (shingles) 19-49=26%, 50-64=43% Age Group 65+ =69% had received influenza vaccine Source: 2010 National Health Interview Survey 5

6 Number of Confirmed and Probable Pertussis Cases, Wisconsin, 1/1/04-2/2/ Number of Investigations Jan-04 Aug-04 Mar-05 Oct-05 May-06 Dec-06 Jul-07 Feb-08 Sep-08 Apr-09 Nov-09 Jun-10 Jan-11 Aug-11 Onset Month-Year Source: Wisconsin Electronic Disease Surveillance System (WEDSS), as of 2/6/2012 6

7 Number of pertussis investigations reported by week of cough onset and status of the investigation, Wisconsin, 1/1/2011-3/29/2012 (N=2,328) Investigation Complete (n=2060) Investigation Ongoing (n=268) Number of Investigations Jan2011 Feb2011Mar2011 Apr2011 May2011 Jun2011 Jul Aug2011 Sep2011 Oct2011 Nov2011 Dec2011 Jan2012 Feb2012Mar2012 Cough Onset Week

8 US Reported Pertussis Incidence

9 Pertussis Source to Infant Age Distribution Of those infants where a source of infection was identified: 17% of the were 0-4 years age 27% were 5-19 years of age 56% were 20+ years of age Source: Bisgard et al PIDJ 23(11): 985 9

10 Direct and Indirect Costs of Pertussis in Adults Causes substantial direct costs in adults 1 : Medical costs range between $243-$338 (mild versus severe cough) 1 dose DTaP approx. $23 Indirect costs in adults 2 : Mean loss of work days for adults: 7 Mean # of medical visits for pertussis: 2.5 2% of adults were hospitalized mean duration of stay was 3 days 6% of adults >50 years old were hospitalized mean duration of stay was 17 days 1 Lee GM et al. Clinical Infectious Disease. 2004;39: De Serres et al. Journal of Infectious Deceases 2000;182:174 (Source) 10

11 Influenza Significant source of morbidity and mortality Highest rates of influenzaassociated deaths are in the very young, the elderly, pregnant women and those with underlying medical conditions Morbidity and Mortality Weekly Report (MMWR) 2010; 59:

12 Other ACIP Immunization Recommendations for Adults - Overall Age Specific: Human Papillomavirus 11 to 26 years for females 11 to age 26 for males* (new) Zoster (Shingles)- age >60 years Pneumococcal- age >65 years * Routine to age 21 years, permissive to 26 years 12

13 Zoster (Shingles) Reactivation of the chickenpox virus that occurs later in life Results in an infectious, painful rash, usually on one part of the body Approximately 1 in 3 individuals will develop zoster 13

14 Adult Immunization Barriers People believe immunization are no longer necessary Complicated Schedules (tracking) Cost of vaccines- Vaccine for Children(VFC), commercial, self pay Vaccine hesitant parents and providers Access to primary care services 14

15 Adult Immunization Strategies School and Daycare Entry Laws WI Immunization Registries (WIR) Non traditional immunization settings i.e. pharmacies, Cocooning Programs Population based assessments in public and private local settings Active broad based coalitions 15

16 Questions? Additional Resources Centers For Disease Control CDC Vaccines Webpage schedule.htm#printable