Full Season Immunization: A New Paradigm Is Evolving 28 Update
Why Is a New Paradigm Needed? It is medically relevant to vaccinate throughout the entire influenza season Influenza immunization recommendations have recently been expanded to approximately 25 million Americans 1,2 The Advisory Committee on Immunization Practices is considering universal influenza recommendations for all Americans 3 Influenza vaccine supply is improving A record 14 million doses were available in 27 4 Between 15 and 2 million doses anticipated in the next few years 5 It is extremely challenging to vaccinate everyone in the current 2 to 3 month immunization window Vaccination throughout the influenza season is necessary to achieve higher immunization rates 1. Centers for Disease Control and Prevention (CDC). Estimates of influenza vaccination target population sizes in 26 and recent vaccine uptake levels. http://www.cdc.gov/flu/professionals/vaccination/pdf/targetpopchart.pdf. Accessed April 1, 28. 2. CDC. Press Release CDC s Advisory Committee Recommends Influenza Vaccination for Children 6 months through 18 years of age. http://www.cdc.gov/od/oc/media/pressrel/28/r8227.htm. Accessed April 1, 28. 3. Abramson JS, Neuzil KM, Tamblyn SE. Annual universal influenza vaccination: ready or not? Clin Infect Dis. 26;42:132-135. 4. Centers for Disease Control and Prevention. Data on File (Vaccine Supply), March 28. MKT15136. 5. Fiore A. Influenza activity in the United States, February 27. Presentation at ACIP. http://www.cdc.gov/vaccines/recs/acip/downloads/mtg-slides-feb7/5-influenza-1-allos_fiore.pdf. Accessed September 1, 27.
Opportunity for a New Paradigm Exists Throughout the Full Influenza Season Patient Visits 4,, 3,5, Diagnosis Visits 25, 3,, 2, 2,5, 2,, Influenza Vaccination Opportunity 15, 1,5, 1,, Influenza vaccination visits a (three-year average) Influenza diagnosis visits a (three-year average) 1, 5, 5, Sep Oct Nov Dec Jan Feb Mar Source: a From medical claims data representing >25% of U.S. vaccinations. Surveillance Data, Inc. Data on file (Electronic physician claims database). October 27. MKT14463.
The Paradigm Message is Being Communicated Advisory Committee on Immunization Practices (ACIP) Recommends immunization begin immediately after vaccine becomes available and continue throughout the full influenza season American Academy of Pediatrics (AAP) Revised its influenza immunization recommendation; influenza immunizations should be given through April 3 th National Influenza Vaccine Summit (NIVS) Importance of immunizing throughout the full season was a main focus at its April 27 meeting American Medical Association (AMA) Modified its influenza immunization strategies to reflect the need to immunize throughout the full season The National Foundation for Infectious Diseases (NFID) Annual Influenza Press Conference on September 19, 27 included focus on the need to immunize throughout the full influenza season National Influenza Vaccination Week (NIVW): Nov. 26 Dec. 2 Scheduled after Thanksgiving to promote the need for immunization throughout the full season
The Paradigm Message Has Not Led to a Change in Healthcare Provider Behavior Vaccinations Diagnosis Visits 4,, 4, 3,5, 18 week gap 35, 3,, 2,5, 22% increase 25 Million high-risk patients missed 27 Million unused doses 3, 25, 2,, 2, 1,5, 15, 1,, 1, 5, 5, 9/1 9/8 9/15 9/22 9/29 1/6 1/13 1/2 1/27 11/3 11/1 11/17 11/24 12/1 12/8 12/15 Sep Oct Nov Dec Jan Feb Mar 12/22 12/29 1/5 1/12 1/19 1/26 2/2 2/9 2/16 2/23 3/1 3/8 3/15 3/22 3/29 26-27 Vaccinations 27-28 Vaccinations 26-27 Influenza Diagnosis 27-28 Influenza Diagnosis Source: From medical claims data representing >25% of U.S. vaccinations. Surveillance Data, Inc. Data on file (Electronic physician claims database). March 28. Reference: Poland GA, Johnson DR. Increasing influenza Vaccination Rates: The Need to Vaccinate Throughout the Entire influenza Season. Am J Med. In press.
Influenza Immunization Timing Does Not Vary Much by Patient Age Group Vaccinations 1,8, 1,6, 1,4, 1,2, 1,, 8, 6, 4, 2, 9/1/27 9/8/27 9/15/27 9/22/27 9/29/27 1/6/27 1/13/27 Influenza Vaccination Opportunity Sep Oct Nov Dec Jan Feb Mar 1/2/27 1/27/27 11/3/27 11/1/27 11/17/27 11/24/27 12/1/27 12/8/27 12/15/27 12/22/27 12/29/27 1/5/28 1/12/28 1/19/28 1/26/28 2/2/28 2/9/28 2/16/28 2/23/28 3/1/28 3/8/28 3/15/28 to 18 Years 18 to 49 Years 5 to 64 Years 65 Years and Older Influenza Diagnosis Source: From medical claims data representing >25% of U.S. vaccinations. Surveillance Data, Inc. Data on file (Electronic physician claims database). March 28. 3/22/28 3/29/28 Diagnosis Visits 4 35 3 25 2 15 1 5
Influenza Immunization Timing Does Not Vary Much by Patient Health Status Vaccinations Diagnosis Visits 2,5, 4 2,, 1,5, Influenza Vaccination Opportunity 35 3 25 2 1,, 15 5, 1 5 9/1/27 9/8/27 9/15/27 9/22/27 9/29/27 1/6/27 1/13/27 1/2/27 1/27/27 11/3/27 11/1/27 11/17/27 11/24/27 12/1/27 12/8/27 12/15/27 12/22/27 12/29/27 1/5/28 1/12/28 1/19/28 1/26/28 2/2/28 2/9/28 2/16/28 2/23/28 3/1/28 3/8/28 3/15/28 3/22/28 3/29/28 Sep Oct Nov Dec Jan Feb Mar Health Risk Healthy Influenza Diagnosis Source: From medical claims data representing >25% of U.S. vaccinations. Surveillance Data, Inc. Data on file (Electronic physician claims database). March 28.
Influenza Immunization Timing Does Not Vary Much by Physician Specialty Vaccinations 1,4, 1,2, 1,, 8, 6, 4, 2, 9/1/27 9/8/27 9/15/27 9/22/27 9/29/27 1/6/27 1/13/27 1/2/27 1/27/27 11/3/27 11/1/27 11/17/27 11/24/27 12/1/27 12/8/27 12/15/27 12/22/27 Influenza Vaccination Opportunity Sep Oct Nov Dec Jan Feb Mar 12/29/27 1/5/28 1/12/28 1/19/28 1/26/28 2/2/28 2/9/28 2/16/28 2/23/28 3/1/28 3/8/28 3/15/28 3/22/28 3/29/28 Pediatrics Family Practice Internal Medicine Other Inf luenza Diagnosis Source: From medical claims data representing >25% of U.S. vaccinations. Surveillance Data, Inc. Data on file (Electronic physician claims database). March 28. Diagnosis Visits 4 35 3 25 2 15 1 5
Market Research Shows Education is the Key Barrier to Immunizing Throughout the Full Influenza Season Market research hypothesis: Something changes in medical practices after Thanksgiving preventing immunization throughout the full season Findings: While medical focus changes seasonally, this was not identified as a barrier to immunization The common belief that drives behavior is that providers believe they are already immunizing their high-risk patients Providers view expanded window as more time to immunize the same patients Practices purchase the same amount of vaccine each year and stop immunizing when inventory is exhausted
Consumers and Providers Heard the Full Season Message but Not the Rationale Flu Shots: It s Not Too Late WebMD 12/7 Flu grips VA; Officials say it s not too late for flu shot AP 2/14/8 Still Time, Reason to Immunize Against Influenza This Season AAFP News Now 3/7 Worried sick about flu? There s still time for a shot Sacramento Bee 1/17/8 This year s flu symptoms are nothing to sneeze at, Health officials: It s not too late to get vaccinated Dallas Morning News 2/2/8
Full Season Immunization Must be Positioned as the Solution to Current Immunization Rates Health care providers have heard the full season message, but did not equate it to immunizing more people Physicians need to understand: Current immunization rates are below Healthy People 21 goals Opportunities exist to immunize more patients Physician recommendation can drive increased immunizations Vaccination is still effective well beyond December Once educated, the overwhelming majority of physicians said they would do something different
Shifting the Paradigm: Improving Immunization Rates Throughout the Full Influenza Season The full season immunization message must be repackaged as the method to improving immunization rates Each of our organizations is in a unique position to do this National Influenza Vaccine Summit is an ideal venue to begin this process